Veroniek Saegeman

• MD PhD
• Consultant at Universitair Ziekenhuis Leuven

Background: Urinary tract infections (UTIs) are one of the most commonly reported infections in Belgian nursing home residents. In older adults, UTI diagnosis and management is complex, often leading to over-diagnosis and irrational antimicrobial use, stressing the need for a guideline approach. Objectives and methods: A consensus statement on t...

Forensic microbiology is a relatively new discipline, born in part thanks to the development of advanced methodologies for the detection, identification and characterization of microorganisms, and also in relation to the growing impact of infectious diseases of iatrogenic origin. Indeed, the increased application of medical practices, such as trans...

Implementation of the Infection Risk Scan in a hospital network by the Hospital Outbreak Support Team The Infection Risk Scan (IRIS) assesses the quality of infection prevention and control (IPC) and antimicrobial stewardship (AMS) in a hospital ward by the standardized measurement of a broad range of quality indicators. IRIS was implemented in the...

Background This paper presents a data-driven strategy for establishing the reportable interval in clinical laboratory testing. The reportable interval defines the range of laboratory result values beyond which reporting should be withheld. The lack of clear guidelines and methodology for determining the reportable interval has led to potential erro...

Background Antimicrobial resistance (AMR) of Mycoplasma genitalium (MG) is a growing concern worldwide and surveillance is needed. In Belgium, samples are sent to the National Reference Centre of Sexually Transmitted Infections (NRC-STI) on a voluntary basis and representative or robust national AMR data are lacking. Aim We aimed to estimate the o...

Background Day care centres (DCCs) are ideal settings for drug-resistant bacteria to emerge. Prevalence numbers of faecal carriage of antimicrobial resistant bacteria in these settings are rare. We aimed to determine the prevalence of faecal antimicrobial resistant bacteria carriage in children attending DCCs and to assess and identify infection ri...

The relevance of postmortem microbiological examinations has been controversial for decades, but the boom in advanced sequencing techniques over the last decade is increasingly demonstrating their usefulness, namely for the estimation of the postmortem interval. This comprehensive review aims to present the current knowledge about the human postmor...

Objectives: Antimicrobial resistance of Mycoplasma genitalium (MG) is a growing concern worldwide. Because reliable data on the burden of resistant MG in Belgium are missing, an additional prospective surveillance program was implemented in 2022 to estimate the real burden of resistant MG in Belgium. Methods: Belgian laboratories (n=21) provided fr...

Background A tool, the Infection Risk Scan has been developed to measure the quality of infection control and antimicrobial use. This tool measures various patient-, ward- and care-related variables in a standardized way. We describe the implementation of this tool in nine hospitals in the Dutch/Belgian border area and the obtained results. Method...

UV-C light for disinfection has experienced a surge in popularity since the outbreak of COVID-19. Currently, many different UV-C systems, with varied properties that impact disinfection performance, are available on the market. Therefore this review aims to bundle the available information on UV-C disinfection to get an overview of its advantages,...

Background Patients with Lyme borreliosis (LB) may report persisting non-specific symptoms such as fatigue, widespread musculoskeletal pain or cognitive difficulties. When present for more than 6 months and causing a reduction in daily activities, this is often referred to as post-treatment Lyme disease syndrome (PTLDS). This study aimed to compare...

SYNOPSIS Background Inpatient quality indicators (IQIs) were previously developed to assess responsible antibiotic use. The aim of this study was the practice testing of these QIs in the hospital setting. Method This study was performed within a Dutch-Belgian border network of hospitals implementing the Infection Risk Scan (IRIS) point prevalence...

From early 2020, a high demand for SARS-CoV-2 tests was driven by several testing indications, including asymptomatic cases, resulting in the massive roll-out of PCR assays to combat the pandemic. Considering the dynamic of viral shedding during the course of infection, the demand to report cycle threshold (Ct) values rapidly emerged. As Ct values...

Objectives: Hospital point prevalence surveys (PPS) are shown to help identifying determinants for inappropriate antimicrobial therapy (AMT) and create feedback opportunities to optimize AMT. Methods: PPS were performed at the AZNikolaas hospital, on four wards with high consumption rates of three alert antibiotics (AB) to judge their appropriat...

Chlorhexidine digluconate (CHG) is an antiseptic frequently used in hospitals to prevent healthcare-related infections. It is used in different formulations for skin antisepsis, oral care, patient bathing, and hand hygiene. Also, CHG impregnated vascular catheters and wound dressings contribute to increased exposure of hospital germs to this biocid...

Multiplexed respiratory viral panels (MRVP) have recently been added to the diagnostic work-up of respiratory infections. This review provides a summary of the main literature of MRVP for patients with regard to 3 different topics. Can the results of MRVP reduce the inappropriate use of antibiotics, can they guide the use of appropriate antiviral t...

This manuscript aims to: 1) provide specific guidelines on PMM techniques in the setting of minimally invasive autopsy (MIA), both for pathologists collecting samples and for microbiologists advising pathologists and interpreting the results and 2) introduce standardization in PMM sampling at MIA. Post-mortem microbiology (PMM) is crucial to identi...

Background and objective: A thorough understanding of the pathogenic mechanisms elicited by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) still requires further research. Until recently, only a restricted number of autopsies have been performed, therefore limiting the accurate knowledge of the lung injury associated with SARS-CoV-2....

The establishment of designated cohort units for older people within residential care settings can be a solution to avoid further spread and therefore the preservation of the capacity of regional hospitals. A far-reaching collaboration, based on the format of shared clinical care, to make such units possible is described.

Background Staphylococcus aureus is one of the main microorganisms causing a surgical site infection. Methicillin resistant staphylococcus aureus (MRSA) surgical site infection treatment may be difficult, requires long-term antibiotic treatment, especially in cases of instrumented procedures, deteriorates the clinical result, and generates a high m...

The i-4-1-Health project is a One Health project on the prevalence and spread of antimicrobial resistance in the human and veterinary domain in the Dutch-Belgian cross-border region. This paper describes the main components of the laboratory protocol that was developed to standardise the microbiological methods used for the detection of intestinal...

Objective: To assess the predictive value of JC virus (JCV) PCR in cerebrospinal fluid (CSF) in the diagnosis of progressive multifocal leukoencephalopathy (PML). Methods: We conducted a retrospective database query to identify patients with positive CSF JCV PCR. Clinical features, final diagnosis and quantitative PCR results were obtained. Res...

Background Serological surveillance, based on the measurement of the presence of specific antibodies in a given population, can be used in addition to traditional and routine disease surveillance methods. The added value of this has been largely documented for vaccine-preventable diseases, but to a lesser extent for vector-borne diseases. This stud...

Objectives: High-quality diagnosis of bloodstream infections (BSIs) is important for successful patient management. As knowledge on current practices of microbiological BSI diagnostics is limited, this project aimed to assess its current state in European microbiological laboratories. Methods: We performed an online questionnaire-based cross-sec...

The goal of the study was to adapt our Middle East respiratory syndrome coronavirus (MERS-CoV) lab-developed test (LDT) to 3 "Sample to Result" (S2R) systems: BD MAX (BD), ELITe InGenius (ELITechGroup), and ARIES (Luminex). The BD MAX and InGenius system allowed use of lab-developed primers and TaqMan probes, while ARIES required conversion to Mult...

Postmortem microbiology (PMM) is a valuable tool in the identification of the cause of death and of factors contributory to death where death has been caused by infection. The value of PMM is dependent on careful autopsy planning, appropriate sampling, minimisation of postmortem bacterial translocation and avoidance of sample contamination. Interpr...

Pulmonary Mycobacterium abscessus infection in cystic fibrosis (CF) patients is difficult to treat and considered a contra‐indication for lung transplantation in most centers. We present four CF patients with chronic pulmonary M. abscessus infection, in whom lung transplantation was performed. Through intensive treatment before transplantation, we...

Background: Fungi are increasingly recognized for their potential role in contributing to pulmonary damage in Cystic Fibrosis (CF). We therefore designed a prospective international study aimed at (i) determining the prevalence of fungi isolated from sputum samples collected from a large CF population, (ii) comparing the performance of different me...

Vancomycin pharmacokinetic (PK) and pharmacodynamic (PD) data in neonates are based on total concentrations. However, only unbound vancomycin is pharmacologically active. The objective was to determine vancomycin protein binding and the covariates impacting unbound vancomycin concentration in neonates and young infants. In neonates and young infant...

Background: Autopsies, including minimally-invasive autopsies, are a powerful tool for determination of the cause of death. When a patient dies from an infection, microbiology is crucial to identify the causative organism. Post-mortem microbiology (PMM) aims to: detect unexpected infections causing sudden deaths; confirm clinically suspected but u...

Background: In Belgium, different routine surveillance systems are in place to follow-up Lyme borreliosis trends. However, accurate data on the disease and monetary burden for the different clinical manifestations are lacking. Despite recommended antibiotic treatment, a proportion of Lyme patients report persisting aspecific symptoms for six month...

Objectives The aim of this verification study was to compare the QuantiFERON®-TB Gold Plus (QFT-Plus) to the QuantiFERON®-TB Gold In Tube (QFT-GIT). The new QFT-Plus test contains an extra antigen tube which, according to the manufacturer additionally elicits a CD8⁺ T-cell response above the CD4⁺ T-cell response. We assessed the value of this tube...

Background Vancomycin, a glycopeptide, is often ad-ministered to treat (suspected) serious gram-positive in-fections caused by Staphylococci, including methicillin-re-sistant Staphylococcus aureus (MRSA) and coagulase-neg-ative Staphylococci (CoNS). Vancomycin pharmacokinetic (PK) and pharmacodynamic (PD) data in neonates are based on total concent...

Objectives: To describe a novel plasmid-borne class D carbapenemase (CHDL) named OXA-427 identified in several Enterobacteriaceae clinical isolates from nine patients in one Belgian hospital. Methods: OXA-427-producing isolates were analysed by an electrochemical imipenem hydrolysis method (BYG Carba test), Carba NP test, conventional phenotypic...

Post-mortem microbiology (PMM) is an important tool in forensic pathology, assisting to determine the cause and manner of death. However, there is a lack of standardisation of PMM sampling. In order to get a better insight into the methods used, the available technical options and developmental needs, ESCMID Study Group for Forensic and Postmortem...

The aim of this study was to evaluate retrospectively the performance of the Xpert MRSA assay in routine practice and its current use in the intensive care unit (ICU) setting of our hospital, since a pre-emptive isolation strategy has been applied. A total of 6473 patients were routinely screened with ESwab for methicillin-resistant Staphylococcus...

Borreliabacteriën zijn verantwoordelijk voor de ziekte van Lyme of Lyme-borreliose. De mens wordt besmet via een beet van een geïnfecteerde teek. De meeste besmettingen komen voort na beten van nymfen (<2 mm groot) en deze blijven vaak onopgemerkt.

This study reports the evaluation of the technical and clinical validation of the O-DiaBorburg kit (DIA), Borrelia burgdorferi PCR kit, ISEX (GENE), and Borrelia burgdorferi sensu lato Real-TM (SAC) for the diagnosis of neuroborreliosis in cerebrospinal fluid based on both Borrelia DNA and CSF samples from patients with clinical suspicion of neurob...

Importance: Hepatitis E virus (HEV) recently has been shown to be an antecedent infection in Guillain-Barré syndrome (GBS), but the clinical spectrum of HEV-associated GBS is not yet documented, and diagnosing acute HEV infection can be a challenge. Objectives: To determine the prevalence of HEV-associated GBS in a Belgian cohort, study the clin...

Binary toxin-producing Clostridium difficile strains such as ribotypes 027 and 078 have been associated with increased Clostridium difficile infection (CDI) severity. Our objective was to investigate the association between presence of the binary toxin gene and CDI severity and recurrence. We performed a laboratory-based retrospective study includi...

We report a case of a 77-year old male who developed a fulminant erysipelas and sepsis, caused by Myroides odoratimimus. Selecting the optimal antibiotic therapy for the treatment of infections with M. odoratimimus is challenging due to limited clinical experience with this micro-organism and its reported multidrug-resistance. Review of previous st...

In surgical units, similar to other healthcare departments, guidelines are used to curb transmission of methicillin resistant Staphylococcus aureus (MRSA). The aim of this study was to calculate the extra costs for material and extra working hours for compliance to MRSA infection control guidelines in the operating rooms of a University Hospital. T...

Hantavirus infections, recently renamed ‘hantavirus fever’ (HTVF), belong to the most common but also most underestimated zoonoses in the world. A small number of reports described the so-called ‘lipid paradox’ in HTVF, i.e. the striking contrast between a very low serum total cholesterol and/or high-density lipoprotein cholesterol (HDLc), and a pa...

Objectives: Currently, there are no European data about the frequency and clinical significance of nontuberculous mycobacteria (NTM) grown from respiratory samples during the treatment of tuberculosis (TB). We determined the frequency and clinical significance of NTM isolated before or during pulmonary tuberculosis treatment in Belgian laboratorie...

We report nosocomial transmission of Streptococcus gallolyticus subsp. pasteurianus among three neonates, one of whom died. Genome analysis of the strains showed a specific pattern of metabolic and regulatory functions as well as of expressed antigens and antibiotic resistance genes that might have contributed to their specific virulence.

Different reports of Pneumocystis jirovecii pneumonia (PcP) outbreaks on oncology and transplant units suggest the possibility of a person-to-person transmission. Based on these reports, we searched retrospectively for possible PcP clusters in UZ Leuven in 2013. A movement and transmission map was established for all patients (n = 21) with a positi...

Conclusion: Post-test probabilities for neonatal hyperbilirubinemia can be calculated using exponential functions defined by UCB bilirubin, DAT, and ABO compatibility results. What is Known: • The diagnostic value of the triad umbilical cord blood bilirubin measurement, direct antiglobulin testing and blood group analysis for neonatal hyperbilirub...

A challenge panel of bacterial strains useful for clinical laboratories to validate their European Committee on Antimicrobial Susceptibility Testing (EUCAST) antimicrobial susceptibility test (AST) system was established. A total of 117 strains, obtained from Belgian Reference Centers (n=57) and from routine clinical samples (n=60) was selected bas...

Objectives: Q fever is a global zoonosis that can cause both acute and chronic infections in humans through aerogenic transmission. Although Q fever was discovered already 80 years ago, this infectious disease remains largely unknown. We studied a case series in a Belgian tertiary care hospital. Methods: A laboratory and file query at our depart...

Infections with Cronobacter sakazakii are mainly described among neonates and infants, with contaminated powdered infant formulas most often incriminated as the cause. We describe here a case of C. sakazakii bacteremia secondary to a suspected cyst infection in a heart-and-kidney transplant patient with polycystic kidney disease. This article is pr...

In the present case, we report a false positive result for the detection of rifampicin (RIF) resistance by the Xpert(®) MTB/RIF assay, version G4.Miliary Mycobacterium tuberculosis infection (miliary TB) was suspected in a 50-year old Angolan woman. Imaging of the thorax and abdomen displayed diffuse lesions. The Xpert(®) MTB/RIF assay conducted on...

Post-mortem microbiology (PMM) is an important tool in forensic pathology, helping to determine the cause and manner of death, especially in difficult scenarios such as sudden unexpected death (SD). Currently, there is a lack of standardization of PMM sampling throughout Europe. We present recommendations elaborated by a panel of European exper...

Over the last several years, carbapenemase-producing Enterobacteriaceae (CPE) have been increasingly detected not only among patients in acute care hospitals, but also in long-term care facilities. In this point prevalence survey, residents from three nursing homes and patients in one rehabilitation center were screened for asymptomatic intestinal...

Escherichia coli ST131 (sequence type 131) is pandemic now. This E. coli clone is characterized by the presence of a plasmid-encoded betalactamase (CTX-M-15) and multidrug resistance (to quinolones, co-trimoxazole, aminoglycosides, etc.). This CTX-M-15 beta-lactamase is a broadspectrum beta-lactamase (extended-spectrum beta-lactamase or ESBL) that...

The emergence of multidrug-resistant microorganisms (MDROs), such as carbapenemaseproducing Enterobacteriaceae (CPE), raises the question of prevention and control of their spread. General principles including hand hygiene and a restrictive usage of antimicrobials are important measures. For screening practices, one often makes a distinction betwee...

Background: Although vancomycin is frequently used to treat neonatal late-onset sepsis, there is no consensus on the optimal dosing regimen. Because many neonates needed dosing adaptation due to suboptimal trough values, the vancomycin dosing regimen in our neonatal department was changed during 2012. Objective: We aimed to document the need for va...

Background Puumala virus (PUUV), a member of the genus hantavirus, can cause nephropathia epidemica, a mild form of haemorrhagic fever with renal syndrome. The method of choice for the serodiagnosis of hantavirus infections are enzyme-linked immunosorbent assays (ELISAs). Objectives Two commercially available PUUV ELISA kits were compared: Hantavi...

Cefazolin is frequently administered for antimicrobial prophylaxis and treatment of infections. In neonates, pharmacokinetic observations are limited and dosing regimens variable. The aim of this study was to describe the pharmacokinetics of cefazolin in neonates based on total and unbound concentrations to optimize cefazolin dosing. Thirty-six neo...

Prevalence of carbapenemase-producing Enterobacteriaceae (CPE) is increasing both in hospitals and in the community. In this point prevalence study, rectal CPE colonization was investigated among 150 nursing home residents. No CPE were detected. Epidemiological data directly linked with CPE colonization in community and nursing home settings are cu...

We evaluated the performance of the ChromID MRSA/ChromID S. aureus biplate for the simultaneous detection of Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) in preoperative screening samples. The sensitivity and specificity were 94.2% and 93.6%, respectively, for the S. aureus compartment and 92.9% and 99.7% for the MRSA compartmen...

The incidence of invasive infections caused by the Aspergillus niger species complex was 0.043 cases/10,000 patient-days in a Belgian university hospital (2005-2011). Molecular typing was performed on 6 available A. niger complex isolates involved in invasive disease from 2010-2011, revealing A. tubingensis, which has higher triazole minimal inhibi...

Both Paecilomyces spp. and Alternaria spp. are hyphomycetes with a worldwide distribution, and with many species being common saprophytes in soil and air. Both species mainly cause infections in immunocompromised patients, but also in an increasing number of immunocompetent hosts. We describe a double-lung transplant patient suffering successively...

Femoral heads are an important source of allograft bone used in reconstructive orthopaedic surgery. The sterility of donor material is of major importance for the recipient. Femoral heads intraoperatively retrieved during hip arthroplasty from medically screened living donors are routinely checked with a surface swab to exclude microbiological cont...

The screening for and diagnosis of bacteriological infections often involves the collection and transportation of swab samples. The Copan ESwab was compared with the dry cotton Copan swab for methicillin-resistant Staphylococcus aureus (MRSA) screening (n = 200 paired samples) and with the Amies agar gel swab (Copan) for the sampling of burn and or...

To determine why incidence of mucormycosis infections was increasing in a large university hospital in Belgium, we examined case data from 2000-2009. We found the increase was not related to voriconazole use but most probably to an increase in high-risk patients, particularly those with underlying hematologic malignancies.

The European Association of Tissue Banks (EATB) Donor Case Workshop is a forum held within the programme of the EATB annual Congress since 2003. This workshop has been used to discuss clinical donor cases with peer review of practice. It was agreed in advance that the experience of the 2007 workshop should be shared by publication as an example of...

Mucormycosis is an angio-invasive mycosis with high morbidity and mortality rates which mainly affects immunocompromised patients. It is no longer an uncommon disease due to the increased incidence of diabetes and use of immunosuppressive agents in the current era. Our objective was to review all cases of proven and probable mucormycosis--according...

Bone allografts retrieved from multi-organ donors can be decontaminated with minimally aggressive methods. Therefore, we evaluated the efficacy of antibiotics and antiseptics in the decontamination of bone fragments actively contaminated with coagulase-negative staphylococci. Gentamicin (512/1,024 microg/mL), rifampicin (400/1,000 microg/mL), chlor...

Transfusion-induced serum sickness reactions are rarely reported in the literature. The Type III hypersensitivity reaction to heterologous proteins involves deposition of complement and immune complexes in small vessel walls resulting in a leukocytoclastic vasculitis. A case of a multiply transfused patient with several episodes of serum sickness r...

Tissue banks culture tissue specimens to confirm the absence of viable micro-organisms after decontamination with antibiotics. It is possible that antibiotic residues attached to decontaminated tissue are introduced into enrichment culture media. These could have an inhibitory effect on the culture results and generate false-negative results. Our a...

Tissue banks provide tissues of human cadaver donors for transplantation. The maximal time limit for tissue retrieval has been set at 24 h postmortem. This study aimed at evaluating the evidence for this limit from a microbiological point of view. The delay of growth in postmortem blood cultures, the identification of the species isolated and clini...

Human skin allografts are important in the treatment of severe burns. Transplantation of skin allografts can cause bacterial transmission. Glycerol in higher concentrations is an appropriate storage medium for allograft cadaver skin and has been attributed an antimicrobial effect. We investigated this effect in more detail. First, the minimal inhib...

In order to reduce the risk of transmission of infectious diseases through transplantation of tissue allografts, one should examine tissues for the presence of microorganisms. However, there are no detailed tissue banking guidelines describing the culture method or incubation time to be used. Therefore, we compared two culture methods--blood agar p...

Allograft infection occurs at a rate not different from that of similar procedures with large allografts or sterilized prosthetic devices and is usually caused by coagulase-negative staphylococci (CNS). CNS are feared for their limited antimicrobial susceptibility. We aimed at investigating this risk. CNS were isolated from 260 of 1461 allograft ti...