The national prevalence survey of nosocomial infections in Belgium, 1984

A national one-day prevalence survey of nosocomial infections was carried out in March 1984 in 106 Belgian acute-care hospitals involving 8723 patients of whom 6130 had undergone surgery. Three infections were studied: surgical wound infection, bacteraemia and urinary-tract infection. One or more of these three infections was recorded in 9.3% of all patients and in 11.8% of surgical patients. Prevalences increased with increasing duration of hospital stay and with higher ages, but the association of HAI with age was no longer significant after correction for duration of hospital stay. Prevalences varied considerably in different specialties. After adjustment for age and duration of stay, there was no association between perioperative antibiotic prophylaxis and the prevalence of the infections studied, but bias due to selection of higher risk patients in the antibiotic group was probable. Larger hospitals had a higher overall prevalence, but populations differed according to the size of the hospital. Bacteraemia was strongly associated with the presence of an intravenous catheter, and urinary-tract infection with a urinary catheter.     

精神病专科医院感染管理对策探讨

目的 探讨精神病专科医院医院感染的危险因素,加强医院感染预防控制措施.方法 完善医院感染制度,强化人员培训;着重环节管理,加强消毒隔离措施;强化医务人员标准预防.结果 医务人员医院感染管理意识明显增强,手卫生依从性由20.0％提高至45.0％,主动发现3起医院感染暴发的隐患.结论 精神病专科医院医院感染管理有其自身的特点,因此应有针对性的采取措施,预防控制医院感染.     

医院感染现患率调查

目的 了解住院患者医院感染的状况及其影响因素,为有效控制医院感染提供科学依据.方法 采用横断面调查方法,即床旁走访和查阅病历相结合,按医院感染病例登记表逐项记录,统一汇总.结果 实查住院患者551例,发现医院感染27例、30例次,现患率为4.90％、例次感染率为5.44％;以下呼吸道感染居首位,占44.44％;革兰阴性杆菌是主要的医院感染致病菌,抗菌药物的应用率为71.51％,呼吸内科和儿科的治疗用药,心内科和消化内科的介入检查治疗、眼科和外科系统的手术预防用药居高不下,＞96.97％,主要存在着用药指征不严、起点高、时间长和联合不当等不合理情况.结论根据现患率的调查,应针对性地开展目标性监测,采取有效的预防控制措施,规范抗菌药物的合理应用,切实降低医院感染的发生率.     

National prevalence survey on hospital infections in Norway

A nationwide prevalence survey was carried out in Norwegian hospitals (excluding mental hospitals) on 23 October 1997. The aim was to assess the magnitude of major hospital-acquired infections (HAIs) prior to the introduction of quarterly prevalence surveys in Norway as required by the new Regulations for Communicable Disease Control in Hospitals. The survey included 71 of 76 possible hospitals, and 12,775 patients. Altogether 779 HAIs were identified--a prevalence rate of 6.1%. Only the four major HAIs were included: urinary tract infection (36.4% of all HAIs); surgical wound infection (28.6%); lower respiratory tract infection (25.4%) and septicaemia (9.6%). Three thousand, three hundred and forty-nine patients had undergone surgery and the prevalence of surgical wound infection was 6.3%. The results form a baseline for the next step in Norweigan hospital infection control; the quarterly prevalence surveys.     

Autochthonous Cases of Tick-Borne Encephalitis,Belgium, 2020

We report 3 confirmed autochthonous tick-borne encephalitis cases in Belgium diagnosed during summer 2020. Clinicians should include this viral infection in the differential diagnosis for patients with etiologically unexplained neurologic manifestations, even for persons without recent travel history.     

2010年医院感染现患率调查分析

目的 了解医院感染现状、抗菌药物使用及医院感染管理中存在的问题,为进一步提高医院感染监控措施提供科学依据.方法 采用床旁调查与住院病历调查相结合的方法.结果 调查的929例住院患者中,医院感染现患率为3.44％;其中以呼吸内科感染率最高;医院感染高发部位主要为下呼吸道占40.00％、其次是泌尿道占22.86％、上呼吸道占8.57％;分离出的病原菌以革兰阴性杆菌为主,占59.07％,常见病原菌为大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、表皮葡萄球菌、鲍氏不动杆菌;调查当日抗菌药物的使用率为55.11％.结论 医院感染现患率调查快速有效,资料准确,问题的切入点反映直接,能够为有效开展目标性监测提供依据.     

The development of a national HIV Plan in Belgium: Achieving consensus despite institutional complexity

BackgroundThe development of a national HIV Plan poses serious challenges to countries with a complex distribution of legal powers such as Belgium. This article explores how the Belgian national HIV Plan 2014–2019 was developed.MethodsApplying the policy streams model of John Kingdon, the analysis of the HIV Plan development process was based on published government statements, parliamentary documents, and websites of stakeholders.ResultsThe Federal Ministry of Health initiative to achieve the HIV Plan was characterized by a coordinating role with a participatory approach towards the other Belgian governments and stakeholders. The 2013 protocol agreement of the Belgian governments committed them to principles, actions, and cooperation, but not to budgets, priorities, or target figures.DiscussionThe Federal government followed a successful strategy to create momentum and commitment to a common national vision on HIV/AIDS. The window of opportunity was not sufficient to create an implementation plan prior to the 2014 elections, and major challenges were left to the subsequent governments, including financing.ConclusionThe country of Belgium represents an example of a consensus strategy to achieve a national HIV Plan with its achievements and limits within institutional complexity and limited Federal legal powers.     

A decade of norovirus genetic diversity in Belgium

Outbreaks of norovirus-associated gastroenteritis occur during all seasons and in various locations, and are recognized as one of the most common causes of nonbacterial food-borne infections. The molecular epidemiology of norovirus infections has not been well characterized in Belgium. To study the incidence of norovirus infections and the nature of the circulating genotypes, 3080 specimens were collected from patients with acute gastroenteritis between 2004 and 2014. Norovirus was detected with RT-PCR in 554 samples (18%). The circulating strains were genotyped based on the variability in the 5′ end of the capsid gene (region C). The GII.4 genotype, which is detected predominantly worldwide, was also the most prevalent genotype in our study (87%). This study shows a high frequency and genetic diversity of norovirus in patients with acute gastroenteritis in health care facilities in Flanders, Belgium.     

Estimating population prevalence of psychiatric conditions by small area with applications to analysing outcome and referral variations

This paper considers the development of estimates of mental illness prevalence for small areas and applications in explaining psychiatric outcomes and in assessing service provision. Estimates of prevalence are based on a logistic regression analysis of two national studies that provides model based estimates of relative morbidity risk by demographic, socio-economic and ethnic group for major psychiatric conditions; household/marital and area status also figure in the regression. Relative risk estimates are used, along with suitably disaggregated census populations, to make prevalence estimates for 354 English local authorities (LAs). Two applications are considered: the first involves analysis of variations in schizophrenia referrals and suicide mortality over English LAs that takes account of prevalence differences, and the second involves assessing hospital referral and bed use in relation to prevalence (for ages 16-74) for a case study area, Waltham Forest in NE London.     

Increasing Incidence of Mucormycosis in University Hospital, Belgium

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.     

精神科男病区医院感染率高发的原因分析与对策

目的分析精神科男病区医院感染率高发的原因,并采取干预措施。方法对精神科男病区2008-2009年的住院患者分为干预前组与干预组,分别进行回顾性与前瞻性调查,将数据进行统计学处理。结果干预前组的医院感染率为14.29%,干预组的医院感染率为5.42%,两组差异有统计学意义(P<0.01)。结论精神科男病区的医院感染率高发是可控可防的。     

精神科住院患者医院感染危险因素logistic回归分析

目的调查精神科住院患者医院感染的特点及其相关危险因素,为采取有效预防控制措施提供依据。方法采用前瞻性监测与回顾性调查相结合的方法,对精神科2007年1月-2011年12月住院患者医院感染状况进行调查,筛选危险因素,采用SPSS13.0软件进行非条件logistic回归分析。结果 1 289例精神科住院患者中发生医院感染94例、99例次,医院感染率和例次感染率分别为7.29%和7.68%;感染部位以呼吸道、胃肠道和泌尿道感染为主,分别占56.56%、16.17%、10.10%;单因素分析显示,年龄、住院天数、住院季节、精神疾病类型、合并基础疾病、住院年度、抗菌药物的使用与医院感染的发生有关(P<0.05);而logistic回归分析得出住院天数、年龄、住院年度是精神科患者发生医院感染的独立危险因素。结论根据精神科医院感染特点,调整监测方案,开展目标性监测,采取综合干预措施,可有效降低医院感染率。     

三级传染病医院的医院感染现患率调查及影响因素分析

目的　了解三级传染病医院的医院感染的实际情况,掌握三级传染病医院的医院感染流行病学特征,评价近年来医院感染持续质量改进的效果,为强化医院感染的预防与控制提供参考依据。方法　采用医院感染实时监控系统与床边调查相结合的方法,对2015年7月8日0—24时我院所有住院患者进行调查分析。结果　本次三级传染病医院的医院感染现患率调查应查853例、实查835例,实查率为98.00％,发生医院感染的有13人（15例次）,医院感染现患率为1.56％,例次感染率为1.80%;肿瘤科和ICU的医院感染现患率较高,其次为肝病科;感染部位以呼吸道为主,占46.67%,其次依次是泌尿道26.67%、胃肠道13.33%、血液系统13.33%;抗菌药物的使用率为45.03％,其中治疗性使用抗菌药物占98.94％;抗菌药物以一联用药为主,占84.84％;使用抗菌药物前病原学送检率为68.35%;三级传染病医院医院感染的影响因素有抗菌药物使用、抗菌药物联用、合并基础疾病及免疫抑制剂的使用。结论　三级传染病医院应加强肿瘤科、ICU及肝病科等科室的感染预防与控制,严格抗菌药物和免疫抑制剂的使用和管理,提高抗菌药物使用前病原学的送检率,以降低医院感染的发生率。     

Impact of ethnicity on the prevalence of psychiatric disorders among migrants in germany

Objectives. Studies on psychiatric disorders among migrants have described higher rates, especially of schizophrenia. Some evidence points to the possibility of misdiagno‐sis for this higher rate; other studies point to the underrepresentation of migrants in psychiatric services, leading to artefactual epidemiological data.

Methods. All admission records of migrants to a psychiatric clinic from 1993 to 1995 were assessed for diagnosis, symptomatology and treatment.

Results. Admissions of 408 migrants, 8.1 % of total admissions, were assessed. Of these, 38.7% received a diagnosis of a schizophrenic disorder, significantly more than the other clinic patients. The mean age at admission was 34.0 years, at onset of illness 28.6 years and at time of migration 20.4 years. Only 8.3% were mentally ill at the time of migration. Language problems correlated with the diagnosis of a schizophrenic disorder.

Conclusion. An underrepresentation of migrants shows differences in the use of psychiatric services. Some evidence from the mental status and reported language problems may explain the higher rate of schizophrenia due to misdiagnosis.     

The survival of psychiatric diagnosis

Past and current debates about applying medical diagnoses to psychological difference in society are examined. Beginning with a brief historical overview from antiquity to 'anti-psychiatry' and a summary of recent debates, the article then offers two case studies of common diagnoses ('depression' and 'schizophrenia'). The main challenge for social science is no longer about what is wrong with psychiatric diagnosis (that is now well rehearsed) but how to account for how and why it has survived. In answering this question about survival, inter-disciplinary work could attend to the pre-empirical positions of mental health researchers; the ways in which mental disorders are similar and different to physical disorders; and the interest work of different social groups defending or attacking psychiatric diagnoses in varying contexts.     

Sodium reduction and the correction of iodine intake in Belgium: Policy options

Many studies suggest that high salt intakes are related to high blood pressure and consequently cardiovascular diseases. In addition salt intake was found to be related with obesity, renal stones, osteoporosis and stomach cancer. Belgium, such as other European countries, is suffering from both salt intakes that are twice as high as the recommended intakes and mild iodine deficiency. No comprehensive strategy encompassing both public health problems has been developed. While specific salt reduction targets for processed foods are still under discussion using a consensus approach with industry, an agreement was signed between the bakery sector and the Ministry of Health in April 2009, to encourage and increase the use of iodised salt in the production of bread. Based on results of recent surveys on population iodine status it is advised not to currently revise iodine concentrations in salt in bread but to advocate for a higher percentage of bakers using iodised salt and to install a good monitoring system to control the percentage of bakers effectively using adequately iodised salt. With regard to salt reduction, it is of utmost importance that all companies contribute and harmonise the salt content of their products according to the lowest possible thresholds in a first step. In order to achieve this goal, it will be necessary, in addition to the consensus approach, to come up with at least some legislative tools such as a salt tax or mandatory labelling of foods exceeding a specific sodium concentration. Once salt reduction targets have been clearly defined in Belgium over the longer term, a legal framework should be set in place where iodine concentration in salt for the production of bread and household salt is strictly regulated by law, to avoid a large variability in the iodine content of salt brands consumed. In conclusion, it is possible to tackle salt reduction and iodine deficiency at the same time on the condition that the approach is coordinated and well monitored. All the interventions and measures taken should clearly include education and communication directed towards consumers, food producers, public health professionals, pharmacists, healthcare workers, and media representatives.     

Epidemiological situation of Lyme borreliosis in Belgium, 2003 to 2012

Background

Some studies show that the incidence of Lyme borreliosis is increasing in different European countries. In order to evaluate if this is also the case in Belgium, different data sources were consulted to describe the epidemiology of Lyme borreliosis in the country during the last decade.

Methods

Data from two databases were analyzed for the time period 2003–2010 and 2003–2012 for respectively: the registration of minimal clinical data from Belgian hospitals (principal and secondary diagnosis), and a sentinel laboratory network reporting positive laboratory results.

Results

The number of hospitalized cases per year remained stable between 2003 and 2010, ranging from 970 (in 2008) to 1453 (in 2006), with a median of 1132.5 cases per year. Between 2003 and 2012, yearly fluctuations in the number of positive tests were reported by the sentinel laboratory network (with a minimum of 996 positive tests in 2007 and a maximum of 1651 positive tests in 2005), but there is no increasing trend over the study period (median = 1200.5 positive tests per year). The highest incidence rates of hospitalization and the highest reported incidence of positive laboratory results are registered in the provinces of Luxemburg, Limburg, Flemish Brabant and Antwerp, with a typical seasonal pattern (peak in September). The age groups affected most are those from 5 to 14 years and 45 to 69.

Conclusion

Based on hospital records and laboratory results, no increasing trend in Lyme disease was observed over the 2003–2012 period in Belgium. These results are in line with the stable incidence of erythema migrans reported by a sentinel network of general practitionners between 2003 and 2009. Multi-source surveillance of vector-borne diseases should be further implemented.     

精神科夜班护士患高血压病情况调查及分析

目的了解精神科夜班护士患高血压病的几率,分析相关因素,探讨有效的干预措施。方法以从事精神科夜班护理工作的护士113人为调查组,另以随机抽取的医院内从事其他工作的人员113人为对照组,对两组分别做了一次高血压病流行病学调查以及HAMA（汉密尔顿焦虑量表）测评。结果从事精神科夜班护理工作的护士焦虑程度更高,患高血压病的几率亦更高。结论精神科夜班护士压力较大,应采取有效的干预措施,帮助精神科夜班护士减轻和消除心理压力,从而积极预防高血压病的发生。