T +32 2 642 57 77Inscription avant le 11 novembre 2009Inschrijving vóór 11 november 2009sur / op www.iph.fgov.be/epidemio/labo

Centre Culturel et de Congrès de Woluwé-St-PierreCultureel en Congrescentrum van St.-Pieters-Woluwe

LIEU | PLAATS

InformATIon | InformATIE

Infection control ESBL EUCAST Antibioresistance

Surveillance Clostridium difficile Sentinel Laboratory network

Risk & Prevention HIV H1n1 Q fever

Diagnosis Aspergillosis molecular microbiology

ProgrAmmE | ProgrAmmA

Responsible editor: Dr J . Peeters | G

eneral director | Rue J. Wytsm

anstraat 14 |1050 Brussels

DIAgnoSE En SUrVEILLAnCE VAn InfECTIEUzE AAnDoEnIngEnDIAgnoSTIC ET SUrVEILLAnCE DES mALADIES InfECTIEUSES

25ste seminarie > 26 november 2009 | 25e séminaire > 26 novembre 2009

Dit seminarie kwam tot stand dankzij de medewerking en financiële steun van de :

Ce séminaire est organisé grâce à la collaboration et à l’appui financier de :

Société Belge de Biologie Clinique (SBBC)

Belgische Vereniging voor Klinische Biologie (BVKB)

Didactisch materiaal – Matériel didactique

GlaxoSmithKline

Stands Advertenties / Publicités

AstraZeneca Becton Dickinson Abbott Diagnostics Biodiphar Becton Dickinson BioTrading Biodiphar Bio-Rad Laboratories BioMérieux Biotest Seralc° BioTrading Inverness Medical Belgium Bio-Rad Laboratories International Medical Products Bruker Daltonics Meridian Bioscience Europe GlaxoSmithKline Siemens Medical Solutions Diagnostcis Lucron Bioproducts Meridian Bioscience Europe Oxoid Wyeth Pharmaceuticals

Organiserend Comité – Comité Organisateur Voorzitter / Président : Dr S. QUOILIN (IPH)

Dr P. BUTAYE (CODA) Dr E. PADALKO (UGent) Dr G. DAUBE (ULg) Dr D. PIERARD (UZ Brussels) Mme G. DUCOFFRE (IPH) Dr C. POTVLIEGE (CH Tivoli) Dr P. GOUBAU (UCL) Dr Y. VAN LAETHEM (UMC St Peter) Dr E. HENDRICKX (IPH) Dr H. VAN OYEN (IPH) Dr G. IEVEN (UZA) Dr J. VERHAEGEN (UZ Leuven) Dr P. MELIN (ULg) Dr K. VERNELEN (IPH)

Rédacteur en chef – Eindredacteur

Mme G. DUCOFFRE

Congresbrochures – Brochures du congrès

Drukkerij WIV – Imprimerie ISP

Table des matières – Inhoud

• Antimicrobial use and resistance at the individual patient level – the IARG study Dr B. CATRY ............................................................................................................................................ 1

• Emergence of transferable carbapenemases in Gram-negative bacteria: a new major resistance threat

Dr Y. GLUPCZYNSKI ………………………………………………………………………………………... ... 3

• Clostridium difficile: surveillance in the Belgian hospitals Dr M.L. LAMBERT ................................................................................................................................... 5

• 25 years of sentinel labs: from local to European approach Dr S. QUOILIN ......................................................................................................................................... 7

• H1N1: hpw to deal in lab and clinic with a new threat Dr Y. VAN LAETHEM & Dr I. THOMAS .................................................................................................. 9

• EUCAST recommandations: practical aspects Dr P. MELIN & Dr J. VAN ELDERE ........................................................................................................ 11

• Quality assessment in Molecular Infectious Diseases: where have we come from? Where are we going?

Dr P. WALLACE ...................................................................................................................................... 13

• Invasive aspergillosis: value of different diagnostic approaches Dr J. MAERTENS .................................................................................................................................... 15

• Current patterns of the HIV pandemic Dr S. DE WIT ........................................................................................................................................... 17

• Q fever: situation in Belgium Dr D. FRETIN ........................................................................................................................................... 19

• Annexe / Bijlage ........................................................................................................................................ 21

Programme

8h30 Registration with walking breakfast / Visit of stands 9h25 Welcome

SESSION 1

Chairpersons: Dr G. Ieven (UZA) & Dr F. Jacobs (Erasmus Hosp.)r G. Ieven (UZA) & Dr F. Jacobs (Erasmus Hosp.)Dr G. Ieven (UZA) & Dr F. Jacobs (Erasmus Hosp.)

9h30 Antimicrobial use and resistance at the individual patient level – the IARG study Dr B. Catry (IPH) 9h55 Emergence of transferable carbapenemases in Gram-negative bacteria: a new major resistance

threat Dr Y. Glupczynski (UCL) 10h20 Clostridium difficile: surveillance in the Belgian hospitals Dr M.L. Lambert (IPH) 10h45 Coffee break / Visit of stands

SESSION 2

Chairpersons: Dr D. Pierard (UZ Brussel) & Dr C. Potvliege (CH Tivoli)

11h05 25 years of sentinel labs: from national to European approach Dr S. Quoilin (IPH) 11h30 EUCAST recomandations: practical aspects how to deal in lab and clinic with a new threat Dr P. Melin (CHU Liège) & Dr J. Van Eldere (UZ Leuven) 12h00 H1N1: how to deal in lab and clinic with a new threat? Dr Y. Van Laethem (UMC St Peter) & Dr I. Thomas (IPH) 12h35 Lunch

SESSION 3

Chairpersons: Dr E. Padalko (UZ Gent) & Dr Y. Van Laethem (UMC St Peter)

14h00 Quality control for Molecular Diagnostics: a review of the collaboration in Belgium Dr W. McKain (QCMD - Scotland) 14h35 Invasive aspergillosis: value of different diagnostic approaches Dr J. Maertens (UZ Leuven) 15h00 Current patterns of the HIV pandemic Dr S. De Wit (UMC St Peter) 15h30 Q fever: situation in Belgium Dr D. Fretin (VAR) 16h00 Closing address 16h15 End of seminar

Avant-propos A l’occasion des 25 ans du séminaire « Diagnostic et surveillance des maladies infectieuses », je tiens à adresser une nouvelle fois mes remerciements • à tous les orateurs qui, au cours de ces séminaires, acceptent de transmettre leur

savoir enrichissant, • aux modérateurs qui fluidifient le rythme des exposés et dynamisent la réflexion

autour des sujets exposés, • à tous les participants qui contribuent à la réussite de ces séminaires, et en

particulier à tous les membres du réseau des Laboratoires Vigies, ayant collaboré ou collaborant de près ou de loin à la surveillance des maladies infectieuses,

• aux sponsors qui permettent la réalisation de ces séminaires, • aux collègues de l’ISP qui donnent un précieux coup de main lors des

préparations et déroulements de ces journées.

A tous, bon séminaire 2009 ! ***** Voorwoord Ter gelegenheid van de 25e verjaardag van het seminarie ‘Diagnose en surveillance van infectieuze aandoeningen’ wens ik nogmaals mijn dank te betuigen aan • alle sprekers die ermee instemmen om op het seminarie hun verrijkende kennis

over te brengen, • de moderators die zorgen voor het vlotte verloop van de uiteenzettingen en de

dynamiek in de debatten rond de uiteengezette onderwerpen, • alle deelnemers die tot het succes van het seminarie bijdragen en in het bijzonder

alle leden van het Peillaboratorianetwerk die in het verleden hebben meegewerkt of vandaag rechtstreeks of onrechtstreeks meewerken aan de surveillance van infectieuze aandoeningen,

• de sponsors die de organisatie van het seminarie mogelijk maken, • de collega's van het WIV die een kostbare bijdrage leveren aan de voorbereiding

en het verloop van het seminarie.

Goed seminarie 2009!

Geneviève Ducoffre

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Associations between antimicrobial consumption and resistance in the individual patient: IARG, a multi-centre study

Dr B. CATRY1, Dr E. HENDRICKX1, Dr R. PREAL2, Dr R. MERTENS2

1IPH – Epidemiology, Brussels 2Intermutualistic Agency, Brussels

bcatry@iph.fgov.be Antimicrobial resistance leads to increased healthcare costs primordially due to a higher morbidity and mortality from infectious diseases, and increased length of hospital stay. The relationship between antimicrobial consumption and antimicrobial resistance is complex and remains far from fully understood. The objective of the present study was to investigate the relationship between the average daily intake of antimicrobial agents and the occurrence of microbial drug resistant organisms, in particular well known pathogens, at the individual patient level both in the ambulatory and in the in-patient setting. The microbiological results of voluntary participating clinical laboratories during 2005 were coupled with the antimicrobial consumption patterns (July 2004-December 2005) as provided by the pooled data of the seven Belgian health insurance funds (intermutualistic agency). Univariate and multivariate logistic regression were used to identify risk factors for antimicrobial resistance following antimicrobial consumption and other patient characteristics (calculation of Odd’s Ratios). A total of 105,198 samples, originating from 16 laboratories and 44,365 patients matched the criteria for further analysis through subsets of combinations of microorganisms and susceptibility profiles. Herein only the first isolate per patient was retained so as to minimize confounding through underlying disease and/or severity of infection. For Staphylococcus aureus, coagulase negative staphylococci, Escherichia coli, and Klebsiella pneumoniae, strong significant relationships (p<0.001) were found between their resistance profiles and the individual consumption of antimicrobial agents expressed as defined daily doses (DDD). This was especially the case for older and newer beta-lactam antibiotics (incl. cephalosporins) and for fluoroquinolones. These three groups of antimicrobial agents counted for 63.45% of total antimicrobial consumption within the study population. For Streptococcus pneumoniae, resistance to penicillines was increased by the use of the group of macrolides, lincosamides and streptogramines. These data strongly support the existence of a risk for acquired antimicrobial resistance in major bacterial pathogens, directly related to the consumption of antimicrobial agents at the individual patient level. When prescribing these agents of vital importance, clinicians should consider that antimicrobial consumption also inherently bears an individual risk for their own (ambulant) patient, besides the resistance induction at the population level that has been known for a long time. Additional information can be found in French and Dutch, respectively, at: http://www.iph.fgov.be/Publicatierapporten/WIV-IMA-NRKP2008FR.pdf http://www.iph.fgov.be/Publicatierapporten/WIV-IMA-NRKP2008NL.pdf Acknowledgements: This study was performed following a request of the Belgian National Council for the Promotion of Quality (Nationale Raad voor Kwaliteitspromotie). Preparations are ongoing for further analyses in collaboration with the University of Antwerp and the University of Hasselt (Diepenbeek).

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THE WORLDWIDE EMERGENCE OF CARBAPENEMASE-PRODUCING AND MULTI-DRUG RESISTANT GRAM-NEGATIVE BACILLI: PARADIGM

OF A SILENTLY DEVELOPING MAJOR THREAT Dr Y.GLUPCZYNSKI, Dr P. BOGAERTS

Cliniques Universitaires UCL de Mont-Godinne, Laboratoire de bactériologie, Yvoir youri.glupczynski@skynet.be

International and local surveillance networks as well as numerous reports in the medical literature provide strong evidence that the prevalence of antibiotic resistant Gram-negative bacilli is escalating worldwide and that is also increasing in many European countries including in Belgium. In particular resistance to carbapenems (imipenem, meropenem,…) is one of the major threats for treatment of infections caused by Gram-negative bacteria, and the production of carbapenemases is the most important molecular mechanism both clinically and epidemiologically. Acquired and plasmid-mediated carbapanemases which have emerged worldwide over the last decade are beta-lactamases which basically may be subdivided into two major molecular groups, differentiated by the hydrolytic mechanism in their active site. The first group contains at least one zinc atom at the active site, establishing them as metallo-enzymes or metallo-β-lactamases (MBLs) (Ambler class B). While at least 7 different phylogenetic classes of MBLs have been reported today, the two most prevalent and widespread enzymes are the Verona integron-encoded metallo-β-lactamase (VIM) and the IMP (IMipenemases)-type carbapenemases. Class B metallo-β-lactamases initially emerged in South-east Asia in the 90’s and then reached Southern Europe (first Greece and Italy at the turn of this century). MBLs of class B were initially located in P. aeruginosa but spread subsequently to different Enterobacteriaceae species (Klebsiella pneumoniae, E. coli and Enterobacter spp.) through horizontal genetic transfer by conjugative or non conjugative plasmids. The second prominent group of carbapenemases utilises serine at the active site and it includes two majors types which belong to genetically distinct classes of β-lactamases (Ambler Classes A and D): Klebsiella pneumoniae carbapenamases (KPC) is the main representative of Class A β-lactamases and it is predominantly found in K. pneumoniae as well as in different Enterobacteriaceae species while specific OXA type carbapenemases (mainly OXA-23, OXA-58 and OXA-40 which all belong to Ambler class D) are nowadays essentially encountered in Acinetobacter baumannii (and presently only very occasionally for some specific OXA-types in Enterobacteriaceae and in Pseudomonas aeruginosa isolates). Overall, all these new carbapenemase resistance genes have recently emerged almost simultaneously in different parts of the world and they have successfully spread mostly as sources of severe systemic infections occurring in patients hospitalized in ICUs or in other hospital units. They have also been the causes of major nosocomial outbreaks on all different continents and some of the major prevailing carbapenemase enzymes have become endemic in several countries (e.g: KPCs in the USA, Israel and Greece, VIMs and IMPs in Greece) OXAs in all countries of the southern Mediterranean basin). Besides causing nosocomial outbreaks, KPC, VIM or IMP and OXA carbapenemases producing bacteria have also raised major therapeutic problems worldwide because of their characteristic multi-drug resistant pattern leaving only very few antibiotic classes (most usually only polymyxins and sometimes tigecycline), active against them. The multidrug resistant pattern of these emerging organisms is due to the fact that they usually harbour multiple resistance genes carried on gene cassettes which may be

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integrated on specific genetic structures (integrons) that may be mobilized through transposons and plasmids across different bacterial species and even in different genera. Specialized genetic structures such as insertion sequences may not only be responsible of the mobility of these resistance determinants but may also carry the promoter sequences which allow them to be expressed in different bacterial hosts. Besides the ease with which most carbapenemase resistance genes may be mobilized and transferred among different bacterial hosts, several successful hyperendemic clones of carbapenemase producing bacteria (e.g. KPC-2 and KPC-3 producing K. pneumoniae and of OXA-23/OXA-58 producing A. baumannii have emerged and spread in different countries (e.g. mainly in the USA in Greece, in Turkey, Israel and in most other countries of the southern Mediterranean basin) accounting for national epidemics and for the subsequent dissemination in many countries trough international travel and transfer of patients and/or of health-care personnel. While recent international surveillance networks (i.e. EARSS surveillance) suggest that the prevalence of carbapenemase-producing may be gradually increasing in Europe and elsewhere, the real situation may be underestimated because the detection of several carbapenemase producers (i.e. KPC) may be difficult based on routine susceptibility testing whatever the testing method. Further the asymptomatic gastrointestinal colonization of patients may often go unrecognized and this may also facilitate the hidden spread of such organisms in the acute care hospitals and possibly also in the community. It is of utmost importance that infection control practitioners and infectious disease specialists should now be aware of the possible occurrence of carbapenem producers and that rapid screening of asymptomatic intestinal carriage be instituted in the setting of transfer of patients who were previously hospitalized in countries where the prevalence of carbapenemase producers is high (i.e. the USA, Greece, Turkey, Israel…). Rapid confirmation of resistance by special tests including molecular testing also is clearly needed to confirm the emergence of new carbapenemase resistance genes, especially in countries so as Belgium where their prevalence is rare and where the resistance level to carbapenems is still low. Owing to the paucity of effective therapeutic options and the lack of perspective for the development of new therapeutic agents, it is crucial to implement rapid effective infection measures to limit the spread of these pathogens. This reviews briefly summarizes the magnitude of carbapenemase and multi-drug associated resistance in Europe, emphasizing where the efforts of the scientific community, the academia, the industry and the political authorities should focus in order to confront this threat. References P. Nordmann, G. Cuzon, T. Naas. The real Threat of Klebsiella pneumoniae carbapenemase-producing bacteria. Lancet Infect Dis 2009; 9: 228-36. Queenan AM, Bush K. Carbapenemases : the versatile β-lactamases. Clin Microbiol Rev 2007; 20: 440-58. Poirel L, Pitout JD, Nordmann P. Carbapenemases molecular diversity and clinical consequences. Future Microbiol 2007; 2:501-12. Souli M, Galani I, Giamarellou H. Emergence of extensively drug-ressitant and pandrug-resistant Gram-negative bacilli in Europe. Eurosurveillance Vol. 13, Issue 47 (20 November 2008), www.eurosurveillance.org Souli M, Kontopidou FV, Papadomichekalis E et al. Clinical consequences of serious infections caused by infections caused by Enterobacteriaceae producing VIM-1 metallo β-lactamase in a Greek university hospital. Clin Infect Dis 2008; 61:296-300. Giakoupi P, Maltezou H, Polemis M et al. KPC-2 producing Klebsiella pneumoniae infections in Greek hodpitals are mainly due to a hyperendemic clone. Eurosurveillance 2009, Vol 14 (Issue 21) 28 May 2009, www.eurosurveillance.org

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CLOSTRIDIUM DIFFICILE: SURVEILLANCE IN THE BELGIAN HOSPITALS

Dr M.L. LAMBERT IPH – Epidemiology, Brussels

marie-laurence.lambert@iph.fgov.be

This presentation will look at long time trends of Clostridium difficile epidemiology in Belgium, and discuss results from the prospective surveillance of Clostridium difficile infections in Belgian hospitals initiated in 2006.

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25 YEARS OF LABORATORY NETWORKS: SENTINEL AND REFERENCE LABORATORIES, FROM LOCAL TO EUROPEAN APPROACH

Dr S. QUOILIN IPH – Epidemiology, Brussels

squoilin@iph.fgov.be

Initiated by the Scientific Institute of Public Health in 1983, 88 laboratories started to send weekly data on about 27 pathogens on paper sheet; covering about 25% of all accredited laboratories in the country. Feedback was given to participants in quarterly report and a yearly report was available for authorities. After 25 years, 100 labs are regularly participating covering nearly 60% of all accredited laboratories and 35 pathogens. The major change experienced during the first 25 years has actually been the amazing development of communication technology. These developments have affected the possibility to send data by electronic channels and the capacity to give timely feedback as well. In order to reduce the workload, some laboratories left the paper sheet, to use, in a first step, a software ‘episurv’ allowing data entry associated with automatic sending via email. In a second step, two others possibilities have been offered: extraction modules with use of email to transmit the data and data web entry. This improvement permits also e.g. to notify each day mandatory infectious diseases to community health inspectorate and to give restricted on line feedback to laboratories. Increasing influence of computerization in our daily life seems naturally take place in health domain too. A balance between evident advantages and possible drifts should be carefully maintained. Sentinel Laboratory Network as valuable tool for surveillance of infectious diseases is making it an essential information provider for public health decisions. Analysis and interpretation of data following epidemiological descriptive triad bring out trends, detect outbreak, and evaluate impact of policy and preventive measures. Regarding the scientific evolution, it becomes more and more evident how essential is the role played by laboratories having developed a specific competency, namely the Reference Laboratories. Follow up of type, subtype, phage, antibioresistance, … offers a crucial complement for infectious diseases surveillance. All these data, correlated with others data sources, contribute also to understand burden of infectious diseases, to model their evolution, to demonstrate impact of external factors, ... To understand their language, data has always to be interpreted at the light of contextual elements. Since human demography, lifestyle, environmental pressure, … make us living in a moving world, determinants will have to be more and more taken into account when drawing the evolution of infectious diseases. In this field also, new technology will help us to explain some observation or to predict some evolution as satellite model, genomics, … which are for the moment in the hall of infectious diseases surveillance’s house. This moving world gives evidence to an European approach of public health. Disappearance of borders imposed to a building European Union to include public health, and infectious diseases in particular, in its framework. In 2005, the European Centre for Disease Control and Prevention was founded to protect EU citizens’ health from infectious diseases. Harmonization of key elements as common case definitions, construction of a common database, interpretation of data at the light of member states particularities, … so many motivating challenges to deal with. In the same direction, WHO modified its International Health Regulation to work on the concept of ‘event’. Each country had to organize itself in order to be able to early detect potential signal of event having potential international spread. Data gathered by Laboratory Networks clearly contribute to Belgian obligation in this field.

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The future of infectious diseases is guaranteed because of human lifestyle and environmental pressure but also because of the capacity of microorganisms to adapt themselves to human defense strategies.

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H1N1: HOW TO DEAL IN LAB AND CLINIC WITH A NEW THREAT Dr Y. VAN LAETHEM & Dr I. THOMAS

UMC St Peter, Brussels / IPH – Virology, Brussels Yves_Vanlaethem@stpierre-bru.be / ithomas@iph.fgov.be

Influenza viruses are continuously evolving, leading to the appearance of new strains potentially responsible for severe epidemics or even pandemics. In Belgium, clinical and virological surveillance of Influenza is conducted by the National Influenza Centre. This surveillance is based on the existence of a network of sentinel general practitioners (GPs). The objectives of this surveillance are namely rapid detection of epidemics, identification of circulating strains, capacity to detect new subtypes or strains potentially dangerous and follow-up of the evolution of these new viruses. In April 2009, a new Influenza virus A/H1N1 of swine origin emerged in USA and Mexico. This new virus spread rapidly to other continents. On 11 June 2009, WHO raised the pandemic alert phase to the maximum level (phase 6). From 27 April to 13 July, the European politic of containment implied the set up of an active surveillance system for the detection of every cases of A/H1N1 (2009) in travellers returning from affected areas and their close contacts in order to minimize the spread of the virus. On 12 May 2009, the National Reference Laboratory has confirmed the first case of influenza A/H1N1 (2009) in a patient returning to Belgium from the U.S. During this period, 614 samples were analysed among which 130 were found positive for the new strain A/H1N1 (2009). The majority of these cases were imported. On the 13th of July, the Belgian health authorities implemented a mitigation phase during which the laboratory confirmation of all suspected cases was not required anymore. However, the surveillance by the sentinel GPs network was reinforced in order to detect the circulation of the A/H1N1 (2009) in the population. An increasing number of cases were confirmed in the laboratory from week 27 until the start of the epidemic observed during week 39. From week 40, the Influenza Like Illness (ILI) curve continued its ascension. In week 43, the ILI incidence rate was estimated as 717/100.000 inhabitants and the proportion of A/H1N1 (2009) positive swabs ranged from 54 up to 69%. Antigenic and genetic analysis of a representative sample of strains isolated in Belgium did not reveal any significant difference with strains isolated elsewhere in the world. Even if the pathogenicity of the virus appears moderate, higher virulence can appear at any time which implies necessity for careful surveillance of the evolution of this new virus.

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EUCAST CRITERIA AND RECOMANDATIONS: PRACTICAL ASPECTS Dr P. MELIN & Dr J. VAN ELDERE

CHU, Liège / UZ Leuven pierrette.melin@chu.ulg.ac.be / johan.vaneldere@uz.kuleuven.ac.be

EUCAST or European Committee on Antimicrobial Susceptibility Testing http://www.eucast.org Since several years, many microbiologists, pharmacologists and infectiologists were convinced there was an urgent need for a revision and harmonization of antimicrobial susceptibility testing (AST) methods and interpretative criteria. CLSI (U.S.), currently used in Belgium, and the different European national breakpoints were equivoccally based on pharmacokinetic and epidemiological criteria. They could present significant differences between them and, some bad correlations between breakpoints and clinical outcome were shown. Evolving therapeutic indications and practices, emergence of new resistance mechanisms, changing dosages, new pharmacokinetic-pharmacodynamic knowledge, clinical outcome data and determination of MICs distribution for wild type populations, were additional factors to stress the need for revision of interpretative criteria for antimicobial susceptibility testing. The answer came from Europe with the EUCAST creation. EUCAST was initiated in 1997 and harmonized breakpoints for most existing antibacterial drugs have been published and are regularly revised since 2002. EUCAST breakpoints are currently becoming available in devices for automated susceptibility testing. A disk diffusion test calibrated to EUCAST MIC breakpoints has been developed and will be launched by the end of 2009.

In 2008, a symposium dedicated to EUCAST was organized by the SBIMC-BVIKM. Advantages, technical limiting factors, clinical and epidemiological consequences were discussed. At the issue of the symposium by vote, it was decided to switch to EUCAST criteria the 1st of January 2010. A working party was constituted to bring the needed helps to ensure favorable conditions for a successfull switch either to microbiologists, to clinicians or to AST devices/reagents suppliers.

Today, in view of this planned introduction of EUCAST breakpoints in Belgium (1st of January 2010), even if many limiting factors are fading one by one, the inventory of remaining tasks or questions remains important and will be presented during this meeting. What is the actual level of preparation of labs and of AST devices/reagents suppliers? What items are on the checklist of things to do before the switch : update of many documents, update of automated AST systems/expert systems, acquisition of new reagents, paper disks, culture media, quality control strains, training, verification and validation of the new disk diffusion procedure, of the new disks or new AST panels.

Will Belgian labs be ready for the switch the 1st of January 2010 or will it be wiser and more realistic to propose a few-month transition period after the 1st of January.

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QUALITY CONTROL FOR MOLECULAR DIAGNOSTICS: A REVIEW OF THE COLLABORATION IN BELGIUM

Dr P. WALLACE QCMD - Scotland

PaulWallace@qcmd.org

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INVASIVE ASPERGILLOSIS: VALUE OF DIFFERENT DIAGNOSTIC APPROACHES Dr J. MAERTENS

UZ Leuven Johan.maertens@uz.kuleuven.ac.be

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CURRENT PATTERNS OF THE HIV PANDEMIC Dr S. DE WIT

UMC St Peter, Brussels stephane_dewit@stpierre-bru.be

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Q FEVER: SITUATION IN BELGIUM Dr D. FRETIN VAR, Brussels

david.fretin@var.fgov.be

Q fever is a zoonosis which is caused by an obligatory intracellular bacterium Coxiella burnetii. This disease, described for the first time among workers in Australia, is now recognized as being endemic worldwide except in New-Zealand. Multiple hosts can serve as reservoir of infection, including many wild and domestic mammals, birds and ticks. Domestic ruminants (sheep, goats and cattle) are recognized as the main sources of human infection. Inhalation of contaminated aerosols is the primary route of human infection. Parturient products and feces of infected animals are the principal sources of contamination. The diagnostics of Q fever is difficult and epidemiological studies are often based on serological investigations. C. burnetii does not grow on standard laboratory bacteriological media and isolation is long, difficult and hazardous to perform. In addition, it requires biosafety level 3 condition. For humans, the diagnostic is mainly based on serological analysis and the immunofluroescence assay (IFA) remains the most common method used to detect antibodies against C. burnetii. The complementation fixation test and ELISA are the routine tests for serodiagnosis in animals. In Belgium, Q fever is present in domestic ruminants and humans.

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Annexe / Bijlage

LIJST VAN THEMA'S VAN SEMINARIES 1985 – 2009 / LISTE DES THEMES DES SEMINAIRES 1985 – 2009

1985 • Surveillance des maladies infectieuses par un réseau de laboratoires de microbiologie

D. WALCKIERS – IHE, Brussels • Sérotypes, biotypes, sous-types et sensibilité aux antibiotiques de souches d’Haemophilus influenzae responsables

de méningites H. DABERNAT - CHU Toulouse, France

• Surveillance van bacteriële meningitis in Nederland H. ZANEN - Univ. Amsterdam, Nederland

• Paludisme importé en Belgique : incidence, traitement G. VAN ROS - IMT, Antwerpen

• Evolution des Salmonelloses en Belgique de 1975 à 1984 M-L CHASSEUR – LIBOTTE - IHE, Brussels

• Listeria monocytogenes : isolement, identification et techniques d’enrichissement P. ANDRE - IHE, Brussels

• Toepassingen van de computer in het laboratorium ; gebruik van de computer bij de surveillance van ziekenhuisinfecties B. GORDTS - AZ St.-Jan, Brugge

1986 • Aspects bactériologiques des infections nosocomiales, pseudomonas aeruginosa

J. DONY • Etude des souches hospitalières isolées en Belgique

S. HEINEMANN • Relation entre résistance bactérienne et consommation des antibiotiques en milieu hospitalier : conséquences sur la

chimioprophylaxie V. JARLIER - CHU Pitié-Salpêtrière, Paris

• Nationale epidemiologische studie over het perioperatief antibioticagebruik bij heelkundige patiënten R. MERTENS - IHE, Brussels

• Aspecten van preventie, surveillance en controle S. LAUWERS - AZ-VUB, Brussels Y. GLUPCZYNSKI - UCL-Mont-Godinne, Yvoir

1987 • Epidemiologie van Yersinia-infecties in België

J. VANDEPITTE - KUL, Leuven • Le rôle des aliments dans les Yersinioses en Belgique

G. WAUTERS - UCL, Liège • Brucellose bij de mens in België

J. DEKEYSER - INRV, Brussels • E. coli comme agents de gastro-entérite

P. DE MOL – ULB, Brussels • Erythema migrans Borreliosis, clinical picture and epidemiology in the Federal Republic of Germany

R. ACKERMANN - R.F. Allemande • Epidémiologie des infections à Borrelia brugdorferi en Belgique

G. BIGAIGNON - UCL, Brussels • Epidemiologie van AIDS in België

J. DESMYTER - KUL, Leuven

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1988 • Recensement des souches isolées par hémoculture ou dans le L.C.R. par un réseau de laboratoires hospitaliers

français (réseau EPIBAC) V. GOULET - Laboratoire National de la Santé, Paris

• Europese studie over antibiotica-gevoeligheid van isolaties uit bloedkweken L. VERBIST - KUL, Leuven

• Fréquence d’isolement des germes isolés des urines; leur sensibilité aux antibiotiques. Expérience d’un réseau de Laboratoires d’Analyse Médicale privés exerçant en médecine ambulatoire en France M. ARMENGAUD - CHU Purpan, Toulouse

• Is kinkhoest een probleem in België? S. LAUWERS - VUB, Brussels A. DENYS - IPB, Brussels

• Epidémiologie hospitalière des Legionella G. WAUTERS - UCL, Brussels

• Infections nosocomiales à Legionella pneumophila à l’hôpital Erasme : épidémiologie et mesures préventives M. STRUELENS - Hôpital Erasme, Brussels

1989 • Rôle du laboratoire dans la surveillance épidémiologique des maladies infectieuses

A. STROOBANT - IHE, Brussels • Les Groupes Régionaux d’Observation de la Grippe : création d’un système d’alerte précoce à partir du réseau

français de surveillance virologique J.M. COHEN - Observation des Maladies et des Epidémies, Paris

• Voorbeelden van vergelijkend diagnostisch onderzoek in de virologie D. VAN BEERS - UZ Brugmann, Brussels S. PATTYN - UIA, Antwerpen

• Bron- en contactopsporing bij melding infectieziekten K. DE SCHRIJVER - Gezondheidsinspectie Vlaamse Gemeenschap, Antwerpen

• Septiemieën in het ziekenhuis : de situatie in België in 1988 R. MERTENS - IHE, Brussels

• Multi-centrische evalutie van bakteriële resistentie in Belgische ziekenhuizen B. GORDTS - AZ St.-Jan, Brugge

• Open discussie over de antibioticaresistentie in België 1990 • Gevoeligheid voor diverse antibiotica van isolaten uit bloedkweken

L. VERBIST - KUL, Leuven • Evolutie van isolaten uit hemocultuur in AZ-VUB

D. PIERARD - VUB, Brussels • Le médecin hygiéniste à l’hôpital : bilan et perspectives un an après

M. STRUELENS - Hôpital Erasme, Bruxelles • Open discussie : Rol van geneesheren- en verpleegkundige-hygiënisten in ziekenhuisygiëne • Listeria : Identification des différentes espèces. Listériose humaine : situation en France et dans le monde

J. ROCOURT - Institut Pasteur, Paris • Aspects épidémiologiques de la listériose en Belgique

D. ART - IHE, Brussels • Surveillance van pneumokkeninfecties in België en het huidig vaccinatiebeleid

J. VERHAEGEN - KUL, Leuven • Le mystère des vaches folles (un danger pour la population belge?)

E. VANOPDENBOSCH - N.I. Deirgn, Onderz., Brussels

23

1991 • Infections hospitalières par Aspergillus fumigatus : risques de contamination, prévention et typage de souches

N. NOLARD - IHE, Brussels • MRSA - an update B.D. COOKSON - Central Public Health Lab., Div. of Hospital infection, London • MRSA en Belgique

M. STRUELENS - Hôpital Erasme, Brussels • Topics uit hospitaalhygiëne • Epidemiologische informatie via videotex

R. CORNELIS, R. SNACKEN - IHE, Brussels • La brucellose bovine en Belgique : une zoonose pour certaines catégories professionnnelles

J. GODFROID – NIDO, Brussels • La résistance de Haemophilus influenzae : évolution en France et dans le monde

H. DABERNAT - Hôpital Purpan, Toulouse • La résistance de H. influenzae en Belgique : situation 91

E. YOURASSOWSKY - H.U. Brugmann, Brussels • Plasmidotypering bij Salmonella voedselinfecties

M. YDE - IHE, Brussels 1992 • Surveillance des maladies infectieuses en Belgique par un réseau de laboratoires de microbiologie :

développements depuis 1983 et perspectives D. WALCKIERS, G. DUCOFFRE - IHE, Brussels

• Surveillance van acute luchtweginfecties en van griep klinische gegevens en biologische aspecten V. VAN CASTEREN, F. YANE - IHE, Brussels

• Yersinia enterocolitica : situation épidémique actuelle en Belgique et à l'étranger G. WAUTERS, L. DE ZUTTER - UCL, RUG

• Chlamydia pneumoniae, respiratoire pathogeen? A. VAN DEN ABEELE – UZ, Gent

• Nationale registratie van post-operatieve wondinfecties : eerste resultaten uit België en Nederland R. MERTENS - IHE, Brussels J.M. VAN DEN BERG – CBO, Utrecht

• Surveillance des infections des plaies post-opératoires. Suivi du malade après sa sortie : expérience pratique dans un hôpital de 250 lits C. RULOT, F. BARDIAU – Hôp. Civil, Marchienne-au-pont

• Nationale registratie van nosocominiale septicemieën : eerste resultaten G. VERSCHRAEGEN – UZ, Gent

• Une épidémie à Pseudomonas aeruginosa dans une unité de soins intensifs C. POTVLIEGE, J. JONCKHEER - Centre Hosp. Tivoli, La Louvière

1993 • Aspects biologiques et épidemiologiques de la leptospirose

G. BIGAIGNON – UCL, Brussels • Surveillance van de pneumokokkeninfecties in België (incl. epidemiologische aspecten en vaccinatiepolitiek)

J. VERHAEGEN – KUL, Leuven • The Epidemiology of Invasive Haemophilus influenzae disease in England and Wales, pre and post vaccination

N. BEGG – CDSC, London • Invasieve H. influenzae in België. Onderzoek naar de incidentie in de Franse Gemeenschap, 1990 - 1992

F. VAN LOOCK - IHE, Brussels • Surveillance par le Centre de Référence

J. LEVY - CHU-St-Pierre, Brussels • Paneldiscussie : vaccinatieperspectieven i.v.m. H. influenzae en pneumokokken

N. BEGG, F. VAN LOOCK, J. LÉVY • Een epidemische hepatitis A episode in een school. Een case-control onderzoek

D. WILDEMEERSCH - Min. Vlaamse Gemeenschap • Euronis. Pneumonie et hygiène dans les services de soins intensifs en Europe

J. FABRY - Centre Hospitalier, Lyon-Sud

24

1994 • Surveillance van groep A Streptokokken infecties in België

H. GOOSSENS – UZ, Antwerpen • Salmonella enteritidis infecties bij pluimvee en hun zoönotische betekenis

R. DUCATELLE – UG, Gent • Tuberculose : situation de la multirésistance en Belgique

M. WANLIN – FARES, Brussels • La surveillance des infections de la plaie opératoire après la sortie de l'hôpital

O. RONVEAUX - IHE, Brussels • Etiologie van acute luchtweginfecties bij kinderen in het U.Z. Antwerpen tijdens de winterperiode 1992-93

M. IEVEN – UZ, Antwerpen • Registratie van nosocomiale virusinfecties in het ziekenhuis

F. DESMET – VUB, Brussels Short communications : • Stratégies de prévention de maladies transmissibles

S. QUOILIN – IHE, Brussels • Zin en onzin van MRSA-screening bij opneming van een patiënt op een verpleegafdeling

A. BORREMANS – KUL, Leuven • A seroepidemiological study on toxoplasmosis

V. LUYASU - Clin. St. Pierre, Ottignies • Vaccinatiesurveillance door huisartsen

J. VAN DER VEKEN - IHE, Brussels • Hépatite C : épidémiologie et modes de transmission

Ch. FRANÇOIS-GERARD - CHU Sart Tilman, Liège • Epidemiologie van Hepatitis B

P. VAN DAMME – UZ, Antwerpen 1995 • Rage humaine : importance de la surveillance et de la prévention chez l'homme et l'animal

F. COSTY - Institut Pasteur, Brussels • Streptocoques ß-hémolytiques du groupe B : surveillance en Belgique par le laboratoire de référence

P. MELIN – CHU, Liège • Méningocoques : surveillance en Belgique par le laboratoire de référence

F. CARION - IHE, Brussels • Meningokokken : 35 jaar surveillance in Nederland

L. SPANJAARD - AMC, Amsterdam • Infectieziekten : elektronische surveillance in België

F. VAN LOOCK - IHE, Brussels • Infectieziekten : elektronische surveillance van infectieziekten : van instrument tot paradigma

D. COULOMBIER - RNSP, Paris • Malaria : surveillance in België

A. VAN GOMPEL – ITG, Antwerpen • HELICS project : Europese standaardisatie voor de surveillance van nosocomiale infecties

R. MERTENS - IHE, Brussels • Utilisation de la technique PCR (Polymerase Chain Reaction) dans le : diagnostic de la maladie de Lyme : développement d'un système de détection de nouvelle génération

E. GODFROID - ULB, Nivelles diagnostic anténatal de l'infection congénitale à Cytomegalovirus C. LIESNARD - Hôpital Erasme, Brussels diagnostic de la Toxoplasmose congénitale et de la Toxoplasmose généralisée chez le patient immuno-déprimé G. BIGAIGNON – UCL, Brussels • SIDA et infection VIH : épidémiologie en Belgique

E. DECLERCQ - IHE, Brussels • Brucellose : bronopsporing bij meldingen

K. DE SCHRIJVER - Min. Vlaamse Gemeenschap, Antwerpen • Infections à Hantavirus dans la région de Chimay : une étude cas-témoins des risques

I. THOMAS - IHE, Brussels • MRSA : surveillance en preventie in België

M. STRUELENS - Hôpital Erasme, Brussels

25

1996 • Politique vaccinale en Belgique

P. GOUBAU – UCL, Brussels • Vaccinatie : Gegevens van de Vlaamse Gemeenschap

K. HOPPENBROUWERS, F. CAPET, K. BOGAERTS – KUL, Leuven • Vaccination : Couvertures vaccinales en Communauté française

B. SWENNEN – ULB, Brussels • Seroprevalentie van difterieantistoffen in Vlaanderen

C. MATHEÏ, P. VAN DAMME, P. BRUYNSEELS et al. – UIA, Antwerpen • Surveillance van mazelen en bof door de Huisartsenpeilpraktijken, 1994-1995

V. VAN CASTEREN - IHE, Brussels • Surveillance des salmonelles en France et en Europe : tendances récentes

J.C. DESENCLOS, P. BOUVET, V. PIERRE et al. – RNSP, Paris • Encéphalopathies spongiformes chez l’animal et chez l’homme

P.P. PASTORET, C. HAMERS, B. BROCHIER et al. – Ulg, Liège • Surveillance des infections en Unités de Soins Intensifs : principes et méthodes

G. HANIQUE – UCL, Brussels • Modalités et coût de la prophylaxie antibiotique chirurgicale en Belgique

O. RONVEAUX, A. SASSE, J.P. SION et al - IHE, Brussels • Is er een toename van de multiresistente tuberculosebacterie in België?

M. UYDEBROUCK, M. WANLIN, M. DUFAUX et al. – VRGT, Brussels • Nationale GOSPIZ surveillance studie naar Glycopeptide-Resistente Enterokokken (GRE)

B. GORDTS - AZ St.-Jan, Brugge • Glycopeptide-Resistente Enterokokken (GRE) : gegevens van het Referentielaboratorium

H. GOOSSENS, P. DESCHEEMAEKER, G. IEVEN – UZ, Antwerpen • Infections intrahospitalières à Klebsiella pneumoniae productrices de β-lactamases à spectre élargi

P. DE MOL – CHU, Liège • Resistentie-opsporing bij gisten : hoe, wanneer en waarom ?

I. SURMONT - AZ H. Hart, Roeselare • Uitbraak van mazelen in de Antwerpse Kempen bij scholieren uit het secundair onderwijs voorjaar 1996

K. DE SCHRIJVER - Min. Vlaamse Gemeenschap, Antwerpen 1997 • Overzicht van recentelijk getypeerde humane herpesvirussen

M. VAN RANST – UZ, Leuven • E. coli O157:H7 en adere VTEC : epidemiologie in België

D. PiERARD – AZ, Brussels • HIV screeningtest : vigilanceprogramma in België

J.-C. LIBEER – IPH, Brussels • Influenza : le risque pandémique

R. SNACKEN – IPH, Brussels • Evaluatie van het gebruik van mengsels van monoclonalen voor detectie van respiratoire virussen

M. IEVEN – AZ, Antwerpen • N. meningitidis : peut-on parler d’épidémie de méningite?

F. CARION – IPH, Brussels • Impact de la vaccination sur les infections invasives à H. influenzae b

J. LEVY – CHU, Brussels • S. pyogenes (G.A.S.) : moleculaire epidémiologie in België

P. DESCHEEMAEKER – UIA, Antwerpen • Apport européen dans la lutte contre les maladies transmissibles : apports et limites de l’action communautaire

L. CHAMBAUD – DGV, Luxembourg • MRSA in rustoorden voor bejaarden en rust- en verzorgingstehuizen

L. NICLAES – ACHG, Leuven • Surveillance des toxi-infections d’origine alimentaire en Belgique

G. DAUBE – MDAOA, Liège

26

1998 • Nosocomial infections in intensive care : results from the Belgian national surveillance, 1996-1998

C. SUETENS - IPH, Brussels • Surgical site infections : surveillance after discharge from the hospital

E. GEUBBELS - RIVM, Bilthoven • Surveillance of antibiotic resistance : which strategies for which objectives?

M. STRUELENS - Hôpital Erasme, Brussels • Viral infections of the C.N.S. : Epidemiological and clinical aspects

P. CRAS - UZ, Antwerpen • Role of the virology laboratory

C. LIESNARD - UZ, Antwerpen • Chlamydia pneumoniae : review and possible link with arteriosclerosis?

M. IEVEN - UZ, Antwerpen • Lessons to be learned from the Bird Flu in Hong Kong in 1997

R. SNACKEN - IPH, Brussels • Contribution of the search for anti-Bartonella henselae antibodies in the diagnosis of the cat scratch disease in

Belgium G. BIGAIGNON - UCL, Brussels

• Cyclospora cayetanensis : diagnosis and situation in Belgium T. CRUCITTI - IPH, Brussels

• Salmonella enteritidis : outbreak investigation in Belgium, January 1998 O. RONVEAUX - IPH, Brussels

• Notification of Communicable Diseases F. VAN LOOCK - IPH, Brussels

1999 • Surveillance of catheter related infections in neonates

L. MAHIEU - UZ, Antwerpen • Catheters with antiseptics or antibiotics : new techniques

P. DAMAS - CHU, Liège • Antiseptics and skin disinfection

G. REYBROUCK - UZ, Leuven • Meningitis : current concepts on spread and prevention

F. VAN LOOCK - IPH, Brussels • B.S.E. and new variant C.J.D. : surveillance and situation in Belgium

P.-P. PASTORET - ULg, Liège • A community outbreak of legionnaires’ disease in a Belgian hotel

S. QUOILIN - IPH, Brussels • Helicobacter pylori : disease, diagnosis, treatment and resistance

Y. GLUPCZYNSKI - UCL, Mont-Godinne - Yvoir • Management of acute sore throat in general pratice : W.V.V.H. – guideline

M. DE MEYERE - UZ, Gent • Management of acute sore throat in general pratice : results of a registration poject

J. VAN DER HEYDEN - IPH, Brussels

27

2000 • Meat contamination by Salmonella, Campylobacter, Y. enterocolitica and EHEC O157 in Belgium

G. DAUBE - ULg, Liège • Antimicrobial resistance of Salmonella and Campylobacter isolated from pig and poultry samples

H. GOOSSENS - UZ, Antwerpen • Salmonella enteritidis still increasing : why?

F. VAN LOOCK - IPH, Brussels • Legionella infections : outbreak at a fair in Kapellen (1999)

K. DE SCHRIJVER - Min. Vlaamse Gemeenschap, Antwerpen • Legionella infections : microbiological diagnosis

S. LAUWERS - AZ-VUB, Brussels • Legal trends in the lab : consequences of privacy protection and human biological material

S. WALLYN - IPH, Brussels • Vaccination coverage in Flanders (1999)

A. VELLINGA - IPH, Brussels • N. meningitidis : recent trends of serodroup C meningococcal disease

F. CARION - IPH, Brussels • M.R.S.A. : should we fear ‘total’ antibiotic resistance?

M. STRUELENS - Hôp. Erasme, Brussels • M.R.S.A. : incidence in Belgian hospitals after introduction of national guidelines

B. JANS - IPH, Brussels • Impact of the reimbursement system on prescribing practices : results at national level

H. GOOSSENS - UZ, Antwerpen • Impact of the reimbursement system on prescribing practices : results of the ESAP study

H. CARSAUW - IPH, Brussels

2001 • Diagnosis of Clostridium difficile infections

M. DELMEE - UCL, Brussels • Microbiological diagnosis of B. pertussis

D. POTTERS - AZ-VUB, Brussels • M.R.S.A. in acute care facilities and nursing homes

A. SCHUERMANS - UZ, Leuven • Evolution of nosocomial septicemia in Belgium : results of the national surveillance, 1992-2001

C. SUETENS - IPH, Brussels • Enteroviral meningitis

M. VAN RANST - UZ, Leuven • Development of infections disease surveillance in the EU

F. VAN LOOCK - IPH, Brussels • Control of Antimicrobial Resistance : initiatives of the European Society for Clinical Microbiology and Infectious

Diseases M. STRUELENS - Hôp. Erasme, Brussels

• European Antimicrobial Resistance Surveillance System in Europe and Belgium : organisation, results and perspectives E. HENDRICKX - IPH, Brussels

• Recent trends in European surveillance of travel associated Legionnaire’s Disease C. JOSEPH - CDSC, London

• Neisseria gonorrhoeae : from Belgium with love M.VAN ESBROECK - ITG, Antwerpen

• Trends in diagnoses of HIV/AIDS based on surveillance data in Belgium, 1985-2000 A. SASSE - IPH, Brussels

• Preventing perinatal group B streptococcal disease : a Belgian public health perspective P. MELIN - CHU, Liège

• Obstetricians’ compliance with CDC guidelines on perinatal group B Streptococcus prevention in the Flanders L. MAHIEU - UZ, Antwerpen

• Recent data on BSE and vCJD, BSE testing and geographical BSE risk E. VANOPDENBOSCH - CODA, Brussels

• Syphilis outbreak in Antwerp, 2001 K. DE SCHRIJVER - Min. Vlaamse Gemeenschap, Antwerpen

28

2002 • Usefulness of real-time PCR in the diagnosis of infections diseases

C. LIESNARD - Hôpital Erasme, Brussels • Sexual transmission of Cytomegalovirus : underevaluation of the risk in women in childbearing age

C. LIESNARD - Hôpital Erasme, Brussels • Prevention of congenital toxoplasmosis

A. NAESSENS - AZ-VUB, Brussels • Norwalk-like Caliciviruses, Rotaviruses and Hepatitis A virus, three food-borne viruses : risks, detection methods and

Belgian status A. SCIPIONI - ULg, Liège

• Metapneumovirus : epidemiology in Holland A. OSTERHAUS - Erasmus University, Rotterdam

• Terrorism, health aspects and Belgian policy J.P. DERCQ - Ministry of Public Health, Brussels

• Malaria – Update : diagnosis, treatment, vaccination A. VAN GOMPEL - ITG, Antwerpen

• Conjugate pneumococcal vaccine J. LEVY - CHU-St-Pierre - Brussels

• Promotion of appropriate use of antimicrobial therapy in the hospital M. STRUELENS - Hôpital Erasme, Brussels

• Antibiotic consumption in humans and animals H. GOOSSENS - UIA, Antwerpen

• Community-acquired pneumonia : diagnosis and epidemiology G. IEVEN - UIA, Antwerpen

• Results of the national surveillance of MREA, 2000 microbiological data Y. DE GHELDRE - UCL-Mont-Godinne, Yvoir

• Multi-resistant Enterobacter aerogenes (MREA) in Belgian hospitals, 2000-2001 B. JANS - IPH, Brussels

• Aspergillus fumigatus : how to avoid nosocomial problems G. VERSCHRAEGEN - RUG, Gent

• National surveillance of nosocomiol infections in intensive care C. SUETENS - IPH, Brussels

2003 • Salmonella : outbreaks and recent trends

J.M. COLLARD – IPH, Brussels • Salmonella : assessment and control of risks

M. HEYNDRICKX – CLO-DVK, Melle • Centers for Molecular Diagnoses : a unique national project

H. GOOSSENS – UIA, Antwerpen • Surveillance of surgical site infections

H. CARSAUW – IPH, Brussels • Epidemiology of antibiotic resistance in Europe : is there a relationship with the levels and patterns of antibiotic use?

D. MONNET – Statens Serum Institut, Copenhagen • Vaccination against N. meningitidis group C

J. LEVY – CHU-St-Pierre, Brussels • Multigenotypic analysis of bacterial genome by micro-array : diagnostic and epidemiologic contribution

J.L. GALA – UCL and Ministry of National Defense, Brussels • Severe Acute Respiratory Syndrome (SARS) : virology, epidemiology and diagnosis

M. VAN RANST – UZ, Leuven • Public health authorities response to SARS threat

R. SNACKEN – IPH, Brussels • Staff protection in case of viral infections : some examples

E. VAN WIJNGAERDEN – UZ, Leuven • Surveillance of STI

G. HANQUET – IPH, Brussels • Molecular epidemiology and antimicrobial susceptibility of MRSA in Belgian hospitals, 1995 - 2001

O. DENIS – Hôpital Erasme, Brussels

29

2004 • Sentinel Laboratory Network (SLN) : contribution to the national and international surveillance

G. DUCOFFRE & G. HANQUET – IPH, Brussels • Estimation of the national representativeness of the SLN

H. VANDENBERGHE – IPH, Brussels • Present usefulness of the SLN and perspectives for the French Community

Y. PIRENNE – French Community, Liège • SLN and Health Inspection : a successful collaboration

K. DE SCHRIJVER – Min. Vlaamse Gemeenschap, Antwerpen • The Dutch SLN : getting to the borrom of infectious disease surveillance

A. BOSMAN – RIVM, Bilthoven • The European Centre for Disease Prevention and Control : concepts and challenges

F. VAN LOOCK – European commission, Luxembourg • MRSA guidelines : from theory to practice

P. DE MOL – CHU, Liège • Epidemiology of human Norovirus infections in Europe

M. KOOPMANS – RIVM, Bilthoven • Vaccine preventable diseases in the process of elimination in Europe

T. LERNOUT – IPH, Brussels • Which methods to use for the diagnosis of ESBL – producing organisms in the year 2004

Y. GLUPCZYNSKI – UCL, Yvoir • Evolution of antibiotic resistance in veterinary medicine and its impact on human health

P. BUTAYE – CODA-CERVA, Brussels

2005

• S. pneumoniae : recent trends J. VERHAEGEN – UZ, Leuven

• Tuberculosis and mycobacterioses : the place of molecular techniques in laboratory diagnosis M. FAUVILLE-DUFAUX – IPH, Brussels

• Multidrug resistant tuberculosis in Belgium A. AERTS – VRGT, Brussels

• Community-acquired MRSA : an emerging pathogen in Belgium O. DENIS – Hôpital Erasme, Brussels

• CJD : recent developments in prion diseases J. IRONSIDE – University of Edinburgh

• CJD : risk of transmission in hospitals P. CRAS – UZ, Antwerpen

• Hand hygiene promotion campaign : the results A. SIMON – UCL, Brussels

• West Nile virus in France 2000-2005 : multi-disciplinary collaboration for multi-species surveil lance and investigations A. MAILLES – InVS, Paris

• Preventing perinatal group B streptococcal disease : update and Belgian guidelines P. MELIN – CHU, Liège

• The battle against antimicrobial resistance and nosocomial events : implementation of a new European initiative in Belgium E. HENDRICKX & C. SUETENS – IPH, Brussels

• The complexity of food poisoning illustrated by some cases K. DIERICK – IPH, Brussels

• Scabies : diagnosis, management and epidemiology L. DE RAEVE – AZ-VUB, Brussels

30

2006

• Rotavirus: epidemiology and new vaccines J. LEVY – UMC St Peter, Brussels

• Enterohemorrhagic E. coli O157 and other serotypes: occurrence in Belgium in humans, animals and food

D. PIERARD – AZ VUB, Brussels & L. DE ZUTTER – Ugent • Two outbreaks of shigatoxin producing E. coli in France

H. DE VALK – InVS, Paris • New epidemic clones of Clostridium difficile: situation in Belgium

M. DELMEE – UCL, Brussels • Rapidly spreading of Clostridium difficile PCR Ribotpe O27, Toxinotype III in the Netherlands and Europe

E. KUIJPER – LUMC, Leiden • Influenza pandemic: is Belgium ready?

Y. VAN LAETHEM – UMC St Peter, Brussels • Surveillance of H5N1 in birds

T. VAN DEN BERG – CERVA, Brussels • Rapid antigen detection: bacteriological aspects

H. RODRIGUEZ – VILLALOBOS – Höpital Erasme, Brussels • Rapid antigen detection: virological aspects

P. GOUBAU – UCL, Brussels • Prevention and control of infections in nursing homes

B. JANS – IPH, Brussels

2007 • Legionella pneumophila: current diagnostic and therapeutic aspects

G. IEVEN – UZ, Antwerpen • Pneumococcal Disease: serotype and molecular epidemiology in relation to disease potential and vaccine coverage

B. HENRIQUES – Swedisch Institute for Infectious Disease Control, Stockholm • Invasive Pneumococcal Disease in children: Belgian epidemiology after introduction of the 7-valent vaccine

G. HANQUET – IPH, Brussels • Recent outbreaks and emerging trends of specific M types of S. pyogenes in Belgium

H. GOOSSENS – UZ, Antwerpen • STIs: diagnostic and clinical implications of recent epidemiology

T. CRUCITTI & M. VANDENBRUAENE – ITG, Antwerpen • HPV: novel vaccines for an old virus

M. VAN RANST – UZ, Leuven • Climate change and impact on infectious diseases

E. LAMBIN – UCL, Brussels • Lyme borreliosis: epidemiology, clinical aspects and laboratory diagnosis

K. LAGROU – UZ, Leuven • ESBL: screening and recommendations for detection

Y. GLUPCZYNSKI – UCL Mont-Godinne, Yvoir • Pigs, an emerging reservoir for MRSA?

O. DENIS – Hôpital Erasme, Brussels

31

2008

• Vaccine prevention of varicella zoster virus Dr M. VAN RANST – UZ, Leuven

• Measles in Belgium, not eliminated yet: description of an outbreak in orthodox Jewish communities in Antwerp Dr G. TOP – Flemish Community, Brussels

• Pertussis: epidemiology and diagnosis; recent CSS-HGR recommendations for vaccination and prevention Dr A. MALFROOT – UZ, Brussel

• Spin-off projects of the European Antimicrobial Resistance Surveillance System (EARSS) Dr M. de Kraker – RIVM, Bilthoven

• Prevalence of ESBLs among fecal E. coli from broiler chickens and the possible transmission to human bacteria Ir A. SMET – VAR, Brussels / UGent

• Nationwide investigation into the prevalence of hospital infections Dr B. GORDTS – AZ St.-Jan, Bruges

• Vector-borne diseases in a changing world: actual and potential risk of mosquito born diseases in Belgium Dr W. VAN BORTEL – ITM, Antwerp

• Chikungunya: questions for surveillance of emerging arbovirosis in oversea territories and continental France Dr D. DEJOUR SALAMANCA – InVS, Saint-Maurice

• Hepatitis A in Belgium: epidemiology and cost-effective¬ness of options for vaccination Dr P. BEUTELS – University of Antwerp

• Molecular epidemiology of tuberculosis in Belgium Dr M. FAUVILLE-DUFAUX – IPH, Brussels

2009

• Antimicrobial use and resistance at the individual patient level – the IARG study Dr B. CATRY – IPH, Brussels

• Emergence of transferable carbapenemases in Gram-negative bacteria: a new major resistance threat Dr Y. GLUPCZYNSKI – UCL Mont-Godinne, Yvoir

• Clostridium difficile: surveillance in the Belgian hospitals Dr M.L. LAMBERT – IPH, Brussels

• 25 years of sentinel labs: from local to European approach Dr S. QUOILIN – IPH, Brussels

• H1N1: hpw to deal in lab and clinic with a new threat Dr Y. VAN LAETHEM – UMC St Peter, Brussels & Dr I. THOMAS – IPH, Brussels

• EUCAST recommandations: practical aspects Dr P. MELIN – CHU, Liège & Dr J. VAN ELDERE – UZ, Leuven

• Quality assessment in Molecular Infectious Diseases: where have we come from? Where are we going? Dr P. WALLACE – QCMD, Scotland

• Invasive aspergillosis: value of different diagnostic approaches Dr J. MAERTENS – UZ, Leuven

• Current patterns of the HIV pandemic Dr S. DE WIT – UMC St Peter, Brussels

• Q fever: situation in Belgium Dr D. FRETIN – VAR, Brussels

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