Susan van den Hof

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Recently, two Dutch hospitals reported outbreaks of Clostridium difficile ribotype 027, toxinotype III. This strain, which was seen earlier in the United States, Canada and the United Kingdom, produces large amounts of toxins due to a defect in the toxin-regulating gene and causes severe diarrhoea. Antibiotic use, especially use of fluoroquinolones, is a(More)
In 1999, an outbreak of Legionnaires' disease affected many visitors to a flower show in the Netherlands. To identify the source of the outbreak, we performed an environmental investigation, as well as a case-control study among visitors and a serologic cohort study among exhibitors to measure exposure to possible sources. Of 77,061 visitors, 188 became ill(More)
Healthcare workers (HCWs) are at increased risk of exposure to tuberculosis (TB). Traditionally, screening for latent TB infection (LTBI) is done using the tuberculin skin test (TST). Interferon-gamma release assays (IGRAs) are now increasingly being used for diagnosis of LTBI, but their role in HCW screening is unclear. A systematic review was conducted of(More)
BACKGROUND The emergence of drug-resistant tuberculosis (TB) hampers TB control. Ten provinces in China performed drug resistance surveys among tuberculosis (TB) patients in 1996-2004 to assess levels of drug resistance. METHODS Provincial drug resistance surveys included all isolates from newly diagnosed, smear-positive TB patients. Drug susceptibility(More)
In the Dutch surveillance for surgical site infections (SSIs), data from 70277 orthopaedic procedures with 1895 SSIs were collected between 1996 and 2003. The aims of this study were: (1) to analyse the trends in SSIs associated with Gram-positive and Gram-negative bacteria; (2) to estimate patient-related risk factors for deep and superficial SSIs after(More)
BACKGROUND After reports of emerging outbreaks in Canada and the United States, Clostridium difficile-associated disease (CDAD) due to polymerase chain reaction ribotype 027 was detected in 2 medium-to-large hospitals in The Netherlands in 2005. METHODS National surveillance was initiated to investigate the spread and the epidemiology of CDAD.(More)
Clostridium difficile-associated diarrhoea (CDAD) presents mainly as a nosocomial infection, usually after antimicrobial therapy. Many outbreaks have been attributed to C. difficile, some due to a new hyper-virulent strain that may cause more severe disease and a worse patient outcome. As a result of CDAD, large numbers of C. difficile spores may be(More)
OBJECTIVE To examine the association between hospital operation volume and surgeon operation volume and the risk of surgical site infection (SSI). DESIGN Prospective, multicenter cohort study based on surveillance data. METHODS Data were obtained from the Dutch surveillance network for nosocomial infections (Preventie Ziekenhuisinfecties door(More)
In 1999-2000, a measles epidemic occurred in The Netherlands, with 3292 reported cases; 94% of the affected patients had not been vaccinated. Only 1 patient had received 2 doses of vaccine. Three patients died, and 16% had complications. For the unvaccinated population, the incidence per 1000 inhabitants 15 months to 14 years old increased from 83 (95%(More)
OBJECTIVE To compare the number of surgical site infections (SSIs) registered after hospital discharge with respect to various surgical procedures and to identify the procedures for which postdischarge surveillance (PDS) is most important. DESIGN Prospective SSI surveillance with voluntary PDS. Recommended methods for PDS in the Dutch national nosocomial(More)