The incidence of laboratory-confirmed cases of enteric pathogens in Denmark 2018: a national observational study.

BACKGROUND: Only a subset of enteric pathogens is under surveillance in Denmark, and knowledge on the remaining pathogens detected in acute gastroenteritis is limited. Here, we present the one-year incidence of all enteric pathogens diagnosed in Denmark, a high-income country, in 2018 and an overview of diagnostic methods used for detection. METHODS: All 10 departments of clinical microbiology completed a questionnaire on test methods and provided 2018-data of persons with positive stool samples with Salmonella species, Campylobacter jejuni/coli, Yersinia enterocolitica, Aeromonas species, diarrheagenic Escherichia coli (Enteroinvasive (EIEC), Shiga toxin-producing (STEC), Enterotoxigenic (ETEC), Enteropathogenic (EPEC), and intimin-producing/attaching and effacing (AEEC)), Shigella species., Vibrio cholerae, norovirus, rotavirus, sapovirus, adenovirus, Giardia intestinalis, Cryptosporidium species, and Entamoeba histolytica. RESULTS: Enteric bacterial infections were diagnosed with an incidence of 229.9 cases/100,000 inhabitants, virus had an incidence of 86/100,000 and enteropathogenic parasites of 12.5/100,000. Viruses constituted more than half of diagnosed enteropathogens for children below 2 years and elderly above 80 years. Diagnostic methods and algorithms differed across the country and in general PCR testing resulted in higher incidences compared to culture (bacteria), antigen-test (viruses), or microscopy (parasites) for most pathogens. CONCLUSIONS: In Denmark, the majority of detected infections are bacterial with viral agents primarily detected in the extremes of ages and with few intestinal protozoal infections. Incidence rates were affected by age, clinical setting and local test methods with PCR leading to increased detection rates. The latter needs to be taken into account when interpreting epidemiological data across the country.

Opportunistic screening of young men for urogenital Chlamydia trachomatis infection in general practice.

Chlamydia trachomatis is a widespread, sexually transmitted infection causing pelvic inflammatory disease, infertility, ectopic pregnancy and chronic pelvic pain among women. Asymptomatic infections among men contribute significantly to maintaining the spread of the infection. In a 1-y intervention study in general practices we aimed to evaluate an opportunistic screening programme targeting 16-25-y-old men. When the young men saw their general practitioner (GP) for the first time during the intervention y, they were offered a test for C. trachomatis based on a first catch urine sample. Main outcome measures were percentage of tested men and prevalence of infection in the intervention practices compared with the test activity in the rest of the county during the intervention y and the y before. GPs in the intervention practices saw 617 (75.6%) of the 814 registered young men during the intervention period. Screening was offered to 300 (48.6%) and 219 (26.9% of the target population) accepted the invitation. The prevalence of infection among screened men was 5.0%. We conclude that opportunistic screening for urogenital C. trachomatis infection in general practice is feasible.