RESUMEN
In Germany, there is an increasing amount of vancomycin-resistant Enterococcus faecium (VREfm) isolates in bloodstream infections (BSIs); however, estimates on recent incidences and disease burden are missing. We aim to estimate the incidence and calculate the annual disease burden in disease-adjusted life years (DALYs) for BSIs due to VREfm in Germany between 2015 and 2020 to support informed decision-making in the field of antimicrobial resistance (AMR). We used the Antibiotic Resistance Surveillance (ARS) system data to obtain incidence estimates. The estimated incidences were used in the Burden of Communicable Disease in Europe (BCoDE) toolkit to calculate the attributable DALYs. A total of 3417 VREfm blood culture-positive isolates were observed within ARS. The estimated incidence of VREfm-BSIs per 100,000 inhabitants increased from 1.4 (95% Uncertainty Interval [UI]: 0.8−1.9) in 2015 to 2.9 (95% UI: 2.4−3.3) in 2020. The estimated burden, expressed in DALYs per 100,000 inhabitants, increased from 8.5 (95% UI: 7.3−9.7; YLD = 0.9, YLL = 7.6) in 2015 to 15.6 (95% UI: 14.6−16.6; YLD = 1.6, YLL = 14) in 2020. The most affected groups within the observed period are the 65−69-year-old males with 262.9 DALYs per 100,000 inhabitants, and in the younger age groups (<30 years), the under-one-year-old with 43.1 DALYs per 100,000 inhabitants and 34.5 DALYs for male and female, respectively. The increasing DALYs of BSIs due to VREfm require targeted prevention and control measures to address their unequal distribution across gender and age, especially for older hospitalized patients, neonates, and infants in Germany.
RESUMEN
OBJETIVOS: descrever o processo de adaptação cultural para o Brasil do Módulo Genérico DISABKIDS para Condicões Crônicas (DCGM-37), um instrumento genérico para mensuração da qualidade de vida de crianças e adolescentes com condições crônicas. MÉTODOS: estudo metodológico, transversal, conduzido em ambulatórios pediátricos brasileiros, incluindo 118 crianças/adolescentes com asma ou diabetes e seus pais/cuidadores. Os processos de tradução-retrotradução e adaptação cultural foram realizados visando a obter equivalência conceitual e semântica em nível de itens. A equivalência de medida foi avaliada por análise estatística, realizada para descrição das propriedades psicométricas iniciais, segundo os critérios de validade e confiabilidade. RESULTADOS: a maioria dos itens foi considerada relevante e 14 deles foram modificados após a fase de validação semântica. Valores para a estatística alfa de Cronbach foram α=0,92 e α=0,93, para a versão crianças/adolescentes e pais/cuidadores respectivamente. A análise das correlações entre itens e dimensões mostrou validade convergente e discriminante satisfatórias. CONCLUSÕES: a fase inicial indica que o instrumento deverá constituir ferramenta válida e confiável para mensuração da qualidade de vida na realidade brasileira.
OBJECTIVES: to describe the process of cultural adaptation to Brazil Generic Module DISABKIDS for Chronic Conditions (DCGM-37), a generic instrument for measuring the quality of life of children and adolescents with chronic conditions. METHODS: a cross-cutting methodological study was carried out in pediatric outpatients clinics in Brazil, covering 118 children/adolescents with asthma or diabetes and their parents or carers. Translation, back-translation and cultural adaptation were carried out to obtain conceptual and semantic equivalence at the level of individual items.Equivalence was measured statistically by describing the initial psychometric properties, using validity and reliability criteria. RESULTS: most of the items were considered relevant and 14 of them were modified following the semantic validation phase. Values for Cronbach's alpha were α=0.92 and α=0.93, for the version for children and adolescents and the version for parents and carers, respectively. Analysis of correlations between items and dimensions revealed a satisfactory degree of convergent and discriminant validity. CONCLUSIONS: the initial phase indicates that DISABKIDS module is a valid and reliable tool for measuring quality of life in a Brazilian context.