WorldCat Identities

Spiteri, Gianfranco

Works: 8 works in 14 publications in 1 language and 54 library holdings
Roles: Editor
Publication Timeline
Most widely held works by Gianfranco Spiteri
Annual epidemiological report reporting on 2009 surveillance data and 2010 epidemic intelligence data( Book )

6 editions published in 2011 in English and held by 46 WorldCat member libraries worldwide

And conclusions -- Introduction -- Epidemiology of communicable diseases in Europe, 2009. Respiratory tract infections; Sexually transmitted infections, including HIV and blood-borne viruses; Food- and waterborne diseases and zoonoses; Emerging and vector-borne diseases; Vaccine-preventable diseases; Antimicrobial resistance and healthcare-associated infections -- Annual threat report: Analysis of potential communicable disease threats to public health in the European Union, 2010 -- Annex List of communicable diseases for EU surveillance
Sexually transmitted infections in Europe 2013( Book )

2 editions published in 2015 in English and held by 2 WorldCat member libraries worldwide

Sexually transmitted infections (STI) are a significant global burden. It is estimated that each year 146 million persons acquire Chlamydia trachomatis infection, 51 million get gonorrhoea, and 5 million contract syphilis worldwide. Apart from the burden of acute infection, STI may cause complications: chlamydia and gonorrhoea can lead to pelvic inflammatory disease and infertility among women, whereas syphilis in pregnant women can cause devastating consequences through congenital syphilis; STI also increase the risk for HIV acquisition. This ECDC surveillance report on STI in Europe describes the epidemiological features and basic trends of the five STI under EU surveillance, Chlamydia trachomatis infection, gonorrhoea, syphilis, congenital syphilis, and lymphogranuloma venereum. It covers the years 2004 to 2013
Is the tide turning again for cephalosporin resistance in Neisseria gonorrhoeae in Europe? results from the 2013 European surveillance( )

1 edition published in 2015 in English and held by 1 WorldCat member library worldwide

Background: The emerging resistance to the extended-spectrum cephalosporins (ESCs) in Neisseria gonorrhoeae together with increasing incidence of gonorrhoea cases in many countries have been global public health concerns. However, in recent years the levels of ESC resistance have d ecreased in several regions worldwide. We describe the European Gonococcal Antimicrobia l Surveillance Programme (Euro-GASP) data from 2013, and compare them to corresponding data from 2009 - 2012. Methods: During 2013, N. gonorrhoeae isolates from 21 participating countries were examined. Antimicrobial susceptibility testing (Etest or agar dil ution) was performed for cefixime, ceft riaxone, ciprofloxacin, azithromycin, spectinomycin and gentamicin. Statisti cal analyses were performed to identi fy significant cha nges in resistance between years and to investigate associations between patients with resistant gonococcal isolates and collected epidemiological variables. Results: In total, 93 (4.7 %) of 1994 isolates displayed resistance to cefixime, representing an increase compared to the 3.9 % detected in 2012 (p = 0.23). Cefixime resistance was detected in 13 (61.9 %) of the 21 countries. Cefixime resistance among men who have sex with men was on ly 1.2 %, compared to 5.6 % and 6.1 % in females and male heterosexuals, respectively. The un ivariate analysis confirmed that isolate s resistant to cefixime were more likely to be from females (OR 4.87, p < 0.01) or male heterosexuals (OR 5.32, p < 0.01). Seven (0.4 %) isolates displayed ceftriaxone resistance (in addition to cefixime resist ance) compared to three and 10 isolates in 2012 and 2011, respectively. All 93 isolates with cefixi me resistance were additionally resist ant to ciprofloxacin and 16 (17.2 %) were also resistant to azithromycin. Among all tested isolates (n = 1994), the ciprofloxacin resistance level (52.9 %) was higher than in 2012 (50.1 %; p = 0.08), and azithromycin res istance (5.4 %) increased since 2012 (4.5 %; p = 0.16). Conclusions: In 2013, the ESC resistance was again slightly increa sing in Europe. This emphasises the importance of implementing the actions outlined in the European and additional response plans, particularly activities strengthening the surveillance of antimicrobial resistance. Ceftriaxone combined with azithromycin remains a satisfactory option for the first-line treatment of gonorrhoea. However novel antimicrobials (new derivatives of previously developed antimicrobials or newly developed antimicrobials) for effective monotherapy or at least inclusion in new dual antimicrobial therapy regimens (combined with previously developed antimicrobials or novel antimicrobials) will likely be required
Risk factors for antimicrobial-resistant Neisseria gonorrhoeae in Europe( )

1 edition published in 2004 in English and held by 1 WorldCat member library worldwide

Background: The European Gonococcal Antimicrobial Surveillance Programme performs antimicrobial resistance surveillance and is coordinated by the European Centre for Disease Prevention and Control. This study used epidemiological and behavioral data combined with the gonococcal susceptibility profiles to determine risk factors associated with harboring resistant gonococci in Europe. Method: From 2009 to 2011, gonococcal isolates from 21 countries were submitted to the European Gonococcal Antimicrobial Surveillance Programme for antimicrobial susceptibility testing. Patient variables associated with resistance to azithromycin, cefixime, and ciprofloxacin were identified using univariate and multivariable logistic regression analyses of odds ratios. Geometric means for ceftriaxone and cefixime minimum inhibitory concentrations (MICs) were compared for patients of different sexual orientation and sex. Results: A total of 5034 gonococcal isolates were tested from 2009 to 2011. Isolates exhibiting resistance to cefixime (MIC > 0.125 mg/L) and ciprofloxacin (MIC > 0.5 mg/L) were significantly associated with infection in heterosexuals (males only for ciprofloxacin), older patients (>25 years of age), or those without a concurrent chlamydial infection in the multivariable analysis. The geometric mean of cefixime and ceftriaxone MICs decreased from 2009 to 2011, most significantly for men who have sex with men, and isolates from male heterosexuals exhibited the highest MICs in 2011. Conclusion: The linking of epidemiological and behavioral data to the susceptibility profiles of the gonococcal isolates has allowed those at higher risk for acquiring antimicrobial resistant Neisseria gonorrhoeae to be identified. Improved data numbers and representativeness are required before evidence-based risk groups can be identified, and subsequent focused treatments or public health intervention strategies can be initiated with confidence
Annual epidemiological report 2011 : reporting on 2009 surveillance data and 2010 epidemic intelligence data( Book )

1 edition published in 2011 in English and held by 1 WorldCat member library worldwide

This report presents the analysis of surveillance data reported for 2009 by the 27 EU Member States and three EEA/EFTA countries, as well as an analysis of threats detected in 2010. It is targeted towards policymakers, epidemiologists and the wider public and aims to provide an overview of the key aspects of communicable diseases in the European Union. The report describes areas where a more concerted public health response is required in order to decrease the present and future burden of communicable disease on society and healthcare systems. The data presented here further contributes to ECDC’s task of providing the evidence-base for public health action. Although the quality and comparability of reported data has improved considerably since the establishment of ECDC, the reader is still cautioned against making direct comparisons of the presented data between countries. Surveillance systems differ widely, and the relationship between reported confirmed case rates and actual incidence varies from country to country for many diseases
Public health surveillance of multidrug-resistant clones of Neisseria gonorrhoeae in Europe : a genomic survey( )

1 edition published in 2018 in English and held by 1 WorldCat member library worldwide

Background Traditional methods for molecular epidemiology of Neisseria gonorrhoeae are suboptimal. Whole-genome sequencing (WGS) offers ideal resolution to describe population dynamics and to predict and infer transmission of antimicrobial resistance, and can enhance infection control through linkage with epidemiological data. We used WGS, in conjunction with linked epidemiological and phenotypic data, to describe the gonococcal population in 20 European countries. We aimed to detail changes in phenotypic antimicrobial resistance levels (and the reasons for these changes) and strain distribution (with a focus on antimicrobial resistance strains in risk groups), and to predict antimicrobial resistance from WGS data. Methods We carried out an observational study, in which we sequenced isolates taken from patients with gonorrhoea from the European Gonococcal Antimicrobial Surveillance Programme in 20 countries from September to November, 2013. We also developed a web platform that we used for automated antimicrobial resistance prediction, molecular typing ( N gonorrhoeae multi-antigen sequence typing [NG-MAST] and multilocus sequence typing), and phylogenetic clustering in conjunction with epidemiological and phenotypic data. Findings The multidrug-resistant NG-MAST genogroup G1407 was predominant and accounted for the most cephalosporin resistance, but the prevalence of this genogroup decreased from 248 (23%) of 1066 isolates in a previous study from 2009%10 to 174 (17%) of 1054 isolates in this survey in 2013. This genogroup previously showed an association with men who have sex with men, but changed to an association with heterosexual people (odds ratio=4%29). WGS provided substantially improved resolution and accuracy over NG-MAST and multilocus sequence typing, predicted antimicrobial resistance relatively well, and identified discrepant isolates, mixed infections or contaminants, and multidrug-resistant clades linked to risk groups. Interpretation To our knowledge, we provide the first use of joint analysis of WGS and epidemiological data in an international programme for regional surveillance of sexually transmitted infections. WGS provided enhanced understanding of the distribution of antimicrobial resistance clones, including replacement with clones that were more susceptible to antimicrobials, in several risk groups nationally and regionally. We provide a framework for genomic surveillance of gonococci through standardised sampling, use of WGS, and a shared information architecture for interpretation and dissemination by use of open access software
Sexually transmitted infections in Europe 2012( Book )

1 edition published in 2014 in English and held by 1 WorldCat member library worldwide

This ECDC surveillance report on sexually transmitted infections (STIs) in Europe covers the years 2003 to 2012 and describes the epidemiological features and basic trends of the five STIs under EU surveillance: chlamydia, gonorrhoea, syphilis, congenital syphilis and lymphogranuloma venereum
Audience Level
Audience Level
  Kids General Special  
Audience level: 0.78 (from 0.52 for Sexually t ... to 0.97 for Public hea ...)

English (14)