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               <mods:identifier type="citation">Euro Surveill. 2018 Aug;23(33):1700798.</mods:identifier>
               <mods:identifier type="issn">1025-496X</mods:identifier>
               <mods:identifier type="uri">https://hdl.handle.net/20.500.12105/25508</mods:identifier>
               <mods:identifier type="pubmedID">30131096</mods:identifier>
               <mods:identifier type="doi">10.2807/1560-7917.ES.2018.23.33.1700798</mods:identifier>
               <mods:identifier type="e-issn">1560-7917</mods:identifier>
               <mods:identifier type="journal">Euro surveillance : bulletin Européen sur les maladies transmissibles = European communicable disease bulletin</mods:identifier>
               <mods:abstract>Background and aim: The trend in reported case counts of invasive Listeria monocytogenes (Lm), a potentially severe food-borne disease, has been increasing since 2008. In 2015, 2,224 cases were reported in the European Union/European Economic Area (EU/EEA). We aimed to validate the microbiological and epidemiological aspects of an envisaged EU/EEA-wide surveillance system enhanced by routine whole genome sequencing (WGS). Methods: WGS and core genome multilocus sequence typing (cgMLST) were performed on isolates from 2,726 cases from 27 EU/EEA countries from 2010-15. Results: Quality controls for contamination, mixed Lm cultures and sequence quality classified nearly all isolates with a minimum average coverage of the genome of 55x as acceptable for analysis. Assessment of the cgMLST variation between six different pipelines revealed slightly less variation associated with assembly-based analysis compared to reads-based analysis. Epidemiological concordance, based on 152 isolates from 19 confirmed outbreaks and a cluster cutoff of seven allelic differences, was good (sensitivity > 95% for two cgMLST schemes of 1,748 and 1,701 loci each; PPV 58‒68%). The proportion of sporadic cases was slightly below 50%. Of remaining isolates, around one third were in clusters involving more than one country, often spanning several years. Detection of multi-country clusters was on average several months earlier when pooling the data at EU/EEA level, compared with first detection at national level. Conclusions: These findings provide a good basis for comprehensive EU/EEA-wide, WGS-enhanced surveillance of listeriosis. Time limits should not be used for hypothesis generation during outbreak investigations, but should be for analytical studies.</mods:abstract>
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                  <mods:topic>Listeria</mods:topic>
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                  <mods:topic>WGS</mods:topic>
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               <mods:subject>
                  <mods:topic>Epidemiology</mods:topic>
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                  <mods:topic>Food-borne infections</mods:topic>
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               <mods:subject>
                  <mods:topic>Laboratory surveillance</mods:topic>
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                  <mods:topic>Public health policy</mods:topic>
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                  <mods:topic>Whole genome sequencing</mods:topic>
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                  <mods:title>Retrospective validation of whole genome sequencing-enhanced surveillance of listeriosis in Europe, 2010 to 2015</mods:title>
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