Lessons from a one-year hospital-based surveillance of acute respiratory infections in Berlin- comparing case definitions to monitor influenza.
Identifieur interne : 000247 ( Main/Exploration ); précédent : 000246; suivant : 000248Lessons from a one-year hospital-based surveillance of acute respiratory infections in Berlin- comparing case definitions to monitor influenza.
Auteurs : Matthias Nachtnebel [Allemagne] ; Benedikt Greutelaers ; Gerhard Falkenhorst ; Pernille Jorgensen ; Manuel Dehnert ; Brunhilde Schweiger ; Christian Tr Der ; Silke Buda ; Tim Eckmanns ; Ole Wichmann ; Wiebke HellenbrandSource :
- BMC public health [ 1471-2458 ] ; 2012.
Descripteurs français
- KwdFr :
- Admission du patient (statistiques et données numériques), Admission du patient (tendances), Adolescent (MeSH), Adulte (MeSH), Adulte d'âge moyen (MeSH), Aire sous la courbe (MeSH), Berlin (épidémiologie), Courbe ROC (MeSH), Femelle (MeSH), Grippe humaine (diagnostic), Grippe humaine (virologie), Grippe humaine (épidémiologie), Hospitalisation (statistiques et données numériques), Humains (MeSH), Hôpitaux communautaires (MeSH), Infections de l'appareil respiratoire (diagnostic), Infections de l'appareil respiratoire (virologie), Infections de l'appareil respiratoire (épidémiologie), Intervalles de confiance (MeSH), Mâle (MeSH), Partie nasale du pharynx (virologie), Réaction de polymérisation en chaîne (MeSH), Sous-type H1N1 du virus de la grippe A (isolement et purification), Surveillance sentinelle (MeSH), Systèmes d'information hospitaliers (MeSH), Unités de soins intensifs (statistiques et données numériques), Vaccins antigrippaux (administration et posologie).
- MESH :
- administration et posologie : Vaccins antigrippaux.
- diagnostic : Grippe humaine, Infections de l'appareil respiratoire.
- isolement et purification : Sous-type H1N1 du virus de la grippe A.
- statistiques et données numériques : Admission du patient, Hospitalisation, Unités de soins intensifs.
- tendances : Admission du patient.
- virologie : Grippe humaine, Infections de l'appareil respiratoire, Partie nasale du pharynx.
- épidémiologie : Berlin, Grippe humaine, Infections de l'appareil respiratoire.
- Adolescent, Adulte, Adulte d'âge moyen, Aire sous la courbe, Courbe ROC, Femelle, Humains, Hôpitaux communautaires, Intervalles de confiance, Mâle, Réaction de polymérisation en chaîne, Surveillance sentinelle, Systèmes d'information hospitaliers.
English descriptors
- KwdEn :
- Adolescent (MeSH), Adult (MeSH), Area Under Curve (MeSH), Berlin (epidemiology), Confidence Intervals (MeSH), Female (MeSH), Hospital Information Systems (MeSH), Hospitalization (statistics & numerical data), Hospitals, Community (MeSH), Humans (MeSH), Influenza A Virus, H1N1 Subtype (isolation & purification), Influenza Vaccines (administration & dosage), Influenza, Human (diagnosis), Influenza, Human (epidemiology), Influenza, Human (virology), Intensive Care Units (statistics & numerical data), Male (MeSH), Middle Aged (MeSH), Nasopharynx (virology), Outcome Assessment, Health Care (MeSH), Patient Admission (statistics & numerical data), Patient Admission (trends), Polymerase Chain Reaction (MeSH), ROC Curve (MeSH), Respiratory Tract Infections (diagnosis), Respiratory Tract Infections (epidemiology), Respiratory Tract Infections (virology), Sentinel Surveillance (MeSH).
- MESH :
- chemical , administration & dosage : Influenza Vaccines.
- geographic , epidemiology : Berlin.
- diagnosis : Influenza, Human, Respiratory Tract Infections.
- epidemiology : Influenza, Human, Respiratory Tract Infections.
- isolation & purification : Influenza A Virus, H1N1 Subtype.
- statistics & numerical data : Hospitalization, Intensive Care Units, Patient Admission.
- trends : Patient Admission.
- virology : Influenza, Human, Nasopharynx, Respiratory Tract Infections.
- Adolescent, Adult, Area Under Curve, Confidence Intervals, Female, Hospital Information Systems, Hospitals, Community, Humans, Male, Middle Aged, Outcome Assessment, Health Care, Polymerase Chain Reaction, ROC Curve, Sentinel Surveillance.
Abstract
BACKGROUND
Surveillance of severe acute respiratory infections (SARI) in sentinel hospitals is recommended to estimate the burden of severe influenza-cases. Therefore, we monitored patients admitted with respiratory infections (RI) in 9 Berlin hospitals from 7.12.2009 to 12.12.2010 according to different case definitions (CD) and determined the proportion of cases with influenza A(H1N1)pdm09 (pH1N1). We compared the sensitivity and specificity of CD for capturing pandemic pH1N1 cases.
METHODS
We established an RI-surveillance restricted to adults aged ≤ 65 years within the framework of a pH1N1 vaccine effectiveness study, which required active identification of RI-cases. The hospital information-system was screened daily for newly admitted RI-patients. Nasopharyngeal swabs from consenting patients were tested by PCR for influenza-virus subtypes. Four clinical CD were compared in terms of capturing pH1N1-positives among hospitalized RI-patients by applying sensitivity and specificity analyses. The broadest case definition (CD1) was used for inclusion of RI-cases; the narrowest case definition (CD4) was identical to the SARI case definition recommended by ECDC/WHO.
RESULTS
Over the study period, we identified 1,025 RI-cases, of which 283 (28%) met the ECDC/WHO SARI case definition. The percentage of SARI-cases among internal medicine admissions decreased from 3.2% (calendar-week 50-2009) to 0.2% (week 25-2010). Of 354 patients tested by PCR, 20 (6%) were pH1N1-positive. Two case definitions narrower than CD1 but -in contrast to SARI- not requiring shortness of breath yielded the largest areas under the Receiver-Operator-Curve. Heterogeneity of proportions of patients admitted with RI between hospitals was significant.
CONCLUSIONS
Comprehensive surveillance of RI cases was feasible in a network of community hospitals. In most settings, several hospitals should be included to ensure representativeness. Although misclassification resulting from failure to obtain symptoms in the hospital information-system cannot be ruled out, a high proportion of hospitalized PCR-positive pH1N1-patients (45%) did not fulfil the SARI case-definition that included shortness of breath or difficulty breathing. Thus, to assess influenza-related disease burden in hospitals, broader, alternative case definitions should be considered.
DOI: 10.1186/1471-2458-12-245
PubMed: 22452874
PubMed Central: PMC3362781
Affiliations:
Links toward previous steps (curation, corpus...)
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Buda</name></author><author><name sortKey="Eckmanns, Tim" sort="Eckmanns, Tim" uniqKey="Eckmanns T" first="Tim" last="Eckmanns">Tim Eckmanns</name></author><author><name sortKey="Wichmann, Ole" sort="Wichmann, Ole" uniqKey="Wichmann O" first="Ole" last="Wichmann">Ole Wichmann</name></author><author><name sortKey="Hellenbrand, Wiebke" sort="Hellenbrand, Wiebke" uniqKey="Hellenbrand W" first="Wiebke" last="Hellenbrand">Wiebke Hellenbrand</name></author></analytic><series><title level="j">BMC public health</title><idno type="eISSN">1471-2458</idno><imprint><date when="2012" type="published">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent (MeSH)</term><term>Adult (MeSH)</term><term>Area Under Curve (MeSH)</term><term>Berlin (epidemiology)</term><term>Confidence Intervals (MeSH)</term><term>Female (MeSH)</term><term>Hospital Information Systems (MeSH)</term><term>Hospitalization (statistics & numerical data)</term><term>Hospitals, Community (MeSH)</term><term>Humans (MeSH)</term><term>Influenza A Virus, H1N1 Subtype (isolation & purification)</term><term>Influenza Vaccines (administration & dosage)</term><term>Influenza, Human (diagnosis)</term><term>Influenza, Human (epidemiology)</term><term>Influenza, Human (virology)</term><term>Intensive Care Units (statistics & numerical data)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Nasopharynx (virology)</term><term>Outcome Assessment, Health Care (MeSH)</term><term>Patient Admission (statistics & numerical data)</term><term>Patient Admission (trends)</term><term>Polymerase Chain Reaction (MeSH)</term><term>ROC Curve (MeSH)</term><term>Respiratory Tract Infections (diagnosis)</term><term>Respiratory Tract Infections (epidemiology)</term><term>Respiratory Tract Infections (virology)</term><term>Sentinel Surveillance (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Admission du patient (statistiques et données numériques)</term><term>Admission du patient (tendances)</term><term>Adolescent (MeSH)</term><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Aire sous la courbe (MeSH)</term><term>Berlin (épidémiologie)</term><term>Courbe ROC (MeSH)</term><term>Femelle (MeSH)</term><term>Grippe humaine (diagnostic)</term><term>Grippe humaine (virologie)</term><term>Grippe humaine (épidémiologie)</term><term>Hospitalisation (statistiques et données numériques)</term><term>Humains (MeSH)</term><term>Hôpitaux communautaires (MeSH)</term><term>Infections de l'appareil respiratoire (diagnostic)</term><term>Infections de l'appareil respiratoire (virologie)</term><term>Infections de l'appareil respiratoire (épidémiologie)</term><term>Intervalles de confiance (MeSH)</term><term>Mâle (MeSH)</term><term>Partie nasale du pharynx (virologie)</term><term>Réaction de polymérisation en chaîne (MeSH)</term><term>Sous-type H1N1 du virus de la grippe A (isolement et purification)</term><term>Surveillance sentinelle (MeSH)</term><term>Systèmes d'information hospitaliers (MeSH)</term><term>Unités de soins intensifs (statistiques et données numériques)</term><term>Vaccins antigrippaux (administration et posologie)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Influenza Vaccines</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Berlin</term></keywords><keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Vaccins antigrippaux</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Influenza, Human</term><term>Respiratory Tract Infections</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Grippe humaine</term><term>Infections de l'appareil respiratoire</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Influenza, Human</term><term>Respiratory Tract Infections</term></keywords><keywords scheme="MESH" qualifier="isolation & purification" xml:lang="en"><term>Influenza A Virus, H1N1 Subtype</term></keywords><keywords scheme="MESH" qualifier="isolement et purification" xml:lang="fr"><term>Sous-type H1N1 du virus de la grippe A</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Hospitalization</term><term>Intensive Care Units</term><term>Patient Admission</term></keywords><keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr"><term>Admission du patient</term><term>Hospitalisation</term><term>Unités de soins intensifs</term></keywords><keywords scheme="MESH" qualifier="tendances" xml:lang="fr"><term>Admission du patient</term></keywords><keywords scheme="MESH" qualifier="trends" xml:lang="en"><term>Patient Admission</term></keywords><keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Grippe humaine</term><term>Infections de l'appareil respiratoire</term><term>Partie nasale du pharynx</term></keywords><keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Influenza, Human</term><term>Nasopharynx</term><term>Respiratory Tract Infections</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Berlin</term><term>Grippe humaine</term><term>Infections de l'appareil respiratoire</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Area Under Curve</term><term>Confidence Intervals</term><term>Female</term><term>Hospital Information Systems</term><term>Hospitals, Community</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Outcome Assessment, Health Care</term><term>Polymerase Chain Reaction</term><term>ROC Curve</term><term>Sentinel Surveillance</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Aire sous la courbe</term><term>Courbe ROC</term><term>Femelle</term><term>Humains</term><term>Hôpitaux communautaires</term><term>Intervalles de confiance</term><term>Mâle</term><term>Réaction de polymérisation en chaîne</term><term>Surveillance sentinelle</term><term>Systèmes d'information hospitaliers</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Surveillance of severe acute respiratory infections (SARI) in sentinel hospitals is recommended to estimate the burden of severe influenza-cases. Therefore, we monitored patients admitted with respiratory infections (RI) in 9 Berlin hospitals from 7.12.2009 to 12.12.2010 according to different case definitions (CD) and determined the proportion of cases with influenza A(H1N1)pdm09 (pH1N1). We compared the sensitivity and specificity of CD for capturing pandemic pH1N1 cases.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>We established an RI-surveillance restricted to adults aged ≤ 65 years within the framework of a pH1N1 vaccine effectiveness study, which required active identification of RI-cases. The hospital information-system was screened daily for newly admitted RI-patients. Nasopharyngeal swabs from consenting patients were tested by PCR for influenza-virus subtypes. Four clinical CD were compared in terms of capturing pH1N1-positives among hospitalized RI-patients by applying sensitivity and specificity analyses. The broadest case definition (CD1) was used for inclusion of RI-cases; the narrowest case definition (CD4) was identical to the SARI case definition recommended by ECDC/WHO.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Over the study period, we identified 1,025 RI-cases, of which 283 (28%) met the ECDC/WHO SARI case definition. The percentage of SARI-cases among internal medicine admissions decreased from 3.2% (calendar-week 50-2009) to 0.2% (week 25-2010). Of 354 patients tested by PCR, 20 (6%) were pH1N1-positive. Two case definitions narrower than CD1 but -in contrast to SARI- not requiring shortness of breath yielded the largest areas under the Receiver-Operator-Curve. Heterogeneity of proportions of patients admitted with RI between hospitals was significant.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Comprehensive surveillance of RI cases was feasible in a network of community hospitals. In most settings, several hospitals should be included to ensure representativeness. Although misclassification resulting from failure to obtain symptoms in the hospital information-system cannot be ruled out, a high proportion of hospitalized PCR-positive pH1N1-patients (45%) did not fulfil the SARI case-definition that included shortness of breath or difficulty breathing. Thus, to assess influenza-related disease burden in hospitals, broader, alternative case definitions should be considered.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">22452874</PMID><DateCompleted><Year>2012</Year><Month>07</Month><Day>30</Day></DateCompleted><DateRevised><Year>2020</Year><Month>03</Month><Day>05</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1471-2458</ISSN><JournalIssue CitedMedium="Internet"><Volume>12</Volume><PubDate><Year>2012</Year><Month>Mar</Month><Day>27</Day></PubDate></JournalIssue><Title>BMC public health</Title><ISOAbbreviation>BMC Public Health</ISOAbbreviation></Journal><ArticleTitle>Lessons from a one-year hospital-based surveillance of acute respiratory infections in Berlin- comparing case definitions to monitor influenza.</ArticleTitle><Pagination><MedlinePgn>245</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/1471-2458-12-245</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Surveillance of severe acute respiratory infections (SARI) in sentinel hospitals is recommended to estimate the burden of severe influenza-cases. Therefore, we monitored patients admitted with respiratory infections (RI) in 9 Berlin hospitals from 7.12.2009 to 12.12.2010 according to different case definitions (CD) and determined the proportion of cases with influenza A(H1N1)pdm09 (pH1N1). We compared the sensitivity and specificity of CD for capturing pandemic pH1N1 cases.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">We established an RI-surveillance restricted to adults aged ≤ 65 years within the framework of a pH1N1 vaccine effectiveness study, which required active identification of RI-cases. The hospital information-system was screened daily for newly admitted RI-patients. Nasopharyngeal swabs from consenting patients were tested by PCR for influenza-virus subtypes. Four clinical CD were compared in terms of capturing pH1N1-positives among hospitalized RI-patients by applying sensitivity and specificity analyses. The broadest case definition (CD1) was used for inclusion of RI-cases; the narrowest case definition (CD4) was identical to the SARI case definition recommended by ECDC/WHO.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Over the study period, we identified 1,025 RI-cases, of which 283 (28%) met the ECDC/WHO SARI case definition. The percentage of SARI-cases among internal medicine admissions decreased from 3.2% (calendar-week 50-2009) to 0.2% (week 25-2010). Of 354 patients tested by PCR, 20 (6%) were pH1N1-positive. Two case definitions narrower than CD1 but -in contrast to SARI- not requiring shortness of breath yielded the largest areas under the Receiver-Operator-Curve. Heterogeneity of proportions of patients admitted with RI between hospitals was significant.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Comprehensive surveillance of RI cases was feasible in a network of community hospitals. In most settings, several hospitals should be included to ensure representativeness. Although misclassification resulting from failure to obtain symptoms in the hospital information-system cannot be ruled out, a high proportion of hospitalized PCR-positive pH1N1-patients (45%) did not fulfil the SARI case-definition that included shortness of breath or difficulty breathing. Thus, to assess influenza-related disease burden in hospitals, broader, alternative case definitions should be considered.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Nachtnebel</LastName><ForeName>Matthias</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Infectious Disease Epidemiology, Robert Koch Institute, DGZ-Ring 1, Berlin 13086, Germany. nachtnebel@post.harvard.edu</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Greutelaers</LastName><ForeName>Benedikt</ForeName><Initials>B</Initials></Author><Author ValidYN="Y"><LastName>Falkenhorst</LastName><ForeName>Gerhard</ForeName><Initials>G</Initials></Author><Author ValidYN="Y"><LastName>Jorgensen</LastName><ForeName>Pernille</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Dehnert</LastName><ForeName>Manuel</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Schweiger</LastName><ForeName>Brunhilde</ForeName><Initials>B</Initials></Author><Author ValidYN="Y"><LastName>Träder</LastName><ForeName>Christian</ForeName><Initials>C</Initials></Author><Author ValidYN="Y"><LastName>Buda</LastName><ForeName>Silke</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Eckmanns</LastName><ForeName>Tim</ForeName><Initials>T</Initials></Author><Author ValidYN="Y"><LastName>Wichmann</LastName><ForeName>Ole</ForeName><Initials>O</Initials></Author><Author ValidYN="Y"><LastName>Hellenbrand</LastName><ForeName>Wiebke</ForeName><Initials>W</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2012</Year><Month>03</Month><Day>27</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>BMC Public Health</MedlineTA><NlmUniqueID>100968562</NlmUniqueID><ISSNLinking>1471-2458</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D007252">Influenza Vaccines</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019540" MajorTopicYN="N">Area Under Curve</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001604" MajorTopicYN="N" Type="Geographic">Berlin</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016001" MajorTopicYN="N">Confidence Intervals</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006751" MajorTopicYN="N">Hospital Information Systems</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006760" MajorTopicYN="N">Hospitalization</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006764" MajorTopicYN="N">Hospitals, Community</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D053118" MajorTopicYN="N">Influenza A Virus, H1N1 Subtype</DescriptorName><QualifierName UI="Q000302" MajorTopicYN="N">isolation & purification</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007252" MajorTopicYN="N">Influenza 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IdType="pubmed">19935413</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></pubmed><affiliations><list><country><li>Allemagne</li></country><region><li>Berlin</li></region><settlement><li>Berlin</li></settlement></list><tree><noCountry><name sortKey="Buda, Silke" sort="Buda, Silke" uniqKey="Buda S" first="Silke" last="Buda">Silke Buda</name><name sortKey="Dehnert, Manuel" sort="Dehnert, Manuel" uniqKey="Dehnert M" first="Manuel" last="Dehnert">Manuel Dehnert</name><name sortKey="Eckmanns, Tim" sort="Eckmanns, Tim" uniqKey="Eckmanns T" first="Tim" last="Eckmanns">Tim Eckmanns</name><name sortKey="Falkenhorst, Gerhard" sort="Falkenhorst, Gerhard" uniqKey="Falkenhorst G" first="Gerhard" last="Falkenhorst">Gerhard Falkenhorst</name><name sortKey="Greutelaers, Benedikt" sort="Greutelaers, Benedikt" uniqKey="Greutelaers B" first="Benedikt" last="Greutelaers">Benedikt Greutelaers</name><name sortKey="Hellenbrand, Wiebke" sort="Hellenbrand, Wiebke" uniqKey="Hellenbrand W" first="Wiebke" last="Hellenbrand">Wiebke Hellenbrand</name><name sortKey="Jorgensen, Pernille" sort="Jorgensen, Pernille" uniqKey="Jorgensen P" first="Pernille" last="Jorgensen">Pernille Jorgensen</name><name sortKey="Schweiger, Brunhilde" sort="Schweiger, Brunhilde" uniqKey="Schweiger B" first="Brunhilde" last="Schweiger">Brunhilde Schweiger</name><name sortKey="Tr Der, Christian" sort="Tr Der, Christian" uniqKey="Tr Der C" first="Christian" last="Tr Der">Christian Tr Der</name><name sortKey="Wichmann, Ole" sort="Wichmann, Ole" uniqKey="Wichmann O" first="Ole" last="Wichmann">Ole Wichmann</name></noCountry><country name="Allemagne"><region name="Berlin"><name sortKey="Nachtnebel, Matthias" sort="Nachtnebel, Matthias" uniqKey="Nachtnebel M" first="Matthias" last="Nachtnebel">Matthias Nachtnebel</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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