title: Prioritizing of bacterial infections transmitted through substances of human origin in Europe.
abstract: Bacteria are the pathogens most frequently transmitted through substances of human origin (SoHO). The European Centre for Disease Prevention and Control (ECDC) organized an expert consultation, with the objective of developing a priority list of bacterial pathogens transmissible via SoHO. The list will be used to further assess risks and determine appropriate preventive measures.
  
  
  
  The 14 most frequently SoHO-transmitted bacteria identified through a scoping literature review were then prioritized during an expert workshop through a methodology based on multicriteria decision analysis. The selection of the prioritization method was based upon an ECDC framework for best practices in conducting risk-ranking exercises. Three transmission pathways, blood and blood components, tissues and cells, and organs, were considered in the ranking exercise.
  
  
  
  According to the ranking score (RS), bacteria were organized within each SoHO pathway into one of four risk tiers: Tier 1 (RS ≥ 0.70), Tier 2 (RS = 0.60-0.69), Tier 3 (RS = 0.40-0.59), or Tier 4 (RS < 0.40). The most consistently identified pathogens in the highest risk Tiers 1 and 2 of all three pathways were: Staphylococcus aureus, Klebsiella spp., Escherichia coli, β-hemolytic streptococci, Pseudomonas spp., and Acinetobacter spp.
  
  
  
  Six bacteria were defined as being of the highest priority in respect of the threat to the safety of SoHO and will be the subject of subsequent in-depth risk assessments to be conducted by ECDC to identify measures to mitigate the risk posed by these bacteria.
authors.affiliation: European Centre for Disease Prevention and Control, Stockholm, Sweden.
authors.forename: Dragoslav
authors.initials: D
authors.lastname: Domanović
authors.affiliation: European Centre for Disease Prevention and Control, Stockholm, Sweden.|Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Cassini
authors.affiliation: Paul-Ehrlich-Institut, Langen, Germany.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Bekeredjian-Ding
authors.affiliation: TRIP Foundation, Amsterdam, the Netherlands.
authors.forename: Arlinke
authors.initials: A
authors.lastname: Bokhorst
authors.affiliation: National Institute for Public Health and the Environment, Utrecht, the Netherlands.
authors.forename: Martijn
authors.initials: M
authors.lastname: Bouwknegt
authors.affiliation: Italian National Blood Centre, National Institute of Health, Rome, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Facco
authors.affiliation: National Blood Transfusion Service, Valletta, Malta.
authors.forename: George
authors.initials: G
authors.lastname: Galea
authors.affiliation: Università degli Studi dell'Insubria, Varese, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Grossi
authors.affiliation: European Homograft Bank (EHB), Brussels, Belgium.
authors.forename: Ramadan
authors.initials: R
authors.lastname: Jashari
authors.affiliation: Austrian Red Cross, Vienna, Austria.
authors.forename: Christoph
authors.initials: C
authors.lastname: Jungbauer
authors.affiliation: Sanquin Blood Supply, Amsterdam, the Netherlands.
authors.forename: Jan
authors.initials: J
authors.lastname: Marcelis
authors.affiliation: EU Commission, Brussels, Belgium.
authors.forename: Ioana
authors.initials: I
authors.lastname: Raluca-Siska
authors.affiliation: Public Health Sweden, Stockholm, Sweden.
authors.forename: Inger
authors.initials: I
authors.lastname: Andersson-Vonrosen
authors.affiliation: European Centre for Disease Prevention and Control, Stockholm, Sweden.
authors.forename: Jonathan E
authors.initials: JE
authors.lastname: Suk
mesh_terms: D001424:Bacterial Infections / Q000382:microbiology / Q000635:transmission*; D003661:Decision Support Techniques; D005060:Europe; D006292:Health Priorities; D006801:Humans; D018570:Risk Assessment / Q000379:methods*