Declarations Ethics approval and consent to participate Not applicable Consent for publication Not applicable Competing interests AS, JS, CK, DG, MB, JH, AV, and MV declare that they have no competing interests. Financial support This study was funded by the board of directors of the Erasmus MC University Medical Center as part of the PE-ONE consortium. The board of directors had no role on the design of the study, in data collection, analysis, interpretation, or writing and approval of the manuscript. Author contributions Conceived and designed the study: MV, JS, AV, MB, JH, DG. Collecting data: AS, AV. Analyzed the data: AS, AV, CK. Wrote the paper: AS, AV. All authors read and approved the final manuscript. Acknowledgements We like to thank Tija Ikanovic, Afroditi Manoliou and the diagnostic department of the Erasmus MC for processing all samples. Additionally, we want to thank all colleagues and interns who helped us with environmental sampling. This study was presented as a poster at the 29th ECCMID in Amsterdam (poster number P2633), 2019, and at the digital 31st ECCMID (abstract number 01369). 166 Chapter 3.2
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