Infectious Diseases and Therapy最新文献

{"title":"Descending Necrotizing Mediastinitis Across Age and Host-Status Groups: Diagnosis, Treatment Phases, and Outcomes in the Literature, with an Illustrative Case.","authors":"Constantin Ionescu, Claudia Simona Cambrea, Ionuţ Bulbuc, Elena Neagu, Bogdan Marian Caraban","doi":"10.1007/s40121-026-01397-2","DOIUrl":"10.1007/s40121-026-01397-2","url":null,"abstract":"<p><strong>Introduction: </strong>Descending necrotizing mediastinitis (DNM) is a rare but life-threatening infection originating from odontogenic, tonsillopharyngeal, or deep cervical sources, and propagating through the cervical fascial planes into the mediastinum. Despite advances in cross-sectional imaging, thoracic surgery, intensive care medicine, and antimicrobial therapy, DNM remains associated with mortality ranging from 11 to 40% across contemporary series. The evidence base is fragmented and lacks a unified framework integrating anatomical, physiological, microbiological, and critical care dimensions. The aims of this study are to map the DNM literature across five predefined age and host-status subgroups, to synthesize differences in source infection, diagnostic pathway, mediastinal extent, treatment phases, ICU burden, microbiological evolution, and outcomes, to appraise methodological quality, and to identify future research priorities.</p><p><strong>Methods: </strong>A scoping review was conducted in accordance with PRISMA-ScR, with incorporation of a prespecified illustrative institutional case for contextual comparison and pregnancy subgroup representation. Structured searches of PubMed/MEDLINE, Scopus, and Web of Science were supplemented by systematic citation chaining and revised eligibility criteria, allowing the inclusion of mixed infectious mediastinitis studies when the DNM subgroup could be clearly distinguished, yielding 18 studies (881 patients) in the final synthesis. A prospectively documented institutional case of DNM in pregnancy was analyzed separately from the PRISMA-tracked literature and used only to contextualize the pregnancy subgroup and to compare the proposed phase-based framework with a high-complexity observed clinical course.</p><p><strong>Results: </strong>The methodological quality of the PRISMA-tracked studies was predominantly Fair to Good; the illustrative institutional case was appraised separately as Fair. The reviewed literature suggested a hypothesis-generating, generally recurrent, phase-based clinical trajectory across subgroups. The institutional case was broadly consistent with the literature-derived pattern in seven of eight phases and differed mostly in the degree of multidrug-resistant microbiological complexity during Phase 7, an exploratory finding that may extend, rather than contradict, the proposed framework. Six recurrent adverse inflection points were identified, while evidence density varied across phases.</p><p><strong>Conclusions: </strong>DNM may be more usefully interpreted as a staged infectious syndrome rather than as an exclusively anatomical or surgical entity. The proposed phase-based framework, derived from structured synthesis of heterogeneous literature and contextualized by a prospectively documented severe case, should be interpreted as a conceptual, hypothesis-generating complement to existing anatomical staging systems rather than as a validated clinical model. Pro","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"2279-2306"},"PeriodicalIF":5.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the Economic and Public Health Impact of New Immunization Strategies in Infants Against Respiratory Syncytial Virus (RSV) in Colombia.","authors":"Maria Carrasquilla-Sotomayor, Nelson J Alvis-Zakzuk, Wilfrido Coronell-Rodríguez, Andres Arias, Lina Moyano-Tamara, Juan Carlos Alvarado-Gonzalez, Fernando De la Hoz-Restrepo, Nelson Alvis-Guzman","doi":"10.1007/s40121-026-01382-9","DOIUrl":"10.1007/s40121-026-01382-9","url":null,"abstract":"<p><strong>Introduction: </strong>Respiratory syncytial virus (RSV) infections are a leading cause of lower respiratory tract infections (LRTI), particularly bronchiolitis and pneumonia, leading to significant hospitalizations and economic burden in infants. In Colombia, RSV is endemic with high morbidity and mortality rates, underscoring the need for effective prophylactic technologies to reduce its impact.</p><p><strong>Methods: </strong>This study aimed to analyze the health and economic impact of new RSV immunization technologies in Colombia, focusing on two interventions: nirsevimab and RSVpreF. A static cohort decision model was used to compare these interventions against the standard of care (palivizumab-SoC), estimating outcomes including hospitalizations, intensive care unit (ICU) admissions, deaths, and event-related healthcare costs. The model included outcomes such as QALYs and direct and indirect event-related costs from the third-party and societal perspectives. Acquisition costs of prophylactic interventions were not included because prices are not publicly available during ongoing negotiations.</p><p><strong>Results: </strong>Nirsevimab was associated with a greater reduction in healthcare events and costs compared to both SoC and RSVpreF. In the base-case scenario, it prevented an additional 44,039 events and was associated with US$23.4 million lower event-related healthcare costs compared to SoC. When compared with RSVpreF, it averted 14,558 more events and was associated with US$8.4 million lower event-related costs. The greatest reduction occurred in primary care visits, with 32,744 and 10,458 fewer cases versus SoC and RSVpreF, respectively, followed by reductions in hospitalizations of 6210 and 2257 cases. Nirsevimab yielded up to 646 additional QALYs compared with RSVpreF and associated with up to US$25.3 million lower event-related costs from avoided health events in societal scenarios. Sensitivity analysis identified nirsevimab efficacy and infection distribution as the key drivers of event-related cost and QALY outcomes.</p><p><strong>Conclusion: </strong>Nirsevimab was associated with larger reductions in RSV-related events, greater reductions in event-related costs, and higher QALYs than SoC and RSVpreF. Its adoption in national immunization programs could significantly reduce the economic and disease burden of RSV and improve infant health.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"2455-2476"},"PeriodicalIF":5.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using the Damage Response Framework as a Lens to Discuss Acinetobacter baumannii Host-Pathogen Interactions: A Narrative Review and a Call to Action.","authors":"Nana Yaa P Sakyi Opoku, Hansel M Fletcher, Jacinda C Abdul-Mutakabbir","doi":"10.1007/s40121-026-01398-1","DOIUrl":"10.1007/s40121-026-01398-1","url":null,"abstract":"<p><p>The Damage Response Framework (DRF) is a conceptual model that evaluates the outcome of host-pathogen interactions (HPI) by assessing the total damage sustained by the host. The DRF emphasizes that disease results from cumulative host injury arising from the interplay between microbial virulence and the host immune response, rather than from the pathogen alone. HPI has been described as a \"tug of war\" between a pathogen and a host; the DRF improves this analogy by grounding it in reality, as both excessive immune activation and insufficient pathogen clearance can lead to host damage and disease. Acinetobacter baumannii is a Gram-negative pathogen known for its extensive drug resistance and immunomodulatory capacities. The interaction among isolate-specific virulence traits, antimicrobial resistance mechanisms, and host immune status determines the pattern and extent of damage, illustrating central tenets of the DRF. Different A. baumannii isolates may therefore produce varied clinical outcomes across different host conditions, depending on the extent of damage they cause. This narrative review discusses A. baumannii infections from the perspective of the DRF, highlighting how applying the DRF can inform our current understanding of A. baumannii pathogenesis by assessing A. baumannii HPI. We also provide brief insights into how the DRF can inform future research and treatment strategies that integrate host and microbial factors to minimize overall damage and improve host outcomes.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"2225-2248"},"PeriodicalIF":5.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response Letter to 'Letter to the Editor Regarding Complementary Strategy of Maternal Immunization and Monoclonal Antibodies for the Prevention of Respiratory Syncytial Virus Among Italian Infants: A Cost-Effectiveness Assessment'.","authors":"Barbara Polistena, Fabio Midulla, Giovanni Sotgiu, Daniela d'Angela, Roberto Di Virgilio, Federico Spandonaro","doi":"10.1007/s40121-026-01393-6","DOIUrl":"10.1007/s40121-026-01393-6","url":null,"abstract":"","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"2579-2581"},"PeriodicalIF":5.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148420726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety Profiles of Seasonal Influenza Vaccines in Chinese Children and Adolescents: A Pooled Analysis of Five Clinical Studies.","authors":"Le Hu, Yue Liu, Siyue Jia, Mingwei Wei, Pengfei Jin, Feng Wen, Hongxing Pan, Kai Chu, Yanjun Chen, Zijie Zhang, Jingxin Li","doi":"10.1007/s40121-026-01405-5","DOIUrl":"10.1007/s40121-026-01405-5","url":null,"abstract":"<p><strong>Introduction: </strong>Safety concerns remain an important barrier to pediatric influenza vaccination, yet directly comparable evidence across vaccine platforms, valency formulations, and administration routes remains limited. This study compared the safety profiles of five seasonal influenza vaccines in Chinese children and adolescents.</p><p><strong>Methods: </strong>We pooled individual-level safety data from five clinical studies including participants aged 6-17 years. Adverse event (AE) incidences and 95% confidence intervals (CIs) were estimated using Clopper-Pearson methods, and multivariable logistic regression models were used to compare AE risks.</p><p><strong>Results: </strong>Among 2885 participants, overall AE incidence was 23.1% (95% CI, 21.6-24.7%). Grade 3 AEs were uncommon (≤ 1.1%), and no serious AEs were reported. AE profiles differed across vaccine platforms: inactivated vaccines were mainly associated with pyrexia and injection-site reactions, whereas trivalent live attenuated influenza vaccine was characterized by rhinorrhea, cough, and nasal congestion. Compared with trivalent inactivated split-virion vaccine, quadrivalent inactivated subunit vaccine was associated with lower odds of any AE (aOR, 0.52; 95% CI, 0.35-0.79) and local AEs (aOR, 0.30; 95% CI, 0.17-0.52).</p><p><strong>Conclusions: </strong>All five vaccines showed acceptable short-term safety, with platform-specific reactogenicity patterns. Among inactivated vaccines, the quadrivalent subunit formulation showed a relative local tolerability advantage.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"2381-2397"},"PeriodicalIF":5.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Effectiveness of Routine Infant Meningococcal B Vaccination in the Netherlands.","authors":"Joost J M Simons, Florian Zeevat, Tjalke A Westra, Jan C Wilschut, Nina M van Sorge, Cornelis Boersma, Maarten J Postma","doi":"10.1007/s40121-026-01375-8","DOIUrl":"10.1007/s40121-026-01375-8","url":null,"abstract":"<p><strong>Introduction: </strong>Invasive meningococcal disease (IMD) is a severe infectious disease that can cause mortality and debilitating sequelae. IMD is typically vaccine-preventable. In the Netherlands, meningococcal serogroup B (MenB) causes almost all IMD cases. The objective of this study was to assess the cost-effectiveness of routine infant MenB vaccination in the Netherlands, using the latest incidence data, real-world evidence and vaccine data.</p><p><strong>Methods: </strong>We used the dynamic transmission cost-effectiveness (DyCE) model to compare routine infant vaccination with three doses of the four-component meningococcal B vaccine (4CMenB) versus no MenB vaccination, from a societal perspective. The model followed 100 cohorts over lifetime, was updated with the most recent Dutch epidemiological evidence, and was adapted in accordance with the latest Dutch health economic guidelines. Additionally, IMD incidence was varied in scenario analyses to model the unpredictable incidence of MenB IMD and potential outbreaks of this disease.</p><p><strong>Results: </strong>Over lifetime, 2367 MenB IMD cases, 1077 long-term sequelae cases and 116 deaths were prevented with 4CMenB vaccination in the base case. 4CMenB vaccination saved 14,703 quality-adjusted life years (QALYs), predominantly by preventing long-term sequelae (45.5%) and deaths (52.2%). The incremental cost-effectiveness ratio (ICER) was €99,752 per QALY gained in the base case and decreased below the willingness-to-pay threshold of 80,000 if the IMD incidence increased by 24%, or if the vaccine acquisition costs decreased by 22% (from €78.5 to €61.45). The ICER was most sensitive to variations in vaccine effectiveness, the incidence of MenB IMD and vaccine acquisition costs.</p><p><strong>Conclusions: </strong>In the Netherlands, 4CMenB vaccination is likely to be cost-effective if MenB incidence increases by 24%. This comprehensive analysis provides decision-makers with new and updated information on the cost-effectiveness of infant vaccination with 4CMenB in the Netherlands.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"2349-2363"},"PeriodicalIF":5.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor Regarding \"Complementary Strategy of Maternal Immunization and Monoclonal Antibodies for the Prevention of Respiratory Syncytial Virus Among Italian Infants: A Cost-Effectiveness Assessment\".","authors":"Claudio Costantino, Gabriele Giorgianni, Roberto Furnari, Vincenzo Di Gaetano, Fabio Massimo Contarino","doi":"10.1007/s40121-026-01391-8","DOIUrl":"10.1007/s40121-026-01391-8","url":null,"abstract":"","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"2575-2578"},"PeriodicalIF":5.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148420791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Isavuconazole in the Treatment of Cryptococcosis: A Real-World Case Series.","authors":"Marta Albanell-Fernández, Andrea Vergara, Ana Martinez-Urrea, Carolina Garcia-Vidal, Marta Ulldemolins, Josep Mensa, Álex Soriano, Marta Bodro","doi":"10.1007/s40121-026-01392-7","DOIUrl":"10.1007/s40121-026-01392-7","url":null,"abstract":"<p><strong>Introduction: </strong>Cryptococcosis is a severe invasive fungal infection with limited therapeutic options beyond fluconazole-based regimens. Isavuconazole, a broad-spectrum triazole antifungal, has emerged as a potential alternative, although clinical data supporting its use remain scarce. We aimed to evaluate the real-world effectiveness and safety of isavuconazole in patients with different forms of cryptococcosis.</p><p><strong>Methods: </strong>A retrospective observational study was conducted at a tertiary-care hospital, including patients with cryptococcosis who received isavuconazole at any treatment phase. Standard microbiological methods were used for pathogen identification and susceptibility testing. Demographic, clinical, and microbiological data were collected. Clinical and microbiological responses and tolerability were assessed at end of treatment or until death.</p><p><strong>Result: </strong>Eight patients with cryptococcosis received isavuconazole, most of whom were immunocompromised. Clinical presentations included pulmonary and disseminated disease, with Cryptococcus neoformans as the predominant species. Isavuconazole was primarily used during the consolidation and maintenance phases, after induction therapy with amphotericin B and flucytosine for 2 weeks in most cases, and as salvage therapy in two patients. It was well tolerated during prolonged treatment (6-12 months). In the two patients with isavuconazole therapeutic drug monitoring, plasma total trough concentrations were within the therapeutic range (5 and 3.5 µg/mL, respectively), whereas cerebrospinal fluid total concentration levels were undetectable. A favorable clinical response was observed in four patients, while three remain on treatment with ongoing clinical improvement; one patient died early. Microbiological clearance was achieved in all culture-positive cases.</p><p><strong>Conclusions: </strong>Isavuconazole demonstrated clinical effectiveness in this cohort of patients across different presentations of cryptococcosis. Treatment was safe and well tolerated, supporting its role as an alternative antifungal option against Cryptococcus, particularly when fluconazole is limited by adverse effects or drug-drug interactions. However, data on central nervous system penetration were limited, and further studies are needed to better define its role in cryptococcal meningitis management.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"2561-2573"},"PeriodicalIF":5.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden of Respiratory Syncytial Virus Infection in Immunocompromised Adults: A Systematic Review of the Evidence From High-Income Countries.","authors":"Pouya Saeedi, Jeffrey R Curtis, Michael Nissen, Kemi Oluwayi, Jean-Yves Pirçon, Bela Vatsa, Veronica Hulstrøm, Yolanda Penders","doi":"10.1007/s40121-026-01379-4","DOIUrl":"10.1007/s40121-026-01379-4","url":null,"abstract":"<p><p>Individuals with immunocompromising conditions or receiving immunosuppressive therapy are at increased risk for severe outcomes and complications from respiratory syncytial virus (RSV). An in-depth systematic investigation into severe RSV disease among immunocompromised adults is lacking. We therefore performed this systematic literature review to summarize the literature (2000-2024) on the burden of RSV disease across a broad spectrum of immunocompromising conditions in adults residing in high-income countries, in terms of the incidence of RSV infection and the prevalence of hospitalizations, complications, and mortality among RSV-infected individuals. Relevant English-language articles were retrieved through PubMed and Embase searches. We included 36 articles in our review. All but four studies were conducted in Europe or the USA. Most evaluated solid organ transplant recipients (n = 11, including 8 evaluating lung transplants) or hematopoietic stem cell transplant recipients (n = 17). Our review shows that, in most studies, substantial proportions of RSV-infected immunocompromised adults required hospitalization (37.5-87.5% in lung transplant, 37.7-68.0% in any solid organ transplant, and 30.3-83.9% in stem cell transplant recipients), intensive care unit admission (11.7% in lung, 3.9-17.9% in any solid organ, and 4.8-29.8% in stem cell transplant recipients), and mechanical ventilation (0.0-10.4% in lung, 3.9-14.3% in any solid organ, and 2.7-29.8% in stem cell transplant recipients). Data from the identified articles indicate that in solid organ (especially lung) and stem cell transplant patients, the degree of immunosuppression-determined by anti-rejection regimens, corticosteroid dosing, and other adjunctive agents-may be an important determinant of the risk of RSV. Our review confirms that RSV poses a significant burden on immunocompromised adults, emphasizing the need to implement preventive strategies such as vaccination in this population.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"2249-2278"},"PeriodicalIF":5.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148351958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Economic Inpatient Burden of Influenza and Influenza-Like Illness in Germany 2019-2025: Analysis of Nationwide Hospital Data.","authors":"Anna C Meyer, Saskia Kiesel, Anahita Poshtiban, Moritz Wick, Oliver Damm","doi":"10.1007/s40121-026-01384-7","DOIUrl":"10.1007/s40121-026-01384-7","url":null,"abstract":"<p><strong>Introduction: </strong>Data on the influenza burden in Germany during and after the global COVID-19 pandemic are limited. This study presents nationwide trends in the clinical and economic inpatient burden of influenza and influenza-like illness (ILI) in the German population from 2019 to 2025.</p><p><strong>Methods: </strong>We conducted a descriptive, retrospective analysis of nationwide hospital data from the German Institute for Hospital Reimbursement covering six consecutive influenza seasons (2019-2020 to 2024-2025). Influenza/ILI hospitalizations were identified using the International Classification of Diseases version 10 (ICD-10) codes J09-J11 recorded as primary diagnosis. Outcomes included hospitalization counts, incidence rates, mean length of stay, ICU admissions, in-hospital mortality, and estimated costs, and were reported for three age groups (0-17 years, 18-59 years, ≥ 60 years). Regional variation across federal states was assessed using directly age-standardized rates.</p><p><strong>Results: </strong>We identified 240,646 influenza/ILI hospitalizations, with the highest burden observed in the 2024-2025 season (87,745 cases; incidence: 105.0/100,000 population). Less than 5000 cases were observed in both the 2020-2021 and 2021-2022 seasons. Across all seasons, adults aged ≥ 60 years accounted for 48% of hospitalizations and 92% of 10,054 in-hospital deaths. In this age group, in-hospital mortality ranged between 5.8% and 12.3% per season. Mean hospitalization costs per case increased during the study period and were highest in older adults, reaching €5430 in 2023-2024 and €5421 in 2024-2025. Total inpatient costs of influenza/ILI were highest in 2024-2025 and estimated at €390 million. Regional hospitalization rates varied considerably, but patterns were inconsistent across seasons.</p><p><strong>Conclusions: </strong>Influenza/ILI causes a substantial and re-emergent inpatient burden in Germany, disproportionately affecting older adults. These findings highlight the need for sustained prevention efforts to reduce the burden of influenza/ILI in Germany. Further research is needed to understand the substantial regional disparities between federal states.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"2335-2348"},"PeriodicalIF":5.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148316991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}