Infectious Diseases and Therapy最新文献

{"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}

{"title":"Sepsis Recognition and Management Gaps in Hospitals: A Post Hoc Analysis of a Subset of Data from the European Sepsis Care Survey.","authors":"Jakub Śmiechowicz, Christian S Scheer, Joanna Bartczak, Alicja Bartkowska-Śniatkowska, Katarzyna Baścik, Sławomir L Czaban, Piotr F Czempik, Wojciech Dąbrowski, Rafał Gałuszka, Maciej Gawor, Janusz Gruszczyk, Ludmiła Hasak, Jarosław Janc, Mateusz Jaworski, Jarosław Luboński, Małgorzata Mikaszewska-Sokolewicz, Tomasz Musiuk, Piotr Smuszkiewicz, Karina Stefańska-Wronka, Michał Śpiewak, Renata Szmigielska, Mariola Tałałaj, Łukasz Tkaczyk, Witold Wasiak, Rafał Wójtowicz, Magdalena Wujtewicz, Joanna Zorska, Barbara Adamik","doi":"10.1007/s40121-026-01387-4","DOIUrl":"10.1007/s40121-026-01387-4","url":null,"abstract":"<p><strong>Introduction: </strong>Sepsis is a life-threatening condition and its management should be a hospital priority. The European Sepsis Care Survey (ESCS) investigated the implementation of guideline recommendations and the availability of infrastructure for sepsis care across Europe. Our objective was to provide a country‑level baseline assessment of sepsis care in hospitals and to identify deficiencies in sepsis recognition and management.</p><p><strong>Methods: </strong>Data from 55 hospitals located in Poland were analyzed regarding sepsis definitions, screening, management, infrastructure, and quality improvement programs (QIPs) in emergency departments (EDs), wards, and intensive care units (ICUs).</p><p><strong>Results: </strong>Sepsis-3 criteria were applied in 44% of hospitals. Sepsis screening and standardized management were used in 27% and 38.2% of EDs, 21% and 30.8% of wards, and 62% and 86.7% of ICUs, respectively. QIPs were present in 37% of hospitals, yet regular sepsis training across departments was reported by only 6.6%. In hospitals with QIPs, key indicators of sepsis care were monitored more frequently, including sepsis cases (76.5% versus 41.4%), mortality (70.6% versus 20.7%), time-to-antibiotics (29.4% versus 0%), bundle compliance (35.3% versus 0%), and also antibiotic stewardship (100% versus 58.6%) (all p < 0.05). Computed tomography (CT) or magnetic resonance imaging (MRI) was available 24 h a day in 94.2% of hospitals. Surgical source control was available 24 h a day in 92.7% of hospitals. Source control by interventional radiology was available in 34.5% of hospitals. Point-of-care lactate testing was available in 80% of emergency departments. Hospital guidelines for antimicrobial therapy in patients with sepsis were present in 65.5% of hospitals.</p><p><strong>Conclusions: </strong>Our study provides a country‑level baseline assessment of sepsis care in hospitals. Overall, adherence to established guidelines for sepsis recognition and management remains low and demands urgent improvement. Hospitals that implemented quality improvement programs demonstrated significantly higher compliance with these guidelines. Strengthening institutional support, establishing structured sepsis programs, and adopting systematic quality improvement approaches are essential to advancing sepsis care.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier, NCT05059808.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"2181-2198"},"PeriodicalIF":5.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13350605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148277353","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":"Effectiveness, Sex Differences, and Patient Experience in Real-World Use of Long-Acting Cabotegravir and Rilpivirine: Results from a Prospective Study.","authors":"Ana González-Cordón, Júlia Calvo, Leire Berrocal, Maite León-Fabo, Maria Martínez-Rebollar, Ivan Chivite, Alexy Inciarte, Paula Arreba, Juan Ambrosioni, Lorena de la Mora, Pilar Callau, Alberto Foncillas, Abiu Sempere, José Luis Blanco, Esteban Martinez, Jose M Miro, Roger Llobet, Elisa de Lazzari, Josep Mallolas, Montserrat Laguno, Berta Torres","doi":"10.1007/s40121-026-01373-w","DOIUrl":"10.1007/s40121-026-01373-w","url":null,"abstract":"<p><strong>Introduction: </strong>Long-acting intramuscular cabotegravir plus rilpivirine (LA-CAB/RPV) administered every 2 months (Q2M) has been available in Spain since January 2023 as a switch strategy for HIV treatment. We evaluated characteristics, effectiveness, tolerability, and acceptance, including patient-reported outcomes, stratified by sex in people with HIV switching to LA-CAB/RPV.</p><p><strong>Methods: </strong>Observational, prospective, cohort study in Hospital Clínic of Barcelona, Spain. Participant characteristics according to sex at birth and treatment effectiveness [HIV-RNA < 50 copies/mL by on treatment (OT), modified intention-to-treat (mITT), and intention to-treat (ITT) analyses] were evaluated. Self-administered electronic questionnaires were collected.</p><p><strong>Results: </strong>From February 2023 to February 2025, 57/741 (8%) women and 684/741 (92%) men started LA-CAB/RPV, compared to 816/5901 (14%) women that continued with other antiretroviral therapy (ART) (p < 0.001) in our cohort. Women were older, had longer time since HIV diagnosis and on ART, lower nadir CD4, and were more frequently Spanish-born than men. Effectiveness by OT, mITT, and ITT in the 461 participants (29 women and 432 men) who reached week 52 of follow-up was 96%, 83%, and 83% and 99%, 92%, and 89%, respectively, without significant differences. There were 8 (1.7%) confirmed virological failures and 40 (9%) discontinuations with no significant differences by sex. Acceptance, tolerability of injections, and HIV medication burden globally improved during follow-up. Women reported more medication burden and disclosure worries than men.</p><p><strong>Conclusions: </strong>Compared to our general cohort, proportionally fewer women than men switched to LA-CAB/RPV. Effectiveness, adherence, tolerability, and acceptance were high without significant differences by sex. In this study, women expressed more frequent disclosure issues and showed significantly different baseline characteristics compared to men, highlighting the importance of sex-disaggregated data analysis. These results should be confirmed in larger studies.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"2103-2119"},"PeriodicalIF":5.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13350573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217653","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 of BNT162b2 COVID-19 Vaccine in Pregnancy: A Systematic Review.","authors":"Elizabeth Thoburn, Vassilis G Giannakoulis, Tianyan Hu, Henry Goebe, Sheetal Raina, Mary M Moran, Benedicte Perreault, Luis Val-Maranes, Evelyn Barron Millar, Isabelle Whittle, Fiona Pearson, Santiago M C Lopez","doi":"10.1007/s40121-026-01378-5","DOIUrl":"10.1007/s40121-026-01378-5","url":null,"abstract":"<p><strong>Introduction: </strong>Since COVID-19 vaccine introduction in December 2020, > 13 billion doses have been distributed globally, including > 5 billion Pfizer-BioNTech (BNT162b2) doses. Real-world evidence in pregnancy remains heterogenous in design and outcome definitions, with limited analysis by dose timing or variant period. Most reviews evaluated COVID-19 vaccines as a class without focus on individual products, limiting product-specific interpretation. Given expanding evidence and public concern around safety of vaccines during pregnancy, an updated, pregnancy-focused systematic review of BNT162b2 safety is warranted. This study aimed to review and synthesize evidence on the safety of Pfizer-BioNTech COVID-19 vaccine in pregnant women, including pregnancy-related outcomes.</p><p><strong>Methods: </strong>A systematic literature review (PROSPERO registered) was conducted in accordance with Cochrane methodology and reported following PRISMA guidelines. Medline and Embase were searched from December 2020 to June 2025, supplemented by regulatory reports and conference searches. Eligible randomized and observational studies reporting obstetric or neonatal outcomes after ≥ 1 dose of BNT162b2 were included. Quality appraisal was conducted using NICE checklists. Results were narratively synthesized and reported following SWiM guidance.</p><p><strong>Results: </strong>Across 25 studies, comprising > 450,000 BNT162b2-vaccinated pregnant women, no increased risk was observed for miscarriage, congenital anomalies, preterm birth, hypertensive disorders, small for gestational age, low birth weight, or neonatal death, with effect estimates broadly consistent and centered around the null across available trimester-stratified analyses, dose numbers, and study design. However, trimester-specific data, particularly for first-trimester exposure, were limited.</p><p><strong>Conclusion: </strong>The cumulative evidence demonstrates a reassuring safety profile for Pfizer-BioNTech (BNT162b2) COVID-19 vaccination with no indication of increased pregnancy-related or neonatal risk. The evidence is mainly observational and heterogeneous, with limited precision for rare outcomes, but the results align with findings from international registry, surveillance, and population-based evidence and support BNT162b2 vaccination in pregnancy as an effective and safe means to reduce preventable maternal morbidity, although evidence remains limited for first-trimester-specific exposure.</p><p><strong>Trial registration: </strong>The review protocol was prospectively registered with PROSPERO [CRD420251080193] [1].</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"2087-2101"},"PeriodicalIF":5.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13350603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148194676","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":"Forecasting the Multidimensional Burdens of Hospital Admissions in LRTIs and COPD: Projections of Healthcare Expenditures, Resource Utilization, and Socioeconomic and Environmental Outcomes for Switzerland.","authors":"Desiree Schnidrig, Thomas Campbell-James, Josia D Schramm, Noel Ackermann, Lindsay Nicholson, Michel Fries, Samuel C Robson, Jörg D Leuppi, Patrick E Beeler","doi":"10.1007/s40121-026-01377-6","DOIUrl":"10.1007/s40121-026-01377-6","url":null,"abstract":"<p><strong>Introduction: </strong>Hospital admissions due to lower respiratory tract infections (LRTIs) and chronic obstructive pulmonary disease (COPD) represent a substantial healthcare challenge for Switzerland. Demographic shift is expected to exacerbate the burden. Thus, multidimensional projections of healthcare resource utilization, environmental, and (socio)economic impact are necessary to facilitate sustainable healthcare planning for these diseases.</p><p><strong>Methods: </strong>BRONCH-2035 employed historical admissions data (2015-2023) and Swiss governmental population scenario forecasts to project nationwide hospital and intensive care unit (ICU) admissions due to LRTIs and COPD between 2025 and 2035. Projections were then leveraged to estimate future inpatient healthcare expenditures, environmental and socioeconomic burden, employing historic tariff data (SwissDRG) alongside data on disease-agnostic greenhouse gas emissions, Swiss governmental employment and Organization for Economic Co-operation and Development (OECD) economic activity.</p><p><strong>Results: </strong>Compared to 2025, 10,055 (18.4%) additional hospitalizations and an additional 488 (14.3%) ICU admissions due to LRTI and COPD were projected for 2035, requiring 338 (21.8%) additional hospital and 7 (15.9%) surplus ICU beds. Future admissions are estimated to result in an additional 100.2 million Swiss francs (CHF) (18.3%) in inpatient healthcare expenditures and 1.3 million kg (21.1%) additional CO₂-equivalent greenhouse gas emissions. Over the period of 2025-2035, LRTI and COPD-related hospitalizations are projected to cause 2.94 million missed workdays, corresponding to 15,402 lost full-time workers, CHF 1.32 billion in productivity losses, 2.46 billion Purchasing Power Parity (PPP) in lost GDP and CHF 151 million in lost tax revenue.</p><p><strong>Conclusions: </strong>BRONCH-2035 is the first study to project the healthcare, environmental and socioeconomic burdens in LRTI and COPD for Switzerland. Population growth and demographic shift alone are projected to exacerbate LRTI and COPD hospitalizations, ICU admissions, inpatient healthcare expenditures, and bed requirements by 2035, alongside socioeconomic and environmental consequences. These findings provide a robust baseline for healthcare planning, highlighting the need for consistent guideline-concordant prevention and structured outpatient care.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"2199-2221"},"PeriodicalIF":5.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13350596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148294888","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":"Efficacy Outcomes of Fecal Microbiota, Live-jslm in Preventing Recurrent Clostridioides difficile Infection from Seven Clinical Studies.","authors":"Teena Chopra, Daniel Van Handel, Brian Baggott, Robert Orenstein, Kelly Reveles, Beth Guthmueller, Shivam Srivastava, Sahil Khanna","doi":"10.1007/s40121-026-01374-9","DOIUrl":"10.1007/s40121-026-01374-9","url":null,"abstract":"<p><p>Clostridioides difficile infection (CDI) is one of the most common healthcare-associated infections in the US, and recurrence remains a major clinical challenge, as standard-of-care antibiotics fail to prevent recurrence in up to one-third of cases. Fecal microbiota, live-jslm (RBL) is the first single-dose, microbiota-based product approved by the US Food and Drug Administration and Health Canada for the prevention of recurrent CDI (rCDI) following standard-of-care antibiotics. The RBL clinical development program is the largest to date for any microbiota-based product, encompassing seven studies and enrolling over 1700 participants to evaluate the safety and efficacy of RBL in preventing rCDI. Although the RBL development program consistently evaluated both efficacy and safety outcomes across all studies, this review summarizes the study designs, with a primary focus on the efficacy outcomes. The program consists of randomized controlled trials, open-label cohorts, retrospective analyses, and real-world data, each contributing unique insights across different patient populations and treatment settings. All studies enrolled adults aged ≥ 18 years with rCDI who received antibiotics for their enrolling CDI episode before RBL administration. Most studies administered RBL rectally, except for an open-label study and a retrospective study, which evaluated colonoscopic administration of RBL. Treatment success was evaluated at 8 weeks, and sustained clinical response was evaluated at 6 or 24 months after RBL and/or placebo administration, depending on the study design. Overall, the study designs for all seven studies were consistent, with slight differences between number of CDI episodes (specifically, 2 studies allowed enrollment after the first CDI recurrence), blinding, controls, and administration routes. Efficacy data of RBL reported across all studies consistently demonstrated RBL is efficacious for the prevention of rCDI in a broad adult population. TRIAL REGISTRATION: ClinicalTrials.gov. NCT01925417; NCT02299570; NCT02589847; NCT03244644; NCT03931941; NCT05831189.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"2071-2086"},"PeriodicalIF":5.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13350609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239238","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":"The Clinical and Symptomatic Burden Among Older Adults with Respiratory Syncytial Virus: A Real-World Survey in Five European Countries.","authors":"Diana Mendes, James Lucas, Emily Quinones, Mayesha Chowdhury, Libby Turner, Stéphane Fiévez, Caroline Lade, Roberto Di Virgilio, Alejandra López-Ibáñez de Aldecoa, James Piercy, Reiko Sato","doi":"10.1007/s40121-026-01380-x","DOIUrl":"10.1007/s40121-026-01380-x","url":null,"abstract":"<p><strong>Introduction: </strong>Although respiratory syncytial virus (RSV) is a common cause of respiratory illness in older adults (≥ 60 years), data on overall burden remain limited. This study investigated the clinical and symptomatic burden in older adults with RSV in Europe.</p><p><strong>Methods: </strong>Data were drawn from the Adelphi RSV Disease Specific Programme (DSP)™, a cross-sectional survey of physicians and their patients with RSV, conducted across Europe between Q4 2023-Q2 2024. Physicians reported demographics, clinical characteristics, symptoms, disease progression, comorbidities, and impact on health-related quality of life (HRQoL) and activities of daily living (ADL). Patients self-reported HRQoL via the Respiratory Infection Intensity and Impact Questionnaire (RiiQ™) and EQ-5D-5L. Patients were grouped as: A-RSV (Acute, symptom onset 0-< 4 weeks), O-RSV (Ongoing, symptom onset 4-< 12 weeks), P-RSV (Post-acute, symptom onset 12-≤ 52 weeks) and H-RSV (Post-hospital discharge, symptom onset ≤ 52 weeks).</p><p><strong>Results: </strong>Overall, 602 physicians reported data on 1581 patients (n = 237 A-RSV, n = 196 O-RSV, n = 588 P-RSV, n = 560 H-RSV). Of those with H-RSV, 34.1% were aged 75 + (A-RSV: 20.7%) and 58.7% had 3 + concomitant conditions (A-RSV: 29.2%) at diagnosis. RSV affected patients' HRQoL and ADL, psychological well-being, relationships and ability to support/care for family members, with differences observed across groups, particularly in patients with H-RSV (all p < 0.01). Of the 417 (26.4%) patients who self-reported HRQoL, differences across RiiQ™ symptom scores were observed (all p < 0.05), indicating higher burden in the A-RSV and H-RSV groups. Differences in overall EQ-5D-5L scores and in the EQ-5D mobility, self-care and anxiety/depression domains were also significant (all p < 0.05).</p><p><strong>Conclusions: </strong>RSV was associated with high burden. Patients experienced a high symptom burden, and patients with O-RSV, P-RSV and H-RSV experienced persistent symptoms over a long duration post-infection. Patients reported poor HRQoL across all outcome measures. Given this burden, focus on preventive measures such as RSV vaccination should be prioritized.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"2121-2143"},"PeriodicalIF":5.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13350625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148251415","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":"Podcast: Immune Persistence After Primary Vaccination with MenQuadfi.","authors":"Mika Rämet, Mike Simon","doi":"10.1007/s40121-026-01370-z","DOIUrl":"10.1007/s40121-026-01370-z","url":null,"abstract":"<p><p>Invasive meningococcal disease (IMD) remains a serious global health concern. Although incidence is generally low, the disease progresses rapidly and carries high fatality rates of 10-15%, with survivors often experiencing long-term sequelae including hearing loss, neurological impairment, or limb amputations. These consequences highlight the need for effective and durable vaccination strategies. IMD incidence and serogroup distribution vary geographically. The highest burden occurs in the African meningitis belt, historically dominated by serogroup A, though recent outbreaks have increasingly involved serogroups C, W, and X. In Europe, serogroup B is most common, particularly in infants and adolescents, while serogroup Y is rising among adults aged ≥ 65 years. These geographical and demographic differences underscore the importance of region-specific vaccination policies. Polysaccharide vaccines targeting serogroups A, C, W, and Y have played an essential role in outbreak control but are associated with certain limitations: they do not induce immune memory and are poorly immunogenic in infants. These limitations led to the development of conjugate vaccines, where polysaccharide antigens are linked to protein carriers to enhance immunogenicity and memory responses. Several quadrivalent conjugate vaccines (MenACWY), MenQuadfi^®, Menveo^®, and Nimenrix^®, are available, which target the same four serogroups, but differ in antigen composition and carrier proteins. However, access to meningococcal vaccines varies across regions. In this podcast, Professor Mika Rämet and Dr Mike Simon discuss the concept of immune persistence and its relevance for evaluating long-term protection provided by quadrivalent meningococcal vaccines. They review persistence data for MenQuadfi from recent clinical trials and a modeling study across multiple age groups and timepoints, comparing these findings with persistence data for other quadrivalent vaccines. Overall, the evidence supports the use of MenQuadfi as a MenACWY option, including for children, to help provide and maintain protection against IMD in the years following primary vaccination.Podcast available for this article. Supplementary material 1 (MP2 156850 kb).</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"2017-2025"},"PeriodicalIF":5.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13350569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148198625","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":"Real-World Data on the Use of Intravenous Fosfomycin for the Treatment of Central Nervous System Infections: a Subgroup Analysis from the FORTRESS Study.","authors":"Dominik Jarczak, Stefan Kluge, Martin Kieninger, Stefan Hagel, Mathias W Pletz, Michael Zoller, Claudia Spies, Sebastian Kintrup, Lukas Antonitsch, Jörg Zundel, Valerio Del Bono, Valentina Galfo, Marco Falcone, Christina Iasonidou, Loredana Sarmati, Laura Campogiani, Abhijit M Bal, George Dimopoulos, Matthias G Vossen, Claudio M Mastroianni, Klaus-Friedrich Bodmann, Carina Herbst, Christian Mayer","doi":"10.1007/s40121-026-01383-8","DOIUrl":"10.1007/s40121-026-01383-8","url":null,"abstract":"<p><strong>Introduction: </strong>Central nervous system (CNS) infections are associated with high morbidity and mortality, and their management is challenged by antimicrobial resistance and limited cerebrospinal fluid (CSF) penetration of many antibiotics. Intravenous fosfomycin (FOS) offers broad-spectrum activity, favourable pharmacokinetics and reliable CSF penetration, making it a potential partner in combination therapy for severe CNS infections. This interim subgroup analysis of the prospective FORTRESS study evaluated real-world treatment patterns, effectiveness and safety of FOS in patients with CNS infections.</p><p><strong>Methods: </strong>FORTRESS is an ongoing multicentre, non-interventional, international study enrolling patients receiving FOS for severe infections. We analysed patients with documented CNS infections among 1019 enrolled up to June 2025. Effectiveness endpoints at end of treatment (EOT) included clinical success (composite endpoint defined as successful clinical response plus concomitant microbiological cure), successful clinical response (defined as complete or partial resolution of signs and symptoms), microbiological cure, clinical failure and in-hospital mortality. Safety outcomes included adverse drug reactions (ADRs; including serious ADRs) and laboratory parameters.</p><p><strong>Results: </strong>A total of 64 patients with CNS infections were included, of which most were critically ill at baseline, with high rates of ICU admission (90.6%), sepsis (42.2%) and mechanical ventilation (35.9%). Included patients were treated for ventriculitis (53.1%), brain abscess/empyema (26.6%), bacterial meningitis (26.6%) and shunt infections (18.8%), mainly caused by Staphylococcus spp. (48.8%). FOS was administered exclusively in combination regimens, generally as second- or third-line therapy, at high daily doses (median 22.1 g/day). At EOT, clinical success was achieved in 82.8% of patients, a successful clinical response in 92.2% and microbiological cure in 85.9%. All-cause in-hospital mortality was 12.5%. Outcomes were especially favourable in bacterial meningitis (94.1% clinical success) and Gram-positive infections (96.6% clinical success). FOS was generally well tolerated. Electrolyte imbalances were the most common ADRs but were mainly mild and did not require treatment modification.</p><p><strong>Conclusions: </strong>These interim real-world data suggest that FOS, used in combination with other antimicrobial agents, is an effective and well-tolerated treatment option for severely ill patients with CNS infections.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier, NCT02979951.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"2145-2165"},"PeriodicalIF":5.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13350624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239167","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":"Infections in Burn Patients: Pathophysiology, Prevention, and Contemporary Therapeutic Strategies in the Era of Antimicrobial Resistance.","authors":"Ana Cătălina Țânțu, Monica Marilena Țânțu, Corneliu Ovidiu Vrancianu, Andreea-Mihaela Sandu, Roxana-Elena Cristian, Marian Constantin, Alina Păunescu, Daniel Diaconescu, Elena Rodica Dragu, Mădălina Olivia Adameșteanu, Bogdan Chioaru, Sorin Cristian Hariga, Cristian Radu Jecan, Ionică Daniel Vîlcea","doi":"10.1007/s40121-026-01376-7","DOIUrl":"10.1007/s40121-026-01376-7","url":null,"abstract":"<p><p>Burn injuries are associated with significant morbidity and mortality, largely driven by infectious complications. Disruption of the skin barrier, systemic inflammation, and postburn immunosuppression promote microbial colonization and progression to local and systemic infections, a challenge further exacerbated by the increasing prevalence of multidrug-resistant organisms (MDRO). Patients with extensive burns, inhalation injury, prolonged hospitalization, and invasive device use are particularly vulnerable. The microbiological profile of burn wound infections evolves dynamically, shifting from early Gram-positive predominance to Gram-negative and multidrug-resistant (MDR) pathogens, including members of the ESKAPE group, in later stages. Effective management, therefore, requires an integrated approach combining early surgical intervention, strict infection control measures, continuous microbiological surveillance, and targeted antimicrobial therapy. This narrative review synthesizes current evidence on the pathophysiology, risk factors, and microbiological dynamics of burn-associated infections, alongside contemporary prevention and treatment strategies, including topical therapies, advanced biomaterials, systemic antibiotic approaches, and antimicrobial stewardship. Emerging strategies such as nanoparticle-based systems and artificial intelligence-driven predictive models highlight a shift toward precision medicine in burn care; however, their clinical translation remains limited by insufficient validation and standardization. In conclusion, optimizing outcomes in burn-associated infections will depend on integrating evidence-based clinical practices with innovative technologies, while reinforcing antimicrobial stewardship and developing validated predictive tools to address the growing burden of antimicrobial resistance.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"2027-2070"},"PeriodicalIF":5.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13350627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217711","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}