Infection最新文献

{"title":"Effective surveillance of acute COVID-19 using a cost- and labor-efficient approach: a paradigm for the longitudinal monitoring of respiratory infections in larger cohorts.","authors":"Paul R Wratil, Niklas A Schmacke, Burak Karakoc, Christopher Dächert, Elif Apak, Franziska Krenn, Sara Bjedov, Irina Badell, Tamara Pflantz, Alexandra Lübke, Vanessa Ferrari, Aldric Namias, Alexander Graf, Natascha Grzimek-Koschewa, Helga Mairhofer, Ina Koeva-Slancheva, Stefan Hörmansdorfer, Stefan Krebs, Helmut Blum, Ernst-W Raschner, Matthias Klein, Stephan Boehm, Veit Hornung, Martin R Fischer, Oliver T Keppler","doi":"10.1007/s15010-025-02526-8","DOIUrl":"10.1007/s15010-025-02526-8","url":null,"abstract":"<p><strong>Purpose: </strong>To reduce the risk of viral transmission in a large cohort of individuals by longitudinal surveillance of COVID-19.</p><p><strong>Methods: </strong>A cost- and labor-effective method was developed for longitudinal screening of acute COVID-19 in larger cohorts with high-level data protection. Herein, individuals would submit self-sampled tongue swabs that were analyzed for viral RNA by pooled reverse transcription-polymerase chain reaction (PCR). Results were communicated online and by telephone. Utilizing this workflow, medical and dental students at a quaternary care hospital were regularly tested between December 16, 2020, and February 17, 2023. Virus variant analysis was performed by melting curve PCR and next-generation sequencing.</p><p><strong>Results: </strong>Our method led to a cost reduction for PCR testing that was greater than 10-fold without compromising the time to result. 3,693 individuals participated, contributing 52,993 samples. 430 cases of acute COVID-19 were detected in total. The testing behavior among participants differed from that of the general population. Periods with high numbers of newly detected cases in the study cohort coincided with high COVID-19 incidences in the public. Furthermore, one COVID-19 outbreak was observed in the cohort that was not matched by an increased incidence in the general population. Longitudinal virus variant analysis showed an overlap between variants detected in the study cohort and the public.</p><p><strong>Conclusion: </strong>Our method enables cost-effective, longitudinal screening for COVID-19 and possibly other respiratory diseases in larger cohorts. At times of high disease burden or if public surveillance is less vigorous, this approach might be useful for the surveillance of vulnerable individuals and healthcare professionals.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"1953-1963"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with persistent bacteraemia among patients with suspected infective endocarditis.","authors":"André Teixeira-Antunes, Virgile Zimmermann, Nicolas Fourré, Nicoleta Ianculescu, Pierre Monney, Georgios Tzimas, Laurence Senn, Piergiorgio Tozzi, Matthias Kirsch, Benoit Guery, Matthaios Papadimitriou-Olivgeris","doi":"10.1007/s15010-025-02537-5","DOIUrl":"10.1007/s15010-025-02537-5","url":null,"abstract":"<p><strong>Purpose: </strong>To ascertain the predictors of persistent bacteraemia among patients with suspected infective endocarditis (IE) and those with IE.</p><p><strong>Methods: </strong>Retrospective study.</p><p><strong>Setting: </strong>This study conducted at a Swiss university hospital (2015-2023) included adult patients with bacteraemia and suspected IE. Persistent bacteraemia was defined as continued positive blood cultures with the same microorganism for at least 48 h from antibiotic treatment initiation. Endocarditis Team classified cases as IE or not IE.</p><p><strong>Results: </strong>Among 2312 episodes of suspected IE, S. aureus was the most common pathogen (1045 episodes; 45%). IE (644; 28%) was the most prevalent infection type. Persistent bacteraemia was observed in 480 (21%) episodes and was independently associated with S. aureus, ≥ 2 positive sets of index blood cultures, resistant bacterium, sepsis, IE, central venous catheter-associated bacteraemia, and acute native bone and joint infections (BJIs), while, streptococcal bacteraemia, appropriate initial antimicrobial treatment and, performance of source control interventions within 48 h were associated with rapid blood culture clearance. Of the 644 IE episodes, persistent bacteraemia was observed in 196 (30%) and was associated with obesity, S. aureus, ≥ 2 positive sets of index blood cultures, resistant bacterium, acute native BJIs, immunologic phenomena, thoracic embolic events, while streptococcal bacteraemia and performance of source control interventions within 48 h were associated with rapid clearance of blood cultures.</p><p><strong>Conclusions: </strong>Persistent bacteraemia was associated with S. aureus and BJI. Delaying source control interventions may increase the risk of persistent bacteraemia. No specific intracardiac lesion was associated with persistent bacteraemia in IE episodes.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"2015-2024"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suspected Buruli ulcer cases in Tonkolili District, Sierra Leone- a prospective cohort study.","authors":"Jonathan Vas Nunes, Lars Wassill, Giulia Mönnink, Abdul-Mac Falama, Hanna Mathéron, Amara Conteh, Maxwell Sesay, Aminata Sesay, Håkon Bolkan, Martin P Grobusch, Frieder Schaumburg","doi":"10.1007/s15010-025-02548-2","DOIUrl":"10.1007/s15010-025-02548-2","url":null,"abstract":"<p><strong>Purpose: </strong>There is a high burden of chronic ulcers in Sierra Leone. However, (early) diagnosis and treatment are challenging. Data on endemicity of Mycobacterium ulcerans is limited to WHO reports from 2008 to 2011.</p><p><strong>Methods: </strong>Patients presenting with wounds at Masanga Teaching Hospital were included in a prospective cohort study and scored following the WHO clinical list for Buruli ulcer (BU). Wounds were screened for M. ulcerans by selective culture on solid and liquid media and loop-mediated isothermal amplification (LAMP) of the M. ulcerans specific IS2404.</p><p><strong>Results: </strong>Between July 2019 and November 2020, 159 patients were included. The median age was 41 years (range: 2-92), 34% (54/159) were female and 56% (89/159) were literate. The median duration of a wound before admission was 12 months (range: 0-720 months), 87% (137/159) of lesions were below the knee. Wounds of 37% (58/159) of the patients were clinically scored as '(very) likely to be Buruli ulcer'. Seven out of 72 patients tested by LAMP were positive for IS2404, two showed specific melting curves. None of the wound swabs yielded a positive culture for M. ulcerans. Ninety-eight (62%) patients had a wound-related surgery during this study, 101 (63%) of patients were improving or healed at the time of discharge.</p><p><strong>Conclusions: </strong>The prevalence of BU based on the WHO scoring system is high in Sierra Leone. National and international awareness, training of healthcare workers, development of in-country bacteriology as well as the furthering of robust molecular and immunological assays could reduce the burden of this neglected tropical disease.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"2073-2082"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of Ensitrelvir in asymptomatic or mild to moderate COVID-19: a systematic review and meta-analysis of randomized controlled trials.","authors":"Muhammad Zain Ul Haq, Saad Ashraf, Muhammad Shahmeer Ullah Shah, Samia Aziz Sulaiman, Ayesha Shaukat, Muhammad Ahsan Ansari, Areeba Aamir Ali Basaria, Laveeza Fatima, Humza Saeed, Aman Goyal, Mohamed Daoud","doi":"10.1007/s15010-025-02582-0","DOIUrl":"10.1007/s15010-025-02582-0","url":null,"abstract":"<p><strong>Introduction: </strong>Since late 2019, COVID-19 has had a catastrophic impact on public health. Ensitrelvir, a new antiviral targeting the SARS-CoV-2 main protease, has reduced viral replication and disease severity. This meta-analysis and systematic review assessed Ensitrelvir's efficacy and safety in patients with mild-to-moderate COVID-19 symptoms.</p><p><strong>Methods: </strong>A comprehensive search was conducted in PubMed (Medline), Scopus, Embase, and CENTRAL up to July 2024 to retrieve randomized controlled trials (RCTs) comparing Ensitrelvir to placebo in adults with mild to moderate, RT-PCR-confirmed COVID-19. Outcomes were assessed at standardized time points, with viral RNA measured at day 4. Mean differences (MD) for continuous outcomes and risk ratios (RR) for binary outcomes, both with 95% confidence intervals (CIs), were calculated using the Mantel-Haenszel random-effects model. Efficacy outcomes included SARS-CoV-2 viral RNA, while safety outcomes included HDL, triglycerides, bilirubin, AST, headache, diarrhea, TEAEs, TRAEs, serious TEAEs, and treatment discontinuation. The quality of the included RCTs was assessed with the Cochrane Risk of Bias 2 (ROB2) tool.</p><p><strong>Results: </strong>The analysis included six RCTs with 2,793 participants: 1,860 received Ensitrelvir and 933 were given a placebo. Ensitrelvir gave significant results for reduced viral RNA levels of SARS-CoV-2 [MD: - 1.35; 95% CI - 1.58 to - 1.13; p < 0.01] and the incidence of lower cholesterol levels [RR: 8.83; 95% CI 4.05 to 19.27; p < 0.01] compared to the placebo group. However, it was associated with increased risks of decreased HDL levels, elevated triglycerides, increased bilirubin, more headaches, and a higher overall occurrence of treatment-emergent adverse events.</p><p><strong>Conclusion: </strong>Ensitrelvir effectively reduces viral load in COVID-19 patients, but its safety profile raises concerns due to significant adverse effects. The benefits must be carefully weighed against the risks, and further research is needed to confirm its role in treatment and to find ways to mitigate these adverse effects.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"1645-1661"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Streptococcus suis endocarditis: prognostic factors and antimicrobial resistance.","authors":"Wilawan Thipmontree, Udomsak Lerssuttipon, Piyapat Chunharas, Rattagan Kajeekul, Atitaya Lewrod, Suganya Yongkiettrakul, Anusak Kerdsin","doi":"10.1007/s15010-025-02497-w","DOIUrl":"10.1007/s15010-025-02497-w","url":null,"abstract":"<p><strong>Purpose: </strong>Streptococcus suis is an important zoonotic pathogen worldwide. This study aims to identify prognostic factors associated with the development of infective endocarditis (IE) and mortality in patients with S. suis bacteremia.</p><p><strong>Methods: </strong>A retrospective cross-sectional study was conducted by reviewing the medical records of patients with culture-confirmed S. suis infection admitted to a tertiary care hospital in Thailand between 2021 and 2023.</p><p><strong>Results: </strong>Among 200 patients with S. suis bacteremia who underwent echocardiograms, 102 (51%) were diagnosed with IE. Between 2021 and 2023, resistance to penicillin in S. suis increased from 13.0 to 38.7%, while intermediate susceptibility to ceftriaxone rose from 2.2 to 13.3%. Patients with S. suis bacteremia were at higher risk of developing IE if the strains were penicillin-resistant (aPR: 7.94, 95% CI: 1.13-55.80) or if persistent bacteremia was present (aPR: 1.58, 95% CI: 1.27-1.96) in multivariable analysis. Other risk factors included illness duration of more than 14 days (aPR: 2.19, 95% CI: 1.66-2.89) and being under 60 years of age (aPR: 1.42, 95% CI: 1.09-1.83). All-cause in-hospital mortality for patients with S. suis IE was 28.4% (95% CI: 19.9-38.2), higher than that of patients without IE (15.3%, 95% CI: 8.8-24.0). Embolic stroke and acute kidney injury increased the risk of death 3.28-fold (95% CI: 1.82-5.91) and 2.87-fold (95% CI: 1.06-7.79), respectively, after adjusting for confounders.</p><p><strong>Conclusion: </strong>S. suis is a common cause of IE, particularly among antimicrobial-resistant strains, leading to high morbidity and mortality. Echocardiography is recommended for patients with S. suis bacteremia, although managing drug-resistant infections remains challenging.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"1779-1787"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for 30-Day mortality and the role of empirical therapy in Pseudomonas aeruginosa bloodstream infections.","authors":"Nicholas Geremia, Federico Giovagnorio, Antonio Vena, Silvia Corcione, Maddalena Giannella, Simone Mornese Pinna, Francesca Giovannenze, Renato Pascale, Davide Fiore Bavaro, Beatrice Brusasco, Vincenzo Scaglione, Malgorzata Mikulska, Veronica Vassia, Marco Merli, Daniele Roberto Giacobbe, Andrea Marino, Giuseppe Accurso, Gabriele Pagani, Domenico Faliero, Benedetta Fumarola, Michele Bartoletti, Pierluigi Viale, Francesco Giuseppe De Rosa, Matteo Bassetti","doi":"10.1007/s15010-025-02603-y","DOIUrl":"10.1007/s15010-025-02603-y","url":null,"abstract":"","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"2243-2256"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caseload, clinical spectrum and economic burden of infectious diseases in patients discharged from hospitals in Germany.","authors":"H Stocker, F Kron, P Hartmann, K de With, M Addo, M Vehreschild, G Fätkenheuer, B Salzberger, L E Sander, Jan Rupp","doi":"10.1007/s15010-025-02507-x","DOIUrl":"10.1007/s15010-025-02507-x","url":null,"abstract":"<p><strong>Background: </strong>Over the last century infectious diseases have been kept under control in industrialized countries thanks to advances in hygiene, prevention and antimicrobial treatments. However, the emergence of HIV, the COVID-19 pandemic, and the rise of resistant bacteria exemplify that infectious diseases continue to pose a global threat. A comprehensive understanding of the caseload, spectrum of infectious diseases and the economic impact they pose is required to develop strategies for managing infectious diseases in a resilient healthcare system.</p><p><strong>Objectives: </strong>(i) to determine the proportion of adult patients discharged from German hospitals with primary diagnoses classified as an infectious disease, (ii) to describe the clinical spectrum of these diagnoses, case characteristics, and hospital settings, and (iii) to estimate the total economic burden that these cases contribute to the in-patient sector of the healthcare system.</p><p><strong>Methods: </strong>A retrospective case-control study was performed using publicly available data on ICD10 codes assigned as primary diagnoses, case characteristics, treatment settings, and cost weights from all patients discharged from German hospitals in 2022.</p><p><strong>Results: </strong>1,728,824 adult patients (12% of all adult patients) were discharged with a primary diagnosis classified as an infectious disease. They were assigned 912 individual ICD10 codes. The 15 and 79 most frequently used codes comprised 40% (top 40% ID population) and 80% (top 80% ID population) of all infectious disease cases, respectively. In the top 80% ID population, patients were older, were more likely to be male, and had higher complexity and comorbidity levels than the reference population, which consisted of all adult patients minus the patients in the top 80% ID population. The mean length of stay of patients forming the top 80% ID population was 8.0 days vs. 6.1 days in the reference population. The median (IQR) cost weight was 0.663 (0.544-1.030) translating into €2,541 per case.</p><p><strong>Conclusions: </strong>In Germany, patients with infectious diseases constitute a significant proportion of all inpatients, with a broad spectrum of conditions. These patients are generally older, more severely ill, and require longer hospital stays than those without a primary infectious disease diagnosis, contributing substantially to the overall economic burden on the healthcare system.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"1863-1873"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clostridioides difficile evolution in a tertiary German hospital through a retrospective genomic characterization.","authors":"Fabian Lorenzo-Diaz, Tilman E Klassert, Cristina Zubiria-Barrera, Amelya Keles-Slevogt, Mario Gonzalez-Carracedo, Mariano Hernandez, Hortense Slevogt, Thomas Grünewald","doi":"10.1007/s15010-025-02576-y","DOIUrl":"10.1007/s15010-025-02576-y","url":null,"abstract":"<p><strong>Purpose: </strong>Clostridioides difficile is a major cause of healthcare-associated infections, contributing to significant morbidity and mortality. This study aimed to investigate the genomic characteristics, antimicrobial resistance (AMR) profiles, and temporal dynamics of C. difficile strains isolated from hospitalized patients in a German tertiary hospital over nearly two decades (1997-2015).</p><p><strong>Methods: </strong>Whole-genome sequencing was performed on 46 toxigenic C. difficile isolates to determine sequence types (STs) and phylogenetic relationships and these were compared to national surveillance data on C. dificile. AMR profiling was conducted to identify key resistance determinants at genetic level while epsilometer minimum inhibitory concentration (MIC) analyses were used to correlate genetic resistance markers with phenotypic resistance. Longitudinal antibiotic usage data were analysed to assess potential associations with resistance profiles and strains evolution.</p><p><strong>Results: </strong>Five predominant STs were identified: ST1 (30%), ST54 (24%), ST3 (22%), ST11 (11%), and ST37 (4%). Phylogenetic analysis showed that ST1 (ribotype 027) emerged as the dominant and persistent lineage, replacing ST11 and ST54 over time. AMR profiling detected several resistance genetic markers such as CDD-1/CDD-2 (carbapenem resistance), ErmB (macrolide-lincosamide-streptogramin B resistance/MLS resistance), and mutations in gyrA (fluoroquinolone resistance) and rpoB (rifampicin resistance). MIC analyses confirmed high resistance rates to moxifloxacin (87%) and rifampicin (59%), while susceptibility to fidaxomicin, metronidazole, and vancomycin remained. The tetM gene, associated with doxycycline resistance, declined as ST11 and ST54 frequencies decreased. Longitudinal analysis revealed a reduction in moxifloxacin resistance following its decreased use, whereas increased doxycycline use paradoxically correlated with reduced resistance.</p><p><strong>Conclusion: </strong>This study highlights the dynamic strain evolution of C. difficile, reflecting national trends in strain evolution. The findings emphasize the strong correlation between epsilometer MIC values and molecular resistance markers. This observation reinforces the integration of genetic surveillance with antibiotic stewardship in the clinical routine to effectively mitigate CDI recurrence. Further research is needed to better understand the complex interactions between antibiotic exposure and strain evolution in hospital environments.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"2209-2218"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 COVID-19 in immunocompromised patients in Germany: a retrospective, observational Study on Health Insurance Data from 2021 to 2022.","authors":"Julia Weinmann-Menke, Clemens-Martin Wendtner, Dennis Häckl, Vanessa Lohe, Phi Long Dang, Fungwe Jah, Nikolaus Kneidinger","doi":"10.1007/s15010-025-02516-w","DOIUrl":"10.1007/s15010-025-02516-w","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with COVID-19 and immunocompromising conditions are threatened with higher morbidity, mortality and a greater economic burden than immunocompetent persons due to an inadequate immune response to infection and vaccination. Health and economic COVID-19 outcomes in 2021 and 2022, a period during which vaccines became available gradually, were investigated.</p><p><strong>Methods: </strong>This retrospective observational study was based on statutory health insurance (SHI) claims data of approximately 2.7 million insurees each of 2021 and 2022, extrapolated to the overall German SHI population. An immunocompromised group was defined via several risk factors. COVID-19-related outcomes were compared to a group without risk factors (immunocompetent group).</p><p><strong>Results: </strong>In both years, COVID-19-associated hospitalizations were significantly elevated in the immunocompromised group (33.11% vs 7.88% in 2021, 19.25% vs 2.21% in 2022), as were ICU admission (9.17% vs 1.75% and 3.94% vs 0.32%), mortality (9.70% vs 1.62% and 3.42% vs 0.30%), and average costs for hospitalizations (17,966 € vs 12,769 € and 16,640 € vs 10,853 €). Hospitalization/intensive care unit (ICU) admission rates and COVID-19 associated mortality decreased from 2021 to 2022 in both groups, but more prominently in the immunocompetent group. Consequently, the gap between both groups increased.</p><p><strong>Conclusion: </strong>From 2021 to 2022, the health and economic burden of COVID-19 remained substantially elevated in the immunocompromised group, despite availability of vaccines and authorized treatments.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"1887-1897"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographic origins, transmission hotspots, and drug resistance mutations of HIV-1 CRF08_BC in Zhejiang Province, China.","authors":"Hehe Zhao, Jun Jiang, Chengliang Chai, Xiaohong Pan, Fan Lyu, Hui Xing, Yi Feng, Wei Cheng, Guixia Li, Jianhua Mei, Ping Zhong, Zhihong Guo, Xin Zhou, Qin Fan, Jiafeng Zhang","doi":"10.1007/s15010-025-02530-y","DOIUrl":"10.1007/s15010-025-02530-y","url":null,"abstract":"<p><strong>Purpose: </strong>To understand the geographic origins, transmission hotspots, and drug resistance mutations (DRMs) of HIV-1 CRF08_BC in Zhejiang Province, China.</p><p><strong>Methods: </strong>This study analyzed HIV-1 CRF08_BC pol sequences collected between 2020 and 2023. Bayesian inference was employed to investigate temporal epidemic trends, while HIV-TRACE and MCODE were used to identify transmission clusters (TCs), key hotspots and super-spreaders. DRMs associated with CRF08_BC were also characterized. Additionally, demographic data were integrated with these findings, allowing for a description of the transmission dynamics.</p><p><strong>Results: </strong>This study revealed that CRF08_BC strains in Zhejiang likely originated from Guangxi, with significant transmission among individuals aged 50 and older, particularly those with low educational levels. Molecular transmission analysis showed that 58.9% of CRF08_BC sequences were in TCs, with geographic concentrations in Taizhou (TZ) and Lishui (LS). 14 large clusters maintained effective reproductive numbers (Re) above 1, representing considerable epidemic growth. Hangzhou (HZ) emerged as a key transmission hub, with 10 TCs showing active transmission. LS established strong epidemiological links with HZ, Ningbo (NB), Taizhou (TZ), and Wenzhou (WZ), creating a pattern of viral spread radiating from LS to surrounding areas. DRMs were identified in 76 cases (6.0%), with NNRTI and NRTI mutations exhibiting distinct geographic clustering.</p><p><strong>Conclusions: </strong>The CRF08_BC strains in Zhejiang likely originated from Guangxi and are mainly found in individuals aged 50 and older with low education. The current epidemic hotspots are in TZ and LS, where NNRTI and NRTI mutations are clustered, significantly impacting treatment efficacy.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"1965-1977"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}