Infection最新文献

{"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}

{"title":"Delayed but successful development of immune memory against SARS-COV-2 after B cell-depleting monotherapy.","authors":"Nicolas Graf, Joseph Bayerl, Barbara Schmidt","doi":"10.1007/s15010-025-02544-6","DOIUrl":"10.1007/s15010-025-02544-6","url":null,"abstract":"<p><strong>Purpose: </strong>Patients receiving CD20-directed therapies are known to insufficiently develop neutralizing antibody titers against SARS-COV-2 after two vaccinations. We investigated the impact of a third and fourth vaccination, possibly deriving predictive factors.</p><p><strong>Methods: </strong>In a monocentric, prospective, non-interventional observational study patients who had received at least one administration of a monoclonal CD20 antibody (mCD20Ab) within 9 months prior to vaccination were included to receive mRNA-based third vaccination. SARS-COV-2 IgG titer was determined before and four weeks after immunisation. Patients without adequate humoral immune response proceeded to a fourth vaccination. Furthermore, tolerability and prespecified potentially influencing factors such as age, baseline lymphocyte counts and others were analysed.</p><p><strong>Results: </strong>Twenty-four patients were included and vaccination was well tolerated. Quantitative analysis of humoral response four weeks after third vaccination revealed a significant increase which, however, did not translate into a clinically relevant seroconversion rate. In the subgroup analysis, patients older than 65 years and mCD20Ab therapy longer than 6 months ago benefited. All evaluable patients on mCD20Ab monotherapy (n = 7) showed an immediate or delayed immune response after third vaccination, while all non-responders (n = 7) were on combination therapy. Clinical parameters such as lymphocyte count, immunoglobulin status and others did not appear to have any influence.</p><p><strong>Conclusion: </strong>An interval of at least 6 months after the last mCD20Ab administration and mCD20Ab monotherapy appears to be favorable for humoral immune response to third vaccination. Furthermore, patients can be reassured that delayed immune responses are possible. Future studies should therefore also investigate seroconversion at later time points.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"2045-2052"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998381","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":"Clinical heterogeneity and treatment outcomes of extrapulmonary tuberculosis in a low-incidence setting: insights from a prospective cohort study.","authors":"Angela Klingmüller, Marie Feldmann, Samuel Rohr, Lea Helmhold, Lena Junker, Margarete Scherer, Jörg-Janne Vehreschild, Kirsten Schmidt-Hellerau, Ada Hoffmann, Jonathan Jantsch, Alexander Simonis, Victor Suárez, Dominic Rauschning, Natalie Funke, Jakob J Malin, Lena M Biehl, Philipp Schommers, Gerd Fätkenheuer, Clara Lehmann, Jan Rybniker, Isabelle Suárez","doi":"10.1007/s15010-025-02500-4","DOIUrl":"10.1007/s15010-025-02500-4","url":null,"abstract":"<p><strong>Purpose: </strong>Tuberculosis (TB) remains a leading cause of morbidity and mortality, with 1.3 million deaths in 2022. Extrapulmonary tuberculosis (EPTB) accounts for approximately 20% of all TB cases. We assessed the clinical presentation and challenges during the course of treatment in EPTB patients in a low-incidence setting.</p><p><strong>Methods: </strong>We conducted a prospective cohort study involving 44 EPTB patients at the University Hospital of Cologne, Germany. Clinical data were collected before and during treatment.</p><p><strong>Results: </strong>The cohort comprised 44 patients originating from 21 countries. Two or more invasive procedures were required for microbiological confirmation in 59% (26/44) of the cases. Sputum culture was positive in 18% (8/44) of patients, with 63% (5/8) showing no radiological signs of pulmonary involvement. The median therapy duration was ten months and increased with disease severity. Paradoxical reactions (PR) occurred in 31% (13/42) of the patients. A previously published clinical scoring system assessing EPTB treatment responses showed a favorable treatment outcome in only 68% (21/31) of the patients in this cohort.</p><p><strong>Conclusion: </strong>EPTB exhibits highly variable disease severity and organ involvement. Treatment initiation is often delayed due to diagnostic challenges. Management is complicated by the frequent occurrence of PR, which can lead to treatment durations exceeding standard recommendations. Clinical scores for treatment response assessment may not be reliably applicable, highlighting the need for alternative biomarkers.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"1809-1818"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604775","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":"Identifying patients at high risk for antibiotic treatment following hospital admission: a predictive score to improve antimicrobial stewardship measures.","authors":"Moritz Beck, Carolin Koll, Uga Dumpis, Christian G Giske, Siri Göpel, Silje Bakken Jørgensen, Johanna Kessel, Lars Kaare Kleppe, Dorthea Hagen Oma, Noa Eliakim Raz, Makeda Semret, Gunnar Skov Simonsen, Maria J G T Vehreschild, Kerstin Albus, Lena M Biehl, Jörg J Vehreschild, Annika Y Classen","doi":"10.1007/s15010-025-02525-9","DOIUrl":"10.1007/s15010-025-02525-9","url":null,"abstract":"<p><strong>Purpose: </strong>Identifying patients for clinical studies evaluating strategies to reduce unnecessary antibiotic usage in hospitals is challenging. This study aimed to develop a predictive score to identify newly hospitalized patients with high likelihood of receiving antibiotics, thus improving patient inclusion in future studies focusing on antimicrobial stewardship (AMS) programs.</p><p><strong>Methods: </strong>This retrospective analysis used data from the PILGRIM study (NCT03765528), which included 1,600 patients across ten international sites. Predictive variables for antibiotic treatment during hospitalization were computed, and an additive score model was developed using logistic regression and 10-fold cross-validation. The PILGRIM score was validated in an independent cohort (validation cohort), with performance metrics assessed.</p><p><strong>Results: </strong>Data from 1,258 patients was included. In the development cohort 52.8% (n = 445) and in the validation cohort 42.4% (n = 134) of patients received antibiotics. Key predictors included hematologic malignancies, immunosuppressive medication, and past hospitalization. The logistic regression model demonstrated an area under the curve of 0.74 in the validation. The final additive score incorporated these predictors plus \"planned elective surgery\" achieving a specificity of 92%, a positive predictive value of 78%, a sensitivity of 41%, and a negative predictive value (NPV) of 69%in validation set.</p><p><strong>Conclusion: </strong>The PILGRIM score effectively identifies newly hospitalized patients likely to receive antibiotics, demonstrating high specificity and PPV. Its application can improve future AMS programs and trial recruitment by facilitating targeted inclusion of patients, especially in the hematological and oncological setting. Further -external and prospective- validation is needed to broaden the model's applicability.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"1941-1952"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963482","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":"Rehospitalizations for ambulatory care sensitive conditions in sepsis survivors- a nationwide cohort study using health claims data 2016-2019.","authors":"Lisa Wedekind, Norman Rose, Antje Freytag, Aurelia Kimmig, Peter Schlattmann, Mathias W Pletz, Thomas Ruhnke, Patrik Dröge, Carolin Fleischmann-Struzek","doi":"10.1007/s15010-025-02606-9","DOIUrl":"10.1007/s15010-025-02606-9","url":null,"abstract":"<p><strong>Purpose: </strong>Sepsis survivors suffer from frequent rehospitalizations, of which a certain proportion is considered preventable by timely and adequate management in the outpatient setting (= ambulatory care sensitive conditions, ACSC). We aimed to assess the frequency of and risk factors for ACSC and infection-associated ACSC rehospitalization among sepsis survivors.</p><p><strong>Methods: </strong>Population-based, retrospective cohort study among using nationwide health claims data of the \"AOK- die Gesundheitskasse\". Sepsis patients with inpatient treatment in 2016-2019 were identified using ICD-codes. Among sepsis hospital survivors, ACSC and infection-related ACSC were identified. Patient-related risk factors for ACSC were assessed by a multiple logistic regression analysis.</p><p><strong>Results: </strong>We included 347,826 sepsis patients and 234,874 sepsis hospital survivors. A total of 53.2% and 21.3% of sepsis survivors had at least one ACSC and infection-related ACSC rehospitalizations in the 12-months post-discharge, respectively. ACSC rehospitalizations often occurred closely after discharge and more frequently affected older, male, care dependent patients as well as those living in rural areas.</p><p><strong>Conclusion: </strong>ACSC are common among sepsis survivors. This underlines to need for structured aftercare programs and interventions in these patients, particularly for ACSC risk groups which comprise older, male, care dependent patients in rural areas.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"2227-2233"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659128","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":"Clinical features, course, and risk factors of infection-associated secondary hemophagocytic lymphohistiocytosis.","authors":"Michael Ruzicka, Thomas Wimmer, Hans-Joachim Stemmler, Stephanie-Susanne Stecher, Hendrik Schulze-Koops, Fabian Hauck, Marion Subklewe, Michael von Bergwelt-Baildon, Karsten Spiekermann","doi":"10.1007/s15010-025-02559-z","DOIUrl":"10.1007/s15010-025-02559-z","url":null,"abstract":"<p><p>Hemophagocytic lymphohistiocytosis (HLH) is an orphan disease characterized by excessive inflammation and poor outcome. We sought to further characterize clinical features, courses, and risk factors of secondary HLH (sHLH) triggered by infection (iHLH). 28 (43.1%) of 65 adult sHLH cases treated at our hospital from 2012-2024 were infection-associated. iHLH patients were mostly male (71.4%). Infectious agents most frequently detected were EBV (57.1%) and leishmania (14.3%). The median time to diagnosis was 13 [6.0;24.8] days. iHLH patients had a mortality rate of 39.3% (median follow-up time: 735 [336;1140] days), worse survival than patients with autoimmune-triggered (hazard ratio: 3.33 (1.01-11.10), p = 0.049), and better survival than patients with paraneoplastic HLH (hazard ratio: 0.19 (0.10-0.84), p = 0.002). Elevated levels of soluble interleukin-2 receptor (sIL2R; > 6,000 I/U), low thrombocyte counts (< 40 G/l), and a history of malignant disease were associated with adverse outcomes. Protracted time to diagnosis was associated with severe disease courses and with leishmaniosis. Further, sIL2R levels correlated positively with prolonged aPTT and thrombocytopenia, and hypertriglyceridemia with elevated INRs. Patients with an elevated sIL2R:ferritin ratio were more likely to have a history of malignant comorbidities. Taken together, sIL2R, thrombocytopenia, and a history of malignant disease are important prognostic factors of iHLH. Patients with high sIL2R levels or hypertriglyceridemia may be at higher risk of bleeding, and patients with elevated sIL2R:ferritin ratios should be assessed for possible malignant comorbidities. Lastly, increased awareness of the disease and newly emerging pathogens (i.e. leishmania) may shorten the time to diagnosis, and thus reduce severe courses of iHLH.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"2135-2147"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158483","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":"Predictors of mortality of enterococcal bacteraemia and the role of source control interventions; a retrospective cohort study.","authors":"Virgile Zimmermann, Nicolas Fourré, Laurence Senn, Benoit Guery, Matthaios Papadimitriou-Olivgeris","doi":"10.1007/s15010-025-02561-5","DOIUrl":"10.1007/s15010-025-02561-5","url":null,"abstract":"<p><strong>Purpose: </strong>To identify predictors of mortality among patients with enterococcal bacteraemia.</p><p><strong>Methods: </strong>This retrospective study was conducted at the Lausanne University Hospital, Switzerland and included adult patients with enterococcal bacteraemia from 2014 to 2023.</p><p><strong>Results: </strong>During the study period, 768 enterococcal bacteraemia episodes were included. The predominant species was Enterococcus faecalis (427 episodes; 56%). Sepsis or septic shock were present in 351 (46%) episodes. The overall 30-day mortality rate was 19% (148 episodes). The Cox multivariable regression model showed that age > 60 years (aHR: 1.75, 95% CI: 1.05-2.90), nosocomial infection (1.78, 1.19-2.65), sepsis or septic shock (3.67, 2.48-5.45), and not performing source control interventions within 48 h, in patients on or discussing of transitioning to limitations of care (5.91, 3.13-11.14) were associated with 30-day mortality. Conversely, infectious diseases (ID) consultation within 48 h (0.40, 0.28-0.57), appropriate antimicrobial therapy within 48 h (0.54, 0.34-0.86), and source control interventions performed within 48 h (0.22, 0.14-0.36) or not warranted (0.54; 0.34-0.86) were associated with survival. Among the 737 episodes without limitation of care, the Cox multivariable regression model showed that nosocomial infection (1.78, 1.19-2.67), sepsis or septic shock (3.76, 2.42-5.82), were associated with 30-day mortality. Conversely, ID consultation within 48 h (0.44, 0.30-0.65), appropriate antimicrobial therapy within 48 h (0.51, 0.30-0.86), and source control interventions performed within 48 h (0.25, 0.16-0.40) or not warranted (0.40; 0.26-0.61) were associated with survival.</p><p><strong>Conclusions: </strong>Our findings underscore the pivotal role of early management of enterococcal bacteraemia, including ID consultation, appropriate antimicrobial treatment initiation and performance of source control interventions.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"2149-2158"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119660","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":"Molecular and ecological determinants of mammalian adaptability in avian influenza virus.","authors":"Muzamil Ahmad Rather, Amreena Hassan, Muttahir Aman, Irfan Gul, Ashaq Hussain Mir, Varsha Potdar, Parvaiz A Koul, Syed Mudasir Ahmad, Nazir Ahmad Ganai, Riaz Ahmad Shah, Naveed Anjum Chikan, Mohamed Faizal Abdul-Careem, Nadeem Shabir","doi":"10.1007/s15010-025-02529-5","DOIUrl":"10.1007/s15010-025-02529-5","url":null,"abstract":"<p><p>The avian influenza virus (AIV) primarily affects birds and poses an increasing concern due to its growing adaptability to other hosts, heightening zoonotic risks. The adaptability is a key factor in AIV to infect multiple non-avian species, including humans, companion animals, aquatic mammals, carnivores, and other mammals. The virus is evolving through genetic mutations and reassortments, leading to the emergence of AIV strains with enhanced virulence and adaptability in mammals. This highlights the critical need to understand the genetic factors of AIV, including mutations in polymerase proteins, surface antigens, and other regulatory proteins, as well as the dynamics of AIV-host interactions and environmental factors such as temperature, humidity, water salinity, and pH that govern the cross-species adaptability of the virus. This review provides comprehensive insights into the molecular/genetic changes AIV undergoes to adapt in mammalian hosts including bovines, swine, equines, canines, and felines. The adaptive mutations in viral polymerase proteins, such as PB2-E627K, and receptor specificity shift facilitate the virus adaptability in mammals. Since AIVs interact with specific receptors on host cells, therefore the type and distribution of receptors are crucial in determining the host range of the virus and its adaptability by facilitating attachment and entry of the virus. This review examines sialic acid receptor distribution and binding patterns in various mammalian hosts, emphasizing how the presence and structure of specific receptors influence viral interaction, adaptation, and transmission. The review concludes that the differential distribution and expression of SA receptors are vital in the mammalian adaptability and tissue tropism of viral strains. Notably, during the adaptation to mammals, AIVs show a shift in preference from α-2,3 to α-2,6 receptors. This review further emphasizes the role of ecological determinants in the adaptation of viruses to mammalian hosts. Low temperatures, high humidity, and neutral to slightly acidic pH levels enhance virus stability, facilitating its persistence in the environment and spread among susceptible hosts. Overall, AIV remains a global health threat, necessitating coordinated efforts in research, surveillance, and public health strategies.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"1575-1601"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962687","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":"Prevention of varicella-zoster virus infection in early childhood children: effect of 1 versus 2 doses of varicella vaccine on antibody levels.","authors":"Dan Wu, Changlei Han, Suting Xiong, Peipei Zhang, Han Gao, Jingyi Jiang, Fengming Wang, Xufeng Lv, Fang Yao, Qinwen Xu","doi":"10.1007/s15010-025-02532-w","DOIUrl":"10.1007/s15010-025-02532-w","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to ascertain the factors influencing the varicella-zoster virus (VZV) IgG seropositivity and to evaluate the efficacy of varicella vaccination with 1- and 2-dose schedules.</p><p><strong>Methods: </strong>A systematic sampling method was employed to recruit subjects. VZV IgG was calculated using the geometric mean concentration (GMC) and a 95% confidence interval (CI). A multifactorial logistic regression model was employed to calculate the odds ratios (OR) and to identify the influential factors for varicella antibody positivity. A generalized additive model for location, shape and scale (GAMLSS) was employed to compare centile reference values and centile curves of antibody levels for different doses of varicella vaccine (VarV).</p><p><strong>Results: </strong>785 individuals were included. The VarV positivity rate was 57.7% for 1 dose and 84.2% for 2 doses. Varicella antibody positivity was significantly associated with VarV doses and time since last vaccination. The GAMLSS model indicated a decline in VZV IgG over time, with the 2-dose group demonstrating superior performance to the 1-dose group across all centile reference values and curves.</p><p><strong>Conclusion: </strong>A 2-dose schedule is more effective in improving both VZV IgG seropositivity and GMC than a single dose. The inclusion of the VarV in routine immunization programme should be considered.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"1993-2003"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795015","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":"A rise in severe necrotizing fasciitis- another consequence of the COVID-19 pandemic?","authors":"Alexander Eijkenboom, Jan Friederichs, Simon Hackl, Sven Hungerer","doi":"10.1007/s15010-025-02564-2","DOIUrl":"10.1007/s15010-025-02564-2","url":null,"abstract":"<p><strong>Purpose: </strong>During the COVID-19 pandemic restrictions such as social distancing, lockdowns and mask mandates were imposed by Germany's government. After these interventions were abolished, an increase in group A streptococcal infections, including necrotizing fasciitis, was observed in our Level 1 trauma center. The aim of this study was to evaluate the incidence of type I and type II necrotizing fasciitis (NF) before, during and after the COVID-19 pandemic.</p><p><strong>Methods: </strong>165 patients with severe NF, treated in our Level 1 trauma center, were included between 2010 and 2023. Patients were categorized into a pre-mask, mask and post-mask group, according to their date of admission relative to the COVID-19 pandemic. Clinical parameters and patient characteristics were assessed between groups.</p><p><strong>Results: </strong>In the pre-mask group, type I NF (69%) was more common than type II NF (31%). In the mask group 95% of patients had type I NF. In the post-mask group, Streptococcus pyogenes triggered type II NF dominated with 74% of all cases. There was a significant increase in NF type II cases in the post-mask group compared to the pre-mask and mask-group (p < 0.001). Patients with NF in the post-mask group appeared significantly healthier and tended to be younger than patients before and during the COVID-19 pandemic.</p><p><strong>Conclusion: </strong>This study supports the hypothesis that the general population has acquired an \"immune debt\" following the COVID-19 pandemic, resulting in an increase in necrotizing fasciitis incidence, especially triggered by Streptococcus pyogenes, after restrictions such as mask mandates and social distancing were lifted.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"2169-2177"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215726","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}