Infection最新文献

{"title":"Piperacillin/tazobactam versus carbapenems for 30-day mortality in patients with ESBL-producing Enterobacterales bloodstream infections: a retrospective, multicenter, non-inferiority, cohort study.","authors":"Thomas Sahlström Månsson, Alice Askemyr, Torgny Sunnerhagen, Johan Tham, Kristian Riesbeck, Lisa Mellhammar","doi":"10.1007/s15010-025-02496-x","DOIUrl":"10.1007/s15010-025-02496-x","url":null,"abstract":"<p><strong>Purpose: </strong>Antimicrobial resistance increases with the use of broad-spectrum antibiotics. Studies evaluating antibiotic stewardship are in high demand. Is piperacillin/tazobactam non-inferior to carbapenems regarding 30-day mortality among patients with bloodstream infections caused by extended-spectrum beta-lactamase-producing Enterobacterales?</p><p><strong>Methods: </strong>This retrospective, multicenter, non-inferiority, cohort study assessed adult patients with bloodstream infections caused by extended-spectrum beta-lactamase-producing Enterobacterales in southern Sweden from 2013 to 2022. Patients were categorized according to the first therapy they received two consecutive doses of (piperacillin/tazobactam or a carbapenem). The primary outcome was 30-day all-cause mortality, measured from when the positive blood cultures were taken. The absolute risk difference for this outcome was calculated for all patients, and two propensity score matched cohorts (empirical and effective), with two different delta limits (5% and 2%). Secondary outcomes included intensive care unit admission, early clinical response, superinfections, relapsed infection and one-year mortality.</p><p><strong>Results: </strong>A total of 644 patients were included. In the piperacillin/tazobactam group, 26/309 patients met the primary outcome, compared to 27/335 patients in the carbapenem group. The absolute risk difference (-0.4%) was statistically significant in the propensity score matched empirical cohort [1-sided 97.5% confidence interval]: -∞ to 4.0, p = 0.008). Piperacillin/tazobactam was non-inferior to carbapenems for all the secondary outcomes in the same cohort, except for the early clinical response.</p><p><strong>Conclusion: </strong>Our findings indicate that piperacillin/tazobactam is non-inferior to carbapenems for treating extended-spectrum beta-lactamase-producing Enterobacterales bloodstream infections, with an acceptable 5% increase in 30-day mortality. We suggest that piperacillin/tazobactam should be used more frequently to decrease antimicrobial resistance.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"1769-1777"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013464","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":"Microbiological diversity among patients with Lemierre syndrome and clinical implications: an individual patient-level analysis.","authors":"Maurus Frehner, Riccardo M Fumagalli, Silvio D Brugger, Silvia Cardi, Filippo Catalani, Alice Trinchero, Alessandro Pecci, Nils Kucher, Luca Valerio, Stefano Barco","doi":"10.1007/s15010-025-02489-w","DOIUrl":"10.1007/s15010-025-02489-w","url":null,"abstract":"<p><strong>Purpose: </strong>Lemierre syndrome is a rare condition traditionally defined by bacterial infection of the head/neck region, local thrombophlebitis, and septic embolism. Although in most cases Fusobacterium necrophorum is isolated, it is questionable whether the presence of this microbe is mandatory for diagnosis. In this study, we investigated microorganisms isolated in cases of Lemierre syndrome and their association with demographical and clinical features.</p><p><strong>Methods: </strong>We conducted an analysis of individual patient data from 712 patients diagnosed with Lemierre syndrome. Demographics, clinical presentation, treatment strategies, and outcomes according to different pathogens were evaluated.</p><p><strong>Results: </strong>Among a total of 712 patients, in 574 cases bacterial growth was detected. In 415 patients Fusobacterium spp. was isolated, in 108 either Streptococcus spp. or Staphylococcus spp., and in 51 other bacteria. Patients with different bacteria differed markedly in age, site of preceding infections, clinical presentation, and treatment. Fusobacterium spp. was typically isolated in younger patients (69% of patients aged 16 to 30 years) while Streptococcus spp. and Staphylococcus spp. were more prevalent in older subjects (30% of patients aged over 45 years). Of all cases with Fusobacterium spp., 63% had a thrombosis of the internal jugular vein and 91% septic embolism, compared with 94% and 69%, respectively, in cases with Streptococcus spp. or Staphylococcus spp.</p><p><strong>Conclusion: </strong>In contrast to the available literature, our study suggests that Lemierre syndrome may be caused by multiple bacterial species, and that the clinical presentation and course may vary according to the specific bacterial species involved.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"1745-1754"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425322","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":"The Tryptophan-Kynurenine pathway in people living with HIV: a systematic review.","authors":"Tshiamo Will Sebigi, Levanco K Asia, Grant G January, Esmé Jansen van Vuren, Monray Edward Williams","doi":"10.1007/s15010-025-02557-1","DOIUrl":"10.1007/s15010-025-02557-1","url":null,"abstract":"<p><strong>Purpose: </strong>HIV-1 disrupts the metabolic profile of people living with HIV (PLWH), including the Tryptophan-Kynurenine (Trp-Kyn) pathway, linked to disease outcomes and comorbidities. Despite numerous studies, consensus on key dysregulated metabolites in antiretroviral therapy (ART)-treated PLWH is lacking. This systematic review compiles data to identify and highlight the most noteworthy Trp-Kyn metabolites.</p><p><strong>Methods: </strong>PubMed, Scopus, and Web of Science databases were searched using a search protocol specifically designed for this study. Studies that investigated the levels of metabolites in the Trp-Kyn pathway in the peripheral blood of PLWH on ART, as well as in healthy control groups were included.</p><p><strong>Results: </strong>Thirteen metabolomic studies that investigated this pathway met our inclusion criteria. The findings revealed that Trp, Kyn, and the Kyn/Trp ratio (indicative of indoleamine 2,3-dioxygenase IDO activity) were the most investigated metabolites in this metabolic pathway. Evidence consistently demonstrated that Trp levels were lower in PLWH, while predicted IDO activity was consistently higher. Despite the widespread investigation of Kyn, there was no clear consensus on its levels in PLWH, with some studies reporting higher levels and others finding no significant differences compared to HIV-negative controls.</p><p><strong>Conclusion: </strong>In the modern ART era, Trp metabolism and IDO activity may play key regulatory roles in HIV-1 pathogenesis, as evidenced by the consistent patterns observed across various studies. These metabolites and related pathways warrant further investigation as potential targets for improved diagnostics, prognostics, and therapeutics in the context of HIV-1.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"1625-1644"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191752","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":"A large outbreak of multiple Salmonella serovars linked to alfalfa sprouts in Norway, October to December 2024.","authors":"Arthur Rakover, Liz E Ødeskaug, Hilde Lund, Heidi Lange, Karina Kaupang, Taran O Skjerdal, Laila Jensvoll, Bjarne Bergsjø, Polina Katsiouleri, Lamprini Veneti, Umaer Naseer, Lin T Brandal","doi":"10.1007/s15010-025-02556-2","DOIUrl":"10.1007/s15010-025-02556-2","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigates a nationwide Salmonella outbreak in Norway during October-December 2024 involving four different serovars-S. Newport, S. Typhimurium, S. Kisarawe, and S. Kinondoni. The investigation aimed to assess the outbreak's scope, identify the source, and implement control measures.</p><p><strong>Methods: </strong>Epidemiological analyses included trawling and targeted questionnaires, a matched case-control study, and grocery receipt analysis. Whole-genome sequencing (WGS) determined genetic links between Salmonella isolates from human cases, food, and environmental samples. Traceback investigations identified potential contamination sources.</p><p><strong>Results: </strong>A total of 230 cases (69% female, median age: 48 years) were identified, with 33% requiring hospitalization. Sprout consumption was reported by 69% of cases interviewed through trawling or targeted questionnaires. Grocery receipts were collected from some of the cases, and half of these had purchased sprouts. A matched case-control study found cases to be associated with consumption of sprouts (penalized adjusted odds ratio of 3.13). WGS established genetic links between clinical, food, and environmental isolates, identifying alfalfa sprouts as the outbreak source. Traceback investigations identified potential risk associated with seeds from an Italian supplier, previously associated with two Salmonella outbreaks in Norway in 2024 and multiple outbreaks across the European Union. The Italian supplier reported negative findings for Salmonella in their self-monitoring checks on seeds sent to Norway. Control measures included product withdrawal, seed batch quarantine, and public health advisories.</p><p><strong>Conclusion: </strong>This multi-serovar outbreak highlights the public health risks associated with consumption of raw sprouts and emphasizes the need for improved detection methods and stricter regulations to prevent future outbreaks.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"2125-2134"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208465","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":"Infections during AML induction chemotherapy in a contemporary cohort without fluoroquinolone prophylaxis.","authors":"S Ehrlich, J Eufinger, N Tahiri, V Jurinovic, S Mansournia, W G Kunz, J Jung, T Herold, M Subklewe, V Bücklein, M von Bergwelt-Baildon, K Spiekermann","doi":"10.1007/s15010-025-02651-4","DOIUrl":"https://doi.org/10.1007/s15010-025-02651-4","url":null,"abstract":"<p><strong>Purpose: </strong>Recent advances in the treatment of acute myeloid leukemia (AML) and optimized supportive care have improved survival outcomes. However, infections during remission induction chemotherapy remain a leading cause of morbidity and mortality. While antifungal prophylaxis is standard, the role of routine antibacterial prophylaxis is increasingly debated due to adverse effects and resistance. This study aimed to characterize infectious complications in a real-world AML cohort receiving induction chemotherapy without routine antibacterial prophylaxis.</p><p><strong>Methods: </strong>We retrospectively analyzed 103 adults with newly diagnosed AML who underwent intensive induction therapy at LMU University Hospital between January 2019 and December 2022. All patients received antifungal prophylaxis whereas antibacterial fluoroquinolone (FQ) prophylaxis was not administered. We assessed febrile episodes, clinically and microbiologically documented infections, ICU/IMC admissions, and 30-/90-day mortality.</p><p><strong>Results: </strong>Febrile episodes occurred in almost all patients. Clinically documented infections accounted for 29.8% and microbiologically confirmed infections for 22.9% of febrile events. Bacteraemia was evenly distributed between Gram-positive and Gram-negative pathogens; multidrug resistance was rare. Proven or probable invasive fungal infections occurred in 6.8% of patients. In 47.2% of cases, the cause of fever remained unknown. Infection-related 30-day mortality was 4.9%. Factors associated with increased 30-day mortality included age ≥ 65 years, ECOG ≥ 2, secondary AML, and ICU/IMC admission for infection.</p><p><strong>Conclusion: </strong>Infections remain a major challenge during AML induction therapy. Our findings suggest that FQ prophylaxis should be reevaluated in this setting, focussing on a more individualized approach. In addition, novel diagnostic tools are urgently needed to enable earlier and more targeted infection management in this high-risk population.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199183","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":"Early and late mortality in vertebral osteomyelitis: who dies within the first year after diagnosis.","authors":"Nikolaus Kernich, Arian Abi-Chokami, Norma Jung, Dorothee Jochimsen, Krishnan Sircar, Ada Marie Hoffmann, Stefan Meuser, Peer Eysel, Carolyn Weber, Juan Manuel Vinas-Rios, Ayla Yagdiran, Norma Jung, Ayla Yagdiran, Nikolaus Kernich, Krishnan Sircar, Julia Fischer, Dorothee Jochimsen, Carolyn Weber, Charlotte Meyer-Schwickerath","doi":"10.1007/s15010-025-02541-9","DOIUrl":"10.1007/s15010-025-02541-9","url":null,"abstract":"<p><strong>Objective: </strong>Vertebral osteomyelitis (VO) is a severe clinical entity associated with high mortality rates, especially within the first year after diagnosis. The aim of this single-center prospective cohort study was to identify and compare predictive factors influencing early and late mortality in patients with conservatively and surgically treated VO.</p><p><strong>Methods: </strong>We conducted a single-center prospective cohort study including patients treated for VO between 2008 and 2020 in a tertiary center in Germany to determine early (death within 30 days after diagnosis) and late mortality (death between day 31 and 365 after diagnosis). Additionally, multivariable analyses were performed to analyze predictive risk factors for early and late mortality.</p><p><strong>Results: </strong>A total of 323 patients were included. 19% died within the first year after diagnosis. Early mortality occurred in 5% and late mortality in 14% of cases. Multivariable analysis revealed chronic kidney disease (CKD) (OR: 13.2, 95% CI 5.7-30.3; p < 0.001) and MSSA (OR: 4.0, 95% CI 1.4-11.1; p = 0.008) as independent risk factors for early mortality, whereas ASA score > 2 (HR: 5.2, 95% CI 2.6-10.6; p < 0.001), age > 70 years (HR: 2.4, 95% CI 1.6-3.7; p < 0.001), CKD (HR: 1.9, 95% CI 1.3-3.0; p = 0.003) and bacteremia (HR: 1.8, 95% CI 1.2-2.7; p = 0.002) were identified as independent risk factors for late mortality.</p><p><strong>Conclusion: </strong>One out of five VO patients dies within the first year after diagnosis. Risk factors for mortality within the first year include CKD and bacteremia. As a consequence in particular those patients should be closely monitored within the first year after.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"2025-2035"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006944","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":"Impact of sarcopenia and obesity on mortality in older adults with SARS-CoV-2 infection: automated deep learning body composition analysis in the NAPKON-SUEP cohort.","authors":"Sabine Schluessel, Benedikt Mueller, Olivia Tausendfreund, Michaela Rippl, Linda Deissler, Sebastian Martini, Ralf Schmidmaier, Sophia Stoecklein, Michael Ingrisch, Sabine Blaschke, Gunnar Brandhorst, Peter Spieth, Kristin Lehnert, Peter Heuschmann, Susana M Nunes de Miranda, Michael Drey","doi":"10.1007/s15010-025-02555-3","DOIUrl":"10.1007/s15010-025-02555-3","url":null,"abstract":"<p><strong>Introduction: </strong>Severe respiratory infections pose a major challenge in clinical practice, especially in older adults. Body composition analysis could play a crucial role in risk assessment and therapeutic decision-making. This study investigates whether obesity or sarcopenia has a greater impact on mortality in patients with severe respiratory infections. The study focuses on the National Pandemic Cohort Network (NAPKON-SUEP) cohort, which includes patients over 60 years of age with confirmed severe COVID-19 pneumonia. An innovative approach was adopted, using pre-trained deep learning models for automated analysis of body composition based on routine thoracic CT scans.</p><p><strong>Methods: </strong>The study included 157 hospitalized patients (mean age 70 ± 8 years, 41% women, mortality rate 39%) from the NAPKON-SUEP cohort at 57 study sites. A pre-trained deep learning model was used to analyze body composition (muscle, bone, fat, and intramuscular fat volumes) from thoracic CT images of the NAPKON-SUEP cohort. Binary logistic regression was performed to investigate the association between obesity, sarcopenia, and mortality.</p><p><strong>Results: </strong>Non-survivors exhibited lower muscle volume (p = 0.043), higher intramuscular fat volume (p = 0.041), and a higher BMI (p = 0.031) compared to survivors. Among all body composition parameters, muscle volume adjusted to weight was the strongest predictor of mortality in the logistic regression model, even after adjusting for factors such as sex, age, diabetes, chronic lung disease and chronic kidney disease, (odds ratio = 0.516). In contrast, BMI did not show significant differences after adjustment for comorbidities.</p><p><strong>Conclusion: </strong>This study identifies muscle volume derived from routine CT scans as a major predictor of survival in patients with severe respiratory infections. The results underscore the potential of AI supported CT-based body composition analysis for risk stratification and clinical decision making, not only for COVID-19 patients but also for all patients over 60 years of age with severe acute respiratory infections. The innovative application of pre-trained deep learning models opens up new possibilities for automated and standardized assessment in clinical practice.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"2111-2124"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077845","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":"Are cefiderocol or sulbactam/durlobactam better than alternative best available treatment for infection by carbapenem-resistant A. baumannii? A systematic literature review.","authors":"Stamatis Karakonstantis, Petros Ioannou, Diamantis P Kofteridis","doi":"10.1007/s15010-025-02527-7","DOIUrl":"10.1007/s15010-025-02527-7","url":null,"abstract":"<p><strong>Purpose: </strong>Cefiderocol (CFDC) and sulbactam/durlobactam (SUL/DUR) are new treatment options against infections by carbapenem-resistant A. baumannii (CRAB). However, whether they outperform contemporary alternative best available therapy (BAT), currently consisting of high-dose ampicillin/sulbactam (AMP/SUL)-based regimens, is unclear.</p><p><strong>Methods: </strong>A systematic review was conducted in PubMed and clinical trial registries to assess regimens used in comparator arms in studies comparing CFDC or SUL/DUR to alternative treatment regimens.</p><p><strong>Results: </strong>Only 1 relevant study was found for SUL/DUR (the registrational Phase 3). Almost all (98%) patients enrolled had pneumonia and the comparator arm was colistin/imipenem, a regimen not recommended for treatment of CRAB infections, especially pneumonia. With regards to CFDC, subgroup analyses (with significant limitations) from 2 randomized trials were disappointing showing higher mortality in CREDIBLE-CR compared to colistin-based treatment and similar mortality in APEKS-NK compared to high-dose meropenem among patients with CRAB infections. The rest (n = 11) of the trials were observational, predominantly single-center (82%) and retrospective (82%), and all but one were conducted in Italy (91%). Although meta-analyses of observational studies suggest better outcomes with CFDC, the comparator arm was colistin-based in all cases and only a minority of patients had received high-dose AMP/SUL.</p><p><strong>Conclusion: </strong>High-quality evidence supporting use of either CFDC or SUL/DUR in favor of high-dose AMP/SUL-based regimens is lacking. This has important stewardship implications. Additionally, both CFDC and SUL/DUR are much more expensive than AMP/SUL, an important consideration especially for low-/mid-income countries. Studies comparing CFDC- and SUL/DUR-based treatments to contemporary alternative BAT are needed.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"1563-1574"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795010","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":"Diverse clinical manifestations of Parvovirus B19 infections during the 2024 outbreak in Germany.","authors":"A Holzem, J Stemler, S Böhm, H Gruell, A Zeuzem, E Schalk, T Schober, C Deppe, J Hübner, M von Bergwelt-Baildon, K Spiekermann","doi":"10.1007/s15010-025-02598-6","DOIUrl":"10.1007/s15010-025-02598-6","url":null,"abstract":"<p><strong>Purpose: </strong>In 2024, human parvovirus B19 (PB19V) infections have increased in Germany and globally. It is an infection associated with a broad spectrum of clinical manifestations. To raise awareness, we present representative cases and virological data from different specialties across three German university hospitals.</p><p><strong>Methods: </strong>Following a nationwide survey by the AGIHO in March 2024 indicating increased PB19V infections, we conducted a retrospective, multi-center descriptive study across Munich, Cologne, and Magdeburg. Anonymized clinical and virological data from 2022 to 2024 were collected, including patient demographics, underlying diseases, and diagnostic findings. Acute PB19V infection was defined by real-time quantitative PCR-based detection of PB19V DNA in any specimen.</p><p><strong>Results: </strong>Clinical manifestations of acute PB19V infections can range from severe anemia and pancytopenia in hematologic patients, to fetal hydrops in pregnant women, and systemic inflammatory symptoms in patients with chronic conditions. In 2024, the Max von Pettenkofer Institute in Munich conducted 936 PB19V PCR tests. A marked increase in positive cases was observed in early 2024, with positivity rates of 16% in Q1 and 18.2% in Q2, compared to an annual positivity rate of 2.3% in 2023. Similar trends were seen at the University Hospitals Cologne and Magdeburg. Most infections were acute with high viral loads. Most cases originated from pediatric, gynecologic, and hematologic departments, highlighting particularly vulnerable patient populations.</p><p><strong>Conclusions: </strong>This resurgence in symptomatic PB19V infections, likely driven by pandemic-related shifts in immunity and exposure, underscores the need for heightened clinical awareness, early testing in high-risk populations, and sustained surveillance to anticipate future outbreaks.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"2219-2226"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642499","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":"RSV is the main cause of severe respiratory infections in infants and young children in Germany - data from the prospective, multicenter PAPI study 2021-2023.","authors":"Martin Wetzke, Matthias Lange, Cordula Koerner-Rettberg, Alexander Kiefer, Michael Kabesch, Sven Armbrust, Kerim Abdelkhalek, Christiane Lex, Markus Hufnagel, Sebastian Bode, Michael Dördelmann, Michael Lorenz, Stefan Arens, Markus Panning, Holger Köster, Rolf Kramer, Mathieu Bangert, Frank Eberhardt, Grit Barten-Neiner, Christine Happle","doi":"10.1007/s15010-025-02484-1","DOIUrl":"10.1007/s15010-025-02484-1","url":null,"abstract":"<p><strong>Background: </strong>Respiratory syncytial virus (RSV) is one of the main causes of morbidity in infants and young children worldwide. Current data on RSV-associated disease burden in Germany before the introduction of new immunization strategies is lacking.</p><p><strong>Methods: </strong>The PAPI study is a multicenter, prospective surveillance study of lower respiratory tract infections (LRTI) in children aged ≤ 24 months in Germany.</p><p><strong>Results: </strong>Data from 1607 children with LRTI hospitalized in twelve German hospitals between September 2021 and May 2023 were analyzed. Among these children, RSV was the most frequently detected pathogen (57.1%), followed by rhino/entero-, metapneumo- and parainfluenza virus. Children with RSV were significantly younger than those with LRTI of other causes (mean of 5.6 ± SD 6.1 vs. mean of 10.1 ± SD 7.3 months, p < 0.001) and more frequently affected in their first six months of life. RSV positive children were significantly more likely to develop hypoxemia (61.9% vs. 44.3%, p < 0.001) and need for intravenous or enteral fluid supplementation (48.1% vs. 43.1%, p = 0.009; 13.2% vs. 5.9%, p < 0.001) than those without RSV.</p><p><strong>Conclusion: </strong>RSV is the dominant pathogen for LRTI-associated hospitalizations in children ≤ 24 months in Germany and associated with a particularly high need for treatment. The ongoing implemented use of RSV immunization according to current recommendations could lead to significant reduction in early childhood morbidity in Germany.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"1715-1723"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457898","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}