Outbreak of SARS-CoV-2 in a geriatric acute-care ward during summer 2023: current aspects of infection control in the postpandemic period.

Aim: Management of a SARS-CoV-2 outbreak in geriatric patients, taking into account the transition to the post-pandemic period.

Methods: PCR tests were conducted to identify the scale of infection during the outbreak; no new patients were admitted to the ward until the availability of the PCR results. Based on the results and individual risk assessment, three cohorts were formed and treated as recommended by the RKI.

The Impact of Clinical Factors and SARS-CoV-2 Variants on Antibody Production in Vaccinated German Healthcare Professionals Infected Either with the Delta or the Omicron Variant.

Background: The aim of the rapid introduction of vaccines during the COVID-19 pandemic was a reduction in SARS-CoV-2 transmission and a less frequent occurrence of severe COVID-19 courses. Thus, we evaluated COVID-19 severity in vaccinated individuals to examine variant-specific symptom characteristics and their clinical impact on the serological immune response.

Methods: A total of 185 individuals previously vaccinated against and infected with the SARS-CoV-2 Delta (B.

Forecasting local hospital bed demand for COVID-19 using on-request simulations.

Accurate forecasting of hospital bed demand is crucial during infectious disease epidemics to avoid overwhelming healthcare facilities. To address this, we developed an intuitive online tool for individual hospitals to forecast COVID-19 bed demand. The tool utilizes local data, including incidence, vaccination, and bed occupancy data, at customizable geographical resolutions.

A case series of severe breakthrough infections observed in nine patients with COVID-19 in a southwestern German university hospital.

Purpose: Vaccination is the key element for protection against COVID-19. Increased vaccination breakthroughs raise the question of whether additional prevention is necessary in case of individual risk factors for a severe course with hospitalization or death despite vaccination.

Methods: Since July 13, 2021, there is an extended reporting requirement by German law.

Antibiotic Stewardship and Therapeutic Drug Monitoring of β-Lactam Antibiotics: Is There a Link? An Opinion Paper.

Purpose: In critically ill patients, changes in the pharmacokinetics (PK) of β-lactams can lead to significant variations in serum concentrations, with possibly detrimental effects on outcomes. The utilization of individually calculated doses, extended infusion regimen, and therapeutic drug monitoring (TDM)-guided dose adjustments can mitigate the PK changes and help to achieve and attain an individual PK target.

Methods: We reviewed relevant literature from 2004 to 2021 using 4 search engines (PubMed, Web of Science, Scopus, and Google Scholar).

Direct-PCR from rectal swabs and environmental reservoirs: A fast and efficient alternative to detect bla carbapenemase genes in an Enterobacter cloacae outbreak setting.

Carbapenemase-producing bacteria are a risk factor in clinical settings worldwide. The aim of the study was to accelerate the time to results during an outbreak situation with bla-positive Enterobacter cloacae by using a real-time multiplex quantitative PCR (qPCR) directly on rectal swab specimens and on wastewater samples to detect carbapenemase-producing bacteria. Thus, we analyzed 681 rectal swabs and 947 environmental samples during a five-month period by qPCR and compared the results to culture screening.

[Evaluation of a SARS-CoV-2 test strategy in a southwestern university hospital at the beginning of the COVID-19 pandemic].

Background: At the beginning of the COVID-19 pandemic, the German Robert Koch Institute (RKI) published several guidelines addressing the medical health services helping to detect SARS CoV‑2. Needing an available and specific test strategy regarding SARS-CoV‑2, our own test strategy strictly followed these testing criteria.

Materials And Methods: Using a retrospective analysis, we verified if such a test strategy was an effective tool in the context of infection prevention control and as reliable SARS-CoV‑2 detection.

Assessing the clinical accuracy of a hand hygiene system: Learnings from a validation study.

There is a need to establish validation standards that allow for comparison of automated hand hygiene systems. To assess the accuracy of an innovative monitoring tool (Sani nudge), 2 test nurses performed clinical standard tasks while being observed by 2 infection preventionists. Data from the direct observations were compared with data obtained from the hand hygiene system (Sani nudge) using an independent-event approach.

Soluble intercellular adhesion molecule (ICAM)-1 detects invasive fungal infections in patients following liver transplantation.

Purpose: Despite antifungal prophylaxis, liver transplanted patients are endangered by invasive fungal infections (IFI). Routinely used microbiological procedures are hallmarked by significant weaknesses, which may lead to a delay in antifungal treatment.

Methods: Culture-based fungal findings, routinely used biomarkers of infection/inflammation (e.

The diagnostic benefit of 16S rDNA PCR examination of infective endocarditis heart valves: a cohort study of 146 surgical cases confirmed by histopathology.

Aims: Upon suspicion of infective endocarditis, the causative microorganism must be identified to optimize treatment. Blood cultures and culturing of removed valves are the mainstay of this diagnosis and should be complemented by growth-independent methods. We assessed the diagnostic benefit of examining removed endocarditis valves by broad-range bacterial PCR to detect causative bacteria in cases where culturing was not available, negative, or inconclusive because a skin commensal was detected, in patients from our clinical routine practice.

Low prevalence of combined linezolid- and vancomycin-resistant Enterococcus faecium from hospital admission screening in an endemic region in Germany.

Background: The emergence and spread of linezolid and combined linezolid/vancomycin resistance in Enterococcus faecium (LVRE) is a major therapeutic challenge. Due to the unavailability of standardized selective culture media for LVRE screening, the detection of LVRE is laborious and costly. Systematic data on LVRE prevalence are scarce, and therefore, supportive evidence for the correct implementation of preemptive strategies is lacking.

Nasal colonization with Staphylococcus aureus is a risk factor for ventricular assist device infection in the first year after implantation: A prospective, single-centre, cohort study.

Objectives: To assess, whether S. aureus nasal colonization is a risk factor for infections in patients with durable ventricular assist device (VAD).

Methods: Prospective, single-centre, cohort study (i) ascertaining S.

Multidrug-Resistant Bacteria and Disease Progression in Patients with End-Stage Liver Disease and after Liver Transplantation.

Background: Multidrug-resistant (MDR) pathogens represent an emerging challenge in end-stage liver disease and in liver transplant recipients.

Methods: We evaluated the impact of MDR bacteria upon clinical outcomes in patients with end-stage liver disease (n = 777) at the time of enrollment on the liver transplant (LTx) waiting list, after first LTx (n = 645), and after second LTx (n = 128).

Results: Colonization/infection with MDR bacteria was present in 72/777 patients on the waiting list, in 98/645 patients at first LTx, and in 46/128 patients at second LTx.

[Diagnostic Approaches in Sepsis - Part 2: Pathogen Detection].

Despite the dissemination of innovative, molecular biology-based and commercially available devices for pathogen detection, culture-based methods with susceptibility testing remain the key principles for guiding antimicrobial treatment of patients suffering from sepsis or septic shock on the ICU. Culture-based methods are able to facilitate pathogen detection from a diversity of specimen (respiratory secretion, intraoperatively obtained smears, aspirates, and so forth). However, the latency from obtainment of the specimen up to pathogen detection with susceptibility testing is a major disadvantage of culture-based methods in critical illness.

[Diagnostic Approaches in Sepsis - Part 1: General Diagnostic Principles, Focus Identification and Source Control].

Sepsis and septic shock represent medical emergencies with persistently high mortality rates. According to the lately revised Surviving Sepsis Campaign (SSC) guidelines, focus identification/pathogen detection and the initial administration of broad-spectrum antibiotics are to be secluded within one hour after recognition of the symptoms of sepsis. However, there is dispute concerning the so called hour-1 bundle.

Postoperative pancreatic fistula: Microbial growth determines outcome.

Background: Postoperative pancreatic fistula is a dangerous complication in pancreatic surgery. This study assessed the impact of microbiologic pathogens detected in postoperative pancreatic fistula on clinical outcomes after partial pancreatoduodenectomy and distal pancreatectomy.

Methods: Microorganisms in postoperative pancreatic fistula were identified by microbiologic analyses from abdominal drains or intraoperative swabs during relaparotomy.

Prolonged antibiotic prophylaxis after thoracoabdominal esophagectomy does not reduce the risk of pneumonia in the first 30 days: a retrospective before-and-after analysis.

Purpose: Thoracoabdominal esophageal resection for malignant disease is frequently associated with pulmonary infection. Whether prolonged antibiotic prophylaxis beyond a single perioperative dose is advantageous in preventing pulmonary infection after thoracoabdominal esophagectomy remains unclear.

Methods: In this retrospective before-and-after analysis, 173 patients between January 2009 and December 2014 from a prospectively maintained database were included.

Risk factors for early viral infections after liver transplantation.

Purpose: Viral infections represent a serious threat for patients after liver transplantation (LT). The identification of risk factors during the early post-transplant period might help to improve prevention of viral infections after LT.

Methods: Between 2004 and 2010, 530 adult patients underwent LT at a large university hospital serving a metropolitan region in Europe.

Detection of pneumonia associated pathogens using a prototype multiplexed pneumonia test in hospitalized patients with severe pneumonia.

Unlabelled: Severe pneumonia remains an important cause of morbidity and mortality. Polymerase chain reaction (PCR) has been shown to be more sensitive than current standard microbiological methods--particularly in patients with prior antibiotic treatment--and therefore, may improve the accuracy of microbiological diagnosis for hospitalized patients with pneumonia. Conventional detection techniques and multiplex PCR for 14 typical bacterial pneumonia-associated pathogens were performed on respiratory samples collected from adult hospitalized patients enrolled in a prospective multi-center study.

Device-related infections in long-term healthcare facilities: the challenge of prevention.

The world is aging and the number of elderly multimorbid patients is steadily increasing. The limited numbers of acute care beds in hospitals, in addition to the need to reduce costs, has led to the introduction of efficient discharge policies, which in turn have increased demand for beds in nursing homes and long-term care facilities (LTCFs). As a consequence, the number of postacute LTCF residents is rising, as is the number of residents requiring complex medical care delivered by use of indwelling medical devices.

Population pharmacokinetics and pharmacodynamic evaluation of intravenous and enteral moxifloxacin in surgical intensive care unit patients.

Objectives: To describe the plasma concentration-time profile of moxifloxacin after intravenous and enteral administration in intensive care unit (ICU) patients and to provide a pharmacodynamic (PD) evaluation with regard to pneumonia.

Patients And Methods: Twenty-five adult patients from a cardiothoracic/mixed surgical ICU were enrolled. Moxifloxacin was given as a standard dose (400 mg once daily).

Assessment of hemodynamic efficacy and safety of 6% hydroxyethylstarch 130/0.4 vs. 0.9% NaCl fluid replacement in patients with severe sepsis: the CRYSTMAS study.

Introduction: Inadequate initial treatment and delayed hemodynamic stabilization (HDS) may be associated with increased risk of death in severe sepsis patients.

Methods: In order to compare the hemodynamic efficacy and safety of 6% HES 130/0.4 and NaCl 0.