Publications by authors named "Siegbert Rieg"

Purpose: To analyze the longitudinal epidemiology and antimicrobial resistance (AMR) patterns of Gram-negative bloodstream infections (BSI) in Germany.

Methods: Post-hoc analysis of prospectively documented BSI due to Escherichia coli, Klebsiella spp., Enterobacter spp.

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  • Non-university hospitals in Germany provide most inpatient care, making it crucial to analyze the quality of antimicrobial prescribing in these facilities.
  • A study conducted in 2021 across 10 hospitals in Baden-Württemberg revealed that 33% of patients received antimicrobial treatment, with most prescriptions being therapeutic.
  • Findings showed low adherence to quality indicators, highlighting the need for improved prescribing practices and the implementation of effective antimicrobial stewardship programs.
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  • Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) are severe, drug-induced skin conditions that can be life-threatening and are now viewed as different levels of the same disease known as epidermal necrolysis (EN).
  • A new guideline has been created based on scientific literature and expert consensus to help medical professionals in diagnosing and treating EN.
  • This guideline targets various specialists like dermatologists and intensive care doctors, as well as informing patients, families, insurers, and policymakers about EN and includes recommendations for acute care and follow-up treatment.
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  • - The study aimed to investigate the role of serotonin levels in patients experiencing post-acute sequelae of COVID-19 (PASC), a condition affecting 10-20% of those who had the virus, characterized by fatigue and other symptoms.
  • - Researchers conducted a case-control study with 34 PASC patients and 14 healthy controls, measuring serum serotonin levels using advanced testing techniques and evaluating patients' ongoing symptoms after infection.
  • - Findings revealed no significant difference in serotonin levels between PASC patients and healthy controls, indicating that serotonin is not a reliable biomarker for PASC diagnosis or treatment, specifically cautioning against using serotonin-based therapies.
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  • Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are serious, mostly drug-related conditions that affect the skin and mucous membranes, categorized under the umbrella term epidermal necrolysis (EN), which varies in severity.* -
  • A new guideline for diagnosing and treating SJS/TEN was created based on extensive scientific research and consensus among experts, involving various medical specialties to provide a comprehensive approach to patient care.* -
  • The guideline is designed for healthcare professionals across multiple fields, as well as patients, their families, insurers, and policymakers, with the first part specifically addressing diagnosis, initial treatment, and systemic immunotherapy.*
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Background: Patients with chronic limb-threatening ischemia (CLTI) and infected leg ulcers are at risk of amputation and postinterventional sepsis.

Methods: This retrospective, single-center study included patients with CLTI and infected leg ulcers who underwent endovascular treatment (EVT) between 2012 and 2021.

Results: The study included 712 patients, 286 (40.

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Recently, an update of the Duke criteria for the diagnosis of infectious endocarditis has been published: the 2023 Duke-ISCVID criteria. To gain an insight into which proportion of patients are affected by the new criteria, and which criteria might be the most relevant for the expected increase in sensitivity, we analysed data from a registry of cardiovascular infections. The 2023 Duke-ISCVID criteria were applied to patients who were diagnosed with and treated for endocarditis after having been classified as "possible" endocarditis according to the 2015 ESC Modified Duke criteria.

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  • There has been a rise in cutaneous infections caused by Corynebacterium diphtheriae among adolescent and young adult refugees in Germany since September 2022, prompting this study to assess treatment options and outcomes.
  • The study included 31 cases from 9 medical centers, revealing that most infections were cutaneous and generally afebrile, with a few cases showing systemic complications requiring more intensive care.
  • The recommended treatment for uncomplicated cases involves topical antiseptics and a 7-day course of antibiotics like clindamycin, while cases with fever or throat symptoms necessitate further medical evaluation, including cultures.
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Purpose: This study investigates the care provision and the role of infectious disease (ID) specialists during the coronavirus disease-2019 (COVID-19) pandemic.

Methods: A survey was conducted at German study sites participating in the Lean European Open Survey on SARS-CoV-2 infected patients (LEOSS). Hospitals certified by the German Society of Infectious diseases (DGI) were identified as ID centers.

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Patients with chronic limb-threatening ischaemia (CLTI) are at risk of foot infections, which is associated with an increase in amputation rates. The use of antibiotics may lead to a higher incidence of antimicrobial resistance (AMR) in subsequent episodes of ischaemic foot infections (IFI). This retrospective single-centre cohort study included 130 patients with IFI undergoing endovascular revascularisation.

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After contracting COVID-19, a substantial number of individuals develop a Post-COVID-Condition, marked by neurologic symptoms such as cognitive deficits, olfactory dysfunction, and fatigue. Despite this, biomarkers and pathophysiological understandings of this condition remain limited. Employing magnetic resonance imaging, we conduct a comparative analysis of cerebral microstructure among patients with Post-COVID-Condition, healthy controls, and individuals that contracted COVID-19 without long-term symptoms.

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COVID-19 vaccination has been shown to prevent and reduce the severity of COVID-19 disease. The aim of this study was to explore the cardioprotective effect of COVID-19 vaccination in hospitalized COVID-19 patients. In this retrospective, single-center cohort study, we included hospitalized COVID-19 patients with confirmed vaccination status from July 2021 to February 2022.

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  • - The study analyzed trends of bloodstream infections (BSI) caused by Enterococcus spp. in adult patients at German tertiary care centers from October 2016 to June 2020, finding a significant increase in cases over this period.
  • - Among 3001 identified patients, E. faecium was the most prevalent species (61%), and the study revealed a concerning rise in vancomycin-resistant enterococci (VRE), which accounted for more than 12% of cases by 2020.
  • - The increase in VRE BSI is linked to factors like prior antibiotic use and invasive procedures, emphasizing the need for better treatment options due to the high mortality associated with these infections.
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Background: Limited evidence on utilisation of health care by recently arrived asylum seekers and refugees in high-income countries is available. This study aims to describe the implementation of an integrated care facility (ICF) in an initial reception centre and measure the utilisation of care and the influence of operational parameters.

Methods: In a retrospective cohort study design, using medical records, we followed inhabitants of a reception centre in Germany between 11.

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Objectives: To investigate, whether inflammatory rheumatic diseases (IRD) inpatients are at higher risk to develop a severe course of SARS-CoV-2 infections compared to the general population, data from the German COVID-19 registry for IRD patients and data from the Lean European Survey on SARS-CoV-2 (LEOSS) infected patients covering inpatients from the general population with SARS-CoV-2 infections were compared.

Methods: 4310 (LEOSS registry) and 1139 cases (IRD registry) were collected in general. Data were matched for age and gender.

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Medicine in Germany is currently facing major structural and economic challenges. Infectious Diseases, with the recent introduction of a new specialty in "Internal Medicine and Infectious Diseases" and with the existing additional training for almost all specializations, will make an important contribution to overcoming these challenges. Expertise in infectious diseases has to be very broad and requires high interdisciplinarity, which makes infectious diseases an attractive and demanding specialty.

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This study aimed to analyze the effect of COVID-19 vaccination on the occurrence of ARDS in hospitalized COVID-19 patients. The study population of this retrospective, single-center cohort study consisted of hospitalized COVID-19 patients with known vaccination status and chest computed tomography imaging between July 2021 and February 2022. The impact of vaccination on ARDS in COVID-19 patients was assessed through logistic regression adjusting for demographic differences and confounding factors with statistical differences determined using confidence intervals and effect sizes.

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  • This study investigates the effectiveness and safety of switching from intravenous to oral antibiotics after 5-7 days in patients with low-risk Staphylococcus aureus bloodstream infections.
  • Conducted across 31 hospitals in Europe, the trial aimed to determine if early oral therapy could maintain patient safety and reduce complications compared to ongoing intravenous treatment.
  • Due to slow participant recruitment, the trial was halted early with 215 participants, and the analysis was adjusted to ensure statistical validity, focusing on whether oral treatment led to acceptable complication rates compared with the traditional intravenous approach.
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Purpose: This study aims to describe clinical, virological and radiological characteristics as well as treatment strategies and outcomes of immunocompromised patients with persistent SARS-CoV-2 replication.

Methods: We performed a retrospective cohort study of immunocompromised patients at the University Medical Center Freiburg between 01/2022 and 05/2023. Patients with substantial immunosuppression and persistent SARS-CoV-2 detection (Ct-value < 30 after 14 days) were included.

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With the outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), global researchers were confronted with major challenges. The German National Pandemic Cohort Network (NAPKON) was launched in fall 2020 to effectively leverage resources and bundle research activities in the fight against the coronavirus disease 2019 (COVID-19) pandemic. We analyzed the setup phase of NAPKON as an example for multicenter studies in Germany, highlighting challenges and optimization potential in connecting 59 university and nonuniversity study sites.

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Allergic reactions to antibiotics belong to hypersensitivity drug reactions and can trigger both immunoglobulin E-mediated symptoms and T cell-mediated symptoms. Skin manifestations are the most common symptoms. Although reporting a penicillin allergy results in considerable restrictions in the treatment of acute infections, which may be associated with poor treatment outcomes, in most cases the label 'penicillin allergy' is not called into question or critically reviewed.

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During August-December 2022, toxigenic Corynebacterium diphtheriae was isolated from 25 refugees with skin infections and 2 refugees with asymptomatic throat colonization at a refugee reception center in Germany. None had systemic toxin-mediated illness. Of erosive/ulcerative skin infections, 96% were polymicrobial.

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  • The study aimed to evaluate if a new telephone intervention improves adherence to preventive measures for asplenic patients at risk of post-splenectomy sepsis (PSS), comparing it to usual care.
  • The researchers enrolled 106 patients in a novel health action process approach (HAPA)-based intervention and compared their outcomes to a historical control group of 113 patients using a specific scoring system called the PrePSS score.
  • Results showed a significant increase in adherence scores for the intervention group (mean score 7.70) versus the control group (mean score 3.73), indicating that this intervention could be beneficial for better management of at-risk asplenic patients.
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Purpose: Recent studies point toward a potential benefit of doxycycline use for post-exposure prophylaxis (PEP) or pre-exposure prophylaxis (PrEP) to prevent sexually transmitted infections (STIs). Although prescribing doxycycline in a prophylactic intention is not generally recommended yet, we noticed an increasing number of inquiries from individuals within the LGBTQ community for doxycycline prescriptions.

Methods: We conducted an anonymous online survey to evaluate the current extent of doxycycline use for PEP or PrEP within the LGBTQ community using REDCap electronic data capture tools.

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The Covid-19 pandemic has pushed many hospitals to their capacity limits. Therefore, a triage of patients has been discussed controversially primarily through an ethical perspective. The term triage contains many aspects such as urgency of treatment, severity of the disease and pre-existing conditions, access to critical care, or the classification of patients regarding subsequent clinical pathways starting from the emergency department.

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