Eurosurveillance最新文献

Introduction: In solid organ transplant (SOT) recipients, hepatitis E virus (HEV) poses a complex clinical challenge, because there is a risk of developing persistent infection. Current European guidelines recommend the screening of HEV in SOT recipients because of the risk of unrecognised infection. Despite these recommendations, routine screening for HEV remains underutilised in clinical practice.

Aim: Our study aimed to determine the prevalence of HEV viraemia and to evaluate the clinical evolution of HEV infection in SOT.

Methods: We performed a multicentre cross-sectional study including adult SOT recipients under follow-up in Spain. All patients were prospectively tested for HEV RNA in peripheral blood. Individuals with detectable viraemia were prospectively followed up every 3 months to evaluate viral persistence.

Results: A total of 940 patients were included in the study. Five patients were infected, supposing a prevalence of HEV infection in Spanish SOT recipients of 0.53% (95% confidence interval: 0.23-1.24). Genotyping was successfully conducted in four cases, all identified as genotype 3. All patients were asymptomatic and had varied levels of liver enzyme elevations. At follow-up, three of the five patients remained HEC RNA-positive, consistent with chronic infection. Overall, the prevalence of chronic HEV infection in our study population was 0.32%.

Conclusion: Our study highlights the need to establish periodic molecular HEV surveillance in SOT recipients.

In September 2025, 50 laboratory-confirmed cases of Legionnaires' disease (LD) were identified in Albertville, in south-eastern France. Initially, 23 patients were only clinically diagnosed and only confirmed later due to limited sensitivity of the urinary antigen screening test used. All cases occurred within 12 days, suggesting a common point source of massive contamination. Despite investigations and the rapid response of LD surveillance partners, the outbreak source has not yet been identified. Vigilance is maintained to detect possible new cases.

In September 2023, a measles outbreak occurred in a middle school (Rhône valley, France), with the index case returning from Asia. Investigations involved case validation, virological analyses, contact tracing and checking vaccination records to determine measles vaccination coverage (VC) and attack rates (AR). Among 643 students, 49 measles cases occurred between 6 September and 18 October 2023 (AR = 7.6%). Two-dose vaccination coverage was 93.5% (601/643). Virological analyses confirmed the measles strains' clonality (genotype D8) and the imported origin. Concordance between health record vaccination status and immunological profile was established for 27 cases. In a sub-cohort of children (all cases and 309 non-cases), AR was 100% in unvaccinated children, and 43.7%, 16.5% and 3.2% among two-dose vaccinated children with the first dose administered at 6-8, 9-11 and ≥ 12 months, respectively. After multivariate binomial regression, vaccine effectiveness (VE) was 96.4% (95% confidence interval (CI): 91.4-98.5) after two-dose vaccination with the first dose at ≥ 12 months, confirming long-term effectiveness of measles-mumps-rubella vaccines. When the first dose was given at 9-11 and 6-8 months, respectively, VE was 83.3% (95% CI: 74.3-89.2) and 60.7% (95% CI: 10.6-82.7). This measles epidemic mainly affected unvaccinated or two-dose vaccinated children with first dose administered before age 12 months.

In 2022-2024, 14,153 of 28,521 (49.6%) new HIV diagnoses in 23 European Union and Economic Area (EU/EEA) countries were late. In adjusted analyses, older age and migrant status increased late diagnosis risk. The proportion of late diagnoses was 2.6-fold higher among migrants with pre-migration HIV acquisition than post-migration. Late-diagnosed migrants with likely post-migration HIV acquisition were often women, ≥ 50-year-olds, heterosexuals, people who inject drugs, or from South and South-East Asia. The 2025 target of < 20% late diagnosis was unachieved.

BACKGROUNDTo enhance antibiotic stewardship and effectively address antimicrobial resistance (AMR), better understanding of subnational antibiotic consumption patterns is essential.AIMWe aimed to assess antibiotic consumption in Germany using data from 2022 and integrated from two surveillance systems, focusing on regional differences by examining non-university acute care hospitals.METHODSWe used pharmacy dispensing data from 525 regional or local hospitals and 35 university hospitals, covering 46.5 million patient days (PD), nearly half of all occupied bed days nationwide, to calculate antibiotic use densities (AUD) for systemic antibiotics, expressed as World Health Organization (WHO) ATC/DDD (Anatomical Therapeutic Chemical/Defined Daily Dose) per 100 patient days (DDD/100 PD). The analysis primarily focused on consumption patterns in non-university hospitals, assessing key antibiotic groups through mixed-effects regression. For sensitivity analyses, we employed hospital-adapted daily dose definitions.RESULTSPooled AUD for participating non-university hospitals was 51.8 DDD/100 PD, with aminopenicillins/beta-lactamase inhibitors being the most prescribed group. Regression analyses, adjusted for hospital size and ward type/admitting specialty, indicated notable regional variation. We identified statistically significant differences in antibiotic consumption, particularly for beta-lactam antibiotics, fluoroquinolones and tetracyclines. For example, several regions exhibited up to 1.4-fold higher use of first- and second-generation cephalosporins compared with the western reference region.CONCLUSIONThis study highlights substantial regional variation in antibiotic use in German acute care hospitals, underlining the importance of further investigation into influencing factors such as regional guidelines and resistance rates. The methodological approach applied here may serve as a model for other countries interested in analysing regional differences in antibiotic consumption.

In July-October 2025, two concurrent Campylobacter jejuni outbreaks (clones ST49#3 and ST52#4) with 112 notified cases were detected through Denmark's whole genome sequencing surveillance programme. The outbreaks were clinically severe: 45 (40%) infected individuals were hospitalised and 16 (14%) had bacteraemia. We estimated 900 laboratory-confirmed outbreak cases. Both outbreaks originated from Danish-produced chicken meat. These outbreaks reveal the vulnerabilities in the current prevention and control framework given by the regulatory tolerance for Campylobacter in fresh poultry meat.

In Spain during March-April 2024, an outbreak of invasive meningococcal disease (IMD) occurred in four young adults, exhibiting high case fatality with two deaths. Cases 1 and 4 were confirmed by isolation of Neisseria meningitidis from blood samples, while Cases 2 and 3 were PCR-confirmed from cerebrospinal fluid (CSF). Serogroup B meningococcus with identical characterisation (B: 19-54, 15: F5-1: ST-34, cc32) was identified for all cases; the outbreak strain genosubtype PorA_VR1: 19-54 had not been previously described. Potential coverage of the outbreak strain by available MenB vaccines could not be predicted by molecular tools, so bactericidal response to the 4CMenB vaccine against the outbreak strain was measured by human serum bactericidal antibody assay (hSBA), defining the strain as covered by the vaccine. Two different social events were involved in transmission of the outbreak strain. According to the national meningococcal disease surveillance protocol, an active search for close contacts of the cases was conducted by public health authorities and timely chemoprophylaxis and/or vaccination with 4CMenB vaccine was recommended to over 200 contacts. The evolution of meningococcal strains with genosubtype 19-54 should be closely monitored, as it might confer a greater transmission capacity.

BACKGROUNDHIV screening strategies in alternative settings, such as emergency departments (EDs), aim to increase diagnosis of occult infections and achieve 95-95-95 targets for 2030.AIMTo assess the effectiveness of an opt-in HIV screening strategy in EDs based on six clinical scenarios from a 2020 Spanish consensus document, while examining patient characteristics and linkage to-care.METHODSThis descriptive, multicentre, retrospective study analysed epidemiological, clinical, and linkage-to-care data of individuals aged ≥ 18 years newly diagnosed with HIV between July 2021 and March 2024 in 17 EDs covering 73% of the population in Catalonia, Spain.RESULTSFrom 23,105 HIV serologies performed, there were 172 new diagnoses (positivity rate: 0.7%). Of these, 88.4% (152/172) were assigned male at birth, had a median age of 39 years (IQR: 30-50), and 47.9% (81/169) were Spanish. Sexual transmission was reported in 75.6% (130/172) of cases, with 55.5% (81/146) heterosexual. Fiebig stage data, available in 78.5% (135/172) of cases, showed 57.8% (78/135) had acute infection. Advanced HIV was found in 24.2% (30/124). Diagnoses related to the six clinical scenarios accounted for 54.6% (94/172) of cases. For all new diagnoses, 82.0% (137/167) were linked to specialised healthcare and started antiretroviral treatment within 9 days (IQR: 4-17), with no significant differences regarding urban/rural hospital coverage areas.CONCLUSIONAn opt-in HIV screening strategy in the ED is feasible and effective, especially in detecting highly transmissible patients with acute infection. However, one in five newly diagnosed individuals remained untreated, highlighting the need for improved linkage to care.

BACKGROUNDFifteen- and 20-valent pneumococcal conjugate vaccines (PCVs) offer broader protection against invasive pneumococcal disease (IPD) than PCV13. Adopting these vaccines may result in decreasing IPD incidence, antibiotic use and antimicrobial resistance (AMR) rates. If the additional serotypes in PCV15 and PCV20 are associated with AMR, AMR rate reduction could be greater than expected from reduced antibiotic consumption alone.AIMThis retrospective analysis assessed the association between AMR and non-PCV13 serotypes in PCV15 and PCV20.METHODSLaboratory-based surveillance data on 8,123 IPD isolates were obtained retrospectively from the Belgian Reference Centre for invasive Streptococcus pneumoniae. Isolates (n = 8,088) were serotyped and tested for AMR. Associations between vaccine serotype groups and AMR were evaluated by multinomial logistic regression. Where associations varied with patients' age, ranges of odds ratios (ORs) are presented.RESULTSPCV15-non-PCV13 and PCV20-non-PCV13 serotypes accounted for 7.4% (n = 597) and 37% (n = 2,992) of IPD isolates respectively. Of non-PCV20 serotypes, 24% (508/2,125) were penicillin resistant. Compared with non-PCV20 serotypes, PCV15-non-PCV13 serotypes were more often associated with erythromycin (ORs: 3.59-9.43) and tetracycline (OR: 2.00) resistance, and with trimethoprim/sulfamethoxazole (OR: 0.11) susceptibility. PCV20-non-PCV15 serotypes were more often associated with amoxicillin (OR: 9.45) and cefotaxime (ORs: 5.06-82.38) resistance, and with erythromycin (ORs: 0.13-0.18), tetracycline (OR: 0.71) and penicillin (ORs: 0.05-0.46) susceptibility.CONCLUSIONPCV20 may lead to a larger decrease in overall IPD incidence than PCV15. Although the PCV20 vaccination impact on AMR may be limited, some resistant or difficult to treat infections could be avoided. Serotype replacement might lead to infections with low level penicillin resistance increasing, but most of these should remain treatable.