THE GOOD, THE BAD, THE UGLY IN BACTERIAL COLONIZATION After leaving the uterus, a neonate immediately encounters a vast world of microbes and begins developing its own microbiota on all exposed body sites and surfaces. Bacterial colonization on the body surface after birth is characterized by a great diversity of microorganisms in which "good" bacteria (eg, Staphylococcus epidermidis, etc) prevent "bad" bacteria (eg, Staphylococcus aureus (S. aureus)) from taking a foothold and potentially going on to cause infection ("the ugly") (of course, this dichotomy does not sufficiently reflect the complex reality of the colonization—infection continuum and pathogenic potential is not exclusively determined by the bacterium itself, but results from a complex array of pathogen–host interactions). Newborns pick up bacteria from the mother, other family members, environment and even pets with infants born at term being readily prepared for microbial interactions. But what happens in preterm neonates with their numerous limitations to adequately incorporate even "good" bacteria into their microbiota and to limit the uncontrolled systemic spread of "bad" bacteria? THE RULES OF COLONIZATION: THE CASE OF S. AUREUS Low birthweight and very preterm neonates, particularly with repeated or prolonged antibiotic administration and long hospital stays, have a higher risk for colonization (and infection) with S. aureus. In a monocentric study with mainly preterm neonates in a non-outbreak setting in Germany, 23% became colonized at some point with S. aureus during their neonatal intensive care unit (NICU) stay.1 Of note, the rate of colonized babies was higher among preterm (26.2%) than in term neonates (8.8%), albeit the latter only composed a small proportion of study participants. Thus, the results may not be representative of healthy term babies, and epidemiology may vary depending on geographical backgrounds. Overall, it took a median of 17 days (interquartile range 11–37 days) to first detection of S. aureus in this study. Low birth weight and longer length of hospital stay were independently associated with higher rates of colonization.1 Similarly, a recent systematic review and meta-analysis for methicillin-resistant Staphylococcus aureus (MRSA) showed that very preterm neonates (gestational age <32 weeks) and very-low birth weight infants (<1500 g) are an important risk group for MRSA colonization.2 There are at least 3 transmission pathways for bacterial colonization in neonatal care: transmission via parents, via healthcare workers (HCWs) and via the patient environment. First, in a study investigating S. aureus transmission between parents and their infants in an intensive care setting, 74 of 190 infants (38.9%) were colonized with S. aureus by 90 days. Furthermore, 42 of 74 (56.8%) had a strain concordant with the parental baseline strain, indicating transmission via the parents.3 Second, HCWs contribute to S. aureus transmission in the NICU setting, as outbreak reports show,4 while data for the nonoutbreak setting are limited and colonization rates among HCWs are rarely assessed. Nevertheless, the NICU setting with its long hospitalization duration and the intimate contact between HCW and neonate in patient care facilitates HCW-to-patient transmissions (no "yuck factor"). Third, transmission via the patient environment is another pathway for bacterial colonization in hospitalized neonates as S. aureus is easily transmitted via hands, surfaces, and fomites. Considering these different pathways of transmission, preventing colonization with S. aureus in neonates usually entails several multimodal strategies, including general infection prevention/control (IPC) interventions (hand hygiene, contact precautions, patient isolation), environmental interventions (cleaning, dedicated equipment), HCW-targeted interventions (staff cohorting or screening), active surveillance and patient decolonization.5 WHO SHOULD BE DECOLONIZED? Given multiple sources of colonization and disregarding indirect environmental sources, it is unclear who might be the most optimal target for decolonization. Parental decolonization may be the most effective measure (to prevent colonization with the parental strain, but not all S. aureus strains), especially in the context of increasing delivery of family-centered care. A randomized controlled trial investigating the effect of parental S. aureus decolonization on transmission of S. aureus to their infants showed that only 13 of 89 neonates (14.6%) were colonized with a concordant S. aureus strain [risk difference, −14.1% (95% confidence interval (CI): −30.8% to −3.9%)], compared with 29 of 101 neonates (28.7%), in which parents did not apply decolonization measures (intranasal mupirocin and 2% chlorhexidine-impregnated cloths for 5 days).3 In an outbreak setting, identifying a colonized source, for example, among front-line clinical staff, with a targeted screening and decolonization strategy may also prove successful.4 DECOLONIZE BOTH MSSA AND MRSA? Much of the evidence generated by transmission and IPC studies regarding colonization/decolonization traditionally centered on MRSA. However, regarding its pathogenic potential itself and infection rates, MSSA is a comparable risk factor for consecutive infection, morbidity and mortality in neonates.6 Consequently, most recent IPC guidelines cover both pathogens in their recommendations.5 CAN NEONATES BE DECOLONIZED AT ALL? Strategies to permanently decolonize especially preterm neonates from MRSA, but also MSSA, show great variability, poor success and lack a solid evidence base,7 especially as a stand-alone IPC measure. A common trunk is the application of nasal mupirocin ointment8 (sometimes also applied to the umbilicus and wounds, see 9) with or without whole body washing with antiseptics active against S. aureus (chlorhexidine gluconate10 or octenidine dihydrochloride 0.1%11) on several consecutive days with varying recommendations for duration. This has some practical challenges related to neonates being obligate nose-breathers and avoidance of hypothermia. The effectiveness and duration of decolonization may be limited by the ubiquitous sources and pathways for recolonization outlined above and the occurrence of infections before colonized neonates are being identified as carriers, leaving decolonization as a reactive and short-term intervention with limited success (compare 8,9). DECOLONIZATION OF BACTERIA OTHER THAN S. AUREUS Skin decolonization with different antiseptics has been investigated in preterm and term neonates to reduce bacterial skin colonization density (and possible consecutive healthcare-associated infections) of bacteria other than S. aureus.12 Another strategy, selective digestive decontamination in critically ill children including neonates, has been discussed in the literature to reduce nosocomial infections caused by microorganisms residing in the oral cavity and gastrointestinal tract.13,14 However, this strategy has not been established as a standard IPC strategy given concerns around short- and long-term side effects of the applied antibiotics and issues around antibiotic resistance and microbiota alterations. NEW FRONTIERS Failure rates in decolonization and high recolonization rates with S. aureus have led to innovative clinical trials investigating maternal/parental skin-to-skin contact ("kangaroo care," "bonding") as an intervention. In a recent study, the decolonization rate in MRSA colonized newborns was increased in the interventional, skin-to-skin group (risk ratio = 2.27; 95% CI: 1.27–4.07; P = 0.003) with a low number needed to treat of 4.0 (95% CI: 2.2–9.4).15 A European-wide cluster-randomized controlled trial ("NeoIPC/NeoDeco", NCT05993442) is currently testing "optimized kangaroo care" as IPC intervention to reduce severe neonatal infection and resistant bacterial colonization. Similarly, microbiota transfer of nonparental bacterial skin strains also seems a potentially promising strategy to use the mechanism of "bacterial interference," suppressing colonization with "bad" bacteria16 and increasing skin microbiota balance towards diversity. However, evidence is currently lacking on what species this bacterial "cocktail" should include and in what concentrations and composition. Furthermore, it is unclear which neonates at what time during their NICU stay would benefit the most and under which circrumstances this approach outweighs the potential risks of systemic infections and uncontrolled spread.16 Overall, this changing view on colonization/decolonization in hospitalized neonates entails a paradigm shift from conceptualizing the skin of neonates as an area where bacteria causative of dysbiosis need to be eliminated—toward an understanding of balancing the neonatal bacterial skin microbiota by adding conducive bacteria and increasing the degree of diversity (Fig. 1) (see also 16). In other fields of clinical microbiology, this concept has been termed as "microbial management" which entails strategies to modulate and curate diverse microbial environments.17 Hospitalized neonates in the NICU are unusual in that they initially have a limited microbiota of their own and are therefore at risk of acquiring a hospital-based microbiota, which differs greatly from the microbiota of newborns co-admitted with mothers on the postnatal ward and promptly discharged home.FIGURE 1.: "Decolonization" vs. "balancing colonization" paradigms in hospitalized neonates.At least 2 paradigms can be identified in the literature as to whether "bad" bacteria need to be eliminated on the skin of hospitalized neonates ("decolonization paradigm"), or whether the skin microbiota needs to be balanced by introducing "good" bacteria ("balancing colonization paradigm"). Decolonizing may take place as application of antiseptic/antibacterial substances resulting in a less diverse population of bacteria ("bacterial diversity") on the neonate's skin. The "balancing colonization" approach may entail "kangaroo care" and results in a higher degree of bacterial diversity on the neonate's skin. Created in BioRender. Bielicki, J. (2025) https://BioRender.com/t18v567Further research is needed to determine the strengths and limitations of parental and nonparental bacterial transfer, for example, via kangaroo care, to micromanage the neonatal skin microbiota toward a diverse and healthy composition with protective features against infections and potentially reducing detrimental bacterial colonization. Even in settings with low prevalence of multidrug-resistant organisms, the microbiota of NICU-hospitalized infants are likely to substantially diverge from what would be considered healthy. Interventions based on the concept of "microbial management" rather than aiming at decolonization may therefore be the most promising and relevant to many high-risk infants globally and deserve to be studied further. Furthermore, baseline surveillance data of multidrug-resistant organism rates is country-specific, differ greatly between different world regions and may limit clinically meaningful application of microbial management strategies in neonates or might entail a greater need for screening and monitoring. ACKNOWLEDGMENTS The authors thank Steffen Engelhart for the critical discussion during manuscript drafting.

Scope: These European Society of Clinical Microbiology and Infectious Diseases guidelines are intended for clinicians involved in diagnosis and treatment of brain abscess in children and adults. Methods: Key questions were developed, and a systematic review was carried out of all studies published since 1 January 1996, using the search terms 'brain abscess' OR 'cerebral abscess' as Mesh terms or text in electronic databases of PubMed, Embase, and the Cochrane registry. The search was updated on 29 September 2022. Exclusion criteria were a sample size <10 patients or publication in non-English language. Extracted data was summarized as narrative reviews and tables. Meta-analysis was carried out using a random effects model and heterogeneity was examined by I-2 tests as well as funnel and Galbraith plots. Risk of bias was assessed using Risk Of Bias in Non-randomised Studies - of Interventions (ROBINS-I) (observational studies) and Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) (diagnostic studies). The Grading of Recommendations Assessment, Development and Evaluation approach was applied to classify strength of recommendations (strong or conditional) and quality of evidence (high, moderate, low, or very low). Questions addressed by the guidelines and recommendations: Magnetic resonance imaging is recommended for diagnosis of brain abscess (strong and high). Antimicrobials may be withheld until aspiration or excision of brain abscess in patients without severe disease if neurosurgery can be carried out within reasonable time, preferably within 24 hours (conditional and low). Molecular-based diagnostics are recommended, if available, in patients with negative cultures (conditional and moderate). Aspiration or excision of brain abscess is recommended whenever feasible, except for cases with toxoplasmosis (strong and low). Recommended empirical antimicrobial treatment for community-acquired brain abscess in immuno-competent individuals is a 3rd-generation cephalosporin and metronidazole (strong and moderate) with the addition of trimethoprim-sulfamethoxazole and voriconazole in patients with severe immuno-compromise (conditional and low). Recommended empirical treatment of post-neurosurgical brain abscess is a carbapenem combined with vancomycin or linezolid (conditional and low). The recommended duration of antimicrobial treatment is 6-8 weeks (conditional and low). No recommendation is offered for early transition to oral antimicrobials because of a lack of data, and oral consolidation treatment after >= 6 weeks of intravenous antimicrobials is not routinely recommended (conditional and very low). Adjunctive glucocorticoid treatment is recommended for treatment of severe symptoms because of perifocal oedema or impending herniation (strong and low). Primary prophylaxis with antiepileptics is not recommended (conditional and very low). Research needs are addressed. Jacob Bodilsen, Clin Microbiol Infect 2024;30:66 (c) 2023 The Author(s). Published by Elsevier Ltd on behalf of European Society of Clinical Microbiology and Infectious Diseases. This is an open access article under the CC BY license (http://creativecommons. org/licenses/by/4.0/).

The authors regret an inconsistency in the reported quality of evidence for Key Question 4 concerning whether neurosurgical aspiration or excision should be used in patients with brain abscess. The reported quality of evidence was described as "low" in the abstract and Table 1 and should instead be "moderate" as stated in the main text. The authors would like to apologise for any inconvenience caused. European society of Clinical Microbiology and Infectious Diseases guidelines on diagnosis and treatment of brain abscess in children and adultsClinical Microbiology and InfectionVol. 30Issue 1PreviewThese European Society of Clinical Microbiology and Infectious Diseases guidelines are intended for clinicians involved in diagnosis and treatment of brain abscess in children and adults. Full-Text PDF Open Access

The field of medical diagnostics is continuously evolving, propelled by technological breakthroughs and an enhanced understanding of infection. Simultaneously, we face the challenge of dealing with outdated microbiological tests—some of which suffer from low accuracy or are used inappropriately. To address this, we are introducing, similar to the "Which trials do we need?" series [ 1 Leibovici L. Paul M. Doernberg S.B. Which randomized controlled trial do we need?. Clin Microbiol Infect. 2022 Dec; 28: 1525https://doi.org/10.1016/j.cmi.2022.10.008 Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar , 2 Leibovici L. Which trials do we need?. Clin Microbiol Infect. 2024 Apr; 5 (S1198-743X(24)00171-X)https://doi.org/10.1016/j.cmi.2024.04.002 Abstract Full Text Full Text PDF Scopus (0) Google Scholar ], a new series of commentaries aimed at examining the landscape of diagnostics. These articles should explore available and potential tests, offering guidance on adopting new methodologies and discontinuing obsolete ones.

The under-representation of women in infectious diseases and clinical microbiology has been well documented.1,2 Besides publishing, active participation in scientific conferences is a crucial part of career development.3 Conferences are a focal point for the dissemination of state-of-the-art research; offer networking opportunities; and create visibility for speakers, especially in prestigious sessions.3,4 Data on gender and geographical representation at international infectious diseases and clinical microbiology conferences, stratified by speaking roles in prestigious sessions, are lacking.

In a grand room bathed in sunlight from towering windows at the AC Hotel Bella Sky in Copenhagen, they found themselves amidst a treasure trove of toys. So, they played, they laughed, and the younger one—feeling secure enough—even fell asleep. What a huge relief it was, we thought, for the first time being able to simultaneously attend a conference session since we became parents. Sometimes, things change, and even for the better.

To characterize the clinical relevance of S. saccharolyticus and to identify criteria to distinguish between infection and contamination. We retrospectively investigated clinical features of patients with S. saccharolyticus detection between June 2009 and July 2021. Based on six criteria, infection was considered likely for patients with a score from 3 to 6 points, infection was considered unlikely for patients with a score from 0 to 2 points. We performed group comparison and logistic regression to identify factors than are associated with likely infection. In addition, whole genome sequencing (WGS) of 22 isolates was performed. Of 93 patients in total, 44 were assigned to the group “infection likely” and 49 to the group “infection unlikely”. Multiple regression analysis revealed “maximum body temperature during hospital stay” to have the strongest predictive effect on likely infection (adjusted odds ratio 4.40, 95

Vancomycin-resistant enterococci (VRE) cause many infections in the healthcare context. Knowledge regarding the epidemiology and burden of VRE infections, however, remains fragmented. We aimed to summarize recent studies on VRE epidemiology and outcomes in hospitals, long-term-care facilities (LTCFs) and nursing homes worldwide based on current epidemiological reports. We searched MEDLINE/PubMed, the Cochrane Library, and Web of Science for observational studies, which reported on VRE faecium and faecalis infections in in-patients published between January 2014 and December 2020. Outcomes were incidence, infection rate, mortality, length of stay (LOS), and healthcare costs. We conducted a meta-analysis on mortality (PROSPERO registration number: CRD42020146389). Of 681 identified publications, 57 studies were included in the analysis. Overall quality of evidence was moderate to low. VRE incidence was rarely and heterogeneously reported. VRE infection rate differed highly (1-55%). The meta-analysis showed a higher mortality for VRE faecium bloodstream infections (BSIs) compared with VSE faecium BSIs (risk ratio, RR 1.46; 95% confidence interval (CI) 1.17-1.82). No difference was observed when comparing VRE faecium vs VRE faecalis BSI (RR 1.00, 95% CI 0.52-1.93). LOS was higher in BSIs caused by E. faecium vs E. faecalis. Only three studies reported healthcare costs. In contrast to previous findings, our meta-analysis of included studies indicates that vancomycin resistance independent of VRE species may be associated with a higher mortality. We identified a lack of standardization in reporting outcomes, information regarding healthcare costs, and state-of-the-art microbiological species identification methodology, which may inform the set-up and reporting of future studies. 2023 Published by Elsevier Ltd on behalf of The Healthcare Infection Society.

Background:A plethora of antimicrobial stewardship (AMS) programs has been initiated during the past years, focusing on hospital settings. Primary-care physicians have seldom been addressed, although the majority of antibiotic prescriptions are issued for outpatients. We sought to investigate attitudes of primary-care physicians and the impact of a customized training course.Methods:Primary-care physicians in southwest Germany were invited to a multi-part training course on AMS in the primary-care setting. Participants were asked to answer a questionnaire about their attitude and factors that hinder them from implementing AMS or enable them to perform AMS. In addition, a knowledge assessment exam at the beginning and end of the training was conducted on selected infectious diseases/syndromes.Results:In total, 36 primary-care physicians participated in the training course. The predominant age group was 51-60 years old (36%; 13/36). The majority, 23/35 (66%), indicated never having had AMS training, while 22/35 (63%) acknowledged partly implementing AMS activities in their daily routine. The primary barrier was lack of expertise, while the main motives were reducing antimicrobial resistance and optimizing patient care. The provision of guidelines was regarded as more important than feedback on their prescription behavior. Exam performance improved from the initial to the final exam on all topics.Conclusion:Customized AMS training courses are a feasible and potentially complimentary tool to address antibiotic misuse in the primary-care setting.

Background: We previously demonstrated in a large multicentre point prevalence study (PPS) a marked variability across German and Austrian centres regarding the management of fever and neutropenia (FN) in children, and a high rate of inappropriate treatments compared to recommendations in the German national FN guidelines. Methods: We analysed local FN standard operating procedures (SOPs) of participating centres and rated their concordance with the German national FN guidelines. To this end, we defined items derived from the German national FN guidelines that we considered essential for any local FN SOP, and assigned points per items. The items comprised “basic requirements of a SOP”; “risk analysis”; “diagnostic approach”; and “use of antibiotics including dosing recommendations”, including sub-categories. Results: Of the 30 participating centres’ SOPs, 29 were of sufficient granularity for detailed analysis. Only 19/29 (66%) and 20/29 (69%) of the SOPs provided a definition of fever and of neutropenia, respectively. The top scoring sub-categories were “empiric treatment” (mean percentage 69%), “laboratory investigations” (62.4%), and “SOP basics” (59.7%). The worst scoring sub-categories were “definitions” (37.7%), “risk analysis” (32.3%), and “outpatient treatment” (15.7%). Conclusions: The majority of the local FN SOPs demonstrated a lack of concordance with the German national guidelines on the management of paediatric FN. These discrepancies may explain the high rate of inappropriate antimicrobial treatments in our previous PPS. Our data indicate that local SOPs should be better adapted to national guidelines, and national guidelines should be conceived with the feedback of end-users, thereby anticipating barriers and facilitating acceptance.

We read with interest Seul Kee Byeon and colleagues’ Article1 in The Lancet Digital Health on a multiomics model to predict the likelihood of severe disease in patients with COVID-19. Improving diagnostics is an important, yet underappreciated, approach to successfully tackle the ongoing COVID-19 pandemic, to reduce morbidity and mortality by potentially informing antiviral treatment, and to manage scarce resources globally. In Byeon and colleagues’ study, the sample size and the number of biomarkers captured within the model are impressive, and the concentration comparison of analyte markers in pre-COVID-19 and post-COVID-19 plasma samples is intriguing.

We evaluated the host-response marker score “BV” and its components TRAIL, IP-10, and CRP in SARS-CoV-2 positive children, and estimated the potential impact on clinical decision-making. We prospectively analyzed levels of TRAIL, IP-10, CRP, and the BV score, in children with suspected COVID-19. Classification of infectious etiology was performed by an expert panel. We used a 5-point-questionnaire to evaluate the intention to treat with antibiotics before and after receiving test results. We screened 111 children, of whom 6 (5.4

Background Due to the high risk of severe infection among pediatric hematology and oncology patients, antimicrobial use is particularly high. With our study, we quantitatively and qualitatively evaluated, based on institutional standards and national guidelines, antimicrobial usage by employing a point-prevalence survey with a multi-step, expert panel approach. We analyzed reasons for inappropriate antimicrobial usage. Methods This cross-sectional study was conducted at 30 pediatric hematology and oncology centers in 2020 and 2021. Centers affiliated to the German Society for Pediatric Oncology and Hematology were invited to join, and an existing institutional standard was a prerequisite to participate. We included hematologic/oncologic inpatients under 19 years old, who had a systemic antimicrobial treatment on the day of the point prevalence survey. In addition to a one-day, point-prevalence survey, external experts individually assessed the appropriateness of each therapy. This step was followed by an expert panel adjudication based upon the participating centers' institutional standards, as well as upon national guidelines. We analyzed antimicrobial prevalence rate, along with the rate of appropriate, inappropriate, and indeterminate antimicrobial therapies with regard to institutional and national guidelines. We compared the results of academic and non-academic centers, and performed a multinomial logistic regression using center-and patient-related data to identify variables that predict inappropriate therapy. Findings At the time of the study, a total of 342 patients were hospitalized at 30 hospitals, of whom 320 were included for the calculation of the antimicrobial prevalence rate. The overall antimicrobial prevalence rate was 44.4% (142/320; range 11.1-78.6%) with a median antimicrobial prevalence rate per center of 44.5% (95% confidence interval [CI] 35.9-49.9). Antimicrobial prevalence rate was significantly higher (p < 0.001) at academic centers (median 50.0%; 95% CI 41.2-55.2) compared to non-academic centers (median 20.0%; 95% CI 11.0-32.4). After expert panel adjudication, 33.8% (48/142) of all therapies were labelled inappropriate based upon institutional standards, with a higher rate (47.9% [68/142]) when national guidelines were taken into consideration. The most frequent reasons for inappropriate therapy were incorrect dosage (26.2% [37/141]) and (de-)escalation/spectrum-related errors (20.6% [29/141]). Multinomial, logistic regression yielded the number of antimicrobial drugs (odds ratio, OR, 3.13, 95% CI 1.76-5.54, p < 0.001), the diagnosis febrile neutropenia (OR 0.18, 95% CI 0.06-0.51, p = 0.0015), and an existing pediatric antimicrobial stewardship program (OR 0.35, 95% CI 0.15-0.84, p = 0.019) as predictors of inappropriate therapy. Our analysis revealed no evidence of a difference between academic and non-academic centers regarding appropriate usage. Interpretation Our study revealed there to be high levels of antimicrobial usage at German and Austrian pediatric oncology and hematology centers with a significant higher number at academic centers. Incorrect dosing was shown to be the most frequent reason for inappropriate usage. Diagnosis of febrile neutropenia and antimicrobial stew-ardship programs were associated with a lower likelihood of inappropriate therapy. These findings suggest the importance of febrile neutropenia guidelines and guidelines compliance, as well as the need for regular antibiotic stewardship counselling at pediatric oncology and hematology centers. Copyright (c) 2023 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Background: Early prognostication of COVID-19 severity will potentially improve patient care. Biomarkers, such as TNF-related apoptosis-inducing ligand (TRAIL), interferon gamma-induced protein 10 (IP-10), and C-reactive protein (CRP), might represent possible tools for point-of-care testing and severity prediction. Methods: In this prospective cohort study, we analyzed serum levels of TRAIL, IP-10, and CRP in patients with COVID-19, compared them with control subjects, and investigated the association with disease severity. Results: A total of 899 measurements were performed in 132 patients (mean age 64 years, 40.2% females). Among patients with COVID-19, TRAIL levels were lower (49.5 vs 87 pg/ml, P = 0.0142), whereas IP-10 and CRP showed higher levels (667.5 vs 127 pg/ml, P < 0.001; 75.3 vs 1.6 mg/l, P < 0.001) than healthy controls. TRAIL yielded an inverse correlation with length of hospital and intensive care unit (ICU) stay, Simplified Acute Physiology Score II, and National Early Warning Score, and IP-10 showed a positive cor- relation with disease severity. Multivariable regression revealed that obesity (adjusted odds ratio [aOR] 5.434, 95% confidence interval [CI] 1.005-29.38), CRP (aOR 1.014, 95% CI 1.002-1.027), and peak IP-10 (aOR 1.001, 95% CI 1.00-1.002) were independent predictors of in-ICU mortality. Conclusions: We demonstrated a correlation between COVID-19 severity and TRAIL, IP-10, and CRP. Multi- variable regression showed a role for IP-10 in predicting unfavourable outcomes, such as in-ICU mortality. registration:

Clinical and laboratory data on newly described staphylococcal species is rare, which hampers decision-making when such pathogens are detected in clinical specimens. Here, we describe Staphylococcus massiliensis detected in three patients at a university hospital in southwest Germany. We report the discrepancy of microbiological findings between matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, 16S-rRNA polymerase chain reaction, and whole-genome sequencing for all three isolates. Our findings highlight the diagnostic pitfalls pertinent to novel and non-model organisms in daily microbiological practice, in whom the correct identification is dependent on database accuracy.

Aim: To estimate the burden of parenting and caregiving duties among clinical microbiologists in Germany and to identify workplace-related support systems and barriers to engaging in career-relevant activities. Methods: A cross-sectional web-based survey was conducted. Participants were asked to answer 37 questions, of which 24 specifically addressed parenting and caregiving duties. Results: Only few workplace-related support systems are currently available, and experiences of job-related disadvantages were frequently reported (27 of 47; 57.4%). Main barriers were a lack of flexible working hours and reliable childcare. Sociocultural norms and a lack of role models were perceived as detrimental. Conclusion: More support systems and a credible culture of family friendliness are needed to prevent jeopardizing the academic potential of young parents.