Shigella flexneri producing OXA-181 was detected from a patient in Ireland in October 2025. The isolate had a meropenem minimum inhibitory concentration (MIC) of 0.12 mg/L. Carbapenemase production was detected by lateral flow immunoassay. The sequence type was ST245 and closely related to sequences previously reported from Ireland and other countries but not previously linked to presence of the blaOXA-181 gene. Carbapenemase production in Shigella spp. has implications for laboratory detection and empiric treatment.

BACKGROUNDAccurate, fully automated systems may increase efficiency of healthcare-associated infections (HAI) surveillance.AIMWe aimed to validate the performance of a fully automated surveillance system for central-line-associated bloodstream infections (CLABSI) in critically ill patients in Switzerland.METHODSWe conducted a multicentre retrospective study across six secondary and tertiary care hospital networks’ intensive care units (ICU). A centrally hosted, fully automated algorithm was implemented to detect catheter-related bloodstream infections (CRBSI), CLABSI and ICU-onset bloodstream infections (ICU-BSI). Algorithm performance was validated against an anonymised manual review of random samples of positive blood cultures. Incidence data were computed for each hospital.RESULTSFrom January 2022 to December 2023, we analysed 131,166 patient days, 108,719 catheter days and 7,832 positive blood cultures from 1,931 ICU patients. Median age was 65 years (interquartile range (IQR): 53–73), 458 (23.7%) were female. For CLABSI and CRBSI, the algorithm demonstrated a specificity of 95.3% (95% confidence interval (CI): 92.7–97.0), sensitivity of 86.5% (95% CI: 79.8–91.2), positive predictive value of 87.0% (95% CI: 80.4–91.7) and negative predictive value of 95.1% (95% CI: 92.5–96.8). CRBSI/CLABSI and ICU-BSI incidence rates were 3.23/1,000 catheter days (95% CI: 2.91–3.57) and 2.42/1,000 patient days (95% CI: 2.17–2.70), respectively. Most identified microorganisms for CRBSI/CLABSI were Staphylococcus epidermidis (15.1%; 53/351), Enterococcus faecium (9.1%; 32/351) and E. faecalis (5.7%; 20/351).CONCLUSIONSWe demonstrate feasibility and external validity of a fully automated system for CLABSI surveillance in critically ill patients, supporting its integration into national HAI prevention and control strategies.

BACKGROUNDWhile West Nile virus (WNV), a mosquito-borne zoonotic pathogen, is detected every year in animals in Spain, clinical human cases occur more sporadically. Most explanatory and predictive models for WNV circulation focus on single components and aggregate multiple year data into a single dataset.AIMWe sought WNV circulation environmental drivers across different ecological components (vectors, reservoirs, and dead-end hosts), by analysing their spatial and temporal dynamics.METHODSWe used active and passive surveillance data collected in Spain between 2003 and 2022, encompassing mosquitoes, 120 bird species, 115 mammal species, and humans. To understand WNV circulation, mosquito spatial and host spatiotemporal models were developed, incorporating current and lagged environmental variables. Our One Health approach integrated the different models to determine WNV exposure risk, including 1 year in advance.RESULTSOver 20 years, WNV exposure risk in Spain rose by 19% in birds, 17% in non-human mammals, and 38% in humans. In birds and non-human mammals, exposure more likely occurred in areas experiencing mean respective annual temperatures > 5 °C and > 8 °C in the previous year. In humans, increased exposure risk concurred with mild winters (> 5.3 °C). Integrating mosquito and host models found the country’s southern half and mediterranean coast most suited for WNV. Predictive models solely using prior-year variables yielded comparable results to contemporaneous ones.CONCLUSIONThe models suggest that annual human WNV transmission may occur more regularly than evidenced by surveillance, possibly due to asymptomatic or misdiagnosed cases. Our framework could serve as an early warning tool, enhancing outbreak preparedness up to 1 year ahead.

BACKGROUNDUp-to-date estimates of chronic hepatitis B virus (HBV) prevalence in both general and key populations are challenging to obtain because of underdiagnosis, heterogeneous surveillance systems and underrepresentation of key populations.AIMWe aimed to test the Workbook Method to estimate chronic HBV prevalence in 2022 across the EU/EEA, by country and among men who have sex with men (MSM), people who inject drugs (PWID) and migrants.METHODSWe used the Robert Koch Institute’s version of the Joint United Nations Programme on HIV/AIDS (UNAIDS) Workbook Method to generate HBV prevalence estimates for each EU/EEA country and for MSM, PWID and migrants within each country. We combined data on population size and HBV prevalence for each population group gathered from scientific sources and reviewed by the European Centre for Disease Prevention and Control’s hepatitis national contact points.RESULTSOverall, 0.7% (lower bound–upper bound: 0.5–0.9%) of the EU/EEA population (3,226,000 (2,397,000–4,149,000) individuals) were estimated to be living with HBV in 2022. National HBV prevalence ranged from 0.1% (0.1–1.0%) to 3.1% (2.8–3.3%). Prevalence estimates varied from 0.8% (0.5–1.0%) to 10.5% (9.3–11.9%) for migrants, < 0.1% to 8.7% (lower and upper bounds not available) for PWID and from < 0.1% (< 0.1– < 0.1%) to 10.5% (10.2–10.8%) for MSM.DISCUSSIONDespite limitations, including the inability to address overlapping populations, these estimates confirm substantial chronic HBV prevalence in the EU/EEA, with considerable variation between countries and population groups. This relatively straightforward method offers an alternative means of generating HBV prevalence estimates.

BACKGROUNDCommunity-acquired Legionnaires’ disease (LD) has increased globally, including Europe. Climatic exposures may contribute to this rise, yet evidence from high-incidence countries, such as Italy, is limited.AIMWe aimed to assess LD seasonality at the national level and the effects of temperature, relative humidity and precipitation on LD incidence at the municipality level.METHODSWe analysed data on notified community-acquired LD cases and national climatic data from 2005 to 2023. Seasonality was assessed (peak-to-trough ratio (PTR)). A case time-series design with distributed lag nonlinear models was applied to estimate 1–10 week lagged effects of climatic exposures on LD incidence at the municipality level, as incidence rate ratios (IRRs).RESULTSOf the 28,662 notified LD cases, 27,458 (95.8%) were included. A clear seasonality was observed in the incidence, with a trough in early spring and a peak in autumn (PTR = 3.62; 95% confidence interval (CI): 2.45–5.34). Higher temperature and relative humidity had the strongest effects 10–9 weeks before disease onset (for 5°C increase above 15°C: IRR = 1.45; 95% CI: 1.33–1.58 and for 5% increase above 60%: IRR = 1.19; 95% CI: 1.12–1.26). Precipitation showed more immediate effects, particularly with a 1-week lag (for 5 mm increase above 10 mm: IRR = 1.07; 95% CI: 1.06–1.09). Findings were consistent among individuals aged ≥ 60 years.CONCLUSIONA clear seasonal pattern was seen in the LD incidence, peaking in summer and autumn. Temperature and humidity increased LD risk over longer lags, while precipitation had shorter-term effects, suggesting climatic exposures influence environmental proliferation and immediate transmission of Legionella.

BACKGROUNDSalmonellosis is the second most notified food-borne infection in Europe. In Czechia (CZ), the notification rate has consistently been above the European average, five times higher in 2013–2022.AIMWe aimed to describe the epidemiology of salmonellosis in CZ in 2012–2023 and identify areas for improving surveillance and public health actions.METHODSWe extracted data on notified salmonellosis cases from the national surveillance system and analysed the dataset for demographic characteristics, hospitalisation, transmission mode and suspected vehicle, descriptively and by chi-square tests and logistic regression.RESULTSIn 2012–2023, 130,990 cases (102.7/100,000 inhabitants) were notified. The overall annual notification rate decreased from 111.7 per 100,000 in 2012–2017 to 94.2 per 100,000 in 2018–2023. Most cases were children and adolescents aged < 15 years (n = 68,370; 52.2%) and most were females (n = 68,425; 52.2%) but males dominated among cases aged < 15 years (35,790/68,370; 52.3%). Few cases were imported (n = 2,627; 2.0%) or outbreak-related (n = 5,361; 4.1%); most were diagnosed in June–October (n = 83,057; 63.4%). Of all notified cases, 22.2% (n = 29,082) were hospitalised. Age of ≥ 40 years was associated with hospitalisation and Salmonella sepsis (p < 0.001). Transmission mode was identified for 59,729 (45.6%) cases.CONCLUSIONDespite a decline, the notification rates of salmonellosis remain high in CZ. The effectiveness of the surveillance system is reflected in relatively low hospitalisation rates compared with some other European countries, yet the source and transmission mode were unidentified in over half of the cases. We encourage enhancing epidemiological investigations, improving sample submission to the National Reference Laboratory and molecular surveillance.

In 2024, based on the European Committee on Antimicrobial Susceptibility Testing breakpoint, we observed a tetracycline resistance prevalence of 62.3% (2,231/3,579) in Neisseria gonorrhoeae isolates from 22 European countries (range: 16.5–100%). Multivariable analysis of correlations between resistance and patients’ epidemiological characteristics found tetracycline resistance associated with men who have sex with men (aOR: 1.38; 95% CI: 1.06–1.79). Our results are important when considering measures against transmission of sexually transmitted bacterial infections in Europe, such as in the context of doxycycline post-exposure prophylaxis (doxy-PEP).

In Europe, the 2025/26 seasonal influenza epidemic started in October 2025. Co-circulation of A(H3N2) and A(H1N1)pdm09 was observed in several countries including France. We estimated early vaccine effectiveness (VE) against influenza virus in French outpatients (5,451 positives/18,816 negatives). A significant VE across all age groups was measured: 28% (95% CI: 17–37) for those aged ≥ 65 years, 45% (95% CI: 36–53) for 18–64-year-olds and 57% (95% CIs: 29–74) for 0–17-year-olds. Reinforcing vaccination uptake is warranted.

BACKGROUNDPertussis remains a serious threat to young infants. In Norway, infants receive an acellular pertussis vaccine (aP) according to a 2 + 1 schedule at 3, 5 and 12 months of age, delivered as a hexavalent vaccine.AIMWe aimed to study susceptibility to pertussis in mothers and infants to guide decisions regarding vaccination in pregnancy.METHODSIn this prospective observational study, we included 366 mother/infant pairs during 2020–2023, collecting blood samples from mothers in late pregnancy, cord blood at delivery and from infants before their first and after their third vaccine dose. We retrieved health registry data on vaccination and pregnancy-related information. IgG antibody levels against pertussis-antigens, diphtheria and tetanus were measured using a multiplex immunoassay.RESULTSOf the pregnant women, 48% (174/366) had low levels of antibodies against pertussis toxin (PT) defined as below 5 IU/mL. Maternal antibodies declined in infants from birth until first vaccination, leaving 72% (154/215) of infants with anti-PT IgG levels below 5 IU/mL. All infants responded well to vaccination and we found no evidence of blunting from high levels (> 40 IU/mL) of maternal antibodies against PT. Infants of mothers who received an aP-containing booster vaccine within 2 years before pregnancy displayed low anti-PT IgG levels, with 58% (15/26) having levels below 5 IU/mL.CONCLUSIONA high proportion of pregnant women and their infants under 3 months of age had low anti-PT antibody levels, indicating high susceptibility to pertussis. The results support the introduction of vaccination against pertussis during pregnancy in Norway.