Jon Salmanton-García

Background: Future health professionals are expected to recommend vaccines, communicate with patients about vaccine safety, and support clinical trial literacy and recruitment during public health emergencies. However, their own willingness to participate in vaccine trials, and the barriers that shape that willingness, remain incompletely characterized across Europe. Objective: This study aimed to assess willingness to participate in future vaccine trials among European students in health-related disciplines and to describe their perceived barriers, motivations, vaccine attitudes, and preferred sources of health information. Methods: We conducted an open, multilingual, cross-sectional web survey within the VACCELERATE network from June to November 2023. National coordinators distributed the survey through institutional mailing lists, student associations, and program channels in participating European countries. Eligible participants were students aged 18 years or older enrolled in medicine, dentistry, nursing, pharmacy, psychology, biomedical sciences, physiotherapy, occupational therapy, or other health-related programs. The questionnaire assessed demographic characteristics, primary sources of health information, vaccine attitudes, willingness to participate in future vaccine trials, barriers among unwilling or unsure respondents, and motivations for participation. Analyses were descriptive, and denominators varied by item because nonmandatory questions could be skipped. Results: Of 1381 eligible respondents, 1192 (86.3%) answered the primary willingness question: 32.9% (n=392) were willing to participate in a future vaccine trial, 38.8% (n=463) were unsure, and 28.3% (n=337) were unwilling. Among the 769 respondents who were unwilling or unsure and selected barriers, the most frequent concerns were potential side effects (n=574, 74.6%) and not wanting to be a “test subject” (n=276, 35.9%). Among 1289 respondents included in the motivation analysis, commonly selected motivators included knowing the risks and side effects involved (n=575, 44.6%), becoming part of the solution to an important health problem (n=584, 45.3%), and knowing that personal safety would be protected (n=500, 38.8%). Conclusions: In this multicountry European sample of health professional students, only one-third reported willingness to participate in future vaccine trials, while the largest group was unsure. The findings suggest that trial-readiness initiatives for future health professionals should prioritize transparent communication about safety monitoring, risks and side effects, participant protections, and the practical conduct of vaccine trials. Because recruitment used an open convenience approach, the results should be interpreted as exploratory and hypothesis generating rather than representative of all European health professional students.

Purpose: Acute respiratory infections (ARI) impose a significant burden on healthcare systems and society. This study aimed to investigate the circulation of respiratory viruses in community-dwelling older adults in Germany. Methods: Participants aged ≥ 50 years in Germany performed multi-pathogen rapid antigen self-tests (MAK5) detecting adenovirus (AdV), severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2), influenza A and B, and respiratory syncytial virus (RSV) on June 1 and December 15, 2024. Participants reported test results, ARI symptoms and duration, medical consultations, work absenteeism, comorbidities, vaccination history, and prior infections. Results: 2,654 participants enrolled in the point prevalence assessment on June 1, 2024 and 2,385 on December 15, 2024. Most tests were negative ( n = 4,807; 93.9%), with an overall detection rate of 5.7%. In June, 153 pathogens were detected, compared to 138 in December. AdV was the most frequently detected pathogen in both June (59/153; 38.6%) and December (44/138; 31.9%), followed by SARS-CoV-2 and influenza A. Among participants with a positive test, at least one ARI symptom was reported by 47.7% in June and 58.7% in December. SARS-CoV-2 was associated with the highest clinical burden, resulting in healthcare utilization in 10.0% and 19.4% of cases and work absenteeism in 10.0% and 13.9% of cases in June and December, respectively. Conclusion: Point prevalence testing revealed substantial AdV circulation, underrepresented in routine surveillance. Its frequent co-detection with other viruses suggests a role as a co-infecting agent. Community-based screening can help identify asymptomatic reservoirs and underreported viral circulation, linking viral detection to clinical and economic impact.

The Infectious Diseases Working Party (AGIHO) was established in 1996 as one of the subgroups of the German Society of Hematology and Medical Oncology (DGHO). Marking its 30th anniversary this year, the AGIHO reflects on a period of significant achievement and growth. Beyond its core mission of developing evidence-based clinical practice guidelines for the prevention, diagnosis, and management of infections in patients with cancer, the AGIHO has evolved into a vital platform for clinical trials, collaborative research, and postgraduate medical education. To ensure long-term sustainability and foster emerging talent, “Young AGIHO” was launched in 2023. This initiative aims to strengthen networking among early career physicians specializing in hematology and oncology with a strong focus on infectious diseases. The working party has also expanded its geographical footprint by integrating colleagues from Austria and Switzerland, thereby enhancing its international presence. Through the publication of guidelines in high-ranking international journals, AGIHO visibility has increased significantly. Representatives of the working party now serve as experts for scientific and health policy committees both nationally and internationally. As one of the DGHO's largest and most active subgroups, the AGIHO is ideally positioned to address future challenges in the field.

Invasive fungal diseases (IFD) pose a major health challenge in Latin America and the Caribbean (LAC), particularly in vulnerable populations. A cross-sectional, survey is distributed between April 2023 and May 2025 to institutions involved in IFD diagnosis or care across LAC. The questionnaire evaluates diagnostic tools, antifungal availability, and therapeutic drug monitoring (TDM). A total of 619 institutions from 23 countries across LAC participate. Candida spp. (92%) and Aspergillus spp. (54%) are most frequently reported as major fungal threats. Culture (90%) is widely available, whereas access to galactomannan (41%), β-D-glucan (29%), and molecular testing (23%) is considerably lower. Availability of antifungals, including liposomal amphotericin B (38%), echinocandins (51%), voriconazole (57%) or posaconazole (33%) is significantly higher in countries with GDP per capita >US$ 10,000, in transplant centres, and in institutions managing people living with HIV. Therapeutic drug monitoring is available in only 36% of centres. Major diagnostic and treatment gaps persist in low-income countries, particularly in access to tools for identifying endemic mycoses. Substantial disparities exist in IFD diagnostic and treatment capacity across LAC, primarily driven by national income and institutional complexity. Strengthening laboratory infrastructure, antifungal access, and integration of fungal disease management into public health systems is urgently needed.

Candida species cause life-threatening bloodstream infections, particularly in critically ill and immunocompromised patients. Although guideline adherence has been shown to improve outcomes, real-world implementation is often constrained. This cross-sectional, web-based survey evaluated current clinical practices and barriers in candidemia management across German healthcare institutions. A structured questionnaire based on the EQUAL Candida score was disseminated online from 10/2023 to 07/2025. Physicians involved in candidemia management reported institutional characteristics, diagnostic practices, antifungal treatment strategies, central line management, and follow-up practices. Data were analyzed using descriptive statistics and chi-square testing. A total of 217 physicians from 147 institutions participated, with 74.5% of participants affiliated with large care facilities. Caspofungin was the predominant first-line therapy (81.4%), whereas fluconazole was used by 5.3% of participants. First-line choice did not differ by years of clinical experience (P = 0.194). Echocardiography was routinely performed by 57% of participants; selective use showed no association with years of clinical experience (P = 0.845) or annual number of candidemia cases (P = 0.089). Ophthalmoscopy was performed routinely by 37% of participants and showed no association with experience (P = 0.907), but was significantly associated with lower annual caseload (P = 0.02) and infectious disease speciality (P = 0.003). Central line removal or replacement within 24 h was reported by 82.5%. Follow-up blood cultures were obtained daily by 31.4%, while 54.8% repeated cultures every 48 h. While core candidemia management practices are generally well implemented in German healthcare institutions, certain recommended diagnostic steps remain underutilized. Targeted educational and structural interventions are needed to strengthen guideline adherence and optimize patient outcomes across diverse settings.

Invasive fungal infections are a major cause of morbi-mortality, particularly in immunocompromised and critically ill patients. Increasing antifungal resistance, unequal access to diagnostics and therapies, and complex host–pathogen interactions highlight the need for coordinated research. The European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Fungal Infection Study Group (EFISG) addresses these challenges by promoting multidisciplinary collaboration and advancing research and education in medical mycology. This study aimed to characterize the global medical mycology workforce using EFISG as a representative international network. A cross-sectional survey was conducted among EFISG members between June and December 2025. The survey collected data on demographics, geographic distribution, professional background, career stage, research interests, language proficiency, and involvement in other scientific societies and ESCMID study groups. A total of 342 members from 72 countries responded, representing two-thirds of all countries with EFISG membership. Most participants were based in Europe (60%). Sex distribution was balanced, and all career stages were included, with 22.8% early-career professionals and 14.6% trainees. Key research interests included epidemiology of fungal infections (68.4%), mycoses in immunocompromised hosts (67.5%), development of diagnostic methods (54.4%), and rare and emerging fungal diseases (54.1%). Infectious disease specialists (52.3%) and microbiologists (42.4%) comprised the majority of respondents, and most reported active participation in other ESCMID study groups and scientific societies. These findings provide the first structured overview of the medical mycology workforce, identifying gaps in representation, training, and emerging research areas, with implications for global capacity building, collaboration, and strategic planning beyond EFISG.

ECMM-Candida III was a pan-European, multicentre observational study of adult patients with blood culture-proven candidemia. Among a total of 632 patients with candidemia across 64 institutions in 20 European countries, a sub-analysis of 396 (63%) cases occurring outside the intensive care unit (ICU) was conducted. Compared with ICU-patients, non-ICU patients had a higher comorbidity burden (median Charlson Comorbidity Index [CCI] 6 vs. 5 in ICU patients, p=0.006). Hematologic and oncologic malignancies were more frequent among non-ICU cases (45.5%, vs 28.4%, pCandida scores were associated with lower mortality risk in the multivariable Cox regression models. In conclusion, despite higher co-morbidity rates, non-ICU patients with candidemia had higher survival rates.

Background: Human metapneumovirus (hMPV) is an increasingly recognized respiratory pathogen in immunocompromised patients, but its impact in haematological malignancies is poorly defined. Unlike influenza or SARS-CoV-2, hMPV has no specific treatment or vaccine, contributing to underdiagnosis and underestimation of its clinical relevance. Method: We performed a multicentre retrospective cohort study within the Epidemiology of COVID-19 in patients with hematological malignancies: A European Haematology Association Survey/ Epidemiology of respiratory viral infections in patients with hematological malignancies: A European Haematology Association Survey registry of haematological patients with hMPV (January 2023–December 2024), comparing clinical features and outcomes with matched influenza and SARS-CoV-2 cohorts. Results: The study included 130 patients with hMPV. Median age was 58.5 years; 57% were male. Plasma cell neoplasms (25%), lymphoma (23%), and acute myeloid leukemia (20%) were the most common hematological malignancies. Hospitalization occurred in 64%, intensive care unit (ICU) admission in 19%, and 30-day mortality was 8%. Most cases (73%) received supportive care only. Secondary infections were common (24%). Chronic renal disease significantly increased mortality risk (hazard ratio 20.9 11.05, P = .014). Compared with influenza and SARS-CoV-2, hMPV patients had comparable severity and outcomes, with 18.5% ICU admission rates versus 25.9% for influenza (P = .316) and 20.9% versus 4.7% for SARS-CoV-2 (P = .006), and 30-day mortality of 5.6% versus 11.1% for influenza (P = .489) and 7.0% versus 2.3% for SARS-CoV-2 (P = .277), yet received fewer targeted interventions. Conclusions: hMPV causes clinically significant disease in patients with hematological malignancy, often necessitating hospital and ICU care, and leading to mortality. In the absence of specific treatments or vaccines, this virus remains an underrecognized pathogen in patients with hematological malignancy. Enhanced clinical awareness and investment in diagnostics, prevention, and therapeutics are needed.