Mathias Pletz

Universitätsklinikum Jena · Institut für Infektionsmedizin und Krankenhaushygiene

Pneumococcal infections elicited by Streptococcus pneumoniae (pneumococcus) (pneumonia, otitis media, sinusitis, meningitis) are frequently occurring diseases that are associated with considerable morbidity and mortality even in developed countries. Pneumococci colonise the nasopharynx of up to 50% of children, and up to 5% of adults are pneumococc...

Background: The unfavourable safety profile of aminoglycosides and the synergistic effects observed in vitro have prompted the development of novel dual β-lactam therapies, e.g. ampicillin/ceftriaxone or ampicillin/ceftaroline, for the treatment of Enterococcus faecalis endocarditis. Objectives: For comparison with in vitro chequerboard assay re...

In 2019, the American Thoracic Society (ATS) / Infectious Diseases Society of America (IDSA) issued a substantial revision of the 2007 guideline on community-acquired pneumonia (CAP). Despite generalization of infectious disease guidelines is limited due substantial geographic differences in microbiological etiology and antimicrobial resistance, th...

Background: For patients with bacteraemia caused by methicillin-sensitive Staphylococcus aureus anti-staphylococcal penicillins (ASPs) or cefazolin are agents of choice. While ASPs are potentially nephrotoxic, cefazolin may be less effective in some S. aureus strains due to an inoculum effect. Objectives: To perform a systematic literature review a...

Die SARS-CoV-2-Pandemie hat ein Defizit an essentieller infektionsepidemiologischer Infrastruktur, insbesondere in Bezug auf die Genomische Erreger-Surveillance (GES) in Deutschland, gezeigt. Zur Vorbereitung auf zukünftige pandemische Notlagen sehen es die Autor*innen als dringend erforderlich an, dieses bestehende Defizit durch den Aufbau einer l...

Purpose: The Co-HCW study is a prospective, longitudinal, single-center observational study that aims to assess the SARS-CoV-2 seroprevalence and infection status in staff members of Jena University Hospital (JUH) in Jena, Germany. Methods: This follow-up study covers the observation period from 19th May 2020 to 22nd June 2021. At each of the th...

Introduction: Two next-generation pneumococcal conjugate vaccines (PCVs), a 15- and a 20-valent PCV (PCV15 and PCV20), have recently been licensed for use in adults, and PCV15 has also been licensed in children. We developed a dynamic transmission model specific for Germany, with the aim to predict carriage prevalence and invasive pneumococcal dis...

Introduction: Ceftazidime-avibactam has proven activity against multidrug-resistant (MDR) bacteria in clinical trials and real-world studies. This study was conducted to describe the patterns of use of ceftazidime-avibactam (including indications and associated antibiotics), and the effectiveness and safety of ceftazidime-avibactam in real-world c...

Rapid screening of hospital admissions to detect asymptomatic carriers of resistant bacteria can prevent pathogen outbreaks. However, the resulting isolates rarely have their genome sequenced due to cost constraints and long turn-around times to get and process the data, limiting their usefulness to the practitioner. Here we used real-time, on-devi...

Understanding persistent cellular and humoral immune responses to SARS-CoV-2 will be of major importance to terminate the ongoing pandemic. Here, we assessed long-term immunity in individuals with mild COVID-19 up to 1 year after a localized SARS-CoV-2 outbreak. CoNAN was a longitudinal population-based cohort study performed 1.5 months, 6 months,...

BACKGROUND Experts are increasingly sounding the alarm: the ongoing war in Ukraine could lead to the spread of antimicrobial resistance across Europe. OBJECTIVE Our report focused on the genomic analysis of multi-drug resistant pathogens collected from Ukrainian soldiers and refugees who were treated in a German hospital. METHODS In 2022, seven U...

Background The COVID-19 pandemic and the associated containment measures had a substantial impact on pathogens causing pneumonia in adults. The objective of this study was to determine the etiology of hospitalized community-acquired pneumonia (CAP) among adults in Germany in 2021, the second year of the COVID-19 pandemic. Methods Since January 202...

Zusammenfassung Hunderttausende Menschen mit Sepsis- und Infektionsfolgen werden derzeit in Deutschland nicht optimal versorgt. Dieses White Paper stellt Maßnahmen zur Verbesserung der Versorgung vor, die von einer multidisziplinären Expertengruppe im Rahmen des Innovationsfonds-Projektes SEPFROK erarbeitet wurden. Eine optimale Versorgung beruht a...

Background Recovery from coronavirus disease 2019 (COVID-19) can be impaired by the persistence of symptoms or new-onset health complications, commonly referred to as Long COVID. In a subset of patients, Long COVID is associated with immune system perturbations of unknown etiology, which could be related to compromised immunoregulatory mechanisms....

Background Brucellosis, a zoonosis mainly transmitted by consumption of unpasteurized dairy products as well as direct contact with infected animals, is endemic in Kyrgyzstan. However, Brucella species in humans have not been investigated and the origin of the disease remains poorly known in wide parts of Сentral Asia. Thus, molecular characterizat...

Objective: Serum neurofilament light chain (sNfL) is a biomarker for neuroaxonal damage and has been found to be elevated in several neurological diseases with neuronal destruction. New onset of confusion is a hallmark of severity in infections. The objective of this study was to determine whether sNfL levels are increased in patients with communi...

Zusammenfassung Die Deutsche Gesellschaft für Pneumologie hat 2021 die AWMF S1-Leitlinie Long-/Post-COVID initiiert. In einem breiten interdisziplinären Ansatz wurde diese S1-Leitlinie basierend auf dem aktuellen Wissensstand gestaltet. Die klinische Empfehlung beschreibt die aktuellen Long- bzw. Post-COVID-Symptome, diagnostische Ansätze und Thera...

Disinfection is a key strategy to reduce the burden of infections. The contact of bacteria to biocides—the active substances of disinfectants—has been linked to bacterial adaptation and the development of antimicrobial resistance. Currently, there is no scientific consensus on whether the excessive use of biocides contributes to the emergence and s...

It was shown that several metabolic states of bacteria with various characteristics such as chemical composition participate in the formation of biofilms. To study the connections and differences among different bacterial metabolic states, five species of bacteria in exponential phase, stationary phase and biofilm have been compared and investigate...

Background: Influenza is a global cause of morbidity and mortality and a significant risk for a future pandemic infection. Host hyperinflammation, similar to that seen in COVID-19, may occur in response to influenza virus pneumonia, with Janus kinase (JAK) signalling and proinflammatory cytokines Interleukin (IL)-1 and IL-6 involved. Immune modulat...

Non-linear imaging modalities have enabled us to obtain unique morpho-chemical insights into the tissue architecture of various biological model organisms in a label-free manner. However, these imaging techniques have so far not been applied to analyze the Galleria mellonella infection model. This study utilizes for the first time the strength of m...

Phages are among the most abundant and diverse biological entities on earth. Phage prediction from sequence data is a crucial first step to understanding their impact on the environment. A variety of bacteriophage prediction tools have been developed over the years. They differ in algorithmic approach, results, and ease of use. We, therefore, devel...

Introduction: Guidelines have improved the management of prosthetic joint infections (PJI). However, it is necessary to reassess the incidence and risk factors for treatment failure (TF) of Staphylococcus aureus PJI (SA-PJI) including functional loss, which has so far been neglected as an outcome. Methods: A retrospective cohort study of SA-PJI...

Background: The Co-HCW study is a prospective, longitudinal single center observational study on the SARS-CoV-2 seroprevalence and infection status in staff members of Jena University Hospital (JUH) in Jena, Germany. Material and Methods: This follow-up study covers the observation period from 19th May 2020 to 22nd June 2021. At each out of three v...

Staphylococcus aureus bloodstream infections (SAB) represent a distinct clinical entity. Due to the frequency and the associated high morbidity and mortality, special requirements apply to the clinical management. Thus, in contrast to coagulase-negative staphylococci, even the detection of S. aureus in a single blood culture bottle is considered to...

Background: Recovery from coronavirus disease 2019 (COVID-19) can be impaired by the persistence of symptoms or new-onset health complications, commonly referred to as Long COVID. In a subset of patients, Long COVID is associated with immune system perturbations of unknown etiology, which could be related to compromised immunoregulatory mechanisms....

The pandemic coronavirus disease 2019 (COVID-19) can cause multi-systemic symptoms that can persist beyond the acute symptomatic phase. The post-acute sequelae of COVID-19 (PASC), also referred to as long COVID, describe the persistence of symptoms and/or long-term complications beyond 4 weeks from the onset of the acute symptoms and are estimated...

Introduction Despite improvements in medical science and public health, mortality of community-acquired pneumonia (CAP) has barely changed throughout the last 15 years. The current SARS-CoV-2 pandemic has once again highlighted the central importance of acute respiratory infections to human health. The “network of excellence on Community Acquired P...

Strategies to contain the current SARS-CoV-2 pandemic relies, beside vaccinations, also on molecular and serological testing. Due to vaccinations and past infections, there is an increasing need for simple and rapid serological tests for the detection of specific human IgG antibodies against antigens of the SARS-CoV-2 virus after vaccination and/or...

Streptobacillus moniliformis is the main cause of human streptobacillosis, also known as rat-bite or Haverhill fever. A correct diagnosis might be delayed due to scarcity, non-specific symptoms, and difficulties in cultivating this fastidious organism. We report on an 85-year-old man with periprosthetic streptobacillosis, which manifested itself in...

Streptococcus pneumoniae has more than 90 serotypes capable of causing a range of disease manifestations, including otitis media, pneumonia, and invasive diseases, such as bacteremia or meningitis. Only a minority (<10%) of pneumococcal diseases are bacteremic with known serotype distribution.

Purpose Some patients experience long-term sequelae after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, despite a present post-COVID condition, defined as “any symptom lasting longer than 12 weeks,” only a subset of patients search for medical help and therapy. Method We invited all adults with a positive re...

Brucellosis poses a significant burden to human and animal health worldwide. Robust and harmonized molecular epidemiological approaches and population studies that include routine disease screening are needed to efficiently track the origin and spread of Brucella strains.

Objectives Understanding persistent cellular and humoral immune responses to SARS-CoV-2 will be of major importance to terminate the ongoing pandemic. Here we assessed long-term immunity in individuals with mild COVID-19 up to one year after a localized SARS-CoV-2 outbreak. Methods CoNAN was a longitudinal population-based cohort study performed 1...

Brucellosis is a globally reemerging and neglected zoonosis causing serious public health problems as well as considerable economic losses due to infection of livestock. Although the epidemiology of brucellosis has been well studied and its various aspects in humans and animals are well understood, it is still one of the most challenging health pro...

Importance: Staphylococcus aureus bacteremia (SAB) is a common and potentially severe infectious disease (ID). Retrospective studies and derived meta-analyses suggest that bedside infectious disease consultation (IDC) for SAB is associated with improved survival; however, such IDCs might not always be possible because of the lack of ID specialists...

Background Sequelae of COVID-19 can be severe and longlasting. We compared frequencies of fatigue, depression and cognitive dysfunction in survivors of SARS-CoV-2-infection and sepsis. Methods We performed a prospective cohort study of 355 symptomatic post-COVID patients who visited our out-patient clinic for post-COVID-19 care. We compared them w...

Strategies to contain the current SARS-CoV-2 pandemic rely, beside vaccinations, also on molecular and serological testing. For any kind of assay development, screening for the optimal antigen is essential. Here we describe the verification of a new protein microarray with different commercially available preparations significant antigens of SARS-C...

Objectives We aim to identify the preoperative and perioperative risk factors associated with post-surgical Staphylococcus aureus prosthetic joint infections (PJI), and to develop and validate risk-scoring systems, to allow a better identification of high-risk patients for more efficient targeted interventions. Methods We performed a multicenter m...

The annual influenza vaccination has been officially recommended for medical staff in Germany since 1988. Nevertheless, the vaccination rate among medical staff is still low. The present study deals with the influenza vaccination rate of staff at a German University hospital over time as well as with the reasons that led to a positive vaccination d...

Purpose While more advanced COVID-19 necessitates medical interventions and hospitalization, patients with mild COVID-19 do not require this. Identifying patients at risk of progressing to advanced COVID-19 might guide treatment decisions, particularly for better prioritizing patients in need for hospitalization. Methods We developed a machine lea...

There are few data on mortality after discharge with community-acquired pneumonia (CAP). Therefore, we evaluated risk factors for 30-day post-discharge mortality after CAP. We included all patients of the prospective multi-national CAPNETZ study between 2002 and 2018 with (1) hospitalized CAP, (2) survival until discharge, and (3) complete follow-u...

Zusammenfassung Hunderttausende Menschen mit Sepsis- und Infektionsfolgen werden derzeit in Deutschland nicht optimal versorgt. Dieses White Paper stellt Maßnahmen zur Verbesserung der Versorgung vor, die von einer multidisziplinären Expertengruppe im Rahmen des Innovationsfonds-Projektes SEPFROK erarbeitet wurden. Eine optimale Versorgung beruht a...

Background Sepsis is one of the leading causes of preventable deaths in hospitals. This study presents the evaluation of a quality collaborative, which aimed to decrease sepsis-related hospital mortality. Methods The German Quality Network Sepsis (GQNS) offers quality reporting based on claims data, peer reviews, and support for establishing conti...

Biofilms are the preferred habitat of microorganisms on living and artificial surfaces. Biofilm-related infections, such as infections of medical implants, are difficult to treat, and due to a reduced cultivability of the included bacteria, difficult to diagnose. Therefore, it is highly important to rapidly identify and investigate biofilms on impl...

Importance: The efficacy of antiplatelet therapy in critically ill patients with COVID-19 is uncertain. Objective: To determine whether antiplatelet therapy improves outcomes for critically ill adults with COVID-19. Design, setting, and participants: In an ongoing adaptive platform trial (REMAP-CAP) testing multiple interventions within multip...

In this article, the affiliation details for Dominic Witzke were incorrectly given as ’Department of Infectious Diseases, Evangelisches Klinikum Bethel, Bielefeld, Germany’, but should have read instead ’Department of Anaesthesiology, Intensive Care, Protestant Hospital of the Bethel Foundation, University Hospital of Bielefeld, Campus Bielefeld-Be...

Metagenomic sequencing is promising for clinical applications to study microbial composition concerning disease or patient outcomes. Alterations of the vaginal microbiome are associated with adverse pregnancy outcomes, like preterm premature rupture of membranes and preterm birth. Methodologically these samples often have to deal with low relative...

The emergence of Klebsiella pneumoniae (K. pneumoniae) in German healthcare is worrying. It is not well-investigated in the veterinary world and food chains. In the current study, antibiotic susceptibility profiles of 24 K. pneumoniae strains isolated from powdered milk samples produced in Germany were investigated by a microdilution test. Next-gen...

Objectives Classification of Staphylococcus aureus bacteremia (SAB) as “complicated” or “uncomplicated” and management of both is based on low-quality evidence. The aim of the study was to determine the degree of agreement among infectious diseases physician experts in the management of patients with SAB. Methods A stepwise RAND-modified Delphi pr...

Background: Cardiac surgery often represents the only treatment option in patients with infective endocarditis (IE). However, IE surgery may lead to a sudden release of inflammatory mediators, which is associated with the severity of postoperative organ dysfunction. We investigated the impact of hemoadsorption during IE surgery on postoperative org...

Background Streptobacillus moniliformis is the main cause of human streptobacillosis, also known as rat-bite or Haverhill fever. Generally transferred by bites or scratches of rats and other rodents or by rat-excrement polluted water, symptoms commonly start to appear after < 10 days and are highly variable. Due to scarcity, non-specific symptoms,...

Zusammenfassung Hintergrund Über die qualitative Bedeutung der testenden Zentren im Gesundheitswesen ist wenig bekannt, gleichzeitig stellen die Late-Presenter eine immer noch große Gruppe bei den HIV-Erstdiagnosen. Ziel der Arbeit Analyse des Einflusses von Testzentren und -grund auf die Prävalenz von HIV-Erstdiagnosen und Late-Presentation, exemp...

The pandemic and the spread of multidrug-resistant pathogens impressively demonstrate that despite all medical and technical progress, infectious diseases still represent a global threat. The occurrence of new or difficult to treat infections due to resistance is determined by the dynamic evolution of pathogens, which can often have an erratic cour...

Background To date, cost-effectiveness of influenza and pneumococcal vaccinations was assumed in several health economic modelling studies, but confirmation by real-world data is sparse. The aim of this study is to assess the effects on health care utilisation and costs in the elderly using real-world data on both, outpatient and inpatient care. M...

Purpose: Insufficient antimicrobial exposure is associated with worse outcomes in sepsis. We evaluated whether therapeutic drug monitoring (TDM)-guided antibiotic therapy improves outcomes. Methods: Randomized, multicenter, controlled trial from January 2017 to December 2019. Adult patients (n = 254) with sepsis or septic shock were randomly ass...