Stefan Hagel

Stefan Hagel
Universitätsklinikum Jena · Institute for Infectious Diseases and Infection Control

MD, MS

About

190
Publications
29,205
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2,659
Citations
Citations since 2017
84 Research Items
2001 Citations
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Introduction
Stefan Hagel currently works at the Institute for Infectious Diseases and Infection Control and Center for Sepsis Control and Care at the Jena University HospitalJena. Stefan does research in Infectious Diseases.

Publications

Publications (190)
Preprint
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...
Preprint
Full-text available
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...
Article
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...
Article
Objectives The optimal treatment duration for vancomycin-resistant enterococcal (VRE) bacteraemia is still a matter of debate. The aim of the present study was to compare short-course (<=9 days) versus long-course (>=10 days) antibiotic treatment in hospitalised adult patients with uncomplicated VRE bacteraemia. Methods This retrospective study wa...
Article
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...
Article
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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...
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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...
Article
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The antibiotic dalbavancin is approved for intravenous treatment of adults with acute bacterial skin and skin structure infections. This study aimed to observe the use, effectiveness, and safety of dalbavancin in clinical practice in Germany. It was a multicentre, prospective, and retrospective registry and consecutively enrolled patients treated w...
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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...
Article
Objectives : Linezolid is a treatment option against multidrug-resistant Gram-positive pathogens. Continuous infusion of linezolid has been proposed to optimise antimicrobial exposure, although pharmacokinetic data from large patient cohorts is lacking. Methods : The population pharmacokinetics and the time-dependent association between linezolid...
Article
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...
Article
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...
Article
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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...
Article
Background: Guidelines recommend empiric therapy with piperacillin/tazobactam (TZP) for spontaneous bacterial peritonitis (SBP) with low risk of multidrug-resistant organisms. Whether coverage of beta-lactam-resistant Gram-positive bacteria, such as ampicillin-resistant Enterococcus faecium, provides clinical benefit in such situations is unknown....
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Background: Infective endocarditis (IE) requires multidisciplinary management. We established an endocarditis team within our hospital in 2011 and a state-wide endocarditis network with referring hospitals in 2015. We aimed to investigate their impact on perioperative outcomes. Methods: We retrospectively analyzed data from patients operated on...
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Abstract Background: Who should be tested for viruses in patients with community acquired pneumonia (CAP), prevalence and risk factors for viral CAP are still debated. We evaluated the frequency of viral testing, virus prevalence, risk factors and treatment coverage with oseltamivir in patients admitted for CAP. Methods: Secondary analysis of GLIM...
Article
Background Infective endocarditis (IE) requires a high degree of suspicion and advanced level of multidisciplinary management. In 2015, the European guidelines recommended the formation of an endocarditis-team (ET) for optimal treatment of IE. In 2011, we already established an ET within the hospital that was only consulted on demand for certain pa...
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Background: Monitoring pathogens of bloodstream infections (BSI) and their antibiotic susceptibility is important to guide empiric antibiotic treatment strategies and prevention programs. This study assessed the epidemiology of BSI and antibiotic resistance patterns at the German Federal State of Thuringia longitudinally. Methods: A surveillance...
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Optimization of antibiotic dosing is a treatment intervention that is likely to improve outcomes in severe infections. The aim of this retrospective study was to describe the therapeutic exposure of steady state piperacillin concentrations (cPIP) and clinical outcome in critically ill patients with sepsis or septic shock who received continuous inf...
Article
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The Gram-negative bacilli Serratia spp., Providencia spp., Morganella morganii, Citrobacter freundii complex, Enterobacter spp. and Klebsiella aerogenes are common Enterobacterales that may harbor inducible chromosomal AmpC beta-lactamase genes. The purpose of the present study was to evaluate treatment outcomes and identify predictors of early tre...
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Leptospirosis is an infectious disease with an increasing incidence worldwide. The clinical presentation is unspecific and ranges from an asymptomatic clinical course to an acute fulminant disease. The current case report describes a 32-year-old male patient who presented with ST segment elevation in the electrocardiogram about 14 days after cross-...
Article
Aim: To describe the population pharmacokinetics (popPK) and probability of target attainment (PTA) of continuous infusion (CI) of meropenem in septic patients receiving renal replacement therapy (RRT). Methods: Fiveteen patients without RRT, 13 patients receiving sustained low-efficiency dialysis (SLED) and 12 patients receiving continuous veno...
Article
Staphylococcus aureus bloodstream infections are associated with a high morbidity and mortality. Nevertheless, significance of a positive blood culture with this pathogen is often underestimated or findings are misinterpreted as contamination, which can result in inadequate diagnostic and therapeutic consequences. We here review and discuss current...
Article
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The Co-HCW study is a prospective cohort study among hospital staff, including healthcare workers (HCWs) and administration staff, at the Jena University Hospital (JUH), Germany. The objectives of this study were to assess SARS-CoV-2 IgG seroprevalence, individual exposure risk factors and compliance of HCWs to wear personal protective equipment (P...
Article
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The aim of this retrospective cohort study at eight hospitals in Germany was to specify influenza-associated in-hospital mortality during the 2017/2018 flu season, which was the strongest in Germany in the past 30 years. A total of 1560 patients were included in the study. Overall, in-hospital mortality was 6.7% (n = 103), in patients treated in th...
Article
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Objectives Due to a substantial proportion of asymptomatic and mild courses, many SARS-CoV-2 infections remain unreported. Therefore, assessment of seroprevalence may detect the real burden of disease. We aimed at determining and characterizing the rate of SARS-CoV-2 infections and the resulting seroprevalence in a defined population. The primary o...
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An amendment to this paper has been published and can be accessed via the original article.
Preprint
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Background: Healthcare workers (HCWs) are at particular risk to acquire SARS-CoV-2 infections. Aim: The objectives of this study were to compare SARS-CoV-2 IgG seroprevalence and compliance to wear personal protective equipment (PPE) between HCWs working within (high-risk) or outside (intermediate-risk) units treating suspected or confirmed COVID-1...
Article
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Objective: Clostridioides difficile infection (CDI) is a common healthcare-associated infection and associated with high morbidity and mortality. As current guidelines recommend treatment stratified for disease severity, this study aimed to identify predictors of 30-day mortality in order to develop a robust prediction model. Design: This was a...
Article
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Background: Herpes simplex virus (HSV) is frequently detected in the respiratory tract of mechanically ventilated patients. The aim of this study was to assess current evidence to determine whether antiviral therapy is associated with better outcomes in these patients. Methods: MEDLINE, ISI Web of Science, Cochrane Database and ClinicalTrials.go...
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[This corrects the article DOI: 10.1371/journal.pntd.0008183.].
Preprint
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Background: Due to the substantial proportion of asymptomatic and mild courses many SARS-CoV-2 infections remain unreported. Therefore, assessment of seroprevalence may detect the real burden of disease. We aimed at determining and characterizing the rate of SARS-CoV-2 infections and the resulting immunity in a defined population. Methods: CoNAN is...
Article
Background Herpes simplex virus type 1 (HSV-1) is frequently detected in the BAL fluid of patients on mechanical ventilation. Research Question The aim of the study was to investigate whether antiviral therapy is associated with improved overall survival within 30 days. Study Design and Methods This was a retrospective cohort study in four ICUs b...
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Introduction Infective endocarditis (IE) is associated with high mortality and morbidity. Multiple organ failure is the main cause of death after surgery for IE. Cardiopulmonary bypass (CPB) can cause a systemic inflammatory response. In a pilot study (REMOVE-pilot (Revealing mechanisms and investigating efficacy of hemoad-sorption for prevention o...
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Introduction Staphylococci are the most commonly identified pathogens in bloodstream infections. Identification of Staphylococcus aureus in blood culture (SAB) requires a prompt and adequate clinical management. The detection of coagulase-negative staphylococci (CoNS), however, corresponds to contamination in about 75% of the cases. Nevertheless, a...
Article
ZUSAMMENFASSUNG Blutstrominfektionen durch Staphylococcus aureus sind schwere Infektionserkrankungen, die mit dem Risiko von sekundären Absiedlungen, Rekurrenzen und hohen Sterblichkeitsraten assoziiert sind. Bei adäquater Diagnostik und Therapie kann das Outcome wesentlich verbessert werden. Alle Patienten mit Staphylococcus-aureus-Bakteriämie sol...
Article
Background: Intercontinental travel contributes to the spread of extended-spectrum beta-lactamase producing Enterobacterales (ESBL-PE). We assessed risk factors for intestinal ESBL-PE colonization in people travelling to low and middle income countries in the tropics and subtropics to better understand how travel affects ESBL-PE spread. Method:...
Article
Objectives: The capability to measure and monitor the quality of antibiotic prescribing is an important component of antibiotic stewardship (ABS) programmes. Several catalogues of consensus-based structure and process-of-care quality indicators (QIs) have been proposed, but only a few studies have tested and validated ABS QIs in practice tests. Th...
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Background: Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection with a hospital mortality in excess of 40%. Along with insufficient and delayed empirical antimicrobial therapy, inappropriate antimicrobial exposure has been identified to negatively affect patient outcomes. Receipt of prolonged infusion...
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Purpose To assess the incidence of Mycoplasma pneumoniae and Chlamydia pneumoniae in the pathogenesis of hospital-acquired respiratory tract infections (RTIs) in critically ill patients. Methods This is a retrospective cohort study of all ICU-patients ≥ 18 years with RTI who underwent conventional culture techniques and PCR testing for both M. pne...
Article
Loop-mediated isothermal amplification (LAMP) is a rapid molecular technique that has been introduced into malaria diagnosis. The test is easy to perform and offers high sensitivity. We report a 53-year-old male patient who was hospitalized with fever attacks, chills, and headache caused 9 months after returning from Africa. During his stay in Afri...
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Introduction Healthcare-associated infections (HAIs) are a major health concern and have substantial effects on morbidity and mortality and increase healthcare costs. We investigated the effect of a hospital-wide program for the prevention of HAIs on additional length of stay (LOS). Methods We analyzed data from a prospective, single-center, quasi...
Article
Zusammenfassung Hintergrund Staphylococcus aureus ist der zweithäufigste Erreger von Blutstrominfektionen. Das klinische Management einer S.-aureus-Blutstrominfektion (SAB) unterscheidet sich von dem bei Blutstrominfektionen durch andere Erreger. Gründe hierfür sind der komplikationsträchtige Verlauf, die hohe Krankenhaussterblichkeit (15 – 40%) un...
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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...
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Purpose Involvement of infectious disease (ID) specialists in the care of hospitalized patients with infections through consultation services improves the quality of care and the outcome of patients. This survey aimed to describe activities and utilization of ID consultations at four German tertiary care hospitals. Methods A 1-month (March 2016) r...
Article
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A prospective cohort study (German Clinical Trial Registry, No. 00005273) was performed to determine pre-admission colonization rates, hospital acquisition risk factors, subsequent infection rates and colonization persistence including the respective molecular epidemiology and transmission rates of extended-spectrum β-lactamase (ESBL)-producing Ent...
Data
Supporting tables and figures to the manuscript. (PDF)
Data
Phylogeny of the E. coli isolates based on the ERIC-PCR band pattern. Analysis was performed applying the Dice similarity coefficient (0.5% optimization, 1% tolerance) using BioNumerics 7.6 software (Applied Math NV, Sint-Martens-Latem, Belgium). Tree construction was performed using the unweighted pair group method with arithmetic means (UPGMA). (...
Article
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Highlights •Real life prevalence and risk factors for viral CAP depend on testing for viruses. •International testing frequency for viruses in patients with CAP is very low. •The most common cause of viral CAP is Influenza virus. •Risk factors for viral CAP are obesity and need for mechanical ventilation. •Globally, there is poor adherence to treat...
Article
Da die Symptome der ambulant erworbenen Pneumonie nicht diagnoseweisend sind, ist daran zu denken und eine laborchemische sowie bildgebende Diagnostik einzuleiten schon die halbe Miete. Was Sie noch beachten sollten und wann Sie Betroffene besser in die Klinik einweisen, erfahren Sie in diesem Beitrag.
Article
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Background: Adequate antibiotic treatment is a prerequisite for the successful treatment of systemic infections. Based on accumulating scientific evidence, a fixed dosage regimen can lead to insufficient and ineffective antibiotic therapy. Thus, the aim of this study was to develop and validate a simplified, but sensitive method for the simultaneo...
Article
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Zusammenfassung Einleitung Staphylococcus-aureus-Bakteriämien sind schwere Infektionserkrankungen mit oftmals langwierigen klinischen Verläufen und hoher Sterblichkeit. Retrospektive Studien zeigen, dass infektiologische Konsile die Adhärenz an Therapiestandards erhöhen und das Überleben von Staphylococcus-aureus-Bakteriämie-Patienten verbessern kö...
Article
Objectives: This study aimed to determine the additional costs and length of stay (LOS) due to surgical site infections (SSIs) after coronary artery bypass grafting (CABG) at Jena University Hospital. Methods: The data of 999 consecutive patients who underwent CABG from January 2013 to December 2014 were collected. We extracted the number, type...
Article
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Objectives: To evaluate whether a hospital-wide infection control programme (ICP) is effective at reducing the burden of healthcare-associated infections (HAIs) and associated severe sepsis/septic shock or death (severe HAIs). Methods: Prospective, quasi-experimental study with two surveillance periods (09/2011-08/2012; 05/2013-08/2014). Startin...
Article
Background: Drivers of antibiotic (AB) resistance (ABR) include outpatient treatment, hospital care and animal husbandry. During the first phase of the One Health project RAI (Responsible Antibiotic Use via Information and Communication) surveys were conducted in these sectors. Objectives: To compare perceptions and attitudes towards ABR among g...
Article
Background: Isavuconazole is a novel antifungal drug, approved for treatment of adults with invasive aspergillosis and mucormycosis. While azoles as a class effect are known to prolong QTc interval, clinical trials have shown that isavuconazole administration may cause shortening in a dose-related manner. Here, we assessed the effects of isavucona...
Article
Im Alter wird das Immunsystem schwächer. Senioren sind daher besonders anfällig für Infektionen und schwere Krankheitsverläufe. Auch das Ansprechen auf Impfungen kann bei Betagten vermindert sein.
Article
Background: The WHO/ATC (Anatomical Therapeutic Chemical) index DDD (WHO-DDD) is commonly used for drug consumption measurement. Discrepancies between WHO-DDD and actual prescribed daily doses (PDD) in hospitals have prompted alternative dose definitions adapted to doses recommended in hospital practice guidelines [recommended daily doses (RDD)]....
Conference Paper
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Background: Healthcare-associated infections (HAI) are one of the leading complications in hospitalized patients and are associated with increased morbidity and mortality. There is no agreement about the frequency of HAIs caused by multidrug resistant organisms (MDROs) in Germany. The aim of this study was to analyse MIC distribution of all isolate...