Health care workers (HCWs) face a higher risk of infection, since they work at the front line of COVID-19 patients’ management. Misinterpretations of current scientific evidence among HCWs may impact the delivery of appropriate care to COVID-19 patients and increase the risk of SARS-CoV-2 transmission in the hospital setting. Moreover, knowledge may affect HCWs perceptions depending on their broad beliefs and past experiences. The aim of this study was to explore the knowledge and perceptions of HCWs regarding COVID-19 issues during the second wave of the pandemic. A cross-sectional survey, involving a printed questionnaire, was conducted from 21 October 2020 to 31 January 2021 in four tertiary care hospitals located at four distant geographical regions in Greece. In total, 294 HCWs participated in this study. The majority of HCWs provided precise responses regarding general knowledge, perceptions, and practices concerning the COVID-19 pandemic. However, responses on hand hygiene and antimicrobial use in HCWs with COVID-19 were mistaken. This study reveals a certain degree of misconceptions and knowledge gaps in HCWs everyday practice, especially regarding hand hygiene and antimicrobial use in COVID-19 patients.

Infective endocarditis (IE) is a disease that may cause significant morbidity and mortality. IE is classically caused by Gram-positive microorganisms; however, Gram-negative bacteria may seldom also be the cause. Campylobacter species cause zoonosis and may also infect humans, mainly causing gastrointestinal infection by C. jejuni or invasive disease by C. fetus, such as bacteremia, sepsis, meningitis, or vascular infection. Campylobacter species IE has rarely been described, and most reports are cases and/or case series. Thus, the characteristics of this disease, including its epidemiology, clinical presentation, treatment, and outcome, remain largely unknown. This study aimed to review all published Campylobacter IE cases and describe their characteristics. A thorough search of PubMed, the Cochrane Library, and Scopus for published studies providing information on epidemiology, clinical findings, treatment, and outcome of Campylobacter IE cases was performed for the present narrative review. A total of 22 studies containing data from 26 patients were located and included. Among all patients, 73.1% were male; the median age was 65 years. Among all patients, 36.4% had a history of a prosthetic valve. The most commonly affected valve was the aortic, followed by the mitral. Fever, heart failure, and sepsis were the most frequent clinical findings. The most commonly isolated pathogen was C. fetus, with only one patient having C. jejuni IE. Antimicrobial resistance was low for all antimicrobials, with tetracycline having the highest resistance. Aminoglycosides and beta-lactams were the most commonly used antimicrobials. Surgery was performed in 48% of patients. The mortality rate was 26.9%. Patients who died were more likely to have sepsis, shock, and heart failure and were less likely to have been treated with aminopenicillins; however, no factor was identified in a multivariate logistic regression model as an independent factor for overall mortality.

Background: Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening hyperinflammatory syndrome that may be triggered by infections such as dengue virus. Due to overlapping features with severe dengue and sepsis, diagnosis of HLH in dengue-infected patients remains challenging. Methods: We conducted a narrative review and individual patient data meta-analysis of published cases of dengue-associated HLH. Eligible studies were identified through a search of PubMed and Scopus databases up to 5 March 2025. Clinical, laboratory, microbiological, treatment, and outcome data were extracted and analyzed. Results: A total of 133 patients from 71 studies were included. The median patient age was 18 years, and 56.8% were male. Common clinical features included fever (96.9%), cytopenias, organomegaly, and liver dysfunction. ALT elevation, jaundice, and hypofibrinogenemia were associated with mortality. DENV-1 was the most common serotype (57.4%) and was negatively associated with death. Overall, 19.3% of patients died. Multivariate analysis did not identify independent mortality predictors. Conclusions: Dengue-associated HLH predominantly affects young individuals and carries significant mortality. Key indicators of poor prognosis include hepatic dysfunction and the presence of shock or organ failure. Early recognition and prompt immunomodulatory treatment, particularly corticosteroids, may improve outcomes.

Background: Vancomycin-resistant Enterococcus (VRE) bacteremia represents a major therapeutic and epidemiological challenge, particularly in regions with high antimicrobial resistance rates such as Southern Europe. Longitudinal local data are essential to guide infection control and antimicrobial stewardship strategies. This study aimed to evaluate temporal trends in incidence, management, and mortality of VRE bacteremia in a tertiary care center in Greece over a six-year period, including comparison before and after the coronavirus disease 2019 (COVID-19) pandemic. Methods: This retrospective observational study included adult patients with VRE bacteremia at the University Hospital of Heraklion, Greece, from 2018 to 2023. Demographic and clinical data, such as the Pitt Bacteremia Index (PBI), as well as microbiological, and treatment data were collected from patient records. Incidence was calculated per 10,000 patient-days. Comparisons were performed between survivors and non-survivors and between pre- and post-COVID-19 eras. Multivariate regression analysis was used to identify predictors of in-hospital mortality. Results: A total of 96 patients were included (mean age 68.6 ± 14.5 years; 56.3% male). The incidence of VRE bacteremia increased more than five-fold during the study period, from 0.242 cases per 10,000 patient-days in 2018 to a peak of 1.344 per 10,000 patient-days in 2022, remaining elevated in 2023 (1.001 per 10,000 patient-days). The overall in-hospital mortality was 54.2%. Non-survivors had significantly higher PBI scores compared to survivors (median 2.5 vs. 0, p = 0.005). In the multivariate analysis, higher PBI was independently associated with in-hospital mortality [odds ratio: 1.449 (95% confidence intervals: 1.166–1.801)]. Appropriate empirical therapy was administered in 41.7% of cases and was not significantly associated with survival. Post-COVID-19 patients were older (69.9 vs. 61.4 years, p = 0.0365), and antimicrobial regimens were more frequently adjusted according to susceptibility testing (55.7% vs. 18.2%, p = 0.0141), but mortality did not significantly differ between periods. Conclusion: VRE bacteremia incidence increased dramatically over the six-year study period in our tertiary center, with persistently high mortality exceeding 50%. Severity of illness at the diagnosis of bacteremia, as measured by the PBI, was an independent predictor of in-hospital mortality. Strengthened infection prevention measures, optimized antimicrobial stewardship, and early aggressive management are urgently needed to mitigate the growing burden of VRE bacteremia.