Health-Care-Workers (HCWs) are considered at high risk for SARS-CoV-2 infection. We sought to compare rates and severity of Coronavirus disease 2019 (COVID-19) among vaccinated and unvaccinated HCWs conducting a retrospective cohort study in two tertiary Academic Hospitals, namely Laiko and Attikon, in Athens, Greece. Vaccinated by BNT162b2 Pfizer-BioNTech COVID-19 mRNA vaccine and unvaccinated HCWs were included and data were collected between 1 January 2021 and 15 September 2021. Overall, 2921 of 3219 HCWs without a history of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection were fully vaccinated during the study period (90.7% at each Hospital). Demographic characteristics were comparable between 102/2921 (3.5%) vaccinated and 88/298 (29.5%) unvaccinated HCWs with COVID-19, although age and occupation differed significantly. None were in need of hospital admission in the vaccinated Group, whereas in the unvaccinated Group 4/88 (4.5%) were hospitalized and one (1.1%) died. Multivariable logistic regression analysis revealed that lack of vaccination was an independent risk factor for COVID-19 with an odds ratio 11.54 (95% CI: 10.75–12.40). Vaccination hesitancy among HCWs resulted to highly increased COVID-19 rates; almost one in three unvaccinated HCWs was SARS-CoV-2 infected during the 9-month period. The absolute need of vaccination of HCWs, including boosting dose, is highlighted. Evidence should be used appropriately to overcome any hesitancy.

Bacterial infections, especially bloodstream infections (BSIs), compromise the overall survival of patients with hematological malignancies undergoing cellular therapies. The interplay between rectal colonization by different types of multidrug-resistant organisms (MDRO) and subsequent BSIs is not fully determined. We aimed to describe the natural history and risk factors for colonization by MDRO, as well as its impact on subsequent BSIs in patients treated with cellular therapies in an environment of antimicrobial resistance. Retrospective, single-center cohort study of consecutive adult hematological malignancies patients treated with allogeneic or autologous hematopoietic cell transplantation (HCT) or chimeric antigen receptor T-cell therapy between 2021 and 2024 in Attikon University Hospital (Greece), with ≥1 available rectal screening test for carbapenem-resistant gram-negative bacilli (CR-GNB) and vancomycin-resistant Enterococcus faecium (VRE). Univariate and multivariate Cox regression were implemented for identifying predictors of CR-GNB and VRE colonization. We also studied the concordance between rectal colonization and subsequent BSIs. One hundred eighty-two patients were included (male: 64%, mean age: 50.2 ± 13 yr, acute myeloid leukemia/myelodysplastic syndrome diagnosis: 55%, relapsing/refractory disease: 58%, allogeneic HCT: 85%). Median duration of hospitalization and neutropenia was 35 and 15 d, respectively. At baseline, 95% of patients were negative on rectal screening for both CR-GNB and VRE, and of those, 8.4% and 23% were colonized with CR-GNB and VRE during follow-up, respectively. Prior colonization with the same pathogen was independently associated with subsequent CR-GNB (HR: 13.0, 95% CI: 2.83 to 59.3) and VRE (HR: 4.83, 95% CI: 2.28 to 10.2) colonization. Seventy-nine patients had ≥1 BSIs (gram-positive: 60%, gram-negative: 38%), with three concordant CR-GNB BSIs among 16 colonized patients (18.7%) and two CR-GNB BSIs among 153 noncolonized patients (1.3%). Regarding VRE, we identified two concordant BSIs among 45 colonized patients (4.4%). Despite the high MDRO prevalence, we observed low rates of CR-GNB colonization in neutropenic patients treated with cellular therapies, with one patient out of five experiencing a concordant CR-GNB BSI. VRE colonization was more frequent, but it rarely resulted in a concordant BSI. These findings highlight the importance of infection control strategies and support de-escalation approaches in empirical antibacterial treatment of febrile neutropenia in this vulnerable population.

Campylobacter jejuni, a common cause of gastroenteritis worldwide, has also been associated with rare extraintestinal infections, including myocarditis. We report a unique case of a 24-year-old male who presented with febrile diarrhea and acute chest pain. Diagnostic investigations revealed elevated cardiac troponin levels, normal electrocardiography findings, and myocardial inflammation on cardiac magnetic resonance imaging, confirming the diagnosis of acute myocarditis. Stool cultures identified Campylobacter jejuni as the causative agent. The patient was managed with supportive care, including hydration and electrolyte replacement, and a three-day course of azithromycin (500 mg daily). He achieved a full recovery and was discharged after eight days, with subsequent follow-up demonstrating the complete resolution of myocardial dysfunction. This case emphasizes the need to consider Campylobacter jejuni-related myocarditis in the differential diagnosis of young patients presenting with chest pain and diarrhea, along with an overview of its diagnostic and therapeutic challenges.

Introduction: Long-term lung sequelae in severe COVID-19 survivors, as well as their treatment, are poorly described in the current literature. Objective: To investigate lung fibrotic sequelae in survivors of severe/critical COVID-19 pneumonia and their fate according to a “non-interventional” approach. Methods: Prospective study of the above COVID-19 survivors after hospital discharge from March 2020 to October 2022. Re-evaluation lasted 3–12 months and included chest HRCT, PFTs, dyspnea, and overall health evaluation by modified Medical Research Council (mMRC) and St. George’s Respiratory Questionnaire (SGRQ), respectively. Results: In this study, 198 patients (61.1% male) with a median age of 57 years (IQR 49–66). After 3 months, 187 (94.4%) patients were assessed; after 6 months, 82 (41.1%) patients were assessed; and after 12 months, 16 (8%) patients were assessed. At each time point, a significant reduction was observed in the extent of COVID-19-associated opacities (p < 0.001 and p = 0.002) and of parenchymal bands (p = 0.014 and p = 0.025). Persisting fibrotic-like changes were observed in 18 (9%) patients (apical findings in 2 patients, fibrotic non-specific interstitial pneumonia-like changes in 14 patients, minimal fibrotic changes in 2 patients). At 3 months, the predicted median FVC% was 93% (80–100%) and the predicted DLCO% was 65% (58–78%) with a statistically significant improvement at 6 months in both (p = 0.001). Moreover, 81.1% had mMRC ≤ 1 and the median SGRQ was 11.65 [0–24.3] with a significant reduction at 6 months in both dyspnea (p < 0.001) and SGRQ (p = 0.027) persisting at 12 months. Conclusions: This prospective study, including only survivors of severe/critical COVID-19 pneumonia, documented the significant improvement in all imaging, functional, and clinical parameters by applying the “non-interventional” approach. These data do not indicate any post-COVID-19 severe/critical pneumonia and “epidemic of widespread pulmonary fibrosis”.

Antimicrobial resistance (AMR) has become a pressing global health concern, and its impact is magnified in the setting of armed conflict. Wars undermine health systems by disrupting infection prevention and control, damaging water and sanitation infrastructure, limiting access to diagnostics, and driving unregulated use of antimicrobials. Infections of war wounds typically follow a temporal pattern: gram-positive organisms dominate the early phase, whereas gram-negative pathogens increasingly complicate care in the following days. Reports consistently describe high rates of methicillin-resistant Staphylococcus aureus (MRSA), while among gram-negative bacteria, Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae are the principal multidrug-resistant agents. In the Eastern Mediterranean Region, resistance levels are among the highest recorded worldwide, with carbapenem-resistant A. baumannii and extended-spectrum β-lactamase (ESBL)–producing Enterobacterales being especially common. In Ukraine, recent analyses highlight the predominance of metallo-β-lactamases, particularly NDM in Enterobacterales and P. aeruginosa, and OXA-23/-72 in A. baumannii. Forced displacement on an unprecedented scale further accelerates the cross-border spread of resistant strains. Surveillance, however, remains patchy: laboratory capacity is frequently impaired, and available studies are heterogeneous in methods and quality, limiting accurate assessment of the burden. This review brings together evidence from recent conflicts in the Middle East and Ukraine, examining resistance trends, underlying drivers, and their implications for clinical practice. Addressing AMR in conflict requires immediate, pragmatic steps: restoration of infection control and water systems, targeted screening of high-risk patients, context-specific antimicrobial stewardship, and the development of lean but standardized surveillance systems suited to resource-limited and insecure environments.