To enhance antibiotic stewardship and effectively address antimicrobial resistance (AMR), better understanding of subnational antibiotic consumption patterns is essential.

We aimed to assess antibiotic consumption in Germany using data from 2022 and integrated from two surveillance systems, focusing on regional differences by examining non-university acute care hospitals.

We used pharmacy dispensing data from 525 regional or local hospitals and 35 university hospitals, covering 46.5 million patient days (PD), nearly half of all occupied bed days nationwide, to calculate antibiotic use densities (AUD) for systemic antibiotics, expressed as World Health Organization (WHO) ATC/DDD (Anatomical Therapeutic Chemical/Defined Daily Dose) per 100 patient days (DDD/100 PD). The analysis primarily focused on consumption patterns in non-university hospitals, assessing key antibiotic groups through mixed-effects regression. For sensitivity analyses, we employed hospital-adapted daily dose definitions.

Pooled AUD for participating non-university hospitals was 51.8 DDD/100 PD, with aminopenicillins/beta-lactamase inhibitors being the most prescribed group. Regression analyses, adjusted for hospital size and ward type/admitting specialty, indicated notable regional variation. We identified statistically significant differences in antibiotic consumption, particularly for beta-lactam antibiotics, fluoroquinolones and tetracyclines. For example, several regions exhibited up to 1.4-fold higher use of first- and second-generation cephalosporins compared with the western reference region.

This study highlights substantial regional variation in antibiotic use in German acute care hospitals, underlining the importance of further investigation into influencing factors such as regional guidelines and resistance rates. The methodological approach applied here may serve as a model for other countries interested in analysing regional differences in antibiotic consumption.

Fifteen- and 20-valent pneumococcal conjugate vaccines (PCVs) offer broader protection against invasive pneumococcal disease (IPD) than PCV13. Adopting these vaccines may result in decreasing IPD incidence, antibiotic use and antimicrobial resistance (AMR) rates. If the additional serotypes in PCV15 and PCV20 are associated with AMR, AMR rate reduction could be greater than expected from reduced antibiotic consumption alone.

This retrospective analysis assessed the association between AMR and non-PCV13 serotypes in PCV15 and PCV20.

Laboratory-based surveillance data on 8,123 IPD isolates were obtained retrospectively from the Belgian Reference Centre for invasive Streptococcus pneumoniae. Isolates (n = 8,088) were serotyped and tested for AMR. Associations between vaccine serotype groups and AMR were evaluated by multinomial logistic regression. Where associations varied with patients’ age, ranges of odds ratios (ORs) are presented.

PCV15-non-PCV13 and PCV20-non-PCV13 serotypes accounted for 7.4% (n = 597) and 37% (n = 2,992) of IPD isolates respectively. Of non-PCV20 serotypes, 24% (508/2,125) were penicillin resistant. Compared with non-PCV20 serotypes, PCV15-non-PCV13 serotypes were more often associated with erythromycin (ORs: 3.59–9.43) and tetracycline (OR: 2.00) resistance, and with trimethoprim/sulfamethoxazole (OR: 0.11) susceptibility. PCV20-non-PCV15 serotypes were more often associated with amoxicillin (OR: 9.45) and cefotaxime (ORs: 5.06–82.38) resistance, and with erythromycin (ORs: 0.13–0.18), tetracycline (OR: 0.71) and penicillin (ORs: 0.05–0.46) susceptibility.

PCV20 may lead to a larger decrease in overall IPD incidence than PCV15. Although the PCV20 vaccination impact on AMR may be limited, some resistant or difficult to treat infections could be avoided. Serotype replacement might lead to infections with low level penicillin resistance increasing, but most of these should remain treatable.

Candidozyma auris has emerged globally as a major threat to public health due to its outbreak causing capacity and antifungal resistance. Outbreaks have proven difficult to control despite enhanced infection prevention measures. Thus, national surveillance is warranted.

We aim to characterise the epidemiology of C. auris cases in Czechia between 2022 and 2024 to investigate whether autochthonous spread is occurring and asses antifungal resistance.

High-resolution genotyping was performed to assess genetic relatedness between isolates. Microbroth dilution was performed on all isolates and underlying mechanisms resistance were inspected with whole genome sequencing.

Eight cases from seven different hospitals were reported, mainly collected from non-sterile sites, in addition to the first documented prosthetic joint infection by C. auris. Only two patients reported travel history. Three clades were found, with the first report of Clade IV in Europe. For one patient, initial isolates were pan-susceptible but after short exposure to fluconazole became resistant with a novel mechanism.

C. auris reported in Czechia in patients without travel history suggests autochthonous spread. Three clades were present, often with unknown route of introduction. Development of fluconazole resistance upon brief exposure highlights the ability of C. auris to rapidly evolve.