Eurosurveillance - Volume 31, Issue 25, 25 June 2026

Enhancing surveillance of bloodstream infections (BSIs) by extracting data from electronic health records (EHR) is often the first step in automating the surveillance of healthcare-associated infections (HAIs).

We assessed existing BSI surveillance systems and the progress in implementing EHR-BSI surveillance within the ECDC project Surveillance from Electronic Health Data (SUREHD).

We summarised information on BSI surveillance systems through meetings with national representatives and review of national surveillance protocols and reports.

Of the 30 EU/EEA countries invited to join the SUREHD project, 17 actively participated from March 2023 to March 2025. All 17 countries conducted BSI surveillance within HAI or antimicrobial resistance programmes, and EHR-BSI surveillance was being implemented nationally (n = 9), regionally (n = 2) or at hospital level (n = 6). Reported challenges included data standardisation (n = 13), IT capacity (n = 10), data linkage (n = 7), system integration (n = 7) and data protection (n = 6). Few countries had access to structured EHR data on patient symptoms (n = 1), infection origin (n = 2) and catheter-related variables (n = 5). Most countries had not yet implemented data validation processes (n = 12) nor decided on standardised vocabularies for most variables. All countries aimed to automate EHR-BSI surveillance.

Automation of BSI surveillance is critically relevant for the development of surveillance systems and to support infection and control measures (IPC) for HAIs. Implementation of automated EHR-based BSI surveillance varied between countries; a generic protocol and a network of experts have established a way forward. Future efforts should focus on harmonisation, data quality, and leveraging EHR-BSI data to strengthen HAI surveillance and to improve IPC.

Chronic hepatitis C (HCV) and hepatitis B (HBV) viruses remain major causes of liver-related morbidity and mortality. Despite a low prevalence in Germany, migration from higher-endemic regions and screening gaps may hinder progress towards World Health Organization (WHO) 2030 elimination targets. Population-based data are needed for surveillance, screening and elimination.

We aimed to estimate prevalence of HCV, HBV and hepatitis D virus (HDV) in adults in Germany.

We retrospectively analysed 10,000 serum samples from the Multilocal and Serial Prevalence Study of Antibodies against SARS-CoV-2 in Germany (MuSPAD, 2020–2021), by age and gender distribution. Samples were pooled and tested for HCV and HBV by PCR, for HBV surface antigen (HBsAg) and for antibodies against HCV and HBV. Samples positive for HBsAg were analysed for HDV.

Active HCV infection (HCV RNA) was detected in four (0.04%; 95% CI: 0.02–0.1) persons. Seroprevalence for HCV was 0.17% (95% CI: 0.11–0.27), highest among 60–69-year-olds (0.53%). Active HBV infection (HBV DNA and/or HBsAg) was detected in 21 participants (0.21%; 95% confidence interval (CI): 0.14–0.32), peaking at 0.44% among 30–39-year-olds. No HDV infection was confirmed.

Recognising that relevant high-risk groups may be underrepresented in our data, the overall HCV and HBV prevalence in Germany appears low but non-negligible. Adults under 35 years are not covered by the national health check programme for all adults aged ≥ 35 years, suggesting potential screening gaps. Systematic HDV testing among HBV-positive individuals and targeted testing strategies may support progress towards WHO elimination goals.