http://edoc.rki.de/176904/44 2026-07-04T08:05:32Z http://edoc.rki.de/176904/13768 Institutionalisierung der Infektionshygiene in Deutschland: Herausforderungen seit der Gründerzeit Buchberger, Barbara; Maidhof, Jana; Dirks, Esther E.; Lexow, Franziska Die Sicherstellung der öffentlichen Gesundheit durch strukturierte Infektionsprävention ist heute fest verankert. Die Etablierung unabhängiger Institutionen, evidenzbasierter Richtlinien und sektorenübergreifender Kooperationen in der Hygiene war jedoch kein Selbstläufer, sondern Ergebnis tiefgreifender historischer Entwicklungen und gesundheitlicher Krisen. Ziel des Beitrags ist es darzustellen, welche Entwicklungen in Deutschland zur Institutionalisierung der Infektionshygiene geführt haben und welchen wechselnden Herausforderungen sie seit der Gründerzeit begegnen muss. Durch Industrialisierung und Urbanisierung entstanden im letzten Drittel des 19. Jahrhunderts Probleme in der Wasserversorgung und Abwasserentsorgung, die zu schweren Infektionsausbrüchen führten. Ab den 1920er-Jahren mussten Lösungen für die gesundheitsgefährdende Luft- und Bodenbelastung infolge des technischen Fortschritts entwickelt werden und nach 1950 gerieten nosokomiale Infektionen in den Fokus. Die Gründung der Königlichen Versuchs- und Prüfungsanstalt für Wasserversorgung und Abwasserbeseitigung 1901 war ein bedeutender Schritt für die Institutionalisierung der Infektionshygiene. Wechselnden Anforderungen entsprechend wurde das Aufgabenspektrum angepasst und zusätzliche Institute gegründet. Durch das Infektionsschutzgesetz sind heute das Robert Koch-Institut und die bei ihm angesiedelte Kommission für Infektionsprävention in medizinischen Einrichtungen und in Einrichtungen der Pflege und Eingliederungshilfe (KRINKO) mandatiert, Aufgaben der Infektionshygiene wahrzunehmen. An Schnittstellen mit anderen für Infektionsprävention und -hygiene zuständigen Einrichtungen des Bundes erzeugt die interinstitutionelle Zusammenarbeit Synergien zum Schutz der Bevölkerung.; The protection of public health through structured infection prevention is now firmly established. However, the establishment of independent institutions, evidence-based recommendations and cross-sectoral cooperation in the field of hygiene was not a foregone conclusion, but rather the result of profound historical developments and health crises. The aim of this article is to describe the developments in Germany that have led to the institutionalisation of infection prevention and control (IPC) and the changing challenges it has faced since its inception. Industrialisation and urbanisation in the last third of the 19th century led to problems with water supply and sewage disposal, which in turn led to serious outbreaks of infection. From the 1920s onwards, solutions had to be developed for the health hazards posed by air and soil pollution as a result of technological progress, and after 1950, nosocomial infections became the focus of attention. The establishment of the Royal Research and Testing Institute for Water Supply and Wastewater Disposal in 1901 was a significant step towards the institutionalisation of IPC. The range of tasks was adapted to changing requirements and additional institutes were founded. Under the Infection Protection Act, the Robert Koch Institute and its Commission for Infection Prevention and Hygiene in Healthcare and Nursing are now mandated to perform IPC tasks. At interfaces with other federal institutions responsible for infection control inter-institutional cooperation creates synergies for the protection of the population. 2026-06-18T00:00:00Z http://edoc.rki.de/176904/13762 Das 3R-Konzept und der Parasit Toxoplasma gondii: Neuere Methoden zur Reduzierung von Tierversuchen Seeber, Frank In diesem Artikel werden einige der Möglichkeiten als auch der Probleme aufgezeigt, die sich ergeben, wenn man die 3R-Prinzipien in der Infektionsforschung einführen möchte. Parasiten – aufgrund ihrer komplexen Lebensweise in mehreren Wirten –, sind dabei besonders anspruchsvoll, wenn als Ziel ein Lebenszyklus vollständig in vitro abgebildet werden soll [12]. Durch die Erfolge der letzten Jahre – sowohl mit Organoid-basierten Kultursystemen als auch in permanenten Muskelzellsystemen – werden viele Tierversuche für Toxoplasma (wie hier dargestellt) und verwandte Parasiten in Zukunft entweder verringert oder, je nach Forschungsfrage, sogar ersetzt werden können [17]. 2025-09-30T00:00:00Z http://edoc.rki.de/176904/13742 Bestandsaufnahme und Evaluierung von Datenquellen im Kontext der psychischen Gesundheit von Kindern und Jugendlichen mit Migrationsgeschichte in Deutschland Bug, Marleen; Koschollek, Carmen; Detering, Bianka; Wiemker, Veronika; Weiss, Julia; Bozorgmehr, Kayvan; Hövener, Claudia Hintergrund: Für eine evidenzbasierte Gesundheitspolitik sind aktuelle, repräsentative Daten über alle Bevölkerungsgruppen sowie inklusive Datensysteme unverzichtbar. In der Verfüg- und Verknüpfbarkeit migrationsbezogener Gesundheitsdaten bestehen jedoch erhebliche Lücken. Am Beispiel der psychischen Gesundheit von Kindern und Jugendlichen (KiJu) mit Migrationsgeschichte wird eine Bestandsaufnahme der in Deutschland verfügbaren Datenquellen vorgenommen und deren Nutzbarkeit für die Gesundheitsberichterstattung (GBE) evaluiert. Methoden: Im Projekt STRONGDATA-Kids wurde ein Mapping von Datenquellen (seit 2000) durchgeführt, die Informationen zur psychischen Gesundheit von KiJu mit Migrationsgeschichte und eine Stichprobengröße von n ≥ 1000 aufweisen. Die Datenqualität sowie Zugangs- und Nutzungsbarrieren wurden mittels einer Scorecard anhand von acht Dimensionen bewertet. Ergebnisse: Es wurden 37 Datenquellen identifiziert. Seit 2019 zeigt sich eine Diversifikation in der Nutzung migrationsbezogener Indikatorik mit Fokus auf Geburtsland (auch der Eltern). Am häufigsten erhoben wurden personale Ressourcen/Resilienz und emotionale- und Verhaltensprobleme. Routinedaten weisen Standardisierung und Zuverlässigkeit auf, Surveys Aktualität und Flexibilität. Die größten Zugangsbarrieren bestehen bei Routinedaten und Surveys auf struktureller Ebene, durch u. a. dezentrale Zuständigkeiten. Diskussion: Routinedaten und Surveys sind ergänzend unverzichtbar für die GBE. Trotz vielfältigerer migrationsbezogener Indikatoren sind methodische und strukturelle Weiterentwicklungen, etwa standardisierte Indikatorensets, notwendig. Ebenso braucht es diversitätsorientierte Forschungsstrategien und systematische Datenverknüpfungen, um die psychische Gesundheit von KiJu valide darzustellen.; Background: Up-to-date and representative data across all populations, as well as inclusive data systems, are essential for evidence-based health policy. However, there are considerable gaps in the availability and linkage of migration-related health data. Using the example of the mental health of children and adolescents (ChAd) with a history of migration, this analysis provides an overview of available data sources in Germany and evaluates their usability for public health reporting (PHR). Methods: Within the STRONGDATA-Kids project, data sources since 2000 were mapped if they included information on the mental health of ChAd with a history of migration and a sample size of n ≥ 1000. Data quality and barriers to access and use were assessed using a scorecard comprising eight dimensions. Results: A total of 37 data sources were identified. Since 2019, a diversification in the use of migration-related indicators can be observed, particularly with regard to country of birth (including that of parents). Personal resources and resilience, as well as emotional and behavioural problems, were most frequently assessed. Routine data show strengths in standardisation and reliability, while surveys ensure timely provision of data and flexibility. The main access barriers to routine data and surveys occur at the structural level, partly due to decentralised responsibilities. Discussion: Routine data and surveys are complementary and both indispensable for PHR. Despite broader use of migration-related indicators, further methodological and structural developments, such as standardised indicator sets, diversity-oriented research strategies and systematic data linkage are needed to validly represent the mental health of ChAd. 2026-05-18T00:00:00Z http://edoc.rki.de/176904/13736 Global, regional, and national incidence and mortality burden of non-COVID-19 lower respiratory infections and aetiologies, 1990–2021: a systematic analysis from the Global Burden of Disease Study 2021 GBD 2021 Lower Respiratory Infections and Antimicrobial Resistance Collaborators; Bender, Rose Grace; Sirota, Sarah Brooke; Swetschinski, Lucien R.; Villanueva Dominguez, Regina-Mae; Novotney, Amanda; Wool, Eve E.; Ikuta, Kevin S.; Vongpradith, Avina; Best Rogowski, Emma Lynn; Doxey, Matthew; Troeger, Christopher E.; Albertson, Samuel B.; Ma, Jianing; He, Jiawei; Maass, Kelsey Lynn; Simões, Eric A. F.; Abdoun, Meriem; Abdul Aziz, Jeza Muhamad; Abdulah, Deldar Morad; Abu Rumeileh, Samir; Abualruz, Hasan; Aburuz, Salahdein; Adepoju, Abiola Victor; Adha, Rishan; Adikusuma, Wirawan; Adra, Saryia; Afraz, Ali; Aghamiri, Shahin; Agodi, Antonella; Ahmadzade, Amir Mahmoud; Ahmed, Haroon; Ahmed, Ayman; Akinosoglou, Karolina; AL-Ahdal, Tareq Mohammed Ali; Al-amer, Rasmieh Mustafa; Albashtawy, Mohammed; AlBataineh, Mohammad T.; Alemi, Hediyeh; Al-Gheethi, Adel Ali Saeed; Ali, Abid; Shujait Ali, Syed Shujait; Alqahtani, Jaber S.; AlQudah, Mohammad; Al-Tawfiq, Jaffar A.; Al-Worafi, Yaser Mohammed; Alzoubi, Karem H.; Amani, Reza; Amegbor, Prince M.; Ameyaw, Edward Kwabena; Amuasi, John H.; Anil, Abhishek; Anyanwu, Philip Emeka; Arafat, Mosab; Areda, Damelash; Arefnezhad, Reza; Atalell, Kendalem Asmare; Ayele, Firayad; Azzam, Ahmed Y.; Babamohamadi, Hassan; Babin, François-Xavier; Bahurupi, Yogesh; Baker, Stephen; Banik, Biswajit; Barchitta, Martina; Barqawi, Hiba Jawdat; Basharat, Zarrin; Baskaran, Pritish; Batra, Kavita; Batra, Ravi; Bayileyegn, Nebiyou Simegnew; Beloukas, Apostolos; Berkley, James A.; Beyene, Kebede A.; Bhargava, Ashish; Bhattacharjee, Priyadarshini; Bielicki, Julia A.; Bilalaga, Mariah Malak; Bitra, Veera R.; Brown, Colin Stewart; Burkart, Katrin; Bustanji, Yasser; Carr, Sinclair; Chahine, Yaacoub; Chattu, Vijay Kumar; Chichagi, Fatemeh; Chopra, Hitesh; Chukwu, Isaac Sunday; Chung, Eunice; Dadana, Sriharsha; Dai, Xiaochen; Dandona, Lalit; Dandona, Rakhi; Darban, Isaac; Dash, Nihar Ranjan; Dashti, Mohsen; Dashtkoohi, Mohadese; Dekker, Denise Myriam; Delgado-Enciso, Ivan; Devanbu, Vinoth Gnana Chellaiyan; Dhama, Kuldeep; Diao, Nancy; Do, Thao Huynh Phuong; Dokova, Klara Georgieva; Dolecek, Christiane; Dziedzic, Arkadiusz Marian; Eckmanns, Tim; Ed-Dra, Abdelaziz; Efendi, Ferry; Eftekharimehrabad, Aziz; Eyre, David William; Fahim, Ayesha; Feizkhah, Alireza; Felton, Timothy William; Ferreira, Nuno; Flor, Luisa S.; Gaihre, Santosh; Gebregergis, Miglas W.; Gebrehiwot, Mesfin; Geffers, Christine; Gerema, Urge; Ghaffari, Kazem; Goldust, Mohamad; Goleij, Pouya; Guan, Shi-Yang; Gudeta, Mesay Dechasa; Guo, Cui; Gupta, Veer Bala; Gupta, Ishita; Habibzadeh, Farrokh; Hadi, Najah R.; Haeuser, Emily; Hailu, Wase Benti; Hajibeygi, Ramtin; Haj-Mirzaian, Arvin; Haller, Sebastian; Hamiduzzaman, Mohammad; Hanifi, Nasrin; Hansel, Jan; Hasnain, Md Saquib; Haubold, Johannes; Hoan, Nguyen Quoc; Huynh, Hong-Han; Iregbu, Kenneth Chukwuemeka; Islam, Md Rabiul; Jafarzadeh, Abdollah; Jairoun, Ammar Abdulrahman; Jalil, Mahsa; Jomehzadeh, Nabi; Joshua, Charity Ehimwenma; Kabir, Awal; Kamal, Zul; Kanmodi, Kehinde Kazeem; Kantar, Rami S.; Karimi Behnagh, Arman; Kaur, Navjot; Kaur, Harkiran; Khamesipour, Faham; Khan, M. Nuruzzaman; Khan suheb, Mahammed Ziauddin; Khanal, Vishnu; Khatab, Khaled; Khatib, Mahalaqua Nazli; Kim, Grace; Kim, Kwanghyun; Kitila, Aiggan Tamene Tamene; Komaki, Somayeh; Krishan, Kewal; Krumkamp, Ralf; Kuddus, Abdul; Kurniasari, Maria Dyah; Lahariya, Chandrakant; Latifinaibin, Kaveh; Le, Nhi Huu Hanh; Le, Thao Thi Thu; Le, Trang Diep Thanh; Lee, Seung Won; Le Pape, Alain; Lerango, Temesgen L.; Li, Ming-Chieh; Mahboobipour, Amir Ali; Malhotra, Kashish; Mallhi, Tauqeer Hussain; Manoharan, Anand; Martinez-Guerra, Bernardo Alfonso; Mathioudakis, Alexander G.; Mattiello, Rita; May, Jürgen; McManigal, Barney; McPhail, Steven M.; Meto, Tesfahun Mekene; Mendez-Lopez, Max Alberto Mendez; Meo, Sultan Ayoub; Merati, Mohsen; Mestrovic, Tomislav; Mhlanga, Laurette; Minh, Le Huu Nhat; Misganaw, Awoke; Mishra, Vinaytosh; Misra, Arup Kumar; Mohamed, Nouh Saad; Mohammadi, Esmaeil; Mohammed, Mesud; Mohammed, Mustapha; Mokdad, Ali H.; Monasta, Lorenzo; Moore, Catrin E.; Motappa, Rohith; Mougin, Vincent; Mousavi, Parsa; Mulita, Francesk; Mulu, Atsedemariam Andualem; Naghavi, Pirouz; Naik, Ganesh R.; Nainu, Firzan; Nair, Tapas Sadasivan; Nargus, Shumaila; Negaresh, Mohammad; Nguyen, Hau Thi Hien; Nguyen, Dang H.; Nguyen, Van Thanh; Nikolouzakis, Taxiarchis Konstantinos; Noman, Efaq Ali; Nri-Ezedi, Chisom Adaobi; Odetokun, Ismail A.; Okwute, Patrick Godwin; Olana, Matifan Dereje; Olanipekun, Titilope O; Olasupo, Omotola O.; Olivas-Martinez, Antonio; Ordak, Michal; Ortiz-Brizuela, Edgar; Ouyahia, Amel; Padubidri, Jagadish Rao; Pak, Anton; Pandey, Anamika; Pantazopoulos, Ioannis; Parija, Pragyan Paramita; Parikh, Romil R.; Park, Seoyeon; Parthasarathi, Ashwaghosha; Pashaei, Ava; Peprah, Prince; Pham, Hoang Tran; Poddighe, Dimitri; Pollard, Andrew; Ponce-De-Leon, Alfredo; Prakash, Peralam Yegneswaran; Prates, Elton Junio Sady; Quan, Nguyen Khoi; Raee, Pourya; Rahim, Fakher; Rahman, Mosiur; Rahmati, Masoud; Ramasamy, Shakthi Kumaran; Ranjan, Shubham; Rao, Indu Ramachandra; Rashid, Ahmed Mustafa; Rattanavong, Sayaphet; Ravikumar, Nakul; Reddy, Murali Mohan Rama Krishna; Redwan, Elrashdy Moustafa Mohamed; Reiner Jr., Robert C.; Reyes, Luis Felipe; Roberts, Tamalee; Rodrigues, Mónica; Rosenthal, Victor Daniel; Roy, Priyanka; Runghien, Tilleye; Saeed, Umar; Saghazadeh, Amene; Sharif-Askari, Narjes Saheb; Sharif-Askari, Fatemeh Saheb; Sahoo, Soumya Swaroop; Sahu, Monalisha; Sakshaug, Joseph W.; Salami, Afeez Abolarinwa; Saleh, Mohamed A.; Salehi omran, Hossein; Sallam, Malik; Samadzadeh, Sara; Samodra, Yoseph Leonardo; Sanjeev, Rama Krishna; Sarasmita, Made Ary; Saravanan, Aswini; Sartorius, Benn; Saulam, Jennifer; Schumacher, Austin E.; Seyedi, Seyed Arsalan; Shafie, Mahan; Shahid, Samiah; Sham, Sunder; Shamim, Muhammad Aaqib; Shamshirgaran, Mohammad Ali; Shastry, Rajesh P.; Sherchan, Samendra P.; Shiferaw, Desalegn; Shittu, Aminu; Siddig, Emmanuel Edwar; Sinto, Robert; Sood, Aayushi; Sorensen, Reed J. D.; Stergachis, Andy; Stoeva, Temenuga Zhekova; Swain, Chandan Kumar; Szarpak, Lukasz; Tamuzi, Jacques Lukenze; Temsah, Mohamad-Hani; Tessema, Melkamu B Tessema; Thangaraju, Pugazhenthan; Tran, Nghia Minh; Tran, Ngoc-Ha; Tumurkhuu, Munkhtuya; Ty, Sree Sudha; Udoakang, Aniefiok John; Ulhaq, Inam; Umar, Tungki Pratama; Umer, Abdurezak Adem; Vahabi, Seyed Mohammad; Vaithinathan, Asokan Govindaraj; Van den Eynde, Jef; Walson, Judd L.; Waqas, Muhammad; Xing, Yuhan; Yadav, Mukesh Kumar; Yahya, Galal; Yon, Dong Keon; Zahedi Bialvaei, Abed; Zakham, Fathiah; Zeleke, Abyalew Mamuye; Zhai, Chunxia; Zhang, Zhaofeng; Zhang, Haijun; Zielińska, Magdalena; Zheng, Peng; Aravkin, Aleksandr Y.; Vos, Theo; Hay, Simon I.; Mosser, Jonathan F.; Lim, Stephen S.; Naghavi, Mohsen; Murray, Christopher J. L.; Kyu, Hmwe Hmwe Background: Lower respiratory infections (LRIs) are a major global contributor to morbidity and mortality. In 2020–21, non-pharmaceutical interventions associated with the COVID-19 pandemic reduced not only the transmission of SARS-CoV-2, but also the transmission of other LRI pathogens. Tracking LRI incidence and mortality, as well as the pathogens responsible, can guide health-system responses and funding priorities to reduce future burden. We present estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 of the burden of non-COVID-19 LRIs and corresponding aetiologies from 1990 to 2021, inclusive of pandemic effects on the incidence and mortality of select respiratory viruses, globally, regionally, and for 204 countries and territories. Methods: We estimated mortality, incidence, and aetiology attribution for LRI, defined by the GBD as pneumonia or bronchiolitis, not inclusive of COVID-19. We analysed 26 259 site-years of mortality data using the Cause of Death Ensemble model to estimate LRI mortality rates. We analysed all available age-specific and sex-specific data sources, including published literature identified by a systematic review, as well as household surveys, hospital admissions, health insurance claims, and LRI mortality estimates, to generate internally consistent estimates of incidence and prevalence using DisMod-MR 2.1. For aetiology estimation, we analysed multiple causes of death, vital registration, hospital discharge, microbial laboratory, and literature data using a network analysis model to produce the proportion of LRI deaths and episodes attributable to the following pathogens: Acinetobacter baumannii, Chlamydia spp, Enterobacter spp, Escherichia coli, fungi, group B streptococcus, Haemophilus influenzae, influenza viruses, Klebsiella pneumoniae, Legionella spp, Mycoplasma spp, polymicrobial infections, Pseudomonas aeruginosa, respiratory syncytial virus (RSV), Staphylococcus aureus, Streptococcus pneumoniae, and other viruses (ie, the aggregate of all viruses studied except influenza and RSV), as well as a residual category of other bacterial pathogens. Findings: Globally, in 2021, we estimated 344 million (95% uncertainty interval [UI] 325–364) incident episodes of LRI, or 4350 episodes (4120–4610) per 100 000 population, and 2·18 million deaths (1·98–2·36), or 27·7 deaths (25·1–29·9) per 100 000. 502 000 deaths (406 000–611 000) were in children younger than 5 years, among which 254 000 deaths (197 000–320 000) occurred in countries with a low Socio-demographic Index. Of the 18 modelled pathogen categories in 2021, S pneumoniae was responsible for the highest proportions of LRI episodes and deaths, with an estimated 97·9 million (92·1–104·0) episodes and 505 000 deaths (454 000–555 000) globally. The pathogens responsible for the second and third highest episode counts globally were other viral aetiologies (46·4 million [43·6–49·3] episodes) and Mycoplasma spp (25·3 million [23·5–27·2]), while those responsible for the second and third highest death counts were S aureus (424 000 [380 000–459 000]) and K pneumoniae (176 000 [158 000–194 000]). From 1990 to 2019, the global all-age non-COVID-19 LRI mortality rate declined by 41·7% (35·9–46·9), from 56·5 deaths (51·3–61·9) to 32·9 deaths (29·9–35·4) per 100 000. From 2019 to 2021, during the COVID-19 pandemic and implementation of associated non-pharmaceutical interventions, we estimated a 16·0% (13·1–18·6) decline in the global all-age non-COVID-19 LRI mortality rate, largely accounted for by a 71·8% (63·8–78·9) decline in the number of influenza deaths and a 66·7% (56·6–75·3) decline in the number of RSV deaths. Interpretation: Substantial progress has been made in reducing LRI mortality, but the burden remains high, especially in low-income and middle-income countries. During the COVID-19 pandemic, with its associated non-pharmaceutical interventions, global incident LRI cases and mortality attributable to influenza and RSV declined substantially. Expanding access to health-care services and vaccines, including S pneumoniae, H influenzae type B, and novel RSV vaccines, along with new low-cost interventions against S aureus, could mitigate the LRI burden and prevent transmission of LRI-causing pathogens. Funding: Bill & Melinda Gates Foundation, Wellcome Trust, and Department of Health and Social Care (UK). 2024-04-15T00:00:00Z