{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T21:43:43Z","timestamp":1790027023270,"version":"4.0.1"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100023448","name":"Robert Koch-Institut","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100023448","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Limiting healthcare-associated infections (HAI) SARS-CoV-2 transmission has been a global challenge. We assessed characteristics of pediatric SARS-CoV-2 HAI outbreaks to better understand HAI transmission in pediatric care. We analyzed PCR-confirmed SARS-CoV-2 outbreak cases notified through statutory surveillance, at case level and at outbreak level, in Germany between 24 February 2020 and 31 December 2023 to describe SARS-CoV-2\u00a0HAI outbreaks in pediatric care and compare them with non-pediatric outbreaks. Pediatric outbreaks included any outbreak in pediatric care or with\u2009&gt;\u200950% of cases among patients aged\u2009&lt;\u200918 years. We calculated age-disaggregated median monthly incidences of SARS-CoV-2 HAI outbreak cases per 100,000 hospitalizations using reimbursement data. Among 36,371 SARS-CoV-2 HAI hospital outbreak cases from 3191 outbreaks, we identified 25 pediatric outbreaks with 241 cases. Of 218 cases with case status information, 181 (83%) were healthcare workers (HCW) and 37 (17%) were patients\u2009&lt;\u200918 years old. Among all 241 cases, five (2%) were severe including one death case whereas 2580 (7%) of non-pediatric HAI cases were severe and 2736 (8%) deaths. Age-disaggregated median monthly outbreak case incidence\u2009&lt;\u200918 years (0.3\/100,000 hospitalizations; range 0.1\u20137.6) was markedly lower than among the\u00a0non-pediatric age group of 18\u201359-year olds (14.8\/100,000 hospitalizations; range 0.1\u2013215.7).<\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusion<\/jats:italic>\n                    : Our results suggest limited SARS-CoV-2 HAI transmission in pediatric care. The high proportion of cases among HCW in pediatric outbreaks underlines the need to protect HCW from infections to further limit HAI transmission. Our findings highlight the value of outbreak surveillance for monitoring HAI transmission patterns in vulnerable sub-groups such as pediatric patients.\n                    <jats:table-wrap>\n                      <jats:table>\n                        <jats:tbody>\n                          <jats:tr>\n                            <jats:td align=\"left\">\n                              <jats:bold>What is Known:<\/jats:bold>\n                            <\/jats:td>\n                          <\/jats:tr>\n                          <jats:tr>\n                            <jats:td align=\"left\">\n                              \u2022\n                              <jats:italic>Children and adolescents experience less severe SARS-CoV-2 illness<\/jats:italic>\n                              .\u2022\n                              <jats:italic>Pediatric care poses unique infection prevention and control challenges<\/jats:italic>\n                              .\n                            <\/jats:td>\n                          <\/jats:tr>\n                          <jats:tr>\n                            <jats:td align=\"left\">\n                              <jats:bold>What is New:<\/jats:bold>\n                            <\/jats:td>\n                          <\/jats:tr>\n                          <jats:tr>\n                            <jats:td align=\"left\">\n                              \u2022\n                              <jats:italic>Pediatric outbreaks were very rare with few severe cases suggesting that pediatric care was less affected by SARS-CoV-2 outbreaks<\/jats:italic>\n                              .\u2022\n                              <jats:italic>Most cases in pediatric outbreaks occurred among healthcare workers pointing to the need to protect HCW from infections and a limited role of pediatric patients and caregivers<\/jats:italic>\n                              .\n                            <\/jats:td>\n                          <\/jats:tr>\n                        <\/jats:tbody>\n                      <\/jats:table>\n                    <\/jats:table-wrap>\n                  <\/jats:p>","DOI":"10.1007\/s00431-025-06680-x","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T23:57:03Z","timestamp":1766015823000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Characteristics of pediatric SARS-CoV-2 healthcare-associated infection outbreaks in Germany, 2020\u20132023: a retrospective observational study"],"prefix":"10.1007","volume":"185","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6708-8348","authenticated-orcid":false,"given":"L. 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The views and opinions expressed herein do not state or reflect those of ECDC. ECDC is not responsible for the data and information collation and analysis and cannot be held liable for conclusions or opinions drawn.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclaimer"}},{"value":"ChatGPT (version GPT-4o) was used to refine the R code for the statistical analysis, as well as for language editing without affecting the analysis or conclusions. The authors retain full responsibility of the content of the manuscript. Participants\u2019 confidentiality was guaranteed by not sharing any sensitive information.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statement on AI"}}],"article-number":"25"}}