{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T10:36:06Z","timestamp":1786703766250,"version":"build-2736575974"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100012681","name":"Universit\u00e4tsklinikum K\u00f6ln","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100012681","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Patients with active lung or lower head and neck cancer (HNC) are at increased risk of infection, particularly hospital-acquired pneumonia (HAP), ventilated HAP (vHAP) and ventilator-associated pneumonia (VAP), due to immunosuppression and treatment-related side effects. These infections are associated with increased mortality, prolonged hospital stays and interruptions in cancer therapy. Despite their clinical relevance, data on epidemiology, risk factors, treatment, and outcomes in this population remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective, observational, multicentre matched cohort study at eight tertiary care centres in Germany and Spain. Patients with lung or lower HNC who received anti-cancer treatment between January 2018 and May 2022 and were hospitalised for at least 48\u00a0h were included. Patients with HAP\/vHAP\/VAP (case group) were matched 1:1 to those without pneumonia (control group) and followed for 90 days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 256 patients were included, with median ages of 65 (cases) and 64 years (controls). Most patients had lung cancer (94%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009240), predominantly in stages III-IV (81%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009207). In the case group, patients had mostly HAP (88%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009113), diagnosed in median 7 days after hospital admission. Common antibiotics given included penicillin derivatives with \u03b2-lactamase inhibitors, cephalosporins and carbapenems. Patients with HAP\/vHAP\/VAP had significantly higher mortality and longer hospital stays (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Cox regression identified HAP\/vHAP\/VAP and dysphagia as independent predictors of mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>HAP\/vHAP\/VAP imposes a significant clinical burden in patients with lung or lower HNC. Early prevention, timely diagnosis, and close monitoring of high-risk patients are essential to improve outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s15010-026-02805-y","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T10:29:22Z","timestamp":1777890562000},"page":"1861-1873","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognosis and aetiology of hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) in patients with active lung or lower head and neck cancer (PEPP-C): a retrospective, matched multicentre cohort study in Germany and Spain"],"prefix":"10.1007","volume":"54","author":[{"given":"Sina M.","family":"P\u00fctz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Engelhard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian M.","family":"Wingen-Heimann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David F.","family":"Brilz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brune","family":"Akrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heike","family":"Kohl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annika Y.","family":"Classen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlota","family":"Gudiol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enric","family":"Sastre-Escola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franziska C.","family":"Trudzinski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arturo Olivares","family":"Rivera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"L\u00fccke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadeusz","family":"Marczewski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayham","family":"Daher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Eisenmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Schmitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anke","family":"Reinacher-Schick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"von Tresckow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebekka","family":"Mispelbaum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tessa","family":"Hattenhauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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ME received travel grants from Tillotts and Pfizer. BA is an employee of Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA, who may or may not own stock and\/or hold stock options in Merck & Co., Inc., Rahway, NJ, USA. HK owns stocks from Merck & Co., Inc., Rahway, NJ, USA and is employed by MSD Sharp & Dohme GmbH. CG received research grants from Merck and Pfizer, honoraria from Merck, Pfizer, Gilead, Shionogi, Advanz Pharma and Takeda, travel grants from Pfizer, Gilead and Shionogi, advisory board fees from Gilead and Shionogi. FCT received honoraria from Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Grifols, Novartis, CSL Behring, Streamed up, RG Gesellschaft f\u00fcr Information und Organisation mbH, PeerVoice, Aponitis Pharma and MedUpdate. EL received honoraria from AstraZeneca, B\u00f6hringer Ingelheim, MSD, Bristol Myers, Regeneron, Janssen, Chiesi, Sanofi, RG \u00c4rztefortbildung, Merck; and travel grants from AstraZeneca, B\u00f6hringer Ingelheim, MSD, Janssen, Chiesi and Sanofi. TM received advisory board fees from BeiGene, honoraria from AstraZeneca, MSD, Bristol Myers Squibb, RG \u00c4rztefortbildung and Merck, and travel grants from AstraZeneca, Roche, Celltrion and BeiGene. AD received travel grants from AstraZeneca Germany. SE received honoraria from Boehringer Ingelheim and AstraZeneca, and received advisory board fees from Regeneron. ARS received advisory board fees from Amgen, AstraZeneca, Aurikamed, Boehringer Ingelheim, Daiichi Sankyo, Onkowissen.de, Roche and Servier Deutschland GmbH, and honoraria from Roche, MCI global\/Deutschland, Pierre Fabre Pharmaceuticals, and research grants from Roche, AIO Studien GmbH, BioNTech, Gentech, Georg-August-Universit\u00e4t G\u00f6ttingen, MSD, Rafael Pharmaceutics, and travel grants from Roche, Pierre Fabre Pharmaceuticals, MCI global\/Deutschland, and consulting fees from MCI global\/Deutschland, and has a chair role at AIO Studien gGmbH. JVT received advisory board fees from AbbVie, Amgen, BeOne, Johnson&Johnson, Lilly and Roche, and honoraria from AbbVie, Amgen, Aurikamed, BeOne, Johnson&Johnson, Lilly, matt and Roche, and travel grants from AbbVie, BeOne, Johnson&Johnson, Lilly, Roche. RM received honoraria and advisory board fees from Johnson&Johnson, travel grants from Johnson&Johnson and Takeda and services such as equipment, materials, drugs, medical writing, gifts from Gilead. TH received honoraria from Johnson&Johnson and AstrZeneca, travel grants from Johnson&Johnson, Takeda, BMS, Regeneron, advisory board fees from Johnson&Johnson and services such as equipment, materials, drugs, medical writing, gifts from Gilead. JJV received research grants from MSD, Gilead, Pfizer, Astellas Pharma, Basilea, German Centre for Infection Research (DZIF), German Federal Ministry of Education and Research (BMBF), Deutsches Zentrum f\u00fcr Luft- und Raumfahrt (DLR), University of Bristol, Rigshospitalet Copenhagen, German Network University Medicine, German Cancer Consortium (DKTK), German Federal Ministry of Health (BMG), European Union, lecture honoraria from MSD, Gilead, Pfizer, Astellas Pharma, Basilea, German Centre for Infection Research (DZIF), University Hospital Freiburg\/Congress and Communication, Academy for Infectious Medicine, University Manchester, German Society for Infectious Diseases (DGI), \u00c4rztekammer Nordrhein, \u00c4rztekammer Hessen, University Hospital Aachen, Back Bay Strategies, German Society for Internal Medicine (DGIM), Shionogi, Molecular Health, Netzwerk Universit\u00e4tsmedizin, Janssen, NordForsk, Biontech, APOGEPHA, German Cancer Consortium (DKTK), University Hospital Oldenburg, meeting and travel support from German Centre for Infection Research (DZIF), University Manchester, German Society for Infectious Diseases (DGI), University Hospital Aachen, German Society for Internal Medicine (DGIM), Netzwerk Universit\u00e4tsmedizin, German Cancer Consortium (DKTK), and advisory board fees from MSD, Gilead, Pfizer, Astellas Pharma, Basilea, German Centre for Infection Research (DZIF), Academy for Infectious Medicine, University Manchester, German Society for Infectious Diseases (DGI), German Society for Internal Medicine (DGIM), Netzwerk Universit\u00e4tsmedizin, Janssen, Biontech. SMWH, DFB, AYC, ESE, AOR, JS, SE and JS have no conflicts of interest.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"A primary ethics vote was obtained at the Ethics Committee of the Department of Medicine at the University of Cologne on February, 7th 2023 (local ethics ID approval 22-1388-retro), as the University Hospital Cologne was the leading study site. The participating study site received their local ethics vote at the respective ethics commission.","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}}]}}