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Background: The diagnosis of scabies has become surprisingly frequent in Germany in recent years and the use of scabicides has risen significantly., Objective: The aim of our survey was to determine whether this trend can also be detected among military personnel of the German Armed Forces (Bundeswehr)., Methods: The study was conducted as a retrospective single-center study over a period of 8 years from 2012 to 2019 in the Department of Dermatology of the Armed Forces Hospital Berlin, Germany. Data were generated from the hospital information system (KIS), which was searched for all scabies-coded diagnoses according to ICD10 code B86 both as outpatients and inpatients. Only first presentations with scabies diagnosis confirmed by dermoscopy or microscopy by a dermatologist were included. Inpatient treatment was required if a patient was not cured after at least three antiscabies treatment cycles in the outpatient setting., Results: The data show that there has been a steady increase in the diagnosis of scabies in Bundeswehr personnel. Moreover, our data show that the number of unsuccessfully treated outpatients increased and required in-hospital treatment., Conclusion: We observed an increase of scabies among German military personnel who represent a typical at-risk group. These results support the observations of an increased incidence of scabies in Germany in general and especially in an at-risk population. With the general increase in scabies cases, there are also increasing numbers of German military personnel who are refractory to treatment, which was largely attributed to inadequate treatment of contact persons and individual treatment errors. Nevertheless, the data also emphasize the low overall prevalence of scabies; therefore, all diagnoses should be confirmed by dermoscopy or microscopy after 14 days whenever possible to rule out the bias of overreporting due to false-positive cases diagnosed only by clinical examination.

Dermatological and venereological expertise is indispensable for the medical care of our soldiers at home and during military missions and represents a major competence in military medicine. Therefore, in the new structure of the combined German Forces medical services, dermatological clinics have been set up at all Bundeswehr hospitals, which, as academic teaching hospitals, are regionally involved in the medical care of the civilian population. In addition to general dermatological and dermatosurgical care, wound treatment and tropical dermatology represent military medicine-related priorities. Dermatological clinics are maintained in an interdisciplinary network at the Bundeswehr hospitals in Berlin, Hamburg, Koblenz, Ulm, and Westerstede. Outpatient dermatological treatment facilities complete the medical care at numerous locations where troops are based.

Background: The resistance of enterococci against various antimicrobial substances including vancomycin has increased markedly. Since 1989 in the USA in particular high resistance rates against vancomycin have been observed but very few surveillance have been published in Europe. Therefore, we conducted a multicenter study in Germany to obtain information about the incidence and distribution of vancomycin and/or high-level aminoglycoside-resistant enterococci., Methods: A total of 2046 enterococcal isolates were identified and susceptibility-testing was performed according to international guidelines., Results: A total number of 90.5% of the enterococcal isolates were identified as Enterococcus faecalis and 7.8% was Enterococcus faecium. Resistance against ampicillin was detected in 56.6% of the Enterococcus faecium isolates, however, in only one Enterococcus faecalis isolate. High-level resistance against gentamycin or streptomycin was observed in 7.3% and 24.8% of the isolates, respectively. Twelve isolates showed resistance against vancomycin, however, cross resistance with teicoplanin was found in only two isolates., Conclusion: The rate of resistance of enterococci in Germany is still considerably lower than in the United States. Previous vancomycin therapy has been implemented as a risk factor for colonization or infection with vancomycin-resistant enterococci. Continued vigilance, decreased use of vancomycin and strict enforcement of infection control measures are appropriate measures to control the growing problem of resistant enterococci.