ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2026
Moraxella species isolated from blood cultures in Europe (MORAXEu): a multicentre study of epidemiology and antimicrobial susceptibility with complementary phylogenomic analysis of publicly available genomes.
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Tone TønjumDepartment of Microbiology, University of Oslo, Oslo, Norway.
Vinicius da Silva Franklin-DuarteDepartment of Microbiology, Oslo University Hospital, Oslo, Norway.
Johan Christian BerildDepartment of Microbiology, Oslo University Hospital, Oslo, Norway.
Konstantina GartzonikaMicrobiology Department, School of Health Science, Faculty of Medicine, University of Ioannina, Ioannina, Greece.
Eirini ChristakiFirst Department of Internal Medicine and Infectious Diseases Unit, Faculty of Medicine, University General Hospital of Ioannina, University of Ioannina, 45110, Ioannina, Greece.
Viktoria Eirini MavromanolakiDepartment of Paediatrics, Aghia Sophia Children's Hospital, 11527, Athens, Greece.
Sofia MarakiDepartment of Clinical Microbiology and Microbial Pathogenesis, University Hospital of Heraklion, 711 10, Crete, Greece.
Anastasia SpiliopoulouDepartment of Microbiology, Medical School, University of Patras, Patras, Greece.
Nikolaos GiormezisDepartment of Microbiology, Medical School, University of Patras, Patras, Greece.
Gergana LengerovaDepartment of Medical Microbiology and Immunology Prof. Dr. Elissay Yanev, Faculty of Medicine, Medical University of Plovdiv, 4002, Plovdiv, Bulgaria.
Yordan KalchevDepartment of Medical Microbiology and Immunology Prof. Dr. Elissay Yanev, Faculty of Medicine, Medical University of Plovdiv, 4002, Plovdiv, Bulgaria.
Ana BudimirDepartment of Clinical Microbiology, University Hospital of Split, Split, Croatia.
Branka BedenićDepartment of Clinical Microbiology, University Hospital of Split, Split, Croatia.
Zana RubicClinical Department for Clinical Microbiology, Prevention and Control of Infectious Diseases, School of Medicine, University of Zagreb, University Hospital Centre Zagreb, Kispatic Street 12, 10000, Zagreb, Croatia.
Antonija SaskorClinical Department for Clinical Microbiology, Prevention and Control of Infectious Diseases, School of Medicine, University of Zagreb, University Hospital Centre Zagreb, Kispatic Street 12, 10000, Zagreb, Croatia.
Karla MilanovicClinical Department for Clinical Microbiology, Prevention and Control of Infectious Diseases, School of Medicine, University of Zagreb, University Hospital Centre Zagreb, Kispatic Street 12, 10000, Zagreb, Croatia.
Monica LickerMicrobiology Department, Multidisciplinary Research Center On Antimicrobial Resistance, 'Victor Babes' University of Medicine and Pharmacy, Timisoara, Romania.
Corina MusuroiMicrobiology Department, Multidisciplinary Research Center On Antimicrobial Resistance, 'Victor Babes' University of Medicine and Pharmacy, Timisoara, Romania.
Mateja PirsInstitute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
Ivana VelimirovicInstitute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
Michael BerktoldInstitute of Hygiene and Medical Microbiology, Medical University of Innsbruck, 6020, Innsbruck, Austria.
Adriána KrajčíkováDepartment of Microbiology, Medical Faculty, Commenius University and University Hospital, Bratislava, Slovakia.
Anezka GryndlerovaDepartment of Medical Microbiology, Second Faculty of Medicine, Charles University and Motol and Homolka University Hospital, Prague, Czech Republic.
Pavel DrevinekDepartment of Medical Microbiology, Second Faculty of Medicine, Charles University and Motol and Homolka University Hospital, Prague, Czech Republic.
Miroslava Htoutou SedlákováDepartment of Microbiology, Medical Faculty, Commenius University and University Hospital, Bratislava, Slovakia.
Milan KolářDepartment of Microbiology, Medical Faculty, Commenius University and University Hospital, Bratislava, Slovakia.
Monika Brzychczy-WlochDepartment of Molecular Medical Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland.
Aldona Olechowska-JarząbDepartment of Microbiology, University Hospital Olomouc and, Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic.
Małgorzata BrauncajsDepartment of Microbiology, University Hospital, Jakubowskiego 2, 30-688, Krakow, Poland.
Filip BielecDepartment of Microbiology and Laboratory Medical Immunology, Medical University of Lodz, Lodz, Poland.
Dominika Seliga-GąsiorMicrobiological Laboratory, University Center for Laboratory Medicine, University Medical Center, Medical University of Warsaw, Warsaw, Poland.
Edyta PodsiadlyMicrobiological Laboratory, University Center for Laboratory Medicine, University Medical Center, Medical University of Warsaw, Warsaw, Poland.
Kristian RiesbeckClinical Microbiology, Department of Translational Medicine, Faculty of Medicine, Lund University, Malmö, Sweden.
Hanna-Sofia AnderssonClinical Microbiology, Department of Translational Medicine, Faculty of Medicine, Lund University, Malmö, Sweden.
Paulo BastosDepartment of Medical and Clinical Pharmacology, Toulouse University Hospital, Toulouse, France.
Truls Michael LeegaardDivision of Medicine and Laboratory Sciences, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
Asger Nellemann RasmussenDepartment of Clinical Microbiology, Copenhagen University Hospital -, Rigshospitalet, Copenhagen, Denmark.
Kristian SchønningDepartment of Clinical Microbiology, Copenhagen University Hospital -, Rigshospitalet, Copenhagen, Denmark.
Stefan GlöcknerInstitute of Medical Microbiology, Jena University Hospital, Friedrich Schiller University, Jena, Germany.
Jürgen RödelInstitute of Medical Microbiology, Jena University Hospital, Friedrich Schiller University, Jena, Germany.
Sara Posadas-CanteraInstitute of Medical Microbiology and Hygiene, Medical Center, Faculty of Medicine, University of Freiburg, 79104, Freiburg, Germany.
Mohamed Tarek BadrInstitute of Medical Microbiology and Hygiene, Medical Center, Faculty of Medicine, University of Freiburg, 79104, Freiburg, Germany.
Tim KintzingerInstitute of Medical Microbiology, University Hospital Münster, Münster, Germany.
Frieder SchaumburgInstitute of Medical Microbiology, University Hospital Münster, Münster, Germany.
Philipp ThelenInstitute of Medical Microbiology and Virology, Carl Von Ossietzky University Oldenburg, Oldenburg, Germany.
Axel HamprechtInstitute of Medical Microbiology and Virology, Carl Von Ossietzky University Oldenburg, Oldenburg, Germany.
Anna DudakovaInstitute for Medical Microbiology, Immunology and Hygiene, University Hospital Cologne and, Faculty of Medicine, University of Cologne, Cologne, Germany.
Jonathan JantschInstitute for Medical Microbiology, Immunology and Hygiene, University Hospital Cologne and, Faculty of Medicine, University of Cologne, Cologne, Germany.
Katharina HoffmannInstitute of Medical Microbiology and Hospital Hygiene, Medical Faculty, Otto Von Guericke University Magdeburg, Magdeburg, Germany.
Achim J KaaschInstitute of Medical Microbiology and Hospital Hygiene, Medical Faculty, Otto Von Guericke University Magdeburg, Magdeburg, Germany.
Damien JacotInstitute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Gilbert GreubInstitute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Jessica LandiSection of Microbiology, Department of Medical and Surgical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy.
Simone AmbrettiSection of Microbiology, Department of Medical and Surgical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy.
Sara CominiOperative Unit of Clinical Pathology, Carlo Urbani Hospital, Ancona, Italy.
Sofia Chiatamone RanieriClinical Pathology and Microbiology Unit, G. Mazzini Hospital, ASL 04 Teramo, 64100, Teramo, Italy.
Enrica SerretielloUOS Microbiology and Virology, San Giovanni Di Dio and Ruggi D Aragona University Hospital, 84131, Salerno, Italy.
Gianluigi FranciUOS Microbiology and Virology, San Giovanni Di Dio and Ruggi D Aragona University Hospital, 84131, Salerno, Italy.
Teresa FascianaDepartment of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties G. D Alessandro, University of Palermo, 90127, Palermo, Italy.
Rogier SchadeAmsterdam UMC, Department of Medical Microbiology and Infection Prevention, Amsterdam, The Netherlands.
Erlangga YusufDepartment of Medical Microbiology and Infectious Diseases, Erasmus Medical Center, Rotterdam, The Netherlands.
Stefanie van Kleef-van KoeveringeDepartment of Clinical Microbiology, University Hospital Antwerp, Edegem, Belgium.
Sarah VandammeDepartment of Clinical Microbiology, University Hospital Antwerp, Edegem, Belgium.
Alexia VerrokenDepartment of Clinical Microbiology, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Hector Rodriguez-VillalobosDepartment of Clinical Microbiology, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Gregory StrubbeLaboratory of Medical Microbiology, Ghent University Hospital, Ghent, Belgium.
Stien VandendriesscheLaboratory of Medical Microbiology, Ghent University Hospital, Ghent, Belgium.
Pauline RabeauInstitut de Biologiedes, Service de Bactériologie Et Des Contrôles Microbiologiques, Hôpitaux de Nantes, CHU de Nantes, 9 Quai Moncousu, 44093Cedex 01, Nantes, France.
Stéphane CorvecInstitut de Biologiedes, Service de Bactériologie Et Des Contrôles Microbiologiques, Hôpitaux de Nantes, CHU de Nantes, 9 Quai Moncousu, 44093Cedex 01, Nantes, France.
Damien DuboisLaboratoire de Bactériologie-Hygiène, CHU de Toulouse, Université de Toulouse, Toulouse, France.
Pauline FlochLaboratoire de Bactériologie-Hygiène, CHU de Toulouse, Université de Toulouse, Toulouse, France.
Delphine ChainierUMR 1092, Université Limoges, INSERM, CHU Limoges, Limoges, France.
Olivier BarraudUMR 1092, Université Limoges, INSERM, CHU Limoges, Limoges, France.
Assaf MizrahiUMR 1302, INSERM, Immunology and New Concepts in ImmunoTherapy, INCITNantes Université, Nantes, France.
Célia BachoService de Microbiologie Clinique, Hôpitaux Saint-Joseph & Marie-Lannelongue, 75014, Paris, France.
Coralie BouchiatUMR 1319, Micalis Institute, Université Paris-Saclay, INRAE, Orsay, AgroParisTech, France.
Tayssir FatahLaboratoire de Bactériologie, Institut Des Agents Infectieux, Hospice Civils de Lyon, Lyon, France.
Hélène MarchandinIRD, Service de Microbiologie Et Hygiène Hospitalière, HydroSciences Montpellier, Univ. Montpellier, CNRS, CHU de Nîmes, Montpellier, France.
Vincent Jean-PierreIRD, Service de Microbiologie Et Hygiène Hospitalière, HydroSciences Montpellier, Univ. Montpellier, CNRS, CHU de Nîmes, Montpellier, France.
Saied AliDepartment of Clinical Microbiology, Royal College of Surgeons in Ireland and Beaumont Hospital, Dublin, Ireland.
Sinead O'DonnellDepartment of Clinical Microbiology, Royal College of Surgeons in Ireland and Beaumont Hospital, Dublin, Ireland.
Maeve DoyleRegional Department of Clinical Microbiology, University Hospital Waterford, Waterford, Ireland.
Zachary RamsamarooRegional Department of Clinical Microbiology, University Hospital Waterford, Waterford, Ireland.
Clarice EganDepartment of Microbiology, St Vincents University Hospital, Elm Park, Dublin, D04 T6F4, Ireland.
Sinead McNicholasDepartment of Microbiology, St Vincents University Hospital, Elm Park, Dublin, D04 T6F4, Ireland.
Kristján Orri HelgasonDepartment of Microbiology, Landspítali University Hospital, Hringbraut, Reykjavík, 101, Iceland.
Betigül ÖngenDepartment of Medical Microbiology, İstanbul, Faculty of Medicine, İstanbul University, Çapa - Fatih, 34093, Istanbul, Türkiye.
Bahar Akgün KarapınarDepartment of Medical Microbiology, İstanbul, Faculty of Medicine, İstanbul University, Çapa - Fatih, 34093, Istanbul, Türkiye.
Özlem OyardıDepartment of Pharmaceutical Microbiology, Faculty of Pharmacy, Gazi University, Ankara, Türkiye.
Burak AksuMedical Microbiology Department, Marmara University School of Medicine, Istanbul, Türkiye.
Javier Colomina-RodriguezMicrobiology Service, University Clinical Hospital of Valencia, Valencia, Spain.
Ignacio TorresMicrobiology Service, University Clinical Hospital of Valencia, Valencia, Spain.
Raul Gilarranz LuengoService of Microbiology, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas, Spain.
Maria Nieves Larrosa EscartínDepartment of Clinical Microbiology, Vall d Hebron Barcelona Hospital Campus, Barcelona, Spain.
Maria Belen Viñado PerezDepartment of Clinical Microbiology, Vall d Hebron Barcelona Hospital Campus, Barcelona, Spain.
Ana Verónica HalperinServicio de Microbiología. Hospital Universitario Ramón y Cajal and, Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), Madrid, Spain.
Rafael CantónServicio de Microbiología. Hospital Universitario Ramón y Cajal and, Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), Madrid, Spain.
Miguel SerucaDepartment of Clinical Pathology, Unidade Local de Saúde de São José, Lisbon, Portugal.
Vasco Santos MendesDepartment of Clinical Pathology, Unidade Local de Saúde de São José, Lisbon, Portugal.
Yuliya VolovetskaServiço de Patologia Clínica, Unidade Local de Saúde Santa Maria, Lisbon, Portugal.
José Melo CristinoServiço de Patologia Clínica, Unidade Local de Saúde Santa Maria, Lisbon, Portugal.
Gabriele BiancoDepartment of Experimental Medicine, University of Salento, Via Provinciale Monteroni N. 165, 73100, Lecce, Italy.
Cristina Costa *Microbiology and Virology Unit, University Hospital Città Della Salute E Della Scienza Di Torino, Turin, Italy.
Matteo Boattini *Microbiology and Virology Unit, University Hospital Città Della Salute E Della Scienza Di Torino, Turin, Italy. matteo.boattini@unito.it.ORCID https://orcid.org/0000-0001-6726-2716
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionMoraxella species are fastidious Gram-negative bacteria capable of causing opportunistic infections, including bloodstream infections, especially in immunocompromised patients. Data on their epidemiology, antimicrobial susceptibility, and phylogenomics in Europe remains limited.
methodsWe conducted a multicentre, retrospective, observational study across 56 European hospital centres between January 1st 2020 and December 31st 2024. All Moraxella species isolated from blood cultures (BCs) were included. Species distribution and antimicrobial susceptibility profiles were analysed. We also performed a phylogenomic analysis of Moraxella genomes deposited in GenBank.
resultsA total of 709 Moraxella isolates were included. Moraxella osloensis (61.1%; n = 433/709) and Moraxella catarrhalis (20.4%; n = 145/709) were the most frequently identified species, followed by Moraxella nonliquefaciens (6.5%; n = 46/709) and Moraxella atlantae (4.8%; n = 34/709). Species distribution differed by age. M. catarrhalis was predominant in paediatric patients, whereas M. atlantae was more common in adults. Most isolates showed > 90% susceptibility to amoxicillin/clavulanate, cefotaxime, fluoroquinolones, and trimethoprim/sulfamethoxazole. Cefotaxime resistance in M. osloensis was more frequent in adults than in children (49% vs. 8%, p = 0.009). Phylogenomic analysis demonstrated the distinction of a core Moraxella group from the divergent Faucicola lineage, with M. osloensis and M. atlantae clustering within the latter.
conclusionsThe epidemiology of Moraxella species from BCs in Europe showed age-group-specific differences in species distribution and generally favourable antimicrobial susceptibility patterns. Phylogenomic data corroborated recent taxonomic revisions, highlighting the need for improved diagnostics, harmonized nomenclature and sustained surveillance to inform management and stewardship of Moraxella bacteraemia.
Indexed as
Antimicrobial resistanceBloodstream infectionFaucicolaGram-negative coccobacilliMoraxellaSepsis
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