Volume 65, Issue 7, 1 October 2017

In this pragmatic multicenter prospective evaluation, introducing β-lactam allergy skin testing at the point of care across 3 hospital antimicrobial stewardship programs resulted in greater use of preferred β-lactam therapy without increasing the risk of adverse drug reactions.

Influenza vaccination during pregnancy decreased the incidence of acute lower respiratory tract infection hospitalizations in infants born to vaccinated mothers. The benefits of protecting against influenza virus infection during early infancy might extend beyond protecting only against influenza-confirmed illness.

Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) CC398 was an increasing cause of bacteremia in Denmark during 2010–2015. Most patients lived in rural areas but had no contact to livestock. Whole-genome sequencing supported that Danish pigs are the most likely source of human LA-MRSA CC398 infections.

The treatment success rate of macrolide-containing regimens was relatively poor with a high default rate, although they had been considered to bring therapeutic advances in the treatment of Mycobacterium avium complex lung disease.

A regimen of 12 weekly doses of directly observed isoniazid and rifapentine (3HP) was well tolerated, with low rates of discontinuation due to adverse drug reactions, and high completion rates among diverse patient cohorts. Completion rates for 3HP in routine healthcare settings were greater than reported from clinical trials and historically observed using other regimens.

The measles elimination goal may require a careful balance between earlier infant protection and the risk of reduced antibody responses and secondary vaccine failure among successive birth cohorts systematically initiated to measles vaccine <15 months of age.

DNA methylation analysis on global gene expression in myocardial samples from patients with end-stage chronic Chagas cardiomyopathy leads to the identification of novel potential disease pathways and therapeutic targets linked to electrical conduction or immune response modulation.

Two MenB-4C doses are recommended based on studies of serum bactericidal antibody using reference strains. Against 4 college outbreak strains, 53%–93% of students had protective titers at 1 month, which decreased to 31%–86% at 7 months. A booster dose may be required to increase duration of protection.

Investigation of an outbreak of Pneumocystis jirovecii infections in 7 heart transplant recipients revealed interhuman transmission of a single strain with documented failure of prophylaxis by atovaquone.

Transmission dynamics of HIV-1 in Kiev were investigated using phylogenetic analysis of pol sequences from recently diagnosed individuals. This revealed bridging between the 3 key populations, and evidence that the sexually transmitted HIV epidemic in Kiev is becoming self-sustaining.

What is the etiology of disseminated infection with bacille Calmette-Guérin (BCG) in patients without previous intravesical BCG administration? The study supports the presence of iatrogenic, catheter-related infection by BCG due to nosocomial contamination with subsequent development of disseminated BCG infection.

We describe the substantial impact of rotavirus vaccine introduction on all-cause and rotavirus diarrhea admissions to a rural Tanzanian referral hospital. Despite this impact, rotavirus remained the leading etiology of diarrhea requiring hospitalization in the third year after vaccine introduction.

Mycoplasma hominis surgical site infections occurred in recipients of an amniotic tissue product. Mycoplasma hominis was found in an unopened vial of product. A multistate investigation to track the product was limited by the lack of a standardized tissue tracking system.

This article describes the epidemiologic methods used to identify a duodenoscope-related outbreak due to multidrug-resistant Klebsiella pneumonia.

The incidence of cellulitis is highly seasonal, and this seasonality may be explained by changes in the weather, specifically, temperature. At population level, admissions to the hospital for cellulitis risk are strongly associated with warmer weather.

In adults with autoimmune disease receiving immunosuppressive therapy, inactivated zoster vaccine was well-tolerated and elicited statistically significant varicella-zoster virus–specific immune responses approximately 28 days post-dose 4, measured by glycoprotein enzyme-linked immunosorbent assay and interferon-gamma enzyme-linked immunospot.

We conducted the present trial to test whether early BCG-Denmark reduces mortality rate in low-weight (LW) neonates. We found that early administration of BCG-Denmark in LW infants is associated with major reductions in mortality rate.

We compared children with 7-valent (PCV7) and 13-valent (PCV13) pneumococcal conjugate vaccine failure in the UK. Vaccine failure was rare; those with PCV13 failure were more likely to be healthy and to develop lower respiratory tract infection with empyema.

Nearly one-third of hospital admissions included a urine culture, with 20% of those admissions having >1 urine culture sent during the hospital stay. Female patients received more urine cultures than male patients regardless of admission, diagnosis, or age.

While a novel regimen for multidrug-resistant tuberculosis has the potential to dramatically improve outcomes, it is imperative to couple recommendations for any novel antimicrobial regimen with corresponding guidance on drug susceptibility testing. We propose a specific, scientifically principled path forward.

Typing studies suggest very few cases of hospital-onset Clostridium difficile infection are acquired from other patients. This suggests most are due to activation of latent C. difficile present on admission or new transmissions from asymptomatic patients. We consider implications for infection control programs.