Volume 65, Issue 8, 15 October 2017

Mortality in patients with severe sepsis and septic shock (SS/SS) attending the emergency department (ED) is considerably high. An early bedside intervention by a dedicated infectious diseases team improves both management and outcome of patients with SS/SS attending the ED.

The mechanism of Zika virus (ZIKV)–induced microcephaly is not well understood. Studies suggest antibody-dependent enhancement (ADE) induced by dengue antibodies. ADE wasn’t observed in vivo in patients who had a dengue virus infection followed by a secondary ZIKV infection.

Cardiovascular disease (CVD) is an increasing cause of morbidity among persons living with human immunodeficiency virus (PLWH). CVD prevention strategies could offer important health benefits for PLWH and should be evaluated.

Testing for integrase inhibitor resistance at the time of HIV diagnosis, in addition to current standard-of-care genotypes, should not be recommended in treatment guidelines; our model-based analysis suggests that testing will likely result in worse clinical outcomes and increased costs.

We sought to explain the drivers of large differences in Clostridium difficile infection rates across acute and long-term care facilities. We found that facility antibiotic use and importation of C. difficile cases were strongly associated with infection rates.

Our analysis show that influenza vaccination attenuated adverse outcomes among adults that were hospitalized with laboratory-confirmed influenza during 2013−14 influenza season, a season in which vaccine viruses were antigenically similar to those circulating.

Neurospecific biomarkers were elevated in pediatric tuberculous meningitis and showed an increasing temporal profile in patients who died, whereas markers of inflammation decreased in all patients regardless of outcome. Secondary injury mechanisms initiated by inflammation likely cause ongoing brain damage.

A large cohort of Ugandans had a 3-fold lower frequency of cells latently infected with human immunodeficiency virus type 1, compared with reports in Americans, a difference not accounted for by pre–antiretroviral therapy viral set point or other demographics.

Men and women in South Africa and men who have sex with men remain at increased risk of Kaposi sarcoma compared with other human immunodeficiency virus–positive persons receiving antiretroviral therapy, probably owing to high human herpesvirus 8 coinfection rates.

We assembled a large cohort of patients from the Veterans Health Administration with bloodstream infections caused by Burkholderia cepacia complex from 1999 through 2015. We observed high mortality, high resistance rates to ceftazidime, and limited use of trimethoprim-sulfamethoxazole and ceftazidime.

During late pregnancy, rilpivirine exposure was lowered by 45%, potentially leading to subtherapy. Despite lower exposure, no perinatal transmission or virologic breakthrough was observed. Once-daily rilpivirine 25 mg may be an alternative treatment option for virologically suppressed pregnant women.

Measurement of the aerosols generated during 7 healthcare procedures showed an increase in particle concentrations over baseline only during nebulized medication administration (NMA) and bronchoscopy with NMA. Recovered bacteria were common environmental organisms.

In this self-controlled case-series analysis using bariatric surgery as an instrument of weight reduction, the risk of skin and soft-tissue infection and respiratory infection decreased significantly after bariatric surgery, whereas the risk of intra-abdominal infection and urinary tract infection increased.

Existing tuberculosis diagnostics fail to distinguish active tuberculosis from latent or cured disease. Indoleamine 2, 3-dioxygenase, an interferon γ–inducible enzyme, is a blood-based tuberculosis biomarker that performed with high accuracy in patients with human immunodeficiency virus infection.

A retrospective study of tuberculosis (TB) treatment outcome in 172 multidrug-resistant/extensively drug-resistant TB patients from Peru shows that gyrA/B resistance mutation detection is no different that culture-based fluoroquinolone drug susceptibility testing in predicting death or treatment failure.

Polymerase chain reaction analysis of rectal swabs from 127 children in rural Zanzibar, taken at time of acute diarrhea and 14 days later, indicates that children in poor settings are heavily exposed to, but rapidly clear, causative and coinfecting enteric pathogens.

Pharmaceutical companies’ declining investment in antimicrobials and the rise of resistance has led to calls for alternative business models for antibacterial drugs. This article describes the pros and cons of the various pull incentives/alternative market models that have been proposed.

We provide a community viewpoint on the risks and benefits of including pregnant women in research to address different forms of tuberculosis that includes recent examples of progress in this area and recommendations for researchers, regulatory authorities, ethics committees, and policymakers.

Findings of randomized controlled trials and robust quasi-experimental and epidemiological studies suggest likely benefits of influenza vaccination for persons with asthma, with reductions in influenza infection, respiratory illness, asthma attacks, and emergency department visits and hospitalizations for influenza-related asthma complications.

Patient care items can be contaminated with healthcare-associated pathogens and serve as a fomite in healthcare facilities. We review the role of patient care items as a fomite and prevention of fomite-related healthcare-associated outbreaks.