Volume 65, Issue 9, 1 November 2017

Between 1993 and 2014, only 25% of pediatric tuberculosis (TB) cases in the United States had culture-confirmed TB. Among those with culture-based drug susceptibility test results, 82 (1.7%) had multidrug-resistant TB. Most completed treatment (88%) despite extensive first- and second-line drug resistance.

HIV infection increases the risk of developing tuberculosis (TB), but our understanding of HIV’s impact on risk of mortality for children treated for TB is limited. We aimed to identify predictors of mortality in children treated for drug-susceptible TB.

Endothelial dysfunction/reduced nitric oxide bioavailability is associated with worse plasma leakage in dengue patients and occurs early in the course of the disease. Endothelial dysfunction correlates with lower plasma l-arginine and higher arginase-1 levels.

We recorded prospective data from 23 patients with Guillain-Barré syndrome (GBS) with proof of recent Zika virus infection. These new patients were old in age and had severe GBS. Arbovirus RNA detection is useful for GBS cases management.

Local implementation of national guidelines in pediatric emergency departments can substantially modify antibiotic prescribing habits, reducing both the antibiotic prescription rate for acute respiratory tract infection and broad-spectrum antibiotic use.

Viral metagenomic surveillance of 187 patients with indeterminate acute liver failure (ALF) from 1998 to 2010 suggests that these patients should be screened for the presence of uncommon viruses and coinfections, although novel viruses associated with ALF were not identified.

Among 431 patients over a 20-year period, with unchanged long treatment delay of 24 days throughout the study period, 15% of patients had negative serum Borrelia antibodies and 28% suffered from residual symptoms after treatment.

Age, historical plasma viral load, and prior ART regimen changes were independently associated with increased hazard of CD4 decline and death while off ART. ART reengagement interventions need further development and may consider prioritizing individuals with these poorer prognostic factors.

Mycoplasma spp may be a significantly underappreciated cause of donor-derived infection, and are difficult to detect via routine laboratory methods. Diagnosis of infection by Mycoplasma spp is important as routine posttransplant antibiotics, typically β-lactams, are not effective against species of this genus.

This prospective study examined the accuracy of a rapid diagnostic test (RDT) to distinguish severe from uncomplicated malaria. We found that a histidine-rich protein-2+/pan-lactate dehydrogenase+ RDT result has high sensitivity (97.6%) for the detection of severe malaria and significantly outperformed existing algorithms.

Routine diagnostic measures are unreliable for diagnosis of Plasmodium malariae; thus, polymerase chain reaction utilization should be considered on admission. Furthermore, prophylaxis appears to have a delaying effect on P. malariae symptoms, similar to its effect on the relapsing species.

A single skin infection in group AStreptococcus–endemic settings induced a significant immune response in 38% of children. Cross-reactive immune responses occurred after skin infections. These cross-reactive responses frequently aligned withemm clusters.

This study describes population-based estimates for quantifying influenza disease burden, health utilization patterns among participants of all ages, and seasonality in different climactic regions. Findings will help place global influenza burden of disease models into better context by providing case-based incidence.

Statin initiators have a lower risk of acute liver injury events and death compared to statin nonusers, regardless of HIV and/or chronic hepatitis C virus infection status.

High plasma IL-5 and IL-7 levels pre–antiretroviral therapy commencement predict cryptococcosis-associated immune reconstitution inflammatory syndrome (C-IRIS) in a case-control study of cryptocococcal meningitis. These data highlight the role of systemic IL-5/IL-7–related immune dysfunction in the pathogenesis of C-IRIS.

World Health Organization Integrated Management of Child Illness guidelines should consider the following revisions for children with chest indrawing pneumonia: referral or daily monitoring with signs of severe respiratory distress, oxygen saturation <93%, moderate malnutrition, or unknown HIV status (when HIV endemic).

Multiple antibiotics listed use in the Severe Sepsis/Septic Shock (SEP-1) Management Bundle in the Center for Medicare and Medicaid Services’ Hospital Inpatient Quality Reporting Program are not appropriate. We provide recommendations for appropriate antibiotics to be utilized in SEP-1.

Parainfluenza virus (PIV) has not been well studied in the hospitalized adult. PIV infection in hospitalized adults manifests across a wide spectrum, from asymptomatic to severe pneumonia. New treatments are promising, and development of a vaccine is underway.

Literature on operating room attire cites air sampling and environmental culture without evidence regarding surgical site infection risk. Evidence is limited to use of sterile gowns and gloves. Naked surgeons shed fewer bacteria into the operating room environment than those wearing scrub suits.