Volume 67, Issue 6, 15 September 2018

In Cambodian villages, 3-month mass drug administration with high coverage using dihydroartemisinin-piperaquine was safe and was followed by the absence of clinical Plasmodium falciparum cases for at least 1 year, despite the presence of multidrug-resistant parasites.

A broader clinical suspicion of Buruli ulcer should be recommended to improve accuracy of its clinical diagnosis. Taking into consideration diagnostic accuracy, time to results, cost-effectiveness, and clinical generalizability, a stepwise approach reserving polymerase chain reaction to microscopy-negative patients performed best.

We sampled 651 recently admitted nursing facility patients and collected clinical and microbiological data over 1629 visits. We found that more than 57% were colonized with 1 or more multidrug-resistant organisms on enrollment, and 56% were colonized at discharge from the facility.

An outbreak of hepatitis C virus at a hospital was associated with drug diversion by a healthcare worker. Healthcare facilities and public health must work together to create proactive, comprehensive approaches to prevent, detect, and respond to drug diversion events.

Genomic surveillance for 2 years revealed that 11 of 12 late-onset group B streptococcus (GBS) infections in one neonatal intensive care unit were linked to ≥1 other GBS case, suggesting that even isolated late-onset GBS cases represent probable nosocomial transmission.

Surveillance for antimicrobial-resistant organisms in nursing facilities is critically important but challenging. We developed simple panels of environmental sites that can be used as a proxy for determining nursing facility patient methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus colonization.

In hepatitis C virus infection, the progression of the clinical stage is associated with gut dysbiosis, even if patients are asymptomatic. Overgrowth of viridans streptococci can contribute to the production of ammonia in chronic hepatitis and liver cirrhosis.

Invasive Haemophilus influenzae disease has increased, particularly due to nontypeable strains and serotype a. A considerable burden of invasive H. influenzae disease affects the oldest and youngest age groups, particularly American Indian and Alaska Native children.

This investigation linked a multistate outbreak of Salmonella Virchow infections to a raw powdered meal replacement product. It highlights the complex nature of food safety and potential risks with similar products not intended to be cooked by consumers before consuming.

Attenuated vaccine effectiveness was observed against both medically attended influenza A and B caused by repeated trivalent inactivated influenza vaccine (TIV) immunization. Significant dose-dependent association was found between the degree of attenuation and the number of prior TIV vaccinations.

In a prospective genomic surveillance study of liver transplant patients, we found that temporal dynamics differed between multidrug-resistant organisms with respect to onset of intestinal colonization, clearance, and infections. Whole-genome sequencing revealed an unexpected diversity of carbapenem-resistant Enterobacteriaceae.

Investigation of atovaquone prophylactic treatment failures during a Pneumocystis infection outbreak in heart transplant recipients revealed a cytochrome b mutation associated with a modification of the protein structure on the binding site of the atovaquone, according to in silico mutagenesis.

Lumbar puncture in bacterial meningitis is only very rarely complicated by cerebral herniation. The interrater reliability of the assessment of contraindications for lumbar puncture on cranial computed tomography is moderate.

Using change point analysis, this study showed that even after long-term successful antiretroviral therapy in human immunodeficiency–infected patients with suppressed viremia, the CD4 cell count, CD4 percentage, and CD4/CD8 ratio did not recover to levels seen in healthy individuals.

Sofosbuvir/velpatasvir (SOF/VEL) may be administered with atazanavir, cobicistat, darunavir, dolutegravir, efavirenz (EFV), elvitegravir, emtricitabine, lopinavir, raltegravir, rilpivirine, ritonavir, tenofovir alafenamide, or tenofovir disoproxil fumarate without dose adjustment. Use of SOF/VEL with EFV is not recommended.

This article describes the contributions of Village Polio Volunteers, a community-based program, to strengthening acute flaccid paralysis surveillance activities in Somalia, in furtherance of global efforts to eradicate polio.

We directly compared the performances of 2 commonly used syphilis screening algorithms to determine the optimal serological syphilis screening algorithm. Moreover, we also analyzed the meaning of isolated reactive results, which exists in both algorithms and has raised much confusion in interpretation.

In a cohort of young black men who have sex with men, we observed high human immunodeficiency virus incidence despite education and access to preexposure prophylaxis (PrEP). Although PrEP has efficacy in clinical trials, we identify barriers to real-world effectiveness.

With the dual threat of increasing antimicrobial resistance and decreasing numbers of novel antimicrobial agents, biomarkers such as procalcitonin and proadrenomedullin may have a role in guiding antimicrobial therapy and limiting excessive use of antimicrobials in immunocompromised patients with cancer.