Volume 69, Issue 2, 15 July 2019

Older adults hospitalized with respiratory syncytial virus (RSV) or influenza were compared. RSV infection was associated with longer hospitalization and greater odds of pneumonia, intensive care unit admission, and 1-year mortality. Recognition of adult RSV disease is needed to facilitate future vaccination and treatment.

We documented a high prevalence of pretreatment drug resistance (PDR) among participants enrolled in trial clinics in rural KwaZulu-Natal. Dual-class PDR to a first-line tenofovir/emtricitabine/efavirenz regimen was associated with poorer virological suppression. However, there was no impact of nonnucleoside reverse transcriptase inhibitor PDR alone.

Infants aged <2 months are at greatest risk for pertussis-related hospitalization, and severe pertussis infections occur in persons of all ages. Pertussis vaccination remains the most important tool for the prevention of severe infection.

This study aimed to evaluate the association between antimicrobial stewardship with financial incentive and a reduction of antibiotic prescribing. This study shows that pay-for-performance can significantly reduce antibiotic use: specifically, the use of broad-spectrum antibiotics.

This study aimed to evaluate possible unintended clinical outcomes related to an antimicrobial program with financial incentive. This study shows that overall there was no significant association between the intervention and unintended clinical consequences in primary and secondary care.

Quantitative molecular testing of stool samples for enteropathogens from diarrheal episodes from a phase 3 rotavirus vaccine efficacy trial revealed high coinfection rates, and there was a 11.3% improvement in vaccine efficacy estimates after accounting for these coinfections.

We report xenodiagnosis results for 47 post-kala-azar dermal leishmaniasis (PKDL) and 15 visceral leishmaniasis (VL) patients. Skin parasite load was strongly associated with positive xenodiagnosis. Compared to VL (66.7%), nodular PKDL was more likely (86%) and macular PKDL less likely (35%) to result in positive xenodiagnosis.

A vancomycin-resistant enterococci outbreak occurred in a large organ transplant center and remained undetected due to limitations of conventional testing methods. Whole genome sequencing revealed a subpopulation of organisms harboring the G2576C mutation affecting 23S ribosomal RNA and conferring resistance to linezolid.

In a large cohort of preterm neonates, a Bacilli-mediated intestinal dysbiosis with a lack of anaerobic bacteria and an accumulation of fermentation products preceded the development of sepsis. These data offer potential biomarkers and therapeutic targets for prevention of sepsis.

Annual mass drug administration (MDA) with dihydroartemisinin-piperaquine over 2 years reduced the incidence of malaria infection and clinical disease, but was not sustained in eastern Gambia. Multiple MDA rounds over large areas may result in larger and sustained transmission reductions.

Frequent door openings during cardiac surgery were independently associated with an increased risk for surgical site infection (SSI). This finding warrants further study to establish a potentially causal relationship between door openings and the occurrence of SSIs.

In prevalent tuberculosis (TB), incident TB, and control samples, we evaluated 13 plasma biomarkers to identify individuals infected with human immunodeficiency virus–1 who were susceptible to active TB: biomarkers differentiated prevalent TB from control samples, but not incident TB.

A pretravel measles-mumps-rubella (MMR) vaccination could offer good value or be cost saving for travelers with a higher risk of measles exposure, especially if they are previously unvaccinated or returning to a US community with heterogeneous MMR coverage.

Using a national inpatient database, 27841 patients diagnosed with pelvic inflammatory disease were identified. Initial treatment for Chlamydia trachomatis was significantly associated with less surgical intervention and lower mortality rate by propensity score–matched analysis.

Telemedicine can virtually integrate treatment for hepatitis C virus (HCV) into the opioid substitution therapy program with virological outcomes equivalent to those in clinical trials. Analysis of psychosocial and demographic variables can also identify patients willing to pursue HCV therapy.

Long-term health-related quality of life does not significantly differ between patients surviving purpura fulminans (PF) and those surviving septic shock unrelated to PF. PF survivors who required limb amputation have an impaired long-term physical health-related quality of life but a preserved mental health.

Infectious diseases (ID) physicians perform valuable roles protecting public health, but many of their activities are poorly compensated. Compensation policy changes are needed to allow the ID field to continue to attract the best and brightest medical students and residents.

Birth cohort studies show that noroviruses are high-incidence pathogens associated with diarrhea among young children, particularly those aged ≥6 months in low/middle-income countries. Evidence for immunity and genetically determined risk factors are provided and important limitations and considerations are discussed.

The detection of Clostridium difficile in inflammatory bowel disease (IBD) patients is a common occurrence. Here, we review the epidemiology, clinical presentation, risk factors, diagnosis, treatment, and outcomes of IBD patients with positive C. difficile tests.