Volume 70, Issue 6, 15 March 2020

Time trends in the incidence of herpes zoster in the US population during 1991–2016 do not support the exogenous boosting hypothesis, which predicted a transient increase in the incidence in adults following the start of universal childhood varicella vaccination.

United States health insurance claims data show that histoplasmosis is associated with a wide spectrum of illness and a substantial burden for some patients. Low targeted testing rates suggest incidental diagnoses and low provider suspicion for histoplasmosis.

Use of dried specimens can increase the number of patients accessing viral load (VL). Adopting partial use of dried specimens will help achieve improved VL access for patients at a lower cost per correct result than complete adoption of dried specimens.

In population-based invasive Staphylococcus aureus (SA) infection surveillance in five U.S. states, methicilin-susceptible SA (MSSA) incidence was 1.8 times higher than methicillin-resistant SA and accounted for most deaths. Public health and infection control prevention and surveillance priorities should include MSSA.

Live-attenuated influenza vaccine (LAIV) studies have found effectiveness ranging from 0–50%. Using mathematical models we show that this can be the result of negative interference and LAIV will not be immunogenic for broad regimes. We make suggestions for optimally choosing vaccine strains.

After adjustment for patient- and treatment-specific time varying factors, there was no significant difference in 28-day survival among patients with Ebola virus disease treated with intravenous fluid compared with those not treated with intravenous fluid in a low-resource setting.

We developed a severity score for childhood pneumonia cases presenting to hospital and compared its ability to predict mortality with other tools. The findings reinforce the utility of World Health Organization danger signs and pulse oximetry for clinical management of pneumonia cases.

Between 2008 and 2018 an increase in IgM−/IgG+ measles cases was observed in Victoria, Australia. The 13 cases identified were commonly vaccinated men with attenuated illnesses, low viral loads, and high IgG titers. Onward transmission was documented from 1 case.

Despite high adherence to clinical guidelines, inappropriate antibiotic treatment is frequent in high-risk neutropenic patients with bacteremia caused by multidrug-resistant gram-negative bacilli. Improving empirical treatment is the only modifiable factor to improve outcomes in patients with Pseudomonas aeruginosa bacteremia.

Thirty-three quality indicators (QIs) for optimal outpatient parenteral antimicrobial therapy (OPAT) care were developed by international experts using a systematic review and a RAND-modified Delphi procedure. These QIs can be used to assess and improve the quality of care provided by OPAT teams.

We compared markers of innate and acquired immunity in adults with symptomatic Clostridioides difficile infection (CDI), asymptomatic carriage, or non-CDI diarrhea. We found markers that distinguish CDI from all other groups, suggesting utility for identifying patients with true clinical CDI.

Based on model predictions, proactive implementation of syringe services programs has the potential to avert more HIV infections in a rural county in the United States than if the programs were implemented reactively after the detection of an outbreak.

This is the first comparative safety study of ototopical fluoroquinolones for treating acute otitis externa in real-world clinical practice. Our findings reinforce the notion that risk-benefit of quinolone ear drops should be carefully evaluated.

There was a 90% risk reduction of late-onset disease when young infants were fed breast milk with natural group B Streptococcus secretory immunoglobin A serotype Ia and III capsular antibody concentrations ≥0.14 µg/mL and ≥2.52 µg/mL, respectively

Women with sexually transmitted infection (STI) were at risk for acquiring HIV, but their risk was not high enough to make preexposure prophylaxis cost-effective for them. Most women diagnosed with HIV did not have previously reported STI.

Markers of anal precancer, anal high-grade squamous intraepithelial lesions (A-HSILs), were assessed in women from the Atlanta Women’s Interagency HIV Study cohort. Anal high-risk human papillomavirus and cervical methylation of FAM19A4 or miIR124-2 had >6-fold increased odds of A-HSIL and are promising noninvasive screening strategies for anal cancer.

Transgender women (TW) experience challenges with retention in human immunodeficiency virus (HIV) care. However, TW who are engaged in care achieve viral suppression that is comparable to that of cisgender women and cisgender men of similar age, race, and HIV risk group. Further research is needed to understand care engagement disparities.

Detailed virological analyses of 180 Indonesian patients infected with avian influenza A/H5N1 virus point to potential differences in virulence and antiviral responses to oseltamivir that may explain the exceptionally high mortality related to these infections in Indonesia compared to other regions.

Sputum multiplex polymerase chain reaction showed a high prevalence of probable bacterial infections in human immunodeficiency virus-infected inpatients with World Health Organization danger signs and cough. Coinfections with tuberculosis, Pneumocystis jirovecii, and viruses were common, but there are no accepted cutoffs for diagnosing respiratory viral infections.

In a large cohort of patients with hepatitis C virus, the incidence and risk of subsequent diabetes was significantly lower for those using directly acting antiviral agents therapy. Treatment benefits were more pronounced in persons with more advanced liver fibrosis.

In children with cerebral malaria, severe disease and blood–brain barrier breakdown were associated with increased admission concentrations of cerebrospinal fluid tau, a marker of axonal injury, which were in turn associated with long-term neurologic and cognitive impairment.

Commensal oropharyngeal Neisseria species show increased minimum inhibitory concentrations to extended-spectrum cephalosporins in recent antibiotic users and may be an important source of antibiotic resistance in pathogens such as N. gonorrhoeae.

Among various CD4 or human immunodeficiency virus (HIV) RNA measures, nadir and cumulative CD4 were the best predictors for anal cancer risk, suggesting a key role for severe, prolonged HIV-induced immunosuppression in anal carcinogenesis. Early antiretroviral therapy may help prevent anal cancer.

This propensity score–matched, nationwide cohort study, including patients from 1977–2015, shows that patients with a history of infective endocarditis had an increased risk of ischemic stroke for up to 2 years after the endocarditis diagnosis, compared to controls.

Our randomized dose-finding trial of 290 adolescents in Tanzania found that a moxidectin-albendazole combination is superior to moxidectin alone for curing Trichuris trichiura and hookworm infections. A flat, dose-response relationship was observed for both treatments.

Adults aged ≥65 years with pulmonary tuberculosis have less-advanced disease but a higher risk of complications during treatment such as death or adverse events. This effect was most pronounced among those aged ≥75 years.

By evaluation with the FIB-4 index, the percentages of patients with mild fibrosis and advanced fibrosis increased and decreased, respectively, after sustained virologic response (SVR), whereas the risk of hepatocellular carcinoma after SVR by the degree of fibrosis was constant over time.

A laboratory screening algorithm using total white blood cell and platelet count cutoff values can be used to rule out anaplasmosis and reduce overutilization of Anaplasma polymerase chain reaction testing, even when disease incidence is relatively high.

Sexually transmitted infections have been increasing among men who have sex with men. Doxycycline prophylaxis for syphilis and chlamydia has been effective in initial trials. Future research should focus on populations with high incidence/morbidity, dose and regimen, and antimicrobial resistance.