Volume 71, Issue 12, 15 December 2020

Children with perinatally acquired HIV (PHIV) in Uganda have evidence of cardiovascular disease risk and structural vascular changes despite viral suppression with antiretroviral therapy. Intestinal barrier dysfunction may be involved in the pathogenesis of subclinical vascular disease in this population.

Among hospitalized patients treated for bacterial pneumonia who achieved clinical cure, microbiologic treatment failure was independently associated with recurrent pneumonia or death.

BK polyomavirus (BKPyV) viremia, whether symptomatic or not, is associated with morbidity and mortality after hematopoietic cell transplantation. Detectable BKPyV-specific T cells, but not cidofovir, are associated with clearance of viremia. This suggests potential benefits in screening for asymptomatic viremia.

Rifampicin can be given as flat-dosing instead of current weight-band dosing. Clinical trial simulations revealed that weight-band dosing results in a small and not clinically relevant decrease in variability in AUC_0–24h between patients compared to flat-dosing.

Recent influenza A(H3N2)v outbreaks in humans were caused by emerging viruses from cluster 2010.1. This study demonstrated that existing A(H3N2)v and seasonal vaccination may not provide sufficient heterologous antibody responses against these viruses, and children remain vulnerable to A(H3N2)v infections.

We evaluated outcomes of patients receiving shorter (5–9 days) versus longer (10–15 days) antibiotic treatment durations for transient bacteremia associated with common infections and did not find a statistically significant difference between groups in a composite outcome of clinical failure.

Baseline 10-year cardiovascular risk scores predicted future cognitive function in older persons living with well-controlled HIV. Cardiovascular risk scores may help to identify individuals, especially women, with HIV who are at risk for worse cognition over time.

The number of cases of severe hand, foot, and mouth disease (HFMD) and enterovirus 71 (EV71) declined by an estimated 52% and 60%, respectively, following initiation of a pediatric EV71 immunization program in Chengdu, China.

We investigated preexisting neutralizing and neuraminidase inhibition (NAI) antibody titers and the odds of H3N2 influenza infection during an outbreak among unvaccinated military recruits. Neutralizing and NAI titers independently decreased the odds of infection with every 2-fold increase in titer.

Baseline patient and pathogen characteristics including prescribed antibiotics can identify patients at risk for subsequent bloodstream infections caused by resistant bacteria. Moreover, by altering the initial treatment, we may be able to prevent subsequent resistance emergence.

Newly diagnosed patients with human immunodeficiency virus-1 (HIV-1) infection rapidly initiating treatment with darunavir/cobicistat/emtricitabine/tenofovir alafenamide demonstrated high rates of virologic suppression, few grade 3–4 and serious adverse events, no postbaseline HIV-1 resistance-associated mutations, and high treatment satisfaction after 48 weeks.

Only at baseline were Lyme disease patients more likely to be symptomatic than matched controls. A biomarker to distinguish the long-term symptoms that are attributable to having had Lyme disease from symptoms of another cause would be desirable.

This open-label randomized controlled trial shows that weekly oral cyclic antibiotic prophylaxis (alternate administration of 2 different antibiotics) is efficient in preventing recurrent urinary tract infections in patients with neurogenic bladder due to spinal cord injury and well tolerated.

NAT2 genotyping to personalize tuberculosis treatment has previously been shown to reduce hepatotoxicity and improve culture conversion rate. We show that routine use of NAT2 genotyping would be highly cost-effective in Brazil, South Africa, and India.

This study provides the first evidence of an association between increasing pre-exposure prophylaxis coverage and decreasing HIV diagnoses at the state and national level in the United States when controlling for changes in viral suppression rates.

The coronavirus disease 2019 (COVID-19) signature composed of 5 indicators (neutrophil count, lymphocyte count, procalcitonin, older age, and C-reactive protein) was an effective prognostic biomarker that could provide risk assessment and predict the survival probability of patients with COVID-19.

A unique COVID-19 line-list database comprising 1407 transmission pairs that formed 643 clusters in mainland China outside Hubei province was reconstructed to estimate superspreading events, serial intervals, and hazard of infection for household vs nonhousehold settings.

We found that a single dose of tocilizumab 400 mg given intravenously for compassionate use in 27 patients with severe SARS-CoV-2 pneumonia appeared to offer benefits in reducing inflammation, oxygen requirements, vasopressor support, and mortality.

Swedish public health responses to coronavirus disease 2019 (COVID-19) were analyzed using individual-based modeling. Partial voluntary self-isolation explains the reported mortality rate. Intensive care utilization is lower than anticipated and age-skewed, suggesting that additional care could benefit older adults.

Healthcare personnel with occupational high-risk exposure to COVID-19 were at increased risk for serious morbidity, healthcare seeking, hospitalization, and absenteeism. Our findings justify the 7-day exclusion from work policy for healthcare personnel with high-risk exposure.

Females had less critical illness and experienced a lower mortality rate than males. Sex was still a prognostic risk factor even adjusting for age and coexisting diseases, and risk factors associated with mortality varied among male and female populations.

RT-PCR testing of all staff reduces the risk of workplace transmission the most, but at increased staff shortages and testing resource needs. Testing staff in quarantine allows some staff to return to work but at slightly increased risk of workplace transmission.

From 4 March to 10 April 2020, Northwell Health Laboratories identified SARS-CoV-2 in 26 735/46 793 tested persons; these data provide detailed insights into the demographics, geographic spread, and delivery of healthcare for SARS-CoV-2 in the New York area.

Human immunodeficiency virus (HIV) status is independently associated with elevated fraction of exhaled nitric oxide levels, suggesting increased eosinophilic airway inflammation that may contribute to the excess risk of chronic pulmonary diseases in people living with HIV.

Pediatric patients are excluded from most COVID-19 therapeutic trials. We outline a rationale for the inclusion of children in COVID-19 therapeutic trials, which enabled us include children of all ages in a therapeutic COVID-19 trial at our institution.

Medicare does not reimburse for home infusion; patients requiring outpatient parenteral antimicrobial therapy must seek treatment in high-risk settings. We recommend policy change to allow for adequate social distancing during the coronavirus disease 2019 pandemic and the increased risk of severe illness in this population.

Although delamanid resistance has been reported in both in vitro and clinical Mycobacterium tuberculosis isolates and mutations conferring delamanid resistance have been identified in fbiA, fbiB, fbiC, ddn, and fgd, there remains no standardized drug susceptibility testing method, and knowledge about clinically relevant molecular resistance mechanisms is limited.