Volume 10, Issue 8, August 2023

Pneumococcal carriage among older adults in Denmark decreased following the COVID-19 lockdown and increased to prepandemic levels after the reopening of society.

Non-nosocomial healthcare-associated infective endocarditis (HCIE) occurs when patients acquire the infection outside the hospital but following contact with the healthcare system. Our data showed that HCIE affects many patients, has high mortality, and shares many similarities with nosocomial infective endocarditis.

Antibiotic exposure is the primary risk factor for clostridioides difficile infection, but the level of risk varies across different antibiotics. This study estimates and compares the risk for community-associated clostridioides difficile infection across 27 different individual antibiotics.

We present high-performing parsimonious risk scores to estimate the risk of nonsusceptibility to trimethoprim-sulfamethoxazole, fluoroquinolone, nitrofurantoin, and third-generation cephalosporin among adult outpatients with complicated urinary tract infections based on variables commonly available on clinical presentation.

In people living with human immunodeficiency virus , levels of anti–receptor-binding domain immunoglobulin G were higher after a booster vaccine, dose with no increase in the cellular immune response.

The study evaluated the safety, tolerability, and adherence of doravirine/lamivudine/tenofovir disoproxil fumarate as a single-tablet regimen for nonoccupational HIV-1 postexposure prophylaxis in 399 individuals. Results showed noncompletion rates of 29% and 20% (intention-to-treat [ITT] and modified ITT).

We provide an overview of the ill-studied field of melioidosis histopathology. Fatal melioidosis presents with necrosis and suppuration and usually without giant cell formation. We show pathogen-specific staining to be useful in establishing a diagnosis in clinically difficult-to-diagnose cases.

The incidence of septicemia and UTI were high within 90 days after CDI. The risk of septicemia was highest after hospital-onset CDI and lowest after community-associated CDI, whereas UTI risk was more uniform across CDI surveillance categories.

People who inject drugs experience a disproportionate burden of COVID-19. Leveraging community and academic expertise and confidence in peers and syringe services programs, this pilot randomized controlled trial evaluated the efficacy of a novel intervention to increase COVID-19 vaccination among people who inject drugs.

This study evaluates the impact of infectious diseases consultation via telemedicine with an established antimicrobial stewardship program on in-hospital mortality in patients with candidemia. Infectious diseases consultation via telemedicine coupled with antimicrobial stewardship can improve outcomes and should be considered for all patients with candidemia at resource-limited sites.

Screening for LTBI in SOT patients is widely recommended. This meta-analysis looked at the predictive value of TST and IGRA for active TB. We found both have a high negative predictive value but neither has a high positive predictive value.

Single and multiple ascending PF-07304814 (lufotrelvir) infusions were generally safe and well tolerated in participants hospitalized with COVID-19. Unbound concentrations of the lufotrelvir active metabolite reached steady state approximately 2- and 4-fold that of in vitro EC₉₀ following 250 and 500 mg/d, respectively.

Examining incidence trends adjusted for the adoption of culture-independent diagnostic testing highlights that trends have remained stable or decreased overall and among subpopulations, whereas resistance to antimicrobials recommended for treatment has increased.

The visceral adiposity index (VAI) is associated with visceral adiposity and is higher among persons with HIV (PWH) with coronary plaque. The VAI may be a useful clinical score to predict increased cardiovascular disease risk that may occur with visceral fat accumulation in PWH.

In lung and heart transplant recipients, antibody responses to severe acute respiratory syndrome coronavirus 2 vaccination are diminished and delayed. Responses are markedly improved with a third vaccine dose, but this improvement is undermined by decreased neutralization against Omicron variants.

We evaluated the real-world impact of a multiplex polymerase chain reaction pneumonia panel on antibiotic de-escalation in critically ill patients with pneumonia at an academic medical center. Antibiotic use decreased, although this pilot study was underpowered to demonstrate significant differences.

We found significantly greater improvements in mental, physical, and overall health-related quality of life in patients with recurrent Clostridioides difficile infection treated with fecal microbiota, live-jslm (REBYOTA [RBL]) than in placebo-treated patients in a randomized, placebo-controlled trial (PUNCH CD3).

Sotrovimab administered intramuscularly at 500 mg was noninferior to 500 mg administered intravenously for treatment of mild/moderate COVID-19 in patients at high risk, as measured by all-cause hospitalization >24 hours or death through day 29, and it was well tolerated. Intramuscular sotrovimab should provide easier outpatient access to COVID-19 treatment.

• People with HIV and SARS-CoV-2 were more likely to be young, Hispanic White or African American, Southern, uninsured, and overweight and have comorbidities.

• People with HIV who had worse outcomes were older, uninsured, underweight, and a current smoker and had comorbidities, unsuppressed viral load, low CD4 count, and no antiretroviral therapy.

Disseminated infection and immunocompromised status were not associated with 1-year mortality after nocardiosis, while advanced infection (dissemination, pulmonary cavitation, and/or pleural involvement) and Nocardia farcinica were significant associations. Microbiologic characteristics and infection phenotype should be considered in patients with nocardiosis.

A modeling analysis showed that MF59-adjuvanted trivalent inactivated influenza vaccine averted 1.72 to 3.44 times as many symptomatic cases and complications as a generic quadrivalent vaccine over 3 influenza seasons in adults ≥65 years of age.

Options are limited for people with HIV and persistent viremia due to adherence barriers. This model-based analysis supports that long-acting, injectable antiretroviral therapy (ART) with effective support services is likely to improve viral suppression and survival outcomes substantially compared with oral ART.

A 10-valent extraintestinal pathogenic Escherichia coli (ExPEC) vaccine was well tolerated and demonstrated a robust functional antibody response against all but 1 serotype. The high dose was selected as optimal, and a reformulated 9-valent ExPEC vaccine is in development as a potential prophylactic vaccine against invasive ExPEC disease.

In this multicenter retrospective cohort study, we observed that among patients hospitalized with COVID-19, those treated with baricitinib had more favorable respiratory improvement by day 7 when compared with tocilizumab, but no differences were observed up to day 28.

Minocycline is well tolerated, inexpensive, and widely accessible and has 67% efficacy for the treatment of macrolide-resistant Mycoplasma genitalium.

Among nonhospitalized individuals, we found evidence to support the association of viral RNA load and infectious virus on some, but not all symptoms. Fever was most strongly associated with infectious virus, supporting the potential for symptom-based isolation guidance for COVID-19.

A decrease in the cytomegalovirus (CMV)–specific T-cell responses during the first month after transplant may predict the development of clinically significant CMV infection and be associated with all-cause mortality in recipients of allogeneic hematopoietic cell transplant who are CMV seropositive.

Children aged 5–11 years with higher antibody levels 14–59 days after a second dose of the Pfizer-BioNTech coronavirus disease 2019 messenger RNA had a lower incidence of postvaccination severe acute respiratory syndrome coronavirus 2 infection. Results were consistent when measured via antibody response or antibody neutralization.

The presence of severe acute respiratory syndrome coronavirus 2 nucleocapsid antigen in blood is an early indicator of coronavirus disease 2019 infection and infectious viral shedding. Sensitive assays provide suitable methods for viable screening and laboratory diagnostic tests in different clinical and research settings.

This article adressess an existing research gap by investigating global prevalence of chronic pain in women with HIV. Better understanding of chronic pain in this population is critical in light of its interplay with HIV care, general well-being, and aging.

This scoping review found that the most commonly reported factors affecting chlamydia and gonorrhea testing uptake among female sex workers are stigma and discrimination, social support, and financial barriers.

The Penn Medicine COVID-19 Therapeutics Committee served as a forum for rapid evidence review and the production of dynamic practice recommendations during the pandemic. We describe how the committee went about its work and how it navigated specific challenging scenarios.

Receipt of antibacterials prior to and during hospital admission was common within 2 large cohorts of febrile inpatients in northern Tanzania. While guideline-consistent prescribing improved over time, a large proportion of participants with bloodstream infection received ineffective antibacterials.