Volume 6, Issue 4, April 2019

Preexposure prophylaxis (PrEP) users in primary care continued PrEP for a median of 8 months. Transgender women experienced higher risk of early discontinuation; younger users experienced late discontinuation. Missed visits during PrEP are associated with discontinuation and should trigger outreach.

This population-wide cohort study highlights the phenomenon of unexpected deaths due to infectious disease, with respect to the key pathogens involved, the most prominent clinical syndromes, characteristics of those who died, and opportunities and challenges for prevention.

The impact of unsolicited antimicrobial stewardship initiated prospective audit and feedback using a standardized Staphylococcus aureus bacteremia management bundle was evaluated. Adherence to evidence-based recommendations was significantly improved with this simple yet effective intervention.

With both liver biopsy (LB) and transient elastography (TE) with controlled attenuation parameter (CAP), advanced fibrosis was more associated with moderate-severe steatosis in patients with hepatitis C virus (HCV) monoinfection than in those with human immunodeficiency virus (HIV)/HCV coinfection. In patients with chronic hepatitis C undergoing liver fibrosis staging, steatosis was detected more often with CAP than with LB, with median CAP scores higher in HCV monoinfection than in HIV/HCV coinfection. A histopathologic finding of steatosis was not reported in >25% of LBs in this clinical setting. The severity of steatosis may be increasing in the modern HCV treatment era.

In this randomized, double-blinded, placebo-controlled phase 2B trial, prevention of recurrent Clostridioides difficile infection with RBX2660 was associated with restorative microbiome changes implicated in resisting C. difficile colonization and recurrence. RBX2660 is more effective than placebo at restoring participant microbiomes.

In hospitalized HIV-infected patients in Uganda, empiric antituberculosis therapy was associated with improved survival among patients with severe sepsis.

Decreasing proton pump inhibitor use and preventing inappropriate antibiotic initiation are modifiable targets to decrease in-hospital vancomycin-resistant Enterococcus (VRE) transmission. Colonization pressures from patients identified as carriers and placed in contact precautions does not increase the odds of VRE acquisition.

Our results demonstrate that sitafloxacin (STFX) may be effective in one-fourth of patients with refractory Mycobacterium avium complex lung disease. Surgery, low minimum inhibitory concentration of STFX, and clarithromycin resistance were predictors of negative sputum culture conversion.

In the country of Georgia, long-term outcomes among patients with extensively drug-resistant tuberculosis reveal significant rates of loss to follow-up and a high posttreatment mortality rate.

Missed visits within the first 12 months after antiretroviral therapy initiation are a major risk factor for subsequent death in persons living with human immunodeficiency virus. Incorporating missed visits in clinical and public health retention and viral suppression programming is advised.

Bacterial resistance continues to increase in the community. We found that community-onset urinary tract infections due to extended-spectrum cephalosporin-resistant Enterobacterales (formerly Enterobacteriaceae) could be predicted with knowledge of 5 clinical factors.

In this phase 2b, randomized, placebo-controlled study of intravenous danirixin in hospitalized influenza patients, all participants achieved a clinical response; danirixin had an acceptable safety profile. Early termination due to low recruitment and small sample size limits interpretation.

Highly efficacious therapies are necessary but not sufficient to eliminate HCV infection in persons with HIV infection. We evaluated the impact of peer-mentors and cash incentives on linkage to HCV treatment and cure in persons with HIV-HCV coinfection who had not been previously treated.

Since implementing use of the gastrointestinal multiplex panel (GIMP), we observed an increase in Yersinia enterocolitica infections, possibly related to the increase in patients with cancer receiving intensive immunosuppression, increased testing due to availability, and increased GIMP sensitivity.

Mandatory influenza vaccination of healthcare workers is not supported by evidence. Efforts at reducing presenteeism are likely to be more effective than mandatory vaccination.