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An Unexpectedly High Incidence of Invasive Fungal Diseases in Solid Organ Transplant Recipients on Belatacept for Organ Rejection Prophylaxis: A Single Center Retrospective Cohort Study Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-03-16 Elizabeth Bell, Jennifer Pisano, Manasa Brown, Daniel Friedman
15% of solid organ transplant recipients on belatacept developed invasive fungal diseases (IFD). The most common IFD were aspergillosis (56%) and candidiasis (22%). The infected cohort was more likely to receive basiliximab, lung transplantation, or identify as White. Higher rates of aspergillosis were seen in this lung cohort than previously reported.
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Hepatitis C virus antiviral drug resistance and salvage therapy outcomes across Australia Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-03-15 Dao Sen Wang, Amy Phu, Kristen McKee, Simone I Strasser, Sinead Sheils, Martin Weltman, Sue Sellar, Joshua S Davis, Mel Young, Alicia Braund, Geoffrey C Farrell, Anne Blunn, Damian Harding, Lucy Ralton, Kate Muller, Scott A Davison, David Shaw, Marnie Wood, Krispin Hajkowicz, Richard Skolen, Jane Davies, Jaclyn Tate-Baker, Adam Doyle, Rhoda Tuma, Simon Hazeldine, Wendy Lam, Natalie Edmiston, Krista
Background Hepatitis C virus (HCV) infection can now be cured with well-tolerated direct acting antiviral (DAA) therapy. However, a potential barrier to HCV elimination is the emergence of resistance-associated substitutions (RASs) which reduce the efficacy of antiviral drugs, but real-world studies assessing the clinical impact of RASs are limited. Here, an analysis of the impact of RASs on retreatment
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Dolutegravir/lamivudine is non-inferior to continuing dolutegravir and non-dolutegravir based triple drug antiretroviral therapy in virologically suppressed people with HIV: DUALING prospective nationwide matched cohort study Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-03-15 Marta Vasylyev, Ferdinand W N M Wit, Carlijn C E Jordans, Robin Soetekouw, Steven F L van Lelyveld, Gert-Jan Kootstra, Corine E Delsing, Heidi S M Ammerlaan, Marjo E E van Kasteren, Annemarie E Brouwer, Eliane M S Leyten, Mark A A Claassen, Robert-Jan Hassing, Jan G den Hollander, Marcel van den Berge, Anna H E Roukens, Wouter F W Bierman, Paul H P Groeneveld, Selwyn H Lowe, Berend J van Welzen, Olivier
Background Confirming the efficacy of dolutegravir/lamivudine in clinical practice with matched controls on suppressive triple-drug antiretroviral regimens would solidify recommendations on its use. Methods DUALING was a prospective cohort study in 24 HIV treatment centers in the Netherlands. HIV-RNA suppressed cases were on triple-drug antiretroviral regimens without prior virological failure or resistance
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Management and Outcomes of Patients at a Specialty Clinic for C. difficile Infection Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-03-15 Aaron Hunt, Larry H Danziger, Stuart Johnson, Andrew M Skinner
Vancomycin and fidaxomicin taper regimens were the most common treatment strategies employed but nearly half of patients (40/83) referred to our C. difficile infection (CDI) clinic did not require further treatment. The overall 60-day CDI recurrence rate was 16.9% (11/65). CDI management at a dedicated clinic may improve clinical outcomes.
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Challenges in Managing Treatment-Resistant Mpox Complicated by Severe Superinfection Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-03-15 Julia C Fortier, Christopher Marsalisi, Elian Cordova, Hui Jun Guo, Jorge Verdecia
Though typically self-limiting, severe mpox infections have been treated with antiviral medications, most notably tecovirimat. Various reports of mpox progression despite tecovirimat treatment exist. Treatment-resistance can be due to acquired mpox strain mutations, most often occurring in an immunocompromised host. We present the case of a male with acquired immunodeficiency syndrome (AIDS) who developed
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Emerging Tick-borne Infections in the Upper Midwest and Northeast United States Among Patients with Suspected Anaplasmosis Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-03-14 Megan E Reller, Emily G Clemens, Johan S Bakken, J Stephen Dumler
Background Emerging tick-transmitted illnesses are increasingly recognized in the United States. To identify multiple potential tick-borne pathogens in patients from the Upper Midwest and Northeast US with suspected anaplasmosis, we used state-of-the-art methods (PCR and paired serology) to test samples from patients in whom anaplasmosis had been excluded. Methods 568 patients without anaplasmosis
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Pharmacotherapeutic considerations in the treatment of nontuberculous mycobacterial infections: A primer for clinicians Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-03-13 Christo Cimino, Christina G Rivera, Jeffrey C Pearson, Benjamin Colton, Douglas Slain, Monica V Mahoney
Non-tuberculous mycobacteria (NTM) can cause a variety of infections, including serious pulmonary disease. Treatment encompasses polypharmacy, with a targeted regimen of 2-5 active medications, depending on site of infection, species, and clinical characteristics. Medications may include oral, intravenous, and inhalational routes. Medication acquisition can be challenging for numerous reasons, including
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“Electronic Phenotyping” Antimicrobials to Facilitate Outpatient Stewardship for Asymptomatic Bacteriuria and Urinary Tract Infection in Renal Transplant Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-03-13 Alex N Zimmet, David Ha, Emily Mui, Mary Smith, Marten Hawkins, William Alegria, Marisa Holubar
Asymptomatic bacteriuria and urinary tract infection in renal transplant are important antimicrobial stewardship targets but are difficult to identify within electronic medical records. We validated an “electronic phenotype” of antibacterials prescribed for these indications. This may be more useful than billing data in assessing antibiotic indication in this outpatient setting.
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Syphilis Treatment: Systematic Review and Meta-Analysis Investigating Non-Penicillin Therapeutic Strategies Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-03-13 Gustavo Yano Callado, Maria Celidonio Gutfreund, Isabele Pardo, Mariana Kim Hsieh, Vivian Lin, Mindy Marie Sampson, Guillermo Rodriguez Nava, Tássia Aporta Marins, Rodrigo Octávio Deliberato, Marinês Dalla Valle Martino, Marisa Holubar, Jorge L Salinas, Alexandre R Marra
Background Penicillin's long-standing role as the gold standard in syphilis treatment has led to global reliance. However, this dependence presents challenges, prompting the need for alternative strategies. We performed a systematic literature review and meta-analysis to evaluate the efficacy of these alternative treatments against non-neurological syphilis. Methods We searched MEDLINE, CINAHL, Embase
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Monthly sulfadoxine-pyrimethamine during pregnancy prevents febrile respiratory illnesses: A secondary analysis of a malaria chemoprevention trial in Uganda Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-03-13 Jordan John Lee, Abel Kakuru, Karen B Jacobson, Moses R Kamya, Richard Kajubi, Anju Ranjit, Stephanie L Gaw, Julie Parsonnet, Jade Benjamin-Chung, Grant Dorsey, Prasanna Jagannathan, Michelle E Roh
Background Trials evaluating drugs for intermittent preventive treatment of malaria in pregnancy (IPTp) have shown dihydroartemisinin-piperaquine (DP) is a more efficacious antimalarial than sulfadoxine-pyrimethamine (SP), but SP is associated with higher birthweight, suggesting SP demonstrates ‘non-malarial’ effects. Chemoprevention of non-malarial febrile illnesses (NMFIs) was explored as a possible
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Evaluation of Three Cytomegalovirus IgG Lateral Flow Assays for Rapid Determination of CMV Serostatus Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-03-13 Laurel Joncas-Schronce, Fatima Ali, Gregory Pepper, Renee D Stapleton, Gordon D Rubenfeld, Michael Boeckh, Ajit P Limaye
Background Cytomegalovirus (CMV) serostatus is a major determinant of CMV infection, disease risk, and transplant outcomes. Current clinical serology assays are limited by relatively slow turnaround time, design for batched testing, need for trained personnel, and/or specialized equipment. Rapid diagnostic assays in development have a role in emerging settings, such as critically ill patients, but
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Concurrent administration of COVID-19 and influenza vaccines enhances Spike-specific antibody responses Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-03-13 Susanna E Barouch, Taras M Chicz, Ross Blanc, Domenic R Barbati, Lily J Parker, Xin Tong, Wenjun Li, Ryan P McNamara
Background The bivalent COVID-19 mRNA boosters became available in fall 2022 and were recommended alongside the seasonal influenza vaccine. However, the immunogenicity of concurrent versus separate administration of these vaccines remains unclear. Methods Here, we analyzed antibody responses in healthcare workers who received the bivalent COVID-19 booster and the influenza vaccine on the same day or
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The Burden of Invasive Fungal Disease Following CAR T-cell Therapy and Strategies for Prevention Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-03-13 Jessica S Little, Eleftheria Kampouri, Daniel Z Friedman, Todd McCarty, George R Thompson, Dimitrios P Kontoyiannis, Jose Vazquez, John W Baddley, Sarah P Hammond
Chimeric antigen receptor (CAR) T-cell therapy is a novel immunotherapy approved for the treatment of hematologic malignancies. This therapy leads to a variety of immunologic deficits that could place patients at risk for invasive fungal disease (IFD). Studies assessing IFD in this setting are limited by inconsistent definitions and heterogeneity in prophylaxis use, although the incidence of IFD after
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Campylobacter infections with and without bacteraemia- a comparative retrospective population-based study Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-03-12 Torgny Sunnerhagen, Rasmus Grenthe, Christian Kampmann, Sara Karlsson Söbirk, Anna Bläckberg
Background Bacteraemia with species in the genus Campylobacter is rare, and knowledge of the disease course in comparison to Campylobacter enteritis is limited. Methods This is a retrospective population-based study. Episodes of Campylobacter bacteraemia, and Campylobacter enteritis with a concurrent negative blood culture, that occurred between 2015 and 2022 in southern Sweden were identified through
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HLA-A*23 is Associated with Lower Odds of Acute Retroviral Syndrome in HIV-1 Infection: A Multicentre Sub-Saharan African Study Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-03-11 Lovisa Lindquist, William Kilembe, Etienne Karita, Matt A Price, Anatoli Kamali, Pontiano Kaleebu, Jianming Tang, Susan Allen, Eric Hunter, Jill Gilmour, Sarah L Rowland-Jones, Eduard J Sanders, Amin S Hassan, Joakim Esbjörnsson
The role of HLA class I and KIR molecules in mediating acute retroviral syndrome (ARS) during HIV-1 infection is unclear. Among 72 sub-Saharan African adults, HLA-A*23 was associated with lower odds of ARS (adjusted OR, 0.10 [95%CI: 0.01-0.48], p=0.009), which warrants further studies to explore its role on HIV-1 specific immunopathogenesis.
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Evolving AIDS- and non-AIDS mortality and predictors in the PISCIS cohort of people living with HIV in Catalonia and the Balearic Islands (Spain), 1998-2020 Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-03-08 Daniel K Nomah, Suju Jamarkattel, Andreu Bruguera, Sergio Moreno-Fornés, Yesika Díaz, Lucía Alonso, Jordi Aceitón, Josep M Llibre, Pere Domingo, Maria Saumoy, Francesc Homar, Francisco Fanjul, Jordi Navarro, Lorena de la Mora, Hernando Knobel, Amat Orti, Raquel Martin-Iguacel, José M Miró, Jordi Casabona, Juliana Reyes-Urueña
Background Effective antiretroviral therapy (ART) has substantially reduced AIDS-related deaths, shifting the focus to non-AIDS conditions in people living with HIV (PLWH). We examined mortality trends and predictors of AIDS- and non-AIDS mortality in the PISCIS cohort of PLWH in Catalonia and the Balearic Islands, Spain, from 1998 to 2020. Methods We used a modified CoDe protocol which has been widely
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Evaluating Clinical Sequelae of the Carbapenem-Valproate Interaction: A Retrospective Analysis Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-03-08 Nick Petrucelli, Bryan D Hayes, Nidhi Shelat, Ramy H Elshaboury, Jeffrey C Pearson, Jennifer L Koehl
Background Previous studies identified a rapid decrease in valproate serum concentrations when co-administered with a carbapenem; however, the specific consequences and subsequent therapy adjustments are not well described. We aimed to investigate the clinical and therapeutic implications of the carbapenem-valproate drug-drug interaction. Methods This retrospective analysis included data from two large
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Characteristics of patients with initial Clostridioides difficile infection (CDI) that are associated with increased risk of multiple CDI recurrences Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-03-06 Alice Y Guh, Rongxia Li, Lauren Korhonen, Lisa G Winston, Erin Parker, Christopher A Czaja, Helen Johnston, Elizabeth Basiliere, James Meek, Danyel Olson, Scott K Fridkin, Lucy E Wilson, Rebecca Perlmutter, Stacy M Holzbauer, Paige D’Heilly, Erin C Phipps, Kristina G Flores, Ghinwa K Dumyati, Rebecca Pierce, Valerie L S Ocampo, Christopher D Wilson, Jasmine J Watkins, Dale N Gerding, L Clifford McDonald
Background Since interventions are available to prevent further recurrence in patients with recurrent Clostridioides difficile infection (rCDI), we identified predictors of multiple rCDI (mrCDI) in adults at the time of presentation with initial CDI (iCDI). Methods iCDI was defined as a positive C. difficile test in any clinical setting during January 2018–August 2019 in a person aged ≥18 years with
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Genetic Susceptibility to Astrovirus Diarrhea in Bangladeshi Infants Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-03-06 Laura Chen, Rebecca M Munday, Rashidul Haque, Dylan Duchen, Uma Nayak, Poonum Korpe, Alexander J Mentzer, Beth D Kirkpatrick, Genevieve L Wojcik, William A Petri, Priya Duggal
Background Astroviral infections commonly cause acute nonbacterial gastroenteritis in children globally. However, these infections often go undiagnosed outside of research settings. There is no treatment available for astrovirus, and Astroviridae strain diversity presents a challenge to potential vaccine development. Methods To address our hypothesis that host genetic risk factors are associated with
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All-cause and infection-attributable mortality amongst adults with bloodstream infection – a population-based study Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-03-06 Jonathan Underwood, Rowena Griffiths, David Gillespie, Ashley Akbari, Haroon Ahmed
Background Bloodstream infections (BSI) are common, life threatening infections. However, it remains unclear whether deaths following BSI are primarily due to uncontrolled infection or underlying comorbidities. We aimed to determine the overall mortality, infection-attributable mortality, and causes of death for four leading bloodstream infection (BSI) pathogens. Methods This retrospective cohort study
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Meeting the Consultation Surge: A Nationwide Survey of Consult Volume and Mitigation Strategies in Infectious Diseases Fellowship Programs Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-03-05 Alfredo J Mena Lora, Ryan Knodle, Scott Borgetti, Brionna Matt, Georgina Osorio, Vidya Sundareshan, Christian Rojas–Moreno, Rachel Bartash, Trevor C Van Schooneveld, Rebecca Reece, Brian Chow, Katya Prakash, Saira Butt, Allison Lastinger
High patient volume in fellowship programs can impact learning, wellness, and patient outcomes. Training programs must find ways to mitigate high consultation volume to protect the learning environment. This survey describes average new consults and average censuses for infectious diseases training programs and strategies implemented to mitigate high volume.
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GRAND PLAN: Safety and Efficacy of Glecaprevir/Pibrentasvir for the Treatment of Hepatitis C Virus Infection Among People Initially Disengaged From Health Care Who Use Drugs—A Systematic Multidisciplinary Approach Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-03-05 Brian Conway, Shana Yi, Rossitta Yung, Shawn Sharma
Background GRAND PLAN is a prospective, open-label, phase 4 study. Based at a single center and with a single arm, GRAND PLAN evaluated the safety and efficacy of an 8-week course of glecaprevir/pibrentasvir (G/P) among active drug users with hepatitis C virus (HCV) infection in a population enriched for factors that may reduce treatment uptake and success, such as disengagement from health care and
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Infectious Diseases Physician Management of Cryptococcal Meningitis in North America – Is Single High-Dose Liposomal Amphotericin B Being Used? Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-03-04 Nathan C Bahr, Susan E Beekmann, Philip M Polgreen, Jeremey B Walker, Andrej Spec, David R Boulware, John W Baddley
Background Several recent randomized trials have been conducted in resource-limited settings for cryptococcal meningitis which have rapidly innovated international guidelines. The 2010 IDSA cryptococcal meningitis guideline has not been updated with recent trials. The 2022 AMBITION-cm trial found that single 10mg/kg dose of liposomal amphotericin B plus daily flucytosine and fluconazole for two weeks
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An Analysis of Social Determinants of Health and their Implications for Hepatitis C Virus Treatment in People Who Inject Drugs: The Case of Baltimore Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-03-02 Luis A Gonzalez Corro, Katie Zook, Miles Landry, Amanda Rosecrans, Robert Harris, Darrell Gaskin, Oluwaseun Falade-Nwulia, Kathleen R Page, Gregory M Lucas
Background Sixty-eight percent of the nearly 3.5 million people living with hepatitis C virus (HCV) in the US are people who inject drugs (PWID). Despite effective treatments, uptake remains low in PWID. We examined the social determinants of health (SDoH) that impact the HCV care cascade. Methods We conducted a secondary analysis of data from 720 PWID in a cluster-randomized trial. We recruited PWID
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Incidence of Diabetes Mellitus and Associated Factors in the Era of Antiretroviral Drugs with a Low Metabolic Toxicity Profile Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-03-01 Maria Luisa Montes, Carmen Busca, Nuria Espinosa, José Ignacio Bernardino, Sofia Ibarra-Ugarte, Luz MartÍn-Carbonero, Cristina Moreno, Juan Macias, Antonio Rivero, Miguel Cervero-Jiménez, Juan González-García
Objective The incidence of type 2 diabetes mellitus (T2DM) has risen dramatically. In PLHIV, chronic disease (now >15 cases/1000 in the general population worldwide) and long-term exposure to ART can alter metabolic processes early, favoring insulin resistance and T2DM. We retrospectively studied the incidence of T2DM and associated factors in the Cohort of the Spanish AIDS Research Network (CoRIS)
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Epidemiology, Timing, and Secondary Prophylaxis of Recurrent Nocardiosis Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-03-01 Zachary A Yetmar, Ryan B Khodadadi, Supavit Chesdachai, Jack W McHugh, Douglas W Challener, Nancy L Wengenack, Wendelyn Bosch, Maria Teresa Seville, Elena Beam
Background Nocardia tends to cause infection in immunocompromised patients or those with chronic pulmonary disease. Nocardia is known to recur, prompting the practice of secondary prophylaxis in patients perceived at high-risk. However, little data exist regarding the epidemiology of recurrent nocardiosis or the effectiveness of secondary prophylaxis. Methods We performed a multicenter, retrospective
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Serial Bronchoalveolar Lavage Fluid Aspergillus Galactomannan and Treatment Response in Invasive Pulmonary Aspergillosis Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-03-01 Daniel Z P Friedman, Elitza S Theel, Randall C Walker, Holenarasipur R Vikram, Raymund R Razonable, Paschalis Vergidis
We studied patients diagnosed with aspergillosis based on positive bronchoalveolar lavage (BAL) Aspergillus galactomannan (GM) who had follow-up BAL sampling within 180 days. GM trend and clinical outcome were concordant in only 60% (30/50). While useful for the initial diagnosis, BAL GM trending does not always correlate with treatment response.
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Patterns and drivers of antifungal prescribing in acute leukaemia: a retrospective cohort study Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-29 Hamish Houston, Peter Dutey-Magni, Matthew Steel, Selina Patel, Wai Keong Wong, Laura Shallcross, Andrew Wilson, Neil Stone
Background Patients with haematological malignancy are at high risk of invasive fungal infections (IFI). Diagnosis is challenging which can lead to overtreatment. Reducing exposure to inappropriate antifungal prescribing is likely to improve patient safety, but modifying prescribing behaviour is difficult. We aimed to describe patterns and drivers of therapeutic antifungal prescribing in a large tertiary
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Which Topics Drive Dissemination? Alternative Bibliometrics Analysis of the Highest-Ranking Articles in Three Infectious Diseases Journals Before COVID-19 Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-28 Jasmine R Marcelin, Shipra Goel, William N Niehaus, Robert C Messersmith, Kelly A Cawcutt
Dissemination of research is paramount to improving patient care. Historically, dissemination is reported in conventional bibliometrics. However, with the increased utilization of digital platforms for communication, alternative bibliometrics describe more real-time dissemination of information. This study documents dissemination of publication topics in Infectious Diseases journals prior to the COVID-19
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A pilot investigation of the association between Vpr amino acid substitutions and peripheral immune marker levels in people living with HIV: implications for neurocognitive impairment Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-27 Levanco K Asia, Esmé Jansen Van Vuren, Iolanthé M Kruger, Monray E Williams
Background Subtype-specific amino acid variations in viral proteins of HIV-1 influence disease progression. Furthermore, Vpr sequence variation correlates with chronic inflammation, a central mechanism in HIV-1 (neuro)pathogenesis. Nevertheless, no clinical study has investigated the link between Vpr sequence variation and peripheral inflammation in people living with HIV. The aim of this pilot study
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Combination of Extended Antivirals with Antiretrovirals for Severe Mpox in Advanced HIV Infection: Case Series of 4 Patients Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-27 Michael T Duong, Pablo Tebas, Bhavya Ancha, Jillian Baron, Pallavi Chary, Stuart N Isaacs, Zsofia Szep
To gauge safety and utility of extended tecovirimat/cidofovir for severe mpox, here we report our experience caring for 4 patients with mpox and advanced HIV at the Hospitals of the University of Pennsylvania during the 2022 global outbreak. Three patients had recurrent courses complicated by super-/co-infections and insufficient nutrition/housing, requiring extended tecovirimat (5-16 weeks) and cidofovir
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A prolonged outbreak of enteric fever associated with illegal miners in the City of Matlosana, South Africa, November 2020 – September 2022 Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-27 Phuti Sekwadi, Anthony Marius Smith, Wellington Maruma, Gift Mongologa, Grace Tsele, Mimmy Ngomane, Nomsa Tau, Shannon Williams, Bolele Disenyeng, Mahlaku Sebiloane, Leigh Johnston, Linda Erasmus, Juno Thomas
Background In South Africa, the annual incidence of enteric fever averaged 0.1 per 100 000 persons between 2003 and 2018. During 2021 an increase in the number of enteric fever cases was observed. An outbreak investigation was conducted to determine the magnitude and source of the outbreak. Methods We performed a cross-sectional descriptive study. Data were collected through telephonic or face-to-face
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Esophageal Candidiasis-Associated Hospitalizations: Declining Rates and Changes in Underlying Conditions, United States, 2010–2020 Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-26 Jeremy A W Gold, Kaitlin Benedict
In a nationally representative hospital discharge database, esophageal candidiasis-associated hospitalization rates per 100,000 population steadily declined from 17.0 (n = 52,698, 2010) to 12.9 (n = 42,355, 2020). During this period, a decreasing percentage of EC-associated hospitalizations involved HIV and an increasing percentage involved gastroesophageal reflux disease, diabetes, and long-term steroid
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Fecal carriage of colibactin encoding Escherichia coli associated with colorectal cancer among a student populace Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-26 Paul A Akinduti, Ovbiosa O Izevbigie, Omobolanle A Akinduti, Ezekiel O Enwose, Emmanuel Amoo
Fecal carriage of colibactin (clb) gene in Escherichia coli is described as potential source that could promote carcinogenesis, progressing to colorectal cancer (CRC). The present study investigated the demographic, dietary and antibiotic consumption variables as correlates for fecal carriage of clb+/Escherichia coli among the student populace. In a randomized cross-sectional survey, E coli ((n=136)
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COVID-19 Immunologic Antiviral therapy with Omalizumab (CIAO) – A Randomized-Controlled Clinical Trial Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-23 Michelle Le, Lauren Khoury, Yang Lu, Connor Prosty, Maxime Cormier, Mathew P Cheng, Robert Fowler, Srinivas Murthy, Jennifer L Y Tsang, Moshe Ben-Shoshan, Elham Rahme, Shirin Golchi, Nandini Dendukuri, Todd C Lee, Elena Netchiporouk
Background Omalizumab is an anti-IgE monoclonal antibody used to treat moderate to severe chronic idiopathic urticaria, asthma and nasal polyps. Recent research suggested that omalizumab may enhance the innate antiviral response and have anti-inflammatory properties. Objective We aimed to investigate the efficacy and safety of omalizumab in adults hospitalized for COVID-19 pneumonia. Methods This was
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Prevalence, clinical features, and predictors of adrenal insufficiency in adults with tuberculosis or HIV: A systematic review and meta-analysis Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-22 Davis Kibirige, Noela Owarwo, Andrew Peter Kyazze, Bethan Morgan, Ronald Olum, Felix Bongomin, Irene Andia-Biraro
Background Despite the high frequency of adrenal insufficiency in patients with tuberculosis or HIV, its diagnosis is often missed or delayed resulting in increased mortality. This systematic review and meta-analysis aimed to document the prevalence, significant clinical features, and predictors of adrenal insufficiency in adult patients with tuberculosis or HIV. Methods We systematically searched
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Cardiometabolic health in pregnancy and postpartum: Findings form a prospective cohort study in South Africa Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-22 Angela M Bengtson, Hlengiwe Madlala, Mushi J Matjila, Julia H Goedecke, Susan Cu-Uvin, Stephen T McGarvey, Erika Werner, Landon Myer
Background The cardiometabolic impact of HIV infection and treatment with antiretroviral therapy (ART) in pregnancy and the postpartum period remains unclear. Methods We enrolled pregnant persons with (PHIV) and without HIV in Cape Town, South Africa who were ≥18 years old at 24-28 weeks gestation and followed them up to 32 months postpartum. We estimated associations between HIV status and cardiometabolic
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Ceftolozane/Tazobactam for the Treatment of Complicated Infections in Hospital Settings—A French Real-world Study Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-22 Jean-François Timsit, Joy Mootien, Brune Akrich, Xavier Bourge, Isabelle Brassac, Bernard Castan, Carole Mackosso, Linsay Monteiro Tavares, Fabrice Ruiz, David Boutoille, Raymond Ruimy
Background This study describes the conditions of use of ceftolozane/tazobactam (C/T) and associated outcomes in French hospital settings. Methods This was a prospective, multicenter, French observational study. Patients who received at least 1 dose of C/T were included and followed up as per routine clinical practice, until stop of C/T. Results A total of 260 patients were enrolled between October
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Attributable Cost of Adult Respiratory Syncytial Virus Illness Beyond the Acute Phase Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-22 Ahuva Averin, Mark Atwood, Reiko Sato, Kari Yacisin, Elizabeth Begier, Kimberly Shea, Daniel Curcio, Linnea Houde, Derek Weycker
Background Estimates of the cost of medically attended lower respiratory tract illness (LRTI) due to respiratory syncytial virus (RSV) in adults, especially beyond the acute phase, is limited. This study was undertaken to estimate the attributable costs of RSV-LRTI among US adults during, and up to one year after, the acute phase of illness. Methods A retrospective observational matched-cohort design
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Optimising the Treatment of Invasive Candidiasis – A Case for Combination Therapy Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-22 R M Wake, P E Allebone-Salt, L L H John, B A Caswall, N P Govender, R Ben-Ami, L W Murray, C Logan, T S Harrison, T A Bicanic
Invasive candidiasis is a rising global health threat with increasing incidence, persistently high mortality and diminishing treatment options. Antifungal resistance has rapidly emerged and spread, with multidrug resistant species deemed an urgent and serious threat (US CDC). While acknowledging the key role of antifungal stewardship and infection control in curbing spread, we examine the role of antifungal
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Combination Antifungal Therapy for Invasive Mucormycosis in Immunocompromised Hosts: A Single-Center Experience Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-22 Brian Lu, David Ha, Sa Shen, Jessica Ferguson Toll, Ailin Kim, Sarah Kim, Emily Mui, Stan Deresinski, Marisa Holubar, William Alegria
Combination antifungal therapy for invasive mucormycosis remains controversial and is inconsistently defined in prior studies. In a cohort of immunocompromised patients with invasive mucormycosis, we found no difference in 6-week mortality with upfront nor salvage combination therapy compared to monotherapy.
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Clinical Presentation, Risk Factors, and Comparison of Laboratory Diagnostics for Seasonal Influenza Virus among Cambodians from 2007-2020 Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-22 Agus Rachmat, Gerard C Kelly, Long Khanh Tran, Nathaniel Christy, Chonthida Supaprom, Vireak Heang, Sokha Dul, Jose A Garcia-Rivera, Satharath Prom, Heng Sopheab, John S Brooks, Ian J Sutherland, Karen S Corson, Andrew G Letizia
Background Despite its global significance, challenges associated with understanding the epidemiology and accurately detecting, measuring, and characterizing the true burden of seasonal influenza remain in many resource-poor settings. Methods A prospective observational study was conducted in Cambodia at 28 health facilities between 2007 and 2020 utilizing passive surveillance data of patients presenting
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Risk of infective endocarditis in Streptococcal mitis bloodstream infections among patients with neutropenia from hematologic malignancies Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-20 Miranda Monk, Nikitha R Patel, Ramy Elshaboury, David W Kubiak, Sarah P Hammond
Streptococcus mitis commonly causes bloodstream infections (BSI) in neutropenic patients, but infrequently results in infective endocarditis (IE) in this population. Among 210 patients with neutropenia and S. mitis BSI, 55% underwent cardiac imaging. None were diagnosed with S. mitis IE; 3 had recurrent S. mitis BSI within 12 weeks.
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Diagnosis and Treatment of Pneumonia in Urgent Care Clinics. Opportunities for Improving Care Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-19 James H Hart, Theadora Sakata, Jacqueline R Eve, Allison M Butler, Anthony Wallin, Chad Carman, Brenda Atwood, Rajendu Srivastava, Barbara E Jones, Edward A Stenehjem, Nathan C Dean
Background Community-acquired pneumonia is a well-studied condition; yet in the urgent care setting, patient characteristics and adherence to guideline-recommended care are poorly described. Within Intermountain Health, a non-profit, integrated healthcare system based in Utah, USA, more patients present to urgent care clinics than emergency departments for pneumonia care. Methods We performed a retrospective
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Pretreatment and Acquired Drug Resistance in HIV-1 Infected Children in Jos, Nigeria Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-19 Augustine O Ebonyi, Jonathan Okpokwu, Holly Rawizza, Philippe Chebu, Beth Chaplin, Donald Hamel, Stephen Oguche, Oche O Agbaji, Atiene S Sagay, Phyllis J Kanki, Godwin E Imade
We determined pretreatment (PDR) and acquired (ADR) HIV drug resistance (HIVDR) among children living with HIV-1 in Jos, Nigeria. Majority (71%) of those who failed first-line ART were on a NVP-containing regimen. The prevalence of pretreatment (48%) and acquired (76%) HIVDR mutations was high in our study. Wider access to HIVDR testing after treatment failure is necessary to optimize second-line treatment
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Challenges to implementing a vaccine for coccidioidomycosis Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-19 Bridget M Barker, George R Thompson, Neil M Ampel
A vaccine for coccidioidomycosis is likely to undergo trials in the near future. In this paper, we raise four questions that should be answered prior to its use and offer our solutions to these questions. These include defining the goals of vaccination, determining who should be vaccinated, how to measure vaccine immunity and protection, and how to address vaccine hesitancy and denial.
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Eosinophilic Liver Abscess: A Case of Locally Acquired Fasciola hepatica in Alberta, Canada Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-19 Teagan King, Miguel M Cabada, Kinga Kowalewska-Grochowska, Stephen Vaughan
Fasciola hepatica is a trematode causing acute and chronic infection. A 33-year old Canadian woman with eosinophilic liver abscesses and no relevant travel was diagnosed with Fasciola hepatica infection. F. hepatica is reported in livestock in Alberta. This is the first case of locally acquired fascioliasis in Canada in over 100 years.
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Risk of primary incident hepatitis C infection following bacterial sexually transmissible infections among gay and bisexual men in Australia from 2016 to 2020 Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-19 Brendan L Harney, Rachel Sacks-Davis, Paul Agius, Daniela K van Santen, Michael W Traeger, Anna L Wilkinson, Jason Asselin, Christopher K Fairley, Norman Roth, Mark Bloch, Gail V Matthews, Basil Donovan, Rebecca Guy, Mark Stoové, Margaret E Hellard, Joseph S Doyle
Background In Australia, the incidence of hepatitis C virus (HCV) has declined among gay and bisexual men (GBM) with HIV since 2015 and is low among GBM using HIV pre-exposure prophylaxis (PrEP). However, ongoing HCV testing and treatment remains necessary to sustain this. To assess the potential utility of STIs to inform HCV testing among GBM with HIV and GBM using PrEP, we examined the association
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SUBA-Itraconazole for Primary Antifungal Prophylaxis After Allogeneic Hematopoietic Cell Transplantation Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-19 Julian Lindsay, Jad Othman, Yvonne Kong, Annie Yip, Sebastiaan Van Hal, Stephen Larsen, Christian Bryant, John Gibson, Ian Kerridge, Keith Fay, William Stevenson, Chris Arthur, Sharon C A Chen, David C M Kong, Matthew Greenwood, Steven A Pergam, Catherine Liu, Monica A Slavin
Background Itraconazole (ITZ) is an effective agent when used as primary invasive fungal disease (IFD) prophylaxis, but is limited by drug tolerability and variability in serum concentrations. A new formulation, SUBA-itraconazole (for “super bioavailability”; S-ITZ), addresses the limitations of conventional ITZ formulations. Methods We conducted a retrospective cohort study at 2 Australian centers
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Histoplasmosis beyond HIV: Clinical characteristics and outcomes in non-HIV population Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-17 A C Tello-Mercado, B Martínez-Guerra, C M Román-Montes, L Seoane-Hernandez, A Rangel-Cordero, R A Martínez-Gamboa, J Sifuentes-Osornio, A Ponce-de-León, M F González Lara, M D Niembro-Ortega
Histoplasmosis is an endemic and invasive mycosis caused by Histoplasma capsulatum. We conducted a retrospective study comparing non-HIV immunosuppressed patients with a historical cohort of HIV and histoplasmosis. We included 199 patients with proven or probable histoplasmosis, of which 25.1% were non-HIV. Diabetes mellitus, chronic kidney disease, hematologic neoplasms, rheumatologic diseases and
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Prevalence of chronic pulmonary aspergillosis in two Tuberculosis treatment clinics in Lagos, Nigeria: a prospective longitudinal study Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-17 Adeyinka A Davies, Abiola O Adekoya, Oluwaseyi J Balogun, Iriagbonse I Osaigbovo, Augustina Nwosu, Titilola Gbaja-biamila, Olubunmi Osinupebi, Jean-Pierre Gangneux, Rita O Oladele
Background Chronic pulmonary aspergillosis (CPA) is an underrecognized but common complication of pulmonary tuberculosis (TB). In Nigeria, a TB-endemic country, there is currently no provision to monitor the development of CPA in patients treated for TB. This study determined the prevalence and incidence of CPA in Lagos, Nigeria. Methods A prospective longitudinal study of patients previously managed
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The Characteristics of Youth with Missed HIV Visits in Alabama Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-16 Jiaying Hao, Dustin M Long, Heather M Relyea Ashley, Henna Budhwani, Tina Y Simpson, Samantha V Hill
Gaps in knowledge remain related to understanding missed HIV visits and youth with HIV (YWH). This study examined data from an Alabama academic HIV clinic with clients aged 16 to 24 years old and found that non virally suppressed and older YWH were associated with missed visits among YWH.
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Ending Race-Conscious College Admissions and Its Potential Impact on the Infectious Disease Workforce Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-16 Florence Momplaisir, Tanya Rogo, Ronika Alexander Parrish, Shirley Delair, Mona Rigaud, Virginia Caine, Judith Absalon, Bonnie Word, Dial Hewlett
On June 29, 2023, the Supreme Court of the United States ruled that race-conscious consideration for college admission is unconstitutional. We discuss the consequences of this ruling on the delivery of equitable care and health system readiness to combat current and emerging pandemics. We propose strategies to mitigate the negative impact of this ruling on diversifying the infectious disease workforce
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The Burden and Impact of Early Post-Transplant Multidrug-resistant Organism Detection Among Renal Transplant Recipients, 2005-2021 Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-16 Ahmed Babiker, Geeta Karadkhele, Andrei Bombin, Rockford Watkins, Chad Robichaux, Gillian Smith, Vivek B Beechar, Danielle B Steed, Jesse T Jacobs, Timothy D Read, Sarah Satola, Christian P Larsen, Colleen S Kraft, Stephanie M Pouch, Michael H Woodworth
Background Reducing the burden of multidrug-resistant organism (MDRO) colonization and infection among renal transplant recipients (RTRs) may improve patient outcomes. We aimed to assess whether the detection of an MDRO or a comparable antibiotic susceptible organism (CSO) during the early post-transplant (EPT) period was associated with graft loss and mortality among RTRs. Methods We conducted a retrospective
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Implementation of a Prospective Index-Cluster Sampling Strategy for the Detection of Pre-Symptomatic Viral Respiratory Infection in Undergraduate Students Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-16 Diya M Uthappa, Micah T McClain, Bradly P Nicholson, Lawrence P Park, Ilya Zhbannikov, Sunil Suchindran, Monica Jimenez, Florica J Constantine, Marshall Nichols, Daphne C Jones, Lori L Hudson, L Brett Jaggers, Timothy Veldman, Thomas W Burke, Ephraim L Tsalik, Geoffrey S Ginsburg, Christopher W Woods
Background and Objectives Index-cluster studies may help characterize the spread of communicable infections in the pre-symptomatic state. We describe a prospective index-cluster sampling strategy (ICSS) to detect pre-symptomatic respiratory viral illness and its implementation in a college population. Methods We enrolled an annual cohort of first-year undergraduates who completed daily electronic symptom
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Association of Nirmatrelvir/Ritonavir Treatment and COVID-19-Neutralizing Antibody Titers in a Longitudinal Health Care Worker Cohort Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-13 Slade Decker, Shaoming Xiao, Carly Dillen, Christina M Schumacher, Aaron M Milstone, Matthew Frieman, Amanda K Debes
Nirmatrelvir/ritonavir (NMV/r) is used for the treatment of coronavirus disease 2019 (COVID-19) infection. However, rebound COVID-19 infections can occur after taking NMV/r. We examined neutralizing antibodies to the severe acute respiratory syndrome coronavirus 2 spike protein before and after infection in people who did and did not take NMV/r to determine if NMV/r impedes the humoral immune response
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A Semi-nested PCR Method for the Diagnosis of Invasive Fungal Infections in Combat Injured Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-13 Graham C Ellis, Faraz Shaikh, M Leigh Carson, Erica Sercy, Laveta Stewart, Jared M Andrews, Wesley R Campbell, Katrin Mende, Joseph M Yabes, David R Tribble, Ralf Bialek, Brian L Wickes, Anuradha Ganesan
Background Among combat injured, invasive fungal infections (IFIs) result in significant morbidity. Cultures and histopathology are the primary diagnostic methods for IFIs, but they have limitations. We previously evaluated a panfungal polymerase chain reaction assay, which was 83% sensitive and 99% specific for angioinvasive IFIs. Herein, we evaluated three less resource-intensive semi-nested assays
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Septic Arthritis of the Spinal Facet Joint: Review of 117 Cases Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-12 John J Ross, Kevin L Ard
Background Septic arthritis of the spinal facet joints is increasingly recognized in the era of magnetic resonance imaging, but its epidemiology, clinical features, management, and prognosis are ill-defined. Methods We review 101 previously published cases, and report 16 cases occurring at our institutions between 2006 and 2018. Results Most patients presented with fever (60%) and back or neck pain
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The Strain and Clinical Outcome of Clostridioides difficile Infection: A meta-analysis Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-08 Claire Nour Abou Chakra, Anthony Gagnon, Simon Lapointe, Marie-Félixe Granger, Simon Lévesque, Louis Valiquette
Background The association between bacterial strains and clinical outcomes in Clostridioides difficile infection (CDI) has yielded conflicting results across studies. We conducted a systematic review and meta-analyses to assess the impact of these strains. Methods Five electronic databases were used to identify studies reporting CDI severity, complications, recurrence, or mortality according to strain
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Hepatitis Delta Virus Reporting Requirements in the United States and Territories: A Systematic Review Open Forum Infect. Dis. (IF 4.2) Pub Date : 2024-02-08 Milaveh Assadi-Rad, Brenda E Acosta, Matthew C Hesterman, Braden S Fallon, Rachel L Hill, Ethan W Farnsworth, Bree Barbeau, Dede Vilven, Keisa M Lynch, Melodie L Weller
Hepatitis D virus (HDV) is a rare co-infection with hepatitis B virus. Currently, HDV is not a nationally notifiable disease in the United States. Only 55% of states and territories require HDV reporting, and most lack defined case definitions. Standardization of reporting requirements is crucial for monitoring HDV epidemiology.