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Estimating post-treatment recurrence after multidrug-resistant tuberculosis treatment among patients with and without HIV: the impact of assumptions about death and missing follow-up Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-09-28 Sara M Sauer, Carole D Mitnick, Uzma Khan, Catherine Hewison, Mathieu Bastard, David Holtzman, Stephanie Law, Munira Khan, Shrivani Padayachee, Saman Ahmed, Afshan K Isani, Aga Krisnanda, Stalz Charles Vilbrun, Sagit Bektasov, Andargachew Kumsa, Wisney Docteur, Karen Tintaya, Mark McNicol, Hakob Atshemyan, Tatiana Voynilo, Thin Thin Thwe, Kwonjune Seung, Michael Rich, Helena Huerga, Palwasha Khan,
Background Quantification of recurrence risk following successful treatment is crucial to evaluating regimens for multidrug- or rifampicin-resistant (MDR/RR) tuberculosis (TB). However, such analyses are complicated when some patients die or become lost during post-treatment-follow-up. Methods We analyzed data on 1,991 patients who successfully completed a longer MDR/RR-TB regimen containing bedaquiline
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Single-dose effectiveness of mpox vaccine in Quebec, Canada: test-negative design with and without adjustment for self-reported exposure risk Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-09-28 Nicholas Brousseau, Sara Carazo, Yossi Febriani, Lauriane Padet, Sandrine Hegg-Deloye, Geneviève Cadieux, Geneviève Bergeron, Judith Fafard, Hugues Charest, Gilles Lambert, Denis Talbot, Jean Longtin, Alexandre Dumont-Blais, Steve Bastien, Virginie Dalpé, Pierre-Henri Minot, Gaston De Serres, Danuta M Skowronski
Introduction During the 2022 mpox outbreak, the province of Quebec, Canada prioritized first doses for pre-exposure vaccination of people at high mpox risk, delaying second doses due to limited supply. We estimated single-dose mpox vaccine effectiveness (VE) adjusting for virus exposure risk based only on surrogate indicators available within administrative databases (e.g. clinical record of sexually
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Effects of BNT162b2 Messenger RNA Vaccine and ChAdOx1 Adenovirus Vector Vaccine on Deaths From Coronavirus Disease 2019 in Adults Aged ≥70 Years Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-09-27 Jamie Lopez Bernal, Nick Andrews, Charlotte Gower, Julia Stowe, Elise Tessier, Ruth Simmons, Mary Ramsay
We estimated the risk of death from coronavirus disease 2019 in vaccinated compared with unvaccinated patients. The risk of death was reduced 44% after 1 dose of the Pfizer-BioNTech BNT162b2 vaccine, 55% after 1 dose of the Oxford-Astrazeneca ChAdOx1 vaccine, and 69% after 2 doses of the BNT162b2 vaccine. This is above the protection provided against infection.
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Adverse Pregnancy Outcomes among HIV-infected Women Taking Isoniazid Preventive Therapy During the First Trimester Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-09-26 Amita Gupta, Michael D Hughes, Jorge Leon Cruz, Anchalee Avihingsanon, Noluthando Mwelase, Patrice Severe, Ayotunde Omoz-Oarhe, Gaerolwe Masheto, Laura Moran, Constance A Benson, Richard E Chaisson, Susan Swindells
Background Tuberculosis prevention using isoniazid (IPT) is recommended for people with HIV, yet data on the safety of first-trimester pregnancy exposure are limited. Methods Planned secondary analysis in a TB prevention trial of adverse pregnancy outcomes among participants assigned to 9-month IPT who became pregnant during (IPT-exposed) or after (unexposed) IPT. Regression models compared binary
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The New Normal: Delayed Peak SARS-CoV-2 Viral Loads Relative to Symptom Onset and Implications for COVID-19 Testing Programs Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-09-26 Jennifer K Frediani, Richard Parsons, Kaleb B McLendon, Adrianna L Westbrook, Wilbur Lam, Greg Martin, Nira R Pollock
Background Early in the COVID-19 pandemic, peak viral loads coincided with symptom onset. We hypothesized that in a highly immune population, symptom onset might occur earlier in infection, coinciding with lower viral loads. Methods We assessed SARS-CoV-2 and influenza A viral loads relative to symptom duration in symptomatic adults (>16y) presenting for testing in Georgia (4/2022-4/2023; Omicron variant
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Risk Factors and Outcomes of Hematogenous Vertebral Osteomyelitis in Patients With Staphylococcus aureus Bacteremia Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-09-25 Tori Kinamon, Michael Dagher, Lawrence Park, Felicia Ruffin, Vance G Fowler, Stacey A Maskarinec
Background Hematogenous vertebral osteomyelitis (HVOM) is an incompletely understood complication of Staphylococcus aureus bacteremia (SAB). Methods Eligible SAB patients with and without HVOM were prospectively enrolled from 1995 through 2019 at Duke University Health System. HVOM was diagnosed either radiographically or microbiologically. Multivariable logistic regression analysis was performed to
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Long-term Cardiovascular, Cerebrovascular, and Other Thrombotic Complications in Coronavirus Disease 2019 Survivors: A Retrospective Cohort Study Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-09-25 Jue Tao Lim, Wee Liang En, An Ting Tay, Deanette Pang, Calvin J Chiew, Benjamin Ong, David Chien Boon Lye, Kelvin Bryan Tan
Background Growing evidence suggests that some coronavirus disease 2019 (COVID-19) survivors experience a wide range of long-term postacute sequelae. We examined the postacute risk and burden of new-incident cardiovascular, cerebrovascular, and other thrombotic complications after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in a highly vaccinated multiethnic Southeast Asian
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Long-acting Injectable Cabotegravir/Rilpivirine Effective in a Small Patient Cohort With Virologic Failure on Oral Antiretroviral Therapy Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-09-23 James B Brock, Peyton Herrington, Melissa Hickman, Aubri Hickman
We report 12 patients with persistent viremia on oral antiretroviral therapy who were initiated on injectable cabotegravir/rilpivirine (iCAB/RPV) without oral lead-in. All patients achieved viral suppression without any virologic rebound. iCAB/RPV may be considered as an option for patients unable to maintain suppression on oral antiretroviral therapy.
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More than a decade since the latest CONSORT non-inferiority trials extension: do infectious diseases trials do enough? Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-09-21 Adam S Komorowski, Carson K L Lo, Andrew K Kapoor, Marek Smieja, Mark Loeb, Dominik Mertz, Anthony D Bai
More than a decade after the Consolidated Standards of Reporting Trials group released a reporting items checklist for non-inferiority randomized controlled trials, the infectious diseases literature continues to underreport these items. Trialists, journals, and peer reviewers should redouble their efforts to ensure infectious diseases studies meet these minimum reporting standards.
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Moving beyond mortality: Development and Application of a Desirability of Outcome Ranking (DOOR) Endpoint for Hospital-Acquired Bacterial Pneumonia and Ventilator-Associated Bacterial Pneumonia Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-09-21 Jessica Howard-Anderson, Toshimitsu Hamasaki, Weixiao Dai, Deborah Collyar, Daniel Rubin, Sumathi Nambiar, Tori Kinamon, Heidi Leister-Tebbe, Carol Hill, Holly Geres, Thomas L Holland, Sarah B Doernberg, Henry F Chambers, Vance G Fowler, Scott R Evans, Helen W Boucher
Background Hospital-acquired and ventilator-associated bacterial pneumonia (HABP/VABP) are frequently caused by multidrug-resistant organisms. Patient-centered endpoints in clinical trials are needed to develop new antibiotics for HABP/VABP. Desirability of outcome ranking (DOOR) is a paradigm for the design, analysis, and interpretation of clinical trials based on a patient-centered, benefit-risk
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Determining herd immunity thresholds for hepatitis A virus transmission to inform vaccination strategies among people who inject drugs in 16 U.S. States Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-09-20 Judy Yang, Nathan C Lo, Emmanuelle A Dankwa, Christl A Donnelly, Ribhav Gupta, Martha P Montgomery, Mark K Weng, Natasha K Martin
Background Widespread outbreaks of person-to-person transmission of hepatitis A virus (HAV), particularly among people who inject drugs (PWID), continue across the United States and globally. However, the herd immunity threshold and vaccination coverage required to prevent outbreaks is unknown. We aimed to use surveillance data and dynamic modeling to estimate herd immunity thresholds among PWID in
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Are contact precautions “essential” for the prevention of healthcare-associated methicillin-resistant Staphylococcus aureus? Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-09-20 Daniel J Diekema, Priya Nori, Michael P Stevens, Matthew W Smith, K C Coffey, Daniel J Morgan
The recently updated SHEA/IDSA/APIC practice recommendations for MRSA prevention in acute care facilities list contact precautions (CP) for patients known to be infected or colonized with MRSA as an “essential practice”, meaning that it should be adopted in all acute care facilities. We argue that existing evidence on benefits and harms associated with CP do not justify this recommendation. There are
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The impact of preventive treatment for multidrug- and rifampin-resistant tuberculosis exceeds trial-based estimates Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-09-18 Parastu Kasaie, Jeff Pennington, Amita Gupta, David W Dowdy, Emily A Kendall
Background Several clinical trials of tuberculosis preventive treatment (TPT) for household contacts of patients with multidrug- or rifampin-resistant tuberculosis (MDR/RR-TB) are nearing completion. The potential benefits of delivering TPT to MDR/RR-TB contacts extend beyond the outcomes that clinical trials can measure. Methods We developed an agent-based, household-structured TB and MDR/RR-TB transmission
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Rifampin Based Therapy for Patients with Staphylococcus aureus Native Vertebral Osteomyelitis: A Systematic Review and Meta-Analysis Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-09-16 Said El Zein, Elie F Berbari, Matteo Passerini, Francesco Petri, Julian Maamari, M Hassan Murad, Parham Sendi, Aaron J Tande
Background Native vertebral osteomyelitis (NVO) caused by Staphylococcus aureus is associated with high risk of treatment failure and increased morbidity. The role of rifampin-based therapy for the treatment of this condition is controversial. The goal of this systematic review and meta-analysis is to explore the efficacy and safety of rifampin-based therapy for the treatment of S. aureus NVO. Methods
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Revisiting cytomegalovirus serology in allogeneic hematopoietic cell transplant recipients Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-09-12 Vera Portillo, Stavroula Masouridi-Levrat, Léna Royston, Sabine Yerly, Manuel Schibler, Maria Mappoura, Sarah Morin, Federica Giannotti, Anne-Claire Mamez, Christian van Delden, Yves Chalandon, Dionysios Neofytos
Background Allogeneic hematopoietic cell transplant recipients (allo-HCTR) with positive CMV serology may have false positive results due to blood product transfusions associated passive immunity. Methods This is a single-center cohort study including consecutive adult allo-HCTR (01.01.2018-31.12.2022) with negative baseline (at hematologic malignancy diagnosis) and indeterminate or low-positive (CMV-IgG-titer:
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Pre-XDR congenital tuberculosis in an extremely premature baby Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-09-08 Alison Boast, Jeu Ann How, Charis Lau, Arun Sett, Damian Gilby, Andrew Burke, Brett McWhinney, Connor Wright, Adrian Tramontana, Maria Globan, Justin Denholm, Stephen M Graham, Joshua Osowicki
We describe a case of congenital tuberculosis in an extremely premature baby, with rapid molecular detection of a pre-XDR pattern of drug resistance. The baby was treated successfully with a regimen including bedaquline and delamanid, drugs not previously described in the treatment of congenital TB.
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Unintended Consequences: Risk of Opportunistic Infections Associated With Long-term Glucocorticoid Therapies in Adults Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-09-06 Daniel B Chastain, Megan Spradlin, Hiba Ahmad, Andrés F Henao-Martínez
Glucocorticoids are widespread anti-inflammatory medications used in medical practice. The immunosuppressive effects of systemic glucocorticoids and increased susceptibility to infections are widely appreciated. However, the dose-dependent model frequently used may not accurately predict the risk of infection in all patients treated with long-term glucocorticoids. In this review, we examine the risks
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Global HIV Incidence Analysis and Implications for Affordability using CAB-LA versus Continuous and Event-Driven Oral PrEP Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-31 Ishani Sharma, Andrew Hill
Background HPTN 083/084 trials showed up to 88% increased efficacy of long-acting cabotegravir (CAB-LA) versus continuous oral tenofovir/emtricitabine (TDF/FTC). However, CAB-LA’s high price limits the number who can be treated within fixed prevention budgets. Global HIV prevention budgets are highly limited, with TDF/FTC widely available as a low-cost generic. In randomised clinical trials, event-driven
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Clinical Outcomes and Management of NAAT-Positive/Toxin-Negative Clostridioides difficile Infection: A Systematic Review and Meta-Analysis Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-31 Connor Prosty, Ryan Hanula, Khaled Katergi, Yves Longtin, Emily G McDonald, Todd C Lee
Background Standalone nucleic acid amplification tests (NAATs) are frequently used to diagnose Clostridioides difficile infections (CDI), although they may be unable to distinguish colonization from disease. A two-stage algorithm pairing NAATs with toxin immunoassays (Toxin) may improve specificity. We evaluated clinical outcomes of patients who were NAAT+/Toxin + versus NAAT+/Toxin- and treated versus
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ECMO-Dependent Fulminant Melioidosis from Caspase 4 Mutation Reversed by Interferon Gamma Therapy Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-30 Aseervatham Anusha Amali, Sharada Ravikumar, Wei Leong Chew, Zhaohong Tan, Qi Hui Sam, Kaiwen W Chen, Dave Boucher, Graeme Maclaren, Louis Yi Ann Chai
We describe bedside-to-bench immunological and genetic elucidation of defective pyroptosis attributable to novel Caspase 4 defect mediating pathogen-triggered inflammatory programmed cell death, in setting of severe pneumonia and abscess-forming melioidosis in an overtly healthy host failing to clear Burkholderia pseudomallei, and how targeted adjunctive biological therapy led to successful outcome
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Individualized antibiotic plans as a quality improvement initiative to reduce carbapenem use for hematopoietic cell transplant patients at a freestanding pediatric hospital Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-29 Adam W Brothers, Daniel J Pak, Nicole M Poole, Matthew P Kronman, Brendan Bettinger, Jennifer J Wilkes, Paul A Carpenter, Janet A Englund, Scott J Weissman
Background Providers must balance effective empiric therapy against toxicity risks and collateral damage when selecting antibiotic therapy for patients receiving hematopoietic cell transplant (HCT). Antimicrobial stewardship (AMS) interventions during HCT are often challenging due to concern for undertreating potential infections. Methods In an effort to decrease unnecessary carbapenem exposure for
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Comparison of bivalent and monovalent mRNA vaccine boosters Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-29 Carlos K H Wong, Kristy T K Lau, Ivan C H Au, Eric H Y Lau, Benjamin J Cowling
In this cohort study conducted in Hong Kong where both bivalent and monovalent formulations of BNT162b2 were available, there was no significant differences in the mortality or hospitalization between those who received bivalent and monovalent mRNA as second boosters. Bivalent and monovalent mRNA boosters appear equally protective against clinical outcomes.
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Antibiotics on Demand: Advances in Asynchronous Telemedicine Call for Increased Antibiotic Surveillance Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-29 Rebecca O’Toole, Kathryn A Martinez, Michael B Rothberg, Gillian Diiorio, Edward A Stenehjem, Kristina E Ward, Kerry L LaPlante
The rapid growth of telehealth services has brought about direct-to-consumer telemedicine platforms, enabling patients to request antibiotics online without a virtual or face-to-face consultation. While telemedicine aims to enhance accessibility, this trend raises significant concerns regarding appropriate antimicrobial use and patient safety. In this viewpoint, we share our first-hand experience with
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Clinical and genomic characterization of a cohort of patients with Klebsiella pneumoniae bloodstream infection Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-24 David J Roach, Susmita Sridhar, Elizabeth Oliver, Sowmya R Rao, Damien M Slater, Wontae Hwang, Kian Hutt Vater, Anupama Dinesh, Firdausi Qadri, Jobayer Chisti, Virginia M Pierce, Sarah E Turbett, Roby P Bhattacharyya, Colin J Worby, Ashlee M Earl, Regina C LaRocque, Jason B Harris
Background The clinical and microbial factors associated with K. pneumoniae bloodstream infections (BSI) are not well characterized. Prior studies have focused on highly resistant or hypervirulent isolates, limiting our understanding of K. pneumoniae strains that commonly cause BSI. We performed a chart review and whole genome sequencing (WGS) to investigate the clinical characteristics, bacterial
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Higher serologic responses of early syphilis to single-dose benzathine penicillin G plus doxycycline versus single-dose benzathine penicillin G alone among people with HIV Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-24 Kai-Hsiang Chen, Hsin-Yun Sun, Chung-Hsu Chen, Yu-Chung Chuang, Yu-Shan Huang, Wang-Da Liu, Szu-Min Hsieh, Wang-Huei Sheng, Aristine Cheng, Tzong-Yow Wu, Kuan-Yin Lin, Chien-Ching Hung
Background Single-dose benzathine penicillin G (BPG) is the preferred therapy for early syphilis, but poorer serologic responses have been observed among people with HIV (PWH). No enhanced regimen has previously been shown to improve serologic outcomes of early syphilis. Methods We conducted a retrospective study to compare the treatment responses to single-dose BPG combined with 7-day doxycycline
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Chronic Hepatitis B Finite Treatment: similar and different concerns with new drug classes Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-24 Marion G Peters, Man-Fung Yuen, Norah Terrault, John Fry, Pietro Lampertico, Ed Gane, Carey Hwang, Luisa M Stamm, Mitchell Leus, Mala K Maini, Patricia Mendez, Isabelle Lonjon-Domanec, Thomas Berg, Su Wang, Poonam Mishra, Eric Donaldson, Stephanie Buchholz, Veronica Miller, Oliver Lenz
Chronic hepatitis B, a major cause of liver disease and cancer, affects over 250 million people worldwide. Currently there is no cure, only suppressive therapies. Efforts to develop finite curative HBV therapies are underway, consisting of combinations of multiple novel agents +/- nucleos(t)ide reverse transcriptase inhibitors. The HBV Forum convened a webinar in July 2021, and subsequent working group
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Clinical epidemiology and risk factors for critical outcomes among vaccinated and unvaccinated adults hospitalized with COVID-19—VISION Network, 10 States, June 2021–March 2023 Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-23 Eric P Griggs, Patrick K Mitchell, Victoria Lazariu, Manjusha Gaglani, Charlene McEvoy, Nicola P Klein, Nimish R Valvi, Stephanie A Irving, Noah Kojima, Edward Stenehjem, Bradley Crane, Suchitra Rao, Shaun J Grannis, Peter J Embi, Anupam B Kharbanda, Toan C Ong, Karthik Natarajan, Kristin Dascomb, Allison L Naleway, Elizabeth Bassett, Malini B DeSilva, Monica Dickerson, Deepika Konatham, Bruce Fireman
Background The epidemiology of COVID-19 continues to develop with emerging variants, expanding population-level immunity, and advances in clinical care. We describe changes in the clinical epidemiology of hospitalized COVID-19 and risk factors for critical outcomes over time. Methods We included adults aged ≥18 years from 10 states hospitalized with COVID-19 June 2021-March 2023 when multiple SARS-CoV-2
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The urgent need to implement point-of-care RNA testing for hepatitis C virus to support elimination Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-23 Shashi N Kapadia, Ashly E Jordan, Benjamin J Eckhardt, David C Perlman
Hepatitis C virus (HCV) elimination is an important global public health goal. However, the United States (US) is not on track to meet the World Health Organization’s 2030 targets for HCV elimination. Recently, the White House proposed an HCV elimination plan that includes point-of-care (POC) HCV RNA testing, which is currently in use in many countries, but is not approved in the US. POC HCV RNA testing
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Cost effectiveness of low-complexity screening tests in community-based case-finding for tuberculosis Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-23 Lukas E Brümmer, Ryan R Thompson, Akash Malhotra, Sourya Shrestha, Emily A Kendall, Jason R Andrews, Patrick Phillips, Payam Nahid, Adithya Cattamanchi, Florian M Marx, Claudia M Denkinger, David W Dowdy
Introduction In high-burden settings, low-complexity screening tests for tuberculosis (TB) could expand the reach of community-based case-finding efforts. The potential costs and cost-effectiveness of approaches incorporating these tests are poorly understood. Methods We developed a microsimulation model assessing three approaches to community-based case-finding in hypothetical populations (India-
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Prevalence, Risk factors, and Shedding of Human Herpes Virus-8 among Men Having Sex With Men Enrolled in a Pre-exposure Prophylaxis Study Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-23 Julien Gras, Marion Helary, Diane Carette, Marine Minier, Maud Salmona, Audrey Gabassi, Marine Saouzanet, Isabelle Charreau, Laurence Meyer, Jean-Michel Molina, Constance Delaugerre
Background Seroprevalence and risk factors for Human Herpesvirus-8 (HHV-8) infection among HIV-negative men who have sex with men (MSM) on pre-exposure prophylaxis (PrEP) have not been well characterized. Our objectives were to assess the prevalence and incidence of HHV-8 infection in MSM enrolled on PrEP and assess viral shedding in seropositive participants. Methods The ANRS IPERGAY study enrolled
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Characteristics and outcomes of US Veterans with immunocompromised conditions at high risk of severe SARS-CoV-2 infection with or without receipt of oral antiviral agents Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-23 Chris A Gentry, Phoi N Nguyen, Sharanjeet K Thind, George Kurdgelashvili, Riley J Williams
Objectives Molnupiravir and nirmatrelvir-ritonavir were the first oral antiviral agents to demonstrate reduced hospitalization or death in patients with SARS-CoV-2, but patients with immunocompromised conditions were not well-represented. The objective of this study was to characterize and compare the clinical outcomes of US Veterans with immunocompromised conditions prescribed oral antivirals to those
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Oral Lipid Nanocrystal Amphotericin B for Cryptococcal Meningitis: A Randomized Clinical Trial Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-22 David R Boulware, Mucunguzi Atukunda, Enock Kagimu, Abdu K Musubire, Andrew Akampurira, Lillian Tugume, Kenneth Ssebambulidde, John Kasibante, Laura Nsangi, Timothy Mugabi, Jane Gakuru, Sarah Kimuda, Derrick Kasozi, Suzan Namombwe, Isaac Turyasingura, Morris K Rutakingirwa, Edward Mpoza, Enos Kigozi, Conrad Muzoora, Jayne Ellis, Caleb P Skipper, Theresa Matkovits, Peter R Williamson, Darlisha A Williams
Background Amphotericin B is the gold standard treatment for severe mycoses. A new orally delivered, less-toxic formulation of amphotericin has been developed. Methods In our randomized clinical trial, we tested oral lipid nanocrystal (LNC) amphotericin B (MAT2203, Matinas Biopharma) vs intravenous (IV) amphotericin for human immunodeficiency virus–associated cryptococcal meningitis in 4 sequential
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Pregnancy and Birth Outcomes in Patients With Multidrug-Resistant Tuberculosis Treated With Regimens That Include New and Repurposed Drugs Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-22 Ismat Lotia Farrukh, Nathalie Lachenal, Malik M Adenov, Saman Ahmed, Yerkebulan Algozhin, Sylvine Coutisson, Epifanio Sánchez Garavito, Catherine Hewison, David Holtzman, Helena Huerga, Aleeza Janmohamed, Palwasha Y Khan, Gamarly Leblanc Jacques, Nino Lomtadze, Nara Melikyan, Carole D Mitnick, Gulnaz Mussabekova, Elna Osso, Sara Perea, Fauziah Asnely Putri, Mahmud Rashidov, Michael L Rich, Yekaterina
Among 43 pregnant women receiving multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB) treatment with bedaquiline and/or delamanid, 98% had favorable treatment outcomes. Of 31 continued pregnancies, 81% had live births with no reported malformations, and 68% of neonates had normal birth weights. Effective MDR/RR-TB treatment during pregnancy can improve maternal outcomes without harming
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Antiretroviral drug exposure and response in obese and morbidly obese people with HIV: a study combining modelling and Swiss HIV Cohort data Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-21 Mattia Berton, Sara Bettonte, Felix Stader, Laurent Decosterd, Philip E Tarr, Françoise Livio, Matthias Cavassini, Dominique L Braun, Katharina Kusejko, Anna Hachfeld, Enos Bernasconi, Alexandra Calmy, Patrick Schmid, Manuel Battegay, Catia Marzolini
Background Obesity is increasingly prevalent among people with HIV (PWH) and can possibly result in suboptimal antiretroviral drug (ARV) exposure and response. However, this has not been thoroughly evaluated given that obese PWH are underrepresented in clinical trials. We performed virtual trials using physiologically based pharmacokinetic (PBPK) modelling combined with observed clinical data to provide
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Potential impact of doxycycline post-exposure prophylaxis prescribing strategies on incidence of bacterial sexually transmitted infections Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-18 Michael W Traeger, Kenneth H Mayer, Douglas S Krakower, Sy Gitin, Samuel M Jenness, Julia L Marcus
Background Doxycycline post-exposure prophylaxis (doxyPEP) reduces bacterial sexually transmitted infection (STI) incidence in people with HIV (PWH) or using HIV preexposure prophylaxis (PrEP). Given concerns about widespread antibiotic use, we identified doxyPEP prescribing strategies to minimize use while maximizing impact on STIs. Methods We used electronic health records of gay and bisexual men
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State-of-the-Art Review: Neurosyphilis Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-18 Matthew M Hamill, Khalil G Ghanem, Susan Tuddenham
We review key concepts in the diagnosis, treatment, and follow-up of individuals with neurosyphilis. We describe the epidemiology of syphilis in the United States, highlight populations that are markedly affected by this infection, and attempt to estimate the burden of neurosyphilis. We describe the cardinal clinical features of early and late (tertiary) neurosyphilis and characterize the clinical
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Population sepsis incidence, mortality, and trends in Hong Kong between 2009–2018 using clinical and administrative data Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-17 Lowell Ling, Jack Zhenhe Zhang, Lok Ching Chang, Lok Ching Sandra Chiu, Samantha Ho, Pauline Yeung Ng, Manimala Dharmangadan, Chi Ho Lau, Steven Ling, Man Yee Man, Ka Man Fong, Ting Liong, Alwin Wai Tak Yeung, Gary Ka Fai Au, Jacky Ka Hing Chan, Michele Tang, Ying Zhi Liu, William Ka Kei Wu, Wai Tat Wong, Peng Wu, Benjamin J Cowling, Anna Lee, Chanu Rhee
Background Sepsis surveillance using electronic health record (EHR)-based data may provide more accurate epidemiologic estimates than administrative data, but experience with this approach to estimate population-level sepsis burden is lacking. Methods This was a retrospective cohort study including all adults admitted to publicly-funded hospitals in Hong Kong between 2009-2018. Sepsis was defined as
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Evaluation of Intussusception Following Pentavalent Rotavirus Vaccine (RotaTeq) Administration in Five Countries in Africa Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-17 Jacqueline E Tate, Jason M Mwenda, Adama Mamby Keita, Toussaint Wendlamita Tapsoba, Edouard Ngendahayo, Bertin Dibi Kouamé, Ahmadou Lamin Samateh, Negar Aliabadi, Seydou Sissoko, Yacouba Traore, Justin Bayisenga, Moufidath Sounkere-Soro, Sheriffo Jagne, Rachel M Burke, Uma Onwuchekwa, Ma Ouattara, Joel B Bikoroti, Kofi N’Zue, Eyal Leshem, Oumar Coulibaly, Issa Ouedraogo, Jeannine Uwimana, Samba Sow
Background A low-level risk of intussusception following rotavirus vaccination has been observed in some settings and may vary by vaccine type. We examined the association between RotaTeq vaccination and intussusception in low-income settings in a pooled analysis from five African countries that introduced RotaTeq into their national immunization program. Methods Active surveillance was conducted in
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Nirmatrelvir resistance – de novo E166V/L50V mutations in an immunocompromised patient treated with prolonged nirmatrelvir/ritonavir monotherapy leading to clinical and virological treatment failure – a case report Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-17 Neta S Zuckerman, Efrat Bucris, Danielle Keidar-Friedman, Muriel Amsalem, Tal Brosh-Nissimov
Resistance of SARS-CoV-2 to antivirals was shown to develop in immunocompromised individuals receiving remdesivir. We describe an immunocompromised patient who was treated with repeated and prolonged courses of nirmatrelvir and developed de-novo E166V/L50F mutations in the Mpro region. These mutations were associates with clinical and virological treatment failure.
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Low CD4 Count or Being Out of Care Increases the Risk for Mpox Hospitalization Among People with HIV and Mpox Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-17 David C Philpott, Robert A Bonacci, Paul J Weidle, Kathryn G Curran, John T Brooks, George Khalil, Amanda Feldpausch, Jessica Pavlick, Pascale Wortley, Jesse G O’Shea
HIV-associated immunosuppression may increase risk of hospitalization with mpox. Among persons diagnosed with mpox in the state of Georgia, we characterized the association between hospitalization with mpox and HIV status. People with HIV and CD4 < 350 cells/mm3 or who were not engaged in HIV care had increased risk of hospitalization.
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“Do We Stay or Do We Go?” The Impact of anti-LGBTQ+ Legislation on the HIV Workforce in the South Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-16 Anna K Person, Christopher P Terndrup, Mamta K Jain, Colleen F Kelley
The HIV workforce continues to face a crisis, particularly in the southern United States. Adding to known issues of administrative burden and less competitive compensation, recent anti-LGBTQ+ legislation threatens the already strained HIV workforce. HIV care providers advocate for all aspects of their patient’s lives, including those needing gender-affirming care. The recent legislative targets against
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Relationships between Schistosoma mansoni infection intensity and nutritional status and anemia among preschool-aged children in Uganda Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-16 Susannah Colt, Cole D Miller, Andrew Edielu, Emily L Webb, Patrice A Mawa, Hannah W Wu, Racheal Nakyesige, Edridah Muheki, Narcis Kabatereine, Amaya L Bustinduy, Jennifer F Friedman
In a cross-sectional analysis of 354 Ugandan children (age 12-48 months) infected with Schistosoma mansoni, we assessed relationships between infection intensity and nutritional morbidities. Higher intensity was associated with an increased risk for anemia (RR = 1.05, CI 1.01-1.10) yet not associated with risk for underweight, stunting, or wasting.
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Identifying Effective Durations of Antibiotic Therapy for the Treatment of Carbapenem-resistant Enterobacterales Bloodstream Infections: A Multicenter Observational Study Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-16 Caitlin L Soto, Alice J Hsu, Jae Hyoung Lee, Kathryn Dzintars, Rebecca Choudhury, Timothy C Jenkins, Erin K McCreary, Katelyn S Quartuccio, Erica J Stohs, Matty Zimmerman, Pranita D Tamma
In a propensity-score-weighted cohort of 183 adults with carbapenem-resistant Enterobacterales bacteremia at 24 United States hospitals, patients receiving short-courses of active therapy (7-10 days, median 9 days) experienced similar odds of recurrent bacteremia or death within 30 days as those receiving prolonged courses of active therapy (14-21 days, median 14 days).
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How we approach suppressive antibiotic therapy (SAT) following debridement, antibiotics, and implant retention for prosthetic joint infection Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-15 Nicolas Cortes-Penfield, Martin Krsak, Laura Damioli, Michael Henry, Jessica Seidelman, Angela Hewlett, Laura Certain
The optimal treatment of prosthetic joint infection (PJI) remains uncertain. Patients undergoing debridement and implant retention (DAIR) receive extended antimicrobial treatment, and some experts leave patients at perceived highest risk of relapse on suppressive antibiotic therapy (SAT). In this narrative review, we synthesize the literature concerning the role of SAT to prevent treatment failure
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Ethics of Controlled Human Infection Studies With Hepatitis C Virus Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-14 Annette Rid, Jordan J Feld, T Jake Liang, Charles Weijer
Global elimination of hepatitis C virus (HCV) will be difficult to attain without an effective HCV vaccine. Controlled human infection (CHI) studies with HCV were not considered until recently, when highly effective treatment became available. However, now that successful treatment of a deliberate HCV infection is feasible, it is imperative to evaluate the ethics of establishing a program of HCV CHI
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Direct-Acting Antiviral Therapy for Treatment of Acute and Recent Hepatitis C Virus Infection: A Narrative Review Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-14 Marianne Martinello, Susanna Naggie, Juergen Kurt Rockstroh, Gail V Matthews
Following the discovery of hepatitis C virus (HCV) in 1989, 3 decades of basic, translational, and clinical research culminated in the development of direct-acting antiviral (DAA) therapy—curative oral treatment for HCV infection. The availability of DAA therapy revolutionized HCV clinical management, including acute (duration of infection <6 mo) and recent (duration of infection <12 mo) infection
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First Do No Harm? Modeling Risks and Benefits of Challenge Trials for Hepatitis C Vaccine Development Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-14 Alyssa Bilinski, Rachel Slimovitch, Andrew Mendlowitz, Jordan J Feld, Joshua A Salomon
Background In 2019, about 58 million individuals were chronically infected with hepatitis C virus. Some experts have proposed challenge trials for hepatitis C virus vaccine development. Methods We modeled incremental infections averted through a challenge approach, under varying assumptions regarding trial duration, number of candidates, and vaccine uptake. We computed the benefit-risk ratio of incremental
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Controlled Human Infection Model for Hepatitis C Virus Vaccine Development: Trial Design Considerations Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-14 Jordan J Feld, Julie Bruneau, Gregory J Dore, Marc G Ghany, Bettina Hansen, Mark Sulkowski, David L Thomas
The design of a clinical trial for a controlled human infection model (CHIM) to accelerate hepatitis C virus (HCV) vaccine development requires careful consideration. The design of a potential approach to HCV CHIM is outlined, involving initial sentinel cohorts to establish the safety and curability of the viral inoculum followed by larger cohorts to establish the spontaneous clearance rate for each
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Risk of Hepatocellular Carcinoma After Spontaneous Clearance of Hepatitis C Virus and in Noncirrhosis Chronic Hepatitis C Patients With Sustained Virological Response: A Systematic Review Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-14 Christine C Hsu, Harish Gopalakrishna, Maria Mironova, Mei-Hsuan Lee, Chien-Jen Chen, Hwai-I Yang, Manfred Wiese, Kyong-Mi Chang, Elizabeth C Wright, Tomilowo Abijo, Jordan J Feld, David E Kaplan
In a hepatitis C virus (HCV)–controlled human infection model (CHIM), healthy volunteers are inoculated with HCV and then treated. Residual hepatocellular carcinoma (HCC) risk after viral clearance is an important consideration when evaluating the CHIM. We estimate HCC risk in spontaneously cleared HCV and in noncirrhosis after sustained virological response (SVR) to HCV treatment in a systematic review
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Volunteering for Infection: Participant Perspectives on a Hepatitis C Virus Controlled Human Infection Model Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-14 Jake D Eberts, Paul Zimmer-Harwood, James W B Elsey, Alastair Fraser-Urquhart, Thomas Smiley
Ethical human subjects research requires participants to be treated safely and respectfully, yet much bioethical debate takes place without participants. We aim to address this gap in the context of controlled human infection model (CHIM) research. Based upon our own experience as study participants, and bolstered by a survey of 117 potential hepatitis C virus CHIM participants, we present ideas to
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Challenge Inoculum for Hepatitis C Virus Controlled Human Infection Model Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-14 T Jake Liang, John L M Law, Thomas Pietschmann, Stuart C Ray, Jens Bukh, Rowena Bull, Raymond T Chung, D Lorne Tyrrell, Michael Houghton, Charles M Rice
For any controlled human infection model (CHIM), a safe, standardized, and biologically relevant challenge inoculum is necessary. For hepatitis C virus (HCV) CHIM, we propose that human-derived high-titer inocula of several viral genotypes with extensive virologic, serologic, and molecular characterizations should be the most appropriate approach. These inocula should first be tested in human volunteers
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Immunological Monitoring in Hepatitis C Virus Controlled Human Infection Model Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-14 Naglaa H Shoukry, Andrea L Cox, Christopher M Walker
Controlled human infection model trials for hepatitis C virus represent an important opportunity to identify correlates of protective immunity against a well-characterized inoculum of hepatitis C virus and how such responses are modified by vaccination. In this article, we discuss the approach to immunological monitoring during such trials, including a set of recommendations for optimal sampling schedule
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Pregnancy outcomes in women screened for tuberculosis infection in Swedish antenatal care Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-11 John Walles, Niclas Winqvist, Stefan R Hansson, Erik Sturegård, Haitham Baqir, Anna Westman, Torbjörn Kjerstadius, Thomas Schön, Per Björkman
Background Tuberculosis (TB) disease has been associated with pregnancy complications. However, the potential impact of TB infection (TBI) on pregnancy outcome is unknown. To investigate this, we conducted a register-based study in immigrant women screened with QuantiFERON assays for TBI in antenatal care in Sweden. Methods Women with history of immigration from TB-endemic countries were eligible for
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Impact of SARS-CoV-2 Arrival Surveillance Screening by Nucleic Acid Amplification Versus Rapid Antigen Detection on Subsequent COVID-19 Infections in Military Trainees Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-10 Daniel J Cybulski, Zachary Matthews, John F Kieffer, Theresa M Casey, Angela B Osuna, Korey Kasper, Dianne N Frankel, James Aden, Heather C Yun, Joseph E Marcus
Background For persons entering congregate settings optimal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) arrival surveillance screening method, nucleic acid amplification (NAAT) versus rapid antigen detection test (RADT), is debated. To aid this, we sought to determine the risk of secondary symptomatic coronavirus disease 19 (COVID-19) among military trainees with negative arrival NAAT
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Diagnostic Accuracy of Hospital Antibiograms in Predicting the Risk of Antimicrobial Resistance in Enterobacteriaceae Isolates: A Nationwide Multicenter Evaluation at the Veterans Health Administration Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-09 Shinya Hasegawa, Daniel Livorsi, Eli N Perencevich, Jonas N Church, Michihiko Goto
Background Many clinical guidelines recommend that clinicians use antibiograms to inform empiric antimicrobial therapy. However, hospital antibiograms are typically generated by crude aggregation of microbiologic data, and little is known about an antibiogram’s reliability in predicting antimicrobial resistance (AMR) risk at the patient-level. We aimed to assess the diagnostic accuracy of antibiograms
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Misclassification of Loss to Care Among Persons with HIV: Improved Capture of Silent Transfers through Surveillance Linkage using Statewide Mandatorily Reported Laboratory Measures Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-09 Daniel E Sack, Meredith Brantley, Melanie Ratliff, Samantha Mathieson, Megan Turner, April C Pettit, Timothy R Sterling, Peter F Rebeiro
HIV-positive individuals lost to follow-up from particular clinics may not be lost to care (LTC). After linking Vanderbilt’s Comprehensive Care Clinic cohort to Tennessee’s statewide HIV surveillance database, LTC decreased from 48.4% to 35.0% at 10 years. Routine surveillance-linkage by domestic HIV clinics would improve LTC and retention measure accuracy.
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The first known human death after infection with the avian influenza (A/H3N8) virus: Guangdong Province, China, March 2023 Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-09 Yali Zhuang, Man Wang, Lijun Liang, Yunxia Mao, Kaibin Wang, Shuhuan Yang, Aiping Deng, Kewen Zeng, Yingtao Zhang, Guanting Zhang, Min Kang, Baisheng Li, Meng Zhang, Shinan Ye
We reported a case of human infection with the H3N8 avian influenza virus, who had multiple myeloma and died of severe infection. Genome analysis showed multiple gene mutations and reassortments without mammalian-adaptive mutations. This report suggested that avian influenza (A/H3N8) virus infection could be lethal for person who were immunocompromised.
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The cost-effectiveness of universal asymptomatic preoperative SARS-CoV-2 PCR screening: a cost-utility analysis Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-09 Shunsuke Uno, Rei Goto, Kimiko Honda, Sho Uchida, Yoshifumi Uwamino, Ho Namkoong, Ayumi Yoshifuji, Kei Mikita, Yaoko Takano, Morio Matsumoto, Yuko Kitagawa, Naoki Hasegawa
Background An early report has shown the clinical benefit of the asymptomatic preoperative SARS-CoV-2 screening test and some clinical guidelines recommended it; however, the cost-effectiveness of asymptomatic screening was not evaluated. We aimed to investigate the cost-effectiveness of universal preoperative screening of asymptomatic patients for SARS-CoV-2 using polymerase chain reaction (PCR) testing
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Remdesivir reduced mortality in immunocompromised patients hospitalized for COVID-19 across variant waves: Findings from routine clinical practice. Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-08 Essy Mozaffari, Aastha Chandak, Robert L Gottlieb, Chidinma Chima-Melton, Stephanie H Read, Heng Jiang, Mel Chiang, EunYoung Lee, Rikisha Gupta, Mark Berry, Andre C Kalil
Background Immunocompromised patients are at high risk of severe COVID-19 and death, yet treatment strategies for immunocompromised patients hospitalized for COVID-19 reflect variations in clinical practice. This comparative effectiveness study investigated the effect of remdesivir treatment on inpatient mortality among immunocompromised patients hospitalized for COVID-19 across all variants of concern
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Infective Endocarditis After Transcatheter versus Surgical Aortic Valve Replacement Clin. Infect. Dis. (IF 11.8) Pub Date : 2023-08-08 Vassili Panagides, Guillermo Cuervo, Jaume Llopis, Mohamed Abdel-Wahab, Norman Mangner, Gilbert Habib, Ander Regueiro, Carlos Mestres, Pilar Tornos, Eric Durand, Christine Selton-Suty, Nikolaj Ihlemann, Niels Bruun, Marina Urena, Enrico Cecchi, Holger Thiele, Emanuele Durante-Mangoni, Costanza Pellegrini, Helene Eltchaninoff, Eugene Athan, Lars Søndergaard, Axel Linke, Pierre Tattevin, David del Val
Background Scarce data are available comparing infective endocarditis (IE) following surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR). This study aimed to compare the clinical presentation, microbiological profile, management, and outcomes of IE after SAVR vs. TAVR. Methods Data were collected from the “Infectious Endocarditis after TAVR International” (enrollment