Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America最新文献

{"title":"In the Literature.","authors":"Stan Deresinski","doi":"10.1093/cid/ciac366","DOIUrl":"https://doi.org/10.1093/cid/ciac366","url":null,"abstract":"JC virus (JCV) is the cause of PML, a usually fatal disease for which there is no known effective therapy. Most individuals are infected with JCV during childhood. Infection is life-long and usually asymptomatic, although urinary excretion of the virus is common. Immunocompromise, as in patients with AIDS, may lead to activation of the virus, with the development of a devastating cerebral infection. JCV has tropism for B lymphocytes, kidney epithelial cells, oligodendrocytes, and astrocytes. These cell types have been known to express surface receptors for JCV that are composed of n-linked glycoproteins containing terminal a 2–6linked sialic acid. This receptor alone is, however, insufficient to allow viral entry into the cell. Permissive cells also express a serotonergic receptor, 5HT2AR, that has now been demonstrated to be a functional receptor for JCV and to be required for its entry into the cell. The nonspecific serotonin-receptor antagonists (metoclopramide, chlorpromazine, and clozapine) each significantly inhibited JCV infection of glial cells, a finding duplicated with 5HT2AR-specific antagonists. These findings point toward a novel potential therapeutic approach involving serotonin receptor antagonists for patients with PML. These drugs, a number of which are available and in use for psychiatric and other indications, have the potential advantage of excellent bioavailability within the CNS, as well as excellent tolerability. HIV Resistance Testing","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":" ","pages":"i-ii"},"PeriodicalIF":11.8,"publicationDate":"2022-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40637401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Brainstem Mass Lesion.","authors":"Natalia E Castillo Almeida, Jorge A Trejo-Lopez, Meltiady Issa, Priya Sampathkumar","doi":"10.1093/cid/ciab786","DOIUrl":"https://doi.org/10.1093/cid/ciab786","url":null,"abstract":"","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":" ","pages":"356-357"},"PeriodicalIF":11.8,"publicationDate":"2022-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40639266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Antimicrobial and Host-Directed Therapies to Improve Clinical Outcomes of Childhood Tuberculous Meningitis.","authors":"Fajri Gafar, Ben J Marais, Heda M Nataprawira, Jan Willem C Alffenaar","doi":"10.1093/cid/ciab1036","DOIUrl":"https://doi.org/10.1093/cid/ciab1036","url":null,"abstract":"To the Editor—We read with interest the article by Thee et al [1], which reported high morbidity and mortality in children routinely treated for tuberculous meningitis (TBM) in 9 European countries, despite the low proportion of patients who presented with the most severe (grade 3) disease and ready availability of advanced supportive care [1]. The casefatality rate in this study (n = 10/104, 9.6%) was lower than global estimates in a recent meta-analysis (19.3%; 95% confidence interval [CI]: 14.0–26.1%), but the risk of neurological sequelae among survivors was high (n = 45/94, 47.9%) and comparable with global estimates (53.9%; 95% CI: 42.6–64.9%) [2]. Optimal treatment for childhood TBM remains unclear, and research should focus on optimizing mycobacterial killing and minimizing deleterious immunological responses to prevent and manage disease complications [3]. We agree with Thee et al [1] that the use of intensified antimicrobial therapy containing high-dose rifampicin and other anti-tuberculosis drugs with good cerebrospinal fluid penetration should be advocated. Based on real-world data from South Africa, a high-dose intensified regimen for 6 months composed of isoniazid, rifampicin, and ethionamide at 20 mg/kg/day and pyrazinamide at 40 mg/kg/day is currently recommended by the World Health Organization as an alternative treatment option for childhood TBM [4]. However, longer-term treatment recommendations will be strongly influenced by 2 ongoing clinical trials to shorten TBM treatment and hopefully improve TBM outcomes in children (TBM-KIDS: NCT02958709; SURE: ISRCTN40829906). A dysregulated host immune response with excessive inflammation and immune-mediated tissue damage contributes to TBM-related morbidity and mortality [3]. As the mainstay of host-directed therapy, corticosteroids have been shown to improve the TBM survival rate [5], but there is no evidence that corticosteroids reduce neurological morbidity and many children develop progressive brain pathology during TBM treatment, despite corticosteroid inclusion [2, 3]. Moreover, corticosteroids are ineffective in reducing cerebrospinal fluid tumor necrosis factor α (TNF-α), the key cytokine involved in the inflammatory response of childhood TBM and a potential major driver of adverse outcomes that occur despite adequate mycobacterial killing [6]. The use of anti–TNF-α agents is a promising approach to limit TNF-α–mediated immunopathology in children with TBM. Recently, 2 case series reported favorable treatment outcomes with infliximab, a monoclonal TNF-α antibody, in childhood and adult patients with TBM in whom the disease course was complicated by paradoxical reactions refractory to steroid treatment [7, 8]. Thalidomide, another anti–TNF-α agent, has also shown encouraging results from observational studies when used at low doses in children with TBM complications [9]; this drug was given in 8.6% of patients in Thee et al study [1]. Prospective clinical trials are warranted t","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":" ","pages":"360-361"},"PeriodicalIF":11.8,"publicationDate":"2022-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1f/4c/ciab1036.PMC9410716.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39727896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of Invasive Fungal Infections in Patients Initiating Ibrutinib and Other Small Molecule Kinase Inhibitors-United States, July 2016-June 2019.","authors":"Jeremy A W Gold, Seda S Tolu, Tom Chiller, Kaitlin Benedict, Brendan R Jackson","doi":"10.1093/cid/ciab1026","DOIUrl":"10.1093/cid/ciab1026","url":null,"abstract":"<p><p>We analyzed administrative data to determine the 1-year incidence of invasive fungal infections (IFIs) in patients beginning small molecule kinase inhibitor (SMKI) therapy. The incidence of IFIs by small molecule kinase inhibitor ranged from 0.0% to 10.6%, with patients taking midostaurin having the highest incidence. An IFI developed in 38 of 1286 patients taking ibrutinib (3.0%).</p>","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":" ","pages":"334-337"},"PeriodicalIF":0.0,"publicationDate":"2022-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9184298/pdf/nihms-1771626.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39716061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High False-Positive Rate of (1,3)-β-D-Glucan in Onco-Hematological Patients Receiving Immunoglobulins and Therapeutic Antibodies.","authors":"Jonathan Tschopp,&nbsp;Anne Sophie Brunel,&nbsp;Olivier Spertini,&nbsp;Anthony Croxatto,&nbsp;Frederic Lamoth,&nbsp;Pierre Yves Bochud","doi":"10.1093/cid/ciab1028","DOIUrl":"https://doi.org/10.1093/cid/ciab1028","url":null,"abstract":"<p><p>Immunoglobulins and/or therapeutic antibody preparations are associated with a high rate of false-positive (1,3)-β-D-glucan (BDG) tests in onco-hematological patients routinely screened for fungal infections. The benefit of BDG monitoring shall be balanced against the risk of false-positive tests leading to unnecessary investigations and costs in this population.</p>","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":" ","pages":"330-333"},"PeriodicalIF":11.8,"publicationDate":"2022-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39796321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lack of Convincing Evidence That Borrelia burgdorferi Infection Causes Either Alzheimer Disease or Lewy Body Dementia.","authors":"Gary P Wormser,&nbsp;Adriana Marques,&nbsp;Charles S Pavia,&nbsp;Ira Schwartz,&nbsp;Henry M Feder,&nbsp;Andrew R Pachner","doi":"10.1093/cid/ciab993","DOIUrl":"https://doi.org/10.1093/cid/ciab993","url":null,"abstract":"<p><p>The role that microorganisms might have in the development of Alzheimer disease is a topic of considerable interest. In this article, we discuss whether there is credible evidence that Lyme disease is a cause of Alzheimer disease and critically review a recent publication that claimed that Borrelia burgdorferi sensu stricto infection, the primary cause of Lyme disease in the United States, may cause Lewy body dementia. We conclude that no convincing evidence exists that Lyme disease is a cause of either Alzheimer disease or Lewy body dementia.</p>","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":" ","pages":"342-346"},"PeriodicalIF":11.8,"publicationDate":"2022-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9410724/pdf/ciab993.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39933391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human Papillomavirus Antibody Levels Following Vaccination or Natural Infection Among Young Men Who Have Sex With Men.","authors":"Eric P F Chow,&nbsp;Christopher K Fairley,&nbsp;Huachun Zou,&nbsp;Rebecca Wigan,&nbsp;Suzanne M Garland,&nbsp;Alyssa M Cornall,&nbsp;Steph Atchison,&nbsp;Sepehr N Tabrizi,&nbsp;Marcus Y Chen","doi":"10.1093/cid/ciab1052","DOIUrl":"https://doi.org/10.1093/cid/ciab1052","url":null,"abstract":"<p><strong>Background: </strong>Australia introduced a school-based gender-neutral human papillomavirus (HPV) vaccination program for girls and boys aged 12-13 years in 2013. We examined HPV type-specific antibody levels in unvaccinated young men who have sex with men (MSM) with natural infection and compared these with levels in those vaccinated against HPV.</p><p><strong>Methods: </strong>Serum specimens at baseline were collected from MSM aged 16-20 years in the HYPER1 (Human Papillomavirus in Young People Epidemiological Research) and HYPER2 studies, conducted in 2010-2013 and 2017-2019, respectively. Merck's 4-plex HPV competitive Luminex Immunoassay was used to quantify HPV6-, HPV11-, HPV16-, and HPV18-specific antibodies. We compared antibody levels for each HPV genotype between unvaccinated men (HYPER1) and vaccinated men (HYPER2) using the Mann-Whitney U test.</p><p><strong>Results: </strong>There were 200 unvaccinated men and 127 vaccinated men included in the analysis. Median antibody levels among vaccinated men were significantly higher than levels among unvaccinated men for HPV6 (223 milli-Merck units per milliliter [mMU/mL] vs 48 mMU/mL, P < .0001), HPV11 (163 mMU/mL vs 21 mMU/mL, P < .0001), HPV16 (888 mMU/mL vs 72 mMU/mL, P < .0001), and HPV18 (161 mMU/mL vs 20 mMU/mL, P < .0001). Antibody levels did not change over time for up to 66 months for all 4 genotypes among vaccinated men.</p><p><strong>Conclusions: </strong>Among young MSM vaccinated with the quadrivalent HPV vaccine, antibody levels for HPV6, HPV11, HPV16, and HPV18 were significantly higher than those in unvaccinated MSM following natural infection. Antibody levels following vaccination appeared to remain stable over time.</p><p><strong>Clinical trials registration: </strong>NCT01422356 for HYPER1 and NCT03000933 for HYPER2.</p>","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":" ","pages":"323-329"},"PeriodicalIF":11.8,"publicationDate":"2022-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39775390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Mycobacterium tuberculosis in Sputum and Reported Symptoms Among Clinic Attendees Compared With a Community Survey in Rural South Africa.","authors":"Indira Govender, Aaron S Karat, Stephen Olivier, Kathy Baisley, Peter Beckwith, Njabulo Dayi, Jaco Dreyer, Dickman Gareta, Resign Gunda, Karina Kielmann, Olivier Koole, Ngcebo Mhlongo, Tshwaraganang Modise, Sashen Moodley, Xolile Mpofana, Thumbi Ndung'u, Deenan Pillay, Mark J Siedner, Theresa Smit, Ashmika Surujdeen, Emily B Wong, Alison D Grant","doi":"10.1093/cid/ciab970","DOIUrl":"10.1093/cid/ciab970","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) case finding efforts typically target symptomatic people attending health facilities. We compared the prevalence of Mycobacterium tuberculosis (Mtb) sputum culture-positivity among adult clinic attendees in rural South Africa with a concurrent, community-based estimate from the surrounding demographic surveillance area (DSA).</p><p><strong>Methods: </strong>Clinic: Randomly selected adults (≥18 years) attending 2 primary healthcare clinics were interviewed and requested to give sputum for mycobacterial culture. Human immunodeficiency virus (HIV) and antiretroviral therapy (ART) status were based on self-report and record review. Community: All adult (≥15 years) DSA residents were invited to a mobile clinic for health screening, including serological HIV testing; those with ≥1 TB symptom (cough, weight loss, night sweats, fever) or abnormal chest radiograph were asked for sputum.</p><p><strong>Results: </strong>Clinic: 2055 patients were enrolled (76.9% female; median age, 36 years); 1479 (72.0%) were classified HIV-positive (98.9% on ART) and 131 (6.4%) reported ≥1 TB symptom. Of 20/2055 (1.0% [95% CI, .6-1.5]) with Mtb culture-positive sputum, 14 (70%) reported no symptoms. Community: 10 320 residents were enrolled (68.3% female; median age, 38 years); 3105 (30.3%) tested HIV-positive (87.4% on ART) and 1091 (10.6%) reported ≥1 TB symptom. Of 58/10 320 (0.6% [95% CI, .4-.7]) with Mtb culture-positive sputum, 45 (77.6%) reported no symptoms. In both surveys, sputum culture positivity was associated with male sex and reporting >1 TB symptom.</p><p><strong>Conclusions: </strong>In both clinic and community settings, most participants with Mtb culture-positive sputum were asymptomatic. TB screening based only on symptoms will miss many people with active disease in both settings.</p>","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":" ","pages":"314-322"},"PeriodicalIF":0.0,"publicationDate":"2022-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9410725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39692808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatitis E Virus Species C Infection in Humans, Hong Kong.","authors":"Siddharth Sridhar,&nbsp;Cyril Chik Yan Yip,&nbsp;Kelvin Hon Yin Lo,&nbsp;Shusheng Wu,&nbsp;Jianwen Situ,&nbsp;Nicholas Foo Siong Chew,&nbsp;Kit Hang Leung,&nbsp;Helen Shuk Ying Chan,&nbsp;Sally Cheuk Ying Wong,&nbsp;Anthony Wai Shing Leung,&nbsp;Cindy Wing Sze Tse,&nbsp;Kitty S C Fung,&nbsp;Owen Tak Yin Tsang,&nbsp;Kam Lun Hon,&nbsp;Vincent Chi Chung Cheng,&nbsp;Ken Ho Leung Ng,&nbsp;Kwok Yung Yuen","doi":"10.1093/cid/ciab919","DOIUrl":"https://doi.org/10.1093/cid/ciab919","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis E virus (HEV) variants belonging to Orthohepevirus species A (HEV-A) are the primary cause of human hepatitis E. However, we previously reported that Orthohepevirus species C genotype 1 (HEV-C1), a divergent HEV variant commonly found in rats, also causes hepatitis in humans. Here, we present a clinical-epidemiological investigation of human HEV-C1 infections detected in Hong Kong, with an emphasis on outcomes in immunocompromised individuals.</p><p><strong>Methods: </strong>A surveillance system for detecting human HEV-C1 infections was established in Hong Kong. Epidemiological and clinical characteristics of HEV-C1 cases identified via this system between 1 August 2019 and 31 December 2020 were retrieved. Phylogenetic analysis of HEV-C1 strain sequences was performed. Infection outcomes of immunocompromised individuals with HEV-A and HEV-C1 infections were analyzed.</p><p><strong>Results: </strong>HEV-C1 accounted for 8 of 53 (15.1%) reverse-transcription polymerase chain reaction (RT-PCR)-confirmed HEV infections in Hong Kong during the study period, raising the total number of HEV-C1 infections detected in the city to 16. Two distinct HEV-C1 strain groups caused human infections. Patients were elderly and/or immunocompromised; half tested negative for HEV immunoglobulin M. Cumulatively, HEV-C1 accounted for 9 of 21 (42.9%) cases of hepatitis E recorded in immunocompromised patients in Hong Kong. Immunocompromised HEV-C1 patients progressed to persistent hepatitis at similar rates (7/9 [77.8%]) as HEV-A patients (10/12 [75%]). HEV-C1 patients responded to oral ribavirin, although response to first course was sometimes poor or delayed.</p><p><strong>Conclusions: </strong>Dedicated RT-PCR-based surveillance detected human HEV-C1 cases that evade conventional hepatitis E diagnostic testing. Immunosuppressed HEV-C1-infected patients frequently progress to persistent HEV-C1 infection, for which ribavirin is a suitable treatment option.</p>","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":" ","pages":"288-296"},"PeriodicalIF":11.8,"publicationDate":"2022-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39577045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaccine Effectiveness Against Life-Threatening Influenza Illness in US Children.","authors":"Samantha M Olson,&nbsp;Margaret M Newhams,&nbsp;Natasha B Halasa,&nbsp;Leora R Feldstein,&nbsp;Tanya Novak,&nbsp;Scott L Weiss,&nbsp;Bria M Coates,&nbsp;Jennifer E Schuster,&nbsp;Adam J Schwarz,&nbsp;Aline B Maddux,&nbsp;Mark W Hall,&nbsp;Ryan A Nofziger,&nbsp;Heidi R Flori,&nbsp;Shira J Gertz,&nbsp;Michele Kong,&nbsp;Ronald C Sanders,&nbsp;Katherine Irby,&nbsp;Janet R Hume,&nbsp;Melissa L Cullimore,&nbsp;Steven L Shein,&nbsp;Neal J Thomas,&nbsp;Laura S Stewart,&nbsp;John R Barnes,&nbsp;Manish M Patel,&nbsp;Adrienne G Randolph","doi":"10.1093/cid/ciab931","DOIUrl":"https://doi.org/10.1093/cid/ciab931","url":null,"abstract":"<p><strong>Background: </strong>Predominance of 2 antigenically drifted influenza viruses during the 2019-2020 season offered an opportunity to assess vaccine effectiveness against life-threatening pediatric influenza disease from vaccine-mismatched viruses in the United States.</p><p><strong>Methods: </strong>We enrolled children aged <18 years admitted to the intensive care unit with acute respiratory infection across 17 hospitals. Respiratory specimens were tested using reverse-transcription polymerase chain reaction for influenza viruses and sequenced. Using a test-negative design, we estimated vaccine effectiveness comparing odds of vaccination in test-positive case patients vs test-negative controls, stratifying by age, virus type, and severity. Life-threating influenza included death or invasive mechanical ventilation, vasopressors, cardiopulmonary resuscitation, dialysis, or extracorporeal membrane oxygenation.</p><p><strong>Results: </strong>We enrolled 159 critically ill influenza case-patients (70% ≤8 years; 51% A/H1N1pdm09 and 25% B-Victoria viruses) and 132 controls (69% were aged ≤8 years). Among 56 sequenced A/H1N1pdm09 viruses, 29 (52%) were vaccine-mismatched (A/H1N1pdm09/5A+156K) and 23 (41%) were vaccine-matched (A/H1N1pdm09/5A+187A,189E). Among sequenced B-lineage viruses, majority (30 of 31) were vaccine-mismatched. Effectiveness against critical influenza was 63% (95% confidence interval [CI], 38% to 78%) and similar by age. Effectiveness was 75% (95% CI, 49% to 88%) against life-threatening influenza vs 57% (95% CI, 24% to 76%) against non-life-threating influenza. Effectiveness was 78% (95% CI, 41% to 92%) against matched A(H1N1)pdm09 viruses, 47% (95% CI, -21% to 77%) against mismatched A(H1N1)pdm09 viruses, and 75% (95% CI, 37% to 90%) against mismatched B-Victoria viruses.</p><p><strong>Conclusions: </strong>During a season when vaccine-mismatched influenza viruses predominated, vaccination was associated with a reduced risk of critical and life-threatening influenza illness in children.</p>","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":" ","pages":"230-238"},"PeriodicalIF":11.8,"publicationDate":"2022-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39816853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}