Clinical Infectious Diseases最新文献

No impact of HIV coinfection on the mortality in patients with hepatitis C virus infection after sustained virological response

IF 11.8 1区医学

Clinical Infectious Diseases Pub Date : 2024-09-18 DOI: 10.1093/cid/ciae473

Jesica Martín-Carmona, Anaïs Corma-Gómez, Francisco Téllez, Dolores Arenga-Barrios, Miriam Serrano-Fuentes, Luis Morano, Diana Corona-Mata, Miguel Nicolás Navarrete Lorite, Francisco Jesús Vera-Méndez, Juan Carlos Alados, Rosario Palacios, Ignacio de los Santos, Paloma Geijo, Arkaitz Imaz, Dolores Merino, Sergio Javier Reus-Bañuls, Maria Jose Galindo, Miguel Ángel López-Ruz, Carlos Galera, Juan A Pineda, Juan Macías

{"title":"No impact of HIV coinfection on the mortality in patients with hepatitis C virus infection after sustained virological response","authors":"Jesica Martín-Carmona, Anaïs Corma-Gómez, Francisco Téllez, Dolores Arenga-Barrios, Miriam Serrano-Fuentes, Luis Morano, Diana Corona-Mata, Miguel Nicolás Navarrete Lorite, Francisco Jesús Vera-Méndez, Juan Carlos Alados, Rosario Palacios, Ignacio de los Santos, Paloma Geijo, Arkaitz Imaz, Dolores Merino, Sergio Javier Reus-Bañuls, Maria Jose Galindo, Miguel Ángel López-Ruz, Carlos Galera, Juan A Pineda, Juan Macías","doi":"10.1093/cid/ciae473","DOIUrl":"https://doi.org/10.1093/cid/ciae473","url":null,"abstract":"Background In patients with hepatitis C virus (HCV) chronic infection and advanced liver disease, the impact of human immunodeficiency virus (HIV) coinfection on the clinical outcome after sustained virological response (SVR) has not been sufficiently clarified. The aim of this study was to compare the mortality after SVR of patients bearing HCV chronic infection and advanced liver fibrosis, with and without HIV-coinfection after a prolonged follow-up. Methods This was a prospective multicenter cohort study including individuals with HIV/HCV-coinfection and patients with HCV-monoinfection from Spain, fulfilling: 1) Liver stiffness (LS) ≥9.5 kPa before treatment; 2) SVR with a direct-acting antiviral (DAA) based regimen; 3) LS measurement available at SVR. The main outcome was overall survival. Mortality attributable to liver disease and non-hepatic causes was also assessed. Results 1,118 patients were included, of whom 676 (60.5%) were living with HIV. The median (Q1-Q3) follow-up was 76 months (57-83). After SVR, 46 (10%) HCV-monoinfected and 74 (11%) HIV/HCV-coinfected patients died. The overall mortality rate (95% CI) was 1.9 (1.6-2.2) per 100 person-years, 1.9 (1.4-2.5) per 100 person-years in patients with HCV-monoinfection and 1.8 (1.6-2.3) per 100 person-years in people living with HIV. In the multivariable analysis, HIV-coinfection was not associated with a shorter survival [0.98 HR (95% confidence interval, CI) = (0.61-1.58), p=0.939]. Conclusions In patients with HCV chronic infection and advanced fibrosis, HIV-coinfection does not reduce the overall survival after SVR.","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":11.8,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142245212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Oral versus intravenous antibiotic therapy for Staphylococcus aureus bacteremia or endocarditis: a systematic review and meta-analysis of randomized controlled trials

IF 11.8 1区医学

Clinical Infectious Diseases Pub Date : 2024-09-18 DOI: 10.1093/cid/ciae476

Ahmad Mourad, Nnamdi Nwafo, Lesley Skalla, Thomas L Holland, Timothy C Jenkins

{"title":"Oral versus intravenous antibiotic therapy for Staphylococcus aureus bacteremia or endocarditis: a systematic review and meta-analysis of randomized controlled trials","authors":"Ahmad Mourad, Nnamdi Nwafo, Lesley Skalla, Thomas L Holland, Timothy C Jenkins","doi":"10.1093/cid/ciae476","DOIUrl":"https://doi.org/10.1093/cid/ciae476","url":null,"abstract":"Background We conducted a systematic review of randomized controlled trials (RCTs) to generate more precise estimates of the efficacy and safety of oral versus intravenous antibiotic therapy for S. aureus bacteremia or endocarditis. Methods MEDLINE, EMBASE, the Cochrane Library, and Web of Science database were searched through February 21st, 2024. RCTs were included if they compared oral versus intravenous antibiotic therapy for S. aureus bacteremia or endocarditis, and appropriately reported outcomes for each group. Risk of bias was assessed using the revised Cochrane tool for assessing risk of bias in randomized trials. Heterogeneity between studies was evaluated with the Cochran’s Q-statistic and I2 test. Treatment effects were summarized with pooled risk ratios using a random effects model meta-analysis. (PROSPERO CRD42024481512) Results Only four RCTs met criteria for inclusion in meta-analysis. Among participants assessed for treatment failure, there was no difference between the oral and intravenous therapy groups (RR 0.99; 95% CI, 0.63–1.57; I2 = 0%). There was also no significant difference in adverse events between oral and intravenous therapy groups (RR 0.65; 95% CI, 0.07–5.94; I2 = 74%); however, the confidence interval is wide, and heterogeneity was high. Conclusions In this systematic review of RCTs comparing oral to intravenous antibiotic therapy for S. aureus bacteremia or endocarditis, few studies met eligibility criteria for inclusion. Meta-analysis of these studies suggests that transitioning from intravenous to oral therapy is likely effective in a subgroup of carefully selected patients. Additional randomized trials are necessary before transition to oral therapy can be routinely recommended.","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":11.8,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142245582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A randomized controlled trial of efficacy and safety of Fecal Microbiota Transplant for preventing recurrent Clostridioides difficile infection 粪便微生物群移植预防艰难梭菌复发感染的有效性和安全性随机对照试验

IF 11.8 1区医学

Clinical Infectious Diseases Pub Date : 2024-09-14 DOI: 10.1093/cid/ciae467

Dimitri M Drekonja, Aasma Shaukat, Yuan Huang, Jane H Zhang, Andrew R Reinink, Sean Nugent, Jason A Dominitz, Anne Davis-Karim, Dale N Gerding, Tassos C Kyriakides

{"title":"A randomized controlled trial of efficacy and safety of Fecal Microbiota Transplant for preventing recurrent Clostridioides difficile infection","authors":"Dimitri M Drekonja, Aasma Shaukat, Yuan Huang, Jane H Zhang, Andrew R Reinink, Sean Nugent, Jason A Dominitz, Anne Davis-Karim, Dale N Gerding, Tassos C Kyriakides","doi":"10.1093/cid/ciae467","DOIUrl":"https://doi.org/10.1093/cid/ciae467","url":null,"abstract":"Background Clostridioides difficile infection (CDI) is the most common cause of healthcare–associated infections in US hospitals with 15%-30% of patients experiencing recurrence. The aim of our randomized, double-blind clinical trial was to assess the efficacy of capsule-delivered fecal microbiota transplantation (FMT) versus placebo in reducing recurrent diarrhea and CDI recurrence. The secondary aim was FMT safety assessment. Methods Between 2018 and 2022, Veterans across the Veterans Health Administration system with recurrent CDI who responded to antibiotic treatment were randomized in a 1:1 ratio to oral FMT or placebo capsules. Randomization was stratified by number of prior CDI recurrences (1 or ≥2). The primary endpoint was clinical recurrence by day 56, defined as &gt;3 unformed stools daily for ≥2 days with or without laboratory confirmation of C. difficile, or death within 56 days. Results The study was stopped due to futility after meeting pre-specified criteria. Of 153 participants (76 FMT, 77 placebo) with an average age of 66.5 years, 25 participants (32.9%) in the FMT arm and 23 (29.9%) in the placebo arm experienced the primary endpoint of diarrhea and possible or definite CDI recurrence or death within 56 days of capsule administration (absolute difference 3.0%; 95% CI [-11.7%, 17.7%]). Stratification by number of recurrences revealed no statistically significant differences. There were no clinically important differences in adverse events. Conclusions FMT therapy vs. placebo did not reduce CDI recurrence or death at 56 days. There were no meaningful differences in adverse events between treatment groups.","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":11.8,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142233264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Effects of Vaccination Status and Age on Clinical Characteristics and Severity of Measles Cases in the United States in the Post-Elimination Era, 2001-2022 2001-2022 年美国麻疹疫苗接种情况和年龄对麻疹病例临床特征和严重程度的影响

IF 11.8 1区医学

Clinical Infectious Diseases Pub Date : 2024-09-13 DOI: 10.1093/cid/ciae470

Jessica Leung, Naeemah A Munir, Adria D Mathis, Thomas D Filardo, Paul A Rota, David E Sugerman, Sun B Sowers, Sara Mercader, Stephen N Crooke, Paul A Gastañaduy

{"title":"The Effects of Vaccination Status and Age on Clinical Characteristics and Severity of Measles Cases in the United States in the Post-Elimination Era, 2001-2022","authors":"Jessica Leung, Naeemah A Munir, Adria D Mathis, Thomas D Filardo, Paul A Rota, David E Sugerman, Sun B Sowers, Sara Mercader, Stephen N Crooke, Paul A Gastañaduy","doi":"10.1093/cid/ciae470","DOIUrl":"https://doi.org/10.1093/cid/ciae470","url":null,"abstract":"Background Despite high vaccine-effectiveness, wild-type measles can occur in previously vaccinated persons. We compared the clinical presentation and disease severity of measles by vaccination status and age in the post-elimination era in the United States. Methods We included U.S. measles cases reported from 2001–2022. Breakthrough measles was defined as cases with ≥1 documented dose of measles-containing vaccine, classic measles as the presence of rash, fever, and ≥1 symptoms (cough, coryza, or conjunctivitis), and severe disease as the presence of pneumonia, encephalitis, hospitalization, or death. Vaccinated cases with low and high avidity IgG were classified as primary (PVF) and secondary (SVF) vaccine failures, respectively. Results Among 4,056 confirmed measles cases, 2,799 (69%) were unvaccinated, 475 (12%) were breakthrough infections, and 782 (19%) had unknown vaccination; 1,526 (38%), 1,174 (29%), and 1,355 (33%) were aged &lt;5, 5–19, and ≥20 years, respectively. We observed a general decline in classic presentation and severe disease with an increase in the number of doses, and less complications among children aged 5–19 years compared to other age-groups. Among 93 breakthrough cases with avidity results, 11 (12%) and 76 (82%) were classified as PVF and SVF, respectively, with a higher proportion of PVFs having a classic measles presentation and severe disease than SVFs. Discussion Breakthrough measles cases tended to have milder disease with less complications. A small proportion of breakthrough infections were due to PVF than SVF. It is critical to maintain high MMR vaccination coverage in the United States to prevent serious measles illnesses.","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":11.8,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142233266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Déjà vu: Unanswered Questions about Fecal Microbiota Transplantation for Recurrent Clostridioides difficile Infection. 似曾相识：粪便微生物群移植治疗复发性艰难梭菌感染的未解之谜。

IF 11.8 1区医学

Clinical Infectious Diseases Pub Date : 2024-09-13 DOI: 10.1093/cid/ciae468

Susan M Poutanen,Susy S Hota

引用次数: 0

Impact of baseline SARS-CoV-2 load in plasma and upper airways on the incidence of acute extrapulmonary complications of COVID-19: a multicentric, prospective, cohort study 血浆和上呼吸道中的 SARS-CoV-2 基线载量对 COVID-19 急性肺外并发症发病率的影响：一项多中心、前瞻性、队列研究

IF 11.8 1区医学

Clinical Infectious Diseases Pub Date : 2024-09-12 DOI: 10.1093/cid/ciae469

Tomas O Jensen, Katrina Harper, Shaili Gupta, Sean T Liu, Nila J Dharan, Jason V Baker, Sarah L Pett, Kathryn Shaw-Saliba, Aliasgar Esmail, Minh Q Ho, Eyad Almasri, Robin L Dewar, Jens Lundgren, David M Vock

{"title":"Impact of baseline SARS-CoV-2 load in plasma and upper airways on the incidence of acute extrapulmonary complications of COVID-19: a multicentric, prospective, cohort study","authors":"Tomas O Jensen, Katrina Harper, Shaili Gupta, Sean T Liu, Nila J Dharan, Jason V Baker, Sarah L Pett, Kathryn Shaw-Saliba, Aliasgar Esmail, Minh Q Ho, Eyad Almasri, Robin L Dewar, Jens Lundgren, David M Vock","doi":"10.1093/cid/ciae469","DOIUrl":"https://doi.org/10.1093/cid/ciae469","url":null,"abstract":"Background Extrapulmonary complications (EPCs) are common in patients hospitalized for COVID-19, but data on their clinical consequences and association with viral replication and systemic viral dissemination is lacking. Methods Patients hospitalized for COVID-19 and enrolled in the TICO (Therapeutics for Inpatients with COVID-19) platform trial at 114 international sites between August 2020 and November 2021 were included in a prospective cohort study. We categorized EPCs into 39 event types within 9 categories and estimated their frequency through day 28 and their association with clinical outcomes through day 90. We analyzed the association between baseline viral burden (plasma nucleocapsid antigen [N-Ag] and upper airway viral load [VL]) and EPCs, adjusting for other baseline factors. Results 2,625 trial participants were included in the study. The median age was 57 years (IQR 46-68), 57.7% were male, and 537 (20.5%) had at least one EPC. EPCs were associated with higher day-90 all-cause mortality (HR 9.6, 95% CI 7.3, 12.7) after adjustment for other risk factors. The risk of EPCs increased with increasing baseline plasma N-Ag (HR 1.21 per log10 ng/L increase, 95% CI 1.09, 1.34), and upper airway VL (HR 1.12 per log10 copies/mL increase, 95% CI 1.04, 1.19), after adjusting for comorbidities, disease severity, inflammatory markers, and other baseline factors. Trial treatment allocation had no effect on EPC risk. Conclusions Systemic viral dissemination as evidenced by high plasma N-Ag and high respiratory viral burden are associated with development of EPCs in COVID-19, which in turn are associated with higher 90-day mortality.","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":11.8,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142233267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Does "Toxoplasma abscess" Properly Describe Brain Lesions Caused by Toxoplasma gondii? 弓形虫脓肿 "能正确描述弓形虫引起的脑损伤吗？

IF 8.2 1区医学

Clinical Infectious Diseases Pub Date : 2024-09-09 DOI: 10.1093/cid/ciae463

José Ernesto Vidal, Amaro Nunes Duarte, Felicia C Chow, Maria Irma Seixas Duarte

引用次数: 0

Vaccine Development Should Be Polytheistic, Not Monotheistic. 疫苗研发应是多神论，而非一神论。

IF 8.2 1区医学

Clinical Infectious Diseases Pub Date : 2024-09-06 DOI: 10.1093/cid/ciae460

Stanley A Plotkin, James M Robinson, Joseph R A Fitchett, Edward Gershburg

引用次数: 0

Adverse impact of azithromycin on the rectal microbiome. 阿奇霉素对直肠微生物群的不良影响