Open Forum Infectious Diseases最新文献

{"title":"What is in the Word \"Antibiotic?\" From Microbial Warfare to Microbial Signaling.","authors":"Carlos R V Kiffer","doi":"10.1093/ofid/ofag632","DOIUrl":"https://doi.org/10.1093/ofid/ofag632","url":null,"abstract":"","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag632"},"PeriodicalIF":3.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Initiation but Suboptimal Completion of Tuberculosis-Preventive Treatment Among People Living With HIV on Antiretroviral Therapy, Persistent Tuberculosis Incidence, and Programmatic Implications: Findings From a 2-Year Multicountry Cohort Study.","authors":"L Chimoyi, S Ginindza, B A S Nonyane, C Mulder, A Bedru, N Kawaza, J E Golub, K Shearer, A Kennar, L Mvusi, K Vilakazi-Nhlapo, T Apollo, M Ncube, C Gwanzura, G Bisa, D Gadissa, T Mabuto, L Tsope, I Rabothata, N Ntombela, K Sithole, S Sisay, M Makgabo, R E Chaisson, G Churchyard, C J Hoffmann, V Chihota","doi":"10.1093/ofid/ofag595","DOIUrl":"10.1093/ofid/ofag595","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis-preventive treatment (TPT) is recommended for those at risk of tuberculosis, but despite encouraging trial data, evidence of its effectiveness from routine settings with diverse TPT regimens is limited. We describe routine TPT implementation outcomes in people living with human immunodeficiency virus (HIV; PLWH) to identify bottlenecks and opportunities for improvement along the cascade of care.</p><p><strong>Methods: </strong>From 2021-2023, we conducted a 24-month prospective cohort study of PLWH facilities in Ethiopia, South Africa and Zimbabwe. Sociodemographic and clinical data were collected at enrollment. During follow-up, we collected TPT initiation, TPT-related adverse effects, and completion data. A subgroup was allocated digital boxes as a proxy measure for assessing treatment completion. Tuberculosis diagnoses were confirmed from clinic records or symptom agnostic sputum testing using Xpert MTB/RIF assay and mycobacteria growth indicator tube (MGIT) culture at 12- and 24 months after enrollment.</p><p><strong>Results: </strong>We enrolled 2095 participants, mostly female (n = 1489 [71.1%]), with a median age of 42 years (interquartile range, 35-50 years). Approximately 60% (n = 1312) were considered eligible for TPT, and 1110 (84.6%) initiated TPT within 60 days of antiretroviral therapy initiation or refill during follow-up (rifapentine and isoniazid [3HP] in 625 and 6 or 12 months of isoniazid [6H/12H] in 487). TPT was completed in 55.4% (406 of 733). Mild symptoms compatible with TPT adverse effects were commonly reported in 3HP versus 6H/12H (190 [31.0%] vs 51 [11.0%], respectively; <i>P</i> < .001]. The tuberculosis incidence rate was 1.27/100 person-years (95% confidence interval, .95-1.69) during study follow-up in a mostly long-term antiretroviral therapy population and was lower for PLWH who completed TPT (adjusted incidence rate ratio, 0.39 [.20-.78]; <i>P</i> = .01).</p><p><strong>Conclusions: </strong>There were losses along the cascade, particularly at completion. In programmatic settings, we observed more potential mild symptoms from 3HP compared to 6H/12H use. Interventions to support TPT completion are needed.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag595"},"PeriodicalIF":3.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Prevalence of Endemic Respiratory Viruses During the COVID-19 Pandemic in Urban and Rural Malawi.","authors":"","doi":"10.1093/ofid/ofag682","DOIUrl":"https://doi.org/10.1093/ofid/ofag682","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/ofid/ofad643.].</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag682"},"PeriodicalIF":3.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Utility of Microbial Cell-Free DNA in the Rapid Diagnosis of Chagas Disease: Chagas Disease Case Series.","authors":"Anissa Amilhamja, Adam Shaikh, Kristin Mondy, Michael Kron, Niki Viradia, Omer Beaird, Jaime Fergie","doi":"10.1093/ofid/ofag584","DOIUrl":"https://doi.org/10.1093/ofid/ofag584","url":null,"abstract":"<p><strong>Background: </strong>Chagas disease (CD) is a leading tropical disease and the most prevalent parasitic infection in Latin America, affecting >7 million people globally and ∼240 000-350 000 individuals within the United States. Though known to be endemic to Latin America, prevalence in the United States is also increasing with improved recognition of locally acquired cases, especially in Texas. Autochthonous cases occur throughout the Southern United States, but the geographic range is anticipated to shift northwards as a result of climate change. Chagas disease is referred to as a \"silent and silenced disease\" by the World Health Organization as most people show no signs or symptoms for years following acute infection, and it primarily affects individuals who are socioeconomically disadvantaged. Historically, Chagas disease has been underrecognized. In the absence of treatment, infected individuals progress to a clinically silent or \"indeterminate form\" of infection that persists for life. While most patients with indeterminate Chagas disease do not have long-term sequelae, ∼30%-40% will develop end-organ cardiac or gastrointestinal disease decades after infection. Due to its protean clinical presentations, diagnosis requires a high clinical index of suspicion and knowledge of the epidemiology. Traditionally, the diagnosis is based on serology, visualization of the parasite in blood, and polymerase chain reaction (PCR), all of which require suspecting the infection. Microbial cell-free DNA (mcfDNA) of blood can serve as a useful tool for detection of <i>Trypanosoma cruzi</i> even when Chagas disease is not suspected.</p><p><strong>Results: </strong>Here we present 7 cases, 3 children and 4 adults, who presented with nonspecific manifestations; CD was not in the initial differential diagnosis in 5 of them. Chagas disease was ultimately diagnosed by Karius Spectrum test. In 1 case, the test was sent to expedite diagnosis in the setting of suspected Chagas reactivation.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag584"},"PeriodicalIF":3.8,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aligning Antimicrobial Stewardship and Infection Prevention Through Repeated Assessment and Feedback: A Multisite Quality Improvement Initiative in Viet Nam.","authors":"Quoc Phuong Nguyen, Van Giang Tran, Hai Yen Nguyen, Thi Phuong Oanh Pham, Trung Cap Nguyen, Minh Dien Vu, Anh Cuong Tran, Thi Ngoc Diep Nguyen, Van Minh Nguyen, Ba Hai Mai, Bao Dung Vo, Thanh Bao Nguyen, Dinh Phu Vu, Thi Thuy Van Pham, Thi Bich Ngoc Hoang, H Rogier van Doorn, Thomas Kesteman, Huong Thi Lan Vu","doi":"10.1093/ofid/ofag605","DOIUrl":"https://doi.org/10.1093/ofid/ofag605","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial stewardship (AMS) and infection prevention and control (IPC) are complementary strategies to improve patient safety and address antimicrobial resistance (AMR). In low- and middle-income countries (LMICs), they are often implemented separately, limiting potential impact.</p><p><strong>Objective: </strong>To evaluate the feasibility of an aligned AMS-IPC improvement approach and describe changes in implementation in Vietnamese hospitals.</p><p><strong>Methods: </strong>We conducted a quality improvement initiative in 4 hospitals within the national AMR surveillance network in Viet Nam (March-September 2025). We used US-CDC's tools to guide implementation, including the Global Antibiotic Stewardship Evaluation Tool (G-ASET) and the Infection Control Assessment and Response (ICAR) tool. Baseline assessments were followed by feedback, multidisciplinary action planning, and targeted capacity building. Follow-up occurred 2-5 months later. Changes were analyzed descriptively using quantitative scores and qualitative synthesis and reported following the SQUIRE 2.0 guidelines.</p><p><strong>Results: </strong>All hospitals had established IPC programs at baseline, while AMS maturity varied. G-ASET scores increased across all sites, with larger absolute gains in hospitals starting from lower baselines. Improvements were seen in leadership and governance, education and training, stewardship actions, and monitoring and reporting. Selected IPC activities aligned with AMS priorities also improved, particularly transmission-based precautions, environmental cleaning, and cross-team coordination. Infrastructure-dependent areas, such as water safety, showed limited short-term progress.</p><p><strong>Conclusions: </strong>This aligned AMS-IPC quality improvement strategy was feasible and associated with improvements in implementation capacity and program maturity over short follow-up. Further studies with longer follow-up, comparator designs, and outcome-level measures are needed to evaluate effectiveness, sustainability, and generalizability.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag605"},"PeriodicalIF":3.8,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tuberculosis Risk in the Returning Traveler: Assessing Tuberculosis Test Conversion Among Routinely Tested Patients at an Asian American Health Center.","authors":"Nozomi Fukui, Zinnia Dong, Amy S Tang, Adam Readhead, Shereen S Katrak","doi":"10.1093/ofid/ofag606","DOIUrl":"https://doi.org/10.1093/ofid/ofag606","url":null,"abstract":"<p><strong>Background: </strong>In the United States, testing for latent tuberculosis (TB) infection is recommended for persons from higher-TB-prevalence countries, but guidelines do not address repeat testing for persons with international travel.</p><p><strong>Methods: </strong>Using 2010-2022 data from a Californian federally qualified health center serving an Asian American population, we measured the incidence of TB test conversion (negative to positive result) and proportion of test converters receiving treatment among routinely tested patients (ie, patients with no history of TB infection, at least one prior negative result, and annual or biennial TB testing). We performed a nested case-control study to measure the association between TB test conversion and travel outside the United States.</p><p><strong>Results: </strong>Of 5668 patients receiving routine TB testing at annual/biennial frequencies, conversions occurred in 117 patients with TB skin tests (2.9%) and 52 patients with interferon-gamma release assays (3.2%); the overall test conversion incidence rate was 2.1/100 person-years. Latent TB infection treatment was initiated in 57% of test converters. Two patients were diagnosed with TB disease after test conversion, representing a 2-year TB incidence rate of 0.35/100 person-years. Patients with documented international travel had a 1.95-fold increased odds of TB test conversion (95% confidence interval 1.07-3.57) compared to patients without documented travel, with most travel occurring in medium or high-TB-prevalence countries.</p><p><strong>Conclusions: </strong>Within a 13-year study period, among a routinely tested population at higher risk of TB infection due to race and nativity, risk of TB test conversion was low. However, recent travel to higher-TB-prevalence settings nearly doubled the odds of TB test conversion.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag606"},"PeriodicalIF":3.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimation of Antimicrobial-Resistant <i>Mycoplasma genitalium</i> Infections in People Aged 14-59 Years: Results From the National Health and Nutrition Examination Survey, United States, 2017-2018.","authors":"Lisa E Manhart, Mary Bridget Waters, Christine M Khosropour, Kristen M Kreisel, Anika Parker, Emily D Pollock, Kevin Hybiske, Jørgen S Jensen","doi":"10.1093/ofid/ofag641","DOIUrl":"10.1093/ofid/ofag641","url":null,"abstract":"<p><p><i>Mycoplasma genitalium</i> antimicrobial resistance is common in US sexual health clinics. Population-level prevalence is unknown. We tested National Health and Nutrition Examination Survey (2017-2018) specimens for <i>M genitalium</i> resistance mutations (n = 58). Macrolide resistance prevalence was 42.7% (95% CI, 24.4%-62.7%). Quinolone resistance was not detected. Macrolide resistance testing should guide azithromycin treatment.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag641"},"PeriodicalIF":3.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Whole-blood Transcriptional Signature Associated With Obstructive Post-tuberculosis Lung Disease.","authors":"Renee E Newby, Lucy Kijaro, Kimberly A Dill-McFarland, Lilian N Njagi, Wilfred B Murithi, Zipporah Mwongera, Moeko Agata, Jodi Byers, Glenna J Peterson, Kevin P Fennelly, Videlis Nduba, David J Horne, Jerry S Zifodya, Thomas R Hawn","doi":"10.1093/ofid/ofag610","DOIUrl":"10.1093/ofid/ofag610","url":null,"abstract":"<p><strong>Background: </strong>Post-tuberculosis (TB) lung disease (PTLD) affects ∼50% of persons with pulmonary TB (PTB). We recently discovered whole blood transcriptional signatures associated with PTLD. We examined whether a minimum gene signature predicts PTLD as a clinically useful biomarker.</p><p><strong>Methods: </strong>We prospectively enrolled 301 treatment naive adults with newly diagnosed PTB (cohort A). We collected whole blood at 0 and 6-month visits, isolated RNA, and measured a modified MTB host response (HR) signature (mHR) based on expression of DUSP3, GBP5, and TMBIM6. We recorded spirometry at 6 (<i>n</i> = 216) and 12 months (<i>n</i> = 210) after treatment initiation and examined the association of the mHR score with PTLD and Mtb aerosolization. We recruited household contacts of cohort A to compare mHR score with non-PTB participants (cohort B).</p><p><strong>Results: </strong>mHR was associated with TB (<i>P</i> = 4.15e-66) when compared to HHCs, treatment response (<i>P</i> = 1.07e-53), and characteristics including CD4 count (<i>P</i> = .003), bacillary load (<i>P</i> = 3.02e-05), lung cavities (<i>P</i> = 1.59e-04), and lung quadrants involved (<i>P</i> = 3.87e-06). The mHR score was not associated with Mtb aerosolization. In total, 105 (50%) participants had PTLD at 12 months including 61 with restriction, 26 with obstruction, and 18 with mixed obstruction and restriction. Baseline mHR was associated with obstructive PTLD at both 6 (<i>P</i> = .003) and 12 months (<i>P</i> = .012) in bivariate and multivariate analyses. The mHR score was not associated with restrictive lung disease.</p><p><strong>Conclusions: </strong>Baseline mHR was associated with obstructive PTLD at 6 and 12 months and may have applications in targeting treatment and prognostication.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag610"},"PeriodicalIF":3.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Neurohistoplasmosis Successfully Treated With Single High-Dose Liposomal Amphotericin B.","authors":"Tarsila Vieceli, Renata de Bastos Ascenço Soares, Taiguara Fraga Guimarães, João Victor Soares Coriolano Coutinho, Debora Brenda Paes Rocha Sabino, Cassia Silva de Miranda Godoy, Daiane F Dalla-Lana, Luana C Bazana, Nathan C Bahr, Alessandro C Pasqualotto","doi":"10.1093/ofid/ofag659","DOIUrl":"10.1093/ofid/ofag659","url":null,"abstract":"<p><p>Disseminated histoplasmosis is a leading AIDS-related opportunistic mycosis and carries high mortality risk. A simplified induction strategy using single high-dose of liposomal amphotericin B (L-AmB) has shown promise for disseminated disease, but persons with central nervous system (CNS) involvement were excluded from the clinical trial. We describe a 35-year-old man with advanced HIV disease (CD4 24 cells/µL) and a high fungal burden who was diagnosed with disseminated histoplasmosis and, subsequently, culture-confirmed CNS involvement. He was administratively withdrawn from the trial when CNS involvement was noted. He was treated within a randomized trial with a single 10 mg/kg dose of L-AmB, followed by antiretroviral therapy (ART) and itraconazole consolidation therapy, with full clinical recovery, normalization of cerebrospinal fluid biochemistry findings, and microbiological clearance. This suggests that a single high-dose L-AmB induction strategy, combined with effective ART and azole consolidation therapy, may be viable in selected patients with CNS involvement.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag659"},"PeriodicalIF":3.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Patients' Voice in <i>Clostridioides difficile</i> Infection: Large Language Model-Assisted Thematic Analysis of Patient Testimonials.","authors":"Javier A Villafuerte-Gálvez, Marco A Noriega, Sena Cakir Colak, Carl V Crawford","doi":"10.1093/ofid/ofag650","DOIUrl":"10.1093/ofid/ofag650","url":null,"abstract":"<p><strong>Background: </strong><i>Clostridioides difficile</i> infection (CDI) imposes a burden that extends well beyond the gastrointestinal tract, yet existing outcome measures only partially capture the patient experience. We used frontier large language models (LLMs) on patient and caregiver narratives at scale to describe how burden shifts with disease course.</p><p><strong>Methods: </strong>We analyzed 189 testimonials from the Peggy Lillis Foundation corpus, sorted into 4 cohorts with recurrence (<i>r</i>) and fulminant (<i>f</i>) severity as axes (rfCDI, fCDI, rCDI, non-rfCDI). Two independent LLMs coded 8 thematic domains, 4 fulminant flags, 13 emerging semantic fields, the dominant dimension, and narrative arcs. Two physicians independently coded a subset for inter-rater reliability (PABAK, Gwet's AC1).</p><p><strong>Results: </strong>Treatment trajectory was the dominant theme in recurrent disease, whereas death and near-death dominated nonrecurrent fulminant narratives. Psychological burden was near-universal in fulminant disease (98.0% in rfCDI, 97.2% in fCDI). Caregiver and bereavement content concentrated in fCDI (66.7%). Diagnostic failure was frequent across recurrent cohorts (47.6-56.1%). Mentions of bacteriotherapy (fecal microbiota transplantation) concentrated in recurrent cohorts (60.2% rfCDI versus 5.6% fCDI). Financial, mental-health, and caregiver burdens were prominent and remain largely unaddressed by guidelines. Human-human reliability was substantial (PABAK 0.79 for semantic fields, 0.76 for domains); arc coding was least reliable.</p><p><strong>Conclusions: </strong>Patient narratives reveal a course-dependent, multidimensional burden in CDI. Concrete gaps exist between what patients prioritize, what guidelines recommend, and what therapy access provides. Frontier-LLM coding, validated against clinicians, offers a reproducible route to translate these priorities into research, care, and policy.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag650"},"PeriodicalIF":3.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}