Open Forum Infectious Diseases最新文献

{"title":"Population Prevalence and Correlates of Syphilis in Rural, Southwestern Uganda.","authors":"Pooja Chitneni, Nicholas Musinguzi, Charles Baguma, Justin M Rasmussen, Emily N Satinsky, Justus Kananura, Patience Ayebare, Patrick Gumisiriza, Godfrey Masette, Mark J Siedner, Jessica E Haberer, Lynn T Matthews, Bernard Kakuhikire, Alexander C Tsai","doi":"10.1093/ofid/ofaf290","DOIUrl":"https://doi.org/10.1093/ofid/ofaf290","url":null,"abstract":"<p><strong>Background: </strong>The global incidence of syphilis has increased in recent years. Understanding syphilis epidemiology will inform screening and treatment programs. However, such data are lacking in many communities. We outline a population-based syphilis screening program in a rural community in southwestern Uganda to describe the population prevalence of syphilis.</p><p><strong>Methods: </strong>In June 2019 we conducted a cross-sectional, population-based study of adults >18 years of age. Two-stage syphilis testing was completed with <i>Treponema pallidum</i> hemagglutination (TPHA) rapid immunochromatographic testing, confirmed by rapid plasma reagin (RPR) in those with positive TPHA (syphilis seroprevalence). We calculate inverse probability of treatment (IPT) weights using logistic regression to estimate the population prevalence of positive TPHA. We included covariates with a univariable α = .10 in multivariable logistic regression models, stratified by sex, to estimate correlates of syphilis seroprevalence.</p><p><strong>Results: </strong>Among 749 participants who participated in this population-based study, 724 (97%) completed syphilis screening. The median age was 42.9 years (standard deviation, 15.6 years) and 456 of 724 (63%) were women. Based on the IPT-weighted adjusted model, the syphilis population seroprevalence was 10.6% (95% confidence interval, 8.4%-13.4%). Among the 62 of 79 (78%) participants who completed RPR testing, all had titers ≤1:4. Syphilis seroprevalence was associated with less education, human immunodeficiency virus (HIV) infection, and ≥2 sexual partners in the prior month among women and with HIV among men.</p><p><strong>Conclusions: </strong>We describe a high prevalence of current or former syphilis (10.6%) in a population-based study in rural Uganda. Syphilis screening and surveillance programs in this region require expansion to capture populations not routinely in care.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 5","pages":"ofaf290"},"PeriodicalIF":3.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174024","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":"Can Adoptive Immunotherapy With Hepatitis E Virus (HEV)-Specific T Cells Address the Unmet Need in Refractory Chronic HEV Infection?","authors":"Temi Lampejo","doi":"10.1093/ofid/ofaf231","DOIUrl":"10.1093/ofid/ofaf231","url":null,"abstract":"<p><p>Chronic hepatitis E virus (HEV) infection, which primarily affects the immunocompromised, can rapidly progress to liver fibrosis and cirrhosis if untreated. However, current therapeutic options are extremely limited and have significant adverse effects. Over the past decade, virus-specific T-cell therapy has shown promise as an alternative safe and effective treatment strategy for other refractory viral infections such as cytomegalovirus, adenovirus, and polyomavirus infections in hematopoietic stem cell and solid organ transplant recipients. Given the key role of T lymphocytes in the control of HEV replication and the fact that HEV-specific T-cell responses are typically diminished in immunosuppressed patients with persistent HEV infection, adoptive immunotherapy with HEV-specific T cells could serve as a novel addition to the HEV treatment repertoire, which is in dire need of expansion.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 5","pages":"ofaf231"},"PeriodicalIF":3.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144160723","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 Rates of Bacteremia and Fluoroquinolone Resistance During an Outbreak of Shigellosis Among People Experiencing Homelessness and Opioid Use Disorder in Philadelphia, Pennsylvania.","authors":"Eleanor Stedman, Andrea Molin, Valencia Oglesby, Erin Torpey, Stephanie Spivack, Kaede V Sullivan, Sara Schultz","doi":"10.1093/ofid/ofaf296","DOIUrl":"https://doi.org/10.1093/ofid/ofaf296","url":null,"abstract":"<p><p>In 2023, Philadelphia reported an outbreak of <i>Shigella flexneri</i> infections. We evaluated all patients hospitalized in our health system with shigellosis during this outbreak. Sixty-seven patients were hospitalized, and 21 (31.3%) were bacteremic. Trimethoprim-sulfamethoxazole was the only antibiotic with reliable susceptibility. Most patients had housing insecurity and opioid use disorder.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 5","pages":"ofaf296"},"PeriodicalIF":3.8,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173917","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":"Hepatitis C Testing in the US Veterans Health Administration: Uptake of United States Preventive Services Taskforce Universal Hepatitis C Screening Guidance.","authors":"Cara D Varley, Lauren A Beste, Elliott Lowy, Timothy R Morgan, David B Ross, Marissa M Maier","doi":"10.1093/ofid/ofaf249","DOIUrl":"10.1093/ofid/ofaf249","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis C virus (HCV) is a risk factor for advanced liver disease and mortality; however, efficacious direct-acting antiviral therapy is available for those who are screened for and ultimately diagnosed with HCV, highlighting the importance of population-based screening. For nearly 25 years, the Veterans Health Administration's (VHA) National Viral Hepatitis Program has leveraged resources to improve screening, diagnosis, and access to HCV care. We aim to assess the status of HCV screening in veterans in care 2021-2023 and identify emerging high-prevalence groups to direct future interventions.</p><p><strong>Methods: </strong>We performed a retrospective cohort analysis evaluating receipt of HCV testing among individuals aged 18-79 years in VHA care 2021-2023. We performed descriptive analyses of demographic and clinical characteristics, as well as the proportions who received HCV screening and confirmatory testing and the proportion with positive test results.</p><p><strong>Results: </strong>In 2021-2023, there were 6 637 294 individuals in VHA care aged 18-79 years. Of these, 75% had received HCV testing, of whom 5% were antibody positive with 95.5% receiving confirmatory testing. Veterans with alcohol use disorder, opioid use disorder, stimulant use disorder, mental health diagnoses, unstable housing, advanced liver disease, hepatitis B, or HIV, all had a statistically significant increased odds of receipt of HCV testing and test positivity.</p><p><strong>Conclusions: </strong>The VHA has successfully tested three quarters of veterans in care 2021-2023, with >95% of those with a positive antibody receiving a confirmatory test. The VHA comprehensive approach to HCV testing can serve as a model for other health systems.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 5","pages":"ofaf249"},"PeriodicalIF":3.8,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094263","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: What Is the Optimal Community-Based Tuberculosis Screening Algorithm for People Who Inject Drugs in a High-Burden Setting?","authors":"","doi":"10.1093/ofid/ofaf273","DOIUrl":"https://doi.org/10.1093/ofid/ofaf273","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/ofid/ofaf191.].</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 5","pages":"ofaf273"},"PeriodicalIF":3.8,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079348","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":"Country-Specific Data and Priorities for Pertussis in Latin America: Recent Findings From the Global Pertussis Initiative.","authors":"Rolando Ulloa-Gutierrez, Daniela Hozbor, María L Avila-Aguero, Gabriela Echániz-Aviles, Angela Gentile, Juan Pablo Torres Torretti, Ulrich Heininger, Rudzani Muloiwa, Carl Heinz Wirsing von König, Kevin Forsyth, Tina Q Tan","doi":"10.1093/ofid/ofaf154","DOIUrl":"10.1093/ofid/ofaf154","url":null,"abstract":"<p><p>In 2023, the Global Pertussis Initiative met to assess the burden of and vaccination policies against pertussis in 10 Latin American countries. Although pertussis is a notifiable disease in the represented countries, poor disease awareness, underrecognition in older individuals, and limited laboratory capacity and supplies challenge the collection of robust epidemiological data. Infants in all 10 countries receive a 3-dose primary series followed by ≥2 boosters. Except for Paraguay and Venezuela, governments of the represented countries advise or mandate vaccination in pregnancy; however, coverage rates remain suboptimal. Healthcare providers and the public should be educated on how mothers and other contacts can serve as asymptomatic carriers of <i>Bordetella pertussis</i> (transmitting disease to vulnerable infants) and of the potentially unique presentation of pertussis in adolescents and adults. The burden of pertussis in Latin America can be reduced by improving vaccination coverage of the primary series, increasing vaccination in pregnancy, and instituting universal vaccination of adults.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 5","pages":"ofaf154"},"PeriodicalIF":3.8,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12069808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040287","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":"Outpatient Parenteral Antimicrobial Therapy Outcomes Metrics Assessment Survey.","authors":"Jina Makadia, Amber C Streifel, Cara D Varley","doi":"10.1093/ofid/ofaf283","DOIUrl":"https://doi.org/10.1093/ofid/ofaf283","url":null,"abstract":"<p><p>We surveyed outpatient parenteral antimicrobial therapy team members to assess the importance of specific program metrics while eliciting collection barriers, which can guide establishing or restructuring programs. Several metrics were felt to be highly important but were not being collected by programs. Identified barriers included a lack of funding, technology support, and staffing.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 5","pages":"ofaf283"},"PeriodicalIF":3.8,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173981","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":"Prevalence, Progression, and Treatment of Asymptomatic Tuberculosis: A Prospective Cohort Study in Lanxi County, Zhejiang Province, China.","authors":"Shijia Ge, Kui Liu, Xineng Jiang, Zhen Feng, Songhua Chen, Yaling Feng, Guoyong Jiang, Zhicheng Yu, Lingyun Song, Lingyun Shao, Yilin Zhang, Feng Sun, Tao Li, Bin Chen, Yang Li, Wenhong Zhang","doi":"10.1093/ofid/ofaf275","DOIUrl":"10.1093/ofid/ofaf275","url":null,"abstract":"<p><strong>Background: </strong>Individuals with asymptomatic tuberculosis (TB) are considered a significant risk to the disease burden and transmission. However, the progression and treatment for asymptomatic TB remain incompletely described.</p><p><strong>Methods: </strong>This prospective cohort study was embedded within a prevalence survey conducted in 2021 and 2022 in Lanxi County, China. All patients with pulmonary TB who consented to participate would be included in the study and were categorized as asymptomatic or symptomatic. For the primary analysis, asymptomatic TB was defined as the absence of current cough, fever, night sweats, weight loss, or hemoptysis. Patients were followed up until 10 November 2024.</p><p><strong>Results: </strong>Among 109 345 individuals screened, 193 were included, of whom 101 (52.3%) were symptomatic and 92 (47.7%) were asymptomatic. The proportion of asymptomatic TB varied from 32.5% to 62.7% depending on varying symptom negative threshold. Fewer asymptomatic patients were bacteriologically confirmed compared to symptomatic patients (71.7% [66/92] vs 90.1% [91/101], <i>P</i> = .001). The median time for asymptomatic patients at screening to develop symptoms was 102 days. Most patients in both groups received treatment for active TB (97.8% vs 99.0%, <i>P</i> = .606). The treatment success rate among asymptomatic patients was comparable to that of symptomatic patients (93.3% vs 96.0%, <i>P</i> = .521), but their treatment duration was significantly shorter (196 vs 273 days, <i>P</i> < .001).</p><p><strong>Conclusions: </strong>In the community setting, a significant number of TB cases were asymptomatic and remained so for months. These cases demonstrated satisfactory treatment coverage and outcomes, with shorter durations compared to symptomatic TB, suggesting the potential for developing shorter regimens for asymptomatic TB.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 5","pages":"ofaf275"},"PeriodicalIF":3.8,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143221","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":"Interest in Long-Acting Preexposure Prophylaxis (PrEP) Among Men at Risk for Human Immunodeficiency Virus Who Use Methamphetamine Participating in a Daily, Oral PrEP Adherence Trial in San Francisco, California.","authors":"Vanessa M McMahan, Emily Pope, Xochitl Luna Marti, John Walker, Albert Y Liu, Phillip O Coffin","doi":"10.1093/ofid/ofaf280","DOIUrl":"10.1093/ofid/ofaf280","url":null,"abstract":"<p><strong>Background: </strong>Methamphetamine use is associated with increased risk for human immunodeficiency virus (HIV) and suboptimal adherence to daily, oral preexposure prophylaxis (PrEP). Long-acting PrEP is a promising HIV prevention method for people who use methamphetamine.</p><p><strong>Methods: </strong>We conducted interviews with participants of a daily, oral PrEP adherence trial at their final visit. Participants were assigned male at birth and reported past-month methamphetamine use and past-year condomless sex with a partner with HIV or unknown status. We conducted a thematic analysis of interview transcripts to assess experiences with daily, oral PrEP and interest in long-acting PrEP.</p><p><strong>Results: </strong>Of 23 participants, median age was 42 (interquartile range, 33-48) years, all were cisgender men, most were White (73%), and approximately half had been homeless or lived in a shelter in the past year (52%). The most common daily, oral PrEP adherence challenges were forgetting to take the medication, followed by not having the medication available and competing priorities. Most participants (91%) were interested in long-acting PrEP. A plurality (43%) preferred injection as the modality, 39% preferred a long-acting pill, and 17% an implant. Most concerns about long-acting PrEP regarded the implant, including the length of time drug is in the body and the insertion/removal procedure; frequent clinic visits were another concern.</p><p><strong>Conclusions: </strong>Most participants who used methamphetamine were interested in and described barriers to daily medications that could be mitigated by long-acting PrEP. Injections were the most preferred modality, although long-acting oral PrEP alleviated concerns for some. Future research should assess optimization of long-acting PrEP delivery to this at-risk population. <b>Clinical Trials Registration.</b> NCT04523519.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 5","pages":"ofaf280"},"PeriodicalIF":3.8,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128302","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":"Metagenomic Next-generation Sequencing in Patients With Infectious Meningoencephalitis: A Comprehensive Systematic Literature Review and Meta-analysis.","authors":"Pedro S Marra, Alexandre R Marra, Eileen Chen, Takaaki Kobayashi, Patrícia Deffune Celeghini, Maria Celidonio Gutfreund, Isabele Pardo, Gabriel O V Lopes, Mariana Kim Hsieh, Nicole A Boodhoo, Daniel Fu, Michael A Torres-Espinosa, Yimeng Li, Rodrigo Octávio Deliberato, Sulwan Mujahid A Algain, Jorge L Salinas, Michael B Edmond, Deyvid Emanuel Amgarten, Fernanda de Mello Malta, Nathalia Villa Dos Santos, João Renato Rebello Pinho, Martineau Louine, Michael R Wilson","doi":"10.1093/ofid/ofaf274","DOIUrl":"https://doi.org/10.1093/ofid/ofaf274","url":null,"abstract":"<p><strong>Background: </strong>We aimed to assess the accuracy, clinical efficacy, and limitations of metagenomic next-generation sequencing (mNGS) for diagnosing infectious meningoencephalitis.</p><p><strong>Methods: </strong>We performed a systematic literature review and meta-analysis of studies that evaluated the performance of mNGS to determine the cause of infectious meningoencephalitis. We explored PubMed, Cumulative Index to Nursing and Allied Health, Embase, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and Web of Science up to 12 November 2024. To perform a meta-analysis, we calculated the pooled diagnostic odds ratio (DOR) for mNGS and for conventional microbiological tests (CMTs) compared to the clinical diagnosis.</p><p><strong>Results: </strong>Thirty-four studies met the inclusion criteria, with mNGS-positive rates ranging from 43.5% to 93.5% for infectious meningoencephalitis. The meta-analysis included 23 studies with 1660 patients. The pooled sensitivity was 0.70 (95% confidence interval [CI], .67-.72), and its specificity was 0.93 (95% CI, .92-.94). The DOR for mNGS was 26.7 (95% CI, 10.4-68.8), compared to 12.2 (95% CI, 3.2-47.0) for CMTs. For tuberculosis meningoencephalitis, mNGS demonstrated a pooled sensitivity of 0.67 (95% CI, .61-.72) and specificity of 0.97 (95% CI, .95-.99), with a DOR of 43.5 (95% CI, 7.4-256.6).</p><p><strong>Conclusions: </strong>Our review indicates that mNGS can be a valuable diagnostic tool for infectious meningoencephalitis, offering high sensitivity and specificity. mNGS's superior DOR compared to that of CMTs highlights its potential for more accurate diagnoses and targeted interventions. Further research is needed to optimize which patients and at what point in the diagnostic process mNGS should be used.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 5","pages":"ofaf274"},"PeriodicalIF":3.8,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173978","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}