Open Forum Infectious Diseases最新文献

{"title":"Missed and Delayed Diagnoses of Acute Human Immunodeficiency Virus (HIV) Infection in a Southern Opt-Out HIV Testing Environment Without Reflex HIV RNA Testing.","authors":"Sarah F Gruber, Eli P Wilber, Brittany Smith, Paulina A Rebolledo, Jonathan A Colasanti, Rishika Iytha, Megan Schwinne, Chad Robichaux, Meredith H Lora","doi":"10.1093/ofid/ofae684","DOIUrl":"https://doi.org/10.1093/ofid/ofae684","url":null,"abstract":"<p><p>Prompt confirmation of human immunodeficiency virus (HIV) is critical. We examined 10 years of discordant results without reflex HIV RNA. Of patients with acute HIV infection, 43.9% (95% confidence interval, 36.2%-52.0%) had confirmation delays >30 days or were never confirmed, indicating a need for reflex RNA to facilitate diagnosis.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 1","pages":"ofae684"},"PeriodicalIF":3.8,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11739807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007839","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":"Ratio of Infections to COVID-19 Cases and Hospitalizations in the United States based on SARS-CoV-2 Seroprevalence Data, September 2021-February 2022.","authors":"Yangyang Deng, Yun Kim, Anna Bratcher, Jefferson M Jones, Muloongo Simuzingili, Adi V Gundlapalli, Melissa Briggs Hagen, Ronaldo Iachan, Kristie E N Clarke","doi":"10.1093/ofid/ofae719","DOIUrl":"https://doi.org/10.1093/ofid/ofae719","url":null,"abstract":"<p><strong>Background: </strong>Understanding the risk of hospitalization from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections can guide effective public health interventions and severity assessments. This study calculated infection-hospitalization ratios (IHRs) and infection-case ratios (ICRs) to understand the relationship between SARS-CoV-2 infections, cases, and hospitalizations among different age groups during periods of Delta and Omicron variant predominance.</p><p><strong>Methods: </strong>After calculating antinucleocapsid SARS-CoV-2 antibody seroprevalence using residual commercial laboratory serum specimens, 2 ratios were computed: (1) IHRs using coronavirus disease 2019 hospitalization data and (2) ICRs using Centers for Disease Control and Prevention surveillance data. Ratios were calculated across age groups (0-17, 18-49, 50-69, and ≥70 years) for 2 time periods (September-December 2021 [Delta] and December 2021-February 2022 [Omicron]).</p><p><strong>Results: </strong>Pediatric IHRs increased from 76.7 during Delta to 258.4 during Omicron. Adult IHRs ranged from 3.0 (≥70 years) to 21.6 (18-49 years) during Delta and from 10.0 (≥70 years) to 119.1 (18-49 years) during Omicron. The pediatric ICR was lower during the Delta period (2.7) compared with the Omicron period (3.7). Adult ICRs (Delta: 1.1 [18-49 years] to 2.1 [70+ years]; Omicron: 2.2 [>70+ years] to 2.9 [50-69 years]) were lower than pediatric ICRs during both time periods.</p><p><strong>Conclusions: </strong>All age groups exhibited a lower proportion of infections associated with hospitalization in the Omicron period than the Delta period; the proportion of infections associated with hospitalization increased with each older age group. A lower proportion of SARS-CoV-2 infections were associated with reported cases in the Omicron period than in the Delta period among all age groups.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 1","pages":"ofae719"},"PeriodicalIF":3.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008137","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":"Severe Acute Respiratory Syndrome Coronavirus 2 Antibody Prevalence and Associated Risk Factors in a Large Cohort of US Children.","authors":"Bozena J Katic, Aspasia Katragkou, Jessica L Alvitres, Manisha Gurumurthy, Charles Li, Joseph V Schwab, Uzma N Hasan, Sunanda Gaur, Alan S Weller, Mary C Kennedy, Cecilia DiPentima, Claudia Rohan, Benjamin Richlin, Dorothy Chu, Isaura Otero, Akhil Patel, Pauline Thomas, Stephen M Friedman","doi":"10.1093/ofid/ofae680","DOIUrl":"10.1093/ofid/ofae680","url":null,"abstract":"<p><strong>Background: </strong>Household transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may play a key role in times of increased infection, particularly among children. We aimed to determine the prevalence of SARS-CoV-2 antibodies and identify risk factors associated with SARS-CoV-2 antibody positivity in children.</p><p><strong>Methods: </strong>Unvaccinated children aged 18 months to 11 years between August 2022 and June 2023 underwent oral fluid testing for SARS-CoV-2 antibodies. Caregivers completed electronic surveys at 4 major healthcare practices in Northern and Central New Jersey. Information was collected on demographics, household size, vaccination status, and prior SARS-CoV-2-related illness. Multivariable logistic regression determined individual and household-level factors associated with SARS-CoV-2 antibody positivity.</p><p><strong>Results: </strong>A total of 870 children provided tests and corresponding surveys. Children were predominantly Hispanic (37%) or non-Hispanic Black (30%), and on average 5.7 years old. Overall SARS-CoV-2 antibody positivity was 68%. Risk factors for SARS-CoV-2 positivity include Hispanic or non-Hispanic Black race/ethnicity (adjusted odds ratios [aOR], 2.29 and 1.95 vs. White race/ethnicity; <i>P < .01</i>) and later enrollment in the study period. Children from households with ≥1 vaccinated adult were 52% less likely to be antibody positive than those from households with no vaccinated adults (aOR: 0.38, [95% confidence interval 0.2 to 0.69]).</p><p><strong>Conclusions: </strong>There is high burden of SARS-CoV-2 infection among children over time. Adult vaccination appears to be a protective factor in helping to mitigate coronavirus disease 2019 (COVID-19) infection among children. Increased vaccination of adults in the community can help inform COVID-19 prevention strategies for minors in the household.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 1","pages":"ofae680"},"PeriodicalIF":3.8,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971525","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":"Preference for HIV Pre-exposure Prophylaxis Access Among Men who Have Sex With Men in China: A Discrete Choice Experiment.","authors":"Wenting Huang, Daniel Stegmueller, Jessica M Sales, Guodong Mi, Fei Yu, Yufen Liu, Patrick S Sullivan, Aaron J Siegler, Jason J Ong","doi":"10.1093/ofid/ofae742","DOIUrl":"https://doi.org/10.1093/ofid/ofae742","url":null,"abstract":"<p><strong>Background: </strong>HIV pre-exposure prophylaxis (PrEP) is highly effective but not widely used by men who have sex with men (MSM; 27%) in China.</p><p><strong>Methods: </strong>In June 2023, an online cross-sectional survey with a discrete choice experiment (DCE) was distributed to PrEP-eligible MSM in China who were at least 18 years old. The DCE explored attributes of PrEP modality (daily pill, on-demand pill, injections, implants), clinical care model (same-day, 2-visit, telehealth prescription), medication pickup (clinic, community health center, pharmacy, MSM-focused community-based organization, home delivery), enhanced support (self-management, smartphone app, text reminder, anonymous peer support group), and cost.</p><p><strong>Results: </strong>A total of 1013 MSM completed the survey; the average age was 31 years, and a quarter had used PrEP. The most influential attributes were cost (relative importance: 64.6%), followed by PrEP modality (27.7%), medication pickup (4.0%), enhanced support (3.5%), and clinical care model (0.2%). The most preferred ways to access PrEP were no-cost on-demand pill, medication home delivery, self-management, and telehealth. The predicted uptake of on-demand PrEP was higher than other modalities, increasing from 22% with no subsidy to 79% with full subsidy, holding the other 3 attributes constant.</p><p><strong>Conclusions: </strong>Chinese MSM have strong preferences regarding accessing PrEP: Low cost is a critical priority, especially important because medication and clinical care are currently entirely unsubsidized in China. Preferences for on-demand PrEP and home delivery indicate methods that the health care system can utilize to best meet the needs of MSM and factors that should be incorporated into future interventions.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 1","pages":"ofae742"},"PeriodicalIF":3.8,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008001","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":"Vaccination Against Influenza and Pneumococcus During Pretravel Health Consultations in the United States: Interventions and Missed Opportunities.","authors":"Loukas Kakoullis, Sowmya R Rao, Edward T Ryan, Allison T Walker, Lin H Chen, Regina C LaRocque","doi":"10.1093/ofid/ofae761","DOIUrl":"https://doi.org/10.1093/ofid/ofae761","url":null,"abstract":"<p><strong>Background: </strong>Infections by <i>Streptococcus pneumoniae</i> and influenza viruses are vaccine-preventable diseases causing great morbidity and mortality. We evaluated pneumococcal and influenza vaccination practices during pre-international travel health consultations.</p><p><strong>Methods: </strong>We evaluated data on pretravel visits over a 10-year period (1 July 2012 through 31 June 2022) from 31 sites in Global TravEpiNet (GTEN), a consortium of US healthcare facilities providing pretravel health consultations. Data were collected using an online structured questionnaire utilized by GTEN providers. We obtained summary statistics and performed multivariable logistic regression models to identify characteristics associated with receiving the vaccinations.</p><p><strong>Results: </strong>At 116 865 pretravel visits, 28 754 (25%) travelers were eligible to receive pneumococcal vaccination and 56 150 (48%) travelers were eligible to receive influenza vaccination. A total of 19 557 (68%) pneumococcal vaccine-eligible travelers were not offered the vaccine at the pretravel visit. Among influenza vaccine-eligible travelers, 8592 (15%) were not offered the vaccine, and an additional 16 931 (30%) travelers declined the vaccine. Influenza vaccine was not available for 8014 (14%) eligible travelers. Nonadministration of the influenza vaccine was most frequent in the months of April through September. Compared to nonacademic centers or centers in the South or Midwest, travelers seen in academic centers or centers in the Northeast were more likely to receive either vaccine.</p><p><strong>Conclusions: </strong>Increasing awareness of global influenza transmission patterns and improving access to routine vaccines at the pretravel encounter may enhance vaccination for respiratory pathogens in departing US international travelers.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 1","pages":"ofae761"},"PeriodicalIF":3.8,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008823","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":"Dynamics of Persistent Submicroscopic and Microscopic <i>Plasmodium falciparum</i> in Pregnant Women Under Intermittent Preventive Treatment: A Study Cohort in Benin.","authors":"Sayeh Jafari-Guemouri, Robinson Dégbègni, Laura Courtois, Manfred Accrombessi, Achille Massougbodji, Xavier C Ding, Nicaise Tuikue Ndam, Atika Mama, Nadine Fievet, Véronique Sarrasin-Hubert, Gilles Cotrell, Valérie Briand","doi":"10.1093/ofid/ofae762","DOIUrl":"https://doi.org/10.1093/ofid/ofae762","url":null,"abstract":"<p><strong>Background: </strong>Malaria infections in pregnancy are a major cause of maternal morbidity and neonatal mortality in sub-Saharan Africa. A high proportion of these infections are submicroscopic, which are usually asymptomatic and therefore untreated during pregnancy. Intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) aims to prevent and treat all potential infections whether submicroscopic or not. However, the resistance of parasites to SP is steadily increasing. The dynamic of microscopic and submicroscopic infections in a cohort of Beninese women throughout their pregnancy and its relation to IPTp-SP has been assessed.</p><p><strong>Methods: </strong>As a subsample of the RECIPAL project, 130 women with at least 2 infections detected by polymerase chain reaction during their pregnancy were included. Infections were categorized as new (isolated) or persistent based on <i>msp-2</i> genotyping, where persistent infections had identical genotypes in all studied time points. Submicroscopic infections were defined as polymerase chain reaction-positive and thick blood smear-negative. The persistence of infections according to IPTp-SP uptake was assessed.</p><p><strong>Results: </strong>A total of 73.1% of women (95 women of 130) had exclusively persistent infections throughout their pregnancy, whereas only 7.7% (10 of 130) had exclusively new infections. During pregnancy, the median time spent with 1 persistent infection was 7.2 weeks. A considerable proportion of these persistent infections 64.3% (72 of 113) was only submicroscopic. Approximately 20% of these persistent infections occurred despite the use of IPTp-SP.</p><p><strong>Conclusions: </strong>Using new antimalarial combinations could contribute to limit the persistence of submicroscopic infections and their probable negative effects on the mother and the fetus.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 1","pages":"ofae762"},"PeriodicalIF":3.8,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11739809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009151","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: Modified Two-Tiered Testing Enzyme Immunoassay Algorithm for Serologic Diagnosis of Lyme Disease.","authors":"","doi":"10.1093/ofid/ofae750","DOIUrl":"https://doi.org/10.1093/ofid/ofae750","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/ofid/ofac272.].</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 1","pages":"ofae750"},"PeriodicalIF":3.8,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932420","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":"Maternal-Infant Respiratory Syncytial Virus and Influenza A Virus Antibody Transfer in Preterm and Full-term Infants.","authors":"Kalee E Rumfelt, Mindy Pike, Jennifer E Stolarczuk, Ava Lekander, Adam S Lauring, Linda O Eckert, Janet A Englund, Emily T Martin, Alisa B Kachikis","doi":"10.1093/ofid/ofae723","DOIUrl":"10.1093/ofid/ofae723","url":null,"abstract":"<p><strong>Background: </strong>Immunization against influenza and respiratory syncytial virus (RSV) protects pregnant individuals and their infants against infection via transplacental transport of immunoglobulin G (IgG). We sought to evaluate the quantity and efficiency of maternal influenza- and RSV-specific IgG transfer in pregnancies with preterm and full-term deliveries.</p><p><strong>Methods: </strong>Delivery samples from 115 maternal-infant pairs (2018-2021) were analyzed for RSV prefusion F and IAV-H3 and IAV-H1 antibodies using electrochemiluminescence assays. We used Wilcoxon rank sum tests, <i>t</i> tests, Pearson correlation coefficients (PCCs), and linear regression to evaluate distributions of IgG results by maternal influenza vaccination status and preterm birth (<37 weeks).</p><p><strong>Results: </strong>Approximately 70% of pregnant persons received influenza vaccine. Maternal and cord antibody concentrations were highest in the influenza-vaccinated group for IAV-H3 and IAV-H1 regardless of preterm birth status (maternal H3, <i>P</i> = .004; cord H3, <i>P</i> = .03; maternal H1, <i>P</i> = .0001; cord H1, <i>P</i> = .0002). Preterm infants had significantly lower cord to maternal IgG transfer ratios for IAV-H3 and RSV when compared with full-term infants (<i>P</i> ≤ .05). Correlations between maternal and cord IgG concentrations were significant (<i>P</i> ≤ .001) for all 3 viruses, with the strongest correlation for H3 (PCC: IAV-H3, 0.77; IAV-H1, 0.68; RSV, 0.62). Associations between maternal IgG transfer and preterm birth were significant for IAV-H3 and RSV (IAV-H3, β = -0.42; RSV, β = -0.63; <i>P</i> ≤ .05).</p><p><strong>Conclusions: </strong>Maternal antibody following vaccination or infection is readily transferred across the placenta. Preterm infants have higher influenza IgG following maternal influenza vaccination and are at highest risk of lower IgG transfer ratios without vaccination.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 1","pages":"ofae723"},"PeriodicalIF":3.8,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932517","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 Prevalence of Multidrug Resistance in Enterobacterales Is Higher in Patients Undergoing Hematopoietic Stem Cell Transplantation.","authors":"Tessa M Andermann, Dylan Brown, Thomas Holowka, Luther A Bartelt, Jonathan S Serody, Paul M Armistead, Katarzyna J Jamieson, Brian P Conlon, Gauri G Rao, Kevin Alby, David van Duin, Heather I Henderson","doi":"10.1093/ofid/ofae760","DOIUrl":"https://doi.org/10.1093/ofid/ofae760","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance is a global public health emergency. Patients undergoing hematopoietic stem cell transplantation (HCT) are at increased risk for severe infections with multidrug-resistant (MDR) organisms, although more data are needed on the relative burden of MDR Enterobacterales (MDR-E) in immunocompromised populations. In this study, we compare the prevalence of Enterobacterales resistance in cultures from patients undergoing HCT with that of non-HCT patients seeking care at a large healthcare system in North Carolina, USA.</p><p><strong>Methods: </strong>We analyzed electronic health data from 52 067 patients aged ≥18 years with a culture positive for Enterobacterales species (2000-2023). Of these, 271 had undergone HCT prior to culture-recovered Enterobacterales. We compared resistance trends over time for specific antibacterial classes using a 5-year moving average and used generalized linear models to estimate prevalence ratios and differences of MDR-E in HCT versus non-HCT patients.</p><p><strong>Results: </strong>HCT recipients overall had a higher prevalence of MDR-E (37.7% vs 19.4%) and resistance for all individual antibiotic classes analyzed. Comparing HCT vs non-HCT groups, the highest prevalence ratio was observed for resistance to aminoglycosides (2.10 [95% confidence interval {CI}, 1.65-2.68]); the largest adjusted absolute difference in nonsusceptibility was observed with quinolones (20.4 [95% CI, 14.9-25.8]). MDR-E infections were associated with double all-cause mortality at 1 year.</p><p><strong>Conclusions: </strong>This large longitudinal study highlights how antimicrobial resistance has consistently been a substantial problem in HCT recipients over the prior 2 decades. Targeting antimicrobial resistance mitigation efforts will be key in reducing the risk of MDR infections in HCT.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 1","pages":"ofae760"},"PeriodicalIF":3.8,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008759","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":"Prospective Trial of a Passive Diversion Device to Reduce Blood Culture Contamination.","authors":"Sami Arnaout, Shannon Stock, Julia M Clifford, Thomas C Greenough, Azalea Wedig, Michael J Mitchell, Richard T Ellison","doi":"10.1093/ofid/ofae751","DOIUrl":"https://doi.org/10.1093/ofid/ofae751","url":null,"abstract":"<p><strong>Background: </strong>Blood culture contaminants can lead to inappropriate antibiotic use, prolonged length of stay, and additional hospital costs. Several devices have been developed to reduce the risk of blood culture contamination by diverting a portion of the initial blood sample from the blood culture bottle. We assessed the effectiveness of 1 blood diversion device (BDD) in a prospective trial performed at the 2 separate emergency departments (EDs) of an academic medical center.</p><p><strong>Methods: </strong>A multiphase prospective crossover trial was performed with the BDD in use at 1 ED and standard equipment at the other ED for 10 weeks, and a second 10-week study phase was conducted with the use of the BDD and standard equipment in the EDs reversed. Contaminants were identified both by standard clinical microbiology lab criteria and by independent retrospective review by 3 infectious disease (ID) physicians. The primary analysis was performed based on intention-to-use data using the physician review of positive blood cultures.</p><p><strong>Results: </strong>A total of 5637 blood samples were obtained, with 5625 samples analyzed after 12 blood culture results were deemed inconclusive by the ID physician review. The University ED had a higher blood culture contamination rate of 2.9% compared with the Memorial ED at 1.4%. In an intention-to-use analysis, the overall contamination rates were 2.0% and 2.9% in the BDD and standard equipment periods, respectively (<i>P</i> = .03), and in an actual-use analysis the contamination rates were 1.2% and 3.0% for the BDD and standard equipment, respectively (<i>P</i> < .001).</p><p><strong>Conclusions: </strong>The BDD was associated with significantly lower blood culture contamination rates at the institution's 2 EDs, with a stronger effect noted at the campus caring for higher acuity patients.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 1","pages":"ofae751"},"PeriodicalIF":3.8,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008105","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}