Nicholas J Blair, Adam Kopp, Christine Kubin, Jesse Cotton, Michael T Yin, Matthew Scherer
{"title":"Association Between Inpatient Medication Treatment for Opioid Use Disorder and Reduced One-Year All-Cause Mortality in Patients With Invasive Bacterial Infections.","authors":"Nicholas J Blair, Adam Kopp, Christine Kubin, Jesse Cotton, Michael T Yin, Matthew Scherer","doi":"10.1093/ofid/ofaf061","DOIUrl":"10.1093/ofid/ofaf061","url":null,"abstract":"<p><p>Invasive bacterial infections are frequent causes of hospitalization among people who use opioids. We evaluated the association between inpatient administration of medication for opioid use disorder with one-year all-cause mortality in patients hospitalized with invasive bacterial infections.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 3","pages":"ofaf061"},"PeriodicalIF":3.8,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586570","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}
Michael S Pulia, Meggie Griffin, Rebecca J Schwei, Aurora Pop-Vicas, Lucas Schulz, Meng-Shiou Shieh, Penelope Pekow, Peter K Lindenauer
{"title":"National Trends in Antibiotic Prescribing for Adults Hospitalized With Coronavirus Disease 2019 and Other Viral Respiratory Infections.","authors":"Michael S Pulia, Meggie Griffin, Rebecca J Schwei, Aurora Pop-Vicas, Lucas Schulz, Meng-Shiou Shieh, Penelope Pekow, Peter K Lindenauer","doi":"10.1093/ofid/ofaf045","DOIUrl":"10.1093/ofid/ofaf045","url":null,"abstract":"<p><strong>Background: </strong>Significant concerns have been raised regarding the overuse of antibiotics among patients hospitalized for coronavirus disease 2019 (COVID-19) and the broad impact of the pandemic on antimicrobial stewardship in acute care. We sought to compare potentially unnecessary antibiotic prescribing over time among patients admitted with symptomatic COVID-19 and non-COVID-19 viral acute respiratory tract infections (ARTIs).</p><p><strong>Methods: </strong>We conducted a repeated cross-sectional analysis of the monthly antibiotic prescribing rate from March 2020 to December 2023 for COVID-19 admissions and from January 2019 to December 2023 for other viral ARTI admissions to 803 acute care hospitals in the United States that contributed data to the Premier Healthcare Database. Our primary outcome was the receipt of ≥1 dose of an antibiotic during the first 5 days of the admission. Secondary outcomes included days and duration of antibiotic therapy.</p><p><strong>Results: </strong>This study included 513 698 COVID-19 and 106 932 non-COVID-19 viral ARTI admissions from March 2020 to December 2023. At the onset of the pandemic, >80% of patients admitted for COVID-19 received antibiotics, and antibiotic prescribing for other viral ARTIs increased to nearly 70%. Antibiotic prescribing for these viral infections declined over time, with prescribing for COVID-19 stabilizing around 35% in 2022-2023 and prescribing for other viral ARTIs returning to 2019 seasonal patterns in 2023, with average monthly prescribing around 50%.</p><p><strong>Conclusions: </strong>Despite improvements since the early part of the COVID-19 pandemic, potentially unnecessary antibiotic prescribing for inpatients with COVID-19 and non-COVID-19 viral ARTIs remains an important antibiotic stewardship target.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 2","pages":"ofaf045"},"PeriodicalIF":3.8,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441593","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}
Henrique Pott, Melissa K Andrew, Zachary Shaffelburg, Michaela K Nichols, Lingyun Ye, May ElSherif, Todd F Hatchette, Jason J LeBlanc, Ardith Ambrose, Guy Boivin, William Bowie, Jennie Johnstone, Kevin Katz, Phillipe Lagacé-Wiens, Mark Loeb, Anne McCarthy, Allison McGeer, Andre Poirier, Jeff Powis, David Richardson, Makeda Semret, Stephanie Smith, Daniel Smyth, Grant Stiver, Sylvie Trottier, Louis Valiquette, Duncan Webster, Shelly A McNeil
{"title":"Oseltamivir Reduces 30-Day Mortality in Older Adults With Influenza: A Pooled Analysis From the 2012-2019 Serious Outcomes Surveillance Network of the Canadian Immunization Research Network.","authors":"Henrique Pott, Melissa K Andrew, Zachary Shaffelburg, Michaela K Nichols, Lingyun Ye, May ElSherif, Todd F Hatchette, Jason J LeBlanc, Ardith Ambrose, Guy Boivin, William Bowie, Jennie Johnstone, Kevin Katz, Phillipe Lagacé-Wiens, Mark Loeb, Anne McCarthy, Allison McGeer, Andre Poirier, Jeff Powis, David Richardson, Makeda Semret, Stephanie Smith, Daniel Smyth, Grant Stiver, Sylvie Trottier, Louis Valiquette, Duncan Webster, Shelly A McNeil","doi":"10.1093/ofid/ofaf058","DOIUrl":"10.1093/ofid/ofaf058","url":null,"abstract":"<p><strong>Background: </strong>Oseltamivir is recommended for the treatment of adults hospitalized with influenza, but adherence is often suboptimal. This may be due to doubts about the reliability of the evidence supporting its benefits, particularly when initiation is delayed. We aimed to assess the effectiveness of oseltamivir in reducing mortality in older adults hospitalized with influenza, with a focus on the timing of initiation.</p><p><strong>Methods: </strong>The CIRN-SOS Network gathered data on severe respiratory illnesses across 5 Canadian provinces during the influenza seasons 2012-2019. Individuals aged ≥65 years with confirmed influenza and available antiviral prescription data were included. We compared the 30-day survival rates of hospitalized patients based on oseltamivir prescription status. Kaplan-Meier estimated survival probability and inverse probability of treatment (IPT)-weighted Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality. The analyses considered the time to antiviral initiation (>48 vs ≤48 hours).</p><p><strong>Results: </strong>Among the 8135 influenza patients studied, 2126 did not receive antiviral treatment, whereas 6009 were treated with oseltamivir. A total of 395 patients were hospitalized for >30 days. The overall mortality rate was 8.32 per 1000 person-days, with 53.9% of the deaths occurring within the first week. Oseltamivir recipients had a 18% lower risk of 30-day mortality (IPT-weighted HR, 0.82 [95% CI, .69-.98]). The benefit was significant for influenza A (IPT-weighted HR, 0.74 [95% CI, .61-.91]) but not for influenza B (IPT-weighted HR, 1.12 [95% CI, .81-1.56]). Oseltamivir remained effective even when initiated after 48 hours (IPT-weighted HR, 0.66 [95% CI, .49-.90]). Influenza vaccination did not mediate the effectiveness of oseltamivir in reducing mortality.</p><p><strong>Conclusions: </strong>Oseltamivir significantly reduces mortality risk in older adults hospitalized with influenza, even when administered after 48 hours, independent of vaccination status. <b>Clinical Trials Registration.</b> NCT01517191.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 2","pages":"ofaf058"},"PeriodicalIF":3.8,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449715","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: Disseminated TB With IRIS Presenting as a Pancreatic Mass in Newly Diagnosed HIV: A Case Report.","authors":"","doi":"10.1093/ofid/ofaf064","DOIUrl":"https://doi.org/10.1093/ofid/ofaf064","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/ofid/ofae746.].</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 2","pages":"ofaf064"},"PeriodicalIF":3.8,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123299","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}
Jyoti S Mathad, Mallika Alexander, Ramesh Bhosale, Shilpa Naik, Lisa Marie Cranmer, Vandana Kulkarni, Sydney Busch, Andrea Chalem, Emily Gitlin, Jun Lei, Anguo Liu, Jin Liu, Yang Liu, Rupak Shivakoti, Amita Gupta, Irina Burd
{"title":"HIV-related Differences in Placental Immunology: Data From the PRACHITi Cohort in Pune, India.","authors":"Jyoti S Mathad, Mallika Alexander, Ramesh Bhosale, Shilpa Naik, Lisa Marie Cranmer, Vandana Kulkarni, Sydney Busch, Andrea Chalem, Emily Gitlin, Jun Lei, Anguo Liu, Jin Liu, Yang Liu, Rupak Shivakoti, Amita Gupta, Irina Burd","doi":"10.1093/ofid/ofaf047","DOIUrl":"10.1093/ofid/ofaf047","url":null,"abstract":"<p><strong>Background: </strong>Maternal HIV infection can affect placental immunology and expression of the neonatal crystallizable fragment receptor (FcRn), which allows transplacental antibody transfer. This study delineated differences in placental FcRn and T-cell expression by HIV status, with or without viral suppression.</p><p><strong>Methods: </strong>This observational cohort study in Pune, India, followed pregnant women with and without HIV through 1 year postpartum; 42 had placenta collected, stratified by HIV status. FcRn expression was analyzed by Western blot (normalized by GADPH) and compared using ImageJ. Placental CD4/CD8 abundance was assessed by immunofluorescent counting per high powered field.</p><p><strong>Results: </strong>The median gestational age at delivery was 38.3 weeks (interquartile range [IQR] 37.5-39.1). Of 18 women living with HIV, all were on combined antiretroviral therapy with a median CD4 of 455 cells/mm<sup>3</sup> (IQR 281-640) at entry and 429 cells/mm<sup>3</sup> (IQR 317-686) at delivery. Ten had undetectable virus (≤40 copies/mL); of those with detectable virus, the median viral load was 151 copies/mL (IQR 118.15-539 334). Relative placental FcRn expression was lower in women living with HIV compared to without (median 0.54 vs 0.84, <i>P</i> = .01) and not associated with CD4 or viral load. Women with HIV had significantly higher abundance of placental CD8+ T cells, regardless of viral suppression, compared to women without.</p><p><strong>Conclusions: </strong>Maternal HIV, even with viral suppression, is associated with lower placental FcRn expression and increased placental CD8+ T cells. These results suggest that dysregulation may not be completely reversed by antiretroviral therapy and could contribute to poorer infant outcomes, even in the absence of mother-to-child HIV transmission.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 3","pages":"ofaf047"},"PeriodicalIF":3.8,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567710","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}
Shawnalyn W Sunagawa, Gabriel Codling, Elizabeth Lyden, Sara H Bares, Kimberly K Scarsi, Joshua P Havens
{"title":"Utilization of Doxycycline Postexposure Prophylaxis at a Midwestern United States HIV/PrEP Clinic.","authors":"Shawnalyn W Sunagawa, Gabriel Codling, Elizabeth Lyden, Sara H Bares, Kimberly K Scarsi, Joshua P Havens","doi":"10.1093/ofid/ofaf062","DOIUrl":"10.1093/ofid/ofaf062","url":null,"abstract":"<p><p>Appropriate, protocol-adherent, doxycycline postexposure prophylaxis prescribing occurred for 70% of prescriptions from our clinic. Most of the nonadherent prescribing was due to missed sexually transmitted infection screenings (89%). As utilization of doxycycline postexposure prophylaxis continues to increase, it is necessary to ensure appropriate follow-up and monitoring.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 2","pages":"ofaf062"},"PeriodicalIF":3.8,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441624","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}
Magda Vergouwe, Emma Birnie, Sarah van Veelen, Jason J Biemond, Brent Appelman, Hessel Peters-Sengers, Godelieve J de Bree, Stephanie Popping, W Joost Wiersinga
{"title":"A Longitudinal Description of the Health-Related Quality of Life Among Individuals at High Risk After SARS-CoV-2 Infection: A Dutch Multicenter Observational Cohort Study.","authors":"Magda Vergouwe, Emma Birnie, Sarah van Veelen, Jason J Biemond, Brent Appelman, Hessel Peters-Sengers, Godelieve J de Bree, Stephanie Popping, W Joost Wiersinga","doi":"10.1093/ofid/ofaf055","DOIUrl":"10.1093/ofid/ofaf055","url":null,"abstract":"<p><strong>Background: </strong>Health-related quality of life (HRQoL) data post-COVID-19 in patients with medical conditions associated with severe disease are lacking. Here, we assess the longitudinal impact of COVID-19 on HRQoL and employment status in individuals at high risk.</p><p><strong>Methods: </strong>This multicenter prospective cohort study included individuals at high risk for severe disease who were hospitalized or not-hospitalized with SARS-CoV-2 infection (September 2021-February 2024). Questionnaires about HRQoL and employment status were collected at 3, 6, and 12 months post-COVID-19 and retrospectively recalled and reported for pre-COVID-19. With a mixed effects model, we assessed the course of and risk factors for changes in HRQoL utility score.</p><p><strong>Results: </strong>Among 332 individuals (median age, 59.8 years [IQR, 48.8-67.1]; 50.6% female), 184 (55.4%) were hospitalized for COVID-19 (intensive care unit admission, 12.0%). High-risk factors included solid organ transplantation (19.6%), hematologic malignancies (28.0%), and immunosuppressive medication use (56.6%). The median HRQoL utility score declined from 0.85 (IQR, 0.74-1.00) pre-COVID-19 to 0.81 (0.70-0.92) 12 months post-COVID-19 (<i>P</i> = .007). Solid organ transplant recipients and patients requiring oxygen therapy were at risk for an HRQoL decrease over 1 year. At 12 months, 45.3% of all employed responders had reported sick leave related to COVID-19 symptoms. Employed patients who reported sick leave had lower median HRQoL utility scores (0.81 [IQR, 0.72-0.91]) than those who did not (0.89 [0.86-1.00], <i>P</i> = .002).</p><p><strong>Conclusions: </strong>Solid organ transplant recipients and individuals requiring oxygen therapy experience a substantial HRQoL decline over 12 months post-COVID-19. Moreover, almost half of employed participants reported COVID-19-related sick leave, correlating with lower HRQoL. This highlights the continuous burden of COVID-19 for this vulnerable population and supports the implementation of preventive approaches.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 2","pages":"ofaf055"},"PeriodicalIF":3.8,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458560","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}
Gregory K Zane, Lindley A Barbee, Ann Duerr, Matthew R Golden, Lisa E Manhart, Dobromir Dimitrov, Christine Khosropour
{"title":"High Incidence and Duration of Antibiotic Use Among a Cohort of Men Who Have Sex With Men in Seattle, Washington.","authors":"Gregory K Zane, Lindley A Barbee, Ann Duerr, Matthew R Golden, Lisa E Manhart, Dobromir Dimitrov, Christine Khosropour","doi":"10.1093/ofid/ofaf051","DOIUrl":"10.1093/ofid/ofaf051","url":null,"abstract":"<p><strong>Background: </strong>Doxycycline postexposure prophylaxis (doxy-PEP) effectively prevents bacterial sexually transmitted infections (STIs) but may increase antibiotic pressure. Little is known about longitudinal antibiotic use among men who have sex with men (MSM), a key population for doxy-PEP.</p><p><strong>Methods: </strong>We analyzed data from a prospective cohort of MSM in Seattle, Washington, from 2016 to 2018, prior to the introduction of doxy-PEP. Antibiotic use and reason for prescription were self-reported in weekly surveys and extracted from medical records. We characterized antibiotic use across 49 weeks of follow-up, stratified by specific antibiotics of interest and reasons for prescription. Incidence rates (IRs) were calculated for the number of incident events of antibiotic initiation per 100 person-years (PY) at risk. We assessed factors associated with antibiotic initiation using negative binomial regression to estimate adjusted incidence rate ratios (IRRs).</p><p><strong>Results: </strong>Among 140 participants, 68.6% (n = 96) received at least 1 antibiotic during follow-up, resulting in an overall IR of 264.5 events of antibiotic initiation per 100 PY and 1696 total days of antibiotic use. STI treatment was the most common reason for antibiotic initiation (IR, 153.5 events per 100 PY; 462 days); however, treatment for other conditions contributed most to overall days of antibiotic use (IR, 42.6 events per 100 PY; 947 days). An age of 25-39 years (IRR, 1.54 [95% confidence interval {CI}, 1.02-2.32]) and a history of bacterial STIs <12 months prior to enrollment (IRR, 1.81 [95% CI, 1.12-2.93]) were significantly associated with higher incidence of antibiotic initiation.</p><p><strong>Conclusions: </strong>Antibiotic consumption among this population was very high. Our analysis provides a necessary foundation for assessing the potential impacts of doxy-PEP.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 2","pages":"ofaf051"},"PeriodicalIF":3.8,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399636","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":"Performance of α-Defensins in Diagnosing Nosocomial Ventriculitis.","authors":"Max W Jacobs, James B Doub","doi":"10.1093/ofid/ofaf060","DOIUrl":"10.1093/ofid/ofaf060","url":null,"abstract":"<p><p>Nosocomial ventriculitis can be an extremely difficult infectious disease process to diagnose, thereby exposing patients to increased morbidity and unwarranted aggressive antibiotics. Thus, novel ventriculitis diagnostics are drastically needed. In this study, we demonstrate excellent sensitivity and specificity of cerebral spinal fluid α-defensins to aid in diagnosing ventriculitis.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 2","pages":"ofaf060"},"PeriodicalIF":3.8,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449719","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}
Sean W X Ong, Nick Daneman, Joshua S Davis, Steven Y C Tong
{"title":"Association of Daily Body Temperature, White Blood Cell Count, and C-reactive Protein With Mortality and Persistent Bacteremia in Patients With <i>Staphylococcus Aureus</i> Bacteremia: A Post Hoc Analysis of the CAMERA2 Randomized Clinical Trial.","authors":"Sean W X Ong, Nick Daneman, Joshua S Davis, Steven Y C Tong","doi":"10.1093/ofid/ofaf063","DOIUrl":"10.1093/ofid/ofaf063","url":null,"abstract":"<p><strong>Introduction: </strong>Classification of patients with <i>Staphylococcus aureus</i> bacteremia as complicated versus uncomplicated is based on a combination of clinical and microbiologic variables. Whether daily body temperature and common laboratory tests such as C-reactive protein (CRP) and white blood cell (WBC) can improve risk stratification algorithms is unclear.</p><p><strong>Methods: </strong>We conducted a post hoc secondary analysis of the CAMERA2 trial, which enrolled hospitalized adult patients with methicillin-resistant <i>S aureus</i> bacteremia and prospectively collected daily body temperature and peripheral blood WBC and CRP. We evaluated the prognostic relevance of each parameter by calculating crude and adjusted odds ratios for 90-day all-cause mortality comparing patients with the abnormal parameter of interest versus those with normal parameters on each day of illness.</p><p><strong>Results: </strong>A total of 345 patients were included in this analysis, of whom 63 (18.3%) died within 90 days. Fever (body temperature ≥38.0 °C) was associated with increased odds of 90-day mortality from day 4 and onwards. Fever later in the illness course was associated with higher adjusted odds of mortality (8.78; 95% confidence interval, 2.78-27.7 on day 7 vs adjusted odds ratio 3.70; 95% CI, 1.58-8.67 on day 4). In contrast, CRP and abnormal WBC count did not demonstrate a consistent or temporal association with mortality.</p><p><strong>Conclusions: </strong>Persistent fever after 72 hours is associated with increased mortality in patients with methicillin-resistant <i>S aureus</i> bacteremia, supporting recommendations that this should be kept as a criterion for classifying patients as either \"high-risk\" or \"complicated.\" Within this dataset, there was limited additional predictive value in WBC or CRP.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 2","pages":"ofaf063"},"PeriodicalIF":3.8,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441577","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}