Open Forum Infectious Diseases最新文献

{"title":"Advancing Antimicrobial Stewardship With Diagnostic Excellence: The Role of Bayesian Reasoning.","authors":"Ephraim L Tsalik, Neha K Prasad, Lee A Fleisher","doi":"10.1093/ofid/ofag213","DOIUrl":"https://doi.org/10.1093/ofid/ofag213","url":null,"abstract":"<p><p>Antimicrobial resistance and inappropriate antibiotic use are urgent threats to global health and patient safety. Early antibiotic prescribing often occurs despite uncertain infection status, leading to unnecessary exposure and contributing to resistance. This article advocates for strengthening antimicrobial stewardship by integrating diagnostic stewardship and Bayesian reasoning to more explicitly consider disease probability in clinical decisions. In particular, probability thresholds should be included in clinical guidelines to inform testing decisions that may prompt antibiotic initiation. We provide several clinical examples and highlight the need for clinician education in Bayesian reasoning, underpinned by real-time decision support tools. Anchoring clinical practice in probability-based frameworks promises to refine antibiotic prescribing, enhance patient safety outcomes, and curb the progression of antimicrobial resistance.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 4","pages":"ofag213"},"PeriodicalIF":3.8,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13112427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777722","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":"Epidemiology and Clinical Features of Cryptococcosis Among Individuals Without HIV Infection: An Observational International Multicenter Study (MSG-11).","authors":"Yee-Chun Chen, Sharon C A Chen, Gerald McGwin, Arunaloke Chakrabarti, Oliver A Cornely, Aleksandra Barac, Harsimran Kaur, Shivaprakash M Rudramurthy, Peter Phillips, Carlos Seas, Rachel McMullen, Peter G Pappas","doi":"10.1093/ofid/ofag134","DOIUrl":"https://doi.org/10.1093/ofid/ofag134","url":null,"abstract":"<p><strong>Background: </strong>Infections due to <i>Cryptococcus</i> species occur globally, mostly reported as central nervous system (CNS) infection among persons with HIV infection. Among persons without HIV infection, cryptococcosis is a growing concern both among immunocompromised and non-immunocompromised individuals. There are few detailed descriptions of these patients outside of North America and Western Europe.</p><p><strong>Methodology: </strong>This prospective, observational, multinational study enrolled HIV-uninfected patients with proven/probable cryptococcosis from 7 countries on 4 continents located in temperate, subtropical and tropical zones. Patients were identified based on culture, histopathology and/or serologic testing. Relevant clinical and epidemiologic data were collected.</p><p><strong>Results: </strong>We identified 103 subjects with proven and probable cryptococcosis. Mean age was 53.8 years and 72% were male. Predisposing conditions were present in 70 patients (68%); most commonly malignancy, non-transplant related immunosuppressive therapy, and solid organ transplantation. Median time to diagnosis in non-immunocompromised individuals was 67 days compared to 19.7, 31.3 and 61 days for organ transplant, hematologic malignancy and other conditions, respectively. Survival at 3 and 12 months was similar across all risk groups.</p><p><strong>Conclusions: </strong>Epidemiology, time to diagnosis, treatment and outcomes for HIV-uninfected persons with cryptococcosis in very diverse geographic regions are similar to data from North America and Western Europe.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 4","pages":"ofag134"},"PeriodicalIF":3.8,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777738","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":"Azole Resistance in <i>Aspergillus fumigatus</i> From Diverse Environments in Ohio, United States, Is Primarily Driven by TR₃₄/L98H and TR₄₆/Y121F/T289A Environmental Signatures.","authors":"Raees A Paul, Sudharsan Sadhasivam, Timothy Frey, Sally A Miller, Pierce A Paul, Melanie L Lewis Ivey","doi":"10.1093/ofid/ofag150","DOIUrl":"https://doi.org/10.1093/ofid/ofag150","url":null,"abstract":"<p><p><i>Aspergillus fumigatus</i> is a leading global human fungal pathogen. Triazole antifungal drugs are used in clinical settings, while triazole demethylase inhibitor (DMI) fungicides are widely applied in the environment to combat plant fungal diseases. Environmental exposure to triazole fungicides may drive cross-resistance to clinical triazoles. To address limited data on environmental azole-resistant <i>A fumigatus</i> (ARAF) in the United States, we conducted surveillance across 75 sites in Ohio, including agricultural (57.3%), naturalized (25.3%), urban (16%), and commercial (1.3%) environments. Samples collected comprised air (n = 411), soil (n = 352), and compost (n = 42). Nested polymerase chain reaction of 397 airborne spore samples detected <i>A fumigatus</i> DNA in 62.7%, with 35.5% wild-type, 17.9% tandem repeat (TR), and 9.3% with mixed genotypes. TR genotype distribution did not differ by environment or DMI use. <i>Aspergillus fumigatus</i> was cultured from 18.1% of air samples, with 1.5% positive for ARAF. From soil and compost, <i>A fumigatus</i> was recovered from 41.4% of samples, of which 9.2% were positive for ARAF. Compost yielded higher <i>A fumigatus</i> (83.3%) and ARAF (21.4%) than soil (36.4% and 1.7%, respectively). ARAF prevalence was higher in urban (9.5%) than agricultural (2.8%) or naturalized (1.4%) environments. Generalized linear models suggested that compost and propiconazole exposure were significant predictors of ARAF occurrence. Among 72 ARAF isolates, 50% and 43% carried TR₃₄/L98H and TR₄₆/Y121F/T289A mutations, respectively, suggesting these mutations as key resistance signatures in Ohio environments. These findings identify compost and DMI exposure as a fertile milieu for ARAF development, highlight urban hotspots, and underscore the need for One Health approaches to resistance management.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 4","pages":"ofag150"},"PeriodicalIF":3.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13095377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777704","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":"Multidimensional Healthy Sleep Characteristics and Pneumonia Risk: A Large-scale, Population-based Prospective Cohort Study.","authors":"Xufeng Fu, Xiaohua Li, Yuanmei Gao, Nan Wu, Ting Ao, Wentao Ni","doi":"10.1093/ofid/ofag233","DOIUrl":"https://doi.org/10.1093/ofid/ofag233","url":null,"abstract":"<p><strong>Background: </strong>Sleep disturbances are hypothesized to increase susceptibility to pneumonia; however, most evidence arises from studies examining isolated sleep characteristics. The relationship between a multidimensional healthy sleep score and pneumonia risk remains unclear. Herein, the association between a multidimensional healthy sleep score and risk of pneumonia was evaluated.</p><p><strong>Methods: </strong>This prospective analysis encompassed 361 589 participants from the United Kingdom (UK) Biobank (mean age: 56.1 years; 46.1% male). Five sleep characteristics-sleep duration, chronotype, insomnia symptoms, snoring, and daytime sleepiness-were used to construct a healthy sleep score (range: 0-5). Participants were categorized into poor (0-1), intermediate (2-3), and healthy (4-5) sleep score categories. Cox proportional hazards models were employed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for pneumonia incidence.</p><p><strong>Results: </strong>Over a median follow-up period of 13.2 years, there were 20 116 new cases of pneumonia. A healthy sleep score was associated with a 26% lower risk of pneumonia (adjusted HR: 0.74, 95% CI: 0.69-0.80). This association exhibited a graded pattern, with higher sleep scores associated with progressively lower risk. The absence of frequent daytime sleepiness (HR: 0.79, 95% CI: 0.74-0.85) and insomnia symptoms (HR: 0.88, 95% CI: 0.86-0.91) exhibited the strongest component-specific inverse associations. Associations were stronger among participants younger than 60 years and females (<i>P</i> for interaction <0.001 for both).</p><p><strong>Conclusions: </strong>A multidimensional healthy sleep score is associated with a lower risk of pneumonia. These findings support the potential relevance of multidimensional sleep assessment to respiratory infection susceptibility and warrant further investigation.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 5","pages":"ofag233"},"PeriodicalIF":3.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147818604","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":"Multicenter Evaluation of Ceftazidime/Avibactam in Pediatric Patients Across the United States: Real-World Insights into the Management of Drug-Resistant Gram-Negative Infections.","authors":"Taylor Morrisette, Grant T Stimes, Gustavo R Alvira-Arill, Christine R Lockowitz, Valerie Yuenger, Evan E Facer, Alex Huang, Dana J Holger, Ali A Althubyani, Amer El Ghali, Jacob Kesner, Wesley D Kufel, Barbara A Santevecchi, Veena Venugopalan, Katie B Olney, Jason G Newland, Jamee Shelley, Lauren Walsh, William S Wilson, Aimee M Dassner, Andrew B Gainey, Richard Lueking, Logan Patterson, Krutika Mediwala Hornback, Stephen A Thacker","doi":"10.1093/ofid/ofag177","DOIUrl":"https://doi.org/10.1093/ofid/ofag177","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance among gram-negative pathogens is a global threat, with children particularly vulnerable due to limited treatment options and age-specific clinical outcomes data. Ceftazidime/avibactam (CZA) is effective against resistant gram-negative bacteria and demonstrates high success rates in adults; however, pediatric data remain limited. This study examined CZA use in children across United States medical centers.</p><p><strong>Methods: </strong>This multicenter, retrospective, observational cohort study included pediatric patients (<18 years) who received ≥48 hours of CZA for suspected or confirmed gram-negative infections between February 2015 and October 2023. The primary outcome was clinical success, defined as occurrence of all 3 components: (1) absence of all-cause mortality within 30 days of CZA initiation, (2) absence of microbiologic and clinical recurrence within 30 days of CZA discontinuation, and (3) resolution or improvement of infection-related signs and symptoms during CZA therapy without modification of therapy due to clinical failure. Secondary outcomes included adverse events attributable to CZA and resistance development to CZA.</p><p><strong>Results: </strong>One-hundred patients were included, with most receiving CZA for targeted therapy (67%). The median (IQR) age and weight were 9.8 (1.9-15.9) years and 24.2 (12.2-49.9) kg, respectively. Nearly all patients (88%) had comorbidities, 42% of patients were immunocompromised, and more than half were admitted to the intensive care unit at the time of index infection. Most infections originated from the respiratory tract (50%), followed by primary bloodstream infections (23%). Carbapenem-resistant <i>Pseudomonas aeruginosa</i> and carbapenem-resistant Enterobacterales were identified in 37% and 31% of patients, respectively. The most frequently administered CZA dosage regimen was 50 mg ceftazidime/kg/dose q8 hours, utilized in 44% of cases, with a median (IQR) treatment duration of 10.1 (6.7-15.7) days. Clinical success was achieved in 76% of patients, while no CZA-attributable adverse events were observed. CZA resistance emerged subsequently in 5% of cases.</p><p><strong>Conclusions: </strong>CZA demonstrated favorable outcomes and safety in a diverse pediatric cohort with drug-resistant infections, supporting its role as a viable therapeutic option in high-risk pediatric populations.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 4","pages":"ofag177"},"PeriodicalIF":3.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13093575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777667","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":"Dissecting Age-Stratified Immunity to Different Dengue Virus Serotypes and Zika Viruses Among Children in a Highly Endemic Region in Sri Lanka.","authors":"Shyrar Tanussiya Ramu, Madushika Dissanayake, Chamini Kanatiwela de Silva, Naduni Dasanthi, Amaya Gunaratne, Saubhagya Danasekara, Laksiri Gomes, Chandima Jeewandara, Nicole L Achee, John P Grieco, H Asita de Silva, D S Anoja F Dheerasinghe, Thomas W Scott, Amy C Morrison, Hasitha Aravinda Tissera, Gathsaurie Neelika Malavige","doi":"10.1093/ofid/ofag224","DOIUrl":"https://doi.org/10.1093/ofid/ofag224","url":null,"abstract":"<p><strong>Background: </strong>Determining serotype-specific, age-stratified dengue virus (DENV) and Zika virus (ZIKV) seroprevalence rates is crucial for implementing vaccines and vector control strategies. Therefore, we sought to assess the age-stratified seroprevalence of monotypic or multitypic exposure in a community cohort in Sri Lanka.</p><p><strong>Methods: </strong>DENV-specific serostatus was assessed in 4161 children aged 4 to 16 years, using an in-house DENV-specific IgG enzyme-linked immunosorbent assay (ELISA), and results were compared with those of a widely used commercial assay (Panbio Dengue IgG Indirect ELISA). We also used a multiplexed, microsphere-based serological assay to characterize monotypic vs multitypic responses and to differentiate exposure rates to different DENV serotypes and ZIKV in a subcohort of children (n = 604).</p><p><strong>Results: </strong>By IgG ELISA, DENV seropositivity was 72.34% (3010/4161), and the seropositivity rate significantly increased with age (Spearman <i>r</i> = 1.0, <i>P</i> = .003). The estimated force of infection was 0.16 (95% credible interval, 0.14-0.17). Of the 604 individuals tested by Luminex, 258 (42.7%) had a monotypic dengue response, whereas 209 (34.9%) had a multitypic response. Moreover, 100 (16.5%) had evidence of a past infection to Zika, while 20 (3.33%) children had antibodies only to ZIKV. Of the 258 individuals with evidence of a monotypic response to DENV, DENV2 (56.83%) and DENV1 (30.57%) accounted for the most infections. There was an inverse correlation between exposure to ZIKV and age (Spearman <i>r</i> = -0.72, <i>P</i> = .007).</p><p><strong>Discussion: </strong>An overall 72.3% of children were seropositive for dengue, with 42.7% having been infected with only 1 DENV in the past. The data suggest that prior immunity to DENV may reduce the risk of ZIKV infection, which should be further assessed.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 5","pages":"ofag224"},"PeriodicalIF":3.8,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841096","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 COMEBACK Study: Social Determinants of Health Impact on Virologic Suppression in a 48-Week Low-Barrier-Care Study of Rapid Antiretroviral Therapy Reinitiation Among Persons With HIV Lost to Care.","authors":"Gregory D Huhn, Rebecca Osborn, Lindsey Roden, Kody Keckler, Camille DeMarco, Patricia Cortes Valadez","doi":"10.1093/ofid/ofag216","DOIUrl":"https://doi.org/10.1093/ofid/ofag216","url":null,"abstract":"<p><strong>Background: </strong>Effectively preventing transmission is critical to ending the HIV epidemic (EHE). The primary objective of the COMEBACK study, a 48-week single-center study, was to reengage lost-to-care persons with HIV and rapidly reinitiate antiretroviral therapy (ART) with bictegravir/emtricitabine/tenofovir alefenamide (B/F/TAF) in a low-barrier-care model to promote virologic suppression (VS).</p><p><strong>Methods: </strong>Adults off ART for ≥2 weeks, without significant B/F/TAF resistance or renal impairment, were started on B/F/TAF upon reengagement after same-day baseline labs (n = 100). Participants self-screened into case management (CM) tiers: minimal, moderate, or advanced. Participants requiring additional support (tier escalation) were identified during the study. The associations of baseline characteristics and 5 social determinants of health (SDoH) assessments with VS status at study end were analyzed.</p><p><strong>Results: </strong>At baseline, the median age was 37 years, with 90% Black and 68% cisgender male. Median CD4+ was 310 cells/mm³, with a median viral load of 11 084 copies/mL (16% VS). Median time off ART was 5 months. Fifty-nine of 100 participants required tier escalation. Sixty-six of 100 participants were retained in care at 48 weeks, with VS (HIV-1 RNA <200 copies/mL) in 54% of the intent-to-treat population and 82% (n = 54/66) of the observed population. One SDoH (adherence concerns) was significantly associated with non-VS. No resistance to B/F/TAF was detected through 48 weeks.</p><p><strong>Conclusions: </strong>VS was high for participants with rapid ART reinitiation retained in care. CM escalation and baseline adherence concerns were associated with non-VS at study end. Achieving VS among high-risk populations disenfranchised from care will likely require further innovation in intense individualized CM and retention approaches to capitalize on low-barrier-care models toward EHE.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 5","pages":"ofag216"},"PeriodicalIF":3.8,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147818569","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":"Whole Genome Sequence-Based Surveillance of Human Clinical <i>Listeria monocytogenes</i> Isolates From Switzerland, 2019-2024.","authors":"Magdalena Nüesch-Inderbinen, Jule Anna Horlbog, Nicole Cernela, Marc J A Stevens, Roger Stephan","doi":"10.1093/ofid/ofag222","DOIUrl":"https://doi.org/10.1093/ofid/ofag222","url":null,"abstract":"<p><strong>Background: </strong><i>Listeria monocytogene</i>s is a foodborne pathogen that poses a significant public health risk due to the high case-fatality rate of listeriosis. Whole genome sequencing (WGS) is critical for identifying outbreak clusters and enables high-resolution characterization of isolates.</p><p><strong>Methods: </strong>We collected 335 <i>L monocytogenes</i> isolates from human cases of listeriosis occurring in Switzerland between 2019 and 2024. WGS was used to identify disease clusters and characterize the phylogenetic relatedness, virulence profiles, and antimicrobial resistance genes of the isolates.</p><p><strong>Results: </strong>The majority (77%) of the cases involved patients aged ≥65 years and was associated with bacteremia. The 5 major clonal complexes (CCs) were CC1, CC4, CC6, CC8, and CC388. The isolates belonged to 35 infection clusters, including 3 large outbreak clusters of 21 to 37 isolates per cluster. Nine smaller clusters included isolates highly related to food isolates obtained up to 4 years earlier. Multiple singly occurring isolates were linked to international outbreaks. WGS identified variations within key virulence factors including premature stop codons in InlA, length polymorphisms of ActA, and amino acid substitutions within PrfA. Hypervirulence associated with <i>Listeria</i> pathogenicity island (LIPI)-3 was found predominantly among CC1, CC4, and CC6 isolates. LIPI-4 was present in CC4 and CC388, and in infrequently occurring ST32, ST213, ST217, ST220, ST382, and ST1460.</p><p><strong>Conclusions: </strong>High-resolution typing of <i>L monocytogenes</i> is effective for the detection of disease clusters and for linking cases to international outbreaks. The identification of rare hypervirulent lineages demonstrates the importance of investigating the phylogenetic relatedness and virulence profiles of clinical <i>L monocytogenes</i>.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 5","pages":"ofag222"},"PeriodicalIF":3.8,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147818550","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":"Effects of High-Intensity Functional Exercise on Cardiorespiratory Fitness and Physical Function in Older Adults With HIV: A Telerehabilitation Randomized Trial.","authors":"Alice S Ryan, Vincent C Marconi, Brandon C Briggs, Alicia J Lozano, Krisann K Oursler","doi":"10.1093/ofid/ofag145","DOIUrl":"10.1093/ofid/ofag145","url":null,"abstract":"<p><strong>Background: </strong>People with HIV (PWH) represent a high-risk patient group that will benefit from easily accessible exercise programs, particularly those centered on high intensity. Yet, limited telerehabilitation programs are available.</p><p><strong>Methods: </strong>In a 12-week randomized clinical trial of PWH ≥50 years of age, we evaluated a novel exercise strategy called Functional Interval Training for Veterans Exercising Through Telehealth (FITVET) to determine the effects on cardiorespiratory fitness, exercise endurance, physical function, and body composition as compared with standard of care. The intervention consisted of center-based group exercise sessions delivered by live videoconferencing 3 times weekly.</p><p><strong>Results: </strong>Among the 89 participants randomized to FITVET or standard-of-care control, the mean (SD) age was 62.9 (7.0) years, and the majority self-identified as Black (88%) and male (97%). Cardiorespiratory fitness increased 4.3% after FITVET (mean [SD], 1.96 [0.47] to 2.07 [0.53] VO₂peak L/min; <i>P</i> = .018), but the between-group difference was not significant. Exercise endurance increased 9.3% with a significant between-group difference (<i>P</i> = .012). Significant between-group differences were also found for physical function outcomes: 30-second arm curl reps (15.1% vs 6.8%, <i>P</i> = .003), \"8-foot up and go\" time (-6.6% vs 0%, <i>P</i> = .024), timed chair stands (-15.7% vs -3.9%, <i>P</i> = .024), and 2-minute step test (22.0% vs 1.3%, <i>P</i> < .001). Measures of total and regional adiposity significantly decreased after FITVET, with android fat mass and percentage body fat showing significant between-group differences.</p><p><strong>Conclusions: </strong>A telerehabilitation program of high-intensity functional exercise in older PWH improved physical function, increased exercise endurance, and reduced adiposity.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 4","pages":"ofag145"},"PeriodicalIF":3.8,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13085956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723358","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":"Methicillin-Resistant <i>Staphylococcus aureus</i> Nasal Swab Utilization as a Predictor for Methicillin-Resistant <i>Staphylococcus aureus</i> Skin and Soft Tissue Infections: A Systematic Review and Meta-analysis.","authors":"Thomas Kalinoski, Michael Kalinoski, Susan Kline, Ann Brearley, Anmol Nigam, James Harmon","doi":"10.1093/ofid/ofag221","DOIUrl":"https://doi.org/10.1093/ofid/ofag221","url":null,"abstract":"<p><strong>Background: </strong>Methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) infections are associated with high morbidity and mortality, though isolation on a culture can often be difficult We performed a systematic review and meta-analysis to examine use of MRSA nasal swabs for the prediction of this organism as a cause of skin and soft tissue infection (SSTI).</p><p><strong>Method: </strong>Electronic databases were systematically searched. Selected studies were combined and data extracted and analyzed to calculate diagnostic performance characteristics.</p><p><strong>Results: </strong>Twenty-five studies were included. The overall positive predictive value was 70% and negative predictive value 87%. The positive and negative predictive values were 77% and 87% for a mixed composite of SSTIs, 71% and 91% for purulent infections, 63% and 87% for diabetic foot infections, and 48% and 79% for surgical site infections, respectively.</p><p><strong>Conclusions: </strong>Nasal screening as a predictor for MRSA SSTIs has a high negative predictive value in areas where MRSA prevalence is low.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 5","pages":"ofag221"},"PeriodicalIF":3.8,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13123859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777801","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}