Open Forum Infectious Diseases最新文献

{"title":"Low Incidence of <i>Clostridioides difficile</i> Infection in Patients Receiving Outpatient Parenteral Antibiotic Therapy at an Urban Academic Medical Center.","authors":"Christopher Vo, Jared Coe, Tabeer Ahmed, Kelsie Cowman, Yi Guo, Priya Nori","doi":"10.1093/ofid/ofaf314","DOIUrl":"10.1093/ofid/ofaf314","url":null,"abstract":"<p><p>Data on <i>Clostridioides difficile</i> infection (CDI) among patients receiving outpatient parenteral antibiotic therapy (OPAT) are limited. Herein, we describe characteristics of OPAT patients with CDI at a large academic medical center. Despite prolonged antibiotic exposure, the incidence rate of CDI was low.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 6","pages":"ofaf314"},"PeriodicalIF":3.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216497","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":"Prognostic Factors of Physical Function Decline Among Middle-Aged Adults With HIV.","authors":"Grace L Kulik, Triin Umbleja, Todd T Brown, Heather J Ribaudo, Steven K Grinspoon, Jennifer A Schrack, Markella V Zanni, Marissa R Diggs, Judith A Aberg, Carl J Fichtenbaum, Carlos D Malvestutto, Sarah M Chu, Judith S Currier, Pamela S Douglas, Gerald S Bloomfield, Alice C Thornton, Michelle A Floris-Moore, Elliot Goodenough, Grant B Ellsworth, Tricia Burdo, Kristine M Erlandson","doi":"10.1093/ofid/ofaf311","DOIUrl":"10.1093/ofid/ofaf311","url":null,"abstract":"<p><strong>Background: </strong>Pitavastatin to REduce Physical Function Impairment and FRailty in HIV (PREPARE) found small declines in physical function overall among people with HIV (PWH). However, there was substantial individual variability. The purpose of this prespecified exploratory analysis was to identify the PWH at greatest risk for physical function decline.</p><p><strong>Methods: </strong>Participant-specific annualized rates of change on annually measured chair rise rate, gait speed, the modified Short Performance Physical Battery (composite of the latter 2 plus balance time), and grip strength were estimated from linear mixed-effect models. Change in performance that was below the 20th percentile of the study population in ≥1 measure was classified as physical function decline. Associations between baseline factors and physical function decline were evaluated with log-binomial regression models.</p><p><strong>Results: </strong>Of 569 participants (81% male, 52% White), the median age (Q1-Q3) was 51 (47-55) years. Half (52%) of the participants had decline in physical function. The risk of decline was higher among females (relative risk [RR], 1.32; 95% CI, 1.12-1.55) and non-Whites (RR, 1.23; 95% CI, 1.05-1.45) and tended to increase with age (50-55 years: RR, 1.04; 95% CI, 0.86-1.26; 55+ vs 40-<50 years: RR, 1.17; 95% CI, 0.98-1.39). In models adjusted for age, sex, and race, we found greater risk of decline among those with history of depression treatment, higher body mass index (BMI), preexisting functional impairment, frailty (by index), and higher baseline high-sensitivity C-reactive protein and interleukin-6 levels.</p><p><strong>Conclusions: </strong>PWH with history of depression treatment, high BMI, or levels of inflammation and those showing early signs of functional impairment may be at higher risk of physical function decline and should be targeted for early interventions to preserve physical function with aging.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 6","pages":"ofaf311"},"PeriodicalIF":3.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302620","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":"Viral Families With Pandemic Potential.","authors":"Amesh Adalja, Thomas Inglesby","doi":"10.1093/ofid/ofaf306","DOIUrl":"10.1093/ofid/ofaf306","url":null,"abstract":"","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 6","pages":"ofaf306"},"PeriodicalIF":3.8,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12141742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248997","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":"Sequencing HIV Diagnostic Samples to Detect Genetic Clusters and Assess Sequence Coverage Gaps.","authors":"Cara J Broshkevitch, Shuntai Zhou, Annalea Greifinger, Kimberly Enders, Nathan Long, Erika Samoff, Kimberly A Powers, Victoria Mobley, Simon D W Frost, Erik Volz, Scott Shone, Joseph J Eron, Myron S Cohen, Ronald Swanstrom, Ann M Dennis","doi":"10.1093/ofid/ofaf305","DOIUrl":"10.1093/ofid/ofaf305","url":null,"abstract":"<p><strong>Background: </strong>HIV molecular cluster detection in the United States relies on HIV sequences obtained from drug resistance testing during clinical care (\"routine care sequences\"). This approach misses people who are not linked to care or who receive care but have uncollected or unreported sequences.</p><p><strong>Methods: </strong>We collected \"HIV test sequences\" from remnant serum samples of people testing newly positive from 2018 through 2021 by a large public health laboratory in North Carolina. We incorporated the HIV test sequences into a statewide molecular cluster analysis and assessed impact on \"active cluster\" detection (≥5 members newly diagnosed). We described data gaps filled by HIV test sequences, comparing (1) the extent of care sequence missingness due to gaps in care linkage vs sequence collection or reporting and (2) the characteristics of people with an HIV test sequence who had a care sequence, care but no care sequence, or no evidence of care.</p><p><strong>Results: </strong>Of 19 770 people included in the cluster analysis, 847 had an HIV test sequence, one-third of whom had no routine care sequence. We identified 13 additional active clusters (a 33% relative increase) and 40 larger active clusters after incorporating HIV test sequences. Most people with an HIV test sequence but no care sequence (78%) had another care indicator, suggesting sequence undercollection or underreporting, but a fifth (22%) had no evidence of care.</p><p><strong>Conclusions: </strong>Higher sequence coverage can improve cluster detection. While increased routine care sequence collection and reporting could fill many data gaps, sequencing remnant HIV test samples could include people without care linkage.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 6","pages":"ofaf305"},"PeriodicalIF":3.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258651","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":"Simplified and Integrated Hepatitis C Virus Testing and Treatment Algorithm for Unhoused People Who Inject Drugs.","authors":"Christian B Ramers, Natalie Vawter, Adam Northrup, Stacey L Klaman, Sydney V Lewis, Aaron Tam, Carolina Del Aguila, Robert Lewis, Blanca Mendez, Letty Reyes, Eva Matthews, Sarah Rojas, Job G Godino","doi":"10.1093/ofid/ofaf302","DOIUrl":"10.1093/ofid/ofaf302","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis C virus (HCV) infection disproportionately affects people who inject drugs (PWID), particularly people experiencing homelessness, who face significant barriers to testing and treatment. Simplified testing and treatment algorithms, including the use of mobile medical units (MMUs), may improve access to care for this population. This study evaluated the effectiveness of a simplified HCV testing and treatment algorithm with integrated care delivered via MMU to unhoused PWID in an urban United States setting.</p><p><strong>Methods: </strong>This pragmatic, randomized controlled trial compared a simplified MMU care model with usual care among 201 PWID who tested positive for HCV antibody. Patients were randomized into simplified MMU or usual care. The primary outcome was treatment initiation within 6 months. Secondary outcomes included treatment completion, sustained virologic response at 12 weeks (SVR12), and initiation of medication-assisted treatment for opioid use disorder.</p><p><strong>Results: </strong>Of 98 patients with confirmed HCV RNA, 33% in the MMU group initiated treatment compared to 24% in the usual care group (<i>P</i> = .4). Treatment completion and SVR12 rates were higher in the usual care group (16% vs 10% and 12% vs 4%, respectively), but differences were not statistically significant. MMUs facilitated faster treatment initiation but encountered challenges with patient retention and follow-up.</p><p><strong>Conclusions: </strong>While the MMU model demonstrated potential for improving rapid access to HCV treatment, overall treatment initiation, retention, and cure rates remained low. A critical need remains to develop approaches that more closely approximate a test-and-treat model to increase treatment initiation and completion and achieve elimination in unhoused PWID.</p><p><strong>Clinical trials registration: </strong>NCT04741750.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 6","pages":"ofaf302"},"PeriodicalIF":3.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234704","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":"Feasibility of Point-of-Care Urine Self-Testing to Measure Tenofovir Adherence and Predict Viral Suppression.","authors":"Renata Buccheri, Matthew A Spinelli, Megan J Heise, David V Glidden, Kevin Sassaman, Tyler Martinson, Hannah R Schmidt, Alexa B D'Angelo, Dustin T Duncan, Keith J Horvath, Sabina Hirshfield, Renessa S Williams, Mallory O Johnson, Christian Grov, Adam Carrico, Monica Gandhi","doi":"10.1093/ofid/ofaf300","DOIUrl":"10.1093/ofid/ofaf300","url":null,"abstract":"<p><p>This study is the first to demonstrate the feasibility of at-home adherence monitoring using a point-of-care urine assay for tenofovir (TFV). Undetectable TFV is strongly associated with lower viral suppression (odds ratio, 0.19, 95% CI, 0.10-0.34; <i>P</i> < .001), supporting a streamlined, effective approach for monitoring adherence between viral load assessments.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 6","pages":"ofaf300"},"PeriodicalIF":3.8,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216496","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":"Infectious Complications of Substance Use: A Retrospective Cohort Study of Hospitalized Veterans.","authors":"Leah Harvey, Hassen Abdulkerim, Judith Strymish, Samantha K Ryan, Jacqueline Boudreau, Allen Gifford, Justeen Hyde, Westyn Branch-Elliman","doi":"10.1093/ofid/ofaf301","DOIUrl":"10.1093/ofid/ofaf301","url":null,"abstract":"<p><p>Invasive bacterial infections (IBI) associated with drug use are increasing, but the full disease burden remains unknown. We characterized national trends in the prevalence of IBI among veterans with evidence of substance use using a large, national cohort. High rates of IBI highlight a need for more comprehensive infection reduction strategies, including emphasis on gram-negative infections.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 6","pages":"ofaf301"},"PeriodicalIF":3.8,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234703","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 Compared With Blood Culture as First-line Diagnostic Method for Bloodstream Infection in Hematologic Patients With Febrile Neutropenia: A Multicenter, Prospective Study.","authors":"Rui Ma, Yue Yin, Jian-Ping Zhang, Mei-Xiang Zhang, Jing-Rui Zhou, Yun He, Wei Gai, Xiao-Hui Zhang, Yu Wang, Lan-Ping Xu, Kai-Yan Liu, Xiao-Jun Huang, Yu-Qian Sun","doi":"10.1093/ofid/ofaf288","DOIUrl":"10.1093/ofid/ofaf288","url":null,"abstract":"<p><p>Bloodstream infection (BSI) is a frequent but lethal complication in hematologic patients with febrile neutropenia (FN). However, blood culture (BC) only detects an organism in 20%-30% of patients with FN. We aimed to evaluate the diagnostic performance of metagenomic next-generation sequencing (mNGS) as a first-line diagnostic method in BSI. This study was prospectively performed in 4 Chinese hematologic centers. In patients aged ≥15 years with hematologic diseases, peripheral blood specimens were collected per patient for simultaneous BC and mNGS at the onset of FN. The clinical physician and mNGS analysis team were double-blinded, and the adjudication of the clinical diagnosis was evaluated by another expert panel of 4 specialists. The primary endpoint of this study was the diagnostic performance of mNGS. This study was registered on ClinicalTrials.gov. Three hundred FN events were enrolled, including 62 definite BSI, 61 probable BSI, 116 infectious FN other than BSI, 55 noninfectious FN events, and 6 FN of indeterminate cause. Among 62 definite BSI cases, mNGS identified causative pathogens in 59 (95.2%). Concurrent BC initially detected pathogens in 59 cases, and 3 additional pathogens consistent with mNGS were later identified in repeated BC testing. The sensitivity, specificity, positive predictive value, and negative predictive value of mNGS were 95.2%, 94.6%, 95.2%, and 94.6%, respectively. The diagnostic time of mNGS was significantly shorter than that of BC (39.7 ± 15.0 vs 119.8 ± 31.9 hours, <i>P</i> < .0001). The findings suggest that the mNGS approach has excellent diagnostic performance for the first-line diagnosis of BSI in patients with FN. The study will promote early diagnosis and better management of the patients.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 6","pages":"ofaf288"},"PeriodicalIF":3.8,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199686","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":"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}