Open Forum Infectious Diseases最新文献

{"title":"Evaluation of the 2023 Duke-International Society of Cardiovascular Infectious Diseases Criteria in a Multicenter Cohort of Patients With Intravenous Drug Use: A Retrospective Study.","authors":"Q Joyce Han, David M Henson, Evin Yucel, Talal S Alnabelsi, Sami A El-Dalati, Molly L Paras","doi":"10.1093/ofid/ofaf126","DOIUrl":"10.1093/ofid/ofaf126","url":null,"abstract":"<p><strong>Background: </strong>Intravenous drug use (IVDU) significantly increases the risk of infective endocarditis (IE). This study evaluates the 2023 Duke-International Society of Cardiovascular Infectious Diseases (ISCVID) criteria for diagnosing IE in patients with a history of IVDU.</p><p><strong>Methods: </strong>This multicenter retrospective study evaluates these criteria in a cohort of 205 patients with intravenous drug use (IVDU) history, comparing outcomes with the 2000 modified Duke criteria. At 2 academic centers, patient records were reviewed for clinical, microbiologic, and imaging data to assess diagnostic classifications.</p><p><strong>Results: </strong>The 2023 Duke-ISCVID criteria reclassified 11 patients (5.3%), primarily due to updates in microbiological criteria, including the inclusion of various streptococcal species and <i>Staphylococcus epidermidis</i> in patients with cardiovascular implantable electronic devices (CIEDs). Notably, an unexpected prevalence of <i>Streptococcus pyogenes</i> as a causative agent was identified in 6 of 20 cases at 1 site.</p><p><strong>Conclusions: </strong>The 2023 Duke-ISCVID criteria reclassified 5% of IE cases in patients with IVDU due to expanded microbiological definitions. The unexpected prevalence of <i>S. pyogenes</i> highlights the need to consider atypical pathogens in high-risk groups.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 3","pages":"ofaf126"},"PeriodicalIF":3.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691755","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":"Impact of <i>Strongyloides stercoralis</i> Coinfection on Disease Severity and Treatment Outcomes in Pulmonary Tuberculosis.","authors":"Nathella Pavan Kumar, Saravanan Munisankar, Bindu Dasan, Arul Nancy, Kannan Thiruvengadam, Kadar Moideen, Sujatha Nott, Vijay Viswanathan, Shanmugam Sivakumar, Syed Hissar, Hardy Kornfeld, Subash Babu","doi":"10.1093/ofid/ofaf009","DOIUrl":"10.1093/ofid/ofaf009","url":null,"abstract":"<p><strong>Background: </strong>This study investigates how <i>Strongyloides stercoralis</i> (Ss) infection impacts pulmonary tuberculosis (PTB) treatment outcomes, disease severity, and bacterial burdens in PTB patients with Ss coinfection.</p><p><strong>Methods: </strong>We used chest x-rays and sputum smear grades to assess lung conditions and bacterial loads in 483 PTB patients. Ss infection was confirmed by seropositivity, and cytokine and profibrotic factor levels were analyzed using multiplex enzyme-linked immunosorbent assay. Treatment outcomes were categorized as favorable (cure without recurrence) or unfavorable (treatment failure or TB recurrence) during treatment or within 12 months postcure.</p><p><strong>Results: </strong>PTB patients coinfected with Ss had significantly higher bacterial loads, increased risk of bilateral lung lesions, and greater likelihood of cavitary disease compared with those without Ss infection. The coinfected individuals exhibit significantly increased levels of cytokines (interleukin [IL]-4, IL-5, IL-13, interferon [IFN]-α, and IFN-β) and profibrotic factors (vascular endothelial growth factor, epidermal growth factor [EGF], fibroblast growth factor 2 [FGF-2], and PDGF-AB/BB [platelet-derived growth factor]) and significantly diminished levels of cytokines (IFN-γ and IL-2).</p><p><strong>Conclusions: </strong>This study underscores the exacerbating impact of Ss coinfection on PTB severity and treatment outcomes, emphasizing the need for integrated management strategies for affected patients.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 3","pages":"ofaf009"},"PeriodicalIF":3.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605817","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":"Rapid Point-of-care Testing to Inform Intrapartum Treatment of Group B <i>Streptococcus</i>-Colonized Women in Uganda.","authors":"Juliet Nsimire Sendagala, Melanie Etti, Rose Azuba, Joseph Peacock, Kirsty Le Doare","doi":"10.1093/ofid/ofae605","DOIUrl":"10.1093/ofid/ofae605","url":null,"abstract":"<p><strong>Introduction: </strong>Maternal Group B <i>Streptococcus</i> (GBS) rectovaginal colonization is an important risk factor for invasive disease in neonates, yet availability of culture-based methods for detection is limited in low-resource settings. We evaluated the diagnostic performance of the HiberGene (HG) GBS loop-mediated isothermal amplification (LAMP) assay for the rapid detection of GBS in rectal/vaginal swabs collected from women in Uganda. This work forms a part of the PROGRESS GBS study.</p><p><strong>Methods: </strong>In phase 1, 1294 rectal and vaginal swabs were collected from pregnant women and inoculated in enrichment (Lim) broth, which was then tested using the HG GBS LAMP assay (<i>sip</i> gene target) and culture on chromogenic agar. In phase 2, 166 swabs from nonpregnant women were tested directly (without the enrichment step). For samples with discordant results, an additional method of testing against multiplex real-time polymerase chain reaction assay was used.</p><p><strong>Results: </strong>Overall, the HG GBS LAMP assay detected more GBS-positive samples (31.3%; 452/1445) than culture-based methods (13.3%; 192/1445). Multiplex polymerase chain reaction-tested results were concordant with LAMP results in 96.3% of cases. The sensitivity and specificity of the LAMP assay, after adjusting for the tiebreaker results of discordant samples, were 94.4% (95% confidence interval, 86.2-99.4) and 99.0% (95% confidence interval, 94.3-100), respectively.</p><p><strong>Conclusions: </strong>The results of this study demonstrate high sensitivity and specificity of the HG GBS LAMP assay for the detection of GBS rectovaginal colonization in our setting. Given its rapid turnaround time, the HG GBS LAMP assay could appropriately be used to screen women for GBS rectovaginal colonization during labor to enable provision of intrapartum antibiotic prophylaxis.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 Suppl 3","pages":"S182-S186"},"PeriodicalIF":3.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605869","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":"Early Childhood Neurodevelopmental Outcomes After Early Infant Invasive Group B Streptococcal Infection in Uganda.","authors":"Samantha Sadoo, Carol Nanyunja, Mary Kyohere, Hannah G Davies, Valerie Tusubira, Cleophas Komugisha, Joseph Peacock, Margaret Sewegaba, Philippa Musoke, Musa Sekikubo, Kirsty Le Doare, Cally J Tann","doi":"10.1093/ofid/ofae602","DOIUrl":"10.1093/ofid/ofae602","url":null,"abstract":"<p><strong>Background: </strong>Group B streptococcal (GBS) sepsis during infancy is a leading cause of child mortality and an important contributor to long-term neurodisability. Data on outcomes among invasive GBS infection survivors in low- and middle-income countries are limited. We present 2-year neurodevelopment and growth outcomes after GBS sepsis in Uganda.</p><p><strong>Methods: </strong>Participants were infants with culture-proven GBS sepsis <3 months of age and a gestationally matched comparison cohort of infants who did not have GBS sepsis in Kampala, Uganda. Neurodevelopmental impairment up to 24 months (corrected age) was assessed using the Bayley Scales of Infant Development and Hammersmith Infant Neurological Examination. Weight, height, mid-upper arm circumference, and occipito-frontal circumference were measured.</p><p><strong>Results: </strong>Neurodevelopmental outcome data were available for 16 survivors of GBS sepsis and 59 comparison children. Among survivors of GBS sepsis, cognitive and language scores were lower (median difference [interquartile range], -5 [-10 to 0] and -8 [-15 to -2], respectively). Moderate to severe neurodevelopmental impairment occurred in 31% (5/16) in the GBS cohort compared with 8.5% (5/59) in the non-GBS cohort. Three children with neurodevelopmental impairment had cerebral palsy (bilateral spasticity), and 2 had global developmental delay without cerebral palsy. GBS sepsis survivors were more likely to have undernutrition compared with comparison children (25% vs 10%), largely due to severe undernutrition among those with cerebral palsy.</p><p><strong>Conclusions: </strong>In this Sub-Saharan African population, survivors of infant GBS sepsis were more likely to have impaired neurodevelopmental and growth outcomes compared with children who did not have GBS sepsis. GBS sepsis survivors should be included in long-term follow-up programs to monitor for neurodevelopmental difficulties and initiate early referrals to support services.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 Suppl 3","pages":"S173-S181"},"PeriodicalIF":3.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605848","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":"Community Perceptions of Neonatal Infection in Uganda.","authors":"Phiona Nalubega, Agnes Ssali, Ritah Namugumya, Hannah G Davies, Mary Kyohere, Musa Sekikubo, Madeleine Cochet, Joseph Peacock, Philippa Musoke, Janet Seeley, Kirsty Le Doare","doi":"10.1093/ofid/ofae607","DOIUrl":"10.1093/ofid/ofae607","url":null,"abstract":"<p><strong>Background: </strong>We investigated awareness of neonatal infections among a population of pregnant women and other community members in Kampala, Uganda. We explored perceived causes of neonatal infections and perceptions of appropriate treatments.</p><p><strong>Methods: </strong>We conducted focus group discussions (FGDs) and in-depth interviews (IDIs) with 97 participants: 25 community leaders who took part in 3 FGDs, 12 pregnant women who took part in IDIs, and 60 pregnant women who took part in 8 FGDs, between November 2019 and October 2020. Data were analyzed thematically. This work formed part of the PROGRESS study, an observational cohort study undertaken in Kampala, Uganda, between November 2018 and April 2021.</p><p><strong>Results: </strong>Beliefs about causes, signs, symptoms, and treatment of infants with suspected infections impacted health-seeking behavior. Some illnesses were perceived to be caused by environmental factors while others were believed to have social or behavioral causes, such as the promiscuity of the male partner causing infections or the mother being bewitched. Local herbs and traditional remedies were the most preferred method of treatment and were commonly relied on to address various health issues rather than conventional medicines. Notably, no participant mentioned vaccines as a way of preventing infections.</p><p><strong>Conclusions: </strong>Pregnant women and community members' understanding of the causes and treatment of neonatal illnesses were diverse, including environmental, social-behavioral, and supernatural causes, while both conventional and traditional remedies were perceived as appropriate treatments and sought accordingly. Understanding community perceptions and practices around neonatal infections is key to improving neonatal health interventions and outcomes.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 Suppl 3","pages":"S206-S211"},"PeriodicalIF":3.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605840","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":"Antenatal Screening for Hepatitis B Virus in Uganda: Missed Opportunities for Diagnosis and Treatment.","authors":"Melanie Etti, Hannah G Davies, Alexander Amone, Mary Kyohere, Valerie Tusubira, Jessica Burt, Geraldine O'Hara, Godfrey Matovu, Joseph Peacock, Annettee Nakimuli, Philippa Musoke, Musa Sekikubo, Kirsty Le Doare","doi":"10.1093/ofid/ofae603","DOIUrl":"10.1093/ofid/ofae603","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis B virus (HBV) infection is a significant cause of morbidity and mortality globally. The World Health Organization estimates that just 10.5% of individuals living with HBV globally are aware of their status. Antenatal care provides an opportunity to screen pregnant women for HBV and to treat those who are eligible to reduce the risk of vertical transmission. We conducted an observational study to determine the proportion of pregnant women with active HBV infection delivering at a government-funded hospital in Kampala, Uganda, to estimate the number of missed opportunities to prevent vertical transmission.</p><p><strong>Methods: </strong>Eligible participants were enrolled via the PROGRESS study, an observational cohort study undertaken in Kampala, Uganda, between November 2018 and April 2021. Results presented here describe data from April 2019 to November 2020. Five milliliters of venous blood was drawn shortly after delivery. Serum aliquots were analyzed for hepatitis B surface antigen (HBsAg). HBsAg-positive participants were informed of their result by telephone and referred to the gastroenterology service for specialist management.</p><p><strong>Results: </strong>In total, 6062 women were enrolled between April 2019 and November 2020. Results were available for 6012 (99.6%) participants, among whom 131 (2.2%) were HBsAg positive. Only 10 of 131 (7.6%) HBsAg-positive participants were successfully referred to the gastroenterology service at Mulago Hospital for treatment of their infection.</p><p><strong>Conclusions: </strong>Our study identified a number of missed opportunities to identify active HBV infection among our pregnant cohort. Additional resources are urgently required to increase the coverage of antenatal HBV screening while also improving treatment pathways for pregnant women with HBV infection in this region.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 Suppl 3","pages":"S193-S199"},"PeriodicalIF":3.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605770","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":"Deciphering Positive Cytomegalovirus Immunoglobulin M Test Results in Immunocompetent Adults Hospitalized With Illness Suspicious for Acute Cytomegalovirus Infection: A Multihospital Study.","authors":"Shrestha Samuel, Samantha Thomas, Louise Asleson, Anny Nguyen, Jeffery L Meier, Rima El-Herte","doi":"10.1093/ofid/ofaf144","DOIUrl":"10.1093/ofid/ofaf144","url":null,"abstract":"<p><strong>Background: </strong>Previously healthy adults hospitalized with an acute undifferentiated illness who test positive for cytomegalovirus (CMV) immunoglobulin M (IgM) in their serum may have a primary CMV infection, CMV reactivation/reinfection, or a false-positive result. We aimed to understand how clinicians interpret and incorporate positive CMV IgM test results into their diagnostic and management decisions.</p><p><strong>Methods: </strong>This was a retrospective case series study of 13 previously healthy, immunocompetent adults hospitalized with an acute illness in a 12-hospital system from 1 January 2017 to 1 January 2020, who tested positive for CMV IgM within 3 days of hospitalization. Twelve of 13 had CMV immunoglobulin G (IgG).</p><p><strong>Results: </strong>Among these 13 adults (median age, 36 years), elevated liver enzymes (100%), fever (85%), hepatosplenomegaly (54%), and headache (38%) were common. Lymphocytosis was observed in 5 patients, reactive lymphocytes in 3, and 1 patient died from hemophagocytic lymphohistiocytosis. Dual positivity for CMV and Epstein-Barr virus (EBV) IgM was frequent, yet only 1 patient was tested for both CMV and EBV DNA in blood or for CMV IgG avidity index, which indicated a primary CMV infection. Of the 6 patients with CMV DNA in blood, 4 received anti-CMV treatment. Uncertainty regarding CMV's role in the illness was common, and final assessments varied even among cases with similar clinical presentations and serologic patterns.</p><p><strong>Conclusions: </strong>Interpreting positive CMV IgM results in immunocompetent adults hospitalized with acute illness is challenging and ambiguous due to test limitations and confounders. Supplemental CMV IgG avidity testing can help determine whether primary CMV infection caused the illness, thereby refining the diagnosis and potentially influencing clinical decision-making.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 3","pages":"ofaf144"},"PeriodicalIF":3.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11935743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710885","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":"Rates of Hospitalization and Death due to COVID-19 in US Veterans With SARS-CoV-2 Infection in the XBB-, JN.1-, and KP-Predominant Eras.","authors":"Taeyoung Choi, Yan Xie, Ziyad Al-Aly","doi":"10.1093/ofid/ofaf115","DOIUrl":"10.1093/ofid/ofaf115","url":null,"abstract":"<p><p>Between September 2023 and October 2024, severe acute respiratory syndrome coronavirus 2 evolved through 3 variant-predominant eras: XBB, JN.1, and KP. Among 130 263 Department of Veterans Affairs patients with coronavirus disease 2019, hospitalization odds declined for JN.1 (0.81; 95% CI, 0.74-0.89) and KP (0.80; 95% CI, 0.72-0.88) compared with XBB, with consistently low in-hospital death rates across all eras.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 3","pages":"ofaf115"},"PeriodicalIF":3.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11919815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664108","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":"Etiology and Antimicrobial Resistance of Culture-Positive Infections in Ugandan Infants: A Cohort Study of 7000 Neonates and Infants.","authors":"Hannah G Davies, Mary Kyohere, Valerie Tusubira, Alexander Amone, Amusa Wamawobe, Cleophas Komugisha, Philippa Musoke, Lauren Hookham, Pooja Ravji, Melanie Etti, Juliet Nsimire Sendagala, Dan R Shelley, Caitlin Farley, Merryn Voysey, Owen B Spiller, Joseph Peacock, Musa Sekikubo, Paul T Heath, Kirsty Le Doare","doi":"10.1093/ofid/ofae629","DOIUrl":"10.1093/ofid/ofae629","url":null,"abstract":"<p><strong>Background: </strong>Epidemiological evidence about the etiology and antimicrobial resistance of neonatal infections remains limited in low-resource settings. We aimed to describe the etiology of neonatal infections in a prospective observational cohort study conducted at two hospital sites in Kampala, Uganda.</p><p><strong>Methods: </strong>Babies admitted to either unit with risk factors or signs of sepsis, pneumonia, or meningitis had a blood culture, nasopharyngeal swab, and lumbar puncture (if indicated) collected. Basic demographics were collected, and babies were followed up until discharge or death to determine admission outcome. Blood cultures were processed using the BACTEC system and identification confirmed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Cerebrospinal fluid was processed using standard microbiological testing and swabs were processed using the multiplex real-time polymerase chain reaction assay. Antimicrobial susceptibilities of bacterial isolates to World Health Organization-recommended first-line antibiotics (ampicillin or benzylpenicillin and gentamicin) were assessed using e-tests.</p><p><strong>Results: </strong>A total of 7323 infants with signs or risk factors for sepsis had blood cultures, 2563 had nasopharyngeal swabs, and 23 had lumbar punctures collected. Eleven percent of blood cultures and 8.6% of swabs were positive. Inpatient mortality was 12.1%, with 27.7% case fatality observed among infants with Gram-negative bloodstream infections. <i>Escherichia coli</i> (14.8%), <i>Acinetobacter</i> spp. (10.3%), and <i>Klebsiella</i> spp. (7.6%), were notable contributors to Gram-negative sepsis, whereas Group B <i>Streptococcus</i> was the predominant Gram-positive pathogen identified (13.5%). Almost 60% of Gram-negative pathogens were ampicillin- and gentamicin-resistant.</p><p><strong>Conclusions: </strong>Our study demonstrates high levels of antimicrobial resistance and inpatient mortality from neonatal sepsis in the first months of life in Uganda. This underscores the pressing need for revised, context-specific antimicrobial treatment guidelines that account for the evolving landscape of antimicrobial resistance in neonatal sepsis.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 Suppl 3","pages":"S157-S164"},"PeriodicalIF":3.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605853","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":"HIV Exposure and Neonatal Sepsis: A Descriptive Etiological Study.","authors":"Patience Atuhaire, Mary Kyohere, Valerie Tusubira, Hannah G Davies, Philippa Musoke, Musa Sekikubo, Amusa Wamawobe, Joseph Peacock, Kirsty Le Doare","doi":"10.1093/ofid/ofae642","DOIUrl":"10.1093/ofid/ofae642","url":null,"abstract":"<p><strong>Background: </strong>Low- and middle-income countries lack data on culture-confirmed sepsis in HIV-exposed infants, despite the reported heightened risk of infectious morbidity. This study describes culture-confirmed sepsis and antibiotic resistance patterns among HIV-exposed children in a large etiological cohort study in Kampala, Uganda.</p><p><strong>Methods: </strong>This was a prospective birth cohort study based at 2 Ugandan sites, as part of the Progressing Group B Streptococcal Vaccines (PROGRESS) study. Any infant with risk factors, signs, or symptoms of infection presenting before 3 months of age had a blood culture and nasopharyngeal swab taken to determine the etiology of neonatal and young infant sepsis.</p><p><strong>Results: </strong>Among 4492 blood cultures, 460 were obtained from HIV-exposed infants. Nine infants (1.9%) had positive blood cultures. The most frequently isolated organisms were <i>Escherichia coli</i>, group B <i>Streptococcus</i>, and <i>Streptococcus viridans</i>, and these organisms demonstrated resistance to the common antibiotics (aminoglycosides, penicillins, and cephalosporins) used for management of suspected sepsis. A higher proportion of the exposed babies died vs HIV-unexposed (15.8 vs 11.2; <i>P</i> = .005). Nasopharyngeal swabs were collected from 114 infants, with 7.9% positive for at least one virus or bacterium.</p><p><strong>Conclusions: </strong>Future work is needed to investigate why mortality among HIV-exposed infants persists despite maternal antiretroviral treatment. Antimicrobial resistance is an increasing concern in this setting.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 Suppl 3","pages":"S187-S192"},"PeriodicalIF":3.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605857","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}