Open Forum Infectious Diseases最新文献

{"title":"Identifying High-Risk Populations for Sexually Transmitted Infections in Chinese Men Who Have Sex With Men: A Cluster Analysis.","authors":"Fang Lu, Bingyang She, Rui Zhao, Gaixia Li, Yawu Hu, Yi Liu, Min Zhao, Lei Zhang","doi":"10.1093/ofid/ofae754","DOIUrl":"https://doi.org/10.1093/ofid/ofae754","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to identify subpopulations of Chinese men who have sex with men (MSM) with distinct sexual behavioral patterns and explore their correlations with sexually transmitted infections (STIs).</p><p><strong>Methods: </strong>We recruited 892 eligible MSM in Xi'an, China, collecting sociodemographic, sexual behavior, and STI data. Cluster analysis identified distinct sexual behavioral patterns, allowing us to examine STI differences across clusters.</p><p><strong>Results: </strong>Among the 892 MSM analyzed, 3 clusters were identified. Cluster 1 (n = 157) exhibited high-risk sexual behavioral patterns, including the highest median number of sexual partners (5 vs 1 in cluster 2 vs 3 in cluster 3, <i>P</i> < .001), lowest consistent condom use for insertive anal sex (0% vs 64.12% vs 99.76%, <i>P</i> = .004) and receptive anal sex (9.22% vs 67.71% vs 98.91%, <i>P</i> = .006), highest uncertainty of partners' STIs (77.07% vs 57.89% vs 64.5%, <i>P</i> < .001), all recent partners being casual, longest length of sequential sexual acts (6 vs 5 vs 5, <i>P</i> = .045), and highest rates of gonorrhea (20.38% vs 10.09% vs 14.99%, <i>P</i> = .019) and chlamydia (16.56% vs 8.33% vs 13.21%, <i>P</i> = .045). Cluster 2 (n = 228) showed the lowest engagement in high-risk behaviors and STIs, characterized by the fewest sexual partners, highest certainty of partner's STIs, and all recent partners being regular. Cluster 3 (n = 507) showed moderate levels of high-risk behaviors and STIs, with the highest consistent condom use during anal sex.</p><p><strong>Conclusions: </strong>This study identified 3 subpopulations of Chinese MSM with distinct sexual behavioral patterns. Targeted public health interventions to the most at-risk subpopulations of MSM are essential for STI prevention.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 1","pages":"ofae754"},"PeriodicalIF":3.8,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11739803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009153","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":"An Observational Study to Determine the Prevalence of COVID-19 Among Hospitalized Patients With Multidrug-Resistant Enterobacterales Infections and Clinical Outcomes, 10 US Sites, 2020--2022.","authors":"Julian E Grass, Sandra N Bulens, Uzma A Ansari, Nadezhda Duffy, Jesse T Jacob, Gillian Smith, Paulina A Rebolledo, Ana Mesa Restrepo, Elisabeth Vaeth, Ghinwa Dumyati, Rebecca Tsay, Hsioa Che Looi, Erin Phipps, Kristina G Flores, Christopher Wilson, Daniel Muleta, Christopher A Czaja, Jennifer Driscoll, Helen Johnston, Ruth Lynfield, Sean O'Malley, Meghan Maloney, Nicole Stabach, Joelle Nadle, Rebecca Pierce, Heather Hertzel, Alice Y Guh","doi":"10.1093/ofid/ofae745","DOIUrl":"https://doi.org/10.1093/ofid/ofae745","url":null,"abstract":"<p><strong>Background: </strong>We investigated hospitalized carbapenem-resistant Enterobacterales (CRE) and extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) cases with and without COVID-19, as identified through Emerging Infections Program surveillance in 10 sites from 2020 to 2022.</p><p><strong>Methods: </strong>We defined a CRE case as the first isolation of <i>Escherichia coli</i>, <i>Enterobacter cloacae</i> complex, <i>Klebsiella aerogenes</i>, <i>K oxytoca</i>, <i>K pneumoniae</i>, or <i>K variicola</i> resistant to any carbapenem. We defined an ESBL-E case as the first isolation of <i>E coli</i>, <i>K pneumoniae</i>, or <i>K oxytoca</i> resistant to any third-generation cephalosporin and nonresistant to all carbapenems tested. Specimens were drawn from a normally sterile site or urine among hospitalized residents of the surveillance area in a 30-day period. We defined COVID-19 as a positive SARS-CoV-2 test result (SC2⁺) within 14 days before CRE or ESBL-E specimen collection and performed multivariable logistic regression analyses.</p><p><strong>Results: </strong>Of 1595 CRE and 1866 ESBL-E hospitalized cases, 38 (2.4%) and 60 (3.2%), respectively, had a SC2⁺. Among these cases, a SC2⁺ was associated with intensive care unit admission (adjusted odds ratio [aOR], 1.69 [95% CI, 1.14-2.50]; aOR, 1.48 [95% CI, 1.03-2.12]) and 30-day mortality (aOR, 1.79 [95% CI, 1.22-2.64]; aOR, 1.94 [95% CI, 1.39-2.70]).</p><p><strong>Conclusions: </strong>CRE and ESBL-E infections among hospitalized patients with preceding COVID-19 were uncommon but had worse outcomes when compared with cases without COVID-19. COVID-19 prevention in patients at risk of CRE and ESBL-E infections is needed, as well as continued infection control measures and antibiotic stewardship for patients with COVID-19.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 1","pages":"ofae745"},"PeriodicalIF":3.8,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009148","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":"Risk Factors for Infection-Attributable Mortality in Patients With <i>Staphylococcus aureus</i> Bacteremia: A Competing Risk Analysis.","authors":"Seongman Bae, Min Soo Kook, Euijin Chang, Jiwon Jung, Min Jae Kim, Yong Pil Chong, Sung-Han Kim, Sang-Ho Choi, Sang-Oh Lee, Yang Soo Kim","doi":"10.1093/ofid/ofae734","DOIUrl":"https://doi.org/10.1093/ofid/ofae734","url":null,"abstract":"<p><strong>Background: </strong>Identifying risk factors for mortality in patients with <i>Staphylococcus aureus</i> bacteremia (SAB) is crucial due to its high fatality. However, data on risk factors for infection-attributable deaths considering competing risk events such as non-infection-attributable deaths remain limited. We performed a competing risk analysis to elucidate risk factors associated with 30-day infection-attributable mortality in a large cohort of patients with SAB.</p><p><strong>Methods: </strong>This retrospective cohort study included adult patients diagnosed with SAB at a tertiary hospital from August 2008 to December 2019. Competing risk analysis was performed using Fine and Gray models to estimate subdistribution hazard ratios (sHRs) for 30-day infection-attributable death.</p><p><strong>Results: </strong>Among 1936 patients, 444 (22.9%) died within 30 days. Of these, 338 (76.1%) were infection-attributable and 106 (23.9%) were non-infection-attributable deaths. The multivariable Fine and Gray model identified significant risk factors for 30-day infection-attributable death (sHRs with 95% confidence intervals): an increase in age by 10 years (1.14 [1.02-1.26]), presence of malignancy (1.54 [1.17-2.02]), liver cirrhosis (2.15 [1.56-2.97]), corticosteroid use (1.61 [1.19-2.17]), septic shock (3.28 [1.98-5.42]), elevated C-reactive protein (1.60 [1.19-2.14]), pneumonia (1.81 [1.21-2.72]), persistent bacteremia (1.73 [1.31-2.30]), and failure to remove the eradicable focus (2.40 [1.38-4.19]) or absence of an eradicable focus (1.49 [1.08-2.04]). Except for age and malignancy, these factors were not significantly associated with non-infection-related death.</p><p><strong>Conclusions: </strong>Specific risk factors for infection-attributable death in patients with SAB were identified, distinct from those for nonattributable death. These findings can aid in the early identification of patients at risk for SAB-attributable mortality.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 1","pages":"ofae734"},"PeriodicalIF":3.8,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952564","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":"Timing of Infection as a Key Driver of Racial/Ethnic Disparities in Coronavirus Disease 2019 Mortality Rates During the Prevaccine Period.","authors":"Ramya Naraharisetti, Rob Trangucci, Krzysztof Sakrejda, Nina B Masters, Ryan Malosh, Emily T Martin, Marisa Eisenberg, Bruce Link, Joseph N S Eisenberg, Jon Zelner","doi":"10.1093/ofid/ofae636","DOIUrl":"10.1093/ofid/ofae636","url":null,"abstract":"<p><p>Disparities in coronavirus disease 2019 mortality are driven by inequalities in group-specific incidence rates (IRs), case fatality rates (CFRs), and their interaction. For emerging infections, such as severe acute respiratory syndrome coronavirus 2, group-specific IRs and CFRs change on different time scales, and inequities in these measures may reflect different social and medical mechanisms. To be useful tools for public health surveillance and policy, analyses of changing mortality rate disparities must independently address changes in IRs and CFRs. However, this is rarely done. In this analysis, we examine the separate contributions of disparities in the timing of infection-reflecting differential infection risk factors such as residential segregation, housing, and participation in essential work-and declining CFRs over time on mortality disparities by race/ethnicity in the US state of Michigan. We used detailed case data to decompose race/ethnicity-specific mortality rates into their age-specific IR and CFR components during each of 3 periods from March to December 2020. We used these estimates in a counterfactual simulation model to estimate that that 35% (95% credible interval, 30%-40%) of deaths in black Michigan residents could have been prevented if these residents were infected along the timeline experienced by white residents, resulting in a 67% (61%-72%) reduction in the mortality rate gap between black and white Michigan residents during 2020. These results clearly illustrate why differential power to \"wait out\" infection during an infectious disease emergency-a function of structural racism-is a key, underappreciated, driver of inequality in disease and death from emerging infections.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 1","pages":"ofae636"},"PeriodicalIF":3.8,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886150","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 Genotype Dynamics of Dengue in Hospitalized Patients in Northern Vietnam Between 2020 and 2022.","authors":"Do Duc Anh, Nguyen Trong The, Truong Nhat My, Le Thi Kieu Linh, Nghiem Xuan Hoan, Peter G Kremsner, Nguyen Linh Toan, Le Huu Song, Thirumalaisamy P Velavan","doi":"10.1093/ofid/ofae753","DOIUrl":"https://doi.org/10.1093/ofid/ofae753","url":null,"abstract":"<p><strong>Background: </strong>Arboviruses, including Dengue (DENV), Zika, and chikungunya, cause recurrent outbreaks of varying intensity in tropical countries. This study aimed to investigate other arboviruses, including Zika and chikungunya, in patients clinically suspected of Dengue and to characterize the circulating Dengue serotypes and genotypes in Northern Vietnam from 2020 to 2022. To date, information on this topic in the region has been limited.</p><p><strong>Methods: </strong>Multiplex real-time polymerase chain reaction (PCR) was used to detect Dengue, Zika, and chikungunya RNA, and DENV serotypes were identified via real-time reverse transcriptase PCR from 426 clinically Dengue suspected patients. Patients were screened for NS1 antigen and anti-DENV immunoglobulin (Ig) G/IgM antibodies. Phylogenetic analysis of DENV Capsid-premembrane gene sequences was performed to investigate genotype distribution.</p><p><strong>Results: </strong>Dengue was confirmed in 95% of cases, with no Zika or chikungunya RNA detected. DENV-2 was the predominant serotype (61%), followed by DENV-1 (31%) and DENV-4 (7%). Coinfections were observed, with DENV-1 and DENV-2 being the most common. In 2022, a high incidence of Dengue cases with warning signs and severe Dengue was observed, accompanied by elevated liver enzyme levels and reduced platelet counts. Phylogenetic analysis revealed that the DENV-1 and DENV-4 serotypes clustered with previously reported regional virus, while DENV-2 showed a shift from genotype Asian I to Cosmopolitan over the study period.</p><p><strong>Conclusions: </strong>This study underscores a significant rise in Dengue severity and shifts in DENV genotypes in recent years in Northern Vietnam, emphasizing the importance of understanding genotype dynamics and clinical dynamics for improving outbreak preparedness and response strategies.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 1","pages":"ofae753"},"PeriodicalIF":3.8,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009152","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":"Disseminated TB With IRIS Presenting as a Pancreatic Mass in Newly Diagnosed HIV: A Case Report.","authors":"Nina Akbar, Peter Mariuz","doi":"10.1093/ofid/ofae746","DOIUrl":"https://doi.org/10.1093/ofid/ofae746","url":null,"abstract":"<p><p>Pancreatic tuberculosis (TB) is an uncommon extrapulmonary presentation of TB. Identification of coinfection with HIV may unmask not only disseminated TB but also immune reconstitution inflammatory syndrome (IRIS). We present the case of a 70-year-old Indian woman newly diagnosed with AIDS and pancreatic tuberculosis with miliary disseminated disease. Her clinical course was complicated by IRIS related to HIV-TB coinfection despite sequential and targeted anti-infective therapies. We review the presentation, pathophysiology, and risk factors for developing IRIS with HIV and pancreatic TB.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 1","pages":"ofae746"},"PeriodicalIF":3.8,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009150","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":"2024 OFID Reviewer Recognition List.","authors":"","doi":"10.1093/ofid/ofae659","DOIUrl":"10.1093/ofid/ofae659","url":null,"abstract":"","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 12","pages":"ofae659"},"PeriodicalIF":3.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876480","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":"Week 96 Results of Bictegravir/Emtricitabine/Tenofovir Alafenamide for HIV Treatment in People With Substance Use Disorders.","authors":"Joshua P Havens, Sara H Bares, Elizabeth Lyden, Nada Fadul, Susan Swindells","doi":"10.1093/ofid/ofae737","DOIUrl":"10.1093/ofid/ofae737","url":null,"abstract":"<p><strong>Background: </strong>The BASE study (NCT03998176), a phase 4, 48-week (W), single-arm, prospective trial, revealed that the use of bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) in people with HIV and substance use disorders (PWH/SUD) was safe and effective without emergent antiretroviral resistance despite incomplete adherence. Here, we present the W96 results.</p><p><strong>Methods: </strong>A retrospective analysis of all participants enrolled in the BASE study was completed from W48 to W96. End points of interest at W96 included the proportion of participants with viral suppression (VS; HIV RNA <50 copies/mL [c/mL]), incidence of protocol-defined virologic failure (PDVF; 2 consecutive ≥400 c/mL), safety, adherence (percentage of days covered [PDC]), retention in care, and prevalence of ongoing substance use.</p><p><strong>Results: </strong>All enrolled BASE participants (n = 43) were included in the W96 analysis. At W48, 21 participants (49%) had achieved VS (intent-to-treat [ITT]). Thirty-six (84%) participants completed W96, with 19 achieving an HIV RNA <50 copies/mL (ITT, 44%; per-protocol, 54%). Seven participants (19%) met PDVF; genotyping was performed on 2, with no evidence of treatment-emergent antiretroviral resistance noted. No safety signals were identified or attributed to B/F/TAF. Adherence to B/F/TAF decreased 18% after W48 (mean PDC: W0-W48, 72%; W48-W96, 54%; <i>P</i> < .01). Participants exhibiting adherence rates of ≥4 doses/wk (PDC ≥57%) were more likely to achieve VS (PDC ≥57%, 84.2%, vs PDC <57%, 15.8%; <i>P</i> < .01). Retention in care remained stable, and participants continued to use substances through W96.</p><p><strong>Conclusions: </strong>At W96, the proportion of PWH/SUD achieving VS with B/F/TAF decreased to 44%, along with an adherence decrease of 18%, with no evidence of treatment-emergent HIV drug resistance occurring.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 1","pages":"ofae737"},"PeriodicalIF":3.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11713015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142951563","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":"Successful Treatment of <i>Candida auris</i> Ventriculitis With Intravenous Liposomal Amphotericin B and Oral Flucytosine: A Case Report.","authors":"Nayoung Kang, Victor Yu-Ching Hsu, Charles Christopher Bailey","doi":"10.1093/ofid/ofae743","DOIUrl":"10.1093/ofid/ofae743","url":null,"abstract":"<p><p><i>Candida auris</i> is a rapidly emerging fungal pathogen associated with high resistance rates, particularly in healthcare settings. It most commonly affects patients with severe underlying medical conditions and requiring complex medical care. Patients with invasive medical devices tend to be at increased risk for getting <i>C auris</i> and developing infection. This article presents a case of <i>C auris</i> ventriculitis successfully treated with intravenous liposomal amphotericin B and oral flucytosine. A 41-year-old man with multiple comorbidities, including recent placement of a ventriculoperitoneal shunt, presented with suspected sepsis. <i>Candida auris</i> was isolated from cerebrospinal fluid cultures. Antifungal therapy along with removal of the shunt led to resolution of infection without complications. This case highlights the challenges posed by <i>C auris</i> infections and underscores the importance of appropriate treatment strategies.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 1","pages":"ofae743"},"PeriodicalIF":3.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932457","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":"Association Between the Need to Change Initial Antifungal Therapy and Treatment Costs in Patients With Invasive Aspergillosis.","authors":"Barbara D Alexander, Melissa Johnson, Mark Bresnik, Vamshi Ruthwik Anupindi, Lia Pizzicato, Mitchell DeKoven, Belinda Lovelace, Craig I Coleman","doi":"10.1093/ofid/ofae747","DOIUrl":"https://doi.org/10.1093/ofid/ofae747","url":null,"abstract":"<p><strong>Background: </strong>Early antifungal initiation in invasive aspergillosis (IA) is recommended. Changing antifungals occurs for a myriad of reasons but associated costs are unclear.</p><p><strong>Methods: </strong>US claims data for adults admitted for IA were identified from 10/1/2015 to 11/30/2022. Patients were stratified by those who did and did not change antifungal therapy. Adjusted all-cause healthcare utilization and costs/patient during index hospitalization and at 1, 6, and 12-months after the index date between the cohorts that did and did not change antifungal therapy were compared.</p><p><strong>Results: </strong>Among 1,192 IA patients, 707 (59.3%) changed their initial antifungal therapy over follow-up. The index hospital length of stay was longer (Δ = 6 days, <i>P</i> < .001) and costs were higher (Δ = $65,149, <i>P</i> < .001) in the change vs. no change cohort. Median 1, 6, and 12-months all-cause costs were higher in patients changing antifungal therapy vs. not (Δ = $90,938-$192,953).</p><p><strong>Conclusions: </strong>Changing antifungals was associated with longer hospital stays and costs and higher all-cause costs over 12-months.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 1","pages":"ofae747"},"PeriodicalIF":3.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11739793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009149","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}