Open Forum Infectious Diseases最新文献

{"title":"Partial Oral Therapy for Infective Endocarditis Among Adult Infectious Diseases Physicians in the United States: An Emerging Infections Network Survey.","authors":"Jack W McHugh, Larry M Baddour, Supavit Chesdachai, Susan E Beekmann, Philip M Polgreen, Walter R Wilson, Daniel C DeSimone","doi":"10.1093/ofid/ofaf580","DOIUrl":"10.1093/ofid/ofaf580","url":null,"abstract":"<p><strong>Background: </strong>Recent clinical trial evidence supports broader use of partial oral therapy (POT) for infective endocarditis (IE), yet real-world uptake in the U.S. has not been investigated.</p><p><strong>Methods: </strong>Adult infectious diseases (ID) physician members of the Infectious Diseases Society of America Emerging Infections Network were surveyed in April-May 2025. A 10-item instrument captured frequency of POT, organism-specific influence, decision factors, barriers, and facilitators.</p><p><strong>Results: </strong>Among 1531 members, 516 (34%) responded; 452 (88%) of them managed IE. POT was uncommon: 16% never used, 53% used in ≤10% of cases, and only 10% used in >25% of patients. Frequent POT rose with caseload (23% in physicians treating >50 IE cases year vs ≤9% in lower-volume groups, <i>P</i> < .001) and with fewer years in clinical practice (13% in <5 yrs vs 5% in ≥25 yrs, <i>P</i> = .013). Comfort with POT depended on the pathogen: 66% were comfortable switching for <i>Streptococcus spp.</i>, 52% for Gram-negative bacilli, 19% for methicillin-resistant <i>Staphylococcus aureus</i>. Three quarters of those who used POT finished with a single agent. In people who inject drugs, 34% of physicians often or always considered an oral regimen. Availability of an active oral agent (75%) and the pathogen involved (69%) were the leading decision drivers; principal barriers were fear of relapse (72%), adherence concerns (53%), and insufficient evidence (48%). Respondents most desired clearer guidelines (75%) and additional data (71%).</p><p><strong>Conclusions: </strong>U.S. adult ID physicians adopt POT for IE sparingly. Updated IE treatment guidelines, additional clinical trial data, and broader access to complex outpatient antimicrobial therapy services may facilitate wider adoption.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf580"},"PeriodicalIF":3.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150387","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 Blood Culture Bottle Shortage and Ordering Restrictions and Clinical Outcomes for Patients With <i>Staphylococcus aureus</i> Bacteremia.","authors":"Romney M Humphries, Ritu Banerjee, William D Dupont, David Gaston, Nicholas McKenzie, Michael Petit, W Dale Plummer, Matthew W Semler, Caroline Taylor, Thomas R Talbot","doi":"10.1093/ofid/ofaf546","DOIUrl":"10.1093/ofid/ofaf546","url":null,"abstract":"<p><strong>Background: </strong>A nationwide shortage of blood culture bottles led to significant restriction of blood culture utilization at our institution.</p><p><strong>Methods: </strong>We evaluated the impact of 3 combined interventions: (1) guidance on appropriate blood culture utilization, (2) restriction of repeat cultures within a 48-hour period, and (3) restriction of initial assessment to a single blood culture set consisting of 1 aerobic and 1 anaerobic blood culture bottle, on the management of patients with <i>Staphylococcus aureus</i> bacteremia (SAB) using an interrupted time series analysis.</p><p><strong>Results: </strong>Prior to the intervention, 90.1% of patients had 2 blood culture sets ordered for initial assessment, versus 5.7% during the intervention and 84.1% postintervention. The median number of cultures to document SAB clearance was 4 (range, 2-17) in the preintervention period, 2 (range, 2-9) during the intervention period, and 4 (range, 3-11) postintervention. The median number of days to SAB clearance was not significantly different across the study periods, nor were days to central venous catheter placement or days of intravenous <i>S aureus</i> therapy. Fewer patients had documented SAB clearance within 24 hours and median time to diagnosis for community-acquired cases was longer in the intervention period, suggesting the restrictions were not without potential clinical impact.</p><p><strong>Conclusions: </strong>These data demonstrate that efforts to reduce blood culture utilization should be implemented with careful stewardship in order to minimize adverse effects for patients with SAB.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf546"},"PeriodicalIF":3.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113674","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":"Incidence and Burden of Respiratory Syncytial Virus-Associated Hospitalizations Among People 65 and Older in France: A National Hospital Database Study.","authors":"Stéphane Marot, Clarisse Demont, Théophile Cocherie, Miao Jiang, Charlotte Charpentier, Andre Araujo, Tianyi Lu, Mathieu Uhart, Nadia El Mouaddin, Magali Lemaitre, Sophie Larrieu, Clélia Bignon-Favary, Emilie Lambourg, Arnaud Cheret, David Martin, Anne-Geneviève Marcelin, Diane Descamps, Vincent Calvez, Quentin Le Hingrat","doi":"10.1093/ofid/ofaf528","DOIUrl":"10.1093/ofid/ofaf528","url":null,"abstract":"<p><strong>Background: </strong>Respiratory Syncytial Virus (RSV) presents a serious threat to older adults, particularly those with chronic conditions, and may lead to severe issues. Hospitalizations are frequently underreported due to diagnostic challenges and a lack of standardized testing. This study estimates national-level RSV hospitalization rates and examines the clinical and economic burden in high-risk elderly populations in France.</p><p><strong>Method: </strong>RSV-coded hospitalizations (2017-2022) were identified using the French National Hospital Discharge database. A correction factor, derived from virological data from two local hospitals, was applied to adjust for under-reporting. Incidence rates were calculated using demographic data, focusing on adults aged 75+ and high-risk individuals aged 65-74 with comorbidities. Hospitalization characteristics and costs were also analyzed.</p><p><strong>Results: </strong>For adults aged 75+, the adjusted incidence of RSV hospitalizations ranged from 85 to 221 per 100,000. Inpatient mortality was 8.9%-10.4%, and annual adjusted costs ranged from €27 to €76 million, with intensive care units (ICU) admissions contributing heavily. High-risk adults aged 65-74 had higher adjusted incidence rates (161-735 per 100,000), along with increased ICU admission rates and disproportionately higher costs due to intensive care needs.</p><p><strong>Conclusions: </strong>The significant burden of RSV on adults aged 75+ and high-risk adults aged 65-74 with chronic conditions remains underreported. Improved diagnostics and targeted vaccination programs are essential to reduce hospitalizations, mortality, and healthcare costs in these vulnerable groups.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf528"},"PeriodicalIF":3.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131606","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":"Impacts of US Bilateral Aid Disruptions on HIV Resurgence in Zambia: A Mathematical Modeling Study.","authors":"Lloyd B Mulenga, Kebby Musokotwane, Suilanji Sivile, Khozya D Zyambo, Roma Chilengi, Kennedy Lishimpi, George Sinyangwe, Sombo Fwoloshi, Chimika Phiri, Henry Phiri, Davies Kampamba, David J Kaftan, Sulani Nyimbili, Daniel T Citron, Hae-Young Kim, Anna Bershteyn","doi":"10.1093/ofid/ofaf511","DOIUrl":"10.1093/ofid/ofaf511","url":null,"abstract":"<p><strong>Background: </strong>Of countries with high HIV prevalence, Zambia had the largest proportion of funding to its HIV program from the United States President's Emergency Plan for AIDS Relief (PEPFAR)-84% at the start of 2025. Abrupt withdrawal of bilateral aid in January 2025 disrupted HIV services. This study aimed to estimate the health and epidemiological consequences of the disruptions, and to what extent impacts could be mitigated by restoring services.</p><p><strong>Methods: </strong>We leveraged a previously developed HIV agent-based network transmission model, Epidemiological MODeling software for HIV, calibrated to Zambian HIV data at the provincial level. Health authorities leading the Zambian HIV program identified data and assumptions regarding impacts of aid disruptions by province and associated uncertainty ranges. We simulated disruptions lasting 3 months, 1 year, 4 years, or unabated, versus a counterfactual of no disruptions, over 2025-2060. Outcomes included additional HIV infections, deaths, and prevalence.</p><p><strong>Results: </strong>Unabated disruptions added 3.3 million HIV acquisitions (8.8x more than no disruption) and 1.6 million HIV deaths (5.3x), with the largest number among women (1.5 million acquisitions, 790 933 deaths) and the largest proportional increase among children (21.6x acquisitions, 20.8x deaths). Restoring services within 3 months would limit additional acquisitions to 54 863 (+13.1%) and additional deaths to 32 550 (+8.7%). HIV prevalence would increase by 4.5x if disruptions were unabated through 2060, but would not change (0.0x) if services were restored within 3 months.</p><p><strong>Conclusions: </strong>Rapid restoration of HIV services disrupted by the 2025 bilateral aid withdrawal could save >1.5 million lives and prevent epidemic resurgence in Zambia.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf511"},"PeriodicalIF":3.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Clinical Spectrum and Dynamics of Sequelae Following Tick-Borne Encephalitis Virus Infection: A Systematic Literature Review.","authors":"","doi":"10.1093/ofid/ofaf558","DOIUrl":"https://doi.org/10.1093/ofid/ofaf558","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/ofid/ofaf317.].</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf558"},"PeriodicalIF":3.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186669","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":"Outcomes 10 Years After Implementing an Emergency Department Opt-out Bloodborne Virus Screening Program.","authors":"Liam Townsend, Fiona Herraghty, Seán Brennan, Conor Grant, Wenzhou Wang, Anne Moriarty, Yvonne Lynagh, Lorraine Clancy, Antoinette Power, Brendan Crowley, Suzanne Norris, Darragh Shields, Colm Bergin","doi":"10.1093/ofid/ofaf547","DOIUrl":"10.1093/ofid/ofaf547","url":null,"abstract":"<p><strong>Background: </strong>Bloodborne viruses (BBV) such as hepatitis B (HBV), hepatitis C (HCV), and HIV pose significant personal and public health risks. Screening and linkage to treating services are important tools in treatment and preventing onward transmission. This study reports outcomes of 10 years of an opt-out BBV screening program in a large urban emergency department (ED).</p><p><strong>Methods: </strong>Starting in July 2015, ED patients undergoing phlebotomy were offered routine BBV screening. We examine acceptance of screening, characteristics of new diagnoses, and onward linkage to care 10 years after program implementation. We also investigate factors associated with new viremic HCV diagnoses within this cohort to inform future service development.</p><p><strong>Results: </strong>Over the 10-year period, acceptance of BBV screening among phlebotomized patients was high (81%). There was no significant change in rates of new diagnoses of HIV, HBV, or HCV, but there was a significant reduction in polymerase chain reaction-positive HCV diagnoses. Linkage to care was high (96% HIV, 89% HBV, 95% HCV). Polymerase chain reaction-positive HCV was associated with people who inject drugs and being discharged directly from the ED.</p><p><strong>Conclusions: </strong>BBV screening in the ED demonstrates sustained acceptability, with a steady rate of new diagnoses detected. It provides high levels of linkage to care. It also identifies active HCV within a population of people who inject drugs attending the ED who are discharged directly without needing admission.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf547"},"PeriodicalIF":3.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138150","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":"Diminished Long-term Vaccine Antibody Persistence in Perinatally Youth Living With HIV on cART.","authors":"German A Contreras, Morouge M Alramadhan, Gloria P Heresi, Abel Castro, James R Murphy","doi":"10.1093/ofid/ofaf559","DOIUrl":"10.1093/ofid/ofaf559","url":null,"abstract":"","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf559"},"PeriodicalIF":3.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138161","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":"Assessing the Impact of Methodological Assumptions on Estimated Age of Disease-Causal Human Papillomavirus Infection in US Females.","authors":"Alhaji Cherif, Xuedan You, John Cook, Miriam Reuschenbach, Ya-Ting Chen, Craig Roberts, Ruifeng Xu","doi":"10.1093/ofid/ofaf548","DOIUrl":"10.1093/ofid/ofaf548","url":null,"abstract":"<p><p>We adapted a previous discrete event simulation model to assess the impact of varying time distributions from disease-causal human papillomavirus (HPV) infection to CIN2+ onset on the estimated age distribution of disease-casual infection in the United States. Differences in these assumptions had minimal effect on estimates, underscoring the importance of expanded HPV vaccination.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf548"},"PeriodicalIF":3.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113537","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":"Neurologic Sequelae After Encephalitis Associated With Dengue Virus in Children.","authors":"Neha Srivastava, Rakesh Mankal, Rohit Beniwal, Aman Agarwal, Umaer Alam, Ashok Kumar Pandey, Rajni Kant, Mahima Mittal","doi":"10.1093/ofid/ofaf521","DOIUrl":"10.1093/ofid/ofaf521","url":null,"abstract":"<p><strong>Background: </strong>Neurologic complications associated with dengue infection have been increasingly recognized globally, particularly following detection of dengue virus in cerebrospinal fluid via polymerase chain reaction. Despite this, no prior study has assessed neurologic sequelae in patients with dengue-associated acute encephalitis syndrome (DEN-AES). This study aimed to evaluate the extent and domains of neurologic sequelae in pediatric DEN-AES cases.</p><p><strong>Methods: </strong>The study was conducted in 2023, including diagnosed DEN-AES cases (≤18 years) discharged between January 2018 and December 2019. DEN-AES was defined as acute fever onset with altered mental status (confusion, disorientation, coma, or inability to speak) and/or new seizures (excluding simple febrile seizures), as confirmed by NS1/IgM enzyme-linked immunosorbent assay and reverse transcription polymerase chain reaction tests for dengue. Long-term sequelae were assessed via home visits with a standardized disability assessment tool. Hospital records provided clinical, biochemical, and laboratory data for analysis.</p><p><strong>Results: </strong>Of 56 children (median age, 7.5 years [IQR, 5-10]; 53.6% male), neurologic sequelae of varying severity were observed in 22 (39.3%) cases. Severe disabilities were noted in 6 children, with 1 postdischarge death. Thirty-four children were fully recovered, scoring 5 on the Liverpool Outcome Score. Cognitive and behavioral impairments were the most common sequelae (37.5%), and 5 children required antiepileptic drugs for ongoing seizure management.</p><p><strong>Conclusions: </strong>Neurologic sequelae were identified in 39% of pediatric DEN-AES cases, underscoring the need for early diagnosis, continuous follow-up, and dedicated rehabilitation policies in dengue-endemic regions to support affected children.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 10","pages":"ofaf521"},"PeriodicalIF":3.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12480735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207074","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":"Costs of 4 Months of Rifampin Versus 2 Months of Double-dose Rifampin for Tuberculosis Infection: Post-Hoc Analysis of a Phase 2b Randomized Trial.","authors":"Kamila Romanowski, Yen Pham Ngoc, Leila Barss, Elias Jabbour, James C Johnston, Hansen Herman, Richard Long, Lika Apriani, Greg Fox, Dick Menzies, Jonathon R Campbell","doi":"10.1093/ofid/ofaf563","DOIUrl":"10.1093/ofid/ofaf563","url":null,"abstract":"<p><strong>Background: </strong>Cost is an important consideration when implementing tuberculosis preventive treatment regimens (TPT). We used data from a phase 2b randomized trial of TPT to estimate overall cost and key drivers of costs for two TPT regimens.</p><p><strong>Methods: </strong>We did a post-hoc analysis of 915 participants aged ≥10 years who were randomized 1:1 to 2 rifampin-based regimens: a four-month daily regimen at 10 mg/kg (4R₁₀) and a 2-month daily regimen at 20 mg/kg (2R₂₀; 461 participants). We collected country-specific costs for medications, evaluations, and medical follow-ups from the three participating countries (Canada, Indonesia, and Viet Nam), and converted all costs to 2024 Canadian dollars. We report the overall costs of each regimen and cost drivers.</p><p><strong>Results: </strong>Overall, 454 participants received 4R₁₀ and 461 participants received 2R₂₀. We found no difference in the cost of 2R₂₀ versus 4R₁₀, with a cost ratio of 0.93 (95% CI: .79-1.07); this was consistent in analyses limited to only those who completed treatment and stratified by country. Costs for medications and the baseline visit accounted for 68%, 49%, and 55% of all costs in Canada, Indonesia, and Viet Nam, respectively. Corresponding costs of routine follow-up visits accounted for approximately 26%, 45%, and 42% of all costs. In all countries, a minority of costs (<10%) were due to additional visits or evaluations not specified in the protocol.</p><p><strong>Conclusions: </strong>Most costs associated with TPT are due to medications and the baseline treatment initiation visit. TPT regimens requiring fewer follow-up visits may reduce overall cost, but the magnitude of this reduction varies by country.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf563"},"PeriodicalIF":3.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113757","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}