Open Forum Infectious Diseases最新文献

{"title":"Good Results for PJI Caused by <i>Corynebacterium</i> spp. After Algorithmic Surgical Approach and Rifampicin Combination in Implant Retention.","authors":"Ana Trebše, Samo Roškar, Anže Mihelič, Rihard Trebše","doi":"10.1093/ofid/ofaf146","DOIUrl":"10.1093/ofid/ofaf146","url":null,"abstract":"<p><strong>Background: </strong><i>Corynebacterium</i> spp. is a rare culprit in periprosthetic joint infections (PJIs), with limited data available on outcomes and appropriate treatment course. The aim of this study was to evaluate the success rate of a clinical cohort of patients with PJI, where <i>Corynebacterium</i> spp. was the causative organism (CPJI), treated according to an institutional algorithm based upon European Bone and Joint Infection Society guidelines.</p><p><strong>Methods: </strong>From the institutional bone infection registry, 44 patients treated for CPJI between 2007 and 2023 were identified. CPJIs were divided into 2 groups according to the isolated microbes: monomicrobial (14 [32%]) and polymicrobial (30 [68%]). Patients were treated with debridement, antibiotics, and implant retention (DAIR; 14 [32%]) or with 1- or 2-stage implant exchange (reimplantation group; 30 [68%]). In 13 (30%) cases, antibiotic combination with rifampicin was used.</p><p><strong>Results: </strong>Out of 44 patients, 4 required further treatment. In monomicrobial CPJI, the treatment course was successful in all patients, whereas in polymicrobial CPJI it was successful in 87%. Antibiotic combination including rifampicin was used in 4 monomicrobial cases (29%) and 9 polymicrobial (30%) cases. In the polymicrobial group, DAIR was successful in 90% (9/10), while the reimplantation group had an 85% (17/20) success rate.</p><p><strong>Conclusions: </strong>In contrast with the previously published papers on CPJI, the results in our cohort were good, with the total cure rate being 91%. The cure rate was slightly lower in the polymicrobial group compared with the monomicrobial: 87% and 100%, respectively. Surgical therapy according to the established institutional algorithm resulted in a high success rate.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 4","pages":"ofaf146"},"PeriodicalIF":3.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753795","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":"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":"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":"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}

{"title":"Seroprevalence of Cytomegalovirus Among Pregnant Women at Kawempe National Referral Hospital, Uganda: A Cross-sectional Study.","authors":"Richard V Katungye, Moses Musooko, Musa Sekikubo, Tobius Mutabazi, Mary Kyohere, Valerie Tusubira, Juliet Nsimire Sendagala, Joseph Peacock, Kirsty Le Doare, Annettee Nakimuli","doi":"10.1093/ofid/ofae604","DOIUrl":"10.1093/ofid/ofae604","url":null,"abstract":"<p><strong>Background: </strong>Maternal primary cytomegalovirus (CMV) infection is associated with abortion and congenital anomalies. In Uganda, the burden of maternal CMV infection is not well studied. This study thus assessed the seroprevalence and factors associated with CMV infection among pregnant women at Kawempe National Referral Hospital in Kampala. This work forms a part of the PROGRESS study, an observational cohort study undertaken in Kampala, Uganda, between November 2018 and April 2021.</p><p><strong>Methods: </strong>We conducted a cross-sectional study between September 2020 and January 2021 among the 639 pregnant women admitted to the labor ward at a government hospital. Sociodemographic, medical, obstetric, and socioeconomic data were collected. Blood samples from study participants were drawn and analyzed for the presence of CMV immunoglobulin G (IgG) and IgM using enzyme-linked immunosorbent assay-based quantitative assays. Further analysis of all IgM-positive samples was conducted using CMV IgG avidity assays. All infants had a nasal polymerase chain reaction (PCR) on the first day of life to investigate CMV positivity. Logistic regression was performed to determine the factors associated with CMV infection.</p><p><strong>Results: </strong>Seroprevalence of CMV IgG among the 637 women was universal (100%), and that of CMV (IgM) was 5.8% (37/637). CMV (IgM) was associated with being low socioeconomic status (odds ratio, 3.44; 95% CI, 1.05-11.32; <i>P</i> = .04). Transmission risk was low, and no infant had a positive PCR for CMV at birth.</p><p><strong>Conclusions: </strong>Universally, by the time women in Kampala conceive, they will have been exposed to CMV. Women of lower socioeconomic status were more likely to have recent CMV infection than their more affluent counterparts, highlighting the need for screening guidelines in this setting.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 Suppl 3","pages":"S200-S205"},"PeriodicalIF":3.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605878","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 Causes of Stillbirths: A Descriptive Etiological Study in Uganda.","authors":"Lauren Hookham, Valerie Tusubira, Amusa Wamawobe, Dan R Shelley, Caitlin Farley, Edward A R Portal, Simon Beach, Hannah G Davies, Konstantinos Karampatsas, Mary Kyohere, Joseph Peacock, Philippa Musoke, Owen B Spiller, Paul T Heath, Musa Sekikubo, Kirsty Le Doare","doi":"10.1093/ofid/ofae606","DOIUrl":"10.1093/ofid/ofae606","url":null,"abstract":"<p><strong>Background: </strong>Every year an estimated 2-3 million babies are stillborn, with a high burden in Africa. Infection is an important driver of stillbirth. There is a lack of data on the bacterial causes of stillbirth in Uganda, contributing to a lack of interventions such as effective prophylaxis and development of maternal vaccine options against the most implicated pathogens.</p><p><strong>Methods: </strong>The PROGRESS study was an observational cohort study undertaken in Kampala, Uganda, between November 2018 and April 2021. If a woman delivered a stillborn baby, consent was sought for the collection of a heart-blood aspirate. One to three mL of blood was collected and sent for culture using the BD Bactec blood culture system. Organism identification was performed using biochemical testing and matrix-assisted laser desorption/ionization-time of flight mass spectrometry. Susceptibilities to appropriate panels of antimicrobials were determined by agar dilution.</p><p><strong>Results: </strong>Kawempe Hospital registered 34 517 births in the study period, of which 1717 (5.0%) were stillbirths. A total of 581 (33.8%) were recruited into the study, and heart blood aspirates were performed on 569 (97.9%). Blood samples were sufficient for analysis of 476, with a total of 108 positive cultures (22.7% of sampled stillbirths). Fifty-nine of 108 blood cultures contained organisms that were considered potential pathogens, giving a pathogen positivity rate of 12.4%. Common pathogens included <i>Enterococcus</i> spp. (n = 14), <i>Escherichia coli</i> (n = 13), viridans streptococci (n = 18), <i>Klebsiella pneumoniae</i> (n = 6), and group B <i>Streptococcus</i> (n = 5). Gram-negative organisms were frequently resistant to commonly used first-line antimicrobials.</p><p><strong>Conclusions: </strong>The high proportion of stillbirths caused by likely pathogenic bacteria in Uganda highlights the potential for prevention with prophylaxis and stresses the need for further investment in this area.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 Suppl 3","pages":"S165-S172"},"PeriodicalIF":3.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605863","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":"Utility of Cytokine Biomarkers for the Diagnosis of Pediatric Pyogenic Musculoskeletal Infections.","authors":"Alexandra T Geanacopoulos, Pui Y Lee, Todd W Lyons, Kailey E Brodeur, Rachael K Aresco, Michael Monuteaux, Ron L Kaplan, Andrea T Cruz, Peter A Nigrovic, Lise E Nigrovic","doi":"10.1093/ofid/ofaf139","DOIUrl":"10.1093/ofid/ofaf139","url":null,"abstract":"<p><strong>Background: </strong>Pyogenic musculoskeletal infections, such as septic arthritis and osteomyelitis, require prompt recognition and treatment but can be challenging to distinguish from Lyme or inflammatory arthritis. Our goal was to identify cytokine biomarkers of musculoskeletal infections.</p><p><strong>Methods: </strong>Using 2 multicenter prospective cohorts of children undergoing emergency department evaluation for musculoskeletal infection, we selected children ≤21 years of age with a musculoskeletal infection (cases) matched by age and sex to children with Lyme and inflammatory arthritis (controls). We performed a 45-cytokine/chemokine panel using the Olink proximity extension assay platform and used receiver operator curve analysis to evaluate the discriminative ability of each cytokine. Using forward stepwise logistic regression, we derived a 3-cytokine panel and compared the accuracy with 5 commonly available plasma biomarkers.</p><p><strong>Results: </strong>We included 47 children with musculoskeletal infection, 48 with Lyme arthritis, and 49 with inflammatory arthritis. Interleukin-6 had the highest accuracy for musculoskeletal infection (area under the curve [AUC], 0.84; 95% CI, 0.77-0.91). A 3-cytokine biosignature panel (interleukin-6, interleukin-17A, and colony stimulating factor-1) had the highest overall accuracy (AUC, 0.90; 95% CI, 0.84-0.96) and performed better than 5 common plasma biomarkers (white blood cell count, absolute neutrophil count, C-reactive protein, erythrocyte sedimentation rate, and procalcitonin; <i>P</i> < .05 for all comparisons).</p><p><strong>Conclusions: </strong>Plasma cytokines can distinguish musculoskeletal infections from Lyme or inflammatory arthritis and may assist initial decision-making for children undergoing evaluation for musculoskeletal infection.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 4","pages":"ofaf139"},"PeriodicalIF":3.8,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753791","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}