Open Forum Infectious Diseases最新文献

{"title":"A Novel Giant Magnetoresistance-Enabled Multiplex Polymerase Chain Reaction Assay for the Diagnosis of Invasive Fungal Infection.","authors":"Paschalis Vergidis, Eloy E Ordaya, Emma Porter, Hannah Sweet, Wei Wang, Anton F Evans, Chi Zhang, Jo-Anne H Young, Xiaoying Liu","doi":"10.1093/ofid/ofaf068","DOIUrl":"10.1093/ofid/ofaf068","url":null,"abstract":"<p><strong>Background: </strong>Despite advances in clinical microbiology, the diagnosis of invasive fungal infections remains challenging. Giant magnetoresistance (GMR) is a novel technology that enables the detection of trace amounts of cell-free DNA (cfDNA). We evaluated a high-multiplex molecular diagnostic assay coupled with GMR-enabled lab-on-a-chip technology that can detect 18 different fungal species.</p><p><strong>Methods: </strong>Analytical performance was evaluated in spiked plasma samples. After amplification, cfDNA was digested. Residual single-stranded DNA was flowed over a GMR sensor that was surface-coated with probes specific to different fungal species. After hybridization, magnetic beads bound to the probe complexes produced a GMR signal that was detected by the sensors. Clinical performance was determined using residual serum samples collected before the initiation of antifungal treatment from 20 patients with infection.</p><p><strong>Results: </strong>The limit of detection of the assay ranged from 5 to 50 copies per polymerase chain reaction (PCR) reaction. Nonspecific signals were not observed in the spiked samples. Fungal cfDNA was detected in 80% of patients with invasive candidiasis (3/4 with candidemia, 5/6 with invasive candidiasis without candidemia), all 3 cases of invasive pulmonary aspergillosis, and all 3 cases of disseminated histoplasmosis. cfDNA was not detected in 2 patients with cryptococcosis (both had negative blood cultures) and 2 patients with <i>Pneumocystis</i> pneumonia.</p><p><strong>Conclusions: </strong>We developed a novel GMR-enabled multiplex PCR assay detecting fungal pathogens that have been prioritized for public health action. Clinical sensitivity was highest in cases of presumed angioinvasion and dissemination. This technology has the potential for use in the clinical microbiology laboratory setting.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 2","pages":"ofaf068"},"PeriodicalIF":3.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143503104","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":"Prevalence of Injection-Related Bacterial and Fungal Infection Among People Who Inject Drugs: A Systematic Review and Meta-analysis.","authors":"Alice Wheeler, Jeffrey Masters, Alyssa Pradhan, Jess Monineath Roth, Louisa Degenhardt, Gregory J Dore, Gail V Matthews, Evan B Cunningham, Amy Peacock, Samantha Colledge-Frisby, Jason Grebely, Behzad Hajarizadeh, Marianne Martinello","doi":"10.1093/ofid/ofaf108","DOIUrl":"https://doi.org/10.1093/ofid/ofaf108","url":null,"abstract":"<p><strong>Background: </strong>Despite the increasing burden of injection-related bacterial and fungal infections, there has been no recent synthesis of their epidemiology. We performed a systematic review and meta-analysis evaluating the prevalence and incidence of injection-related infections among people who inject drugs.</p><p><strong>Methods: </strong>We searched EMBASE, MEDLINE, Web of Science, and PsycINFO for articles published since 1 January 2010. Eligible studies assessed the prevalence or incidence of ≥1 injection-related infection among people who recently injected drugs. Random-effects meta-analysis was used to calculate pooled estimates of infection prevalence, according to infection type and prevalence period.</p><p><strong>Results: </strong>Of 8097 articles identified, 87 were eligible for inclusion (prevalence, 78; incidence, 9). Data were available for 25 countries, including 10 low- or middle-income countries. The prevalence of skin and soft-tissue infections (including skin abscess and cellulitis) was 13% in the past month (95% confidence interval [CI], 9%-19% [11 studies]), 30% in the past 3-12 months (23%-37% [23 studies]), and 47% across the lifetime (29%-66% [7 studies]). The prevalence of endocarditis was 2% in the past month (95% CI, 1%-3% [4 studies]), 2% in the past 3-12 months (2%-3% [5 studies]), and 6% across the lifetime (3%-10% [8 studies]). Prevalence of sepsis and/or bloodstream infection was 1% in the past month (95% CI, 1%-2% [2 studies]), 7% in the past 3-12 months (4%-13% [3 studies]), and 8% across the lifetime (3%-19% [5 studies]).</p><p><strong>Conclusions: </strong>Injection-related infections are a common complication of injecting drug use. Interventions to reduce their occurrence and associated disease burden are needed.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 4","pages":"ofaf108"},"PeriodicalIF":3.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753777","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":"Metformin Treatment and Immune Reconstitution in People With HIV and Type 2 Diabetes: A Matched Retrospective Study.","authors":"Tintin Bäckdahl, Pontus Hedberg, Jan Vesterbacka, Christina Carlander, Anders Sönnerborg, Piotr Nowak","doi":"10.1093/ofid/ofaf110","DOIUrl":"https://doi.org/10.1093/ofid/ofaf110","url":null,"abstract":"<p><strong>Background: </strong>Despite effective antiretroviral treatment (ART), HIV infection is associated with immune dysfunction and inflammation. Metformin has shown beneficial immunological and anti-inflammatory effects, including in people with HIV (PWH). We studied the potential association between metformin treatment and immune reconstitution in PWH.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study set in Stockholm, Sweden. PWH with T2DM who initiated metformin treatment after at least 2 years on effective ART (exposed individuals) and metformin-naïve PWH (controls) were matched in a 1:1 ratio based on age, sex, baseline immune status, and duration of ART. Outcomes included mean values of CD4 cell counts and CD4/CD8 ratios from 1.5 years to 3.5 years after compared with 2 years before the exposed individual started metformin treatment (index date).</p><p><strong>Results: </strong>Among 1332 PWH, 43 metformin-exposed individuals (median age, 48 years; 11 years since start of ART) with T2DM and 43 nondiabetic controls (median age, 47 years; 11 years since start of ART) were included in the matched analyses. The median (interquartile range) change in CD4 T-cell count was 35 (-21 to 125) cells/μL among exposed individuals and 48 (-18 to 100) cells/μL among controls (<i>P</i> = .96). The corresponding numbers were 0.10 (0.03 to 0.20) and 0.08 (0.02-0.16) for CD4/CD8 ratio (<i>P</i> = .18). No differences were observed in subgroup analyses of PWH with low CD4 T-cell counts and CD4/CD8 ratios.</p><p><strong>Conclusions: </strong>No significant differences in immune reconstitution were observed between metformin-treated individuals and matched controls over the 2-year follow-up period.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 4","pages":"ofaf110"},"PeriodicalIF":3.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753725","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":"Levofloxacin to Prevent Bacterial Infection in Patients With Acute Myeloid Leukemia Treated by Venetoclax and Azacitidine: A Toulouse-Bordeaux DATAML Registry Study.","authors":"Xavier Brousse, Nicolas Rasandisona, Emilie Bérard, Harmony Leroy, Karen Delavigne, Nathan Mottal, Suzanne Tavitian, Thibaut Leguay, Léopoldine Lapierre, Eric Delabesse, Audrey Bidet, Martin Gauthier, Diane Lara, Anne Banos, Jennifer Guiraud, Pauline Floch, Leila Ghenim, Audrey Sarry, Anne-Charlotte de Grande, Clémentine Béranger, Christian Récher, Arnaud Pigneux, Sarah Bertoli, Pierre-Yves Dumas","doi":"10.1093/ofid/ofaf105","DOIUrl":"10.1093/ofid/ofaf105","url":null,"abstract":"<p><strong>Objectives: </strong>Antibiotic prophylaxis for patients with cancer remains a controversial issue and is not broadly recommended for hematological malignancies. The venetoclax (VEN) and azacitidine (AZA) combination allows for high rates of complete remission in acute myeloid leukemia (AML) but enhances the incidence of febrile neutropenia (FN) compared to AZA alone, making primary antibiotic prophylaxis a relevant question.</p><p><strong>Patients and methods: </strong>Patients with AML who received VEN-AZA were selected from the DATAML registry to investigate the use of levofloxacin (LEVO) prophylaxis, administered at 500 mg/day from day 10 following the first course of VEN-AZA, until neutrophil recovery (>0.5 × 10⁹/L).</p><p><strong>Results: </strong>A cohort of 258 patients was identified (median age 69.8 years, interquartile range 20.4-87.4), with 72 having received LEVO and 186 treated with standard of care (SOC). VEN-AZA was used for newly diagnosed AML in 52.7% of cases. FN occurred in 33.3% of LEVO patients versus 37.1% of SOC patients (<i>P</i> = .572). Time from day 10 VEN-AZA to FN was significantly delayed in LEVO patients (12.5 days vs 8 in SOC; <i>P</i> = .037). Pulmonary infections were considerably reduced by LEVO (10.2% vs 1.4%, <i>P</i> = .018) as well as those involving Enterobacterales (9.1% vs 1.4%; <i>P</i> = .029). No early increase in fluoroquinolone resistance was detected (<i>P</i> = .142).</p><p><strong>Conclusions: </strong>Levofloxacin as primary prophylaxis in patients with AML treated with VEN-AZA seems to decrease the rate of documented infections even if the incidence of FN was not significantly decreased. This prophylaxis shaped a different clinical and microbiological landscape without significant increase of antibiotic resistance.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 3","pages":"ofaf105"},"PeriodicalIF":3.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605826","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":"Population Genetic Structure and Human Adaptation of Kaposi Sarcoma-Associated Herpesvirus.","authors":"Alessandra Mozzi, Diego Forni, Rachele Cagliani, Cristian Molteni, Mario Clerici, Manuela Sironi","doi":"10.1093/ofid/ofaf111","DOIUrl":"10.1093/ofid/ofaf111","url":null,"abstract":"<p><strong>Background: </strong>Kaposi sarcoma-associated herpesvirus (KSHV), the etiologic agent of Kaposi sarcoma, is human-specific and is thought to have emerged from primate-infecting gammaherpesviruses. KSHV seroprevalence shows geographic variation, being highest in sub-Saharan Africa, intermediate in the Mediterranean area, and low in most other locations. However, KSHV prevalence is also particularly high in specific regions such as the Miyako Islands (Japan).</p><p><strong>Methods: </strong>We retrieved KSHV genomes from public repositories and analyzed geographic patterns using principal component analysis and STRUCTURE. Adaptation to the human host was investigated by likelihood ratio tests for positive selection. Protein structures were derived from the HerpesFolds database.</p><p><strong>Results: </strong>Most non-African genomes are genetically separated by the African genomes, and the latter are divided into 2 main lineages. The African genomes received most of their ancestry from 2 populations showing limited drift, suggesting an African origin for circulating KSHV strains. Several non-African genomes instead have most of their ancestry covered by a highly drifted ancestral population. However, some non-African genomes show similar ancestry proportions to the African ones, including those from Miyako Islands and the variant F subtype sampled in France. Molecular analysis of adaptation to the human host identified core genes as the major selection targets, including 2 viral enzymes that counteract human immune defenses.</p><p><strong>Conclusions: </strong>We suggest that the genetic diversity of extant strains reflects relatively recent demographic events associated with viral lineage extinctions, which may have influenced KSHV epidemiology. Adaptation to the human host involved changes in core genes, possibly a strategy to optimize protein-protein interactions.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 3","pages":"ofaf111"},"PeriodicalIF":3.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616657","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":"Derivation and Internal Validation of a Clinical Prediction Model for Diagnosis of Spotted Fever Group Rickettsioses in Northern Tanzania.","authors":"Robert J Williams, Ben J Brintz, William L Nicholson, John A Crump, Ganga Moorthy, Venace P Maro, Grace D Kinabo, James Ngocho, Wilbrod Saganda, Daniel T Leung, Matthew P Rubach","doi":"10.1093/ofid/ofaf100","DOIUrl":"10.1093/ofid/ofaf100","url":null,"abstract":"<p><p>Spotted fever group rickettsioses (SFGR) pose a global threat as emerging zoonotic infectious diseases; however, timely and cost-effective diagnostic tools are currently limited. We used data from 449 patients presenting to 2 hospitals in northern Tanzania between 2007 and 2008, of which 71 (15.8%) met criteria for acute SFGR based on ≥4-fold rise in antibody titers between acute and convalescent serum samples. We fit random forest classifiers incorporating clinical and demographic data from hospitalized febrile participants as well as Earth observation hydrometeorological predictors from the Kilimanjaro Region. In cross-validation, a prediction model with 10 clinical predictors achieved an area under the receiver operating characteristic curve of 0.65 (95% confidence interval, .48-.82). A combined prediction model with clinical, hydrometeorological, and environmental predictors (20 predictors total) did not significantly improve model performance. Novel strategies are needed to improve the diagnosis of acute SFGR, including the identification of diagnostic biomarkers that could enhance clinical prediction models.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 3","pages":"ofaf100"},"PeriodicalIF":3.8,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11893975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605810","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":"Enhanced <i>Chlamydia trachomatis</i> and <i>Neisseria gonorrhoeae</i> Sexually Transmitted Infections and Associated Risk Factors in Fiji Following the Coronavirus Disease 2019 Pandemic.","authors":"Isabella C Auchus, Joelle Brown, Mike Kama, Sara G Vargo, Rachel Devi, Jenni Singh, Deborah Dean","doi":"10.1093/ofid/ofaf101","DOIUrl":"10.1093/ofid/ofaf101","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease 2019 pandemic impact on sexually transmitted infections in countries practicing syndromic management remains unknown. We conducted cross-sectional surveys in Fiji to assess increases and risk factors for <i>Neisseria gonorrhoeae</i> (NG) and <i>Chlamydia trachomatis</i> (CT) infections pre- and postpandemic.</p><p><strong>Methods: </strong>We enrolled women, men who have sex only with women (MSW), and men who have sex with men (MSM) aged 18-40 years, collected sociodemographic/behavioral data, and tested vaginal, urethral, and rectal samples using Xpert-CT/NG. Risk factors were evaluated using regression models.</p><p><strong>Results: </strong>Of 1955 participants, 6.4% (95% confidence interval [CI], 5.4%-7.6%) had gonorrhea, increasing significantly postpandemic >2-fold among women aged 25-40 years and >4-fold among MSM, MSW, and men aged 18-24 and 25-40 years; 20.0% (95% CI, 18.3%-21.8%) had chlamydia, increasing significantly postpandemic among younger women and approximately 2- to 4-fold among MSW and younger and older men. Increases were driven by urethral/vaginal infections. Coinfections increased significantly postpandemic among older women. Postpandemic gonorrhea was associated with difficulty obtaining condoms (adjusted relative risk [aRR], 2.7 [95% CI, 1.0-8.0]) and ≥2 partners (aRR, 2.6 [95% CI, 1.0-7.1]) among younger women, and iTaukei ethnicity (aRR, 4.7 [95% CI, 1.4-16.5]) and heavy alcohol use (aRR, 7.1 [95% CI, 2.5-19.7]) among older women. Postpandemic chlamydia was associated with having a casual sex partner among younger (aRR, 1.7 [95% CI, 1.0-2.9]) and older (aRR, 1.9 [95% CI, 1.1-3.4]) women and with being unmarried (aRR, 1.7 [95% CI, 1.0-2.7]). iTaukei men had increased risk postpandemic for gonorrhea (aRR, 3.7 [95% CI, 1.3-10.6]) and chlamydia (aRR, 2.5 [95% CI, 1.3-4.9]). More than 50% of infected participants did not meet syndromic treatment criteria and would have remained untreated.</p><p><strong>Conclusions: </strong>Postpandemic increases in gonorrhea and chlamydia-with risk factors varying by pathogen, gender, and age-require immediate interventions to reduce infection and transmission in Fiji.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 3","pages":"ofaf101"},"PeriodicalIF":3.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567787","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 Diphtheria in Antananarivo, Madagascar, and Cambodia.","authors":"Florence Campana, Gaelle Noel, Mahdi Rajabizadeh, Aina Harimanana, Lala Rafetrarivony, Gauthier Delvallez, Mallorie Hide, Soda Meng, Solohery Lalaina Razafimahatratra, Bunnet Dim, Mohand Ait-Ahmed, Laurence Borand, Jean-Marc Collard, Nicole Guiso, Fabien Taieb","doi":"10.1093/ofid/ofaf091","DOIUrl":"10.1093/ofid/ofaf091","url":null,"abstract":"<p><strong>Background: </strong>Amidst a global resurgence of diphtheria cases with numerous outbreaks recorded worldwide since 2000, a better understanding of this vaccine-preventable disease's circulation is needed.</p><p><strong>Methods: </strong>We retrospectively analyzed sera from 2 sero-epidemiological cross-sectional studies in Madagascar and Cambodia on fully primo-vaccinated 3- to 15-year-olds. Using enzyme-linked immunosorbent assay (ELISA) and seroneutralization (Vero Cell TNT) for the 3- to 8-year-olds with low ELISA titration values (<0.01 IU/mL), we assessed (i) the duration of protection by primary vaccination for 3- to 8-year-olds and (ii) the level of diphtheria in children and adolescents. Seropositivity was defined as a titration value (by ELISA or TNT) of at least 0.1 IU/mL and was used as a proxy for diphtheria infection among individuals >6 years postvaccination.</p><p><strong>Results: </strong>Seven hundred forty-five children in Cambodia and 949 children in Madagascar were included. Our results show significantly more unprotected children among the 5- to 6-year-olds than among the 3- to 4-year-olds, with 41.1% (39/95) vs 26.7% (27/101; <i>P</i> = .03) in Cambodia and 21.4% (27/126) vs 8.0% (9/113; <i>P</i> < .01) in Madagascar. In Cambodia and Madagascar, respectively, 27.8% and 20.7% of the participants whose primary vaccination was performed >6 years earlier were seropositive, suggesting diphtheria infection. In both countries, we observed a higher rate of infected children when the last vaccine injection had been received 7-8 years or 11-12 years earlier vs 5-6 years earlier.</p><p><strong>Conclusions: </strong>Our data show that the disease is present at high levels in Cambodia and Madagascar and that the national recommendation-primary vaccination-is not sufficient: Booster doses appear necessary at around 6 years of age and for adolescents, as recommended by the World Health Organization.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 3","pages":"ofaf091"},"PeriodicalIF":3.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597413","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":"Enhancing Hepatitis B Virus Vaccine Uptake and Immunity Through Long-Acting Antiretroviral Therapy Programmatic Synergy in the US South.","authors":"Eudiah Ochieng, Vickie Robinson, Erica Anderson, Larisa Niles-Carnes, Bradley L Smith, Wendy S Armstrong, Meredith Lora, Jonathan A Colasanti, Lauren F Collins","doi":"10.1093/ofid/ofaf096","DOIUrl":"10.1093/ofid/ofaf096","url":null,"abstract":"<p><p>We leveraged a long-acting antiretroviral therapy program infrastructure in the US South to vaccinate 32 of 39 (82%) eligible persons with HIV against hepatitis B virus. Novel interprofessional programmatic synergy may facilitate hepatitis B virus vaccine uptake in a population uniquely at risk in the era of 2-drug and injectable antiretroviral therapy.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 3","pages":"ofaf096"},"PeriodicalIF":3.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567790","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":"Illuminating the Challenges and Diagnostic Utility of Plasma Microbial Cell-Free DNA Sequencing in Suspected Infective Endocarditis: A Retrospective Observational Cohort Study.","authors":"Myeongji Kim, Pansachee Damronglerd, Sofia Molina Garcia, Zachary A Yetmar, Samrah Razi, Nischal Ranganath, Maryam Mahmood, Omar M Abu Saleh","doi":"10.1093/ofid/ofaf099","DOIUrl":"10.1093/ofid/ofaf099","url":null,"abstract":"<p><strong>Background: </strong>Infective endocarditis (IE) is a life-threatening infection often challenging to diagnose, particularly in culture-negative cases. Plasma microbial cell-free DNA (mcfDNA) sequencing has shown potential for detecting pathogens in IE. However, its clinical utility, diagnostic impact, and limitations remain debated. This study evaluates its use in diagnosing and managing IE in a tertiary care setting.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included adult patients (≥18 years) who underwent mcfDNA sequencing via the Karius test for suspected IE at Mayo Clinic Rochester between December 2019 and February 2024. Diagnostic classification followed the 2023 Duke-International Society of Cardiovascular Infectious Diseases criteria. Data on demographics, clinical features, routine microbiologic workup, and mcfDNA sequencing results were collected. Statistical analysis was conducted to evaluate diagnostic utility and treatment impact.</p><p><strong>Results: </strong>Among 141 patients, 66 had a diagnosis of IE, with mcfDNA sequencing identifying pathogens in 60.6% of them, compared with 39.4% with routine workup. mcfDNA sequencing was the sole microbiologic test with positive results in 33.3% of patients, leading to antimicrobial adjustments in 50.0% of that group. Clinically insignificant mcfDNA sequence detection occurred in 28.6% of patients without a diagnosis of IE.</p><p><strong>Conclusions: </strong>mcfDNA sequencing is a valuable adjunctive tool for diagnosing culture-negative IE and guiding antimicrobial therapy when clinical suspicion is high. However, its utility depends on appropriate clinical context, highlighting the need for careful test interpretation and further prospective studies to assess patient-centered outcomes and cost-effectiveness.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 3","pages":"ofaf099"},"PeriodicalIF":3.8,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567713","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}