Open Forum Infectious Diseases最新文献

{"title":"Early Mortality and Health Care Costs in Patients Recently Diagnosed With Kaposi Sarcoma at the National Cancer Institute, Mexico City.","authors":"Daniel Carpio-Guadarrama, Antonio Camiro-Zúñiga, Renzo Pérez-Dorame, Alexandra Martin-Onraët, Diana García-Escutia, María José Mendoza-Palacios, Patricia Volkow-Fernández","doi":"10.1093/ofid/ofae648","DOIUrl":"10.1093/ofid/ofae648","url":null,"abstract":"<p><strong>Background: </strong>Kaposi sarcoma (KS) is a marker of advanced HIV disease; it is still the most frequent AIDS-associated malignancy in Mexico despite universal access to antiretroviral therapy, reflecting a gap in early HIV diagnosis.</p><p><strong>Methods: </strong>The objectives of the study were to describe people with HIV with KS who died within 30 days of admission at INCan (National Cancer Institute) and to quantify resources and years of life lost (YLL). We collected demographic data, HIV-related variables, all diagnostic and therapeutic procedures, hospitalizations, and estimated YLL and disability-adjusted life years.</p><p><strong>Results: </strong>Eighteen (6.7%) people with HIV with KS from 270 patients admitted at INCan from 2014 to 2021 were included. The median age was 31 years (IQR 27-36), and the median days from admission to death and from HIV diagnosis to death were 15 (IQR, 6-24) and 73 (IQR, 30-857), respectively. Upon admission, the median HIV viral load was 314 476 copies/mL (IQR, 140 709-695 613); CD4+ T cells, 93 cells/mL (IQR 35-124); and CD4/CD8 ratio, 0.08 (IQR, 0.06-0.12). Coinfections were diagnosed in 14 (77.7%) patients. The average expenditure per patient was US $7685.99 USD, and the total YLL was 737.4 with a median 42 years (IQR, 37.7-47) per patient. The total care cost was US $183 947.48, equivalent to a screening program in key populations, which would have allowed the early detection of 1227 cases and saved 8410 disability-adjusted life years.</p><p><strong>Conclusions: </strong>Reinforcement of early HIV infection detection in key population programs should be prioritized to reduce KS-associated deaths and YLL and for rational use of health budgets.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 11","pages":"ofae648"},"PeriodicalIF":3.8,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682276","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 <i>Trypanosoma cruzi</i> Infection in Solid Organ Transplant Recipients: A Neglected Disease in America.","authors":"German A Contreras, George Golovko","doi":"10.1093/ofid/ofae650","DOIUrl":"10.1093/ofid/ofae650","url":null,"abstract":"<p><p>This study investigates the prevalence of <i>Trypanosoma cruzi</i> infection among solid organ transplant recipients in the United States from 2019 to 2023 before transplantation. Utilizing data from a large multicenter network, we identified a rising seroprevalence of 4.8% from 1523 solid organ transplant recipients at the time of the evaluation for transplantation, particularly among lung and heart transplant recipients. The findings highlight the need for improved screening protocols to address this neglected tropical disease in transplant populations.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 12","pages":"ofae650"},"PeriodicalIF":3.8,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11600953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740010","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":"Perceptions and Barriers to Outpatient Antiviral Therapy for COVID-19 and Influenza as Observed by Infectious Disease Specialists in North America: Results of an Emerging Infections Network (EIN) Survey, February 2024.","authors":"Jordan B Singleton, Dennis Wang, Souci Louis, Dallas J Smith, Anastasia S Lambrou, Susan E Beekmann, Claire M Midgley, Philip Polgreen, Shikha Garg, Jessica N Ricaldi, Timothy M Uyeki, Scott Santibañez, Pragna Patel","doi":"10.1093/ofid/ofae666","DOIUrl":"10.1093/ofid/ofae666","url":null,"abstract":"<p><p>Antiviral therapy is underutilized for outpatients at increased risk for severe COVID-19 or influenza. Results from this survey offer insights into treatment barriers from the infectious disease specialist perspective. Further education is needed about the benefits of early antiviral therapy.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 12","pages":"ofae666"},"PeriodicalIF":3.8,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751235","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":"Searching for Immunocompromising Conditions in Low-risk Adults After Invasive Pneumococcal Disease: An Opportunity to Uncover Multiple Myeloma Early.","authors":"Guillermo Maestro de la Calle, Javier Mateo Flores, Pilar Brañas, Esther Viedma, Carlos Lumbreras Bermejo","doi":"10.1093/ofid/ofae653","DOIUrl":"10.1093/ofid/ofae653","url":null,"abstract":"<p><p>There is a paucity of data on the prevalence of newly diagnosed immunosuppressive conditions following a first invasive pneumococcal infection (IPI) in adults considered to be at low risk for it. A total of 352 IPIs were reviewed over a 7-year period, with 39 (11.1%) ultimately analyzed. A 3.4-year follow-up period revealed that 4 patients (10.3%) had been diagnosed with immunosuppressive conditions. Of these, 3 had been diagnosed with multiple myeloma (MM). These findings indicate that in adults who experience a first IPI and are at low risk for it, MM should be strongly considered and addressed as early as possible.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 11","pages":"ofae653"},"PeriodicalIF":3.8,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11584514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710770","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":"Do Patients With Candidemia Need an Ophthalmologic Examination?","authors":"Alice Lehman, Katelyn M Tessier, Victoria Sattarova, Sandra Rocio Montezuma, Susan Kline, Serin Edwin Erayil","doi":"10.1093/ofid/ofae663","DOIUrl":"https://doi.org/10.1093/ofid/ofae663","url":null,"abstract":"<p><strong>Background: </strong>The Infectious Diseases Society of America recommends a screening dilated retinal examination by an ophthalmologist for all patients with candidemia. Conversely, the American Academy of Ophthalmology recommends against routine screening in patients with candidemia without symptoms.</p><p><strong>Methods: </strong>In a collaborative effort between infectious diseases and ophthalmology, we examined the incidence of ocular complications in 308 patients with candidemia and subsequently measured the rate of fundoscopic examinations, risk factors for ocular complications, management changes, and outcomes.</p><p><strong>Results: </strong>Among those who received fundoscopic exams, findings suspicious for ocular candidiasis were found in 12 patients (8%, 12/148). After independent review by ophthalmology and infectious diseases, 3 patients were found to have alternate pathologies that explained their ocular findings. Nine patients (6%, 9/148) were adjudicated as having presumed <i>Candida</i> chorioretinitis. Of these 9 patients, 4 (44%) were asymptomatic, and 2 (22%) were unable to declare symptoms. No patients were definitively determined to have <i>Candida</i> endophthalmitis. Ocular candidiasis was not found to have a statistically significant association with symptoms or comorbidities. Ocular candidiasis was more likely to be found at ophthalmology exams >7 days from first positive <i>Candida</i> blood culture. The number needed to screen to detect presumed <i>Candida</i> chorioretinitis among asymptomatic patients was 20.</p><p><strong>Conclusions: </strong>Based on the available evidence and high risk of morbidity of eye involvement, continued ophthalmological screens seem prudent, but a definitive consensus was found to be challenging given a lack of outcome data. Additional investigations are warranted. Ophthalmology screenings have a higher sensitivity at >7 days from positive blood culture.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 12","pages":"ofae663"},"PeriodicalIF":3.8,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11651149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847065","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":"Symptomatic <i>Entamoeba dispar</i> Infections Among Men Who Have Sex With Men, New York City, 2018.","authors":"Kimberly Mergen, Lisa Alleyne, Robert Fitzhenry, Rajmohan Sunkara, Bruce Gutelius, Ashley Alderman, Michelle C Dickinson, Emily McGibbon, Corinne N Thompson, Susan Madison-Antenucci","doi":"10.1093/ofid/ofae658","DOIUrl":"10.1093/ofid/ofae658","url":null,"abstract":"<p><p><i>Entamoeba histolytica</i> is considered the primary species causing the parasitic gastrointestinal infection amebiasis. A cluster of amebiasis infections was identified in 2018 among men who have sex with men in New York City and was likely caused by <i>Entamoeba dispar</i>, traditionally considered to be nonpathogenic.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 12","pages":"ofae658"},"PeriodicalIF":3.8,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11643342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829463","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":"A Road Map to Hepatitis C Elimination: Yesterday, Today, and Tomorrow.","authors":"Luis A Gonzalez Corro, Gregory M Lucas, Kathleen R Page","doi":"10.1093/ofid/ofae661","DOIUrl":"10.1093/ofid/ofae661","url":null,"abstract":"<p><p>There are an estimated 3.5 million people with hepatitis C virus (HCV) infection in the United States, resulting in 15 000 HCV-related deaths in 2019 and approximately $7 billion annually in healthcare costs. Although the United States had experienced declining incidence, since 2010 hepatitis C infections have rebounded. The history of HCV treatment can be seen as a series of scientific triumphs that should be celebrated as the accomplishments that they represent. But new treatments will only get us so far: Social determinants of health drive the majority of health outcomes. Without addressing the factors that impact the lives of our patients, we will fall short in the outcomes we seek. Public health systems, hospital networks, and governments must work more cohesively to eradicate hepatitis C. We have the tools, both biomedical and social. The end of hepatitis C depends on our willingness to make use of them.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 11","pages":"ofae661"},"PeriodicalIF":3.8,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11584410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710635","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":"<i>The Long and Winding Road</i>: Three-year Mortality Following Prescription of Multidrug Antibiotic Treatment for <i>Mycobacterium avium complex</i> Pulmonary Disease in United States Medicare Beneficiaries With Bronchiectasis.","authors":"Cara D Varley, Jennifer H Ku, Emily Henkle, Luke Strnad, Kevin L Winthrop","doi":"10.1093/ofid/ofae639","DOIUrl":"10.1093/ofid/ofae639","url":null,"abstract":"<p><strong>Background/aims: </strong>Although increased mortality has been reported among people with <i>Mycobacterium avium complex</i> pulmonary disease (MAC-PD), data are limited on survival associated with various antibiotic regimens used to treat MAC-PD. We conducted a comparative analysis of 3-year mortality in Medicare beneficiaries with bronchiectasis using various MAC-PD regimens.</p><p><strong>Methods: </strong>We included Medicare beneficiaries aged ≥65 years with bronchiectasis (01/2006-12/2014). We limited our cohort to new MAC-PD therapy users. MAC-PD therapy was defined as ≥60-day prescriptions for a macrolide plus ≥1 other MAC-PD antibiotic. Guideline-based therapy (GBT) included a macrolide, ethambutol, and/or rifamycin. Using Cox proportional hazard models, we calculated adjusted hazard ratios (aHR) for death up to 3 years after therapy start between the following groups: (1) 2007 GBT versus non-GBT; (2) 2020 GBT versus non-GBT; and (3) macrolide-ethambutol-rifamycin (3-drug) versus macrolide-ethambutol (2-drug).</p><p><strong>Results: </strong>We identified 4820 new MAC-PD therapy users, of whom 866 (17.9%) were deceased within 3 years of therapy initiation. Of 3040 (63.1%) beneficiaries prescribed 2007 GBT, 472 (15.5%) were deceased by 3 years, compared to 394 (22.1%) of 1780 (36.9%) prescribed non-GBT (aHR 0.82; 95% confidence interval [CI], .72-.94). We observed a similar trend for 2020 GBT versus non-GBT (aHR 0.81; 95% CI, .70-.94]). Three-year-mortality was similar between those starting 3-drug versus 2-drug regimens (aHR 0.89; 95% CI, .74-1.08]).</p><p><strong>Conclusions: </strong>Among Medicare new MAC-PD therapy users, 3-year-mortality was higher in those prescribed non-GBT regimens compared to GBT regimens. Whether this finding suggests improved efficacy of GBT and/or differential characteristic of those using non-GBT regimens deserves further study.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 11","pages":"ofae639"},"PeriodicalIF":3.8,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11584409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710616","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":"Gut Microbiome in Human Melioidosis: Composition and Resistome Dynamics from Diagnosis to Discovery.","authors":"Soumi Chowdhury, Robert F J Kullberg, Bastiaan W Haak, Claudio Duran, Venkat A Earny, Vandana K Eshwara, Trevor D Lawley, W Joost Wiersinga, Chiranjay Mukhopadhyay","doi":"10.1093/ofid/ofae654","DOIUrl":"10.1093/ofid/ofae654","url":null,"abstract":"<p><strong>Background: </strong>Melioidosis, attributable to the soil-dwelling bacterium <i>Burkholderia pseudomallei</i>, stands as a paramount global health challenge, necessitating extended courses of antibiotics. While murine studies identified the gut microbiota as a modulator of bacterial dissemination during melioidosis, the human intestinal microbiota during melioidosis remains uncharacterized. Here, we characterized gut microbiota composition and antimicrobial resistance (AMR) genes at diagnosis, during treatment, and postdischarge for melioidosis. We hypothesized that the gut microbiota of melioidosis patients would be extensively distorted.</p><p><strong>Methods: </strong>In this prospective observational cohort, stool samples of patients with culture-confirmed melioidosis admitted to a tertiary care hospital in India were collected at diagnosis, 14 days after diagnosis, or discharge (whichever occurred first) and at 6 months postinfection. Family members or neighbors served as community controls. The gut microbiota and resistome were profiled by shotgun metagenomic sequencing.</p><p><strong>Results: </strong>We longitudinally analyzed the gut microbiota of 70 fecal samples from 28 patients and 16 community controls. At diagnosis, the gut microbiota of patients differed from that of controls, characterized by high abundances of potentially pathogenic bacteria, a loss of butyrate-producing bacteria, and higher levels of AMR genes. Microbiota composition and resistome remained different from community controls at 6 months, driven by total antibiotic exposure. During hospitalization, gut microbiota profiles were associated with secondary <i>Klebsiella pneumoniae</i> infections.</p><p><strong>Conclusions: </strong>This first study on gut microbiota composition and resistome in human melioidosis showed extensive disruptions during hospitalization, with limited signs of restoration 6 months postinfection. Given the adverse outcomes linked with microbiome perturbations, limiting microbiota disruptions or using microbiota-restorative therapies (eg, butyrate-producing probiotics) may be beneficial.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 11","pages":"ofae654"},"PeriodicalIF":3.8,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the US Maternal Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis (Tdap) Vaccination Program on Preventing Pertussis in Infants 2 to <6 Months of Age: A Case-Control Evaluation.","authors":"Tami H Skoff, Amy B Rubis, Pam Daily Kirley, Karen Scherzinger, Melissa McMahon, Suzanne McGuire, Kathy Kudish, Paul R Cieslak, Nong Shang, Susan Hariri","doi":"10.1093/ofid/ofae655","DOIUrl":"10.1093/ofid/ofae655","url":null,"abstract":"<p><strong>Background: </strong>To protect infants aged <2 months against pertussis, the United States recommends Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) vaccination during each pregnancy. Data are limited on the strategy's effectiveness against pertussis in infants aged ≥2 months.</p><p><strong>Methods: </strong>Pertussis case infants aged 2 to <6 months with cough onset between 1 January 2011 and 31 December 2014 were identified in 6 US states. Controls were 2 to <6 months of age, hospital matched, and selected by birth certificate. Mothers were interviewed to collect demographic and healthcare information. Provider-verified vaccination history was obtained for infants and mothers. Adjusted odds ratios (aORs) were calculated using conditional logistic regression; overall vaccine effectiveness (VE) was estimated as (1 - aOR)×100. To describe maternal Tdap VE modified by infant DTaP (diphtheria and tetanus toxoids and acellular pertussis) doses, case-control sets were unmatched, and a time-to-event analysis was conducted through a generalized linear mixed model.</p><p><strong>Results: </strong>A total of 335 cases and 927 controls were enrolled. The overall adjusted VE estimate for Tdap during pregnancy was 45.6% (95% confidence interval [CI], 5.8%-68.5%) and increased slightly, but not significantly, against infant hospitalization (55.7% [-116.8% to 90.9%]). Although point estimates were not significant, VE was modified by infant DTaP doses (58.8% [95% CI, -6.0% to 84.0%] for 0 DTaP doses, 30.5% [-21.4% to 60.2%] for 1 dose, and 3.2% [-170.8% to 65.4%] for 2 doses).</p><p><strong>Conclusions: </strong>Our study suggests that there is some benefit of maternal Tdap vaccination beyond the first 2 months of life, however, on-time vaccination of infants remains critical to maintain protection from pertussis.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 11","pages":"ofae655"},"PeriodicalIF":3.8,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11584412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710701","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}