Open Forum Infectious Diseases最新文献

{"title":"Time to Initiation of Hepatitis B Treatment is Reduced With the Use of the Xpert HBV Viral Load Kit.","authors":"Hailemichael Desalegn, Nega Berhe, Lasse Rossvoll, Fikadu Girma, Dawit Brhane, Ahmed Hussen, Waqtola Cheneke, Asgeir Johannessen","doi":"10.1093/ofid/ofaf238","DOIUrl":"https://doi.org/10.1093/ofid/ofaf238","url":null,"abstract":"<p><p>Timely initiation of hepatitis B virus treatment is essential for improving prognosis and outcomes. In Ethiopia, the use of the Xpert hepatitis B virus viral load kit significantly shortened the turnaround time compared to standard laboratory methods. By reducing the time to a treatment decision to 1 day, the Xpert kit allowed for quicker treatment initiation at lower costs, potentially saving lives that might otherwise be lost due to treatment delays.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 5","pages":"ofaf238"},"PeriodicalIF":3.8,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032535","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: Multiplex Gastrointestinal Panel Testing in Hospitalized Patients With Acute Diarrhea in Thailand.","authors":"","doi":"10.1093/ofid/ofaf229","DOIUrl":"https://doi.org/10.1093/ofid/ofaf229","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/ofid/ofae322.].</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 4","pages":"ofaf229"},"PeriodicalIF":3.8,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039155","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":"Previously Undiagnosed Disease \"X\" in the Democratic Republic of the Congo: Malaria's Potential Role in the Outbreak.","authors":"Yura K Ko, Jesse Gitaka, Bernard N Kanoi, Billy E Ngasala, Mariko Kanamori, Wataru Kagaya, Akira Kaneko","doi":"10.1093/ofid/ofaf240","DOIUrl":"https://doi.org/10.1093/ofid/ofaf240","url":null,"abstract":"","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 5","pages":"ofaf240"},"PeriodicalIF":3.8,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013297","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":"Relationship Among Village Doctor Training Level, Proximity to a Main Road, and Availability to Administer Intravenous Fluids for Diarrheal Illness.","authors":"Mohammad Ashraful Amin, Ishtiakul I Khan, Zahid Hasan Khan, Olivia R Hanson, Md Taufiqul Islam, Debashish Biswas, Md Golam Firoj, Eric J Nelson, Firdausi Qadri, Melissa H Watt, Daniel T Leung, Sharia M Ahmed, Ashraful I Khan","doi":"10.1093/ofid/ofaf235","DOIUrl":"10.1093/ofid/ofaf235","url":null,"abstract":"<p><p>Treatment of life-threatening diarrheal illness in rural areas of Bangladesh relies on the training and accessibility of informal health care providers such as village doctors. We found that village doctors located closer to main roads were more likely to be government trained but just as likely to administer intravenous fluids.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 5","pages":"ofaf235"},"PeriodicalIF":3.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973337","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 Diagnostic Stewardship Success: Implementing a Urine Culture Reflex Policy in the Emergency Department of a Large Safety-Net Hospital.","authors":"Joslyn Strebe, Emily Wong, Rosalind Ma, Jackie Nguyen, Michael Dang, Kristi Morgan, Shawn Hall, Bonnie C Prokesch","doi":"10.1093/ofid/ofaf228","DOIUrl":"https://doi.org/10.1093/ofid/ofaf228","url":null,"abstract":"<p><strong>Background: </strong>Urinalyses and urine cultures (UCs) are frequently ordered simultaneously in emergency departments (EDs) to increase efficiency and decrease triaging times. However, this often comes at the cost of overdiagnosis and overtreatment of urinary tract infections. Our study examines the rates of UC orders and hospital savings after implementation of a reflex UC system in a large safety-net county hospital ED. Differences in rates of antibiotic use are also described.</p><p><strong>Methods: </strong>The electronic medical records of eligible patients were analyzed before and after implementation of a reflex UC ordering system, and rates of UC processing were documented to estimate savings to the hospital and the healthcare payer. As a secondary analysis, 7 days of medical records both before and after intervention were reviewed to describe absolute rates of antibiotic prescribing and adverse events attributed to antibiotics.</p><p><strong>Results: </strong>Data analysis of 9 months after initiation of a reflex UC protocol revealed a decrease in the average of monthly cultures processed by 20.3%, resulting in a hospital cost savings of $425 000 with savings to the healthcare payer on the order of $5 650 000 in prevented cultures alone. Secondary analysis revealed a small but not statistically significant decrease in the number of antibiotics prescribed after intervention (from 40.76% to 38.11%) with similar rates of adverse effects.</p><p><strong>Conclusions: </strong>Implementation of a reflex UC protocol in the ED of a large safety-net hospital resulted in a decrease of the number of cultures being processed, leading to substantial healthcare savings, which is particularly important in a resource-limited setting. While the implementation of the protocol resulted in cost savings due to diagnostic stewardship, the impact of such a protocol on antibiotic stewardship requires further study.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 5","pages":"ofaf228"},"PeriodicalIF":3.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031517","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":"Comprehensive Care for People Who Use Drugs: Combining Infectious Diseases Services, Harm Reduction, and Primary Care.","authors":"Ryan D Knodle, Sarah E Messmer, Albert L Murphy, Renata O Smith, Michael Huyck, Karen Cotler, Antonio D Jimenez, Stockton M Mayer","doi":"10.1093/ofid/ofaf226","DOIUrl":"10.1093/ofid/ofaf226","url":null,"abstract":"<p><strong>Background: </strong>People who use drugs (PWUD) have not only increased risk of infectious diseases but also low uptake of primary care. Community-based harm reduction (HR) programs are trusted sources of care among this vulnerable population. Expansion of services offered through these programs may improve access and engagement; we assessed uptake of services within a pilot program in Chicago that offered comprehensive primary care, infectious diseases consultation, and substance use disorder (SUD) and HR services.</p><p><strong>Methods: </strong>PWUD seeking HR services were referred by outreach workers with lived SUD experiences to primary care and infectious diseases providers embedded in the HR program. We reviewed all clinical encounters occurring from 19 October 2018 to 31 December 2021. We assessed patient demographics and visit types and determined the number of encounters for those with and without SUD. We compared characteristics of encounters for individuals with and without SUD using χ² tests and Wilcoxon rank sum tests.</p><p><strong>Results: </strong>Over the study period, services were rendered to 552 unique patients in 1720 clinical encounters. Patients were predominantly male (70.7%), their median age was 43 years (IQR, 19-71), and 75.2% had public insurance. Care for active SUD made up a sizable majority of encounters (n = 1227, 71.3%), and nearly a quarter of these addressed infections often associated with PWUD. Encounters addressing hepatitis C and HIV represented 20% of all encounters.</p><p><strong>Conclusions: </strong>Colocating primary care and infectious diseases services in a community-based HR program in Chicago allowed for high utilization of critical health care offerings by PWUD. This comprehensive care model helps address the unique needs of this population while mitigating common barriers to care.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 5","pages":"ofaf226"},"PeriodicalIF":3.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992924","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":"COVID-19 Reinfections in the City of São Paulo, Brazil: Prevalence and Socioeconomic Factors.","authors":"Daniel Tavares Malheiro, Kauê Capellato Junqueira Parreira, Patricia Deffune Celeghini, Gustavo Yano Callado, André Luis Franco Cotia, Miguel Cendoroglo Neto, Marcelo A S Bragatte, Isaac Negretto Schrarstzhaupt, Vanderson Sampaio, Takaaki Kobayashi, Michael B Edmond, Alexandre R Marra","doi":"10.1093/ofid/ofaf181","DOIUrl":"https://doi.org/10.1093/ofid/ofaf181","url":null,"abstract":"<p><strong>Background: </strong>Identifying those most susceptible to COVID-19 reinfection and understanding the associated characteristics is essential for developing effective prevention and control strategies. We aimed to evaluate the influence of social determinants, regional disparities, and variant evolution on COVID-19 reinfection rates.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study in São Paulo, Brazil, involving laboratory-confirmed COVID-19 patients. Reinfection was defined as a subsequent positive COVID-19 test at least 90 days after the previous confirmed infection. We assessed socioeconomic indicators, demographic factors, and spatial correlations. Reinfection rates were analyzed across different variants and subvariants.</p><p><strong>Results: </strong>Among 73 741 patients, 5626 (7.6%) experienced reinfections, with most (95.0%) having 1 reinfection. Reinfection rates increased significantly during the Omicron period, particularly with subvariants BA.1, BA.2/BA.4, BA.5, and XBB/XBB.1.5/XBB.1.16. The highest rates were seen in patients initially infected during the BA.2/BA.4 and BA.5 periods, who were later reinfected by XBB subvariants. Socioeconomic indicators, including lower Human Development Index, higher proportions of informal settlements, and lower employment rates, were significantly associated with higher reinfection rates. Geospatial analysis showed significant clustering of reinfections in areas with higher social vulnerability.</p><p><strong>Conclusions: </strong>COVID-19 reinfection rates were heavily influenced by socioeconomic disparities and variant-specific factors. Regions with lower Human Development Index and worse socioeconomic conditions experienced higher reinfection rates. These findings highlight the need for targeted public health interventions focused on vulnerable populations, particularly in areas with greater social inequality. As new variants continue to emerge, ongoing surveillance and adaptive public health strategies will be critical to reducing reinfections.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 4","pages":"ofaf181"},"PeriodicalIF":3.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033146","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":"Stability of Monkeypox Virus on Commonly Contacted Surfaces in Clinical Settings.","authors":"Andra Banete, Jacklyn R Hurst, Winfield Yim, Emily Chien, Kuganya Nirmalarajah, Robert A Kozak, Samira Mubareka","doi":"10.1093/ofid/ofaf225","DOIUrl":"10.1093/ofid/ofaf225","url":null,"abstract":"<p><p>Monkeypox virus (MPXV), the etiologic agent of mpox, is an enveloped DNA virus that may persist on various surfaces, contributing to fomite-mediated transmission. The ongoing global outbreak of mpox has highlighted an urgent need to understand the environmental stability of MPXV. This study investigates the stability of MPXV on surfaces encountered in clinical settings. The persistence of viable MPXV and viral DNA was evaluated using porous (gauze, cotton, and scrubs), and nonporous (stainless steel, polypropylene plastic, intravenous tubing, N95 masks, and nitrile gloves) materials. Surfaces were inoculated with 10⁵, 10⁶, and 10⁷ TCID₅₀ (50% Tissue Culture Infectious Dose) MPXV and incubated at room temperature (22 °C) and 4 °C for up to 21 days to determine the effect of temperature and inoculum titre on virus viability. We show that MPXV stability is influenced by both surface type and temperature, with nonporous surfaces and lower temperatures supporting longer virus viability. Infectious MPXV was detected for up to 21 days on intravenous tubing and nitrile gloves at 4 °C, whereas porous materials like cotton showed rapid loss of infectivity, especially at room temperature. Notably, we found that viral DNA did not correlate with the presence of infectious virus, suggesting that molecular assays may overestimate fomite-mediated transmission risks. Our findings provide novel insights into MPXV persistence in clinical environments, extending prior knowledge by systematically quantifying virus viability across multiple surface types and temperature conditions. These findings underscore the importance of stringent decontamination protocols in clinical settings and highlight the need for comprehensive methods for risk assessment to evaluate the potential for MPXV transmission from contaminated surfaces.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 5","pages":"ofaf225"},"PeriodicalIF":3.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174391","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 Case of Persistently Positive Mpox PCR for 1 Year in a Patient With Advanced HIV.","authors":"Haitham Alaithan, Neha Venkatesh, Prathit A Kulkarni, Richard J Hamill, Maria C Rodriguez-Barradas","doi":"10.1093/ofid/ofaf230","DOIUrl":"https://doi.org/10.1093/ofid/ofaf230","url":null,"abstract":"<p><p>Mpox (previously called monkeypox) is a self-limited vesiculopustular skin disease caused by the monkeypox virus. Symptoms and skin findings typically resolve within 4 weeks in immunocompetent patients. This report describes a case of persistent Mpox infection with polymerase chain reaction positivity lasting greater than 1 year after initial infection in a patient with advanced HIV.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 5","pages":"ofaf230"},"PeriodicalIF":3.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013295","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":"Different Clinical Severity and Outcomes in a Cohort of Patients With Dengue With Warning Signs in an Endemic Latin American City.","authors":"Mara Gómez-Zambrano, Daniela Torres-Hernández, Monica A Murillo-Ortiz, Isabel C Hurtado, Diana M Dávalos, Erika Cantor, Pio López, Nathan D Grubaugh, Eduardo López-Medina","doi":"10.1093/ofid/ofaf227","DOIUrl":"10.1093/ofid/ofaf227","url":null,"abstract":"<p><p>We used a detailed dengue classification to assess the variability in disease severity and outcomes in a cohort of patients classified as \"dengue with warning signs\" according to the 2009 World Health Organization (WHO) criteria. We describe a wide range of severity and outcomes, which highlights the need and potential to improve the current WHO dengue classification.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 4","pages":"ofaf227"},"PeriodicalIF":3.8,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007453","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}