Therapeutic Advances in Infectious Disease最新文献

{"title":"A prospective study to evaluate high dose daptomycin pharmacokinetics and pharmacodynamics in <i>Staphylococcus</i> spp. infective endocarditis.","authors":"Simona De Gregori, Annalisa De Silvestri, Mara Capone, Vincenzina Monzillo, Paola Giordani, Raffaele Bruno, Elena Seminari","doi":"10.1177/20499361241296232","DOIUrl":"10.1177/20499361241296232","url":null,"abstract":"<p><strong>Background: </strong>Daptomycin pharmacokinetics and pharmacodynamics data relative to higher doses in patients are necessary for clinical practice.</p><p><strong>Objectives: </strong>A monocentric, prospective study that enrolled patients with a diagnosis of <i>Staphylococcus</i> spp. infective endocarditis treated with daptomycin according to clinical practice, to evaluate the pharmacokinetics/pharmacodynamics of different daptomycin daily doses (group A: 8-10 and group B: 11-12 mg/kg).</p><p><strong>Design and methods: </strong>A monocentric, prospective, cohort study that enrolled patients with a diagnosis of <i>Staphylococcus</i> spp. infective endocarditis treated with daptomycin. Daptomycin was administered by intravenous infusion over a 30-min period for at least five consecutive days before PK study.</p><p><strong>Results: </strong>Twenty-two patients were included. Native valve infectious endocarditis (IE) was diagnosed in 9 patients, prosthetic valve IE was diagnosed in 10 patients and 3 patients had concomitant intracardiac device infections. All patients showed a microbiologic response with negative blood cultures by day 5 (1-3 interquartile rate (IQR) 3-8). The median calculated AUC_0-24 was 1298 (1-3 IQR 1069-1484) and 1459 (1-3 IQR 1218-1711) µg*h/mL, with the corresponding clearance of 0.49 (1-3 IQR 0.37-0.57) and 0.57 (1-3 IQR 0.40-0.71) L/h, respectively. A value of area under the curve/minimum inhibitory concentration (AUC/MIC) > 666 was reached by all patients; however, 4 out of 15 patients in group A and 1 out of 14 patients in group B did not reach the pharmacokinetic/pharmacodynamic (PK/PD) target of 1061; therefore, AUC/MIC equal to or above 1061 was reached by 73.3% in group A and 92.9% in group B.</p><p><strong>Conclusion: </strong>From a PK/PD point of view, all patients reached the value of AUC/MIC > 666, while roughly 70% of patients in group A and 90% in group B reached the target value of AUC/MIC>1061. Even if this cut-off value is arbitrary, 11-12 mg/kg daily dose could be taken into consideration in case of serious infections characterised by a high inoculum or in cases of prosthetic valve infections.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"12 ","pages":"20499361241296232"},"PeriodicalIF":3.8,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11713942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distribution and antifungal susceptibility of <i>Candida</i> species causing vulvovaginal candidiasis and urinary tract infection in Medlatec healthcare system, Ha Noi city, Vietnam in 2023.","authors":"Pham Van Ngai, Tran Huu Dat, Luu Yen Nhi, Tran Thi Khanh Linh, Nguyen Thi Thu, Vu Lan Anh, Bui Thi Thu Dung, Pham Van Tran, Nguyen Thi Hien, Nguyen Thai Son, Trinh Thi Que, Do Ngoc Anh","doi":"10.1177/20499361241311465","DOIUrl":"https://doi.org/10.1177/20499361241311465","url":null,"abstract":"<p><strong>Background: </strong>Vulvovaginal candidiasis and urinary tract infections caused by <i>Candida</i> are common diseases. While the most common causative agent is <i>C. albicans</i>, other species, such as non-<i>C. albicans</i>, can also be responsible. Susceptibility to antifungal drugs varies among <i>Candida</i> species, but there is very limited information available from Vietnam.</p><p><strong>Objectives: </strong>To determine the species distribution and antifungal susceptibility patterns of <i>Candida</i> isolated from urine and vaginal samples of patients tested at the Medlatec healthcare system in 2023.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>The study describes a cross-sectional analysis of over 102 <i>Candida</i> isolates obtained from urine and vaginal samples of patients using the testing services at Vietnam Medlatec healthcare system from January to December 2023. Species identification of <i>Candida</i> isolates was performed using germ tube test and Vitek^® 2 systems. Antifungal susceptibility testing was carried out using the VITEK^® 2 card for yeast fungi. Minimum inhibitory concentrations for these isolates were classified according to the Clinical and Laboratory Standards Institute guidelines (M27-A3 and M27M44S-ED3).</p><p><strong>Results: </strong>In this investigation, five different <i>Candida</i> species were identified. Among these isolates, <i>C. albicans</i> (78.43%) was the most frequent, followed by <i>C. tropicalis</i> (11.76%), <i>C. glabrata</i> (4.91%), <i>C. parapsilosis</i> (1.96%), and <i>C. krusei</i> (0.98%). The resistance rates to fluconazole, voriconazole, caspofungin, micafungin, and amphotericin B were 7.7%, 4.2%, 4.0%, 1.0% and 1.0%, respectively.</p><p><strong>Conclusion: </strong>The most common species found in this population was <i>C. albicans</i>. Our findings also showed a high frequency of non-<i>albicans Candida</i> species causing fungal urinary tract infections. The resistance rates of isolated <i>Candida</i> strains to echinocandins and amphotericin B were low, while some strains were found to be resistant to fluconazole and voriconazole.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"12 ","pages":"20499361241311465"},"PeriodicalIF":3.8,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a nurse practitioner-led dedicated outpatient parenteral antibiotic therapy clinic on patient outcomes and administrative workload: a retrospective cohort study.","authors":"Makoto Ibaraki, Zachary Gruss, Emily Wings, Jaclyn E Geronimo, Janine M Varnes, Joel A Kammeyer","doi":"10.1177/20499361241305308","DOIUrl":"10.1177/20499361241305308","url":null,"abstract":"<p><strong>Background: </strong>Outpatient parenteral antibiotic therapy (OPAT) enhances patient safety, improves outcomes, and reduces healthcare costs by decreasing 30-day readmissions and adverse events. However, the optimal structure and follow-up protocols for OPAT programs remain undefined. Identifying high-risk patients for readmission and managing adverse drug events (ADEs) are critical components of OPAT care.</p><p><strong>Objectives: </strong>This study aimed to evaluate the impact of a dedicated OPAT clinic on hospital readmissions, and quantified the administrative workload required to manage patients on OPAT post-discharge.</p><p><strong>Design: </strong>A retrospective, pre-post cohort study compared patient outcomes before and after the implementation of a dedicated OPAT clinic across a single clinic and multiple hospitals.</p><p><strong>Methods: </strong>Patients discharged on OPAT from October 2018 to March 2019 (control group) and from September 2021 to February 2022 (intervention group) were included. The primary outcome was 30-day hospital readmission. Secondary outcomes included administrative workload measured by telephone calls and nursing tasks. Data were analyzed using univariate and multivariate logistic regression models to identify independent risk factors for readmission.</p><p><strong>Results: </strong>A total of 361 patients were included (median age 63 years, 62.1% men). Of these, 239 patients (66.2%) received OPAT post-clinic implementation. Common diagnoses included bacteremia (17.7%) and osteomyelitis (17.5%), with MRSA (17.2%) and Streptococci (14.4%) as predominant pathogens. The median OPAT duration was 14 days, and the median hospital stay was 7 days. Readmissions within 30 days occurred in 24.9% of patients, while 27.7% visited the emergency department. ADEs were reported in 18.9% of patients. Readmission rates decreased from 30.5% in the pre-clinic cohort to 20.1% in the post-clinic cohort (<i>p</i> ⩽ 0.05). The OPAT clinic managed 690 calls, illustrating the substantial administrative burden associated with coordinating care. Most calls addressed lab results (22.6%) and peripherally inserted central catheter-related issues (11.3%).</p><p><strong>Conclusion: </strong>The implementation of a dedicated OPAT clinic was associated with reduced readmissions and improved patient management, suggesting that structured follow-up care may improve outcomes. This study highlights the administrative challenges of OPAT, emphasizing the need for dedicated personnel and efficient coordination. Future research should focus on optimizing OPAT care models and establishing sustainable funding strategies.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241305308"},"PeriodicalIF":3.8,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical utility of plasma microbial cell-free DNA sequencing in determining microbiologic etiology of infectious syndromes in solid organ transplant recipients.","authors":"Jesal R Shah, Muhammad Rizwan Sohail, Todd Lasco, John A Goss, Mayar Al Mohajer, Sarwat Khalil","doi":"10.1177/20499361241308643","DOIUrl":"10.1177/20499361241308643","url":null,"abstract":"<p><strong>Background: </strong>Metagenomic next-generation sequencing (mNGS) is increasingly being used for microbial detection in various infectious syndromes. However, data regarding the use of mNGS in solid organ transplant recipients (SOTR) are lacking.</p><p><strong>Objectives: </strong>To describe and analyze real-world clinical impact of mNGS using plasma microbial cell-free DNA (mcfDNA) in SOTR.Design: Retrospectively reviewed all adult SOTR who underwent mNGS testing using plasma mcfDNA at Baylor St Luke's Medical Center from March 2017 to February 2023.</p><p><strong>Methods: </strong>Clinical impact (positive, neutral, and negative) was assessed using standardized objective criteria. Three Infectious Diseases physicians independently performed clinical adjudication to determine the correlation of mcfDNA results with clinical diagnosis. A descriptive analysis of the patient and clinical characteristics was performed.</p><p><strong>Results: </strong>A total of 113 mcfDNA tests in liver (42%), kidney (35%), lung (20%) and heart (13%) transplant recipients were performed in the study period. The most common clinical syndromes were pneumonia (36%), fever of unknown origin (16%), and intra-abdominal infections (15%). Most (80, 71%) of the mcfDNA test results were positive for microorganisms. Twenty-seven (24%) cases were classified as positive clinical impact, 82 (73%) were neutral and 4 (3%) were negative, respectively.</p><p><strong>Conclusion: </strong>In SOTR, mcfDNA sequencing can add a positive clinical impact in a quarter of the cases and identify microorganisms beyond conventional microbiological testing across clinical syndromes. The negative clinical impact was rare. However, larger prospective studies are needed to define the optimal timing and utilization of mcfDNA in the sequence of diagnostic evaluation for syndrome-specific workup in SOTR.</p><p><strong>Summary: </strong>Metagenomic next-generation sequencing (mNGS) is a novel diagnostic tool that can identify difficult-to-detect microorganisms in SOTR. Our study demonstrates that the mNGS test resulted in a positive clinical impact in 1 out of 4 patients.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241308643"},"PeriodicalIF":3.8,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epilepsia partialis continua in a child with disseminated tuberculosis: a case report and review of literature.","authors":"Aakash Mahesan, Arvinder Wander, Ramandeep Singh, Madhu S Gaddigoudar, Ankit Kumar Meena","doi":"10.1177/20499361241304476","DOIUrl":"10.1177/20499361241304476","url":null,"abstract":"<p><p>Tuberculosis can present myriad manifestations, affecting multiple organ systems. Common central nervous system (CNS) manifestations include vomiting, headache, blurred vision, neck stiffness, altered sensorium, seizures, and focal neurological deficits. Epilepsia partialis continua (EPC) is a rare manifestation of CNS tuberculosis. An 11-year-old female patient presented with abnormal twitching movements on the left side, specifically involving the upper limbs, while maintaining full awareness, which is suggestive of EPC. This was preceded by symptoms such as headache, poor appetite, and abdominal pain for 3 months, along with a transient episode of weakness in the left upper limb. An electroencephalogram revealed abundant spike-wave discharges from F8 T4 and C4 P4 in the right hemisphere. The EPC was refractory to anti-seizure medications. Brain MRI revealed multiple contrast-enhancing lesions and magnetic resonance spectroscopy showed a lipid peak that suggested tuberculomas. Further investigations confirmed multisystem involvement, including the gastrointestinal and genitourinary tracts. The treatment of EPC involves addressing the underlying etiology alongside the use of anti-seizure medications. In our patient, the EPC responded well to antitubercular therapy combined with corticosteroids. Given the prevalence of tuberculosis in developing countries, it should be considered early in the differential diagnosis, as it is a treatable cause of EPC.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241304476"},"PeriodicalIF":3.8,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between dolutegravir-based antiretrovirals and high blood pressure among adults with HIV in southern Ethiopia: a cross-sectional study.","authors":"Agete Tadewos Hirigo, Daniel Yilma, Ayalew Astatkie, Zelalem Debebe","doi":"10.1177/20499361241306942","DOIUrl":"10.1177/20499361241306942","url":null,"abstract":"<p><strong>Background: </strong>Dolutegravir (DTG), a novel antiretroviral therapy (ART) for HIV, is increasingly adopted across sub-Saharan Africa. However, its impact on blood pressure in Ethiopia remains unclear, highlighting a need for further studies.</p><p><strong>Objective: </strong>This study aimed to investigate the association between DTG-based first-line regimens and other covariates of high blood pressure (HBP) among adults living with HIV receiving care at health facilities in Hawassa City, southern Ethiopia.</p><p><strong>Design: </strong>A cross-sectional study.</p><p><strong>Methods: </strong>Data were collected between January 2023 and May 2024 among 444 systematically selected adults, complemented with a review of their medical records. HBP was defined according to the seventh report of the Joint National Committee (JNC7) guidelines, with a threshold of systolic or diastolic blood pressure of ⩾120/80 mmHg. Multivariable logistic regression analysis was performed to identify predictors of HBP. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were computed to determine statistically significant associations.</p><p><strong>Results: </strong>Of the study participants, 58.3% were women and 41.7% were men, resulting in a response rate of 95.5%. The mean (standard deviation (SD]) age of the participants was 38.4(±8.9) years. The prevalence of HBP was 57.9% (95% CI: 52.5-62.4), with 40.5% classified as prehypertension and 17.3% as hypertension. Among participants with hypertension, 84.4% were newly diagnosed. Initiating ART with DTG-based regimens was associated with higher odds of HBP (AOR 5.9; 95% CI: 1.5-22.7) and switching to DTG-based regimens also increased the odds of HBP (AOR 3.8; 95% CI: 1.1-13.9). Other significant covariates associated with HBP included being male (AOR 2.6; 95% CI: 1.4-4.9), age >45 years (AOR 2.0; 95% CI: 1.2-3.4), high waist-to-height ratio (AOR 2.4; 95% CI: 1.1-4.9), inadequate vegetable intake (AOR 1.7; 95% CI: 1.0-2.7), low physical activity (AOR 2.4; 95% CI: 1.1-5.4), and LDL-cholesterol (AOR 1.1; 95% CI: 1.0-1.2).</p><p><strong>Conclusion: </strong>Proactive blood pressure screening and management are important for individuals on DTG-based regimens. In addition, early identification and intervention of modifiable risk factors through comprehensive strategies and regular screenings are pivotal for improving cardiovascular health among individuals on ART.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241306942"},"PeriodicalIF":3.8,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual wellness clinic collaborative initiative with a large urban emergency department: sexual health outcomes and linkage to HIV pre-exposure prophylaxis.","authors":"Ruby Massey, Joesph A Mason, Eleanor E Friedman, Kimberly A Stanford, Damaris Garcia, Jackson Montgomery, Jessica Schmitt, Aniruddha Hazra","doi":"10.1177/20499361241306181","DOIUrl":"10.1177/20499361241306181","url":null,"abstract":"<p><strong>Introduction: </strong>Despite escalating rates of sexually transmitted infections (STIs) in the United States (US), there has been progressive divestment of sexual health services leading to the reliance on emergency departments (EDs) for sexual healthcare, particularly among vulnerable populations. The Sexual Wellness Clinic (SWC), a novel care delivery model operating in collaboration with the ED, offers comprehensive sexual health services.</p><p><strong>Objectives: </strong>This study aims to analyze the demographics, STI positivity, and HIV Pre-Exposure Prophylaxis (PrEP) uptake among patients accessing the SWC.</p><p><strong>Design: </strong>This was a retrospective cohort study of patients attending the SWC between February 20, 2019, and September 30, 2022.</p><p><strong>Methods: </strong>Sociodemographic characteristics, STI testing results, and PrEP initiation data were collected from the electronic health record (EHR). Two multivariable logistic regression models were employed to assess associations between patient factors and STI positivity or PrEP initiation.</p><p><strong>Results: </strong>Among 651 individuals across 785 SWC visits, the majority were Black or African American (94.6%), 18-29 years of age (53.2%), and on Medicaid (65.8%). Of all visits, 27.3% resulted in a syphilis diagnosis, 16.1% tested positive for chlamydia test, and 15.0% tested positive for gonorrhea. Decreased STI positivity was associated with insertive vaginal sex (adjusted odds ratio (aOR): 0.34, <i>p</i> = 0.0079) while using condoms most of the time use was associated with increased STI positivity (aOR: 2.68, <i>p</i> = 0.0038). Eighty SWC patients started PrEP on the same day as their visit, most of which were non-Hispanic Black (96.26%), assigned female at birth (53.75%), and on Medicaid or Medicare (68.75%). Factors associated with PrEP initiation at the SWC included a previous STI (aOR: 3.78, <i>p</i> < 0.001), oral sex (aOR: 2.33, <i>p</i> = 0.008), receptive anal sex (aOR: 3.55, <i>p</i> = 0.010), having a partner with HIV (aOR: 8.95, <i>p</i> = 0.019), and participation in transactional sex (aOR: 29.46, <i>p</i> = 0.029).</p><p><strong>Conclusion: </strong>Patients seen within the SWC were priority patient populations for sexual health services and PrEP linkage. The SWC was able to promote the initiation of same-day PrEP in Black cisgender women, a key population that continues to experience inequities in PrEP coverage. The SWC functions as a model for sexual healthcare delivery in populations with unmet sexual health needs.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241306181"},"PeriodicalIF":3.8,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11645765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic performance of the Cobas MTB and Logix Smart MTB for diagnosing pulmonary and extrapulmonary tuberculosis: a cross-sectional study of diagnostic tests.","authors":"Miguel Hueda-Zavaleta, Juan Carlos Gomez de la Torre, Diana Minchón-Vizconde, Claudia Barletta-Carrillo, Cesar Copaja-Corzo, Gustavo Tapia-Sequeiros, Cinthya Flores, Cristian Piscoche, Cecilia Miranda, Ada Mendoza, Vicente A Benites-Zapata","doi":"10.1177/20499361241304516","DOIUrl":"10.1177/20499361241304516","url":null,"abstract":"<p><strong>Background: </strong>Molecular tests have contributed to reducing the mortality rate through early and accurate diagnosis of tuberculosis (TB). This is due to their low processing complexity and diagnostic accuracy superior to conventional methods.</p><p><strong>Objective: </strong>To evaluate the diagnostic performance of Cobas MTB and Logix Smart MTB compared to Xpert MTB/RIF Ultra for pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB).</p><p><strong>Design: </strong>A cross-sectional study of diagnostic tests was carried out in a clinical laboratory in Lima, Peru.</p><p><strong>Methods: </strong>All pulmonary and extrapulmonary samples from patients with presumptive TB who had been subjected to smear microscopy, Xpert MTB/RIF Ultra, Cobas MTB, Logix Smart MTB, and mycobacteria culture were included to determine their diagnostic performance.</p><p><strong>Results: </strong>A total of 175 samples were included, 102 (58.3%) of pulmonary origin and 73 (41.7%) of extrapulmonary origin. Among the total samples, 19 (10.9%) had positive cultures (all were pulmonary samples), 48 (27.4%) had positive Xpert MTB/RIF Ultra results, 45 (25.7%) had positive Cobas MTB results, and 36 (20.6%) had positive Logix Smart MTB results. The agreement between Cobas MTB and Logix Smart with the Xpert MTB/RIF Ultra was 97.1% and 93.8%, respectively. Compared to Xpert MTB/RIF Ultra, the area under the curve/receiver operating characteristic and sensitivity of the Cobas MTB and Logix Smart methods were 0.95 and 91.7%, and 0.90 and 81.0%, respectively.</p><p><strong>Conclusion: </strong>Cobas MTB and Logix Smart presented adequate performance for diagnosing pulmonary and extrapulmonary tuberculosis comparable to the Xpert MTB/RIF Ultra.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241304516"},"PeriodicalIF":3.8,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11645770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HIV drug resistance following pre-exposure prophylaxis failure among key populations in sub-Saharan Africa: a systematic review and meta-analysis protocol.","authors":"Ezechiel Ngoufack Jagni Semengue, Evariste Molimbou, Naomi-Karell Etame, Christelle Aude Ka'e, Collins Chenwi Ambe, Alex Durand Nka, Pamela Patricia Tueguem, Aurelie Minelle Kengni Ngueko, Rachel Audrey Nayang Mundo, Désiré Takou, Jean-De-Dieu Anoubissi, Zacheaus Zeh Akiy, David Anouar Kob Ye Same, Duplextine Aimée Ngougo, Serges Billong, Carlo-Federico Perno, Nicaise Ndembi, Joseph Fokam","doi":"10.1177/20499361241306207","DOIUrl":"10.1177/20499361241306207","url":null,"abstract":"<p><strong>Background: </strong>Key populations (KP) are highly vulnerable to HIV acquisition and account for 70% of new infections worldwide. To optimize HIV prevention among KP, the World Health Organization recommends the combination of emtricitabine plus tenofovir disoproxil fumarate for pre-exposure prophylaxis (PrEP). However, PrEP failure could be attributed to drug resistance mutations (DRMs) but this is unexplored in sub-Saharan Africa (SSA).</p><p><strong>Objectives: </strong>We aim to conduct a systematic review that will provide evidence on the prevalence of HIV drug resistance (HIVDR) following PrEP failure among KP in SSA.</p><p><strong>Design: </strong>This will be a systematic review and meta-analysis of studies conducted in sub-Saharan Africa.</p><p><strong>Methods and analysis: </strong>This systematic review will include randomized and non-randomized trials, cohorts, case controls, cross-sectional studies, and case reports evaluating the prevalence of HIVDR following PrEP failure among KP (i.e., gay men and men who have sex with men, female sex workers, transgenders, people who inject drugs, prisoners, and detainees) in SSA. Results will be stratified according to various KP, age groups (adolescents and adults), and geographic locations. Primary outcomes will be \"the prevalence of PrEP failure among KP\" and \"the prevalence of HIVDR after PrEP failure\" in SSA. Secondary outcomes would be \"the prevalence of DRMs and drug susceptibility\" and \"the level of adherence to PrEP.\" A random-effects model will be used to calculate pooled prevalence if data permit and we will explore potential sources of heterogeneity.</p><p><strong>Discussion: </strong>Our findings will provide estimates of HIVDR following PrEP failure among KP in SSA. In addition, determinants of PrEP failure and driving factors of the emergence of DRMs will also be investigated. Evidence will help in selecting effective antiretrovirals for use in PrEP among KP in SSA.</p><p><strong>Registration: </strong>PROSPERO: CRD42023463862.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241306207"},"PeriodicalIF":3.8,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11645767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stigma and associated sex disparities among patients with tuberculosis in Uganda: a cross-sectional study.","authors":"Juliet N Sekandi, Trang Quach, Ronald Olum, Damalie Nakkonde, Leila Farist, Rochelle Obiekwe, Sarah Zalwango, Esther Buregyeya","doi":"10.1177/20499361241305517","DOIUrl":"10.1177/20499361241305517","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) is the leading cause of death from a single infectious agent globally. The stigma associated with TB, encompassing self, anticipated, and public stigma, has significant negative effects on treatment adherence. In Uganda, limited data exist on the prevalence of stigma and its relationship with sex among patients with TB.</p><p><strong>Objectives: </strong>We aimed to evaluate the prevalence of three types of stigma and their relationship with the sex of patients undergoing TB treatment.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>This cross-sectional study was conducted among patients living with TB attending selected TB clinics in Kampala, Uganda, between July 2020 and March 2021. We collected data on sociodemographics and used 13 items to capture the self, anticipated, and public stigma from which we composed the dependent variables. We employed multivariable logistic regression analysis to evaluate the association between sex and the three stigma types. Additionally, we considered potential confounders such as age, HIV, and employment status. Statistical significance was defined as <i>p</i> < 0.05.</p><p><strong>Results: </strong>In this study, we enrolled 144 participants with a mean age of 35.8 years (standard deviation = 12). Half of the participants were female, 44.4% had a secondary education, 37.5% were unemployed, and 32.6% were living with both HIV and TB. The prevalence of self-stigma was 71.1%, anticipated stigma was 75.7%, and public stigma was 41.7%. Significant factors associated with self-stigma were female sex (adjusted odds ratio (AOR): 2.35, 95% confidence interval (CI): 1.02-5.74) and unemployment (AOR: 2.95, 95% CI: 1.16-8.58). Living with HIV was significantly associated with anticipated stigma (AOR: 3.58, 95% CI: 1.38-11.23). However, none of the evaluated variables showed a significant association with public stigma.</p><p><strong>Conclusion: </strong>Our study showed a relatively high prevalence of self, anticipated, and public stigma among TB patients. Notably, females and unemployed individuals were at a higher risk of self-stigma, while those with HIV/AIDS and TB were more likely to report anticipated stigma. To combat stigma effectively, interventions should be tailored to cater to sex-specific needs and persons living with HIV. Future research should delve further into determinants of TB-related stigma in high-burden settings.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241305517"},"PeriodicalIF":3.8,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11645763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}