2 Minute Medicine ® - Infectious Disease

1. Overall vaccine efficacy ranged from 83.1% to 86.6% during the 10-year period. 2. Detectable concentrations of antibodies persisted at the 8.5-year mark in Qindong. Evidence Rating Level: 1 (Excellent) Study Rundown: Hepatitis E virus (HEV) is a leading cause of acute viral hepatitis worldwide. Currently, two recombinant HEV vaccines exist; however, little is known about their long-term safety and efficacy. This randomized controlled trial aimed to assess the durability of hepatitis E vaccine efficacy over 10 years in a Chinese population...

1. Patients randomized to receive the paravertebral block (PVB) and erector spinae plane block (ESPB) had significantly more effective prevention and minimization of the impacts of post-herpetic neuralgia (PHN) in the acute period post-Herpes Zoster infection. 2. Patients randomized to receive PVB or ESPB additionally required less oral rescue analgesics and reported significantly higher quality of life at 15, 30, and 60 days post-block compared to controls.  Evidence Rating Level: 1 (Excellent) Herpes Zoster (HZ, or shingles) is a reactivation of the Varicella Zoster virus, and a painful dermatomal rash is usually a defining acute feature of the condition...

1. Therapeutic response at days 10-13 was greater in the gepotidacin group compared to the nitrofurantoin group across both trials. 2. Gepotidacin use was associated with diarrhea as the most common adverse event and no significant fatalities were reported. Evidence Rating Level: 1 (Excellent) Study Rundown: Urinary tract infections (UTIs) affect a large portion of women worldwide. While many antimicrobial treatment options exist, concerns regarding growing antibacterial resistance prompt a need for novel therapeutics...

1. In this randomized controlled trial, there was a decreased risk of any and severe respiratory syncytial virus (RSV) lower respiratory disease in the group that received the vaccine compared to the group that received the placebo. 2. T he vaccinated group had a higher risk of preterm birth than the placebo group . Evidence Rating Level: 1 (Excellent) Study Rundown: RSV is a major cause of respiratory tract infections in young children, particularly infants under six months. The virus particularly affects those living in low- and middle-income countries, where interventions are needed...

1. In this cohort study, neutralizing autoantibodies against interleukin-23 (anti-IL-23) were associated with severe, persistent opportunistic infections in patients with invasive bacterial, mycobacterial, and fungal infections. 2. Among a cohort of patients with thymoma, anti-IL-23 was associated with higher infection status. Evidence Rating Level: 2 (Good) Study Rundown: Anti-cytokine antibodies are increasingly recognized in immunodeficiency and severe infectious conditions. IL-23 and interleukin-12 (IL-12), whose structures share a common protein subunit (p40), are two cytokines that both engage the IL-12Rβ1 receptor and are essential for the production of interferon-γ...

1. Novel assay, NG-LFA, showed strong sensitivity and specificity compared to NG-PCR in both urine and vaginal specimens. 2. NG-MAST showed 93 different sequence types out of 156 LFA-positive specimens. Evidence Rating Level: 2 (Good) Study Rundown: To address the need for a rapid and cost-effective point-of-care test, a Neisseria gonorrhoeae novel lateral flow assay (NG-LFA) was developed to meet World Health Organization (WHO) and Foundation for Innovative New Diagnostics (FIND) criteria. This randomized controlled trial aimed to evaluate the NG-LFA’s performance in symptomatic male and female patients...

1. This retrospective cohort study found that in one surgeon’s practice, administration of vancomycin/tobramycin local antibiotic powder (LAP) after open treatment of fractures resulted in an 8.3% reduction in deep surgical site infections (SSIs) compared with no LAP procedures. Evidence Rating Level : 2 (Good) Conflicting data exist regarding LAP effectiveness in reducing SSIs in orthopedic surgery. While the VANCO trial showed no significant reduction in deep SSIs with vancomycin LAP, post hoc analysis suggested a decrease in gram-positive infections offset by gram-negative ones...

1. This prospective cohort study found that confirmed or suspected SARS-CoV-2 infection was associated with decreased rates of clinical pregnancy in those undergoing  in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), or frozen-thawed embryo transfer (FET). Evidence Rating Level :1 (Excellent) Some research suggests SARS-CoV-2 infection has potential influences on embryo development during controlled ovarian stimulation and increased risks during pregnancy. However, the impact of SARS-CoV-2 infection shortly after embryo transfer in IVF, ICSI or FET is unexplored...

1. The R21/Matrix-M vaccine had a high 12-month efficacy across seasonal and standard sites. 2. The reduction in malarial infection rates was 4 times greater at seasonal sites compared to standard sites. Evidence Rating Level: 1 (Excellent) Study Rundown: The R21/Matrix-M vaccine is a novel vaccine for the prevention of Plasmodium falciparum infection in regions with moderate to high malaria transmission. In a recent phase 2b trial, the vaccine demonstrated high efficacy against clinical malaria with seasonal administration...

1. This retrospective cohort study found that the addition of hyperbaric oxygen therapy (HBOT) to surgery in patients with necrotizing soft tissue infections (NSTIs) reduced mortality, amputation and non-home discharges. 2. These effects were accompanied by longer hospital stays and higher costs. 3. In a subgroup analysis of patients with sepsis, the effects of decreased mortality, amputation, and non-home discharges persisted with no impact on length of stay and costs compared with the non-HBOT group.   Evidence Rating Level : 2 (Good) NSTIs are life-threatening, managed with early diagnosis, surgery, and antibiotics...

1. Children randomized to the MenA group rather than the Vi-TT group were more likely to be diagnosed with typhoid fever. 2. Overall Vi-TT vaccine efficacy was 78.3% with the highest efficacy seen for children aged 2-4 years. Evidence Rating Level: 1 (Excellent) Study Rundown: Typhoid conjugate vaccines in Africa and Asia have shown high short-term efficacy, but data on long-term protection are limited. This study presents the final analysis of a trial in Malawi, spanning over 4 years, to assess vaccine efficacy over time and by age group...

1. In this large population-based study of adults in South Korea, there was an increased risk of developing encephalitis within 28 days of COVID-19 vaccination only for those who received the AstraZeneca (ChAdOx1-S) vaccine, but no increased risk of developing meningitis post-vaccination.  Evidence Rating Level: 2 (Good) Over 5.5 billion people worldwide have received at least one dose of a COVID-19 vaccine. Encephalitis and meningitis have been reported as rare but serious adverse events of special interest (AESIs)...

1. In this retrospective study, in patients with prolonged symptoms of coronavirus disease 2019 (COVID-19), cognitive deficits lasting a year or longer were more likely to be reported. 2. The greatest associations with cognitive deficits were found in individuals affected by COVID-19 near the beginning of the pandemic and those hospitalized. Evidence Rating Level: 2 (Good) Study Rundown: Coronavirus disease has been implicated in having negative long-term effects such as brain fog and poor memory. In the present study, participants were tasked with completing eight cognitive tests on their devices...

1. In this randomized controlled trial, among hospitalized adults with a complicated urinary tract infection (UTI), cefepime-taniborbactam was superior to meropenem in achieving microbiologic and clinical resolution. 2. Cefepime-taniborbactam had a similar safety profile to meropenem with comparable rates of serious adverse events. Evidence Rating Level: 1 (Excellent) Study Rundown: Complicated UTI, including acute pyelonephritis, accounts for a high number of hospitalizations. Emerging bacterial resistance to b-lactam antibiotics poses a challenge in treating these serious infections...

1. In this cohort study, patients with uncomplicated gram-negative bacteremia who were switched from intravenous (IV) to oral antibiotics demonstrated similar 90-day all-cause mortality to those receiving prolonged IV antibiotic treatment.  2. Patients in the early switch arm were no more likely to experience infection recurrence or complications related to antibiotic use at 30 and 90 day follow-up.  Evidence Rating Level: 2 (Good)         Study Rundown: Gram-negative bacteremia poses a significant health concern, and clinicians are tasked with assigning the proper antibiotic treatment and duration for these patients...

1. In this nationwide, population-based retrospective cohort study, dental procedures did not increase the risk of periprosthetic joint infections (PJI) in patients who have undergone primary and revision total knee arthroplasty (TKA). 2. Prophylactic antibiotics in these patients did not reduce the PJI risk, while posttraumatic arthritis was associated with PJI. Evidence Rating Level : 2 (Good) The efficacy of prophylactic antibiotics before dental procedures to prevent PJI post-total joint arthroplasty (TJA) remains uncertain despite multiple guideline revisions...

1. In people with pre-existing medical conditions, there is a higher risk of long COVID in short sleepers compared with average-length sleepers. 2. Increasing habitual sleep may be a potential modifiable risk factor for long COVID in people with pre-existing conditions. Evidence Rating Level: 1 (Excellent) The risk of long COVID-19—defined as persisting symptoms and long-term sequelae after a COVID-19 infection—has been linked to pre-existing conditions such as chronic obstructive pulmonary disease, anxiety, depression, heart disease, hypertension, and diabetes...

1. In this randomized controlled trial, high-dose simvastatin did not reduce the need for organ support among critically ill patients with coronavirus disease 2019 (COVID-19). 2. High-dose simvastatin was associated with increased rates of serious adverse events amongst critically ill patients with COVID-19. Evidence Rating Level: 1 (Excellent) Study Rundown: Among critically ill patients who are admitted to hospitals with COVID-19, access to affordable and effective medications continues to remain inequitably distributed around the world...

1. In a retrospective cohort analysis, patients with severe SARS-CoV-2 infection were more likely to experience additional symptoms (e.g., fatigue, shortness of breath) in the 31-150 days following a positive test.  2. It was also found that more severe SARS-CoV-2 infections were linked to increased incidence of diabetes, hematologic disorders, and respiratory diseases in the months following a positive test.  Evidence Rating Level: 2 (Good) The SARS-CoV-2 pandemic has caused millions of infections and deaths worldwide since the first recorded cases...

1. In this randomized controlled trial, infants who received a dose of azithromycin during their routine well visit had comparable mortality rates to placebo. 2. No differences were observed between the azithromycin and placebo groups with regard to rates of caregiver-reported hospitalization, sick-child clinic visits, or adverse events. Evidence Rating Level: 1 (Excellent) Study Rundown: Previous mass distribution of azithromycin in sub-Saharan regions has been shown to reduce childhood all-cause mortality, particularly among infants one to 11 months of age...