2 Minute Medicine ® - Infectious Disease

1. In a long-term follow-up study of an earlier randomized control trial, participants demonstrated sustained immunity 10 years after receiving a 3-dose series of human papilloma virus (HPV) vaccination. 2. There were no HPV-related malignancies or vaccine-related serious adverse events during the follow-up period. Evidence Rating Level: 1 (Excellent) Study Rundown: The risk of HPV-related cancer is lifelong, and therefore any benefit from HPV vaccination needs to be durable across time. This extension study sought to determine the long-term immunogenicity and safety of the 9-valent HPV (9vHPV) vaccine at 10 years following vaccination...

1. In this randomized controlled trial, a maternally administered vaccine for infant group B streptococcus (GBS) demonstrated a reduced risk of invasive GBS. 2. There was no significant difference in number of adverse events seen in patients who received the vaccine. Evidence Rating Level: 1 (Excellent) Study Rundown: GBS can cause sepsis and meningitis in newborns, with the primary risk factor being exposure to maternal rectovaginal group B streptococcal colonization during delivery. Often, pregnant women receive intrapartum antibiotic prophylaxis if they test positive for the GBS screen...

1.  In this randomized controlled trial, among patients living with human immunodeficiency virus (HIV) at low-to-moderate risk of cardiovascular disease, pitavastatin calcium was superior to placebo in reducing the risk of a major adverse cardiovascular event (MACE). 2. The trial was stopped early due to evidence of the efficacy and safety of pitavastatin. Evidence Rating Level: 1 (Excellent) Study Rundown: Patients with HIV are living longer on anti-retroviral therapy (ART) and have a significantly higher risk of developing cardiovascular diseases, even under optimal ART and with undetectable HIV titers...

1. In this surveillance study, the prevalence of markers of artemisinin resistance has increased to over 20% between 2016 and 2021 within 11 sampled districts in Uganda.  2. The prevalence of 469V and 675V mutations has increased by approximately 54% in northern Uganda. Evidence Rating Level: 1 (Excellent) Study Rundown: Malaria remains a significant public health challenge in certain global regions. The majority of global malaria cases and related deaths occur in Africa where control of malaria is primarily achieved through insecticides and artemisinin-based combination therapy...

1.  In a retrospective analysis of a cohort of general internal medicine physicians, it was found that antimicrobial prescribing was 30% higher in the 4th quartile compared to the 1st quartile, indicating considerable variability in physician prescribing. 2. Variation in antimicrobial prescribing did not predict clinical outcomes after discharge, but in-hospital mortality was associated with higher intensity prescribing for antimicrobials.  Evidence Rating Level: 2 (Good) The concept of antimicrobial stewardship among medical professionals is well-established, and preventing overuse is widely recognized as the most feasible way to prevent increasing levels of antimicrobial resistance on a global scale...

1. The prevalence of Hepatitis C infection during pregnancy increased between 1998 and 2018, coinciding with the opioid epidemic.  2. Individuals of White race, lower socioeconomic status, and a history of substance use were more likely to be infected with Hepatitis C during pregnancy.  3. Hepatitis C Infection was associated with a greater risk of gestational hypertension, cesarean delivery, preterm labour, poor fetal growth, and fetal distress . Evidence Rating Level: 2 (Good) Study Rundown: Hepatitis C virus (HCV) is the most prevalent chronic bloodborne infection in the United States...

1. This randomized clinical trial found that an oral lipid nanocrystal (LNC) formulation of amphotericin B was no less effective in the treatment of cryptococcal meningitis in patient cohorts with Human Immunodeficiency Virus (HIV). Early fungicidal activity in the cerebrospinal fluid was comparable among both experimental and control groups. 2. LNC also demonstrated higher tolerability compared to intravenous (IV) amphotericin, as well as a comparable safety profile.  Evidence Rating Level: 1 (Excellent) HIV and acquired immune deficiency syndrome (AIDS) predisposes sufferers to opportunistic infections...

1. Patients with inappropriate hospital admission (IHA) experience twice more adverse events (AEs) on average than appropriately admitted patients.  2. IHA is associated with longer ICU stays resulting from AEs compared to AEs experienced by non-IHA patients. Evidence Rating Level: 2 (Good) The concept of health overuse refers to when the harm outweighs the benefit to a patient when health services are provided, such as with inappropriate hospital admissions (IHA). Health overuse can result in adverse events (AEs), such as healthcare-associated infections...

1. There was no statistically significant difference in recovery time in patients with COVID-19 pneumonia using treatment with abatacept, cenicriviroc, or infliximab compared to standard care. 2. Safety assessment endpoints showed no significant difference between the trial drugs and placebo, as both groups had a similar incidence of serious adverse events (SAE). Evidence Rating Level: 1 (Excellent)     Study Rundown: This research study aims to address the immunopathology of COVID-19, which involves irregular immune cell function and cytokine/chemokine network dysregulation...

1. Among those treated for Hepatitis C Virus (HCV) infection, leading causes of death included drug abuse, liver failure, and liver cancer, and all-cause mortality was higher for those treated for HCV compared to the general population.  Evidence rating level: 2 (Good) Interferon-free antiviral agents have changed the landscape of hepatitis C virus (HCV) infection since 2014. Compared to previous management options, current treatments are shorter in duration and more effective, leading to HCV cure in >95% of patients...

1. In this observational study, long-acting antiretroviral therapy (LA-ART) was effective at maintaining virologic suppression in persons living with human immunodeficiency virus (PLWH) with preexisting suppression. 2. Long-acting antiretroviral therapy was also effective at demonstrating virologic suppression in PLWH with viremia.  Evidence Rating Level: 1 (Excellent) Study Rundown: Daily oral ART for the treatment of human immunodeficiency virus (HIV) is currently the cornerstone of maintaining viral suppression...

 1.  In a prospective cohort study, white blood cell (WBC) count, absolute neutrophil count (ANC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and procalcitonin (PCT) were elevated in pediatric patients with a musculoskeletal infection. 2. WBC count, ANC, CRP, ESR, and PCT were distinguished musculoskeletal infections from Lyme arthritis and other types of inflammatory arthritis. Evidence Rating Level: 2 (Good) Study Rundown: Bacterial musculoskeletal infections (MSKI) are serious conditions that require rapid recognition and treatment...

1. In this prospective cohort study, those who met aerobic and strength training recommendations had a significantly lower risk of influenza and pneumonia mortality than those who met neither guideline. 2. As for muscle strengthening, compared to those who engaged in <2 episodes per week, those who engaged in 2 episodes of strength training had a lower risk of influenza and pneumonia mortality, while those with ≥7 episodes/week had a higher risk. Evidence Rating Level: 2 (Good) The importance of physical activity may extend beyond cardiovascular, neurological, and cancer risk modification...

1. For children suffering from acute sinusitis, administering antibiotics showed limited advantages for those without nasopharyngeal bacterial pathogens at the initial diagnosis. 2. In children with acute sinusitis, the color of nasal discharge had weak correlation with bacterial infection and no bearing on antibiotic efficacy. Evidence Rating Level: 1 (Excellent) Study Rundown: Acute sinusitis is frequently diagnosed based on clinical symptoms in children, leading to presumptive treatment with antibiotics without pathogen testing...

1. In this prospective cohort study, rapid coronavirus disease 2019 (COVID-19) antigen tests had optimal performance when asymptomatic participants were tested three times at 48-hour intervals. 2. Additionally, rapid antigen tests had an optimal performance for symptomatic participants when they tested two times at 48-hour intervals. Evidence Rating Level: 1 (Excellent) Study Rundown: At-home rapid antigen tests (Ag-RDTs) for COVID-19 offer a fast and convenient testing option. Although, reports on Ag-RDT performance have demonstrated heterogeneous results with sensitivities ranging from 35...

1. This quality improvement study’s results suggested that more selective urine testing was conducted in 3 years as the percentage of patients with a positive urine culture with asymptomatic bacteriuria (ASB) (diagnostic stewardship metric) declined from 34.1% to 22.5%. 2. The percentage of patients with ASB who received antibiotics (antibiotic stewardship metric) and antibiotic duration for ASB did not significantly change (82.0% to 76.3% and 6.38 to 5.93 days). Evidence Rating Level: 2 (Good) Study Rundown: It is very common for hospitalized patients to experience ASB...

1. In this case-control study, adults with mpox were less likely to have been partially or fully vaccinated with the JYNNEOS vaccine compared to those without. 2. The adjusted effectiveness of the JYNNEOS vaccination amongst participants with two doses was estimated to be 66%.  Evidence Rating Level: 2 (Good) Study Rundown: Mpox is a viral illness that can be transmitted to humans from contact with other infected humans, animals, or contaminated materials. Recently, a large global outbreak of mpox was reported, to which the Food and Drug Administration within the United States responded with approval of an emergency authorization for the use of the JYNNEOS vaccine...

1. In this randomized controlled trial, 48 weeks of buleviritide treatment resulted in reduced hepatitis D r ibonucleic acid (RNA) levels in patients with chronic hepatitis D.  2. The buleviritide group also had lower alanine transaminase (ALT) levels as compared to controls.  Evidence Rating Level: 1 (Excellent) Study Rundown: Hepatitis D virus (HDV) is an RNA virus that requires hepatitis B surface antigen for entry into hepatocytes and for propagation. HDV infection is estimated to affect between 10 million and 20 million individuals worldwide...

1. In this randomized controlled trial, patients with ulcerative colitis taking mirikizumab had higher rates of clinical remission compared to those taking a placebo. 2. Opportunistic infections occurred more frequently in the mirikizumab group.  Evidence Rating Level: 1 (Excellent) Study Rundown: Recent clinical trials and approval of monoclonal antibody treatments for ulcerative colitis suggest interleukin-23 as a promising therapeutic target. Mirikizumab is a humanized monoclonal antibody that binds a subunit of interleukin-23...

1. In the retrospective chart review, complicated dengue was rare in travelers who were infected. 2. Severe symptoms noted in complicated dengue included liver disease, myocarditis, and neurologic dysfunction. Evidence Rating Level: 1 (Excellent) Study Rundown: About 50 to 100 million cases of symptomatic dengue virus infection are reported annually. However, classifying the severity of dengue can be challenging. Currently, the 2009 World Health Organization dengue classification is used, distinguishing dengue with warning signs and severe dengue...