Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America

BACKGROUND: People living with human immunodeficiency virus (HIV) infection have higher risk for chronic kidney disease (CKD), defined by a reduced estimated glomerular filtration rate (eGFR). Previous studies have implicated epigenetic changes related to CKD; however, the mechanism of HIV-related CKD has not been thoroughly investigated. METHODS: We conducted an epigenome-wide association study of eGFR among 567 HIV-positive and 117 HIV-negative male participants in the Veterans Aging Cohort Study (VACS) to identify epigenetic signatures of kidney function...

Omadacycline, an aminomethylcycline, is a novel member of the tetracycline class of antibiotics. It has received approval by the U.S. Food and Drug Administration (FDA) for treatment of community-acquired bacterial pneumonia (CABP) and acute bacterial skin and skin structure infections (ABSSSIs) and is available in both oral and intravenous formulations. It is also being evaluated in clinical trials for the treatment of cystitis and pyelonephritis. The omadacycline molecule was designed to overcome tetracycline resistance and has broad spectrum activity that includes gram-positive bacteria, gram-negative bacteria, anaerobes, atypicals, and other drug-resistant strains like methicillin-resistant Staphylococcus aureus (MRSA), as well as Yersinia pestis and Bacillus anthracis, organisms of biodefense interest...

BACKGROUND: A reduced, two-dose schedule of human papillomavirus (HPV) vaccination has been endorsed for preadolescent women on the basis of immunogenicity data from randomised trials, and limited data suggest even one dose may provide sufficient protection. Surveillance of the impact of fewer than three vaccine doses on clinical endpoints in the targeted age group is warranted. METHODS: We conducted a nationwide cohort study of all women between 17-25 years, living in Denmark between 2006 and 2016...

No abstract text is available yet for this article.

BACKGROUND: Endemic outbreaks of hantaviruses pose a critical public health threat worldwide. Hantaan orthohantavirus (HTNV) causes hemorrhagic fever with renal syndrome (HFRS) in humans. Using comparative genomic analyses of partial and nearly complete sequences of HTNV from humans and rodents, we are able to localize, with limitations, the putative infection locations for HFRS patients. Partial sequences might not reflect precise phylogenetic positions over the whole-genome sequence; finer granularity of rodent sampling reflects more precisely the circulation of strains...

No abstract text is available yet for this article.

BACKGROUND: Malaysia aims to eliminate malaria by 2020. However, while cases of Plasmodium falciparum and P. vivax have fallen substantially, the incidence of zoonotic malaria from P. knowlesi continues to increase, presenting a major challenge to regional malaria control efforts. Here we report incidence of all Plasmodium species in Sabah, including zoonotic P. knowlesi, during 2015-2017. METHODS: Microscopy-based malaria notification data and PCR results were obtained from the Sabah Department of Health and State Public Health Laboratory, respectively, from January 2015 to December 2017...

No abstract text is available yet for this article.

Tuberculosis is the primary infectious disease killer worldwide, with a growing threat from multidrug- resistant cases. Unfortunately, classic growth-based phenotypic drug susceptibility testing (DST) remains difficult, costly and time-consuming, while current rapid molecular testing options are limited by the diversity of antimicrobial resistant genotypes that can be detected at once. Next generation sequencing (NGS) offers the opportunity for rapid, comprehensive DST without the time or cost burden of phenotypic tests and can provide useful information for global surveillance...

At 128 US hospitals from 2009-2014, a 17% decline occurred annually in central venous catheter tips sent for culture-a six-fold decrease relative to blood culture sampling trends. Positive predictive value was low (23%). Tip cultures are often not being used in accordance with practice guideline recommendations and offer limited independent treatment opportunities.

In a multicenter, observational propensity-score weighted cohort of 249 adults with uncomplicated Pseudomonas aeruginosa bloodstream infections, patients receiving short-course (median 9 days, interquartile range [IQR] 8-10) therapy had a similar odds of recurrent infection or death within 30 days as those receiving longer courses (median 16 days, IQR 14-17).

No abstract text is available yet for this article.

BACKGROUND: While antibiotics are life-saving drugs, their use is not without risk, including adverse events and antibiotic resistance. The majority of US antibiotic prescriptions are prescribed in outpatient settings, making outpatient antibiotic prescribing an important antibiotic stewardship target. The primary objective of this study was to describe trends in US outpatient oral antibiotic prescriptions from 2011-2016. METHODS: We estimated annual oral antibiotic prescription rates using national prescription dispensing count data from IQVIA Xponent divided by census estimates for 2011-2016...

BACKGROUND: There have been concerns about reduced adherence and HIV virological suppression (VS) amongst clinically well people living with HIV initiating antiretroviral treatment (ART) with high pre-ART CD4 cell counts. We compared virological outcomes by pre-ART CD4 count, where universal ART initiation was provided in the HPTN 071 (PopART) trial in South Africa prior to routine national and international implementation. METHODS: This prospective cohort study included adults initiating ART at facilities providing ART irrespective of CD4 count since January 2014...

BACKGROUND: Elevated viral load (VL) early after antiretroviral therapy (ART) initiation appears frequently in pregnant and postpartum women living with HIV, however the relative contributions of pre-ART drug-resistant mutations (DRM) versus non-adherence in the aetiology of elevated VL are unknown. METHODS: Within a cohort of women initiating ART during pregnancy in Cape Town, South Africa, we compared women with elevated VL after initial suppression (cases, n=80) incidence-density matched to women who maintained suppression over time (controls, n=87)...

BACKGROUND: In 2011, Argentina experienced the highest pertussis incidence and mortality rates in the last decade; 60% of deaths were among infants aged <2 months. In response, a dose of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine was recommended for all pregnant women at ≥20 weeks of gestation. Although recent studies suggest maternal Tdap vaccination is effective at preventing infant disease, no data have come from low or middle-income countries, nor from ones using whole-cell pertussis vaccines for primary immunization...

BACKGROUND: Microbial translocation from the gut to circulation contributes to immune activation during HIV infection and is usually assessed by measuring plasma levels of bacterial lipopolysaccharide (LPS). Gut fungal colonization increases during HIV infection and elevated systemic levels of the fungal polysaccharide (13)--D-Glucan (DG) have been reported in people living with HIV (PLWH). We assessed plasma DG in 146 early and chronic PLWH and investigated its contribution to systemic immune activation...

BACKGROUND: Little is known on the use of artesunate compared to quinine for the treatment of imported malaria cases in non-endemic countries with high level of care. Therefore, we compared the two treatments in terms of mortality, hospital and intensive care unit discharge rates. METHODS: We analyzed the cohort of all severe imported malaria patients reported to the French National Reference Center from 2011 to 2017. After controlling for differences between quinine and artesunate treated individuals using the inverse probability of treatment weighting method, 28 day mortality rate was compared between the groups as well as hospital and ICU discharge rates using Kaplan Meier estimation and weighted Cox proportional hazard models...

BACKGROUND: Limited information exists regarding the burden of emergency department (ED) visits due to scabies in the United States (US). The goal of this study was to provide population-level estimates regarding scabies visits to American EDs. METHODS: This study was a retrospective analysis of the nationally representative National Emergency Department Sample from 2013-2015. Outcomes included adjusted odds for scabies ED visits, adjusted odds for inpatient admission due to scabies in the ED scabies population, predictors for cost of care, and seasonal/regional variation in cost and prevalence of scabies ED visits...

BACKGROUND: Cancer patients are at a higher risk for developing influenza (flu) related complications. It is unclear if the flu vaccine exacerbates immune events in patients treated with ICIs. METHODS: We conducted an IRB-approved retrospective review of advanced cancer patients on ICIs who received the flu vaccine during three consecutive seasons; 2014-15, 15-16, and 16-17. The primary outcome assessed was any "new onset" immune-related adverse event (IRAE)...