Clinical Infectious Diseases

BACKGROUND: Limitations in the sensitivity and accessibility of diagnostic tools for childhood tuberculosis contribute to the substantial gap between estimated cases and cases notified to national tuberculosis programs. Thus, tools to make accurate and rapid clinical diagnoses are necessary to initiate more children on antituberculosis treatment. METHODS: We analyzed data from a prospective cohort of children <13 years being routinely evaluated for pulmonary tuberculosis in Cape Town, South Africa from March 2012 to November 2017...

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BACKGROUND: Vancomycin-resistant enterococci (VRE) are a major cause of morbidity and mortality in immunocompromised patients. Tracking the dissemination of VRE strains is crucial to understand the dynamics of emergence and spread of VRE in the hospital setting. METHODS: Whole genome sequencing (WGS) and phylogenetic analyses were performed to identify dominant VRE strains and potential transmission networks between 35 patients with VRE-positive rectal swabs and their rooms (main rooms and bathrooms) on the leukemia (LKM) and the hematopoietic cell transplant (HCT) floors...

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BACKGROUND: Published data is limited on the prevalence and risk of recurrence of extraintestinal invasive E. coli infections (IEIs) in the United States. METHODS: All inpatient and hospital-based outpatient visits occurring between 2009-2016 at hospitals with continuous microbiology data submission to the Premier Healthcare Database for 90 days prior to the admission/visit and 12 months following it were included in analysis. IEI was defined as having positive E...

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BACKGROUND: Mass drug administration (MDA) with azithromycin (AZ) is being considered as a strategy to promote child survival in sub-Saharan Africa, but the mechanism by which AZ reduces mortality is unclear. To better understand the nature and extent of protection provided by AZ, we explored the profile of protection by time since administration, using data from a household-randomised, placebo-controlled trial in Burkina Faso and Mali. METHODS: Between 2014 and 2016, 30,977 children aged 3-59 months received seasonal malaria chemoprevention (SMC) with sulphadoxine-pyrimethamine plus amodiaquine and either AZ or placebo monthly, on four occasions each year...

BACKGROUND: Current guidelines recommend rules for stopping nucleos(t)ide analogues (NAs) in chronic hepatitis B (CHB) patients, but off-therapy relapse is still high. This study aimed to identify predictors of off-therapy relapse and improve existing stopping rules. METHODS: This retrospective study included 488 CHB patients (262 HBeAg-positive and 226 HBeAg-negative) who discontinued NAs. Post-treatment relapse was investigated. RESULTS: During the median follow-up period of 73...

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We report the emergence of non-susceptibility to cefiderocol from a subpopulation of Pseudomonas aeruginosa recovered from a patient without history of cefiderocol exposure. Whole genome sequencing identified mutations in major iron transport pathways previously associated with cefiderocol uptake. Susceptibility testing should be performed before therapy with siderophore cephalosporins.