Volume 73, Issue 5, 1 September 2021

We evaluated the risk for stroke and myocardial infarction after herpes zoster, according to treatment with antiviral agents. In patients with herpes zoster, use of antiviral agents was significantly associated with lower risk of cardiovascular events.

Cardiogenic shock presents in 5% of patients with infective endocarditis and is associated with poor prognosis. Early identification and differentiation from septic shock as well as proper initial management are crucial.

Blood Leishmania parasite load, determined by qPCR, is a promising early biomarker to predict relapse in visceral leishmaniasis patients and might particularly be useful in the context of dose finding studies of new chemical entities.

Implementation of a rapid phenotypic diagnostic test, plus antimicrobial stewardship intervention for Gram-negative bloodstream infections, was associated with significantly faster time to institutional preferred therapy without change in clinical outcomes. Occasional erroneous results contributed to incorrect ASP recommendations.

TNF-α–secreting CD38⁺CD27^–CD4⁺ T cells is a robust biomarker for diagnosing TB with high accuracy (>90%). This antigen-specific assay works with whole blood and can be effectively translated into a reliable field-compatible in vitro diagnostic test.

This study provides one of the first assessments of the burden of multiple respiratory viruses during influenza season among persons aged ≥1 year. Influenza, human coronavirus (hCoV), and human rhinovirus (hRV) cause a substantial burden of outpatient visits in persons of all ages.

A cluster of 14 Neisseria gonorrhoeae isolates with high-level azithromycin resistance was identified in Indiana, primarily among white men who have sex with men. Although few patients named each other as partners, genomic sequencing revealed isolates as closely related.

During the 2017–2018 and 2018–2019 US influenza seasons, the adjuvanted trivalent inactivated influenza vaccine (aIIV3) demonstrated statistically significantly greater effectiveness in reducing influenza-related medical encounters versus standard, egg-derived quadrivalent influenza vaccines (IIV4) and the high-dose trivalent inactivated influenza vaccine (HD-IIV3).

In a randomized controlled trial, doxycycline twice daily for 1 week was significantly more effective than a single dose of azithromycin for the treatment of rectal chlamydia in men who have sex with men.

A strong innate immune response was associated with symptoms of acute retroviral syndrome (ARS). Plasma induced protein (IP)-10 was profoundly activated, associated with most ARS symptoms, and may be a candidate biomarker to differentiate a stronger innate immunity during hyperacute human immunodeficiency virus type 1 (HIV-1) infection.

Incident infections drove growth of Human Immunodeficiency Virus (HIV) genetic clusters in San Diego over the past 20 years. Molecular surveillance that includes detection of incident cases will provide a more effective molecular detection and response strategy for ending the HIV epidemic.

Fluoroquinolones are recommended in the management of staphylococcal periprosthetic joint infections. This study identifies that fluoroquinolone use is associated with a significantly higher unplanned drug discontinuation rate compared with non-fluoroquinolones when administered for a duration of 3 to 6 months.

The Auckland Cellulitis Pathway utilized the Dundee Cellulitis Classification and promoted oral antibiotic treatment for patients with mild disease. The pathway improved adherence to antibiotic guidelines, which resulted in reduced mortality and length of stay.

Among 1005 patients with low-risk methicillin-susceptible Staphylococcus aureus bacteremia, short-course antimicrobial therapy did not increase the risk of 90-day mortality compared with prolonged-course therapy. Moreover, risk of relapse was not associated with treatment duration.

Rifampicin is undetectable in the cerebrospinal fluid (CSF) of the majority of tuberculosis meningitis patients at standard dosing. Highdose rifampicin administered intravenously 20 mg/kg and orally 35 mg/kg resulted in therapeutic CSF rifampicin concentrations with no excess toxicity in a population consisting predominantly of people living with human immunodeficiency virus (HIV).

Prospective and retrospective data (2008–2017) from pediatric otolaryngology practices in 23 US states showed numbers of children with juvenile-onset recurrent respiratory papillomatosis (JORRP) and JORRP incidence have declined significantly. Declines are most likely due to human papillomavirus (HPV) vaccination.

The Infectious Diseases Society of America has developed 2 curricula, a core and an advanced, to prepare the next generation of clinicians in antimicrobial stewardship to meet the challenges of antimicrobial resistance, patient safety, and healthcare quality improvement.

We review research of experimental therapeutics targeting CXCR4, a key coreceptor for human immunodeficiency virus type 1 (HIV-1) entry. The advances in the discovery of small molecules, peptides, and larger molecules and their prospect of clinical applications as potential new anti-HIV therapeutics are discussed.

The indirect standardization method can be used to adjust children’s hospitals’ antimicrobial use data for differences in case mix and generate observed to expected ratios for comparison. Case mix adjustment reduces apparent variation between hospitals and reveals unexpected outlier hospitals.

The number of Staphylococcus aureus skin and soft tissue infections patients recorded at 3 US medical centers during 2006–2016 was stable and lacked key comorbidities. Most patients with recurrences had 1 recurrence, half of which occurred in the first 3 months following primary infection.

Merging high-quality data from 3 multicenter randomized controlled trials allowed us to conduct a post hoc analysis that showed that insertion using ultrasound guidance was associated with an increased infectious risk in central venous catheters inserted in critically ill patients.

In Vietnam, a large proportion of hepatitis B virus (HBV)-infected people may need antiviral therapy. With a better accuracy than the simplified World Health Organization treatment criteria free of HBV DNA, the simple TREAT-B score may help scaling-up and decentralize HBV treatment coverage.

Ending the Human Immunodeficiency Virus (HIV) Epidemic recommends hotspot-based intervention, defining hotspot as a case count aggregate. We recommend using geographic hotspots instead of case count aggregates for planning purposes. The model may be used by any jurisdiction with active HIV surveillance data.

Three months after recovery from acute coronavirus disease 2019 (COVID-19), this study shows that, while the pulmonary parenchyma is recovering, a substantial number of patients report severe problems in several health domains, including fatigue, functional impairment, and quality of life.

Conjugate vaccines have significantly reduced the incidence of bacterial meningitis, especially in children. The impact of vaccination has been limited by concurrent serotype replacement, and disease replacement by non-vaccine-targeted bacteria. The residual incidence remains high in neonates and the elderly.

The world’s first vending machine–based, decentralized, anonymous urine self-collection system for human immunodeficiency virus testing was launched in Chinese colleges since 2016. This approach was proven to reach high-risk students by cross-analysis of social networks used by these groups.

Based on studies published to date, QuantiFERON-TB Gold Plus (QFT-Plus) and QuantiFERON-TB Gold In-Tube (QFT-GIT) have a very similar diagnostic performance. Further studies are needed to determine if QFT-Plus has a higher sensitivity than QFT-GIT in immunocompromised hosts and young children.

A multicentered intervention based on the Core Elements of Antibiotic Stewardship was conducted to improve outpatient acute respiratory tract infection management. Intervention was associated with reduced antibiotic prescribing and reductions in hospitalization.

In a tuberculosis-preventive treatment program in Karachi, Pakistan, the cost per completed course was lower for 12-dose isoniazid and rifapentine than for 6 months of daily isoniazid.

In Hong Kong, during the coronavirus disease 2019 (COVID-19) pandemic, the number of closely contacted people decreased by 59%. Close contact control contributed >47% to infection risk reduction, confirming that human behavior was significantly influenced by the COVID-19 pandemic.

Stratification of the risk of infective endocarditis (IE) in patients with Staphylococcus aureus bacteremia is essential. In patients with negative VIRSTA, screening echocardiography may be unnecessary due to the low frequency of IE. In PREDICT-negative patients, despite the low frequency of IE, it is not low enough to omit echocardiography.

Community-based malaria case management programs that only administer antimalarial treatments to febrile children with positive malaria rapid diagnostic test results may not provide causative treatment in a high proportion of febrile children in the majority of malaria-endemic countries of Africa.

Infant serotype-specific anticapsular IgG concentrations ≥1.04 and ≥1.53 µg/mL were associated with 90% risk reduction of serotype Ia and III invasive group B Streptococcus (GBS) disease, respectively. These findings could assist in the licensure of a GBS polysaccharide-protein conjugate vaccine based on immunogenicity and safety.

Baloxavir marboxil is a single-dose oral antiinfluenza drug with a novel mechanism of action. This real-world data study indicates that baloxavir marboxil may reduce hospitalization after influenza outpatient treatment compared with neuraminidase inhibitor treatment.

Using the test-negative design and linked databases, influenza vaccine effectiveness against all-cause mortality within 30 days of influenza testing was 20%, increasing to 34% after correcting for exposure misclassification. Therefore, vaccination may prevent deaths following influenza infection in older adults.

The population pharmacokinetic model described dolutegravir in maternal and infant plasma and transplacental and breastmilk passage. Based on infant elimination profiles, dolutegravir provided a median of 4.5 days prophylactic coverage to breastfed infants following maternal drug cessation 3-15 days postpartum.

Human Immunodeficiency Virus (HIV) care during the COVID-19 pandemic requires changes in healthcare delivery. The use of telemedicine, for example, can help compensate for the reduction in face-to-face patient–physician encounters and accelerate a new HIV care model.

Controlled human infection models of severe acute respiratory syndrome coronavirus 2 have inherent risks to the individual study participant and to third-party contacts. Risks may be minimized with proper risk mitigation strategies.