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Comparison of At-Home Versus In-Clinic Receipt of Long-Acting Injectable Cabotegravir/Rilpivirine 在家接受长效注射卡博特拉韦/利匹韦林与在诊所接受长效注射卡博特拉韦/利匹韦林的比较
IF 11.8 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-10-08 DOI: 10.1093/cid/ciae472
Stephanie E Kirk, Christina Young, Hayley Berry, Rochelle Hanson, Angela Moreland, Virginia Fonner, Mulugeta Gebregziabher, Jamila Williams, Eric G Meissner
Background The need for frequent travel to a clinic could impair access to injectable antiretroviral therapy for persons living with human immunodeficiency virus type 1 (HIV-1) infection. We hypothesized that allowing persons receiving treatment with long-acting injectable cabotegravir plus rilpivirine (LA CAB/RPV) to receive and store the medication in their own refrigerator prior to in-home administration by a healthcare provider would be as safe and effective as receiving treatment in a clinic. Methods Persons prescribed LA CAB/RPV in the Infectious Diseases clinic at the Medical University of South Carolina were offered enrollment in this non-randomized, observational study between August 2021 and December 2022. After in-clinic receipt of the initial LA CAB/RPV injection, participants chose to receive each subsequent injection over the following 12-months either in clinic or at home. Results The 33 enrolled participants were primarily Black (64%), male (73%), and had a median age of 46. Three participants stopped LA CAB/RPV and transitioned to oral antiretroviral therapy due to allergy (n = 1), loss of virologic suppression (n = 1), and visit adherence (n = 1) concerns. A comparable number of participants received treatment primarily in clinic (n = 18) relative to at home (n = 15). Injection site pain/soreness was common (52% of injections) but did not differ between groups. There were no differences in safety or efficacy between groups and both groups reported high treatment satisfaction. All participants were virologically suppressed and retained in care at the end of the study. Conclusions At-home administration of LA CAB/RPV by a healthcare provider was comparably safe, effective, and associated with high participant satisfaction relative to in-clinic administration.
背景 需要频繁往返诊所可能会影响人类免疫缺陷病毒 1 型(HIV-1)感染者接受注射抗逆转录病毒疗法。我们假设,让接受长效注射卡博替拉韦加利匹韦林(LA CAB/RPV)治疗的患者在接受医疗服务提供者上门给药之前,在自家冰箱中接收和储存药物,与在诊所接受治疗一样安全有效。方法 在 2021 年 8 月至 2022 年 12 月期间,南卡罗来纳医科大学传染病诊所开具 LA CAB/RPV 处方的患者可参加这项非随机观察研究。在诊所接受首次 LA CAB/RPV 注射后,参与者可选择在随后的 12 个月中在诊所或家中接受后续注射。结果 33 名参加者主要为黑人(64%)、男性(73%),中位年龄为 46 岁。由于过敏(1 人)、病毒学抑制丧失(1 人)和就诊依从性(1 人)等原因,3 名参与者停止了 LA CAB/RPV,转而接受口服抗逆转录病毒疗法。与在家接受治疗的人数(15 人)相比,主要在诊所接受治疗的人数(18 人)与在家接受治疗的人数(15 人)相当。注射部位疼痛/酸痛很常见(52% 的注射),但组间没有差异。两组在安全性和疗效方面没有差异,两组的治疗满意度都很高。研究结束时,所有参与者的病毒均被抑制,并继续接受治疗。结论 由医疗服务提供者在家中注射 LA CAB/RPV 与在诊所注射 LA CAB/RPV 相比,安全、有效且参与者满意度高。
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引用次数: 0
Superiority trials in invasive aspergillosis: a harsh reality check with the IA-DUET (HOVON502) trial 侵袭性曲霉菌病的优势试验:IA-DUET(HOVON502)试验的残酷现实检验
IF 11.8 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-10-08 DOI: 10.1093/cid/ciae501
Hanne Lamberink, Sammy Huygens, Robina Aerts, Katrien Lagrou, Elena van Leeuwen-Segarceanu, Tom Lodewyck, Laurens Nieuwenhuizen, Maarten F Corsten, Ine Moors, Sophie Servais, Julien De Greef, Maya Hites, Astrid Demandt, Alexander Schauwvlieghe, Johan Maertens, Bart Rijnders
The IA-DUET study aimed to compare azole-echinocandin combination with azole monotherapy for invasive aspergillosis. Recruitment was hindered by patient ineligibility, competing studies, and guidelines favoring combination therapy when azole resistance was unknown. The low IA-attributable mortality suggests future trials may benefit from cluster randomization or composite endpoints to enhance efficiency.
IA-DUET研究旨在比较唑类-棘白菌素联合疗法和唑类单药疗法对侵袭性曲霉菌病的治疗效果。由于患者不符合条件、竞争性研究以及指南倾向于在唑类药物耐药性未知的情况下采用联合疗法,因此招募工作受到了阻碍。可归因于侵袭性曲霉菌病的死亡率较低,这表明未来的试验可能会受益于分组随机化或复合终点以提高效率。
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引用次数: 0
Implications of Undiagnosed Subclinical Cryptococcal Meningitis in Clinically Asymptomatic Low-Titer Cryptococcal Antigenemia Among PLWH: More Questions to Answer. 临床无症状低滴度隐球菌抗原血症对 PLWH 中未确诊的亚临床隐球菌脑膜炎的影响:更多问题需要解答。
IF 8.2 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-10-08 DOI: 10.1093/cid/ciae507
Samadhi Patamatamkul
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引用次数: 0
Toxoplasma qPCR kinetics to guide pre-emptive treatment of toxoplasmosis after allogeneic hematopoietic stem cell transplantation 用弓形虫 qPCR 动力学指导同种异体造血干细胞移植后弓形虫病的预防性治疗
IF 11.8 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-10-08 DOI: 10.1093/cid/ciae488
Robina Aerts, Alienor Xhaard, Christine Robin, Andreas H Groll, Catherine Cordonnier, Katrien Lagrou, Stéphane Bretagne
Background Recent ECIL-guidelines recommend a quantitative PCR (qPCR) guided pre-emptive treatment approach to toxoplasmosis in seropositive recipients of allogeneic hematopoietic cell transplantation (allo-HCT). While qPCR might serve as a sensitive tool for early Toxoplasma detection, its role in treatment follow-up remains unknown. Methods We analyzed the qPCR kinetics of allo-HCT recipients experiencing either Toxoplasma infection (TI, n=71) or disease (TD, n=14) in relation to different parameters. We included 85 patients with available qPCR values expressed as quantitative cycle (Cq) from four large hematological centers from 2009 to 2023, and kinetic analysis was performed in a selection of 74 patients screened at least weekly with blood qPCR. Day 0 (D0) was the day of anti-Toxoplasma treatment start or (when untreated) day of diagnosis. Results Time to qPCR negativity was inversely proportional to the Cq value at D0 (p=0.0063). Not reaching negativity at D10 was associated with a significantly higher mortality at D30 (p=0.023). Patients with a high D0-parasitic load and patients with TD showed slower clearance (p<0.001, p=0.032). Time to negativity was not significantly different for patients started on prophylactic vs curative doses as first-line treatment regimen (p=0.16). Conclusions This study underscores the predictive value of qPCR kinetics monitoring in allo-HCT patients with toxoplasmosis. With the aforementioned risk factors, clinicians can identify patients at high-risk for worse outcome. Our results support to consider a therapeutic change or reinforcement if the parasitic load does not decrease after 10 days, supplementing existing clinical guidelines.
背景 最近的 ECIL 指南建议对异体造血细胞移植(allo-HCT)血清阳性受者的弓形虫病采用定量 PCR(qPCR)指导的先期治疗方法。虽然 qPCR 可作为早期检测弓形虫的灵敏工具,但其在治疗随访中的作用仍不清楚。方法 我们分析了发生弓形虫感染(TI,71 例)或疾病(TD,14 例)的异体造血干细胞移植受者的 qPCR 动力学与不同参数的关系。我们纳入了 2009 年至 2023 年期间来自四个大型血液学中心的 85 名患者,这些患者的 qPCR 值以定量周期(Cq)表示,我们还选择了至少每周进行一次血液 qPCR 筛查的 74 名患者进行动力学分析。第 0 天(D0)为开始抗弓形虫治疗的当天或(未治疗时)诊断当天。结果 qPCR 阴性时间与 D0 时的 Cq 值成反比(p=0.0063)。D10时未达到阴性与D30时死亡率显著升高有关(p=0.023)。D0寄生虫量高的患者和TD患者的清除速度较慢(p<0.001,p=0.032)。作为一线治疗方案,开始使用预防性剂量与治疗性剂量的患者出现阴性的时间没有明显差异(p=0.16)。结论 本研究强调了 qPCR 动力学监测在弓形虫病异体肝移植患者中的预测价值。通过上述风险因素,临床医生可以识别出预后较差的高风险患者。如果寄生虫载量在 10 天后仍未下降,我们的研究结果支持考虑改变治疗方法或加强治疗,这也是对现有临床指南的补充。
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引用次数: 0
Risk of tuberculosis after achieving HIV virological suppression on antiretroviral therapy: a Danish nationwide prospective cohort study 抗逆转录病毒疗法达到艾滋病毒病毒学抑制后的结核病风险:丹麦全国前瞻性队列研究
IF 11.8 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-10-08 DOI: 10.1093/cid/ciae499
Amrit Kaur Virdee, Fredrikke Christie Knudtzen, Josep M Llibre, Lars Haukali Omland, Niels Obel, Nina Breinholt Stærke, Johanna Åhsberg, Iben Ørsted, Gitte Kronborg, Rajesh Mohey, Maria del Pilar Fernandez Montejo, Isik Somuncu Johansen, Raquel Martin-Iguacel
Background In countries with low tuberculosis (TB) burden, the risk of TB in people with HIV (PWH) once HIV virological suppression is achieved is not fully understood. Methods In a nationwide cohort, we included all adult PWH from the Danish HIV Cohort initiating antiretroviral therapy (ART) (1995-2017) without prior TB disease. We used Kaplan-Meier estimation and Poisson regression to calculate TB incidence rate (IR) after six months of ART, along with associated risk factors and mortality rates (MR). Results Among 6,849 PWH initiating ART (median follow-up 7.4 years), 84 developed TB (IR 1.4/1000 person-year [PY]), 54 of them beyond six months of ART initiation, IR 0.97/1000 PY (95%CI:1.17-1.79): 1.95 (95%CI:1.34-2.76) in non-Danish born, 0.36 (95%CI:0.21-0.62) in Danish-born without injection drug use (IDU), and 2.95 (95%CI:1.53-5.66) in Danish-born with IDU. Danish-born with suppressed viremia, and no IDU or known TB exposures had the lowest risk (IR 0.05/1000 PY). In the adjusted analysis, being non-Danish born (aIRR 4.27[95%CI:2.36-7.72]), IDU (aIRR 4.95[95%CI:2.55-9.62]), and previous AIDS-defining events (aIRR 2.05[95%CI:1.06-3.94]) raised TB risk, while suppressed HIV-RNA (aIRR 0.58[95%CI:0.34-0.99]) reduced it. The overall MR for HIV/TB co-infected post- ART was high, at 48.9/1000 PY (95%CI:30.4-78.7). Conclusions The TB risk remains elevated in PWH beyond six months of ART initiation, especially among migrants, IDU, those without suppressed HIV-RNA, and individuals exposed to high TB endemic areas or with social risk determinants of health. Conversely, PWH without these risk factors have a TB risk similar to the general population and would not require targeted TB screening strategies.
背景 在结核病(TB)负担较轻的国家,HIV 病毒抑制后的 HIV 感染者(PWH)患结核病的风险尚不完全清楚。方法 在一个全国性队列中,我们纳入了丹麦 HIV 队列中所有开始接受抗逆转录病毒疗法(ART)(1995-2017 年)且之前未患结核病的成年感染者。我们使用 Kaplan-Meier 估计和泊松回归法计算抗逆转录病毒疗法 6 个月后的结核病发病率 (IR),以及相关风险因素和死亡率 (MR)。结果 在 6849 名开始接受抗逆转录病毒疗法的 PWH 中(中位数随访时间为 7.4 年),84 人患上了结核病(IR 为 1.4/1000 人年),其中 54 人在开始接受抗逆转录病毒疗法 6 个月后发病,IR 为 0.97/1000 人年(95%CI:1.17-1.79):非丹麦出生者的 IR 值为 1.95(95%CI:1.34-2.76),未使用注射毒品的丹麦出生者的 IR 值为 0.36(95%CI:0.21-0.62),使用注射毒品的丹麦出生者的 IR 值为 2.95(95%CI:1.53-5.66)。病毒血症得到抑制、没有注射吸毒或已知结核病暴露的丹麦出生者的风险最低(IR 0.05/1000PY)。在调整后的分析中,非丹麦出生(aIRR 4.27[95%CI:2.36-7.72] )、IDU(aIRR 4.95[95%CI:2.55-9.62] )和既往艾滋病定义事件(aIRR 2.05[95%CI:1.06-3.94] )会增加结核病风险,而抑制 HIV-RNA (aIRR 0.58[95%CI:0.34-0.99] )会降低风险。接受抗逆转录病毒疗法后的艾滋病毒/结核病合并感染者的总体 MR 较高,为 48.9/1000 PY (95%CI:30.4-78.7)。结论 在开始接受抗逆转录病毒疗法 6 个月后,PWH 的结核病风险仍然很高,尤其是在移民、注射吸毒者、HIV-RNA 未得到抑制者、暴露于结核病高流行区或具有社会健康风险决定因素的人群中。相反,没有这些风险因素的感染者的结核病风险与普通人群相似,不需要有针对性的结核病筛查策略。
{"title":"Risk of tuberculosis after achieving HIV virological suppression on antiretroviral therapy: a Danish nationwide prospective cohort study","authors":"Amrit Kaur Virdee, Fredrikke Christie Knudtzen, Josep M Llibre, Lars Haukali Omland, Niels Obel, Nina Breinholt Stærke, Johanna Åhsberg, Iben Ørsted, Gitte Kronborg, Rajesh Mohey, Maria del Pilar Fernandez Montejo, Isik Somuncu Johansen, Raquel Martin-Iguacel","doi":"10.1093/cid/ciae499","DOIUrl":"https://doi.org/10.1093/cid/ciae499","url":null,"abstract":"Background In countries with low tuberculosis (TB) burden, the risk of TB in people with HIV (PWH) once HIV virological suppression is achieved is not fully understood. Methods In a nationwide cohort, we included all adult PWH from the Danish HIV Cohort initiating antiretroviral therapy (ART) (1995-2017) without prior TB disease. We used Kaplan-Meier estimation and Poisson regression to calculate TB incidence rate (IR) after six months of ART, along with associated risk factors and mortality rates (MR). Results Among 6,849 PWH initiating ART (median follow-up 7.4 years), 84 developed TB (IR 1.4/1000 person-year [PY]), 54 of them beyond six months of ART initiation, IR 0.97/1000 PY (95%CI:1.17-1.79): 1.95 (95%CI:1.34-2.76) in non-Danish born, 0.36 (95%CI:0.21-0.62) in Danish-born without injection drug use (IDU), and 2.95 (95%CI:1.53-5.66) in Danish-born with IDU. Danish-born with suppressed viremia, and no IDU or known TB exposures had the lowest risk (IR 0.05/1000 PY). In the adjusted analysis, being non-Danish born (aIRR 4.27[95%CI:2.36-7.72]), IDU (aIRR 4.95[95%CI:2.55-9.62]), and previous AIDS-defining events (aIRR 2.05[95%CI:1.06-3.94]) raised TB risk, while suppressed HIV-RNA (aIRR 0.58[95%CI:0.34-0.99]) reduced it. The overall MR for HIV/TB co-infected post- ART was high, at 48.9/1000 PY (95%CI:30.4-78.7). Conclusions The TB risk remains elevated in PWH beyond six months of ART initiation, especially among migrants, IDU, those without suppressed HIV-RNA, and individuals exposed to high TB endemic areas or with social risk determinants of health. Conversely, PWH without these risk factors have a TB risk similar to the general population and would not require targeted TB screening strategies.","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":11.8,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142385621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correspondence to Otogenic Meningitis Surgery Outcome Study. 通讯作者:耳源性脑膜炎手术结果研究。
IF 11.8 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-10-07 DOI: 10.1093/cid/ciae503
Yin-Chung Yang,Brian Shiian Chen,Chen Dong,James Cheng-Chung Wei
{"title":"Correspondence to Otogenic Meningitis Surgery Outcome Study.","authors":"Yin-Chung Yang,Brian Shiian Chen,Chen Dong,James Cheng-Chung Wei","doi":"10.1093/cid/ciae503","DOIUrl":"https://doi.org/10.1093/cid/ciae503","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":11.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142385161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
48-week viral suppression rates in people with HIV starting long-acting CAB/RPV with initial viremia. 开始使用长效 CAB/RPV 的艾滋病毒感染者初始病毒血症 48 周病毒抑制率。
IF 8.2 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-10-05 DOI: 10.1093/cid/ciae500
Matthew D Hickey, Nathanael Gistand, Janet Grochowski, Francis Mayorga-Munoz, Elizabeth Imbert, John D Szumowski, Jon Oskarsson, Mary Shiels, Samantha Dilworth, Ayesha Appa, Diane V Havlir, Monica Gandhi, Katerina Christopoulos

Background: We previously demonstrated at the Ward 86 HIV clinic in San Francisco that long-acting cabotegravir/rilpivirine (LA-CAB/RPV) can rapidly lead to viral suppression (VS) in people with HIV (PWH) with viremia due to adherence challenges. We now evaluate VS durability in this population.

Methods: We conducted a retrospective cohort study of PWH who started LA-CAB/RPV with viremia (HIV RNA viral load [VL]≥50 copies/mL) before December 2022. Our primary outcome was VS (VL<50 copies/mL) with LA-CAB/RPV persistence (not discontinued or late by >14 days) at 48 weeks, using the closest VL to 48+/-8 weeks. We also describe viral failure (VF), defined as <2-log VL decline at 4 weeks or VL≥200 copies/mL after initial VS with emergent CAB- or RPV-associated resistance mutations; and overall 48-week VS including those switched to alternative ART.

Results: Fifty nine PWH initiated LA-CAB/RPV with viremia and were included in analysis; 49% had CD4<200 cells/µL and median baseline VL was 42,900 copies/mL (Q1-Q3 5,272-139,038). At 48 weeks, 47 met the primary outcome of VS with LA-CAB/RPV persistence (80%; 95%CI 67-89%). Five had VF with resistance (three with RPV-associated mutations, two with CAB and RPV-associated mutations) and one was lost-to-follow-up. At week 48, two of those with VF were suppressed on alternative regimens (lenacapavir+BIC/TAF/FTC and CAB+lenacapavir). Overall week 48 VS on either LA-CAB/RPV or alternative ART was 92% (54/59).

Conclusions: In PWH initiating LA-CAB/RPV with initial viremia, 48-week VS (<50 copies/mL) was 92%. Long-acting ART can be an important tool for improving VS among patients who face adherence challenges to oral ART.

背景:我们曾在旧金山的 Ward 86 HIV 诊所证实,长效卡博替拉韦/利匹韦林(LA-CAB/RPV)可迅速导致因依从性难题而出现病毒血症的 HIV 感染者(PWH)的病毒抑制(VS)。我们现在对这一人群的病毒抑制持久性进行评估:我们对 2022 年 12 月前开始接受 LA-CAB/RPV 治疗并伴有病毒血症(HIV RNA 病毒载量 [VL]≥50 拷贝/毫升)的 PWH 进行了一项回顾性队列研究。我们的主要结果是 48 周时的 VS(VL14 天),使用最接近 48+/-8 周的 VL。我们还描述了病毒失败(VF),定义为 结果:59名PWH在开始接受LA-CAB/RPV治疗时出现了病毒血症,并纳入了分析;49%的PWH有CD4Conclusions:在最初出现病毒血症并开始接受 LA-CAB/RPV 治疗的 PWH 中,48 周 VS (
{"title":"48-week viral suppression rates in people with HIV starting long-acting CAB/RPV with initial viremia.","authors":"Matthew D Hickey, Nathanael Gistand, Janet Grochowski, Francis Mayorga-Munoz, Elizabeth Imbert, John D Szumowski, Jon Oskarsson, Mary Shiels, Samantha Dilworth, Ayesha Appa, Diane V Havlir, Monica Gandhi, Katerina Christopoulos","doi":"10.1093/cid/ciae500","DOIUrl":"https://doi.org/10.1093/cid/ciae500","url":null,"abstract":"<p><strong>Background: </strong>We previously demonstrated at the Ward 86 HIV clinic in San Francisco that long-acting cabotegravir/rilpivirine (LA-CAB/RPV) can rapidly lead to viral suppression (VS) in people with HIV (PWH) with viremia due to adherence challenges. We now evaluate VS durability in this population.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of PWH who started LA-CAB/RPV with viremia (HIV RNA viral load [VL]≥50 copies/mL) before December 2022. Our primary outcome was VS (VL<50 copies/mL) with LA-CAB/RPV persistence (not discontinued or late by >14 days) at 48 weeks, using the closest VL to 48+/-8 weeks. We also describe viral failure (VF), defined as <2-log VL decline at 4 weeks or VL≥200 copies/mL after initial VS with emergent CAB- or RPV-associated resistance mutations; and overall 48-week VS including those switched to alternative ART.</p><p><strong>Results: </strong>Fifty nine PWH initiated LA-CAB/RPV with viremia and were included in analysis; 49% had CD4<200 cells/µL and median baseline VL was 42,900 copies/mL (Q1-Q3 5,272-139,038). At 48 weeks, 47 met the primary outcome of VS with LA-CAB/RPV persistence (80%; 95%CI 67-89%). Five had VF with resistance (three with RPV-associated mutations, two with CAB and RPV-associated mutations) and one was lost-to-follow-up. At week 48, two of those with VF were suppressed on alternative regimens (lenacapavir+BIC/TAF/FTC and CAB+lenacapavir). Overall week 48 VS on either LA-CAB/RPV or alternative ART was 92% (54/59).</p><p><strong>Conclusions: </strong>In PWH initiating LA-CAB/RPV with initial viremia, 48-week VS (<50 copies/mL) was 92%. Long-acting ART can be an important tool for improving VS among patients who face adherence challenges to oral ART.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":8.2,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Antimicrobial Shortages: A Global Issue Impacting Infectious Diseases. 抗菌药短缺:影响传染病的全球性问题。
IF 8.2 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-10-05 DOI: 10.1093/cid/ciae498
Anna S Bartoo, Mary A Gilmer, Eric M Tichy

Shortages of antimicrobial agents rank second among all pharmaceutical classes and are persistent and increasing. Underlying reasons for shortages include manufacturing and quality issues, market economics, and changes in demand. Antimicrobial shortages result in compromised outcomes, higher treatment costs, contribute to antibiotic resistance, and may lead to increased adverse effects.

抗菌剂的短缺在所有药品类别中位居第二,而且持续存在并不断增加。造成短缺的根本原因包括生产和质量问题、市场经济和需求变化。抗菌药短缺导致治疗效果受损、治疗成本增加、抗生素耐药性产生,并可能导致不良反应增加。
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引用次数: 0
2024 Clinical Practice Guideline Update by the Infectious Diseases Society of America on Complicated Intra-abdominal Infections: Risk Assessment in Adults and Children. 2024 美国传染病学会关于并发腹腔内感染的临床实践指南更新:成人和儿童的风险评估。
IF 8.2 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-10-04 DOI: 10.1093/cid/ciae347
Robert A Bonomo, Anthony W Chow, Fredrick M Abrahamian, Mary Bessesen, E Patchen Dellinger, Morven S Edwards, Ellie Goldstein, Mary K Hayden, Romney Humphries, Keith S Kaye, Brian A Potoski, Jesús Rodríguez-Baño, Robert Sawyer, Marion Skalweit, David R Snydman, Pranita D Tamma, Katelyn Donnelly, Dipleen Kaur, Jennifer Loveless

This paper is part of a clinical practice guideline update on the risk assessment, diagnostic imaging, and microbiological evaluation of complicated intra-abdominal infections in adults, children, and pregnant people, developed by the Infectious Diseases Society of America. In this paper, the panel provides a recommendation for risk stratification according to severity of illness score. The panel's recommendation is based on evidence derived from systematic literature reviews and adheres to a standardized methodology for rating the certainty of evidence and strength of recommendation according to the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach.

本文是美国传染病学会制定的关于成人、儿童和孕妇复杂性腹腔内感染的风险评估、影像诊断和微生物学评价的临床实践指南更新版的一部分。在本文中,专家小组提出了根据疾病严重程度评分进行风险分层的建议。专家小组的建议基于系统性文献综述中的证据,并按照 GRADE(建议、评估、发展和评价分级)方法对证据的确定性和建议的强度进行了标准化评级。
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引用次数: 0
2024 Clinical Practice Guideline Update by the Infectious Diseases Society of America on Complicated Intraabdominal Infections: Diagnostic Imaging of Suspected Acute Cholecystitis and Acute Cholangitis in Adults, Children, and Pregnant People. 2024 美国传染病学会关于并发腹腔内感染的临床实践指南更新:成人、儿童和孕妇疑似急性胆囊炎和急性胆管炎的诊断成像。
IF 8.2 1区 医学 Q1 IMMUNOLOGY Pub Date : 2024-10-04 DOI: 10.1093/cid/ciae349
Robert A Bonomo, Morven S Edwards, Fredrick M Abrahamian, Mary Bessesen, Anthony W Chow, E Patchen Dellinger, Ellie Goldstein, Mary K Hayden, Romney Humphries, Kaye, Brian A Potoski, Rodríguez-Baño, Robert Sawyer, Marion Skalweit, David R Snydman, Pranita D Tamma, Katelyn Donnelly, Jennifer Loveless

This article is part of a clinical practice guideline update on the risk assessment, diagnostic imaging, and microbiological evaluation of complicated intraabdominal infections in adults, children, and pregnant people, developed by the Infectious Diseases Society of America. In this article, the panel provides recommendations for diagnostic imaging of suspected acute cholecystitis and acute cholangitis. The panel's recommendations are based on evidence derived from systematic literature reviews and adhere to a standardized methodology for rating the certainty of evidence and strength of recommendation according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.

本文是美国传染病学会制定的关于成人、儿童和孕妇复杂性腹腔内感染的风险评估、影像诊断和微生物学评价的临床实践指南更新版的一部分。在本文中,专家组就疑似急性胆囊炎或急性胆管炎的影像诊断提出了建议。专家小组的建议基于系统文献综述中的证据,并按照 GRADE(建议评估、发展和评价分级)方法对证据的确定性和建议的强度进行了标准化分级。
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引用次数: 0
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Clinical Infectious Diseases
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