Darren P. R. Troeman, Derek Y. Hazard, C. H. van Werkhoven, L. Timbermont, S. Malhotra-Kumar, M. Wolkewitz, Alexey Ruzin, F. Sifakis, Stephan Harbarth, J. A. J. W. Kluytmans, H. Goossens, Jelle Vlaeminck, T. Vilken, B. Xavier, C. Lammens, Marc Bonten, Marjolein van Esschoten, Fleur P. Paling, Claudia Recanatini, F. Coenjaerts, Brett Selman, S. Weber, Miquel Ekkelenkamp, L. van der Laan, Bas P. Vierhout, E. Couvé-Deacon, Miruna David, David Chadwick, M. Llewelyn, Andrew Ustianowski, Tony Bateman, D. Mawer, B. Carevic, Sonja Konstantinovic, Zorana Djordjevic, J. Horcajada, Dolores Escudero, Miquel Pujol Rojo, Julián de la Torre Cisneros, Francesco Castelli, Giuseppe Nardi, P. Barbadoro, Mait Altmets, P. Mitt, A. Todor, Serban Ion Bubenek Turconi, Dan Corneci, D. Sandesc, Valeriu Gheorghiță, Radim Brát, Ivo Hanke, Jan Neumann, Tomáš Tomáš, W. Laffut, Annemie Van den Abeele, S. van Rooij, Edith Schasfoort, C. Brugman, Janet Couperus, Karin Van Beek, N. Cuperus, Sophie Corthals, Liesbeth Bryssinck, Stalin Solo
The independent effects of extranasal only carriage, carriage at multiple bodily sites, or the bacterial load of colonizing Staphylococcus aureus (SA) on the risk of developing SA surgical site infections and postoperative bloodstream infections (SA SSI/BSIs) are unclear. We aimed to quantify these effects in this large prospective cohort study. Surgical patients aged 18 years or older were screened for SA carriage in the nose, throat or perineum within 30 days prior to surgery. SA carriers and non-carriers were enrolled in a prospective cohort study in a 2:1 ratio. Weighted multivariable Cox proportional hazard models were used to assess the independent associations between different measures of SA carriage and occurrence of SA SSI/BSI within 90 days after surgery. We enrolled 5,004 patients in the study cohort; 3,369 (67.3%) were SA carriers. 100 SA SSI/BSI events occurred during follow-up, and 86 (86 %) of these events occurred in SA carriers. The number of colonized bodily sites (adjusted hazard ratio [aHR] 3.5 to 8.5) and an increasing SA bacterial load in the nose (aHR 1.8 to 3.4) were associated with increased SA SSI/BSI risk. However, extranasal only carriage was not independently associated with SA SSI/BSI (aHR 1.5, 95% CI 0.9; 2.5). Nasal SA carriage was associated with an increased risk of SA SSI/BSI and accounted for the majority of SA infections. Higher bacterial load, as well as SA colonization at multiple bodily sites, further increased this risk.
仅鼻腔外携带、身体多个部位携带或定植金黄色葡萄球菌（SA）的细菌量对发生 SA 手术部位感染和术后血流感染（SA SSI/BSI）风险的独立影响尚不清楚。我们的目标是在这项大型前瞻性队列研究中量化这些影响。 我们对年龄在 18 岁或以上的手术患者进行了筛查，以确定他们是否在手术前 30 天内在鼻腔、咽喉或会阴部携带 SA。SA携带者和非携带者按2:1的比例被纳入前瞻性队列研究。我们使用加权多变量 Cox 比例危险模型来评估不同的 SA 携带量与术后 90 天内 SA SSI/BSI 发生率之间的独立关联。 我们在研究队列中纳入了 5,004 名患者，其中 3,369 人（67.3%）为 SA 携带者。随访期间发生了 100 起 SA SSI/BSI 事件，其中 86 起（86%）发生在 SA 携带者身上。体表定植部位的数量（调整后危险比 [aHR] 3.5 至 8.5）和鼻腔内 SA 细菌量的增加（aHR 1.8 至 3.4）与 SA SSI/BSI 风险的增加有关。然而，仅鼻腔外带菌与 SA SSI/BSI 无关（aHR 1.5，95% CI 0.9; 2.5）。 鼻腔SA携带与SA SSI/BSI风险增加有关，并占SA感染的大多数。更高的细菌负荷以及多个身体部位的 SA 定植进一步增加了这一风险。
{"title":"Association of Staphylococcus aureus bacterial load and colonization sites with the risk of postoperative S. aureus infection","authors":"Darren P. R. Troeman, Derek Y. Hazard, C. H. van Werkhoven, L. Timbermont, S. Malhotra-Kumar, M. Wolkewitz, Alexey Ruzin, F. Sifakis, Stephan Harbarth, J. A. J. W. Kluytmans, H. Goossens, Jelle Vlaeminck, T. Vilken, B. Xavier, C. Lammens, Marc Bonten, Marjolein van Esschoten, Fleur P. Paling, Claudia Recanatini, F. Coenjaerts, Brett Selman, S. Weber, Miquel Ekkelenkamp, L. van der Laan, Bas P. Vierhout, E. Couvé-Deacon, Miruna David, David Chadwick, M. Llewelyn, Andrew Ustianowski, Tony Bateman, D. Mawer, B. Carevic, Sonja Konstantinovic, Zorana Djordjevic, J. Horcajada, Dolores Escudero, Miquel Pujol Rojo, Julián de la Torre Cisneros, Francesco Castelli, Giuseppe Nardi, P. Barbadoro, Mait Altmets, P. Mitt, A. Todor, Serban Ion Bubenek Turconi, Dan Corneci, D. Sandesc, Valeriu Gheorghiță, Radim Brát, Ivo Hanke, Jan Neumann, Tomáš Tomáš, W. Laffut, Annemie Van den Abeele, S. van Rooij, Edith Schasfoort, C. Brugman, Janet Couperus, Karin Van Beek, N. Cuperus, Sophie Corthals, Liesbeth Bryssinck, Stalin Solo","doi":"10.1093/ofid/ofae414","DOIUrl":"https://doi.org/10.1093/ofid/ofae414","url":null,"abstract":"\u0000 \u0000 \u0000 The independent effects of extranasal only carriage, carriage at multiple bodily sites, or the bacterial load of colonizing Staphylococcus aureus (SA) on the risk of developing SA surgical site infections and postoperative bloodstream infections (SA SSI/BSIs) are unclear. We aimed to quantify these effects in this large prospective cohort study.\u0000 \u0000 \u0000 \u0000 Surgical patients aged 18 years or older were screened for SA carriage in the nose, throat or perineum within 30 days prior to surgery. SA carriers and non-carriers were enrolled in a prospective cohort study in a 2:1 ratio. Weighted multivariable Cox proportional hazard models were used to assess the independent associations between different measures of SA carriage and occurrence of SA SSI/BSI within 90 days after surgery.\u0000 \u0000 \u0000 \u0000 We enrolled 5,004 patients in the study cohort; 3,369 (67.3%) were SA carriers. 100 SA SSI/BSI events occurred during follow-up, and 86 (86 %) of these events occurred in SA carriers. The number of colonized bodily sites (adjusted hazard ratio [aHR] 3.5 to 8.5) and an increasing SA bacterial load in the nose (aHR 1.8 to 3.4) were associated with increased SA SSI/BSI risk. However, extranasal only carriage was not independently associated with SA SSI/BSI (aHR 1.5, 95% CI 0.9; 2.5).\u0000 \u0000 \u0000 \u0000 Nasal SA carriage was associated with an increased risk of SA SSI/BSI and accounted for the majority of SA infections. Higher bacterial load, as well as SA colonization at multiple bodily sites, further increased this risk. \u0000","PeriodicalId":510506,"journal":{"name":"Open Forum Infectious Diseases","volume":"68 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141810372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Prathiksha Giridharan, K. Nagarajan, Sriram Selvarauju, A. Frederick, Esakkipriya Subbiah, Sasikumar Mani, Kannan Thiruvengadam, T. Selvavinayagam, C. Padmapriyadarsini, H. Murugesan, Priya Rajendran, Makesh Kumar, R. Krishnan, P. Kumaran, J. Chitra, V. Rani, L. Venkatesan, P. Munivaradhan, D. Nithyakumar, V. Rameshbabu, P. K. Venkatramana, N. Premkumar, S. V. J. Rajkumar, T. Thangaraj, A. Devanathan, P. Balaji, T. K. Bharath, J. Udayakumar, Wilkingson Mathew, John Arockia Doss, A. Vasudevan, K. Anbarasan, M. Mahesh Kumar, P. Kumaravel, P. Chandrasekar, K. Vasudevan, G. Eswaran, R. Krishna Bahadur, J. Jeeva, E. Duraivel, R. Karunanidhi, S. Kathiravan
There is lack of research evidence on the quantitative relationship between symptom burden and healthcare-seeking among individuals with presumptive tuberculosis. Data was derived from a cross-sectional population-based tuberculosis survey conducted between February 2021 to July 2022 in 32 districts of India. Eligible and consented participants (>15 years) underwent TB symptom screening and history elicitation. Fairlie decomposition analysis was used to estimate the net differences in healthcare seeking due to varied symptom burden [from 1+ burden (>1 symptom) to 4+ burden (> 4 symptoms] and decomposed using observable covariates based on logit models with 95% confidence intervals. Of the 130932 individuals surveyed, 9540 (7.3%) reported at least one TB symptom recently, of whom 2,678 (28.1%, 95% CI 27.1-28.9) reportedly sought health care. The net differences in healthcare-seeking between persons with symptom burden of 1+ to 4+ ranged from 6.6 percentage points (95% CI,4.8 to 8.4) to 7.7 percentage points (95% CI, 5.2- 10.2] as compared to persons with less symptom burden. The presence of expectoration, fatigue, and loss of appetite largely explained healthcare seeking (range 0.9 to 3.1 percentage points or 42.89% to 151.9%). The presence of fever, cough, past TB care seeking, weight loss and chest pain moderately explained (5.3% to 25.3%) healthcare seeking. Increased symptom burden and symptoms other than the commonly emphasized cough and fever largely explained healthcare seeking. Orienting TB awareness and risk communications towards symptom burden and illness perceptions could help address population gaps in healthcare seeking for TB.
{"title":"Estimating and explaining the differences in healthcare seeking by symptom burden among persons with presumptive tuberculosis. Findings from a population-based tuberculosis prevalence survey in a high-burden setting in India","authors":"Prathiksha Giridharan, K. Nagarajan, Sriram Selvarauju, A. Frederick, Esakkipriya Subbiah, Sasikumar Mani, Kannan Thiruvengadam, T. Selvavinayagam, C. Padmapriyadarsini, H. Murugesan, Priya Rajendran, Makesh Kumar, R. Krishnan, P. Kumaran, J. Chitra, V. Rani, L. Venkatesan, P. Munivaradhan, D. Nithyakumar, V. Rameshbabu, P. K. Venkatramana, N. Premkumar, S. V. J. Rajkumar, T. Thangaraj, A. Devanathan, P. Balaji, T. K. Bharath, J. Udayakumar, Wilkingson Mathew, John Arockia Doss, A. Vasudevan, K. Anbarasan, M. Mahesh Kumar, P. Kumaravel, P. Chandrasekar, K. Vasudevan, G. Eswaran, R. Krishna Bahadur, J. Jeeva, E. Duraivel, R. Karunanidhi, S. Kathiravan","doi":"10.1093/ofid/ofae412","DOIUrl":"https://doi.org/10.1093/ofid/ofae412","url":null,"abstract":"\u0000 \u0000 \u0000 There is lack of research evidence on the quantitative relationship between symptom burden and healthcare-seeking among individuals with presumptive tuberculosis.\u0000 \u0000 \u0000 \u0000 Data was derived from a cross-sectional population-based tuberculosis survey conducted between February 2021 to July 2022 in 32 districts of India. Eligible and consented participants (>15 years) underwent TB symptom screening and history elicitation. Fairlie decomposition analysis was used to estimate the net differences in healthcare seeking due to varied symptom burden [from 1+ burden (>1 symptom) to 4+ burden (> 4 symptoms] and decomposed using observable covariates based on logit models with 95% confidence intervals.\u0000 \u0000 \u0000 \u0000 Of the 130932 individuals surveyed, 9540 (7.3%) reported at least one TB symptom recently, of whom 2,678 (28.1%, 95% CI 27.1-28.9) reportedly sought health care. The net differences in healthcare-seeking between persons with symptom burden of 1+ to 4+ ranged from 6.6 percentage points (95% CI,4.8 to 8.4) to 7.7 percentage points (95% CI, 5.2- 10.2] as compared to persons with less symptom burden. The presence of expectoration, fatigue, and loss of appetite largely explained healthcare seeking (range 0.9 to 3.1 percentage points or 42.89% to 151.9%). The presence of fever, cough, past TB care seeking, weight loss and chest pain moderately explained (5.3% to 25.3%) healthcare seeking.\u0000 \u0000 \u0000 \u0000 Increased symptom burden and symptoms other than the commonly emphasized cough and fever largely explained healthcare seeking. Orienting TB awareness and risk communications towards symptom burden and illness perceptions could help address population gaps in healthcare seeking for TB.\u0000","PeriodicalId":510506,"journal":{"name":"Open Forum Infectious Diseases","volume":"118 49","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141821349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Higher Prevalence of Immunosuppression Among US Adults: Implications for COVID-19 and Respiratory Pathogen Vaccinations","authors":"Yijia Li, C. N. Kotton","doi":"10.1093/ofid/ofae415","DOIUrl":"https://doi.org/10.1093/ofid/ofae415","url":null,"abstract":"","PeriodicalId":510506,"journal":{"name":"Open Forum Infectious Diseases","volume":" 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141825803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Antuori, A. Not, J. Mesías-Gazmuri, V. González, Marcos Montoro-Fernández, C. Folch, V. Saludes, M. Villar, M. Meroño, S. Paytubi, L. Alemany, C. Folch, L. Ferrer, V. González, R. Muñoz, J. Mesías-Gazmuri, L. Egea, J. Casabona, E. Martró, V. Saludes, A. Antuori, A. Not, S. González-Gómez, L. Alemany, M. A. Pavón, S. Paytubi, A. Esteban, M. Vergara, V. Rodríguez, F. Morey, S. Tous, A. Montoliu, S. de Sanjosé, L. Villegas, M. Villar, H. Adell, K. Santander, M. Meroño, M. Cebrián, C. Carrascal, E. Longares, L. Martínez, R. Almirall, R. Mansilla, P. Lletjós, G. Drou-Roget, A. Álvarez-Vargas, J. Casabona, E. Martró
Transgender women sex workers (TWSW) and men sex workers (MSW) are especially vulnerable to acquiring hepatitis B virus (HBV) infection. We aimed to describe HBV prevalence (HBsAg and HBcAb) and associated risk factors for HBV exposure (HBcAb), to assess vaccination status and risk factors for no prior vaccination and to compare HBV prevalence and vaccination status between TWSW and MSW. The SexCohort study was advertised to TWSW and MSW through several communication channels. At cohort entry through two community-based organizations in Barcelona, the study population was screened for HBV and other STIs, and an epidemiological questionnaire was administered (N=271). Overall, 93.0% of participants were migrants, mostly from South and Central American countries. HBsAg prevalence was 1.9% (TWSW, 2.4% vs. MSW, 0.9%; p=0.42), and previous exposure to HBV was 31.8% (TWSW, 38.5% vs. MSW, 20.8%; p=0.002). Over five years of sex work (aOR=9.35), prior exposure to Treponema pallidum (aOR=3.49) and treatment with anxiolytic drugs (aOR=3.23) were associated with HBV exposure. Overall, 33.7% of participants exhibited immunity from vaccination (TWSW, 30.8% vs. MSW, 38.61%; p<0.001), while 34.4% were candidates to HBV vaccination (TWSW, 30.8% vs. MSW, 40.6%; p<0.001). Never having been on PrEP for HIV (OR=4.23) and non-Spanish origin (OR=5.00) were associated with no prior HBV vaccination. There is a need to reinforce screening and vaccination programs aimed at TWSW and MSW as integrated services offered at the community centers commonly accessed by these populations.
{"title":"High hepatitis B prevalence and vaccination needs among transgender women and men sex workers in Barcelona, Spain","authors":"A. Antuori, A. Not, J. Mesías-Gazmuri, V. González, Marcos Montoro-Fernández, C. Folch, V. Saludes, M. Villar, M. Meroño, S. Paytubi, L. Alemany, C. Folch, L. Ferrer, V. González, R. Muñoz, J. Mesías-Gazmuri, L. Egea, J. Casabona, E. Martró, V. Saludes, A. Antuori, A. Not, S. González-Gómez, L. Alemany, M. A. Pavón, S. Paytubi, A. Esteban, M. Vergara, V. Rodríguez, F. Morey, S. Tous, A. Montoliu, S. de Sanjosé, L. Villegas, M. Villar, H. Adell, K. Santander, M. Meroño, M. Cebrián, C. Carrascal, E. Longares, L. Martínez, R. Almirall, R. Mansilla, P. Lletjós, G. Drou-Roget, A. Álvarez-Vargas, J. Casabona, E. Martró","doi":"10.1093/ofid/ofae410","DOIUrl":"https://doi.org/10.1093/ofid/ofae410","url":null,"abstract":"\u0000 \u0000 \u0000 Transgender women sex workers (TWSW) and men sex workers (MSW) are especially vulnerable to acquiring hepatitis B virus (HBV) infection. We aimed to describe HBV prevalence (HBsAg and HBcAb) and associated risk factors for HBV exposure (HBcAb), to assess vaccination status and risk factors for no prior vaccination and to compare HBV prevalence and vaccination status between TWSW and MSW.\u0000 \u0000 \u0000 \u0000 The SexCohort study was advertised to TWSW and MSW through several communication channels. At cohort entry through two community-based organizations in Barcelona, the study population was screened for HBV and other STIs, and an epidemiological questionnaire was administered (N=271).\u0000 \u0000 \u0000 \u0000 Overall, 93.0% of participants were migrants, mostly from South and Central American countries. HBsAg prevalence was 1.9% (TWSW, 2.4% vs. MSW, 0.9%; p=0.42), and previous exposure to HBV was 31.8% (TWSW, 38.5% vs. MSW, 20.8%; p=0.002). Over five years of sex work (aOR=9.35), prior exposure to Treponema pallidum (aOR=3.49) and treatment with anxiolytic drugs (aOR=3.23) were associated with HBV exposure. Overall, 33.7% of participants exhibited immunity from vaccination (TWSW, 30.8% vs. MSW, 38.61%; p<0.001), while 34.4% were candidates to HBV vaccination (TWSW, 30.8% vs. MSW, 40.6%; p<0.001). Never having been on PrEP for HIV (OR=4.23) and non-Spanish origin (OR=5.00) were associated with no prior HBV vaccination.\u0000 \u0000 \u0000 \u0000 There is a need to reinforce screening and vaccination programs aimed at TWSW and MSW as integrated services offered at the community centers commonly accessed by these populations.\u0000","PeriodicalId":510506,"journal":{"name":"Open Forum Infectious Diseases","volume":" 30","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141827781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paula Teichner, Nadine Chamay, Emilie Elliot, Miguel Pascual-Bernáldez, Deanna Merrill, Cindy Garris, Ronald D’Amico, Cecy Felizarta, Emma Torres, R. V. Van Solingen-Ristea, Bryan Baugh, P. Patel, V. Vannappagari, Samia Dakhia, Joseph W Polli, Louise Garside, Richard Grove, S. Thiagarajah, E. Birmingham, J. van Wyk
Cabotegravir (CAB) + rilpivirine (RPV) dosed monthly or every 2 months is a complete long-acting (LA) regimen for the maintenance of HIV-1 virologic suppression. Across the Phase 3/3b trials, the most frequently reported adverse events were injection site reactions (ISRs). We present pooled ISR characteristics and outcomes for participants receiving CAB+RPV LA through Week 96 of the FLAIR and ATLAS-2M studies, and survey results from healthcare providers (HCPs) giving injections (e.g. injectors) in the ATLAS, FLAIR, and ATLAS-2M studies to determine optimal injection techniques. Surveys were anonymous, self-administered online questionnaires that queried provider demographics, injection experience, and techniques to minimize pre-/post-injection discomfort. Data were summarized using descriptive statistics. Overall, 8453 ISRs were reported by 801 participants receiving ≥1 injection of CAB LA/RPV LA. Most ISRs were mild to moderate in severity (Grade 1–2, 99%), with a median (interquartile range) duration of 3 days (2–4), and rarely led to withdrawal (2%). Surveys were completed by 181 HCPs across 113 sites. Pushing the intramuscular injection at slow speed (66%), bringing the medication to room temperature (58%), and relaxing the gluteus muscle before injecting (53%) were ranked as effective pre-injection/injection procedure practices for minimizing pain. Most injectors (60%) indicated that a prone position provided optimal patient comfort, and 41% had no preference on injection medication order. Taken together, the data demonstrating favorable tolerability with CAB+RPV LA injections over the long term and simple techniques routinely used by injectors to help optimize the administration of CAB+RPV LA injections.
{"title":"Cabotegravir + Rilpivirine Long-Acting: Overview of Injection Guidance, Injection Site Reactions, and Best Practices for Intramuscular Injection Administration","authors":"Paula Teichner, Nadine Chamay, Emilie Elliot, Miguel Pascual-Bernáldez, Deanna Merrill, Cindy Garris, Ronald D’Amico, Cecy Felizarta, Emma Torres, R. V. Van Solingen-Ristea, Bryan Baugh, P. Patel, V. Vannappagari, Samia Dakhia, Joseph W Polli, Louise Garside, Richard Grove, S. Thiagarajah, E. Birmingham, J. van Wyk","doi":"10.1093/ofid/ofae282","DOIUrl":"https://doi.org/10.1093/ofid/ofae282","url":null,"abstract":"\u0000 \u0000 \u0000 Cabotegravir (CAB) + rilpivirine (RPV) dosed monthly or every 2 months is a complete long-acting (LA) regimen for the maintenance of HIV-1 virologic suppression. Across the Phase 3/3b trials, the most frequently reported adverse events were injection site reactions (ISRs).\u0000 \u0000 \u0000 \u0000 We present pooled ISR characteristics and outcomes for participants receiving CAB+RPV LA through Week 96 of the FLAIR and ATLAS-2M studies, and survey results from healthcare providers (HCPs) giving injections (e.g. injectors) in the ATLAS, FLAIR, and ATLAS-2M studies to determine optimal injection techniques. Surveys were anonymous, self-administered online questionnaires that queried provider demographics, injection experience, and techniques to minimize pre-/post-injection discomfort. Data were summarized using descriptive statistics.\u0000 \u0000 \u0000 \u0000 Overall, 8453 ISRs were reported by 801 participants receiving ≥1 injection of CAB LA/RPV LA. Most ISRs were mild to moderate in severity (Grade 1–2, 99%), with a median (interquartile range) duration of 3 days (2–4), and rarely led to withdrawal (2%). Surveys were completed by 181 HCPs across 113 sites. Pushing the intramuscular injection at slow speed (66%), bringing the medication to room temperature (58%), and relaxing the gluteus muscle before injecting (53%) were ranked as effective pre-injection/injection procedure practices for minimizing pain. Most injectors (60%) indicated that a prone position provided optimal patient comfort, and 41% had no preference on injection medication order.\u0000 \u0000 \u0000 \u0000 Taken together, the data demonstrating favorable tolerability with CAB+RPV LA injections over the long term and simple techniques routinely used by injectors to help optimize the administration of CAB+RPV LA injections.\u0000","PeriodicalId":510506,"journal":{"name":"Open Forum Infectious Diseases","volume":"21 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141098379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Meital Elbaz, Tomer Hoffman, D. Yahav, S. Dovrat, Nesrin Ghanem-Zoubi, A. Atamna, Daniel Grupel, S. Reisfeld, M. Hershman-Sarafov, P. Ciobotaro, R. Najjar-Debbiny, Tal Brosh-Nissimov, B. Chazan, Orit Yossepowitch, Y. Wiener‐Well, Ora Halutz, Shelley Reich, R. Ben-Ami, Y. Paran
Early reports described an increased risk of herpes zoster following receipt of mRNA-based COVID-19 vaccines. To assess whether COVID-19 vaccine is associated with Varicella zoster virus induced neurologic disease (VZV-ND). This was a multicenter retrospective case-control study with a test-negative design conducted at twelve hospitals in Israel. We included all patients admitted with VZV-ND between January 2020 and December 2021, and matched controls with a negative PCR VZV in CSF. We identified 188 patients meeting the case definition of VZV-ND admitted during the study period. Case patients were matched with 376 controls. There was no significant variation in the incidence of VZV-ND cases between one year period preceding and one year period following the deployment of BNT162b2 in Israel. Analysis of persons who had received at least one dose of COVID-19 vaccine (N= 259) showed similar proportions of VZV-ND and non-VZV-ND in four time intervals (30, 42, 50, 60 days) following the last vaccine dose. Median time from the last vaccine dose to hospitalization with neurological syndrome, was 53 days (IQR 25-128) and 82 days (IQR 36-132) for VZV-ND and non-VZV-ND, respectively, not reaching statistical significance (p=0.056). The rate of VZV-ND in vaccinated patients was no different from the rate in the unvaccinated group (30.9% versus 35.4%, p=0.2). We did not find an association between COVID19 vaccine and VZV-ND. Since COVID-19 vaccine is now recommends yearly, every fall and winter, establishing the safety of the vaccine is of great importance.
{"title":"Varicella zoster virus-induced neurological disease after COVID-19 Vaccination: A Multicenter Observational Cohort Study","authors":"Meital Elbaz, Tomer Hoffman, D. Yahav, S. Dovrat, Nesrin Ghanem-Zoubi, A. Atamna, Daniel Grupel, S. Reisfeld, M. Hershman-Sarafov, P. Ciobotaro, R. Najjar-Debbiny, Tal Brosh-Nissimov, B. Chazan, Orit Yossepowitch, Y. Wiener‐Well, Ora Halutz, Shelley Reich, R. Ben-Ami, Y. Paran","doi":"10.1093/ofid/ofae287","DOIUrl":"https://doi.org/10.1093/ofid/ofae287","url":null,"abstract":"\u0000 \u0000 \u0000 Early reports described an increased risk of herpes zoster following receipt of mRNA-based COVID-19 vaccines.\u0000 \u0000 \u0000 \u0000 To assess whether COVID-19 vaccine is associated with Varicella zoster virus induced neurologic disease (VZV-ND).\u0000 \u0000 \u0000 \u0000 This was a multicenter retrospective case-control study with a test-negative design conducted at twelve hospitals in Israel. We included all patients admitted with VZV-ND between January 2020 and December 2021, and matched controls with a negative PCR VZV in CSF.\u0000 \u0000 \u0000 \u0000 We identified 188 patients meeting the case definition of VZV-ND admitted during the study period. Case patients were matched with 376 controls. There was no significant variation in the incidence of VZV-ND cases between one year period preceding and one year period following the deployment of BNT162b2 in Israel. Analysis of persons who had received at least one dose of COVID-19 vaccine (N= 259) showed similar proportions of VZV-ND and non-VZV-ND in four time intervals (30, 42, 50, 60 days) following the last vaccine dose. Median time from the last vaccine dose to hospitalization with neurological syndrome, was 53 days (IQR 25-128) and 82 days (IQR 36-132) for VZV-ND and non-VZV-ND, respectively, not reaching statistical significance (p=0.056). The rate of VZV-ND in vaccinated patients was no different from the rate in the unvaccinated group (30.9% versus 35.4%, p=0.2).\u0000 \u0000 \u0000 \u0000 We did not find an association between COVID19 vaccine and VZV-ND. Since COVID-19 vaccine is now recommends yearly, every fall and winter, establishing the safety of the vaccine is of great importance.\u0000","PeriodicalId":510506,"journal":{"name":"Open Forum Infectious Diseases","volume":"7 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141099190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tom P Lodise, Keith S Kaye, Anne Santerre Henriksen, Gunnar Kahlmeter
Antimicrobial resistance in uropathogens commonly causing urinary tract infections (UTIs) is a growing problem internationally. Pivmecillinam, the oral prodrug of mecillinam, has been used for over 40 years, primarily in Northern Europe and Canada. It is recommended in several countries as a first-line agent for the treatment of uncomplicated UTIs (uUTIs) and is now approved in the United States (US). We performed a structured literature search to review the available evidence on susceptibility of common uUTI-causing uropathogens to mecillinam. Among 38 studies included in this literature review, susceptibility rates for Escherichia coli (E. coli) to mecillinam – including resistant phenotypes such as extended-spectrum β-lactamase–producing E. coli – exceed 90% in most studies. High rates of susceptibility were also reported among many other uropathogens including Klebsiella spp., Enterobacter spp., and Citrobacter spp. In the current prescribing climate within the US, pivmecillinam represents a viable first-line treatment option for patients with uUTI.
{"title":"Review of the in vitro microbiological activity of mecillinam against common uropathogens in uncomplicated urinary tract infection (uUTI): focus on resistant pathogens","authors":"Tom P Lodise, Keith S Kaye, Anne Santerre Henriksen, Gunnar Kahlmeter","doi":"10.1093/ofid/ofae296","DOIUrl":"https://doi.org/10.1093/ofid/ofae296","url":null,"abstract":"\u0000 Antimicrobial resistance in uropathogens commonly causing urinary tract infections (UTIs) is a growing problem internationally. Pivmecillinam, the oral prodrug of mecillinam, has been used for over 40 years, primarily in Northern Europe and Canada. It is recommended in several countries as a first-line agent for the treatment of uncomplicated UTIs (uUTIs) and is now approved in the United States (US). We performed a structured literature search to review the available evidence on susceptibility of common uUTI-causing uropathogens to mecillinam. Among 38 studies included in this literature review, susceptibility rates for Escherichia coli (E. coli) to mecillinam – including resistant phenotypes such as extended-spectrum β-lactamase–producing E. coli – exceed 90% in most studies. High rates of susceptibility were also reported among many other uropathogens including Klebsiella spp., Enterobacter spp., and Citrobacter spp. In the current prescribing climate within the US, pivmecillinam represents a viable first-line treatment option for patients with uUTI.","PeriodicalId":510506,"journal":{"name":"Open Forum Infectious Diseases","volume":"74 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141101763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Sixt, F. Moretto, S. Das Neves, L. Amoureux, C. Neuwirth, L. Piroth, M. Blot, P. Chavanet, J. Bador
Among 15 strains of Listeria monocytogenes tested, a synergy between amoxicillin and ceftriaxone was observed in 14 (93%) using MIC strips, 12 (80%) using checkerboard methods and for two of the 3 strains tested with time killing curve. This association may be an alternative treatment for listeriosis in the future.
{"title":"Amoxicillin and ceftriaxone: a synergistic association against Listeria monocytogenes","authors":"T. Sixt, F. Moretto, S. Das Neves, L. Amoureux, C. Neuwirth, L. Piroth, M. Blot, P. Chavanet, J. Bador","doi":"10.1093/ofid/ofae295","DOIUrl":"https://doi.org/10.1093/ofid/ofae295","url":null,"abstract":"\u0000 Among 15 strains of Listeria monocytogenes tested, a synergy between amoxicillin and ceftriaxone was observed in 14 (93%) using MIC strips, 12 (80%) using checkerboard methods and for two of the 3 strains tested with time killing curve. This association may be an alternative treatment for listeriosis in the future.","PeriodicalId":510506,"journal":{"name":"Open Forum Infectious Diseases","volume":"53 42","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141108760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reply to Heldman et al","authors":"E. Bell, Jennifer Pisano, Daniel Friedman","doi":"10.1093/ofid/ofae292","DOIUrl":"https://doi.org/10.1093/ofid/ofae292","url":null,"abstract":"","PeriodicalId":510506,"journal":{"name":"Open Forum Infectious Diseases","volume":"63 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141123286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aleece MacPhail, C. Dendle, Monica Slavin, R. Weinkove, Michael Bailey, D. Pilcher, Zoe McQuilten
Neutropenic sepsis frequently requires admission to an Intensive Care Unit (ICU). Differences between subgroups of patients with neutropenic sepsis are not well characterised. To investigate clinical outcomes among patients with neutropenic sepsis and haematological malignancy, metastatic solid cancer, or no cancer diagnosis. Retrospective cohort study of all patients admitted to ICU in Australia or New Zealand between January 2000 and December 2022 with a primary admission diagnosis of sepsis and total white cell count <1.0 × 109cells/L. We identified 8,617 ICU admissions with neutropenic sepsis (Haematological malignancy n = 4,660; metastatic solid cancer n = 1,034; no cancer n = 2,800). Patients with haematological malignancy were younger (median 61.5 years) with low rates of chronic comorbidities (4.7%), and were usually admitted to ICU from the ward (67.4%). Mechanical ventilation rates were 20.2% and in-hospital mortality was 30.6%. Patients with metastatic solid cancers were older (median 66.3 years), with higher rates of chronic comorbidities (9.9%), and were usually admitted to ICU from the emergency department (50.8%). Mechanical ventilation rates were 16.9% and in-hospital mortality was 42.4%. Patients with no documented cancer had highest rates of mechanical ventilation (41.7%) and mortality (46.3%). Neutropenia was independently associated with mortality among patients with solid cancers or no cancer, but did not confer increased risk among patients with haematological malignancy (OR 0.98, 95% CI 0.90–1.06, p = 0.60). Patients with neutropenic sepsis and haematological malignancy, metastatic solid cancer, or no cancer diagnosis constitute three distinct clinical groups. Management approaches should be tailored accordingly.
{"title":"Neutropenic sepsis in the Intensive Care Unit: differences in clinical profile and outcomes according to the cause of neutropenia","authors":"Aleece MacPhail, C. Dendle, Monica Slavin, R. Weinkove, Michael Bailey, D. Pilcher, Zoe McQuilten","doi":"10.1093/ofid/ofae289","DOIUrl":"https://doi.org/10.1093/ofid/ofae289","url":null,"abstract":"\u0000 \u0000 \u0000 Neutropenic sepsis frequently requires admission to an Intensive Care Unit (ICU). Differences between subgroups of patients with neutropenic sepsis are not well characterised.\u0000 \u0000 \u0000 \u0000 To investigate clinical outcomes among patients with neutropenic sepsis and haematological malignancy, metastatic solid cancer, or no cancer diagnosis.\u0000 \u0000 \u0000 \u0000 Retrospective cohort study of all patients admitted to ICU in Australia or New Zealand between January 2000 and December 2022 with a primary admission diagnosis of sepsis and total white cell count <1.0 × 109cells/L.\u0000 \u0000 \u0000 \u0000 We identified 8,617 ICU admissions with neutropenic sepsis (Haematological malignancy n = 4,660; metastatic solid cancer n = 1,034; no cancer n = 2,800). Patients with haematological malignancy were younger (median 61.5 years) with low rates of chronic comorbidities (4.7%), and were usually admitted to ICU from the ward (67.4%). Mechanical ventilation rates were 20.2% and in-hospital mortality was 30.6%. Patients with metastatic solid cancers were older (median 66.3 years), with higher rates of chronic comorbidities (9.9%), and were usually admitted to ICU from the emergency department (50.8%). Mechanical ventilation rates were 16.9% and in-hospital mortality was 42.4%. Patients with no documented cancer had highest rates of mechanical ventilation (41.7%) and mortality (46.3%).\u0000 Neutropenia was independently associated with mortality among patients with solid cancers or no cancer, but did not confer increased risk among patients with haematological malignancy (OR 0.98, 95% CI 0.90–1.06, p = 0.60).\u0000 \u0000 \u0000 \u0000 Patients with neutropenic sepsis and haematological malignancy, metastatic solid cancer, or no cancer diagnosis constitute three distinct clinical groups. Management approaches should be tailored accordingly.\u0000","PeriodicalId":510506,"journal":{"name":"Open Forum Infectious Diseases","volume":"125 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141123665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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