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Open Forum Infectious Diseases

Héloïse M Delagrèverie, Constance Delaugerre, Sharon R Lewin, Steven G Deeks, Jonathan Z Li
In chronic human immunodeficiency virus (HIV)-1 infection, long-lived latently infected cells are the major barrier to virus eradication and functional cure. Several therapeutic strategies to perturb, eliminate, and/or control this reservoir are now being pursued in the clinic. These strategies include latency reversal agents (LRAs) designed to reactivate HIV-1 ribonucleic acid transcription and virus production and a variety of immune-modifying drugs designed to reverse latency, block homeostatic proliferation, and replenish the viral reservoir, eliminate virus-producing cells, and/or control HIV replication after cessation of antiretroviral therapy...
October 2016: Open Forum Infectious Diseases
Rachael M Hiebert, Robert C Welliver, Zhongxin Yu
Fusarium species are ubiquitous fungi causing a wide array of infections, including invasive disease in the immunosuppressed. We present a fusarium bone infection in a child with Pearson syndrome and review the literature. Ten cases of fusarium osteomyelitis were reported in the past 40 years, and we review the treatments.
October 2016: Open Forum Infectious Diseases
Aliya Yamin, Ethan Bornstein, Rachel Hensel, Omar Mohamed, Russell R Kempker
Background.  Despite the low and decreasing prevalence of tuberculosis (TB) in the United States, there remain certain high-risk groups with high incidence rates. The targeted screening and treatment of latent TB infection (LTBI) among these high-risk groups are needed to achieve TB elimination; however, by most accounts, LTBI treatment completion rates remain low. Methods.  We retrospectively studied all patients accepting treatment for LTBI at the Fulton County Health Department TB clinic over 2 years...
October 2016: Open Forum Infectious Diseases
Constantina Boikos, Lawrence Joseph, Christine Martineau, Jesse Papenburg, David Scheifele, Larry C Lands, Gaston De Serres, Mark Chilvers, Caroline Quach
Background.  We aimed to explore the detection profile of influenza viruses following live-attenuated intranasal influenza vaccination (LAIV) in children aged 2-19 years with and without cystic fibrosis (CF). Methods.  Before the 2013-2014 influenza season, flocked nasal swabs were obtained before vaccination and 4 times in the week of follow-up from 76 participants (nCF: 57; nhealthy: 19). Influenza was detected by reverse transcription polymerase chain reaction (RT-PCR) assays. A Bayesian hierarchical logistic regression model was used to estimate the effect of CF status and age on influenza detection...
October 2016: Open Forum Infectious Diseases
Michelle K Haas, Kristen Dalton, Bryan C Knepper, Sarah A Stella, Lilia Cervantes, Connie S Price, William J Burman, Philip S Mehler, Timothy C Jenkins
Background.  Syndrome-specific interventions are a recommended approach to antibiotic stewardship, but additional data are needed to understand their potential impact. We implemented an intervention to improve the management of inpatient community-acquired pneumonia (CAP) and evaluated its effects on antibiotic and resource utilization. Methods.  A stakeholder group developed and implemented a clinical practice guideline and order set for inpatient, non-intensive care unit CAP recommending a short course (5 days) of a fluoroquinolone-sparing antibiotic regimen in uncomplicated cases...
October 2016: Open Forum Infectious Diseases
Manon R Haverkate, Shayna Weiner, Karen Lolans, Nicholas M Moore, Robert A Weinstein, Marc J M Bonten, Mary K Hayden, Martin C J Bootsma
Background.  High prevalence of Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae has been reported in long-term acute care hospitals (LTACHs), in part because of frequent readmissions of colonized patients. Knowledge of the duration of colonization with KPC is essential to identify patients at risk of KPC colonization upon readmission and to make predictions on the effects of transmission control measures. Methods.  We analyzed data on surveillance isolates that were collected at 4 LTACHs in the Chicago region during a period of bundled interventions, to simultaneously estimate the duration of colonization during an LTACH admission and between LTACH (re)admissions...
October 2016: Open Forum Infectious Diseases
Sara C Keller, Sara E Cosgrove, Yvonne Higgins, Damani A Piggott, Greg Osgood, Paul G Auwaerter
Background.  The use of suppressive antibiotics in treatment of orthopedic hardware infections (OHIs), including spinal hardware infections, prosthetic joint infections, and infections of internal fixation devices, is controversial. Methods.  Over a 4-year period at 2 academic medical centers, patients with OHI who were treated with debridement and retention of hardware components, with single-stage exchange, or without surgery were studied to determine whether use of oral antibiotics for at least 6 months after diagnosis impacts successful treatment of the infection at 1 year after diagnosis...
October 2016: Open Forum Infectious Diseases
Yong-Qiang Deng, Na-Na Zhang, Chun-Feng Li, Min Tian, Jia-Nan Hao, Xu-Ping Xie, Pei-Yong Shi, Cheng-Feng Qin
The ongoing Zika virus (ZIKV) outbreaks have raised global concerns due to its unexpected clinical manifestations. Antiviral development is of high priority in response to the ZIKV emergency. In this study, we report that an adenosine analog NITD008 has potent in vitro and in vivo antiviral activity against ZIKV. The compound can effectively inhibit the historical and contemporary ZIKV strains in cultures as well as significantly reduce viremia and prevent mortality in A129 mice. Our results have demonstrated that NITD008 is potent inhibitor of ZIKV and can be used as reference inhibitor for future ZIKV antiviral drug screen and discovery...
October 2016: Open Forum Infectious Diseases
George M Carter, Aryan Esmaeili, Hardikkumar Shah, Debbie Indyk, Matthew Johnson, Michael Andreae, Henry S Sacks
People living with human immunodeficiency virus frequently use dietary supplements, including probiotics, but concern exists about ingesting live organisms. We performed a systematic review of the benefits of probiotics and a meta-analysis of sepsis risk. We undertook a protocol-driven, comprehensive review to identify all relevant studies, assess their quality, and summarize the evidence. Of 2068 references, 27 were analyzed. The data suggest possible benefits for CD4 count, recurrence or management of bacterial vaginosis, and diarrhea management...
October 2016: Open Forum Infectious Diseases
Joel T Katz, Shahram Khoshbin
No abstract text is available yet for this article.
October 2016: Open Forum Infectious Diseases
Jennifer P Collins, Lars F Westblade, Evan J Anderson
No abstract text is available yet for this article.
October 2016: Open Forum Infectious Diseases
Reyaud Rahman, Maria Jesus Sanchez Martin, Shamdeo Persaud, Nicolas Ceron, Dwayne Kellman, Lise Musset, Keith H Carter, Pascal Ringwald
Because of concerns about possible emergence of artemisinin resistance strains of Plasmodium falciparum in mining areas of the interior of Guyana, a 7-day artesunate trial was conducted from March to December 2014. The day-3 parasite clearance rate, the efficacy of artesunate at day 28, and polymorphism of Kelch 13 (PfK13)-the marker of artemisinin resistance-were assessed. The study confirmed the continued sensitivity of P falciparum to artemisinin. A 7-day course of artesunate was 100% efficacious with only 2% (95% confidence interval, ...
September 2016: Open Forum Infectious Diseases
Lei Zhou, Ruiqi Ren, Jianming Ou, Min Kang, Xiaoxiao Wang, Fiona Havers, Xiang Huo, Xiaoqing Liu, Qianlai Sun, Yongchao He, Bo Liu, Shenggen Wu, Yali Wang, Haitian Sui, Yongjie Zhang, Shaopei Tang, Caiyun Chang, Lunhui Xiang, Dong Wang, Shiguang Zhao, Suizan Zhou, Tao Chen, Nijuan Xiang, Carolyn M Greene, Yanping Zhang, Yuelong Shu, Zijian Feng, Qun Li
Background.  Human infections with avian influenza A(H7N9) virus have been associated with exposure to poultry and live poultry markets (LPMs). We conducted a case-control study to identify additional and more specific risk factors. Methods.  Cases were laboratory-confirmed A(H7N9) infections in persons in China reported from October 1, 2014 to April 30, 2015. Poultry workers, those with insufficient data, and those refusing participation were excluded. We matched up to 4 controls per case by sex, age, and residential community...
September 2016: Open Forum Infectious Diseases
Alan L Schooley, Pocha Samuel Kamudumuli, Sitaram Vangala, Chi-Hong Tseng, Chifundo Soko, Julie Parent, Khumbo Phiri, Andreas Jahn, Dan Namarika, Risa M Hoffman
Background.  Given the uncertainty about the ability of a single CD4 count to accurately classify a patient as antiretroviral therapy (ART) eligible, we sought to understand the extent to which CD4 variability results in misclassification at a CD4 threshold of 500 cells/mm(3). Methods.  We performed a prospective study of CD4 variability in Malawian human immunodeficiency virus-infected, ART-naive, World Health Organization (WHO) stage 1 or 2, nonpregnant adults. CD4 counts were performed daily for 8 days...
September 2016: Open Forum Infectious Diseases
Sanjiv M Baxi, Makeda L Robinson, Marie F Grill, Brian S Schwartz, Sarah B Doernberg, Catherine Liu
Little is known about the clinical presentation and outcomes associated with spinal implant infections. Here, we describe a single center's experience in a retrospective cohort of 109 individuals with spinal implant infections, including clinical, microbiological, therapeutic, and outcome data.
September 2016: Open Forum Infectious Diseases
Sahera Dirajlal-Fargo, Carlee Moser, Todd T Brown, Theodoros Kelesidis, Michael P Dube, James H Stein, Judith Currier, Grace A McComsey
Background.  Antiretroviral therapy (ART) can alter glucose metabolism, but little data exist on the association of raltegravir (RAL) with insulin resistance. Methods.  A5260s was a substudy of A5257, a prospective open-label randomized trial in which human immunodeficiency virus (HIV)-infected treatment-naive participants were randomized to tenofovir-emtricitabine (TDF/FTC) plus atazanavir-ritonavir (ATV/r), darunavir-ritonavir (DRV/r), or RAL over 96 weeks. Baseline and changes in insulin resistance as estimated by the homeostatic model assessment of insulin resistance (HOMA-IR) were assessed...
September 2016: Open Forum Infectious Diseases
Shereen Katrak, Lawrence P Park, Christopher Woods, Andrew Muir, Charles Hicks, Susanna Naggie
Background.  Hepatitis C virus (HCV) infection is a leading cause of cirrhosis and the primary cause of liver transplantation in the United States, and coinfection with human immunodeficiency virus (HIV) increases the risk of comorbidities. However, healthcare utilization (HCU) patterns among HIV/HCV-coinfected patients are poorly understood. This study compared the rates of HCU and reasons for hospital admission among HCV-infected, HIV-infected, and HIV/HCV-coinfected veterans. Methods.  Hepatitis C virus- and HIV-infected and HIV/HCV-coinfected veterans in care with the Department of Veterans Affairs (VA) from 1998 to 2009 (n = 335 371, n = 28 179, n = 13 471, respectively) were identified by HIV- and HCV-associated International Classification of Diseases, Ninth Revision codes from the clinical case registry...
September 2016: Open Forum Infectious Diseases
Nancy F Crum-Cianflone
Background.  Invasive aspergillosis may occur in the setting of severe influenza infections due to viral-induced respiratory epithelium disruption and impaired immune effects, but data are limited. Methods.  A retrospective study was conducted among severe influenza cases requiring medical intensive care unit (ICU) admission at an academic center during the 2015-2016 season. Data collected included respiratory cultures, medical conditions and immunosuppressants, laboratory and radiographic data, and outcomes...
September 2016: Open Forum Infectious Diseases
Lee M Hampton, Laurel Garrison, Jessica Kattan, Ellen Brown, Natalia A Kozak-Muiznieks, Claressa Lucas, Barry Fields, Nicole Fitzpatrick, Luis Sapian, Teresa Martin-Escobar, Stephen Waterman, Lauri A Hicks, Celia Alpuche-Aranda, Hugo Lopez-Gatell
Background.  A Legionnaires' disease (LD) outbreak at a resort on Cozumel Island in Mexico was investigated by a joint Mexico-United States team in 2010. This is the first reported LD outbreak in Mexico, where LD is not a reportable disease. Methods.  Reports of LD among travelers were solicited from US health departments and the European Working Group for Legionella Infections. Records from the resort and Cozumel Island health facilities were searched for possible LD cases. In April 2010, the resort was searched for possible Legionella exposure sources...
September 2016: Open Forum Infectious Diseases
Guillermo V Sanchez, Adam L Hersh, Daniel J Shapiro, James F Cawley, Lauri A Hicks
We examined US nurse practitioner (NP) and physician assistant (PA) outpatient antibiotic prescribing. Antibiotics were more frequently prescribed during visits involving NP/PA visits compared with physician-only visits, including overall visits (17% vs 12%, P < .0001) and acute respiratory infection visits (61% vs 54%, P < .001). Antibiotic stewardship interventions should target NPs and PAs.
September 2016: Open Forum Infectious Diseases
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