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Open Forum Infectious Diseases

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https://www.readbyqxmd.com/read/29181424/comparative-effectiveness-of-prophylactic-strategies-for-perinatal-transmission-of-hepatitis-b-virus-a-network-meta-analysis-of-randomized-controlled-trials
#1
Zhi-Xian Chen, Xun Zhuang, Xiao-Hong Zhu, Yan-Li Hao, Gui-Fang Gu, Meng-Zhi Cai, Gang Qin
Background: Perinatal transmission is the main route of hepatitis B virus (HBV) transmission. While several measures have been attempted as means of preventing perinatal HBV transmission, the optimal strategy remains inconclusive. Methods: We conducted a comprehensive search, through December 2016, for randomized controlled trials (RCTs) that compared the following measures among pregnant women with HBV infection: placebo/none, active immunoprophylaxis (hepatitis B vaccine series starting at birth [HBVac]), passive-active immunoprophylaxis (hepatitis B immunoglobulin and vaccine [HBIG+HBVac]), prenatal HBIG administration (HBIG/HBIG+HBVac), and prenatal antiviral therapy (AVT/HBIG+HBVac)...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29181423/biliary-strongyloides-stercoralis-with-cholecystitis-and-extensive-portal-vein-thrombosis
#2
Laura M Filkins, David C Gaston, Blaine Mathison, Timothy Smith, Marc Roger Couturier, Ryan D Murphy, Claire Ciarkowski, Kimberly E Hanson, Paloma F Cariello
We report the rare finding of Strongyloides stercoralis rhabditiform larvae in biliary fluid, here associated with cholecystitis and near total portal vein thrombosis. The role of S. stercoralis leading to atypical clinical presentations and difficulty diagnosing strongyloidiasis in such patients with appropriate geographic exposure is discussed.
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29181422/carbapenem-resistant-enterobacteriaceae-infections-in-patients-on-renal-replacement-therapy
#3
Brandon Eilertson, Eric Cober, Sandra S Richter, Federico Perez, Robert A Salata, Robert C Kalayjian, Richard R Watkins, Yohei Doi, Keith S Kaye, Scott Evans, Vance G Fowler, Robert A Bonomo, Jack DeHovitz, Barry Kreiswirth, David van Duin
Background: Patients on chronic intermittent renal replacement therapy (RRT) are at risk for infection with carbapenem-resistant Enterobacteriaceae (CRE). However, the impact of RRT on outcomes after CRE infections remains to be defined. Here we perform a comparison of outcomes for CRE-infected patients with preserved renal function compared with CRE-infected patients on RRT. Methods: Cases and controls were defined from a prospective cohort of CRE-infected patients from the Consortium on Resistance against Carbapenems in Klebsiella and other Enterobacteriaceae (CRACKLE)...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29181421/sociodemographic-and-clinical-factors-associated-with-increasing-bacterial-sexually-transmitted-infection-diagnoses-in-men-who-have-sex-with-men-accessing-care-at-a-boston-community-health-center-2005-2015
#4
Kenneth H Mayer, Kevin M Maloney, Kenneth Levine, Dana King, Chris Grasso, Douglas S Krakower, Eli S Rosenberg, Stephen L Boswell
Background: The reasons why bacterial sexually transmitted infections (BSTIs) are increasing in US men who have sex with men (MSM) have not been fully characterized. Methods: An open cohort of MSM accessing medical care at a Boston community health center was used to assess secular trends in BSTI diagnoses. Frequency of infection and the estimated population size were used to calculate diagnosis rates. Poisson models were fit for multivariable analyses. Results: Between 2005 and 2015, 19 232 men had at least 1 clinic visit...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29181420/autoantibodies-to-granulocyte-macrophage-colony-stimulating-factor-associated-with-severe-and-unusual-manifestations-of-cryptococcus-gattii-infections
#5
Nancy F Crum-Cianflone, Pamela V Lam, Sarah Ross-Walker, Lindsey B Rosen, Steven M Holland
Cryptococcus gattii infections, especially including those with severe clinical manifestations, may be related to underlying host immunologic factors. We present 2 cases with autoantibodies to granulocyte-macrophage colony-stimulating factor (GM-CSF), a key cytokine in macrophage function. Immunologic evaluation for anti-GM-CSF antibodies may be important to inform management and counseling.
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29181419/decrease-in-seminal-hiv-1-rna-load-after-praziquantel-treatment-of-urogenital-schistosomiasis-coinfection-in-hiv-positive-men-an-observational-study
#6
Nicholas Midzi, Takafira Mduluza, Boniface Mudenge, Leslie Foldager, Peter D C Leutscher
Background: Urogenital schistosomiasis due to Schistosoma hematobium infection is hypothesized to cause increased HIV-1 RNA shedding in semen in HIV co-infected men as result of chronic egg-induced inflammation in the prostate and the seminal vesicles. The effect of treatment with the antihelminthic agent praziquantel on seminal HIV-1 RNA load was assessed in this study. Methods: HIV-1 RNA load was determined in blood plasma and semen at baseline and at 10-week follow-up...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29181418/asymptomatic-cardiovascular-syphilis-with-aortic-regurgitation-requiring-surgical-repair-in-an-hiv-infected-patient
#7
Daniel S Graciaa, Marina B Mosunjac, Kimberly A Workowski, Russell R Kempker
A 47-year-old man with HIV infection presented 10 years after initial secondary syphilis diagnosis and treatment for routine follow-up. His HIV was well controlled on antiretroviral therapy. Rapid plasma reagin was 1:1, and TP-PA was reactive. Physical examination revealed a wide pulse pressure, a systolic murmur, and an early diastolic decrescendo murmur. Echocardiogram revealed moderate to severe aortic regurgitation, and subsequent computed tomography angiogram showed a 6.8-cm fusiform aneurysm of the proximal ascending aorta...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29164170/impact-of-procalcitonin-guided-antibiotic-management-on-antibiotic-exposure-and-outcomes-real-world-evidence
#8
Michael R Broyles
Background: Delayed pathogen identification and nonspecific clinical findings make definitive decisions regarding antibiotics challenging. The stimuli of bacterial toxins and inflammation make procalcitonin (PCT) unique in its ability to differentiate bacterial infection from other causes of inflammation, and thus it is useful for antibiotic management. The objective of our study was to evaluate the impact of a PCT algorithm (PCT-A) on current practice. Methods: A single-center, retrospective cohort study was conducted to evaluate the impact of adding PCT-A to stewardship practices...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29164169/tuberculosis-patients-who-are-a-potential-source-for-unprotected-exposure-in-health-care-systems-a-multicenter-case-control-study
#9
Jose Cadena, Norys A Castro-Pena, Heta Javeri, Brian Hernandez, Joel Michalek, Ana Fuentes Arzola, Miloni Shroff, Chetan Jinadatha, Gustavo Valero, Jason Bowling, Jean Przykucki, Michele Adams, James Jorgensen, Jan E Patterson, Pranavi Sreeramoju
Setting: Five health care systems in Texas. Objective: To describe the epidemiology of inadequate isolation for pulmonary tuberculosis leading to tuberculosis (TB) exposures from confirmed TB patients and the patient factors that led to the exposures. Design: A retrospective cohort and case-control study of adult patients with TB resulting in exposures (cases) vs those TB patients who did not result in exposures (controls) during January 2005 to December 2012...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29164168/aids-related-endemic-mycoses-in-western-cape-south-africa-and-clinical-mimics-a-cross-sectional-study-of-adults-with-advanced-hiv-and-recent-onset-widespread-skin-lesions
#10
Ilan S Schwartz, Chris Kenyon, Rannakoe Lehloenya, Saskya Claasens, Zandile Spengane, Hans Prozesky, Rosie Burton, Arifa Parker, Sean Wasserman, Graeme Meintjes, Marc Mendelson, Jantjie Taljaard, Johann W Schneider, Natalie Beylis, Bonnie Maloba, Nelesh P Govender, Robert Colebunders, Sipho Dlamini
Background: Skin lesions are common in advanced HIV infection and are sometimes caused by serious diseases like systemic mycoses (SM). AIDS-related SM endemic to Western Cape, South Africa, include emergomycosis (formerly disseminated emmonsiosis), histoplasmosis, and sporotrichosis. We previously reported that 95% of patients with AIDS-related emergomycosis had skin lesions, although these were frequently overlooked or misdiagnosed clinically. Prospective studies are needed to characterize skin lesions of SM in South Africa and to help distinguish these from common HIV-related dermatoses...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29071284/characterizing-cefepime-neurotoxicity-a-systematic-review
#11
REVIEW
Ayesha A Appa, Rupali Jain, Robert M Rakita, Shahin Hakimian, Paul S Pottinger
Neurotoxicity due to cefepime has not been well characterized. We performed a systematic review of the literature and included 5 additional cases from our center. Of the 198 cases found, the mean age was 67 years and 87% of patients had renal dysfunction. The most common clinical features were diminished level of consciousness (80%), disorientation/agitation (47%), and myoclonus (40%). It is worth noting that nonconvulsive status epilepticus was relatively common with 31% of cases, whereas only 11% had convulsive seizures...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29062862/high-rates-of-occult-hepatitis-b-virus-infection-in-hiv-positive-individuals-initiating-antiretroviral-therapy-in-botswana
#12
Kathleen Ryan, Motswedi Anderson, Ivayla Gyurova, Lilliam Ambroggio, Sikhulile Moyo, Teresa Sebunya, Joseph Makhema, Richard Marlink, Max Essex, Rosemary Musonda, Simani Gaseitsiwe, Jason T Blackard
BACKGROUND: Hepatitis B surface antigen (HBsAg)-negative but hepatitis B virus (HBV) DNA-positive infection-known as occult hepatitis B infection (OBI)-occurs in 1% to >15% of HIV-positive individuals in the United States and South Africa, respectively. However, there are no data on OBI from Botswana, a country known to be hyperendemic for chronic HBV infection and to have a significant HIV burden. METHODS: Two hundred seventy-two adults enrolled in an HIV treatment study of tenofovir/emtricitabine as the nucleoside backbone who were previously determined to be HBsAg negative were tested for HBV DNA at baseline and 1 year after initiation of highly active antiretroviral therapy (HAART)...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29062861/pneumocystis-pcr-it-is-time-to-make-pcr-the-test-of-choice
#13
Laura Doyle, Sherilynn Vogel, Gary W Procop
BACKGROUND: The testing strategy for Pneumocystis at the Cleveland Clinic changed from toluidine blue staining to polymerase chain reaction (PCR). We studied the differences in positivity rates for these assays and compared each with the detection of Pneumocystis in companion specimens by cytology and surgical pathology. METHODS: We reviewed the results of all Pneumocystis test orders 1 year before and 1 year after the implementation of a Pneumocystis-specific PCR...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29062860/in-utero-art-exposure-and-birth-and-early-growth-outcomes-among-hiv-exposed-uninfected-infants-attending-immunization-services-results-from-national-pmtct-surveillance-south-africa
#14
Vundli Ramokolo, Ameena E Goga, Carl Lombard, Tanya Doherty, Debra J Jackson, Ingunn Ms Engebretsen
BACKGROUND: Despite the recognized benefit of antiretroviral therapy (ART) for preventing and treating HIV, some studies have reported adverse birth outcomes with in utero ART exposure. We evaluated the effect of infant in utero HIV and ART exposure on preterm delivery (PTD), low birth weight (LBW), small for gestational age (SGA), and underweight for age (UFA) at 6 weeks. METHODS: We surveyed 6179 HIV-unexposed-uninfected (HUU) and 2599 HIV-exposed-uninfected (HEU) infants...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29026872/top-questions-in-id-pre-exposure-prophylaxis-for-hiv
#15
Douglas S Krakower, Stephanie E Cohen, Kenneth H Mayer
HIV pre-exposure prophylaxis (PrEP) is highly efficacious at preventing HIV acquisition. This review discusses ways to identify candidates for PrEP, recommended PrEP regimens, baseline and follow-up evaluations, applications of PrEP for HIV-serodiscordant couples, resources to address financial barriers, investigational strategies for PrEP, and educational resources for clinicians and patients.
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29026871/tigecycline-as-a-second-line-agent-for-legionnaires-disease-in-severely-ill-patients
#16
Deepika Slawek, Diana Altshuler, Yanina Dubrovskaya, Eddie Louie
Treatment of Legionnaires' disease in severely ill or immunosuppressed patients presents a clinical challenge. Tigecycline (TG) achieves high concentrations intracellularly and has been shown to be effective against L. pneumophila in animal and cell models. We report our experience using TG as second-line therapy. Clinical response was seen in most patients after switching to TG alone or as a combination therapy.
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29026870/comparing-injecting-drug-users-with-others-receiving-outpatient-parenteral-antibiotic-therapy
#17
Pauline M Dobson, Mark R Loewenthal, Kellie Schneider, Katy Lai
No abstract text is available yet for this article.
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29026869/associations-between-antiretroviral-treatment-and-avascular-bone-necrosis-the-swiss-hiv-cohort-study
#18
Cornelia Bayard, Bruno Ledergerber, Markus Flepp, Thanh Lecompte, Estelle Moulin, Matthias Hoffmann, Rainer Weber, Cornelia Staehelin, Caroline Di Benedetto, Christoph A Fux, Philip E Tarr, Barbara Hasse
BACKGROUND: HIV-infected individuals have an increased risk of avascular bone necrosis (AVN). Antiretroviral therapy (ART) and particularly protease inhibitors (PI) have been implicated as a risk factor. We aimed to study the associations of ART with the occurrence of AVN among Swiss HIV Cohort Study participants (SHCS). METHODS: We used incidence density sampling to perform a case control study within the Swiss HIV Cohort Study (SHCS) comparing prospectively collected AVN cases and controls by conditional logistic regression analysis...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29026868/antifungal-susceptibility-testing-practices-at-acute-care-hospitals-enrolled-in-the-national-healthcare-safety-network-united-states-2011-2015
#19
Snigdha Vallabhaneni, Mathew Sapiano, Lindsey M Weiner, Shawn R Lockhart, Shelley Magill
We assessed availability of antifungal susceptibility testing (AFST) at nearly 4000 acute care hospitals enrolled in the National Healthcare Safety Network. In 2015, 95% offered any AFST, 28% offered AFST at their own laboratory or at an affiliated medical center, and 33% offered reflexive AFST. Availability of AFST improved from 2011 to 2015, but substantial gaps exist in the availability of AFST.
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29026867/prevalence-of-carbapenem-resistant-gram-negative-infections-in-the-united-states-predominated-by-acinetobacter-baumannii-and-pseudomonas-aeruginosa
#20
Bin Cai, Roger Echols, Glenn Magee, Juan Camilo Arjona Ferreira, Gareth Morgan, Mari Ariyasu, Takuko Sawada, Tsutae Den Nagata
BACKGROUND: Carbapenem-resistant (CR) Gram-negative pathogens are recognized as a major health concern. This study examined the prevalence of infections due to 4 CR Gram-negative species (Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Escherichia coli) in the United States and assessed their impact on hospital stays and mortality. METHODS: Hospitalized patients with laboratory-confirmed infection due to any of the 4 Gram-negative pathogens were identified from the Premier Healthcare Database...
2017: Open Forum Infectious Diseases
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