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Open Forum Infectious Diseases

Julia Kang Cornett, Vimal Bodiwala, Victor Razuk, Devangi Shukla, Navaneeth Narayanan
Background: Persons born between 1945 and 1965 account for an estimated 81% of those infected with hepatitis C virus (HCV) in the United States. However, up to 60% remain undiagnosed. Prior studies have reported HCV screening results from large urban emergency departments. Methods: This is a retrospective cohort study of patients in the 1945-1965 birth cohort tested for HCV in a large emergency department (ED) in New Jersey from June 1, 2016, through December 31, 2016...
April 2018: Open Forum Infectious Diseases
Marcos C Schechter, Destani Bizune, Michelle Kagei, David P Holland, Carlos Del Rio, Aliya Yamin, Omar Mohamed, Alawode Oladele, Yun F Wang, Paulina A Rebolledo, Susan M Ray, Russell R Kempker
Background: Antiretroviral therapy (ART) for persons with HIV infection prevents tuberculosis (TB) disease. Additionally, sequential ART after initiation of TB treatment improves outcomes. We examined ART use, retention in care, and viral suppression (VS) before, during, and 3 years following TB treatment for an inner-city cohort in the United States. Methods: Retrospective cohort study among persons treated for culture-confirmed TB between 2008 and 2015 at an inner-city hospital...
April 2018: Open Forum Infectious Diseases
Quratulain Kizilbash, Adriana Vasquez, Barbara Seaworth
We describe 2 young, female patients who developed drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome while on treatment for pulmonary tuberculosis (TB). Active TB was treated successfully with second-line TB medications, including moxifloxacin, ethambutol, linezolid, and amikacin for 18 months.
April 2018: Open Forum Infectious Diseases
Benjamin Seri, Albert Minga, Delphine Gabillard, Bamori Dembele, Seidou Konate, Jérôme Le Carrou, Lambert Dohoun, Yao Abo, Sophie Karcher, Patrick Coffie, Thérèse N'Dri-Yoman, Alain Attia, Serge P Eholié, Christine Danel, Karine Lacombe, Xavier Anglaret, Anders Boyd
Background: Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) share common risk factors. The parallel description of their frequency over time may help capture their similarities and differences. Methods: Using data from the National Transfusion Center of Abidjan, we estimated the following over a 20-year period: (1) the prevalence of HIV and hepatitis B surface antigen (HBsAg) positivity at first contact; and (2) the incidence of HIV and HBsAg seroconversion in negative first-time blood donors...
April 2018: Open Forum Infectious Diseases
Andrés F Henao-Martínez, Carlos Franco-Paredes, Alan G Palestine, Jose G Montoya
We report a family who acquired acute toxoplasmosis after a trip to Central America. One member developed severe clinical manifestations including bilateral chorioretinitis, hepatitis, and myocarditis requiring therapy. Symptomatic acute toxoplasmosis is unusual and possesses a diagnostic challenge. We discuss the clinical and epidemiological implications, laboratory diagnosis, and treatment plan.
April 2018: Open Forum Infectious Diseases
Asger D Krog, Johanna M Axelsson, Anna-Louise R Bondgaard, Jørgen A Kurtzhals
A healthy 72-year-old Danish male presenting with recurring sigmoid volvulus was found to be infested with Schistosoma mansoni . No other explanation for recurring volvulus was found. A travel history 12 years ago, which included bathing in the Botswana Okavango delta for 10 minutes, revealed the likely time and place of infection. To our knowledge, this is the first reported case of recurrent sigmoid volvulus and chronic intestinal schistosomiasis in a patient from a nonendemic area.
April 2018: Open Forum Infectious Diseases
Peter W Schreiber, Adrian Schmid, Stefania Fagagnini, Arne Kröger, Bart Vrugt, Cäcilia S Reiner, Katia Boggian, Marc Schiesser, Beat Müllhaupt, Huldrych F Günthard
Brucellosis is a common, worldwide zoonosis. Clinical presentation is protean and often goes unrecognized. Hepatic brucelloma is a rare local complication of chronic brucellosis. We report a case in which magnetic resonance imaging and positron emission tomography imaging prompted suspicion of a hepatic malignancy. Diagnosis was ultimately made by serology and polymerase chain reaction of resected liver tissue.
April 2018: Open Forum Infectious Diseases
Rickard Nordén, Jesper Magnusson, Anna Lundin, Ka-Wei Tang, Staffan Nilsson, Magnus Lindh, Lars-Magnus Andersson, Gerdt C Riise, Johan Westin
Background: Major hurdles for survival after lung transplantation are rejections and infectious complications. Adequate methods for monitoring immune suppression status are lacking. Here, we evaluated quantification of torque teno virus (TTV) and Epstein-Barr virus (EBV) as biomarkers for defining the net state of immunosuppression in lung-transplanted patients. Methods: This prospective single-center study included 98 patients followed for 2 years after transplantation...
April 2018: Open Forum Infectious Diseases
Benjamin J Eckhardt, Matthew Scherer, Emily Winkelstein, Kristen Marks, Brian R Edlin
Hepatitis C virus (HCV) is a significant public health problem that disproportionately afflicts people who inject drugs. We describe outcomes of HCV treatment co-located within a syringe services program (SSP). Fifty-three participants started therapy, and 91% achieved sustained virologic response. SSPs provide an effective venue for HCV treatment.
April 2018: Open Forum Infectious Diseases
Julianna G Gardner, Adriana M Rueda, Daniel M Musher
We describe 22 patients who developed pneumococcal pneumonia within 96 hours of respiratory tract instrumentation. In 59% of cases, the time to onset of symptoms was <24 hours. Instrumentation bypasses normal protective barriers and carries organisms directly to the lower airways, leading to the rapid development of pneumonia.
April 2018: Open Forum Infectious Diseases
Susy S Hota, Susan M Poutanen
Clostridium difficile infection, a common hospital-associated infection, is a gastrointestinal illness that becomes recurrent in about 25% of infected patients. Fecal microbiota transplantation (FMT) is increasingly supported by clinical trials as an effective treatment for recurrent Clostridium difficile infection, but a number of questions remain about how it can be optimally performed. In this Perspective, we discuss controversies in FMT methodologies and reporting within randomized controlled trials, all of which may influence clinical outcomes in treated patients...
March 2018: Open Forum Infectious Diseases
Nicholas A Turner, Rebekah Moehring, Christina Sarubbi, Rebekah H Wrenn, Richard H Drew, Coleen K Cunningham, Vance G Fowler, Deverick J Anderson
Background: Penicillin allergy frequently impacts antibiotic choice. As beta-lactams are superior to vancomycin in treating methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia, we examined the effect of reported penicillin allergy on clinical outcomes in patients with MSSA bacteremia. Methods: In this retrospective cohort study of adults with MSSA bacteremia admitted to a large tertiary care hospital, outcomes were examined according to reported penicillin allergy...
March 2018: Open Forum Infectious Diseases
Guillaume Mabileau, Otilia Scutelniciuc, Maia Tsereteli, Ivan Konorazov, Alla Yelizaryeva, Svetlana Popovici, Karimov Saifuddin, Elena Losina, Manoela Manova, Vinay Saldanha, Jean-Elie Malkin, Yazdan Yazdanpanah
Background: We evaluated the effectiveness and cost-effectiveness of interventions targeting hepatitis C virus (HCV) and HIV infections among people who inject drugs (PWID) in Eastern Europe/Central Asia. We specifically considered the needle-syringe program (NSP), opioid substitution therapy (OST), HCV and HIV diagnosis, antiretroviral therapy (ART), and/or new HCV treatment (direct acting antiviral [DAA]) in Belarus, Georgia, Kazakhstan, Republic of Moldova, and Tajikistan. Methods: We developed a deterministic dynamic compartmental model and evaluated the number of infections averted, costs, and incremental cost-effectiveness ratios (ICERs) of interventions...
March 2018: Open Forum Infectious Diseases
Kristin N Nelson, Carlos G Grijalva, Sopio Chochua, Paulina A Hawkins, Ana I Gil, Claudio F Lanata, Marie R Griffin, Kathryn M Edwards, Keith P Klugman, Jorge E Vidal
Background: Although asymptomatic carriage of Streptococcus pneumoniae ( Spn ) is common, acquisition of the bacteria is the first step in disease pathogenesis. We examined the effect of introduction of the 7-valent pneumococcal vaccine on Spn carriage patterns in a cohort of Peruvian children. Methods: We used data from a prospective cohort study that collected monthly nasopharyngeal samples from children under 3 years of age. Spn isolates were serotyped using Quellung reactions, and bacterial density was determined by quantitative polymerase chain reaction...
March 2018: Open Forum Infectious Diseases
Judith M Martin, Alejandro Hoberman, Nader Shaikh, Timothy Shope, S Onika Bhatnagar, Stan L Block, Mary Ann Haralam, Marcia Kurs-Lasky, Michael Green
Background: In children with acute otitis media (AOM), a decrease in nasopharyngeal (NP) colonization with vaccine serotypes of Streptococcus pneumoniae has been noted since the introduction of pneumococcal conjugate vaccines (PCVs). The purpose of this study is to describe corresponding changes in colonization with Haemophilus influenzae. Methods: In 4 separate studies, we obtained NP cultures from children aged 6-23 months presenting with AOM. Cohort 1 was recruited before routine use of PCV7 (1999-2000); 93% of children in cohort 2 (2003-2005) and 100% in cohort 3 (2006-2009) received ≥2 doses of PCV7...
March 2018: Open Forum Infectious Diseases
Yan Li, Ann George, Sami Arnaout, Jennifer P Wang, George M Abraham
Splenic infarction is a rare complication of infectious mononucleosis. We describe 3 cases of splenic infarction attributed to infectious mononucleosis that we encountered within a 2-month period. We underscore the awareness of this potential complication of infectious mononucleosis and discuss the differential diagnosis of splenic infarction, including infectious etiologies. While symptomatic management is usually sufficient for infectious mononucleosis-associated splenic infarction, close monitoring for other complications, including splenic rupture, is mandated...
March 2018: Open Forum Infectious Diseases
Angelo Clemenzi-Allen, Elvin Geng, Katerina Christopoulos, Hali Hammer, Susan Buchbinder, Diane Havlir, Monica Gandhi
Housing instability negatively impacts outcomes in people [living] with human immunodeficiency virus (PLHIV), yet the effect of diverse living arrangements has not previously been evaluated. Using 6 dwelling types to measure housing status, we found a strong inverse association between housing instability and viral suppression across a spectrum of unstable housing arrangements.
March 2018: Open Forum Infectious Diseases
Jason P Burnham, Margaret A Olsen, Dustin Stwalley, Jennie H Kwon, Hilary M Babcock, Marin H Kollef
Background: Multidrug-resistant organism (MDRO) infections are associated with high mortality and readmission rates. Infectious diseases (ID) consultation improves clinical outcomes for drug-resistant Staphylococcus aureus bloodstream infections. Our goal was to determine the association between ID consultation and mortality following various MDRO infections. Methods: This study was conducted with a retrospective cohort (January 1, 2006-October 1, 2015) at an academic tertiary referral center...
March 2018: Open Forum Infectious Diseases
David P Serota, Mary Elizabeth Sexton, Colleen S Kraft, Federico Palacio
Acinetobacter baumannii is a rare but emerging cause of fulminant community-acquired pneumonia (CAP-AB). We describe a patient from a rural area who developed acute respiratory distress syndrome and septic shock. We describe risk factors and characteristics of this syndrome and review published cases of CAP-AB from North America.
March 2018: Open Forum Infectious Diseases
Sarah Boudova, Katrina Mark, Samer S El-Kamary
Current guidelines recommend only hepatitis C virus (HCV) risk-based screening during pregnancy. We examined screening practices at a major medical center and found inconsistent risk-based screening and the presence of HCV among women with no known risk factors. We make a case for the implementation of universal HCV screening during pregnancy.
March 2018: Open Forum Infectious Diseases
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