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Open Forum Infectious Diseases

Nicolas Cazals, Quentin Le Hingrat, Bruno Abraham, Patricia Da Silva, Laure Guindre, Sylvie Goffart, Florence Damond, Benoît Visseaux, Charlotte Charpentier, Sylvie Ranger-Rogez, Diane Descamps
More than 1 million individuals, mainly in West Africa, are thought to be infected with HIV-2. Acute HIV-2 infection is rarely observed, only 2 primary infections have been described to date. We report a detailed case of HIV-2 primary infection in a 69-year-old French bisexual Caucasian man, thereby providing valuable insights into HIV-2 early infection.
October 2018: Open Forum Infectious Diseases
Safa S Almarzoky Abuhussain, Michelle A Burak, Danyel K Adams, Kelsey N Kohman, Serina B Tart, Athena L V Hobbs, Gabrielle Jacknin, Michael D Nailor, Katelyn R Keyloun, David P Nicolau, Joseph L Kuti
Background: Acute bacterial skin and skin structure infections (ABSSSIs) are a frequent cause of emergency department (ED) visits. Providers in the ED have many decisions to make during the initial treatment of ABSSSI. There are limited data on the patient factors that influence these provider decisions. Methods: An anonymous survey was administered to providers at 6 EDs across the United States. The survey presented patient cases with ABSSSIs ≥75 cm2 and escalating clinical scenarios including relapse, controlled diabetes, and sepsis...
October 2018: Open Forum Infectious Diseases
Susan E Cohn, Lisa B Haddad, Anandi N Sheth, Christina Hayford, Joan S Chmiel, Patrick F Janulis, Justin Schmandt
Background: In 1988, 1 of 3 women (W) and heterosexual men living with human immunodeficiency virus (HIV) reported wanting children, but little is known about parenting desires of men who have sex with men (MSM) living with HIV. We examined parenting desires among persons initiating antiretroviral therapy (ART). Methods: Of 1809 participants in the AIDS Clinical Trials Group (ACTG) Study 5257, 1425 W aged ≤45 years or men completed questionnaires about parenting desires at baseline and 96 weeks after initiating ART...
October 2018: Open Forum Infectious Diseases
Atibordee Meesing, Raymund R Razonable
This study of 64 solid organ and hematopoietic stem cell transplant recipients found that peripheral blood absolute lymphocyte count of <610 and <830/µL, respectively, correlated with cytomegalovirus infection. In an era when sophisticated measures of CMV-specific T cells are emerging, we emphasize the utility of the inexpensive and readily-available absolute lymphocyte count.
October 2018: Open Forum Infectious Diseases
Ling-Hong Zhou, Xuan Wang, Rui-Ying Wang, Hua-Zhen Zhao, Ying-Kui Jiang, Jia-Hui Cheng, Li-Ping Huang, Zhong-Qing Chen, De-Hui Wang, Li-Ping Zhu
Background: Chronic and granulomatous invasive fungal rhinosinusitis are important causes of blindness and craniocerebral complications. However, the classification of these 2 diseases remains controversial. Methods: We retrospectively analyzed patients with chronic and granulomatous invasive fungal rhinosinusitus in a Chinese tertiary hospital from 2009 to 2017, with a focus on classification and comparisons. Results: Among 55 patients enrolled in our study, 11 (11/55, 20%) had granulomatous invasive fungal rhinosinusitis (GIFRS) and 44 (44/55, 80%) had chronic invasive fungal rhinosinusitis (CIFRS)...
October 2018: Open Forum Infectious Diseases
Valeria Fabre, Theodore Markou, Anna Sick-Samuels, Clare Rock, Edina Avdic, Stephanie Shulder, Kathryn Dzintars, Heather Saunders, Jennifer Andonian, Sara E Cosgrove
Background: Approaches to changing providers' behavior around Clostridium difficile (CD) management are needed. We hypothesized that case-specific teaching points and face-to-face discussions with prescribers and nurses would improve management of patients with a positive CD test. Methods: Charts of patients age ≥18 years with positive CD tests hospitalized July 2016 to May 2017 were prospectively reviewed to assess CD practices and generate management recommendations...
October 2018: Open Forum Infectious Diseases
Briann Fischetti, Kushal Shah, David R Taft, Leonard Berkowitz, Anjali Bakshi, Agnes Cha
Background: Although nucleoside reverse transcriptase inhibitors have been associated with lactic acidosis, lamivudine (3TC) has not been reported to have an increased risk with elevated concentrations. Therefore, some recommend that the lowest tablet strength of 3TC be considered in patients with kidney disease to avoid the inconvenience of liquid formations. Our institution avoids dose-adjusting 3TC until creatinine clearance (CrCl) <30 mL/min and uses 100-150-mg tablets daily in hemodialysis...
October 2018: Open Forum Infectious Diseases
Teena Chopra, Christopher Rivard, Reda A Awali, Amar Krishna, Robert A Bonomo, Federico Perez, Keith S Kaye
Background: Residents of long-term acute care hospitals (LTACHs) are considered important reservoirs of multidrug-resistant organisms, including Carbapenem-resistant Enterobacteriaceae (CRE). We conducted this study to define the characteristics of CRE-infected/colonized patients admitted to an LTACH and the molecular characteristics of the CRE isolates. Methods: This retrospective study was conducted to collect information on demographic and comorbid conditions in CRE-colonized/infected patients admitted to a 77-bed LTACH in Detroit between January 2011 and July 2012...
October 2018: Open Forum Infectious Diseases
Mona Marin, Tricia L Kitzmann, Lisa James, Patricia Quinlisk, Wade K Aldous, John Zhang, Cristina V Cardemil, Chris Galeazzi, Manisha Patel, Ismael R Ortega-Sanchez
Background: The United States is experiencing mumps outbreaks in settings with high 2-dose measles-mumps-rubella (MMR) vaccine coverage, mainly universities. The economic impact of mumps outbreaks on public health systems is largely unknown. During a 2015-2016 mumps outbreak at the University of Iowa, we estimated the cost of public health response that included a third dose of MMR vaccine. Methods: Data on activities performed, personnel hours spent, MMR vaccine doses administered, miles traveled, hourly earnings, and unitary costs were collected using a customized data tool...
October 2018: Open Forum Infectious Diseases
Pranavi Sreeramoju, Lucia Dura, Maria E Fernandez, Abu Minhajuddin, Kristina Simacek, Thomas B Fomby, Bradley N Doebbeling
Background: Health care-associated infections (HAIs) are a socio-technical problem. We evaluated the impact of a social change intervention on health care personnel (HCP), called "positive deviance" (PD), on patient safety culture related to infection prevention among HCP. Methods: This observational study was done in 6 medical wards at an 800-bed public academic hospital in the United States. Three of these wards were randomly assigned to receive PD intervention on HCP...
October 2018: Open Forum Infectious Diseases
Jake R Morgan, Tamar F Barlam, Mari-Lynn Drainoni
Background: Antibiotic-resistant bacterial infections are a major threat to public health, yet improper use of antibiotics remains high. Infectious Diseases (ID) fellows play a major role in antibiotic stewardship efforts, but there is little research on how they view stewardship activities. We performed a qualitative study to explore ID fellows' experiences and perspectives regarding their antibiotic stewardship training and their role as future antibiotic stewards. Methods: We conducted 17 in-depth interviews with ID fellows across the country...
September 2018: Open Forum Infectious Diseases
Joanne D Stekler, Lauren R Violette, Lisa Niemann, Vanessa M McMahan, David A Katz, Jared M Baeten, Robert M Grant, Kevin P Delaney
Regular HIV testing is required to ensure the safety of HIV pre-exposure prophylaxis (PrEP). We describe and discuss a series of false-positive HIV test results from an individual receiving PrEP. The expansion of PrEP will likely result in greater numbers of false-positive test results that may pose challenges for interpretation.
September 2018: Open Forum Infectious Diseases
Catharine Chambers, Danuta M Skowronski, Caren Rose, Gaston De Serres, Anne-Luise Winter, James A Dickinson, Agatha Jassem, Jonathan B Gubbay, Kevin Fonseca, Steven J Drews, Hugues Charest, Christine Martineau, Martin Petric, Mel Krajden
We investigated sex as a potential modifier of influenza vaccine effectiveness (VE) between 2010-2011 and 2016-2017 in Canada. Overall VE was 49% (95% confidence interval [CI], 43% to 55%) for females and 38% (95% CI, 28% to 46%) for males (absolute difference [AD], 11%; P = .03). Sex differences were greatest for influenza A(H3N2) (AD, 17%; P = .07) and B(Victoria) (AD, 20%; P = .08) compared with A(H1N1)pdm09 (AD, 10%; P = .19) or B(Yamagata) (AD, -3%; P = .68). They were also more pronounced in older adults ≥50 years (AD, 19%; P = ...
September 2018: Open Forum Infectious Diseases
J E Sherbuk, K A McManus, E T Rogawski McQuade, T Knick, Z Henry, R Dillingham
Background: Hepatitis C is now curable for most individuals, and national goals for elimination have been established. Transmission persists, however, particularly in nonurban regions affected by the opioid epidemic. To reach goals of elimination, barriers to treatment must be identified. Methods: In this open cohort of all individuals diagnosed with active hepatitis C from 2010 to 2016 at a large medical center, we identified patient and clinic characteristics associated with our primary outcome, sustained virologic response (SVR)...
September 2018: Open Forum Infectious Diseases
(no author information available yet)
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September 2018: Open Forum Infectious Diseases
Andreas Knudsen, Kristina Thorsteinsson, Thomas E Christensen, Philip Hasbak, Rasmus Sejersten Ripa, Inge Panum, Anne-Mette Lebech, Andreas Kjaer
Background: People living with HIV (PLWH) appear to be at increased risk of cardiovascular disease (CVD), and this is possibly more pronounced in women living with HIV (WLWH). In the general population, men are more likely to develop obstructive coronary artery disease (CAD), and women often present with a nonobstructive pattern with cardiac microvascular dysfunction. We investigated cardiac microvascular function in men and women living with HIV and tested for association with cytomegalovirus (CMV) immunoglobulin G (IgG), as this has been associated with CVD in PLWH...
September 2018: Open Forum Infectious Diseases
Simon Agolory, Michael de Klerk, Andrew L Baughman, Souleymane Sawadogo, Nicholus Mutenda, Ndumbu Pentikainen, Naemi Shoopala, Adam Wolkon, Negussie Taffa, Gram Mutandi, Anna Jonas, Assegid Tassew Mengistu, Edington Dzinotyiweyi, Dimitri Prybylski, Ndapewa Hamunime, Amy Medley
Background: In 2015, Namibia implemented an Acceleration Plan to address the high burden of HIV (13.0% adult prevalence and 216 311 people living with HIV [PLHIV]) and achieve the UNAIDS 90-90-90 targets by 2020. We provide an update on Namibia's overall progress toward achieving these targets and estimate the percent reduction in HIV incidence since 2010. Methods: Data sources include the 2013 Namibia Demographic and Health Survey (2013 NDHS), the national electronic patient monitoring system, and laboratory data from the Namibian Institute of Pathology...
September 2018: Open Forum Infectious Diseases
Joji Suzuki, Jennifer Johnson, Mary Montgomery, Margaret Hayden, Christin Price
Hospitalizations for people who inject drugs (PWID) with infectious complications requiring prolonged antibiotic therapy are increasing in the context of the opioid epidemic. Although outpatient parenteral antimicrobial therapy (OPAT) is routinely offered to patients without a history of injection drug use (IDU), PWID are often excluded from consideration of OPAT. To better assess the evidence base for the safety and effectiveness of OPAT for PWID, we conducted a review of the published literature. Results suggest that OPAT may be safe and effective for PWID, with rates of OPAT completion, mortality, and catheter-related complications comparable to rates among patients without a history of IDU...
September 2018: Open Forum Infectious Diseases
George A Yendewa, Eva Poveda, Sulaiman Lakoh, Sahr A Yendewa, Darlinda F Jiba, Angel Salgado-Barreira, Foday Sahr, Robert A Salata
A high prevalence of late-stage disease (75.4%) and severe immunosuppression (23.3%) was observed in 155 newly diagnosed human immunodeficiency virus patients in Freetown, Sierra Leone during August to November 2017. Within the late-stage diagnosis group, a significantly high proportion of patients reported fever (84.2% vs 65.2%; P = .01), weight loss (82.2% vs 63.5%; P = .01), and malaise (89.7% vs 71.7%; P = .05). Fever was identified as the only independent predictor of late-stage disease in this study.
September 2018: Open Forum Infectious Diseases
Chanu Rhee, Rui Wang, Maximilian S Jentzsch, Heather Hsu, Alison Tse Kawai, Robert Jin, Kelly Horan, Carly Broadwell, Grace M Lee
In July 2012, the Centers for Medicare & Medicaid Services ceased hospital Medicaid reimbursements for certain health care-acquired conditions. Using billing data from 2008-2014, we found no impact of this policy on rates of 2 targeted conditions, vascular catheter-associated infections and catheter-associated urinary tract infections, among Medicaid or non-Medicaid patients.
September 2018: Open Forum Infectious Diseases
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