Background Healthcare workers (HCWs) are a priority group for coronavirus disease 2019 (COVID-19) and influenza vaccination. We evaluated sociodemographic and occupational factors, attitudes, and knowledge associated with the uptake of primary and booster doses of COVID-19 and seasonal influenza vaccines among HCWs. Methods Between February 2022 and February 2023, we administered a structured questionnaire

Objectives Neisseria meningitidis is primarily associated with severe systemic infections but can infect the eye and periocular tissues. Most meningococcal eye infections have a mild prognosis, but there is a significant increase in the risk of invasive disease. UK public health guidelines recommend chemoprophylaxis for meningococcal eye infection cases and contacts. This study involved a clinical

Background An effective therapeutic strategy for HBV cure remains an urgent unmet need. We aimed to define the incidence, kinetics and predictors of hepatitis B surface antigen (HBsAg) loss in people living with HIV and HBV (PLWH-HBV) following HBV-active antiretroviral therapy (ART) in PLWH-HBV in Asia. Method 97 PLWH-HBV commencing HBV-active ART were recruited prospectively in Thailand (n=94) and

Background Post-viral secondary bacterial infection, such as those caused by Streptococcus pneumoniae, are strongly associated with influenza and respiratory syncytial virus (RSV). However, data evaluating this relationship with coronavirus disease 2019 (COVID-19) is limited. Methods A retrospective analysis was conducted in hospitalized patients in Veterans Affairs (VA) Hospitals across the United

Background In vitro, meropenem is shown to restore the activity of rifampicin in rifampicin-resistant Mycobacterium tuberculosis strains. This phase 2a trial aimed to determine if addition of rifampicin increases the early bactericidal activity (EBA) of meropenem plus amoxicillin/clavulanate in patients with rifampicin-resistant tuberculosis (RR-TB). Methods Individuals with RR-TB were randomized to

Refractory disseminated coccidioidomycosis (DCM) is a severe disease with limited treatment options. This report reviews our own and prior published experiences using adjunctive interferon-γ therapy in refractory DCM, showing overall favorable responses in patients without Signal Transducer and Activator of Transcription 1 gain-of-function mutations.

Background Young children have a high risk of developing tuberculosis (TB) disease following infection with Mycobacterium tuberculosis (M.tb) in the absence of preventive treatment. Infection prevalence and risk factors for infection impact delivery of prevention strategies. We aimed to determine the prevalence of infection in child household contacts aged < 5 years exposed to adults with confirmed

People with HIV (PWH) have increased risk of complications from measles. Only 11.2% of 13,622 PWH in one U.S. clinic had presumptive measles immunity. The most significant correlates of seronegativity were younger age, white race, and CD4 count <200 cells/µL. Increasing measles immunity in PWH is essential given increasing outbreaks.

Background We report an interim analysis of safety and efficacy of pemivibart in individuals with (cohort A) or without (cohort B) significant immunocompromise in the phase 3 CANOPY trial. Methods Eligible participants (≥18 years; negative for current SARS-CoV-2 infection) received 2 intravenous 4500-mg pemivibart infusions (cohort A) or were randomized 2:1 to receive blinded pemivibart or placebo

Ethics is central to one-on-one and population-level infectious diseases care. To give home and voice to the full scope of infectious diseases ethics, from grand to granular, from bedside to global, we hereby inaugurate the Ethics Rounds section of Clinical Infectious Diseases.

From drug use in the hospital to patient-directed discharges and threatening behavior, challenging behaviors arise frequently in inpatients with infectious complications of substance use disorders (SUDs). The management of such challenging behaviors can bring key ethical values into tension and be susceptible to clinician bias. Here, we characterize the ethical tensions that emerge in the management

This article provides a focused update to the clinical practice guideline on the treatment and management of patients with COVID-19, developed by the Infectious Diseases Society of America. The guideline panel presents a recommendation on the use of vilobelimab in hospitalized adults with critical COVID-19. The recommendation is based on evidence derived from a systematic literature review and adheres

Background Diagnosis of infection with hepatitis C virus (HCV) is the first step to accessing curative treatment, yet many infected adults in the United States are unaware of their infection. Viral-first HCV testing strategies may improve diagnosis. We assessed the cost-effectiveness of several hepatitis C testing strategies compared with the currently recommended testing algorithm. Methods We used

Background To mitigate the risk of circulating vaccine-derived poliovirus type 2 (cVDPV2) establishment and associated paralytic cases, oral polio vaccine 2 was globally withdrawn from the routine immunization schedule in 2016, soon after the certification of wild poliovirus type 2 eradication. We investigated the epidemiology of cVDPV2 outbreak and impact of type 2 immunization response in Pakistan

Background Arterial catheter-drawn blood culture sampling may reduce patient discomfort and healthcare providers’ workload. Guidelines discourage transcatheter blood culture collection due to contamination risks, mainly derived from data on venous catheter-drawn cultures. However, contamination rates of arterial catheter-drawn cultures have not been comprehensively evaluated compared with venipuncture-

Background Bloodstream infections (BSI) caused by carbapenem-resistant gram-negative bacilli (CR-GNB) are difficult-to-treat infections associated with high mortality. Outcomes of BSI due to CR-GNB may vary in different countries. Methods Prospective observational, multicentric study, including consecutive hospitalized index patients aged ≥18 years, with a positive blood culture for CR-GNB, between

Background Hepatitis A virus infection (HAV), hepatitis B virus infection (HBV), and tetanus are important vaccine-preventable infections among individuals with substance use disorder (SUD). Hospitalizations may represent opportunities for preventive care. Up-to-date data on screening and vaccination practices for this high-risk population are needed in these settings. Methods In a retrospective cohort

Dolutegravir resistance is an increasing concern. An analysis of the DTG RESIST study found that among 227 integrase sequences from 7 African countries (all non-B subtypes), 59 (26.0%) had at least 1 major drug resistance mutation (primarily G118R and E138A/K/T), with 49 (21.6%) predicted to have high-level resistance to dolutegravir.

Background Doxycycline is a frequently used alternative treatment for community-acquired pneumonia in hospitalized patients, but the evidence base is limited. The study aimed to compare outcomes in community-acquired pneumonia patients treated with doxycycline or azithromycin in combination with beta-lactams. Methods We evaluated patients with community-acquired pneumonia admitted to Mayo Clinic hospitals

Background Despite tuberculosis being a well-known concern in advanced HIV patients, the STATIS trial, which focused on its management, highlighted significant mortality rates. Histoplasmosis, a fungal disease endemic in sub-Saharan Africa, presents with similar clinical manifestations as of tuberculosis. Therefore, it may be prevalent and potentially responsible for deaths in advanced HIV patients

Background Tuberculosis preventive treatment (TPT) is highly effective at preventing tuberculosis (TB) disease but is poorly implemented. We aimed to determine whether home-based contact management improves TPT uptake among close child contacts compared to the facility-based standard of care. Methods We conducted a pragmatic cluster-randomized trial among close contacts of TB clients aged <15 years

BACKGROUND It is not recommended to perform tuberculin skin tests (TSTs) or interferon-γ release assays (IGRAs) in the 4 weeks following live-virus vaccination because these vaccines are thought to increase the risk of false-negative results. METHODS We retrospectively analyzed TST and IGRA results for 158 484 US-bound immigrant and refugee children aged 2-14 years who received a required medical examination

This multicenter study highlights the critical role of ID pharmacists in supporting ID consult services, with 89% of 1,518 curbside inquiries from ID clinicians resulting in clinical management changes as recommended by the pharmacist. These findings emphasize the necessity of ID pharmacists in optimizing multidisciplinary patient care.

Herpes simplex virus (HSV) reactivation and acyclovir resistance are common complications in immunocompromised individuals. We report a pediatric hematopoietic stem cell transplantation (HSCT) recipient who received HSV-1-specific T cells from a partially human leukocyte antigen (HLA) matched donor for severe acyclovir-resistant HSV-1 mucositis resulting in clinical improvement, reduced plasma viral

Background The impact of long-term virological suppression and CD4 count recovery on non-AIDS defining cancers (NADC) is unclear. We determined whether poor immune recovery was associated with incident cancer risk in people with HIV with virological suppression (VS). Methods Participants from the D:A:D and RESPOND collaborations in Europe and Australia who achieved ≥2 years of VS on ART between Dec

BACKGROUND Infectious diseases (ID) physicians play a crucial role in public health emergencies. Effective collaboration between public health agencies and healthcare providers is essential for a coordinated response. However, there is limited information on how ID physicians and health departments collaborate and which areas need to be improved. Here, we identify ways to enhance public health preparedness

Background Data on the epidemiology of healthcare facility-associated (HCFA) nontuberculous mycobacteria (NTM) are sparse. We performed a multicenter longitudinal cohort study of HCFA NTM epidemiology. Methods We retrospectively analyzed positive cultures for NTM performed from 2012 through 2020 within a network of 10 US academic hospitals and associated clinics. A unique NTM episode was defined as

Background Reliable information on the burden of antimicrobial resistance (AMR) is necessary to confront the threat of antimicrobial resistance. We sought to examine the association between AMR and mortality across cultured bacterial bloodstream pathogens in the province of Ontario, Canada. Methods We used linked microbiology data from 114 hospital, community, and public health laboratories to develop

Background WHO recommends 2 doses of HPV vaccine for adults without HIV but 3 doses in persons with HIV. There are no immunogenicity data on the 2 doses schedule in women with HIV (WWH). Methods Prospective study comparing 2 (month (M) 0,6) versus 3 (M 0,2,6) doses of 9-valent (9v) vaccine (Gardasil9®MSD) in WWH (15-40 years), on antiretrovirals with HIVRNA<400cp/ml; enrollment 2018-2021. After an

People with HIV may be at increased risk for long COVID after acute SARS-CoV-2 infection. We investigated the association between HIV and long COVID in two large electronic health record databases. Using data from the Patient-Centered Clinical Research Network (PCORnet) and the National Clinical Cohort Collaborative (N3C) from 1/1/2018 to 4/30/2024, our analytic sample included individuals aged ≥21

Background Limited diagnostic access in resource-limited settings contributes to poor health outcomes among bacterial sepsis patients and the spread of antimicrobial resistance (AMR). Molecular diagnostic profiling of AMR may enable faster targeting of antibiotic therapies, improving clinical outcomes, reducing AMR development, and saving costs. Methods We modeled the impact of a culture-dependent

Background Bedaquiline-based oral short-course regimens (SCR) for rifampicin-resistant tuberculosis (RR-TB) are highly effective in clinical trials but outcomes in programmatic settings may be more modest. We evaluated clinical and bacteriological outcomes with a seven-drug, linezolid-containing SCR in a high-burden programmatic setting. Methods This prospective cohort study enrolled adults with newly

Background Over 200,000 pregnant people fall ill with tuberculosis (TB) annually. Little is known about the impact of pregnancy on TB outcomes. Methods This study used surveillance data from Brazil’s Ministry of Health. We included women 11-49 years old newly diagnosed with drug-susceptible TB disease between 2016-2022, treated with a first-line anti-TB regimen, and with a known treatment outcome.

Doxycycline post-exposure prophylaxis (doxy-PEP) reduced bacterial sexually transmitted infection (STI) incidence in a sexual health clinic over 96 weeks (n=4,592; 2,524 on doxy-PEP), particularly for chlamydia and syphilis, with smaller effects for gonorrhea. Continued surveillance for gonorrhea and antibiotic resistance is essential to evaluate doxy-PEP’s long-term effectiveness.

Background Due to high prevalence of Kaposi Sarcoma (KS)-Associated Herpesvirus (KSHV) among people with HIV, KSHV-associated disease (KAD) may be increased after kidney transplantation from donors with HIV (HIV D+) to recipients with HIV (HIV R+). Methods Anti-KSHV antibodies were measured in HIV R+ and donors with and without HIV (HIV D-) using a 30-antigen multiplex assay within three multicenter

Background Risk factors for severe respiratory syncytial virus (RSV) illness include early infancy, premature birth, and underlying medical conditions. However, the clinical significance of respiratory viral co-detection is unclear. We compared the clinical outcomes of young children with RSV-only detection and those with RSV viral co-detection. Methods We conducted active, population-based surveillance

Background The 2021 update of the CDC clinical guidelines for HIV preexposure prophylaxis (PrEP) recommended both antigen/antibody (Ag/Ab) and RNA testing at PrEP initiation and routine follow-up. We assessed real-world utilization and performance of HIV tests among oral PrEP users. Methods An oral PrEP user cohort was constructed using the HealthVerity database that included linked diagnoses, laboratory

Background Cytomegalovirus (CMV) infection is a leading complication following hematopoietic stem cell transplant (HSCT) and solid organ transplant (SOT). Virus-specific T-cells (VST) have been used for the prophylaxis and treatment of CMV infections. We conducted a scoping review to catalogue and characterize the existing literature. Methods Systematic searches were performed in collaboration with

Nocardiosis is an uncommon yet potentially devastating infection. Nocardia tends to affect individuals with chronic lung disease or immunocompromising conditions, 2 groups increasing in number. Incidence of nocardiosis is likely to increase as well, and it is vital to have an approach to this complex disease. Here, we aim to review the presentation, diagnosis, and management of Nocardia in the modern

BACKGROUND Current methods are insufficient alone for outbreak detection in hospitals. Real-time genomic surveillance offers the potential to detect otherwise unidentified outbreaks. We initiated and evaluated the Enhanced Detection System for Healthcare-associated Transmission (EDS-HAT), a real-time genomic surveillance program for outbreak detection and mitigation. METHODS This study was conducted

Background Nursing home (NH) residents are susceptible to healthcare-associated infections (HAIs). Alignment among NHs, hospitals, and health departments is critical for effective implementation of infection prevention efforts. We tested a collaborative model that engaged hospitals and NHs to reduce infections among NH residents. Methods We recruited 92 NHs and 15 hospitals over four 12-month cohorts

Background Transmitted drug resistance (TDR) may compromise the effect of antiretroviral therapy (ART), highlighting the necessity for continuous monitoring. Methods The study was conducted across 31 provincial-level administrative divisions of China. Demographic information and blood samples were collected from participants at diagnosis of human immunodeficiency virus (HIV) infection between April

Background Studies have demonstrated an inverse log-linear relationship between body mass index (BMI) and tuberculosis incidence. However, a person’s BMI is dynamic and longitudinal changes may be more informative than cross-sectional assessments. We evaluate the association between cross-sectional and changing BMI and risk of tuberculosis and describe longitudinal trajectories in a high-risk cohort

Background There is limited data to support routine remdesivir use in the contemporary era of SARS-CoV-2 with widespread seropositivity. Methods A restriction of remdesivir among adult immunocompetent patients was implemented across an 8-hospital health system. A pre-post quasi-experimental design was used to compare patients 12 months pre-intervention (June 2022 - May 2023) to 12 months post-intervention