Volume 70, Issue 12, 15 June 2020
In The Literature
ARTICLES AND COMMENTARIES
Cost-effectiveness of an Environmental Cleaning Bundle for Reducing Healthcare-associated Infections
We evaluated the cost-effectiveness of an environmental cleaning bundle for preventing healthcare-associated infections. Compared with current hospital cleaning practices, bundle implementation was cost-effective at $4684 per quality-adjusted life-years based on predicted reductions in Staphylococcus aureus bacteremia and vancomycin-resistant infection rates.
In a study of 203 patients with suspected central nervous system infections, cranial computed tomography was done prior to lumbar puncture in the majority of patients, irrespective of guideline indications, and was not associated with treatment delays.
Case Fatality Ratio Estimates for the 2013–2016 West African Ebola Epidemic: Application of Boosted Regression Trees for Imputation
Corrected for imperfect imputation, boosted regression trees generated more representative case fatality ratio estimates than could be obtained without imputation. These estimates, used in tandem with other resources, are essential for public health planning and evaluation in resource-poor settings.
Early Impact of 13-Valent Pneumococcal Conjugate Vaccine Use on Invasive Pneumococcal Disease Among Adults With and Without Underlying Medical Conditions—United States
Following introduction of pneumococcal conjugate vaccine in the United States, incidence of invasive pneumococcal disease declined through herd effects among adults with and without underlying medical conditions. Invasive pneumococcal disease cases were identified among adults ≥19?years old through Active Bacterial Core surveillance (ABCs), an active, laboratory/population-based system established by the Centers for Disease Control and Prevention’s (CDC) Emerging Infections Program with approximately 23.2 million adults. A?case was defined as isolation of pneumococcus from a sterile site (eg, blood, cerebrospinal fluid) in a resident of an ABCs area .
Projected Population Benefit of Increased Effectiveness and Coverage of Influenza Vaccination on Influenza Burden in the United States
Mathematical modeling demonstrated how increases in influenza vaccine effectiveness or coverage during influenza seasons of varying severity would result in substantial reductions to influenza-associated illnesses, medically attended illnesses, and hospitalizations in the United States.
Viral Shedding in Recipients of Live Attenuated Influenza Vaccine in the 2016–2017 and 2017–2018 Influenza Seasons in the United Kingdom
We observed differences in (H1N1)pdm09 vaccine virus shedding rates with a change in the (H1N1)pdm09 live attenuated influenza vaccine strain. We show that age and vaccination history impact shedding levels.
Effectiveness of the Live Attenuated Influenza Vaccine: Was the Addition of the Second Type B Lineage a Step Too Far?
Leading causes of childhood encephalitis are epidemic enteroviruses/parechovirus or bacterial in infants; influenza, herpes simplex virus, or enteroviruses in children; and immune-mediated or Mycoplasma pneumoniae in older children/adolescents. Cause was unknown in 17%. Death (5%) and short-term neurological morbidity (27%) were frequent.
Reductions in Methicillin-resistant Staphylococcus aureus, Clostridium difficile Infection and Intensive Care Unit–Acquired Bloodstream Infection Across the United Kingdom Following Implementation of a National Infection Control Campaign
This study provides evidence for a large intensive care unit (ICU) population–level reduction in all significant ICU-acquired bloodstream infections across the UK ICU network between 2007 and 2012 in conjunction with the implementation of a national infection control program.
Serologic Markers of Previous Malaria Exposure and Functional Antibodies Inhibiting Parasite Growth Are Associated With Parasite Kinetics Following a Plasmodium falciparum Controlled Human Infection
In this controlled human malaria infection study with Plasmodium falciparum sporozoite challenge, individuals with serological evidence of higher recent and cumulative malaria exposure had a longer prepatent period, lower mean parasite density at the time of treatment, and fewer symptoms of malaria.
Each Additional Day of Antibiotics Is Associated With Lower Gut Anaerobes in Neonatal Intensive Care Unit Patients
In neonatal intensive care unit patients who received 3 common antibiotic regimens, each additional day of therapy was associated with 16% lower gut anaerobes within 1 week postantibiotic exposure, after adjustment for known variables of gut microbiota diversity.
Prior to mass drug administration, we estimate that lymphatic filariasis (LF) cost 5.25 million disability-adjusted life years and US $5.765 billion annually. The high burden of LF without control demonstrates the need for the Global Programme to Eliminate LF.
Safety and Immunogenicity of a Second Dose of an Investigational Maternal Trivalent Group B Streptococcus Vaccine in Nonpregnant Women 4–6 Years After a First Dose: Results From a Phase 2 Trial
A second dose of the investigational trivalent group B streptococcus (GBS) vaccine, given 4–6 years after the first dose, elicited a robust immune response for each vaccine serotype in nonpregnant women, including in those with undetectable predose 1 anti-GBS antibody levels.
Many cervical intraepithelial neoplasias (CINs) regress spontaneously or persist, but to date there is no method to predict progression. In this study, we show that a DNA methylation classifier can predict progression or regression of untreated CIN grade 2.
Posaconazole-induced pseudohyperaldosteronism is associated with higher posaconazole serum concentrations, which are correlated with increased blood pressure, decreased potassium, and an increase in 11-deoxycortisol.
Neural tube defects have been reported among infants born from women taking a wide range of antiretrovirals in 4 pharmacovigilance databases. Safety reports were inconsistent between databases and very hard to interpret
Long-term Impact of Pneumococcal Conjugate Vaccines on Invasive Disease and Pneumonia Hospitalizations in Indigenous and Non-Indigenous Australians
Prevalence of Hepatitis B Virus Infection Among US Adults Aged 20–59 Years With a History of Injection Drug Use: National Health and Nutrition Examination Survey, 2001–2016
From 2001–2016, 4.6% of 163 million US adults, and 19.7% of 4.9 million with an injection drug use (IDU) history, had histories of hepatitis B virus infection. This represents 7.6 million adults, including 970?000 with IDU histories.
We identified multiple pathogenic clinical isolates of Clostridioides difficile that produced high levels of toxin A?but minimal or no toxin B, highlighting the pathogenic significance of toxin A?and implications for C.?difficile infection diagnoses, treatment, and vaccine development.
Interleukin (IL)-1β and IL-10 Host Responses in Patients With Staphylococcus aureus Bacteremia Determined by Antimicrobial Therapy
In this study, we evaluate the host cytokines interleukin (IL)-1β and IL-10 response in the first 7?days of Staphylococcus aureus bacteremia (SaB) treatment. β-lactam therapy resulted in a more favorable host response, underscoring the importance of using β-lactams whenever possible for SaB, including select methicillin-resistant S.?aureus patients to help elicit favorable host cytokine response profiles.
Increased Prevalence of Neurocognitive Impairment in Aging People Living With Human Immunodeficiency Virus: The ANRS EP58 HAND 55–70 Study
In a cross-sectional matched controlled study in people living with human immunodeficiency virus aged 55 to 70 years with controlled viremia, we found that neurocognitive impairment was significantly increased, and HIV significantly associated with impairment after controlling for other predictors.
Cost-effectiveness of Direct Antiviral Agents for Hepatitis C Virus Infection and a Combined Intervention of Syringe Access and Medication-assisted Therapy for Opioid Use Disorders in an Injection Drug Use Population
In people who inject drugs, considering health-sector costs, the use of direct antiviral agents (DAA) was the most cost-effective intervention. With criminal justice system–related costs, DAA, implemented with medication-assisted treatment and syringe access programs, become the most cost-effective.
Early Clinical Infancy Outcomes for Microcephaly and/or Small for Gestational Age Zika-Exposed Infants
High Rates of Drug-induced Liver Injury in People Living With HIV Coinfected With Tuberculosis (TB) Irrespective of Antiretroviral Therapy Timing During Antituberculosis Treatment: Results From the Starting Antiretroviral Therapy at Three Points in TB Trial
Post hoc analysis of the Starting Antiretroviral Therapy at Three Points in Tuberculosis trial demonstrates high incidence rates of liver injury among human immunodeficiency virus (HIV)–tuberculosis (TB) coinfected patients receiving concomitant treatment for TB and HIV.
Clinical Features, Epidemiology, and Climatic Impact of Genotype-specific Human Metapneumovirus Infections: Long-term Surveillance of Hospitalized Patients in South Korea
There were differences between characteristics of each human metapneumovirus (hMPV) genotype infection, but disease severity was not altered according to hMPV subtype. Our 10-year surveillance provides valuable information about clinical characteristics of hMPV infections and climate factors contributing to viral transmission.
Low Hepatitis C Reinfection Following Direct-acting Antiviral Therapy Among People Who Inject Drugs on Opioid Agonist Therapy
The hepatitis C virus reinfection rate was low among people who inject drugs on opioid agonist therapy. Rates were higher among those reporting ongoing injection drug use. Attention should be paid to high-risk behaviors following successful treatment with direct-acting antivirals.
Hepatitis C Virus Reinfection Rate Among Persons Who Use Drugs and Are Maintained on Medication Treatment for Opioid Use Disorder
National Trends in Incidence of Purulent Skin and Soft Tissue Infections in Patients Presenting to Ambulatory and Emergency Department Settings, 2000–2015
Recent deaths of migrant children from overwhelming infections in US detainment centers have brought to light outbreaks in these facilities, delays in medical care, and inadequate medical expertise. Advocacy by clinicians and professional societies is critical to resolving this crisis.
A systematic approach is essential to accurately diagnose, classify, and manage spinal cord stimulator infections. Deep infection involving the implant components usually warrants device removal to achieve cure. Duration of antimicrobial therapy depends on the clinical presentation.
INNOVATIONS IN DESIGN, EDUCATION AND ANALYSIS (IDEA)
Average Weighted Accuracy: Pragmatic Analysis for a Rapid Diagnostics in Categorizing Acute Lung Infections (RADICAL) Study
The management of infectious disease relies very heavily on diagnostic information. Current standard evaluations of diagnostic tests do not effectively convey the clinical significance of the test, which is critical to informing clinical decision-making. AWA provides an alternative whereby the goal is to evaluate diagnostic utility using a holistic perspective.