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Publisher: Oxford University Press   (Total: 396 journals)

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Showing 1 - 200 of 396 Journals sorted alphabetically
ACS Symposium Series     Full-text available via subscription   (SJR: 0.189, CiteScore: 0)
Acta Biochimica et Biophysica Sinica     Hybrid Journal   (Followers: 5, SJR: 0.79, CiteScore: 2)
Adaptation     Hybrid Journal   (Followers: 9, SJR: 0.143, CiteScore: 0)
Advances in Nutrition     Hybrid Journal   (Followers: 46, SJR: 2.196, CiteScore: 5)
Aesthetic Surgery J.     Hybrid Journal   (Followers: 6, SJR: 1.434, CiteScore: 1)
African Affairs     Hybrid Journal   (Followers: 64, SJR: 1.869, CiteScore: 2)
Age and Ageing     Hybrid Journal   (Followers: 91, SJR: 1.989, CiteScore: 4)
Alcohol and Alcoholism     Hybrid Journal   (Followers: 18, SJR: 1.376, CiteScore: 3)
American Entomologist     Full-text available via subscription   (Followers: 7)
American Historical Review     Hybrid Journal   (Followers: 153, SJR: 0.467, CiteScore: 1)
American J. of Agricultural Economics     Hybrid Journal   (Followers: 41, SJR: 2.113, CiteScore: 3)
American J. of Clinical Nutrition     Hybrid Journal   (Followers: 145, SJR: 3.438, CiteScore: 6)
American J. of Epidemiology     Hybrid Journal   (Followers: 175, SJR: 2.713, CiteScore: 3)
American J. of Hypertension     Hybrid Journal   (Followers: 25, SJR: 1.322, CiteScore: 3)
American J. of Jurisprudence     Hybrid Journal   (Followers: 18, SJR: 0.281, CiteScore: 1)
American J. of Legal History     Full-text available via subscription   (Followers: 8, SJR: 0.116, CiteScore: 0)
American Law and Economics Review     Hybrid Journal   (Followers: 27, SJR: 1.053, CiteScore: 1)
American Literary History     Hybrid Journal   (Followers: 15, SJR: 0.391, CiteScore: 0)
Analysis     Hybrid Journal   (Followers: 21, SJR: 1.038, CiteScore: 1)
Animal Frontiers     Hybrid Journal  
Annals of Behavioral Medicine     Hybrid Journal   (Followers: 15, SJR: 1.423, CiteScore: 3)
Annals of Botany     Hybrid Journal   (Followers: 36, SJR: 1.721, CiteScore: 4)
Annals of Oncology     Hybrid Journal   (Followers: 42, SJR: 5.599, CiteScore: 9)
Annals of the Entomological Society of America     Full-text available via subscription   (Followers: 10, SJR: 0.722, CiteScore: 1)
Annals of Work Exposures and Health     Hybrid Journal   (Followers: 32, SJR: 0.728, CiteScore: 2)
AoB Plants     Open Access   (Followers: 4, SJR: 1.28, CiteScore: 3)
Applied Economic Perspectives and Policy     Hybrid Journal   (Followers: 18, SJR: 0.858, CiteScore: 2)
Applied Linguistics     Hybrid Journal   (Followers: 56, SJR: 2.987, CiteScore: 3)
Applied Mathematics Research eXpress     Hybrid Journal   (Followers: 1, SJR: 1.241, CiteScore: 1)
Arbitration Intl.     Full-text available via subscription   (Followers: 20)
Arbitration Law Reports and Review     Hybrid Journal   (Followers: 14)
Archives of Clinical Neuropsychology     Hybrid Journal   (Followers: 30, SJR: 0.731, CiteScore: 2)
Aristotelian Society Supplementary Volume     Hybrid Journal   (Followers: 3)
Arthropod Management Tests     Hybrid Journal   (Followers: 2)
Astronomy & Geophysics     Hybrid Journal   (Followers: 43, SJR: 0.146, CiteScore: 0)
Behavioral Ecology     Hybrid Journal   (Followers: 52, SJR: 1.871, CiteScore: 3)
Bioinformatics     Hybrid Journal   (Followers: 302, SJR: 6.14, CiteScore: 8)
Biology Methods and Protocols     Hybrid Journal  
Biology of Reproduction     Full-text available via subscription   (Followers: 10, SJR: 1.446, CiteScore: 3)
Biometrika     Hybrid Journal   (Followers: 20, SJR: 3.485, CiteScore: 2)
BioScience     Hybrid Journal   (Followers: 29, SJR: 2.754, CiteScore: 4)
Bioscience Horizons : The National Undergraduate Research J.     Open Access   (Followers: 1, SJR: 0.146, CiteScore: 0)
Biostatistics     Hybrid Journal   (Followers: 17, SJR: 1.553, CiteScore: 2)
BJA : British J. of Anaesthesia     Hybrid Journal   (Followers: 165, SJR: 2.115, CiteScore: 3)
BJA Education     Hybrid Journal   (Followers: 64)
Brain     Hybrid Journal   (Followers: 68, SJR: 5.858, CiteScore: 7)
Briefings in Bioinformatics     Hybrid Journal   (Followers: 48, SJR: 2.505, CiteScore: 5)
Briefings in Functional Genomics     Hybrid Journal   (Followers: 3, SJR: 2.15, CiteScore: 3)
British J. for the Philosophy of Science     Hybrid Journal   (Followers: 35, SJR: 2.161, CiteScore: 2)
British J. of Aesthetics     Hybrid Journal   (Followers: 26, SJR: 0.508, CiteScore: 1)
British J. of Criminology     Hybrid Journal   (Followers: 585, SJR: 1.828, CiteScore: 3)
British J. of Social Work     Hybrid Journal   (Followers: 88, SJR: 1.019, CiteScore: 2)
British Medical Bulletin     Hybrid Journal   (Followers: 7, SJR: 1.355, CiteScore: 3)
British Yearbook of Intl. Law     Hybrid Journal   (Followers: 32)
Bulletin of the London Mathematical Society     Hybrid Journal   (Followers: 4, SJR: 1.376, CiteScore: 1)
Cambridge J. of Economics     Hybrid Journal   (Followers: 62, SJR: 0.764, CiteScore: 2)
Cambridge J. of Regions, Economy and Society     Hybrid Journal   (Followers: 11, SJR: 2.438, CiteScore: 4)
Cambridge Quarterly     Hybrid Journal   (Followers: 9, SJR: 0.104, CiteScore: 0)
Capital Markets Law J.     Hybrid Journal   (Followers: 2, SJR: 0.222, CiteScore: 0)
Carcinogenesis     Hybrid Journal   (Followers: 2, SJR: 2.135, CiteScore: 5)
Cardiovascular Research     Hybrid Journal   (Followers: 14, SJR: 3.002, CiteScore: 5)
Cerebral Cortex     Hybrid Journal   (Followers: 45, SJR: 3.892, CiteScore: 6)
CESifo Economic Studies     Hybrid Journal   (Followers: 17, SJR: 0.483, CiteScore: 1)
Chemical Senses     Hybrid Journal   (Followers: 1, SJR: 1.42, CiteScore: 3)
Children and Schools     Hybrid Journal   (Followers: 5, SJR: 0.246, CiteScore: 0)
Chinese J. of Comparative Law     Hybrid Journal   (Followers: 4, SJR: 0.412, CiteScore: 0)
Chinese J. of Intl. Law     Hybrid Journal   (Followers: 23, SJR: 0.329, CiteScore: 0)
Chinese J. of Intl. Politics     Hybrid Journal   (Followers: 9, SJR: 1.392, CiteScore: 2)
Christian Bioethics: Non-Ecumenical Studies in Medical Morality     Hybrid Journal   (Followers: 10, SJR: 0.183, CiteScore: 0)
Classical Receptions J.     Hybrid Journal   (Followers: 25, SJR: 0.123, CiteScore: 0)
Clean Energy     Open Access   (Followers: 1)
Clinical Infectious Diseases     Hybrid Journal   (Followers: 65, SJR: 5.051, CiteScore: 5)
Clinical Kidney J.     Open Access   (Followers: 3, SJR: 1.163, CiteScore: 2)
Communication Theory     Hybrid Journal   (Followers: 22, SJR: 2.424, CiteScore: 3)
Communication, Culture & Critique     Hybrid Journal   (Followers: 27, SJR: 0.222, CiteScore: 1)
Community Development J.     Hybrid Journal   (Followers: 27, SJR: 0.268, CiteScore: 1)
Computer J.     Hybrid Journal   (Followers: 9, SJR: 0.319, CiteScore: 1)
Conservation Physiology     Open Access   (Followers: 2, SJR: 1.818, CiteScore: 3)
Contemporary Women's Writing     Hybrid Journal   (Followers: 9, SJR: 0.121, CiteScore: 0)
Contributions to Political Economy     Hybrid Journal   (Followers: 5, SJR: 0.906, CiteScore: 1)
Critical Values     Full-text available via subscription  
Current Developments in Nutrition     Open Access   (Followers: 1)
Current Legal Problems     Hybrid Journal   (Followers: 27)
Current Zoology     Full-text available via subscription   (Followers: 2, SJR: 1.164, CiteScore: 2)
Database : The J. of Biological Databases and Curation     Open Access   (Followers: 8, SJR: 1.791, CiteScore: 3)
Digital Scholarship in the Humanities     Hybrid Journal   (Followers: 14, SJR: 0.259, CiteScore: 1)
Diplomatic History     Hybrid Journal   (Followers: 20, SJR: 0.45, CiteScore: 1)
DNA Research     Open Access   (Followers: 5, SJR: 2.866, CiteScore: 6)
Dynamics and Statistics of the Climate System     Open Access   (Followers: 4)
Early Music     Hybrid Journal   (Followers: 15, SJR: 0.139, CiteScore: 0)
Economic Policy     Hybrid Journal   (Followers: 39, SJR: 3.584, CiteScore: 3)
ELT J.     Hybrid Journal   (Followers: 24, SJR: 0.942, CiteScore: 1)
English Historical Review     Hybrid Journal   (Followers: 52, SJR: 0.612, CiteScore: 1)
English: J. of the English Association     Hybrid Journal   (Followers: 14, SJR: 0.1, CiteScore: 0)
Environmental Entomology     Full-text available via subscription   (Followers: 11, SJR: 0.818, CiteScore: 2)
Environmental Epigenetics     Open Access   (Followers: 3)
Environmental History     Hybrid Journal   (Followers: 27, SJR: 0.408, CiteScore: 1)
EP-Europace     Hybrid Journal   (Followers: 2, SJR: 2.748, CiteScore: 4)
Epidemiologic Reviews     Hybrid Journal   (Followers: 9, SJR: 4.505, CiteScore: 8)
ESHRE Monographs     Hybrid Journal  
Essays in Criticism     Hybrid Journal   (Followers: 17, SJR: 0.113, CiteScore: 0)
European Heart J.     Hybrid Journal   (Followers: 57, SJR: 9.315, CiteScore: 9)
European Heart J. - Cardiovascular Imaging     Hybrid Journal   (Followers: 9, SJR: 3.625, CiteScore: 3)
European Heart J. - Cardiovascular Pharmacotherapy     Full-text available via subscription   (Followers: 1)
European Heart J. - Quality of Care and Clinical Outcomes     Hybrid Journal  
European Heart J. : Case Reports     Open Access  
European Heart J. Supplements     Hybrid Journal   (Followers: 8, SJR: 0.223, CiteScore: 0)
European J. of Cardio-Thoracic Surgery     Hybrid Journal   (Followers: 9, SJR: 1.681, CiteScore: 2)
European J. of Intl. Law     Hybrid Journal   (Followers: 186, SJR: 0.694, CiteScore: 1)
European J. of Orthodontics     Hybrid Journal   (Followers: 4, SJR: 1.279, CiteScore: 2)
European J. of Public Health     Hybrid Journal   (Followers: 20, SJR: 1.36, CiteScore: 2)
European Review of Agricultural Economics     Hybrid Journal   (Followers: 10, SJR: 1.172, CiteScore: 2)
European Review of Economic History     Hybrid Journal   (Followers: 29, SJR: 0.702, CiteScore: 1)
European Sociological Review     Hybrid Journal   (Followers: 40, SJR: 2.728, CiteScore: 3)
Evolution, Medicine, and Public Health     Open Access   (Followers: 11)
Family Practice     Hybrid Journal   (Followers: 15, SJR: 1.018, CiteScore: 2)
Fems Microbiology Ecology     Hybrid Journal   (Followers: 12, SJR: 1.492, CiteScore: 4)
Fems Microbiology Letters     Hybrid Journal   (Followers: 24, SJR: 0.79, CiteScore: 2)
Fems Microbiology Reviews     Hybrid Journal   (Followers: 30, SJR: 7.063, CiteScore: 13)
Fems Yeast Research     Hybrid Journal   (Followers: 14, SJR: 1.308, CiteScore: 3)
Food Quality and Safety     Open Access   (Followers: 1)
Foreign Policy Analysis     Hybrid Journal   (Followers: 23, SJR: 1.425, CiteScore: 1)
Forest Science     Hybrid Journal   (Followers: 7, SJR: 0.89, CiteScore: 2)
Forestry: An Intl. J. of Forest Research     Hybrid Journal   (Followers: 16, SJR: 1.133, CiteScore: 3)
Forum for Modern Language Studies     Hybrid Journal   (Followers: 6, SJR: 0.104, CiteScore: 0)
French History     Hybrid Journal   (Followers: 33, SJR: 0.118, CiteScore: 0)
French Studies     Hybrid Journal   (Followers: 20, SJR: 0.148, CiteScore: 0)
French Studies Bulletin     Hybrid Journal   (Followers: 10, SJR: 0.152, CiteScore: 0)
Gastroenterology Report     Open Access   (Followers: 2)
Genome Biology and Evolution     Open Access   (Followers: 12, SJR: 2.578, CiteScore: 4)
Geophysical J. Intl.     Hybrid Journal   (Followers: 35, SJR: 1.506, CiteScore: 3)
German History     Hybrid Journal   (Followers: 22, SJR: 0.161, CiteScore: 0)
GigaScience     Open Access   (Followers: 4, SJR: 5.022, CiteScore: 7)
Global Summitry     Hybrid Journal   (Followers: 1)
Glycobiology     Hybrid Journal   (Followers: 14, SJR: 1.493, CiteScore: 3)
Health and Social Work     Hybrid Journal   (Followers: 56, SJR: 0.388, CiteScore: 1)
Health Education Research     Hybrid Journal   (Followers: 15, SJR: 0.854, CiteScore: 2)
Health Policy and Planning     Hybrid Journal   (Followers: 24, SJR: 1.512, CiteScore: 2)
Health Promotion Intl.     Hybrid Journal   (Followers: 22, SJR: 0.812, CiteScore: 2)
History Workshop J.     Hybrid Journal   (Followers: 31, SJR: 1.278, CiteScore: 1)
Holocaust and Genocide Studies     Hybrid Journal   (Followers: 28, SJR: 0.105, CiteScore: 0)
Human Communication Research     Hybrid Journal   (Followers: 13, SJR: 2.146, CiteScore: 3)
Human Molecular Genetics     Hybrid Journal   (Followers: 8, SJR: 3.555, CiteScore: 5)
Human Reproduction     Hybrid Journal   (Followers: 71, SJR: 2.643, CiteScore: 5)
Human Reproduction Open     Open Access  
Human Reproduction Update     Hybrid Journal   (Followers: 20, SJR: 5.317, CiteScore: 10)
Human Rights Law Review     Hybrid Journal   (Followers: 56, SJR: 0.756, CiteScore: 1)
ICES J. of Marine Science: J. du Conseil     Hybrid Journal   (Followers: 52, SJR: 1.591, CiteScore: 3)
ICSID Review     Hybrid Journal   (Followers: 10)
ILAR J.     Hybrid Journal   (Followers: 2, SJR: 1.732, CiteScore: 4)
IMA J. of Applied Mathematics     Hybrid Journal   (SJR: 0.679, CiteScore: 1)
IMA J. of Management Mathematics     Hybrid Journal   (SJR: 0.538, CiteScore: 1)
IMA J. of Mathematical Control and Information     Hybrid Journal   (Followers: 2, SJR: 0.496, CiteScore: 1)
IMA J. of Numerical Analysis - advance access     Hybrid Journal   (SJR: 1.987, CiteScore: 2)
Industrial and Corporate Change     Hybrid Journal   (Followers: 10, SJR: 1.792, CiteScore: 2)
Industrial Law J.     Hybrid Journal   (Followers: 35, SJR: 0.249, CiteScore: 1)
Inflammatory Bowel Diseases     Hybrid Journal   (Followers: 44, SJR: 2.511, CiteScore: 4)
Information and Inference     Free  
Integrative and Comparative Biology     Hybrid Journal   (Followers: 8, SJR: 1.319, CiteScore: 2)
Interacting with Computers     Hybrid Journal   (Followers: 11, SJR: 0.292, CiteScore: 1)
Interactive CardioVascular and Thoracic Surgery     Hybrid Journal   (Followers: 7, SJR: 0.762, CiteScore: 1)
Intl. Affairs     Hybrid Journal   (Followers: 60, SJR: 1.505, CiteScore: 3)
Intl. Data Privacy Law     Hybrid Journal   (Followers: 25)
Intl. Health     Hybrid Journal   (Followers: 6, SJR: 0.851, CiteScore: 2)
Intl. Immunology     Hybrid Journal   (Followers: 3, SJR: 2.167, CiteScore: 4)
Intl. J. for Quality in Health Care     Hybrid Journal   (Followers: 37, SJR: 1.348, CiteScore: 2)
Intl. J. of Constitutional Law     Hybrid Journal   (Followers: 63, SJR: 0.601, CiteScore: 1)
Intl. J. of Epidemiology     Hybrid Journal   (Followers: 226, SJR: 3.969, CiteScore: 5)
Intl. J. of Law and Information Technology     Hybrid Journal   (Followers: 5, SJR: 0.202, CiteScore: 1)
Intl. J. of Law, Policy and the Family     Hybrid Journal   (Followers: 26, SJR: 0.223, CiteScore: 1)
Intl. J. of Lexicography     Hybrid Journal   (Followers: 9, SJR: 0.285, CiteScore: 1)
Intl. J. of Low-Carbon Technologies     Open Access   (Followers: 1, SJR: 0.403, CiteScore: 1)
Intl. J. of Neuropsychopharmacology     Open Access   (Followers: 3, SJR: 1.808, CiteScore: 4)
Intl. J. of Public Opinion Research     Hybrid Journal   (Followers: 9, SJR: 1.545, CiteScore: 1)
Intl. J. of Refugee Law     Hybrid Journal   (Followers: 35, SJR: 0.389, CiteScore: 1)
Intl. J. of Transitional Justice     Hybrid Journal   (Followers: 11, SJR: 0.724, CiteScore: 2)
Intl. Mathematics Research Notices     Hybrid Journal   (Followers: 1, SJR: 2.168, CiteScore: 1)
Intl. Political Sociology     Hybrid Journal   (Followers: 37, SJR: 1.465, CiteScore: 3)
Intl. Relations of the Asia-Pacific     Hybrid Journal   (Followers: 23, SJR: 0.401, CiteScore: 1)
Intl. Studies Perspectives     Hybrid Journal   (Followers: 9, SJR: 0.983, CiteScore: 1)
Intl. Studies Quarterly     Hybrid Journal   (Followers: 45, SJR: 2.581, CiteScore: 2)
Intl. Studies Review     Hybrid Journal   (Followers: 23, SJR: 1.201, CiteScore: 1)
ISLE: Interdisciplinary Studies in Literature and Environment     Hybrid Journal   (Followers: 2, SJR: 0.15, CiteScore: 0)
ITNOW     Hybrid Journal   (Followers: 1, SJR: 0.103, CiteScore: 0)
J. of African Economies     Hybrid Journal   (Followers: 15, SJR: 0.533, CiteScore: 1)
J. of American History     Hybrid Journal   (Followers: 46, SJR: 0.297, CiteScore: 1)
J. of Analytical Toxicology     Hybrid Journal   (Followers: 14, SJR: 1.065, CiteScore: 2)
J. of Antimicrobial Chemotherapy     Hybrid Journal   (Followers: 15, SJR: 2.419, CiteScore: 4)
J. of Antitrust Enforcement     Hybrid Journal   (Followers: 1)
J. of Applied Poultry Research     Hybrid Journal   (Followers: 4, SJR: 0.585, CiteScore: 1)
J. of Biochemistry     Hybrid Journal   (Followers: 40, SJR: 1.226, CiteScore: 2)
J. of Burn Care & Research     Hybrid Journal   (Followers: 9, SJR: 0.768, CiteScore: 2)
J. of Chromatographic Science     Hybrid Journal   (Followers: 18, SJR: 0.36, CiteScore: 1)
J. of Church and State     Hybrid Journal   (Followers: 11, SJR: 0.139, CiteScore: 0)
J. of Communication     Hybrid Journal   (Followers: 53, SJR: 4.411, CiteScore: 5)
J. of Competition Law and Economics     Hybrid Journal   (Followers: 35, SJR: 0.33, CiteScore: 0)
J. of Complex Networks     Hybrid Journal   (Followers: 2, SJR: 1.05, CiteScore: 4)
J. of Computer-Mediated Communication     Open Access   (Followers: 26, SJR: 2.961, CiteScore: 6)
J. of Conflict and Security Law     Hybrid Journal   (Followers: 12, SJR: 0.402, CiteScore: 0)
J. of Consumer Research     Full-text available via subscription   (Followers: 43, SJR: 5.856, CiteScore: 5)

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Journal Cover
Clinical Infectious Diseases
Journal Prestige (SJR): 5.051
Citation Impact (citeScore): 5
Number of Followers: 65  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1058-4838 - ISSN (Online) 1537-6591
Published by Oxford University Press Homepage  [396 journals]
  • In the Literature
    • PubDate: Fri, 14 Sep 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy713
      Issue No: Vol. 67, No. 7 (2018)
       
  • News
    • PubDate: Fri, 20 Jul 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy587
      Issue No: Vol. 67, No. 7 (2018)
       
  • Acetaminophen as a Renoprotective Adjunctive Treatment in Patients With
           Severe and Moderately Severe Falciparum Malaria: A Randomized, Controlled,
           Open-Label Trial
    • Authors: Plewes K; Kingston H, Ghose A, et al.
      Pages: 991 - 999
      Abstract: AbstractBackgroundAcute kidney injury independently predicts mortality in falciparum malaria. It is unknown whether acetaminophen’s capacity to inhibit plasma hemoglobin-mediated oxidation is renoprotective in severe malaria.MethodsThis phase 2, open-label, randomized controlled trial conducted at two hospitals in Bangladesh assessed effects on renal function, safety, pharmacokinetic (PK) properties and pharmacodynamic (PD) effects of acetaminophen. Febrile patients (>12 years) with severe falciparum malaria were randomly assigned to receive acetaminophen (1 g 6–hourly for 72 hours) or no acetaminophen, in addition to intravenous artesunate. Primary outcome was the proportional change in creatinine after 72 hours stratified by median plasma hemoglobin.ResultsBetween 2012 and 2014, 62 patients were randomly assigned to receive acetaminophen (n = 31) or no acetaminophen (n = 31). Median (interquartile range) reduction in creatinine after 72 hours was 23% (37% to 18%) in patients assigned to acetaminophen, versus 14% (29% to 0%) in patients assigned to no acetaminophen (P = .043). This difference in reduction was 37% (48% to 22%) versus 14% (30% to −71%) in patients with hemoglobin ≥45000 ng/mL (P = .010). The proportion with progressing kidney injury was higher among controls (subdistribution hazard ratio, 3.0; 95% confidence interval, 1.1 to 8.5; P = .034). PK–PD analyses showed that higher exposure to acetaminophen increased the probability of creatinine improvement. No patient fulfilled Hy’s law for hepatotoxicity.ConclusionsIn this proof-of-principle study, acetaminophen showed renoprotection without evidence of safety concerns in patients with severe falciparum malaria, particularly in those with prominent intravascular hemolysis.Clinical Trials RegistrationNCT01641289.
      PubDate: Mon, 12 Mar 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy213
      Issue No: Vol. 67, No. 7 (2018)
       
  • Primaquine Pharmacokinetics in Lactating Women and Breastfed Infant
           Exposures
    • Authors: Gilder M; Hanpithakphong W, Hoglund R, et al.
      Pages: 1000 - 1007
      Abstract: AbstractBackgroundPrimaquine is the only drug providing radical cure of Plasmodium vivax malaria. It is not recommended for breastfeeding women as it causes hemolysis in glucose-6-phosphate dehydrogenase (G6PD)–deficient individuals, and breast milk excretion and thus infant exposure are not known.MethodsHealthy G6PD-normal breastfeeding women with previous P. vivax infection and their healthy G6PD-normal infants between 28 days and 2 years old were enrolled. Mothers took primaquine 0.5 mg/kg/day for 14 days. Primaquine and carboxyprimaquine concentrations were measured in maternal venous plasma, capillary plasma, and breast milk samples and infant capillary plasma samples taken on days 0, 3, 7, and 13.ResultsIn 20 mother–infant pairs, primaquine concentrations were below measurement thresholds in all but 1 infant capillary plasma sample (that contained primaquine 2.6 ng/mL), and carboxyprimaquine was likewise unmeasurable in the majority of infant samples (maximum value 25.8 ng/mL). The estimated primaquine dose received by infants, based on measured breast milk levels, was 2.98 µg/kg/day (ie, ~0.6% of a hypothetical infant daily dose of 0.5 mg/kg). There was no evidence of drug-related hemolysis in the infants. Maternal levels were comparable to levels in nonlactating patients, and adverse events in mothers were mild.ConclusionsThe concentrations of primaquine in breast milk are very low and therefore very unlikely to cause adverse effects in the breastfeeding infant. Primaquine should not be withheld from mothers breastfeeding infants or young children. More information is needed in neonates.Clinical Trials RegistrationNCT01780753.
      PubDate: Sat, 24 Mar 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy235
      Issue No: Vol. 67, No. 7 (2018)
       
  • Expanding the Use of Primaquine for the Radical Cure of Plasmodium vivax
    • Authors: Price R; Douglas N.
      Pages: 1008 - 1009
      Abstract: PrimaquinemalarialactationThailand
      PubDate: Sat, 24 Mar 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy236
      Issue No: Vol. 67, No. 7 (2018)
       
  • Efficacy and Safety of Glecaprevir/Pibrentasvir in Patients Coinfected
           With Hepatitis C Virus and Human Immunodeficiency Virus Type 1: The
           EXPEDITION-2 Study
    • Authors: Rockstroh J; Lacombe K, Viani R, et al.
      Pages: 1010 - 1017
      Abstract: AbstractBackgroundOnce-daily glecaprevir coformulated with pibrentasvir (glecaprevir/pibrentasvir) demonstrated high rates of sustained virologic response 12 weeks after treatment (SVR12) in patients with hepatitis C virus (HCV) genotype 1–6 infection. This phase 3 study evaluated the efficacy and safety of glecaprevir/pibrentasvir in patients with chronic HCV genotype 1–6 and human immunodeficiency virus type 1 (HIV-1) coinfection, including patients with compensated cirrhosis.MethodsEXPEDITION-2 was a phase 3, multicenter, open-label study evaluating glecaprevir/pibrentasvir (300 mg/120 mg) in HCV genotype 1–6/HIV-1–coinfected adults without and with compensated cirrhosis for 8 and 12 weeks, respectively. Patients were either HCV treatment-naive or experienced with sofosbuvir, ribavirin, or interferon, and antiretroviral therapy (ART) naive or on a stable ART regimen. Treatment-experienced genotype 3–infected patients were excluded. The primary endpoint was the SVR12 rate.ResultsIn total, 153 patients were enrolled, including 16 (10%) with cirrhosis. The SVR12 rate was 98% (n = 150/153; 95% confidence interval, 95.8–100), with no virologic failures in 137 patients treated for 8 weeks. One genotype 3–infected patient with cirrhosis had on-treatment virologic failure. Most adverse events were mild in severity; 4 patients (2.6%) had serious adverse events, all deemed unrelated to glecaprevir/pibrentasvir. Treatment discontinuation was rare (<1%). All patients treated with ART maintained HIV-1 suppression (<200 copies/mL) during treatment.ConclusionsGlecaprevir/pibrentasvir for 8 weeks in noncirrhotic and 12 weeks in cirrhotic patients is a highly efficacious and well-tolerated treatment for HCV/HIV-1 coinfection, regardless of baseline HCV load or prior treatment with interferon or sofosbuvir.Clinical trial registrationNCT02738138.
      PubDate: Fri, 16 Mar 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy220
      Issue No: Vol. 67, No. 7 (2018)
       
  • National Trends in Parental Human Papillomavirus Vaccination Intentions
           and Reasons for Hesitancy, 2010–2015
    • Authors: Hanson K; Koch B, Bonner K, et al.
      Pages: 1018 - 1026
      Abstract: AbstractBackgroundHuman papillomavirus (HPV) vaccination uptake remains lower than other recommended adolescent vaccines in the United States. Parental attitudes are important predictors of vaccine uptake, yet little is known about how they have changed over time.MethodsParticipants included US residents aged 13–17 years with documented vaccination status who had received <3 doses of HPV vaccine whose parents responded to the National Immunization Survey–Teen, 2010–2015.ResultsOf the 76971 participants, 63.0% were male, 58.8% were non-Hispanic white, and 14.4 years was the median age. The percentage of unvaccinated teens decreased from 2010 to 2015, yet, annually, parents of unvaccinated teens of both sexes most often reported that they were “not likely at all” to vaccinate their teen. The percentage decreased significantly from 41.5% to 31.2% (P < .001) for parents of unvaccinated females from 2010 to 2015 but did not change among parents of males from 2012 to 2015. Conversely, parents of undervaccinated teens of both sexes reported higher and increasing vaccination intent over time. In 2015, nearly one-third of parents of unvaccinated teens reported that the vaccine was “not needed/necessary.” Concerns about vaccine safety and side effects declined among parents of unvaccinated females but increased among parents of males (7.3% to 14.8%; P < .001).ConclusionsAlthough parental vaccination intent and knowledge improved over time, intent remains low and many parents still have significant concerns about HPV vaccination, even after series initiation. Multiple strategies are needed to improve series initiation and completion in the United States.
      PubDate: Tue, 27 Mar 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy232
      Issue No: Vol. 67, No. 7 (2018)
       
  • Malaria and Nutritional Status Among Children With Severe Acute
           Malnutrition in Niger: A Prospective Cohort Study
    • Authors: Oldenburg C; Guerin P, Berthé F, et al.
      Pages: 1027 - 1034
      Abstract: AbstractBackgroundThe relationship between malaria infection and nutritional status is complex. Previous studies suggest malaria may increase the incidence and severity of malnutrition, while malnutrition may increase the risk of malaria infection. Here, we report bidirectional associations between malaria and nutritional status among children with uncomplicated severe acute malnutrition (SAM).MethodsThis study is a secondary analysis of a randomized, controlled trial for the treatment of uncomplicated SAM in Niger. Children aged 6–59 months were enrolled and followed for 12 weeks. Malaria infection was assessed using an histidine-rich protein 2 (HRP2) rapid diagnostic test at admission and at any follow-up visit with fever. We assessed the association of nutritional status at admission on malaria incidence using Cox proportional hazards regression and malaria infection at admission on nutritional recovery and weight and height gain using linear regression.ResultsOf 2399 children included in the analysis, 1327 (55.3%) were infected with malaria at admission. Malaria incidence was 12.1 cases/100 person-months among those without malaria infection at admission. Nutritional status at admission was not associated with malaria incidence. Children with malaria infection at admission and subsequently treated with an artemisinin-based combination therapy had increased weight gain (0.38 g/kg/day; 95% confidence interval [CI], 0.07 to 0.69) and reduced height gain (−0.002 mm/day; 95% CI, −0.004 to −0.0008).ConclusionsMalaria infection was common among children treated for uncomplicated SAM. Malaria infection may impair height gain. Proper medical and nutritional management should be ensured to prevent adverse effects of malaria infection.Clinical Trials RegistrationNCT01613547.
      PubDate: Wed, 07 Mar 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy207
      Issue No: Vol. 67, No. 7 (2018)
       
  • Two Distinct Patterns of Clostridium difficile Diversity Across Europe
           Indicating Contrasting Routes of Spread
    • Authors: Eyre D; Davies K, Davis G, et al.
      Pages: 1035 - 1044
      Abstract: AbstractBackgroundRates of Clostridium difficile infection vary widely across Europe, as do prevalent ribotypes. The extent of Europe-wide diversity within each ribotype, however, is unknown.MethodsInpatient diarrheal fecal samples submitted on a single day in summer and winter (2012–2013) to laboratories in 482 European hospitals were cultured for C. difficile, and isolates the 10 most prevalent ribotypes were whole-genome sequenced. Within each ribotype, country-based sequence clustering was assessed using the ratio of the median number of single-nucleotide polymorphisms between isolates within versus across different countries, using permutation tests. Time-scaled Bayesian phylogenies were used to reconstruct the historical location of each lineage.ResultsSequenced isolates (n = 624) were from 19 countries. Five ribotypes had within-country clustering: ribotype 356, only in Italy; ribotype 018, predominantly in Italy; ribotype 176, with distinct Czech and German clades; ribotype 001/072, including distinct German, Slovakian, and Spanish clades; and ribotype 027, with multiple predominantly country-specific clades including in Hungary, Italy, Germany, Romania, and Poland. By contrast, we found no within-country clustering for ribotypes 078, 015, 002, 014, and 020, consistent with a Europe-wide distribution. Fluoroquinolone resistance was significantly more common in within-country clustered ribotypes (P = .009). Fluoroquinolone-resistant isolates were also more tightly clustered geographically with a median (interquartile range) of 43 (0–213) miles between each isolate and the most closely genetically related isolate, versus 421 (204–680) miles in nonresistant pairs (P < .001).ConclusionsTwo distinct patterns of C. difficile ribotype spread were observed, consistent with either predominantly healthcare-associated acquisition or Europe-wide dissemination via other routes/sources, for example, the food chain.
      PubDate: Fri, 06 Apr 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy252
      Issue No: Vol. 67, No. 7 (2018)
       
  • Dynamics of Afebrile Plasmodium falciparum Infections in Mozambican Men
    • Authors: Galatas B; Martí-Soler H, Nhamussua L, et al.
      Pages: 1045 - 1052
      Abstract: AbstractBackgroundAfebrile Plasmodium falciparum infections usually remain undetected and untreated in the community and could potentially contribute to sustaining local malaria transmission in areas aiming for malaria elimination.MethodsThirty-two men with afebrile P. falciparum infections detected with rapid diagnostic test (RDTs) were followed for 28 days. Kaplan-Meier estimates were computed to estimate probability of parasite positivity and of reducing parasitemia by half of its initial level by day 28. Trends of parasite densities quantified by microscopy and real-time quantitative polymerase chain reaction (qPCR) were assessed using Poisson regression models, and the microscopy-to-qPCR positivity ratio was calculated at each time point. Three survival distributions (Gompertz, Weibull, and gamma) were used to evaluate their strength of fit to the data and to predict the median lifetime of infection.ResultsThe cumulative probability of parasite qPCR positivity by day 28 was 81% (95% confidence interval [CI], 60.2–91.6). Geometric mean parasitemia at recruitment was 516.1 parasites/μL and fell to <100 parasites/μL by day 3, reaching 56.7 parasites/μL on day 28 (P < .001). The ratio of P. falciparum–positive samples by microscopy to qPCR decreased from 0.9 to 0.52 from recruitment to day 28. The best model fit to the data was obtained assuming a Gompertz distribution.ConclusionsAfebrile P. falciparum infections detectable by RDT in semi-immune adults fall and stabilize at low-density levels during the first 4 days after detection, suggesting a rapid decline of potential transmissibility in this hidden parasite reservoir.Clincial trials registrationNCT02698748
      PubDate: Tue, 13 Mar 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy219
      Issue No: Vol. 67, No. 7 (2018)
       
  • A Competing-Risk Approach for Modeling Length of Stay in Severe Malaria
           Patients in South-East Asia and the Implications for Planning of Hospital
           Services
    • Authors: Keene C; Dondorp A, Crawley J, et al.
      Pages: 1053 - 1062
      Abstract: AbstractBackgroundManagement of severe malaria with limited resources requires comprehensive planning. Expected length of stay (LOS) and the factors influencing it are useful in the planning and optimisation of service delivery.MethodsA secondary, competing-risk approach to survival analysis was performed for 1217 adult severe malaria patients from the South-East Asia Quinine Artesunate Malaria Trial.ResultsTwenty percent of patients died; 95.4% within 7 days compared to 70.3% of those who were discharged. Median time to discharge was 6 days. Compared to quinine, artesunate increased discharge incidence (subdistribution-Hazard ratio, 1.24; [95% confidence interval 1.09–1.40]; P = .001) and decreased incidence of death (0.60; [0.46–0.80]; P < .001). Low Glasgow coma scale (discharge, 1.08 [1.06–1.11], P < .001; death, 0.85 [0.82–0.89], P < .001), high blood urea-nitrogen (discharge, 0.99 [0.99–0.995], P < .001; death, 1.00 [1.00–1.01], P = .012), acidotic base-excess (discharge, 1.05 [1.03–1.06], P < .001; death, 0.90 [0.88–0.93], P < .001), and development of shock (discharge, 0.25 [0.13–0.47], P < .001; death, 2.14 [1.46–3.12], P < .001), or coma (discharge, 0.46 [0.32–0.65], P < .001; death, 2.30 [1.58–3.36], P < .001) decreased cumulative incidence of discharge and increased incidence of death. Conventional Kaplan-Meier survival analysis overestimated cumulative incidence compared to competing-risk model.ConclusionsClinical factors on admission and during hospitalisation influence LOS in severe malaria, presenting targets to improve health and service efficiency. Artesunate has the potential to increase LOS, which should be accounted for when planning services. In-hospital death is a competing risk for discharge; an important consideration in LOS models to reduce overestimation of risk and misrepresentation of associations.
      PubDate: Mon, 19 Mar 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy211
      Issue No: Vol. 67, No. 7 (2018)
       
  • A Randomized Controlled Trial of the Safety and Immunogenicity of Tetanus,
           Diphtheria, and Acellular Pertussis Vaccine Immunization During Pregnancy
           and Subsequent Infant Immune Response
    • Authors: Halperin S; Langley J, Ye L, et al.
      Pages: 1063 - 1071
      Abstract: AbstractBackgroundImmunization of pregnant women with tetanus-diphtheria-acellular pertussis vaccine (Tdap) provides protection against pertussis to the newborn infant.MethodsIn a randomized, controlled, observer-blind, multicenter clinical trial, we measured the safety and immunogenicity of Tdap during pregnancy and the effect on the infant’s immune response to primary vaccination at 2, 4, and 6 months and booster vaccination at 12 months of age. A total of 273 women received either Tdap or tetanus-diphtheria (Td) vaccine in the third trimester and provided information for the safety analysis and samples for the immunogenicity analyses; 261 infants provided serum for the immunogenicity analyses.ResultsRates of adverse events were similar in both groups. Infants of Tdap recipients had cord blood levels that were 21% higher than maternal levels for pertussis toxoid (PT), 13% higher for filamentous hemagglutinin (FHA), 4% higher for pertactin (PRN), and 7% higher for fimbriae (FIM). These infants had significantly higher PT antibody levels at birth and at 2 months and significantly higher FHA, PRN, and FIM antibodies at birth and 2 and 4 months, but significantly lower PT and FHA antibody levels at 6 and 7 months and significantly lower PRN and FIM antibody levels at 7 months than infants whose mothers received Td. Differences persisted prebooster at 12 months for all antigens and postbooster 1 month later for PT, FHA, and FIM.ConclusionsThis study demonstrated that Tdap during pregnancy results in higher levels of antibodies early in infancy but lower levels after the primary vaccine series.Clinical Trials RegistrationNCT00553228.
      PubDate: Fri, 13 Jul 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy244
      Issue No: Vol. 67, No. 7 (2018)
       
  • Cost-effectiveness of Preventive Therapy for Tuberculosis With Isoniazid
           and Rifapentine Versus Isoniazid Alone in High-Burden Settings
    • Authors: Johnson K; Churchyard G, Sohn H, et al.
      Pages: 1072 - 1078
      Abstract: AbstractBackgroundA short-course regimen of 3 months of weekly rifapentine and isoniazid (3HP) has recently been recommended by the World Health Organization as an alternative to at least 6 months of daily isoniazid (isoniazid preventive therapy [IPT]) for prevention of tuberculosis (TB). The contexts in which 3HP may be cost-effective compared to IPT among people living with human immunodeficiency virus are unknown.MethodsWe used a Markov state transition model to estimate the incremental cost-effectiveness of 3HP relative to IPT in high-burden settings, using a cohort of 1000 patients in a Ugandan HIV clinic as an emblematic scenario. Cost-effectiveness was expressed as 2017 US dollars per disability-adjusted life year (DALY) averted from a healthcare perspective over a 20-year time horizon. We explored the conditions under which 3HP would be considered cost-effective relative to IPT.ResultsPer 1000 individuals on antiretroviral therapy in the reference scenario, treatment with 3HP rather than IPT was estimated to avert 9 cases of TB and 1 death, costing $9402 per DALY averted relative to IPT. Cost-effectiveness depended strongly on the price of rifapentine, completion of 3HP, and prevalence of latent TB. At a willingness to pay of $1000 per DALY averted, 3HP is likely to be cost-effective relative to IPT only if the price of rifapentine can be greatly reduced (to approximately $20 per course) and high treatment completion (85%) can be achieved.Conclusions3HP may be a cost-effective alternative to IPT in high-burden settings, but cost-effectiveness depends on the price of rifapentine, achievable completion rates, and local willingness to pay.
      PubDate: Fri, 30 Mar 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy230
      Issue No: Vol. 67, No. 7 (2018)
       
  • Intermittent Preventive Treatment for Malaria in Pregnancy: Optimization
           of Target Concentrations of Dihydroartemisinin-Piperaquine
    • Authors: Savic R; Jagannathan P, Kajubi R, et al.
      Pages: 1079 - 1088
      Abstract: AbstractBackgroundDihydroartemisinin-piperaquine (DHA-PQ) is highly efficacious as intermittent preventive therapy for malaria during pregnancy (IPTp). Determining associations between piperaquine (PQ) exposure, malaria risk, and adverse birth outcomes informs optimal dosing strategies.MethodsHuman immunodeficiency virus–uninfected pregnant women (n = 300) were enrolled in a placebo-controlled trial of IPTp at 12–20 weeks’ gestation and randomized to sulfadoxine-pyrimethamine every 8 weeks, DHA-PQ every 8 weeks, or DHA-PQ every 4 weeks during pregnancy. Pharmacokinetic sampling for PQ was performed every 4 weeks, and an intensive pharmacokinetic substudy was performed in 30 women at 28 weeks’ gestation. Concentration-effect relationships were assessed between exposure to PQ; the prevalence of Plasmodium falciparum infection during pregnancy; outcomes at delivery including placental malaria, low birth weight, and preterm birth; and risks for toxicity. Simulations of new dosing scenarios were performed.ResultsModel-defined PQ target venous plasma concentrations of 13.9 ng/mL provided 99% protection from P. falciparum infection during pregnancy. Each 10-day increase in time above target PQ concentrations was associated with reduced odds of placental parasitemia, preterm birth, and low birth weight, though increases in PQ concentrations were associated with QT interval prolongation. Modeling suggests that daily or weekly administration of lower dosages of PQ, compared to standard dosing, will maintain PQ trough levels above target concentrations with reduced PQ peak levels, potentially limiting toxicity.ConclusionsThe protective efficacy of IPTp with DHA-PQ was strongly associated with higher drug exposure. Studies of the efficacy and safety of alternative DHA-PQ IPTp dosing strategies are warranted.Clinical Trials RegistrationNCT02163447.
      PubDate: Wed, 14 Mar 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy218
      Issue No: Vol. 67, No. 7 (2018)
       
  • Changing Rates of Chronic Pseudomonas aeruginosa Infections in Cystic
           Fibrosis: A Population-Based Cohort Study
    • Authors: Crull M; Somayaji R, Ramos K, et al.
      Pages: 1089 - 1095
      Abstract: AbstractBackgroundChronic Pseudomonas aeruginosa lung infection is associated with significant morbidity and mortality in cystic fibrosis (CF). It is not known whether recent advances in care have affected the rates of chronic infection. We aimed to determine if the rates of developing new chronic P. aeruginosa infection among adolescents and adults with CF significantly changed over time.MethodsThe cohort consisted of individuals with CF followed in the Cystic Fibrosis Foundation Patient Registry aged ≥13 years without chronic P. aeruginosa at baseline. Multivariable regression models accounting for within-patient correlation were used to assess the change in rate of developing chronic P. aeruginosa infection between 2003 and 2012.ResultsA total of 15504 individuals were followed for a median of 5 (interquartile range, 2–9) years. The annual rates of developing new chronic P. aeruginosa decreased from 14.3% in 2003 to 6.4% in 2012. After adjusting for potential confounders, relative risk (RR) of developing chronic P. aeruginosa infection decreased significantly over time compared to 2003 (P value test of trend < .001). Compared with 2003, the RR of developing chronic P. aeruginosa infection in 2012 was 0.33 (95% confidence interval, 0.30–0.37). No significant increases in risk of chronic infections with other major CF bacterial pathogens relative to 2003 were identified.ConclusionsAmong individuals with CF, a significant decrease in the risk and rates of developing chronic P. aeruginosa infection between 2003 and 2012 was observed. Whether this decline results in changes in clinical outcomes warrants further exploration.
      PubDate: Fri, 09 Mar 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy215
      Issue No: Vol. 67, No. 7 (2018)
       
  • Ranking Hospitals Based on Colon Surgery and Abdominal Hysterectomy
           Surgical Site Infection Outcomes: Impact of Limiting Surveillance to the
           Operative Hospital
    • Authors: Yokoe D; Avery T, Platt R, et al.
      Pages: 1096 - 1102
      Abstract: AbstractBackgroundHospital-specific surgical site infection (SSI) performance following colon surgery and abdominal hysterectomies can impact hospitals’ relative rankings around quality metrics used to determine financial penalties. Current SSI surveillance largely focuses on SSI detected at the operative hospital.MethodsWe performed a retrospective cohort study to assess the impact on hospitals’ relative SSI performance rankings when SSI detected at nonoperative hospitals are included. We used data from a California statewide hospital registry to assess for evidence of SSI following colon surgery or abdominal hysterectomies performed 1 March 2011 through 30 November 2013 using previously validated claims-based SSI surveillance methods. Risk-adjusted hospital-specific rankings based on SSI detected at operative hospitals versus any California hospital were generated.ResultsAmong 60059 colon surgeries at 285 hospitals and 64918 abdominal hysterectomies at 270 hospitals, 5921 (9.9%) colon surgeries and 1481 (2.3%) abdominal hysterectomies received a diagnosis code for SSI within the 30 days following surgery. Operative hospital surveillance alone would have missed 7.2% of colon surgery and 13.4% of abdominal hysterectomy SSIs. The proportion of an individual hospital’s SSIs detected during hospitalizations at other hospitals varied widely. Including nonoperative hospital SSIs resulted in improved relative ranking of 11 (3.9%) colon surgery and 13 (4.8%) hysterectomy hospitals so that they were no longer in the worst performing quartile, mainly among hospitals with relatively high surgical volumes.ConclusionsStandard SSI surveillance that mainly focuses on infections detected at the operative hospital causes varying degrees of SSI underestimation, leading to inaccurate assignment or avoidance of financial penalties for approximately 1 in 11–16 hospitals.
      PubDate: Fri, 16 Mar 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy223
      Issue No: Vol. 67, No. 7 (2018)
       
  • Intestinal Barrier Dysfunction and Microbial Translocation in Human
           Immunodeficiency Virus–Infected Pregnant Women Are Associated With
           Preterm Birth
    • Authors: Shivakoti R; Gupte N, Kumar N, et al.
      Pages: 1103 - 1109
      Abstract: AbstractBackgroundPreterm birth (PTB) rates are high in human immunodeficiency virus (HIV)–infected populations, even when on treatment. Still, only a subset of all births in HIV-infected pregnant women result in PTB, suggesting that risk factors other than HIV infection itself are also important. Inflammation is a known risk factor in uninfected populations, but its role in HIV-infected population have not been studied; in addition, the immune pathways involved are not clear and noninvasive immune markers with predictive value are lacking. Our objective was to determine the association of select markers of inflammation with PTB in HIV-1–infected pregnant women.MethodsWithin a randomized trial of pregnant women receiving nevirapine (Six-Week Extended-Dose Nevirapine [SWEN] trial), we nested a case-control study (n = 107; 26 cases, 81 controls) to determine the association of maternal inflammation with PTB. Cases were defined as PTB (<37 weeks’ gestational age). We assessed inflammation by measuring plasma levels of markers of general inflammation (C-reactive protein [CRP]), intestinal barrier dysfunction (intestinal fatty acid binding protein [I-FABP]), and microbial translocation/monocyte activation (soluble CD14 [sCD14] and CD163 [sCD163]). Multivariable logistic regression was used to determine the odds of PTB per log2 increase of each marker.ResultsIn multivariable models, there was increased odds of PTB per unit increase of log2 sCD14 (adjusted odds ratio [aOR], 2.45; 95% confidence interval [CI], 1.24–4.86), log2 sCD163 (aOR, 3.87; 95% CI, 1.43–10.49), and log2 I-FABP (aOR, 2.28; 95% CI, 1.18–4.41) but not log2 CRP (aOR, 0.72; 95% CI, .48–1.09).ConclusionsOur results show that select immune markers can identify women at higher risk for PTB in HIV-1–infected populations and suggest that modulating gut barrier integrity and microbial translocation may affect PTB.Clinical Trials RegistrationNCT00061321.
      PubDate: Sat, 24 Mar 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy253
      Issue No: Vol. 67, No. 7 (2018)
       
  • Human Babesiosis Caused by a Babesia crassa–Like Pathogen: A Case
           Series
    • Authors: Jia N; Zheng Y, Jiang J, et al.
      Pages: 1110 - 1119
      Abstract: AbstractBackgroundHuman babesiosis is an emerging health problem in China.MethodsBabesia were identified in ticks, sheep, and humans in northeastern China using polymerase chain reaction (PCR) followed by genetic sequencing. We enrolled residents who experienced a viral-like illness after recent tick bite or were healthy residents. We defined a case using the definition for babesiosis developed by the US Centers for Disease Control and Prevention.ResultsA Babesia crassa–like agent was identified in Ixodes persulcatus and Haemaphysalis concinna ticks using PCR followed by sequencing. The agent was characterized through phylogenetic analyses of the 18S rRNA gene, the β-tubulin gene, and the internal transcribed spacer region. We tested sheep as a possible reservoir and found that 1.1% were infected with the B. crassa–like agent. We screened 1125 human participants following tick bites using B. crassa–specific PCR and identified 31 confirmed and 27 suspected cases. All the patients were previously healthy except for 1 with an ovarian tumor. Headache (74%), nausea or vomiting (52%), and fever (48%) were the most common clinical manifestations of confirmed cases. Six of 10 cases remained PCR positive for B. crassa–like infection 9 months after initial diagnosis. Asymptomatic infections were detected in 7.5% of 160 local residents.ConclusionsWe identified B. crassa–like infection in people in northeastern China that caused mild to moderate symptoms. The possibility of more severe disease in immunocompromised patients and of transmission through the blood supply due to asymptomatic infections justifies further investigation of this reported infection.
      PubDate: Sat, 10 Mar 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy212
      Issue No: Vol. 67, No. 7 (2018)
       
  • Coxiella burnetii: A Hidden Pathogen in Interstitial Lung Disease'
    • Authors: Melenotte C; Izaaryene J, Gomez C, et al.
      Pages: 1120 - 1124
      Abstract: AbstractWe report 7 patients with interstitial lung disease seen at computed tomographic scan review. Coxiella burnetii infection was diagnosed in situ in 1 lung biopsy specimen. Q fever may be a cofactor of interstitial lung disease, especially in endemic areas.
      PubDate: Fri, 06 Apr 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy278
      Issue No: Vol. 67, No. 7 (2018)
       
  • Clinical Significance of Human Herpesvirus 6 Positivity on the FilmArray
           Meningitis/Encephalitis Panel
    • Authors: Green D; Pereira M, Miko B, et al.
      Pages: 1125 - 1128
      Abstract: AbstractA review of 15 patients who tested positive for human herpesvirus 6 (HHV-6) on the FilmArray Meningitis/Encephalitis panel revealed that the majority were unlikely to have HHV-6 encephalitis. Criteria to assist interpretation of HHV-6 positive results are presented.
      PubDate: Mon, 09 Apr 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy288
      Issue No: Vol. 67, No. 7 (2018)
       
  • Predicting Influenza H3N2 Vaccine Efficacy From Evolution of the Dominant
           Epitope
    • Authors: Bonomo M; Deem M.
      Pages: 1129 - 1131
      Abstract: AbstractWe predict vaccine efficacy with a measure of antigenic distance between influenza A(H3N2) and vaccine viruses based on amino acid substitutions in the dominant epitope. In 2016–2017, our model predicts 19% efficacy compared with 20% observed. This tool assists candidate vaccine selection by predicting human protection against circulating strains.
      PubDate: Tue, 17 Apr 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy323
      Issue No: Vol. 67, No. 7 (2018)
       
  • Twenty-first Century Cures Act and Antimicrobial Susceptibility Testing:
           Clinical Implications in the Era of Multidrug Resistance
    • Authors: Humphries R; Hindler J, Jane Ferraro M, et al.
      Pages: 1132 - 1138
      Abstract: AbstractClinical laboratories act at the frontline of identification of infections caused by multidrug-resistant organisms, and yet the tools they apply are often woefully out of date. Incomplete adoption of current testing standards, updated breakpoints, and tests for new drugs across laboratories has been exacerbated by lack of coordination between standards development organizations (SDOs), pharmaceutical companies, susceptibility test manufacturers, and the US Food and Drug Administration. The 21st Century Cures Act includes provisions to enable alignment between these groups by (1) allowing recognition of breakpoints set by qualified SDOs; (2) publicly posting recognized breakpoints; and (3) reviewing breakpoints for necessary updates, every 6 months. Combined, these provisions will ensure more rapid recognition of current breakpoints, improving detection and management of resistant infections. Although several limitations remain, this will ultimately allow susceptibility test manufacturers to more readily update to current breakpoints.
      PubDate: Wed, 23 May 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy432
      Issue No: Vol. 67, No. 7 (2018)
       
  • A Patient With Multiorgan Failure and Fusiform Rod-Shaped Bacteria in the
           Blood Smear
    • Authors: Claessen K; van Rossum A, Bolleboom I, et al.
      Pages: 1139 - 1141
      Abstract: A 65-year-old man without a significant medical history presented to the emergency department with abdominal pain and diarrhea. He did not use any relevant medication. At physical examination, he was somnolent and hemodynamically unstable with a high fever. His peripheral circulation was poor with significant marbling of both legs, his abdomen was diffusely painful on palpation, his left leg had a necrotizing wound without an additional abscess or cellulitis (Figure 1), and he had scratches on both hands. The rest of his physical examination findings were unremarkable.
      PubDate: Fri, 14 Sep 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy101
      Issue No: Vol. 67, No. 7 (2018)
       
  • Breakthrough Invasive Fungal Infections on Isavuconazole Prophylaxis and
           Treatment: What Is Happening in the Real-World Setting'
    • Authors: Fung M; Schwartz B, Doernberg S, et al.
      Pages: 1142 - 1143
      Abstract: To the Editor—Invasive fungal infections (IFIs) cause significant morbidity and mortality among immunocompromised hosts (IHs), particularly in those with hematologic malignancy and following stem-cell and solid organ transplantation. Prophylaxis with mold-active antifungals such as voriconazole and posaconazole is widely employed in high-risk populations to decrease IFIs and improve patient outcomes [1, 2]. Breakthrough IFIs due to resistant and atypical fungal pathogens are now increasingly described, however [3].
      PubDate: Sat, 31 Mar 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy260
      Issue No: Vol. 67, No. 7 (2018)
       
  • Duration of Zika Viremia in Serum
    • Authors: Fontaine A; de Laval F, Belleoud D, et al.
      Pages: 1143 - 1144
      Abstract: To the Editor—Zika virus emerged in French Guiana in December 2015 shortly after its first occurrence on the American continent [1]. In this context of emergence, molecular diagnostic approach is essential to confirm first human cases and to monitor the outbreak. Nevertheless, its use must be based on a robust diagnostic algorithm built from data of Zika virus RNA persistence in body fluids with minimal bias.
      PubDate: Fri, 30 Mar 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy261
      Issue No: Vol. 67, No. 7 (2018)
       
  • Reply to Fontaine
    • Authors: Barzon L; Percivalle E, Pacenti M, et al.
      Pages: 1144 - 1145
      Abstract: To the Editor—We thank Fontaine and colleagues for their report, which estimated the duration of Zika virus (ZIKV) RNA detection in the serum of 38 patients with symptomatic infection, and for their comments [1] on our recent article, which described the dynamics of ZIKV RNA shedding in different body fluids and the antibody response in 30 subjects with acute infection [2]. The median time from symptom onset to ZIKV RNA clearance in serum estimated by Fontaine (5 days, 95% confidence interval [CI] 4.1–5.6) was shorter than the median estimates assessed by our study [2] (11.5 days, 95% CI 9–33) and by the study in a cohort of 150 participants from Puerto Rico [3] (14 days, 95% CI 11–17). According to Fontaine and colleagues, the latest studies overestimated the duration of viremia due to biases, such as inclusion of asymptomatic individuals, low sample size, weekly or intermittent sampling. We agree that these factors could have affected the accuracy of the estimates, but we would like to emphasize that the dynamics of ZIKV viremia and time to clearance may vary among individuals due to different clinical conditions, which were present in part in our series of patients. For example, previous flavivirus immunity might accelerate ZIKV RNA clearance from blood, like in the case of secondary dengue virus infection; immunodeficiency and immunosuppression may delay viral clearance and increase the risk of severe disease; pregnancy may be associated with ZIKV persistence in blood.
      PubDate: Fri, 30 Mar 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy262
      Issue No: Vol. 67, No. 7 (2018)
       
  • Mechanical Thrombectomy for Patients With Infective Endocarditis and
           Ischemic Large-Vessel Stroke
    • Authors: Cuervo G; Caballero Q, Rombauts A, et al.
      Pages: 1145 - 1146
      Abstract: To the Editor—We have read with interest the article by Ambrosioni et al [1] reporting their successful experience through the performance of mechanical thrombectomy (MT) in the management of 6 patients experiencing acute ischemic stroke with proximal vessel occlusion secondary to infective endocarditis (IE). Those patients were properly treated by timely stroke code activation, with a short delay in groin puncture, and early dramatic recovery was achieved in 4 of 6 cases (67%), without bleeding complications.
      PubDate: Thu, 05 Apr 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy272
      Issue No: Vol. 67, No. 7 (2018)
       
  • Reply to Cuervo et al
    • Authors: Ambrosioni J; Urra X, Llopis J, et al.
      Pages: 1146 - 1147
      Abstract: To the Editor—We thank Dr. Cuervo et al for their interest in our article [1], and we are happy to note the favorable results with mechanical thrombectomy (MT) in infectious endocarditis (IE) at their institution. Indeed, their experience is even better than ours, because 3 out of 3 patients presented early dramatic neurological recovery, and all 3 were alive at 1-year follow-up [2].
      PubDate: Tue, 24 Apr 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy305
      Issue No: Vol. 67, No. 7 (2018)
       
  • Cross-Border Transmission of Ebola Virus as the Cause of a Resurgent
           Outbreak in Liberia in April 2016
    • Authors: Mate S; Wiley M, Ladner J, et al.
      Pages: 1147 - 1149
      Abstract: To the Editor—We present new information regarding an outbreak of Ebola virus (EBOV) disease (EVD) in Liberia in early 2016 that was associated with a resurgent outbreak (“flare-up”) in N’zérékoré, Guinea, described by Diallo et al [1]. During the course of the Guinean flare-up, 3 EVD cases were diagnosed in Monrovia, Liberia. We describe genomic and epidemiologic evidence demonstrating that the Liberian cases were the result of cross-border transmission from the N’zérékoré flare-up [1]. On 31 March 2016, an oropharyngeal swab sample from a deceased 30-year-old Liberian woman (patient A) tested positive for EBOV RNA by quantitative reverse-transcription polymerase chain reaction performed at the National Reference Laboratory in Liberia. Blood samples collected from her 2 children, 5-year-old and 2-year-old boys, also tested EBOV positive on 2 April (patient B) and 5 April (patient C) by quantitative reverse-transcription polymerase chain reaction. Genetic and epidemiologic investigations were initiated to distinguish among 3 potential modes of infection: (1) transmission from a persistently infected survivor within Liberia, (2) reintroduction from active transmission of EBOV ongoing in Guinea, and (3) an independent spillover from a nonhuman reservoir.
      PubDate: Thu, 05 Apr 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy281
      Issue No: Vol. 67, No. 7 (2018)
       
  • Erratum
    • Pages: 1150 - 1150
      Abstract: An error appeared in the initial publication of this article [Bojang A., Camara B., Jagne Cox I., et al. Long-term Impact of Oral Azithromycin Taken by Gambian Women During Labor on Prevalence and Antibiotic Susceptibility of Streptococcus pneumoniae and Staphylococcus aureus in Their Infants: Follow-up of a Randomized Clinical Trial. Clin Infect Dis https://doi.org/10.1093/cid/ciy254]. This article was originally published with an error in that the figure legends were missing for figures 1 and 2. The legends are as follows:
      PubDate: Tue, 14 Aug 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy428
      Issue No: Vol. 67, No. 7 (2018)
       
  • Erratum
    • Pages: 1151 - 1151
      Abstract: An error appeared in the initial publication of this article [Ram R, Halavy Y. Amit O. Extended versus Bolus Infusion of Broad Spectrum β-Lactams for Febrile Neutropenia: an Unblinded Randomized Trial. Clin Infect Dis https://doi.org/10.1093/cid/ciy258]. This article was originally published with the following error: In Table 3, under Per-Protocol population section, the first column should be labeled “Intermittent Bolus (n = 48)” and the second column should be labeled “Extended Infusion (n = 43)”.
      PubDate: Wed, 22 Aug 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy467
      Issue No: Vol. 67, No. 7 (2018)
       
  • Erratum
    • Pages: 1151 - 1151
      Abstract: An error appeared in the initial publication of this article [Huang K-H G, Cluzet V, Hamilton K and Fadugba O. The Impact of Reported Beta-Lactam Allergy in Hospitalized Patients With Hematologic Malignancies Requiring Antibiotics. Clin Infect Dis 2018; 67:27–33. This article was originally published with an error in the abstract. The abstract’s 30-day mortality rates are quoted as “7.6% vs 15.8%” but should be “7.6% vs 5.3%”.
      PubDate: Fri, 10 Aug 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy431
      Issue No: Vol. 67, No. 7 (2018)
       
 
 
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