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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: 53, SJR: 2.196, CiteScore: 5)
Aesthetic Surgery J.     Hybrid Journal   (Followers: 6, SJR: 1.434, CiteScore: 1)
African Affairs     Hybrid Journal   (Followers: 65, SJR: 1.869, CiteScore: 2)
Age and Ageing     Hybrid Journal   (Followers: 91, SJR: 1.989, CiteScore: 4)
Alcohol and Alcoholism     Hybrid Journal   (Followers: 19, SJR: 1.376, CiteScore: 3)
American Entomologist     Full-text available via subscription   (Followers: 7)
American Historical Review     Hybrid Journal   (Followers: 156, SJR: 0.467, CiteScore: 1)
American J. of Agricultural Economics     Hybrid Journal   (Followers: 42, SJR: 2.113, CiteScore: 3)
American J. of Clinical Nutrition     Hybrid Journal   (Followers: 167, SJR: 3.438, CiteScore: 6)
American J. of Epidemiology     Hybrid Journal   (Followers: 189, 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: 19, 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: 16, SJR: 0.391, CiteScore: 0)
Analysis     Hybrid Journal   (Followers: 22, SJR: 1.038, CiteScore: 1)
Animal Frontiers     Hybrid Journal   (Followers: 1)
Annals of Behavioral Medicine     Hybrid Journal   (Followers: 16, SJR: 1.423, CiteScore: 3)
Annals of Botany     Hybrid Journal   (Followers: 36, SJR: 1.721, CiteScore: 4)
Annals of Oncology     Hybrid Journal   (Followers: 55, 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: 57, 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: 44, SJR: 0.146, CiteScore: 0)
Behavioral Ecology     Hybrid Journal   (Followers: 52, SJR: 1.871, CiteScore: 3)
Bioinformatics     Hybrid Journal   (Followers: 317, SJR: 6.14, CiteScore: 8)
Biology Methods and Protocols     Hybrid Journal  
Biology of Reproduction     Full-text available via subscription   (Followers: 9, 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: 175, SJR: 2.115, CiteScore: 3)
BJA Education     Hybrid Journal   (Followers: 65)
Brain     Hybrid Journal   (Followers: 68, SJR: 5.858, CiteScore: 7)
Briefings in Bioinformatics     Hybrid Journal   (Followers: 50, 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: 36, SJR: 2.161, CiteScore: 2)
British J. of Aesthetics     Hybrid Journal   (Followers: 25, SJR: 0.508, CiteScore: 1)
British J. of Criminology     Hybrid Journal   (Followers: 591, SJR: 1.828, CiteScore: 3)
British J. of Social Work     Hybrid Journal   (Followers: 85, SJR: 1.019, CiteScore: 2)
British Medical Bulletin     Hybrid Journal   (Followers: 6, SJR: 1.355, CiteScore: 3)
British Yearbook of Intl. Law     Hybrid Journal   (Followers: 33)
Bulletin of the London Mathematical Society     Hybrid Journal   (Followers: 4, SJR: 1.376, CiteScore: 1)
Cambridge J. of Economics     Hybrid Journal   (Followers: 65, 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: 46, SJR: 3.892, CiteScore: 6)
CESifo Economic Studies     Hybrid Journal   (Followers: 18, SJR: 0.483, CiteScore: 1)
Chemical Senses     Hybrid Journal   (Followers: 1, SJR: 1.42, CiteScore: 3)
Children and Schools     Hybrid Journal   (Followers: 6, 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: 22, SJR: 0.329, CiteScore: 0)
Chinese J. of Intl. Politics     Hybrid Journal   (Followers: 10, 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: 27, SJR: 0.123, CiteScore: 0)
Clean Energy     Open Access   (Followers: 1)
Clinical Infectious Diseases     Hybrid Journal   (Followers: 68, SJR: 5.051, CiteScore: 5)
Communication Theory     Hybrid Journal   (Followers: 23, SJR: 2.424, CiteScore: 3)
Communication, Culture & Critique     Hybrid Journal   (Followers: 27, SJR: 0.222, CiteScore: 1)
Community Development J.     Hybrid Journal   (Followers: 28, 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: 2)
Current Legal Problems     Hybrid Journal   (Followers: 29)
Current Zoology     Full-text available via subscription   (Followers: 3, 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: 16, SJR: 0.139, CiteScore: 0)
Economic Policy     Hybrid Journal   (Followers: 41, SJR: 3.584, CiteScore: 3)
ELT J.     Hybrid Journal   (Followers: 24, SJR: 0.942, CiteScore: 1)
English Historical Review     Hybrid Journal   (Followers: 54, SJR: 0.612, CiteScore: 1)
English: J. of the English Association     Hybrid Journal   (Followers: 15, 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: 3, 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: 19, SJR: 0.113, CiteScore: 0)
European Heart J.     Hybrid Journal   (Followers: 62, 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: 2)
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: 195, 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: 30, SJR: 0.702, CiteScore: 1)
European Sociological Review     Hybrid Journal   (Followers: 42, SJR: 2.728, CiteScore: 3)
Evolution, Medicine, and Public Health     Open Access   (Followers: 12)
Family Practice     Hybrid Journal   (Followers: 16, SJR: 1.018, CiteScore: 2)
Fems Microbiology Ecology     Hybrid Journal   (Followers: 15, SJR: 1.492, CiteScore: 4)
Fems Microbiology Letters     Hybrid Journal   (Followers: 28, SJR: 0.79, CiteScore: 2)
Fems Microbiology Reviews     Hybrid Journal   (Followers: 32, SJR: 7.063, CiteScore: 13)
Fems Yeast Research     Hybrid Journal   (Followers: 13, SJR: 1.308, CiteScore: 3)
Food Quality and Safety     Open Access   (Followers: 1)
Foreign Policy Analysis     Hybrid Journal   (Followers: 25, 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: 21, 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: 13, SJR: 2.578, CiteScore: 4)
Geophysical J. Intl.     Hybrid Journal   (Followers: 36, SJR: 1.506, CiteScore: 3)
German History     Hybrid Journal   (Followers: 23, 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: 13, SJR: 1.493, CiteScore: 3)
Health and Social Work     Hybrid Journal   (Followers: 56, SJR: 0.388, CiteScore: 1)
Health Education Research     Hybrid Journal   (Followers: 16, 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: 15, SJR: 2.146, CiteScore: 3)
Human Molecular Genetics     Hybrid Journal   (Followers: 9, SJR: 3.555, CiteScore: 5)
Human Reproduction     Hybrid Journal   (Followers: 72, SJR: 2.643, CiteScore: 5)
Human Reproduction Open     Open Access  
Human Reproduction Update     Hybrid Journal   (Followers: 19, SJR: 5.317, CiteScore: 10)
Human Rights Law Review     Hybrid Journal   (Followers: 61, SJR: 0.756, CiteScore: 1)
ICES J. of Marine Science: J. du Conseil     Hybrid Journal   (Followers: 56, 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: 37, SJR: 0.249, CiteScore: 1)
Inflammatory Bowel Diseases     Hybrid Journal   (Followers: 49, 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: 63, 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: 36, SJR: 1.348, CiteScore: 2)
Intl. J. of Constitutional Law     Hybrid Journal   (Followers: 64, SJR: 0.601, CiteScore: 1)
Intl. J. of Epidemiology     Hybrid Journal   (Followers: 239, 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: 25, SJR: 0.223, CiteScore: 1)
Intl. J. of Lexicography     Hybrid Journal   (Followers: 10, 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: 11, SJR: 1.545, CiteScore: 1)
Intl. J. of Refugee Law     Hybrid Journal   (Followers: 38, 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: 40, 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: 48, SJR: 2.581, CiteScore: 2)
Intl. Studies Review     Hybrid Journal   (Followers: 25, 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: 16, 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: 5, 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: 10, 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: 12, SJR: 0.139, CiteScore: 0)
J. of Communication     Hybrid Journal   (Followers: 55, SJR: 4.411, CiteScore: 5)
J. of Competition Law and Economics     Hybrid Journal   (Followers: 37, 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: 29, SJR: 2.961, CiteScore: 6)
J. of Conflict and Security Law     Hybrid Journal   (Followers: 13, SJR: 0.402, CiteScore: 0)
J. of Consumer Research     Full-text available via subscription   (Followers: 47, SJR: 5.856, CiteScore: 5)
J. of Crohn's and Colitis     Hybrid Journal   (Followers: 10, SJR: 2.728, CiteScore: 5)

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Journal Cover
Clinical Infectious Diseases
Journal Prestige (SJR): 5.051
Citation Impact (citeScore): 5
Number of Followers: 68  
  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]
  • News
    • PubDate: Fri, 18 Jan 2019 00:00:00 GMT
      DOI: 10.1093/cid/ciy972
      Issue No: Vol. 68, No. 3 (2019)
  • In the Literature
    • PubDate: Fri, 18 Jan 2019 00:00:00 GMT
      DOI: 10.1093/cid/ciy1046
      Issue No: Vol. 68, No. 3 (2019)
  • In the Eye of the Beholder: A Conjunctival Lesion in a Woman With Acute
           Myelogenous Leukemia
    • Authors: McGuffin S; Bharadwaj R, Gonzalez-Cuyar L, et al.
      Pages: 525 - 529
      PubDate: Fri, 18 Jan 2019 00:00:00 GMT
      DOI: 10.1093/cid/ciy394
      Issue No: Vol. 68, No. 3 (2019)
  • Efficacy of Ceftazidime-Avibactam Salvage Therapy in Patients With
           Infections Caused by Klebsiella pneumoniae Carbapenemase–producing K.
    • Authors: Tumbarello M; Trecarichi E, Corona A, et al.
      Pages: 355 - 364
      Abstract: BackgroundCeftazidime-avibactam (CAZ-AVI) has been approved in Europe for the treatment of complicated intra-abdominal and urinary tract infections, as well as hospital-acquired pneumonia, and for gram-negative infections with limited treatment options. CAZ-AVI displays in vitro activity against Klebsiella pneumoniae carbapenemase (KPC) enzyme producers, but clinical trial data on its efficacy in this setting are lacking.MethodsWe retrospectively reviewed 138 cases of infections caused by KPC-producing K. pneumoniae (KPC-Kp) in adults who received CAZ-AVI in compassionate-use programs in Italy. Case features and outcomes were analyzed, and survival was then specifically explored in the large subcohort whose infections were bacteremic.ResultsThe 138 patients started CAZ-AVI salvage therapy after a first-line treatment (median, 7 days) with other antimicrobials. CAZ-AVI was administered with at least 1 other active antibiotic in 109 (78.9%) cases. Thirty days after infection onset, 47 (34.1%) of the 138 patients had died. Thirty-day mortality among the 104 patients with bacteremic KPC-Kp infections was significantly lower than that of a matched cohort whose KPC-Kp bacteremia had been treated with drugs other than CAZ-AVI (36.5% vs 55.8%, P = .005). Multivariate analysis of the 208 cases of KPC-Kp bacteremia identified septic shock, neutropenia, Charlson comorbidity index ≥3, and recent mechanical ventilation as independent predictors of mortality, whereas receipt of CAZ-AVI was the sole independent predictor of survival.ConclusionsCAZ-AVI appears to be a promising drug for treatment of severe KPC-Kp infections, especially those involving bacteremia.
      PubDate: Sat, 09 Jun 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy492
      Issue No: Vol. 68, No. 3 (2018)
  • Vancomycin Monotherapy May Be Insufficient to Treat Methicillin-resistant
           Staphylococcus aureus Coinfection in Children With Influenza-related
           Critical Illness
    • Authors: Randolph A; Xu R, Novak T, et al.
      Pages: 365 - 372
      Abstract: BackgroundCoinfection with influenza virus and methicillin-resistant Staphylococcus aureus (MRSA) causes life-threatening necrotizing pneumonia in children. Sporadic incidence precludes evaluation of antimicrobial efficacy. We assessed the clinical characteristics and outcomes of critically ill children with influenza–MRSA pneumonia and evaluated antibiotic use.MethodsWe enrolled children (<18 years) with influenza infection and respiratory failure across 34 pediatric intensive care units 11/2008–5/2016. We compared baseline characteristics, clinical courses, and therapies in children with MRSA coinfection, non-MRSA bacterial coinfection, and no bacterial coinfection.ResultsWe enrolled 170 children (127 influenza A, 43 influenza B). Children with influenza–MRSA pneumonia (N = 30, 87% previously healthy) were older than those with non-MRSA (N = 61) or no (N = 79) bacterial coinfections. Influenza–MRSA was associated with increased leukopenia, acute lung injury, vasopressor use, extracorporeal life support, and mortality than either group (P ≤ .0001). Influenza-related mortality was 40% with MRSA compared to 4.3% without (relative risk [RR], 9.3; 95% confidence interval [CI], 3.8–22.9). Of 29/30 children with MRSA who received vancomycin within the first 24 hours of hospitalization, mortality was 12.5% (N = 2/16) if treatment also included a second anti-MRSA antibiotic compared to 69.2% (N = 9/13) with vancomycin monotherapy (RR, 5.5; 95% CI, 1.4, 21.3; P = .003). Vancomycin dosing did not influence initial trough levels; 78% were <10 µg/mL.ConclusionsInfluenza–MRSA coinfection is associated with high fatality in critically ill children. These data support early addition of a second anti-MRSA antibiotic to vancomycin in suspected severe cases.
      PubDate: Sat, 09 Jun 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy495
      Issue No: Vol. 68, No. 3 (2018)
  • The Concern for Vancomycin Failure in the Treatment of Pediatric
           Staphylococcus aureus Disease
    • Authors: Thomsen I.
      Pages: 373 - 374
      Abstract: (See the Major Article by Randolph et al on pages 365–72.)
      PubDate: Sat, 09 Jun 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy497
      Issue No: Vol. 68, No. 3 (2018)
  • Molecular-based Testing for Sexually Transmitted Infections Using Samples
           Previously Collected for Vaginitis Diagnosis
    • Authors: Van Der Pol B; Daniel G, Kodsi S, et al.
      Pages: 375 - 381
      Abstract: BackgroundVaginal symptoms are a leading cause of primary care visits for women. Individuals exhibiting symptoms often receive laboratory testing based on clinic-specific standards of care. Thus, women seen at a family practice clinic might only receive a vaginitis workup, whereas those seen at a sexually transmitted diseases clinic could be more likely to receive only sexually transmitted infection (STI) testing.MethodsThe likelihood of STIs was assessed in women from whom samples were tested for vaginitis using a molecular diagnostic assay. Positivity rates for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis DNA, detected using the BD MAX CT/GC/TV assay, were calculated. Concordance between the BD MAX Vaginal Panel and the BD MAX CT/GC/TV assay for detection of T. vaginalis was determined.ResultsWomen with bacterial vaginosis alone or with concurrent Candida spp infections had high rates of coinfection with sexually transmitted infections (24.4%–25.7%); samples from women who were negative for vaginitis had significantly lower positivity rates (7.9%; P < .001). Trichomonas vaginalis results were concordant between the BD MAX Vaginal Panel and the BD MAX CT/GC/TV assay in 559 of 560 samples tested.ConclusionsThese data suggest, as have other studies, that women with vaginitis symptoms may be at risk for an STI. Molecular testing could provide broad diagnostic coverage for symptomatic women and improve patient management, regardless of the type of clinic in which patients are treated.
      PubDate: Thu, 02 Aug 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy504
      Issue No: Vol. 68, No. 3 (2018)
  • Antibody Responses to Influenza A/H1N1pdm09 Virus After Pandemic and
           Seasonal Influenza Vaccination in Healthcare Workers: A 5-Year Follow-up
    • Authors: Trieu M; Jul-Larsen Å, Sævik M, et al.
      Pages: 382 - 392
      Abstract: BackgroundThe 2009 influenza pandemic was caused by the A/H1N1pdm09 virus, which was subsequently included in the seasonal vaccine, up to 2016/2017, as the A/H1N1 strain. This provided a unique opportunity to investigate the antibody response to H1N1pdm09 over time.MethodsHealthcare workers (HCWs) were immunized with the AS03-adjuvanted H1N1pdm09 vaccine in 2009 (N = 250), and subsequently vaccinated with seasonal vaccines containing H1N1pdm09 for 4 seasons (repeated group), <4 seasons (occasional group), or no seasons (single group). Blood samples were collected pre and at 21 days and 3, 6, and 12 months after each vaccination, or annually (pre-season) from 2010 in the single group. The H1N1pdm09-specific antibodies were measured by the hemagglutination inhibition (HI) assay.ResultsPandemic vaccination robustly induced HI antibodies that persisted above the 50% protective threshold (HI titers ≥ 40) over 12 months post-vaccination. Previous seasonal vaccination and the duration of adverse events after the pandemic vaccination influenced the decision to vaccinate in subsequent seasons. During 2010/2011–2013/2014, antibodies were boosted after each seasonal vaccination, although no significant difference was observed between the repeated and occasional groups. In the single group without seasonal vaccination, 32% of HCWs seroconverted (≥4-fold increase in HI titers) during the 4 subsequent years, most of whom had HI titers <40 prior to seroconversion. When excluding these seroconverted HCWs, HI titers gradually declined from 12 to 60 months post–pandemic vaccination.ConclusionsPandemic vaccination elicited durable antibodies, supporting the incorporation of adjuvant. Our findings support the current recommendation of annual influenza vaccination in HCWs.Clinical Trials RegistrationNCT01003288.
      PubDate: Sat, 09 Jun 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy487
      Issue No: Vol. 68, No. 3 (2018)
  • Short-course High-dose Liposomal Amphotericin B for Human Immunodeficiency
           Virus–associated Cryptococcal Meningitis: A Phase 2 Randomized
           Controlled Trial
    • Authors: Jarvis J; Leeme T, Molefi M, et al.
      Pages: 393 - 401
      Abstract: BackgroundWe performed a phase 2 noninferiority trial examining the early fungicidal activity (EFA) of 3 short-course, high-dose liposomal amphotericin B (L-AmB) regimens for cryptococcal meningitis (CM) in Tanzania and Botswana.MethodsHuman immunodeficiency virus (HIV)-infected adults with CM were randomized to (i) L-AmB 10 mg/kg on day 1 (single dose); (ii) L-AmB 10 mg/kg on day 1 and 5 mg/kg on day 3 (2 doses); (iii) L-AmB 10 mg/kg on day 1 and 5 mg/kg on days 3 and 7 (3 doses); or (iv) L-AmB 3 mg/kg/day for 14 days (control). All patients also received oral fluconazole 1200 mg/day for 14 days. Primary endpoint was mean rate of clearance of cerebrospinal fluid cryptococcal infection (EFA). Noninferiority was defined as an upper limit of the 2-sided 95% confidence interval (CI) of difference in EFA between intervention and control <0.2 log10 colony-forming units (CFU)/mL/day.ResultsEighty participants were enrolled. EFA for daily L-AmB was –0.41 log10 CFU/mL/day (standard deviation, 0.11; n = 17). Difference in mean EFA from control was –0.11 (95% CI, –.29 to .07) log10 CFU/mL/day faster with single dose (n = 16); –0.05 (95% CI, –.20 to .10) log10 CFU/mL/day faster with 2 doses (n = 18); and –0.13 (95% CI, –.35 to .09) log10 CFU/mL/day faster with 3 doses (n = 18). EFA in all short-course arms was noninferior to control. Ten-week mortality was 29% (n = 23) with no statistical difference between arms. All arms were well tolerated.ConclusionsSingle-dose 10 mg/kg L-AmB was well tolerated and led to noninferior EFA compared to 14 days of 3 mg/kg/day L-AmB in HIV-associated CM. Induction based on a single 10 mg/kg L-AmB dose is being taken forward to a phase 3 clinical endpoint trial.Clinical Trials RegistrationISRCTN 10248064.
      PubDate: Tue, 26 Jun 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy515
      Issue No: Vol. 68, No. 3 (2018)
  • The Safety of Influenza and Pertussis Vaccination in Pregnancy in a Cohort
           of Australian Mother-Infant Pairs, 2012–2015: The FluMum Study
    • Authors: McHugh L; Marshall H, Perrett K, et al.
      Pages: 402 - 408
      Abstract: BackgroundInactivated influenza vaccine (IIV) and pertussis vaccination are recommended in pregnancy. Limited safety data exist for women who received IIV vaccine during the first trimester of pregnancy or received both vaccines in pregnancy. We assessed adverse birth outcomes between vaccinated and unvaccinated pregnancies.MethodsAmong prospectively enrolled Australian “FluMum” participants (2012–2015), primary exposure was receipt and timing of IIV during pregnancy. Primary outcomes included preterm birth, low birthweight at term (LBWT), and small for gestational age (SGA). We compared birth outcomes for IIV in pregnancy with women unvaccinated in pregnancy using Cox proportional hazard ratios (HRs) with 95% confidence intervals (CIs). Adjusted HRs (aHRs) controlled for potential confounding variables. Sensitivity analyses were conducted in a subgroup of women who received pertussis vaccination during pregnancy to assess whether associations between IIV and adverse outcomes were maintained after adjusting for pertussis vaccination.ResultsAmong 8827 participants in our study, women who received IIV in pregnancy did not have an elevated risk of an adverse birth outcome compared with unvaccinated pregnant women: preterm births (HR, 1.10 [95% CI, .92–1.31]; P = .28); LBWT (HR, 1.05 [95% CI, .76–1.44]; P = .77); or SGA (HR, 0.99 [95% CI, .86–1.15]; P = .94). Adjustment for pertussis vaccination during pregnancy yielded similar results: preterm births (aHR, 1.05 [95% CI, .82–1.34]; P = .69); LBWT (aHR, 0.81 [95% CI, .50–1.29]; P = .37); SGA (aHR, 0.92 [95% CI, .74–1.14]; P = .43). There was no evidence of elevated risk by trimester of IIV.ConclusionsNo significant associations were found between maternal IIV or pertussis vaccination in pregnancy and adverse birth outcomes, regardless of the trimester of pregnancy a vaccination was given compared to unvaccinated pregnancies.
      PubDate: Fri, 23 Nov 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy517
      Issue No: Vol. 68, No. 3 (2018)
  • Serologic Follow-up of Middle East Respiratory Syndrome Coronavirus Cases
           and Contacts—Abu Dhabi, United Arab Emirates
    • Authors: Al Hosani F; Kim L, Khudhair A, et al.
      Pages: 409 - 418
      Abstract: BackgroundAlthough there is evidence of person-to-person transmission of Middle East respiratory syndrome coronavirus (MERS-CoV) in household and healthcare settings, more data are needed to describe and better understand the risk factors and transmission routes in both settings, as well as the extent to which disease severity affects transmission.MethodsA seroepidemiological investigation was conducted among MERS-CoV case patients (cases) and their household contacts to investigate transmission risk in Abu Dhabi, United Arab Emirates. Cases diagnosed between 1 January 2013 and 9 May 2014 and their household contacts were approached for enrollment. Demographic, clinical, and exposure history data were collected. Sera were screened by MERS-CoV nucleocapsid protein enzyme-linked immunosorbent assay and indirect immunofluorescence, with results confirmed by microneutralization assay.ResultsThirty-one of 34 (91%) case patients were asymptomatic or mildly symptomatic and did not require oxygen during hospitalization. MERS-CoV antibodies were detected in 13 of 24 (54%) case patients with available sera, including 1 severely symptomatic, 9 mildly symptomatic, and 3 asymptomatic case patients. No serologic evidence of MERS-CoV transmission was found among 105 household contacts with available sera.ConclusionsTransmission of MERS-CoV was not documented in this investigation of mostly asymptomatic and mildly symptomatic cases and their household contacts. These results have implications for clinical management of cases and formulation of isolation policies to reduce the risk of transmission.
      PubDate: Wed, 13 Jun 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy503
      Issue No: Vol. 68, No. 3 (2018)
  • The Cost-effectiveness of Antimicrobial Lock Solutions for the Prevention
           of Central Line–Associated Bloodstream Infections
    • Authors: Pliakos E; Andreatos N, Ziakas P, et al.
      Pages: 419 - 425
      Abstract: BackgroundAntimicrobial lock solutions are a low-cost strategy that can reduce the incidence of central line–associated bloodstream infection (CLABSI). The aim of this study was to evaluate the cost-effectiveness of antimicrobial locks for the prevention of CLABSI.MethodsWe constructed a decision-analytic model comparing antimicrobial lock solutions to heparin locks for the prevention of CLABSI in 3 settings: hemodialysis, cancer treatment, and home parenteral nutrition. Cost-effectiveness was determined by calculating CLABSIs prevented and incremental cost-effectiveness ratios. Uncertainty was addressed by plotting cost-effectiveness planes and acceptability curves for various willingness-to-pay thresholds.ResultsIn probabilistic analysis, at a willingness to pay of $50000, antimicrobial lock solutions had a 96.24% chance of being cost-effective, compared with heparin locks in the hemodialysis setting, an 88.00% chance in the cancer treatment setting, and a 92.73% chance in the home parenteral nutrition setting. In base-case analysis, antimicrobial lock solutions resulted in savings of $68721.03 for the hemodialysis setting, $85061.41 for the cancer setting, and $78513.83 for the home parenteral nutrition setting per CLABSI episode prevented.ConclusionsIn 3 distinct and clinically important settings (hemodialysis, cancer treatment, and home parenteral nutrition), antimicrobial lock solutions are an effective strategy for the prevention of CLABSI, and their use can result in significant healthcare savings.
      PubDate: Tue, 26 Jun 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy511
      Issue No: Vol. 68, No. 3 (2018)
  • Insights From the Geographic Spread of the Lyme Disease Epidemic
    • Authors: Eddens T; Kaplan D, Anderson A, et al.
      Pages: 426 - 434
      Abstract: BackgroundLyme disease is the most common reportable zoonotic infection in the United States. Recent data suggest spread of the Ixodes tick vector and increasing incidence of Lyme disease in several states, including Pennsylvania. We sought to determine the clinical presentation and healthcare use patterns for pediatric Lyme disease in western Pennsylvania.MethodsThe electronic medical records of all patients with an International Classification of Disease, Ninth Revision, diagnosis of Lyme disease between 2003 and 2013 at Children’s Hospital of Pittsburgh were individually reviewed to identify confirmed cases of Lyme disease. The records of 773 patients meeting these criteria were retrospectively analyzed for patient demographics, disease manifestations, and healthcare use.ResultsAn Lyme disease increased exponentially in the pediatric population of western Pennsylvania. There was a southwestward migration of Lyme disease cases, with a shift from rural to nonrural zip codes. Healthcare provider involvement evolved from subspecialists to primary care pediatricians and emergency departments (EDs). Patients from nonrural zip codes more commonly presented to the ED, while patients from rural zip codes used primary care pediatricians and EDs equally.ConclusionsThe current study details the conversion of western Pennsylvania from a Lyme-naive to a Lyme-epidemic area, highlighting changes in clinical presentation and healthcare use over time. Presenting symptoms and provider type differed between those from rural and nonrural zip codes. By elucidating the temporospatial epidemiology and healthcare use for pediatric Lyme disease, the current study may inform public health measures regionally while serving as an archetype for other areas at-risk for Lyme disease epidemics.
      PubDate: Sat, 16 Jun 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy510
      Issue No: Vol. 68, No. 3 (2018)
  • Antibody Persistence at the Population Level 5 Years After Mass
           Vaccination With Meningococcal Serogroup A Conjugate Vaccine (PsA-TT) in
           Burkina Faso: Need for a Booster Campaign'
    • Authors: Yaro S; Njanpop Lafourcade B, Ouangraoua S, et al.
      Pages: 435 - 443
      Abstract: BackgroundIn Burkina Faso, serogroup A meningococcal (NmA) conjugate vaccine (PsA-TT, MenAfriVac) was introduced through a mass campaign in children and adults in December 2010. Similar to a serological survey in 2011, we followed population-level antibody persistence for 5 years after the campaign and estimated time of return to previously-published pre-vaccination levels.MethodsWe conducted 2 cross-sectional surveys in 2013 and early 2016, including representative samples (N = 600) of the general population of Bobo-Dioulasso, Burkina Faso. Serum bactericidal antibody titers (rabbit complement) were measured against NmA reference strain F8236 (SBA-ref), NmA strain 3125 (SBA-3125), and NmA–specific immunoglobulin G (IgG) concentrations.ResultsDuring the 2016 survey, in different age groups between 6 and 29 years, the relative changes in geometric means compared to 2011 values were greater among younger age groups. They were between -87% and -43% for SBA-ref; -99% and -78% for SBA-3125; and -89% and -63% for IgG. In linear extrapolation of age-specific geometric means from 2013 to 2016, among children aged 1–4 years at the time of the PsA-TT campaign, a return to pre-vaccination levels should be expected after 12, 8, and 6 years, respectively, according to SBA-ref, SBA-3125, and IgG. Among older individuals, complete return to baseline is expected at the earliest after 11 years (SBA-ref and SBA-3125) or 9 years (IgG).ConclusionsBased on SBA-3125, a booster campaign after 8 years would be required to sustain direct immune protection for children aged 1–4 years during the PsA-TT campaign. Antibodies persisted longer in older age groups.
      PubDate: Thu, 26 Jul 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy488
      Issue No: Vol. 68, No. 3 (2018)
  • Sustaining Protection Against Epidemic Meningitis in Africa After
    • Authors: Greenwood B.
      Pages: 444 - 445
      Abstract: African meningitis beltvaccinationduration of protection
      PubDate: Thu, 26 Jul 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy489
      Issue No: Vol. 68, No. 3 (2018)
  • Pharmacokinetics of Efavirenz 400 mg Once Daily Coadministered With
           Isoniazid and Rifampicin in Human Immunodeficiency Virus–Infected
    • Authors: Cerrone M; Wang X, Neary M, et al.
      Pages: 446 - 452
      Abstract: BackgroundThe World Health Organization recommends efavirenz 400 mg (EFV400) as first-line antiretroviral therapy, with a disclaimer that no data with anti-tuberculosis (TB) treatment exist. Many people living with human immunodeficiency virus (PLWH) require TB treatment with isoniazid (INH) and rifampicin (RIF), which affect cytochrome P450 and antiretroviral exposure.MethodsPLWH receiving tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC)/EFV 600 mg with a viral load (VL) <50 copies/mL switched to TDF/FTC/EFV400. Genetic polymorphisms and pharmacokinetic (PK) parameters of EFV400 without (PK1) and with INH/RIF following 4 (PK2) and 12 (PK3) weeks of coadministration were evaluated.ResultsTwenty-six PLWH were enrolled; 22 completed PK2. All maintained VL <50 copies/mL throughout the study. Geometric mean ratio (GMR) PK2/PK1 of EFV400 maximum plasma concentration (Cmax), area under the curve (AUC), and concentration at 24 hours postdose (C24h) were 0.91 (90% confidence interval [CI], .83–.99), 0.91 (90% CI, .79–1.05), and 0.85 (90% CI, .72–.99), respectively. GMRs (90% CI) of PK3/PK2 and PK3/PK1 Cmax, AUC, and C24h were 0.95 (.86–1.05) and 0.92 (.83–1.01), 0.88 (.75–1.03) and 0.84 (.75–.93), and 0.84 (.72–.99) and 0.75 (.62–.92), respectively. Eleven of 22 participants carried polymorphisms in the CYP2B6 gene associated with slow EFV metabolism.ConclusionsINH/RIF coadministration was associated with limited changes in EFV400 AUC (<25%), and EFV400 concentrations were maintained within ranges of those measured in PLWH in the ENCORE-1 study, irrespective of CYP2B6 genotype. The coadministration of EFV400 with anti-TB treatment can be considered and this is being confirmed in PLWH with TB.Clinical Trials RegistrationNCT02832778.
      PubDate: Mon, 06 Aug 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy491
      Issue No: Vol. 68, No. 3 (2018)
  • Decreasing Incidence of Skin and Soft-tissue Infections in 86 US Emergency
           Departments, 2009–2014
    • Authors: Morgan E; Hohmann S, Ridgway J, et al.
      Pages: 453 - 459
      Abstract: BackgroundThe incidence of skin and soft-tissue infections (SSTIs), for which human immunodeficiency virus (HIV) is a significant risk factor, in United States emergency departments (EDs) increased dramatically after 2000 with the emergence of community-associated methicillin-resistant Staphylococcus aureus. Few studies have examined SSTI incidence among HIV-infected and non–HIV-infected patients in the United States after 2010.MethodsData were obtained for patient encounters at all academic medical center EDs affiliated with the Vizient clinical data warehouse assigned an SSTI-associated code based on the International Classification of Diseases, Ninth Revision, between 1 January 2009 and 31 December 2014. The rate was calculated per 1000 ED encounters by year and stratified by SSTI, HIV infection, or both, and by age group, race, payer type, and region of care. Poisson regression was used to assess temporal change over the study period.ResultsIn 2009–2014, a total of 47317 HIV-associated and 820440 SSTI-associated encounters were recorded among 25239781 ED patient encounters. The rate of SSTIs decreased by 8% among all patients and by 14.6%, among those with HIV infection. The SSTI incidence overall decreased from 32.0 to 29.7 per 1000 ED encounters between 2009 and 2014. HIV-infected patients had a significantly higher rate of SSTIs than HIV-uninfected patients (adjusted rate ratio, 1.91; 95% confidence interval, 1.84–1.99).ConclusionsThe decline in SSTI incidence in US EDs between 2009 and 2014 is a remarkable epidemiologic shift from the increase in SSTIs after 2000, and further research is necessary to assess reasons for this decrease.
      PubDate: Fri, 15 Jun 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy509
      Issue No: Vol. 68, No. 3 (2018)
  • Prevalence of Trichomonas vaginalis Infection Among US Males,
    • Authors: Daugherty M; Glynn K, Byler T.
      Pages: 460 - 465
      Abstract: BackgroundTrichomoniasis results from adhesion of Trichomonas vaginalis to the mucous membrane of the urethra or vagina. It has been estimated to have a higher incidence rate than both gonorrhea and chlamydia combined. Although females can experience both clinical symptoms and obstetrical complications, male infections are largely asymptomatic and often unreported. We aim to estimate the prevalence of trichomoniasis in US males using the National Health and Nutrition Examination Survey (NHANES) database.MethodsThe NHANES database was queried for all men aged 18–59 years during the years 2013–2016. During these years, the survey included urine testing for trichomoniasis using transcription-mediated amplification. Information was also obtained regarding patient demographics and other sexually transmitted infections.ResultsOverall, 0.49% of men aged 18–59 years tested positive for trichomoniasis. The highest rate was seen in black men (3.6%). There was no significant association with trichomoniasis and age. Higher rates of infection were seen in smokers, those with herpes simplex virus type 2 (HSV-2) infection, men who had sex at an early age, those with less condom usage, and those with more lifetime sexual partners.ConclusionThe rates of trichomonas infection in US males are lower than in women. Infections are strongly associated with black males, HSV-2 infection, and other factors known to increase rates of sexually transmitted infection. This information may be helpful for counseling, screening, and management of patients.
      PubDate: Sat, 09 Jun 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy499
      Issue No: Vol. 68, No. 3 (2018)
  • The Candidate Blood-stage Malaria Vaccine P27A Induces a Robust Humoral
           Response in a Fast Track to the Field Phase 1 Trial in Exposed and
           Nonexposed Volunteers
    • Authors: Steiner-Monard V; Kamaka K, Karoui O, et al.
      Pages: 466 - 474
      Abstract: BackgroundP27A is an unstructured 104mer synthetic peptide from Plasmodium falciparum trophozoite exported protein 1 (TEX1), the target of human antibodies inhibiting parasite growth. The present project aimed at evaluating the safety and immunogenicity of P27A peptide vaccine in malaria-nonexposed European and malaria-exposed African adults.MethodsThis study was designed as a staggered, fast-track, randomized, antigen and adjuvant dose-finding, multicenter phase 1a/1b trial, conducted in Switzerland and Tanzania. P27A antigen (10 or 50 μg), adjuvanted with Alhydrogel or glucopyranosil lipid adjuvant stable emulsion (GLA-SE; 2.5 or 5 μg), or control rabies vaccine (Verorab) were administered intramuscularly to 16 malaria-nonexposed and 40 malaria-exposed subjects on days 0, 28, and 56. Local and systemic adverse events (AEs) as well as humoral and cellular immune responses were assessed after each injection and during the 34-week follow-up.ResultsMost AEs were mild to moderate and resolved completely within 48 hours. Systemic AEs were more frequent in the formulation with alum as compared to GLA-SE, whereas local AEs were more frequent after GLA-SE. No serious AEs occurred. Supported by a mixed Th1/Th2 cell-mediated immunity, P27A induced a marked specific antibody response able to recognize TEX1 in infected erythrocytes and to inhibit parasite growth through an antibody-dependent cellular inhibition mechanism. Incidence of AEs and antibody responses were significantly lower in malaria-exposed Tanzanian subjects than in nonexposed European subjects.ConclusionsThe candidate vaccine P27A was safe and induced a particularly robust immunogenic response in combination with GLA-SE. This formulation should be considered for future efficacy trials.Clinical Trials RegistrationNCT01949909, PACTR201310000683408.
      PubDate: Tue, 26 Jun 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy514
      Issue No: Vol. 68, No. 3 (2018)
  • Depressive Symptoms and Engagement in Human Immunodeficiency Virus Care
           Following Antiretroviral Therapy Initiation
    • Authors: Bengtson A; Pence B, Mimiaga M, et al.
      Pages: 475 - 481
      Abstract: BackgroundThe effect of depressive symptoms on progression through the human immunodeficiency virus (HIV) treatment cascade is poorly characterized.MethodsWe included participants from the Centers for AIDS Research Network of Integrated Clinic Systems cohort who were antiretroviral therapy (ART) naive, had at least 1 viral load and HIV appointment measure after ART initiation, and a depressive symptom measure within 6 months of ART initiation. Recent depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9) and categorized using a validated cut point (PHQ-9 ≥10). We followed participants from ART initiation through the first of the following events: loss to follow-up (>12 months with no HIV appointment), death, administrative censoring (2011–2014), or 5 years of follow-up. We used log binomial models with generalized estimating equations to estimate associations between recent depressive symptoms and having a detectable viral load (≥75 copies/mL) or missing an HIV visit over time.ResultsWe included 1057 HIV-infected adults who contributed 2424 person-years. At ART initiation, 30% of participants reported depressive symptoms. In multivariable analysis, recent depressive symptoms increased the risk of having a detectable viral load (risk ratio [RR], 1.28; 95% confidence interval [CI], 1.07, 1.53) over time. The association between depressive symptoms and missing an HIV visit (RR, 1.20; 95% CI, 1.05, 1.36) moved to the null after adjustment for preexisting mental health conditions (RR, 1.00; 95% CI, 0.85, 1.18).ConclusionsRecent depressive symptoms are a risk factor for unsuppressed viral load, while preexisting mental health conditions may influence HIV appointment adherence.
      PubDate: Tue, 12 Jun 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy496
      Issue No: Vol. 68, No. 3 (2018)
  • Etiological Characterization of the Cutaneous Ulcer Syndrome in Papua New
           Guinea Using Shotgun Metagenomics
    • Authors: Noguera-Julian M; González-Beiras C, Parera M, et al.
      Pages: 482 - 489
      Abstract: BackgroundTreponema pallidum subsp pertenue and Haemophilus ducreyi are causative agents of cutaneous ulcer (CU) in yaws-endemic regions in the tropics. However, a significant proportion of CU patients remain polymerase chain reaction (PCR) negative for both bacterial agents. We aimed to identify potential additional etiological agents of CU in a yaws-endemic region.MethodsThis population-based cohort study included children in Lihir Island (Papua New Guinea) examined during a yaws eradication campaign in October 2013–October 2014. All consenting patients with atraumatic exudative ulcers of >1 cm diameter were enrolled. Lesional swabs were collected for real-time PCR testing for T. pallidum subsp pertenue and H. ducreyi. We then performed shotgun whole DNA metagenomics sequencing on extracted DNA and taxonomically assigned shotgun sequences using a human microbiome reference.ResultsSequence data were available for 122 samples. Shotgun sequencing showed high classification agreement relative to PCR testing (area under the curve for T. pallidum/H. ducreyi was 0.92/0.85, respectively). Clustering analysis of shotgun data revealed compositional clusters where the dominant species (median relative abundance ranged from 32% to 66%) was H. ducreyi (23% of specimens), T. pallidum subsp pertenue (16%), Streptococcus dysgalactiae (12%), Arcanobacterium haemolyticum (8%), and Corynebacterium diphtheriae (8%). Sample clustering derived from ulcer microbial composition did not show geographical patterns.ConclusionsThese data suggest a diverse etiology of skin ulcers in yaws-endemic areas, which may help design more accurate diagnostic tools and more effective antimicrobial treatment approaches to the cutaneous ulcer syndrome.
      PubDate: Sat, 16 Jun 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy502
      Issue No: Vol. 68, No. 3 (2018)
  • Relationship Between Brain Arterial Pathology and Neurocognitive
           Performance Among Individuals With Human Immunodeficiency Virus
    • Authors: Gutierrez J; Byrd D, Yin M, et al.
      Pages: 490 - 497
      Abstract: BackgroundHuman immunodeficiency virus–positive (HIV+) individuals have higher rates of cognitive impairment and cerebrovascular disease compared with uninfected populations. We hypothesize that cerebrovascular disease, specifically brain large artery disease, may play a role in HIV-associated neurocognitive disorders (HAND).MethodsParticipants (N = 94) in the Manhattan HIV Brain Bank study were followed on average 32 ± 33 months with repeated neuropsychological examinations until death. We used five cognitive domains (motor, processing speed, working memory, verbal fluency, and executive functioning) to assess ante mortem performance. We quantified the diameter of the lumen and arterial wall thickness obtained during autopsy. The diagnoses of HAND were attributed using the American Academy of Neurology nosology. We used generalized linear mixed model to account for repeated measures, follow-up time, and codependence between arteries. Models were adjusted for demographics, viral loads, CD4 counts, history of opportunistic infections, and vascular risks.ResultsWe included 94 HIV+ individuals (mean age 56 ± 8.3, 68% men, 54% African American). In adjusted models, there was an association between arterial wall thickness and global cognitive score (B = −0.176, P value = .03), processing speed (B = −0.175, P = .05), and verbal fluency (B = −0.253, P = .02). Participants with incident or worsening HAND had thicker brain arterial walls (B = 0.523 ± 0.234, P = .03) and smaller arterial lumen (B = −0.633 ± 0.252, P = .01).ConclusionsWe report here a novel association between brain arterial wall thickening and poorer ante mortem cognitive performance and diagnosis of incident or worsening HAND at death. Strategies to preserve the arterial lumen or to prevent wall thickening may impact HAND.
      PubDate: Sat, 11 Aug 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy501
      Issue No: Vol. 68, No. 3 (2018)
  • Repurposing an Old Drug for a New Epidemic: Ursodeoxycholic Acid to
           Prevent Recurrent Clostridioides difficile Infection
    • Authors: Webb B; Brunner A, Lewis J, et al.
      Pages: 498 - 500
      Abstract: Recurrent Clostridioides difficile infection (rCDI) may be mediated in part by secondary bile acids. Here we report salvage therapy with ursodeoxycholic acid (UDCA) to prevent rCDI in 16 high-risk patients. Patients on UDCA had a low observed recurrence rate (12.5%). Controlled trials are needed to confirm these observations.
      PubDate: Wed, 18 Jul 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy568
      Issue No: Vol. 68, No. 3 (2018)
  • Developing and Assessing the Feasibility of a Home-based Preexposure
           Prophylaxis Monitoring and Support Program
    • Authors: Siegler A; Mayer K, Liu A, et al.
      Pages: 501 - 504
      Abstract: We piloted PrEP@Home, a preexposure prophylaxis system of remote laboratory and behavioral monitoring designed to replace routine quarterly follow-up visits with home care to reduce the patient and provider burden. The system was highly acceptable and in-demand for future use, and more than one-third of participants reported greater likelihood of persisting in care if available.
      PubDate: Wed, 04 Jul 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy529
      Issue No: Vol. 68, No. 3 (2018)
  • A ROADMAP Plan to Address Research Needs for Gonococcal Antimicrobial
           Resistance in China
    • Authors: Chen X; Yin Y, Li X.
      Pages: 505 - 510
      Abstract: Gonococcal antimicrobial resistance (AMR) has become a global threat significantly hampering the control of gonorrhea. Many socioeconomic, biological, behavioral, and programmatic factors have played an important role in driving the emergence, transmission and spread of gonococcal AMR. However, research to address these scientific and programmatic questions is limited in China. Here we propose a ROADMAP (acronym for resistance surveillance, outcomes due to AMR, antibiotic stewardship and application, diagnostic tools, mechanisms of AMR, antimicrobial assessment, and population pharmacokinetics and pharmacodynamics) plan for expanding interdisciplinary collaborations to address the research needs in China.
      PubDate: Mon, 09 Jul 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy566
      Issue No: Vol. 68, No. 3 (2018)
  • A Systematic Review and Meta-analysis of Ventilator-associated Pneumonia
           in Adults in Asia: An Analysis of National Income Level on Incidence and
    • Authors: Bonell A; Azarrafiy R, Huong V, et al.
      Pages: 511 - 518
      Abstract: BackgroundVentilator-associated pneumonia (VAP) is the commonest hospital-acquired infection (HAI) in intensive care. In Asia, VAP is increasingly caused by resistant gram-negative organisms. Despite the global antimicrobial resistance crisis, the epidemiology of VAP is poorly documented in Asia.MethodsWe systematically reviewed literature published on Ovid Medline, Embase Classic, and Embase from 1 January 1990 to 17 August 2017 to estimate incidence, prevalence, and etiology of VAP. We performed a meta-analysis to give pooled rates and rates by country income level.ResultsPooled incidence density of VAP was high in lower- and upper-middle-income countries and lower in high-income countries (18.5, 15.2, and 9.0 per 1000 ventilator-days, respectively). Acinetobacter baumannii (n = 3687 [26%]) and Pseudomonas aeruginosa (n = 3176 [22%]) were leading causes of VAP; Staphylococcus aureus caused 14% (n = 1999). Carbapenem resistance was common (57.1%).ConclusionsVAP remains a common cause of HAI, especially in low- and middle-income countries, and antibiotic resistance is high.
      PubDate: Thu, 05 Jul 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy543
      Issue No: Vol. 68, No. 3 (2018)
  • Ceftazidime/Avibactam, Meropenem/Vaborbactam, or Both' Clinical and
           Formulary Considerations
    • Authors: Pogue J; Bonomo R, Kaye K.
      Pages: 519 - 524
      Abstract: Ceftazidime/avibactam and meropenem/vaborbactam are changing the management of invasive infections due to carbapenem-resistant Enterobacteriaceae (CRE), leading to higher rates of clinical cure, decreased mortality, and decreased rates of acute kidney injury compared with colistin-based regimens. However, these 2 agents are not interchangeable with regard to management of CRE infections, and clinicians need to be aware of their differences. This review focuses on differences in the in vitro activity of these agents as a function of mechanism of carbapenem resistance, the clinical data supporting their superiority over colistin-based therapy, and the differences between agents with regard to propensity for selection of resistance. Furthermore, considerations and recommendations for hospital formularies and antibiotic stewardship programs regarding positioning of these agents are discussed.
      PubDate: Wed, 18 Jul 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy576
      Issue No: Vol. 68, No. 3 (2018)
  • The Consequences of Medically Important Invasive Arthropods: The
           Longhorned Tick, Haemaphysalis longicornis
    • Authors: Haddow A.
      Pages: 530 - 531
      Abstract: To the Editor—Invasive arthropods of medical and veterinary importance pose a major threat to the biosecurity of the United States [1]. The establishment of these species, which includes biting arthropods such as ticks and mosquitoes, increases the transmission potential for both native and introduced enzootic pathogens. Thus, the risk of pathogen spillover into human and domestic animal populations is exacerbated by the presence of such species. Recently, one invasive species, the longhorned tick, Haemaphysalis longicornis, was introduced and established in the United States.
      PubDate: Sat, 11 Aug 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy695
      Issue No: Vol. 68, No. 3 (2018)
  • The Complex Case of Aspergillus and Mortality
    • Authors: van de Peppel R; de Boer M.
      Pages: 531 - 532
      Abstract: To the Editor—With great interest we have read the article by Zilberberg et al [1] about outcomes of hospitalizations with invasive aspergillosis (IA). We compliment Zilberberg et al for describing the disease burden and costs associated with IA on this scale. Many recent medical journal articles about IA start their introduction by mentioning the high mortality associated with this condition. This easily leads to the assumption that this condition is often the direct cause of death. In this study again, the attention is drawn to the increased mortality observed in the group of patients with a discharge diagnosis of IA. However, we would like to bring to attention that care should be taken when interpreting the reported associations as causal relations.
      PubDate: Tue, 28 Aug 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy698
      Issue No: Vol. 68, No. 3 (2018)
  • Reply to van de Peppel and de Boer
    • Authors: Zilberberg M; Shorr A.
      Pages: 532 - 532
      Abstract: To the Editor—We agree with Drs van de Peppel and de Boer that there is reason to be cautious with the mortality estimates attributable to invasive aspergillosis (IA). In our study we reported propensity-adjusted IA-associated mortality of 14.1%, as compared to 10.3% among non-IA patients. As the letter correctly states, the structure of the database we used, the Healthcare Cost and Utilization Project National Inpatient Sample, did not allow for building competing risk models for hospital mortality to account for other possible causes. Some residual confounding, which we mentioned as a limitation in the Discussion section of our article, despite our attempts to mitigate its effects, may further jeopardize the accuracy of our estimates. The fact that our IA-associated mortality is substantially lower than what has been reported in prior investigations [1, 2] may be related to (1) true reductions in hospital mortality over time, (2) the limited time frame of our analysis (hospitalization), or (3) our broader inclusion of risk factors for IA, as noted by van de Peppel and de Boer.
      PubDate: Tue, 28 Aug 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy699
      Issue No: Vol. 68, No. 3 (2018)
  • Respiratory Infections as Predictors of Hospital Admission for Myocardial
           Infarction and Stroke: Pathophysiologic and Therapeutic Considerations
    • Authors: Kounis N; Koniari I, Soufras G, et al.
      Pages: 533 - 533
      Abstract: To the Editor—We read with interest the study of Blackburn et al [1], in which respiratory infections caused by influenza, parainfluenza, rhinovirus, respiratory syncytial virus, adenovirus, or human metapneumovirus were predictors of hospital admission for myocardial infarction and stroke, in particular among those aged ≥75 years but not in people aged <65 years. The authors attributed this association to proinflammatory cytokines, thrombotic events, disruption of atherosclerotic plaques, physiological impacts on heart rate, vasoconstriction, and perhaps comorbidities. They suggested evaluation of the impact of vaccination, antivirals, and antithrombotic agents.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy685
      Issue No: Vol. 68, No. 3 (2018)
  • Editor’s Note
    • Pages: 534 - 534
      Abstract: The revised manuscript entitled “Comparison of the Impact of Pneumococcal Conjugate Vaccine 10 or Pneumococcal Conjugate Vaccine 13 on Invasive Pneumococcal Disease in Equivalent Populations” by Naucler, et al. has been submitted by the authors as a replacement for the originally published version of the manuscript. Following publication, the authors became aware of several discrepancies in the originally designated crossover dates between vaccine products in certain counties from the actual crossover dates. After an extensive effort to more clearly delineate vaccine crossover dates, the authors have reanalyzed their data and have submitted a corrected manuscript. This version of the manuscript has been reviewed by members of the Editorial Board and is being republished after retraction of the original version of the manuscript.
      PubDate: Tue, 09 Oct 2018 00:00:00 GMT
      DOI: 10.1093/cid/ciy857
      Issue No: Vol. 68, No. 3 (2018)
  • Erratum
    • Pages: 534 - 534
      Abstract: An error appeared in an article published in the 15 July 2017 issue of the journal [Adimora AA, Cole SR, Eron JJ. US Black Women and Human Immunodeficiency Virus Prevention: Time for New Approaches to Clinical Trials. Clin Infect Dis 2017: 65:324–7]. The journal editors wish to clarify the authors’ potential conflicts of interest. No outside support was provided for activities related to the publication. Dr Adimora has received payment for consultative services provided to Merck and ViiV. Her institution has received payment for her consultative services to Gilead Sciences. Dr Eron has received payment for consultative services provided to Merck, Bristol-Myers Squibb, Hanssen, Gilead Sciences and ViiV. His institution has received payment for research grants from Gilead Sciences, Janssen, ViiV Healthcare, Bristol-Myers Squibb, and Abbvie. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest.
      PubDate: Wed, 16 May 2018 00:00:00 GMT
      DOI: 10.1093/cid/cix1078
      Issue No: Vol. 68, No. 3 (2018)
  • Erratum
    • Pages: 534 - 534
      Abstract: An error appeared in the 15 September 2017 issue of the journal [Kossow A, Kampmeier S, Willems S, et al. Control of Multidrug-Resistant Pseudomonas aeruginosa in Allogeneic Hematopoietic Stem Cell Transplant Recipients by a Novel Bundle Including Remodeling of Sanitary and Water Supply Systems. Clin Infect Dis 2017; 65:935–942. The last name of the sixth author should be “Burkhardt” [not “Burckhardt”].
      PubDate: Wed, 16 May 2018 00:00:00 GMT
      DOI: 10.1093/cid/cix1080
      Issue No: Vol. 68, No. 3 (2018)
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