Volume 12, Issue 4, April 2025

Prevalence of abscess in the past year was 48% and 35% among samples of people who inject drugs in 2018 and 2022, respectively. Injecting more than once daily, less consistent use of sterile needles, and not always cleaning skin with an alcohol swab before injecting were associated with abscesses.

In this study, among persons with HIV who use substances, polysubstance use was common and was independently associated with reporting more SDOH domains at risk and more adverse childhood trauma than no substance use. PWH who use any substances reported more mental health symptoms than controls and whether polysubstance use or single-substance use appeared less important than for SDOH at risk.

Symptom-based screening is insufficient for early diagnosis of all tuberculosis cases. A fully community-based approach to tuberculosis screening is feasible and acceptable for vulnerable populations, such as people who inject drugs. Chest x-ray with computer-aided detection software for tuberculosis is a promising tool.

People who use drugs face a higher risk of invasive fungal diseases, regardless of traditional risk factors. The incidence of invasive fungal disease in this population is rising. The most common fungal infections are invasive candidiasis and mold infections.

Among all patients with community-acquired infective endocarditis, injection drug use conferred 12-times greater odds of mortality during 5 years as compared with no injection drug use. Five-year survival of infective endocarditis in people who inject drugs was 69%.

Infective endocarditis disproportionally affects patients who inject drugs. Alternative treatment strategies for endocarditis in patients who inject drugs (such as outpatient parenteral antibiotic therapy, long-acting lipoglycopeptides, and oral antibiotic therapy) are underutilized in Tennessee for this patient population.

Substance use is a risk factor for the transmission and spread of certain infections. People with substance abuse should be screened for hepatitis B virus, hepatitis C virus, and HIV as their behavior makes them a high-risk population.

Among a cohort of people who inject drugs living at the San Diego-Tijuana border, unstable housing, female sex and previous sexually transmitted infection (STI) were significantly associated with higher odds of having a bacterial STI.

This trial is among the first randomized controlled trials to test an integrated substance use treatment, patient navigation and HIV care intervention to achieve viral suppression among persons with uncontrolled HIV infection and cocaine use.

Low-threshold HCV care features operational flexibility, leverages new technologies, and requires extensive patient outreach. Conflicting organizational culture, a difficult funding environment, and unmet social needs serve as barriers to low-threshold care. Adequate staffing for care coordination is a crucial component.

The InMOTION mobile pharmacy and clinic (MPC) is the first legalized mobile retail pharmacy and clinic in the United States. The MPC meets people where they are at a community level to address the intersectional needs of substance use, infectious disease, mental health, and social support, often neglected by fragmented healthcare systems for people who use drugs.

A rapid systematic review found antivirals and spike protein receptor-binding antibodies not associated with serious adverse events when used to treat COVID-19. Tocilizumab was associated with neutropenia and convalescent plasma was associated with bleeding events; both were associated with infection.

Hepatitis A vaccination in people with HIV leads to lower seroconversion rates and less durable antibody responses compared to immunocompetent individuals. We highlight in this review the potential need for serologic monitoring and revaccination strategies that would optimize lifelong protection.

This systematic review and meta-analysis reveals high antibiotic resistance in Salmonella typhi and Salmonella paratyphi in Pakistan, with alarming resistance to first-line antibiotics. The emergence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains highlights the urgent need for updated treatment guidelines, improved antibiotic stewardship, and enhanced vaccination efforts in endemic regions.

This study demonstrates the use of personalized phage therapy to target Staphylococcus epidermidis infections in patients with left ventricular assist devices. It highlights the potential of patient-specific phages to reduce biofilm-associated infections, especially in combination with antibiotics like rifampicin.

There is a high prevalence of third-generation cephalosporin- and carbapenem-resistant Klebsiella pneumoniae causing health care–associated bacteremia of urinary origin in Spain. There is also a predominance of ST307/CTX-M-15 and other multidrug-resistant high-risk clones. Third-generation cephalosporin- and carbapenem-resistant K pneumoniae infections were associated with prior antibiotic use and inadequate empirical treatment.

COVID-19 reinfection rates in São Paulo were driven by socioeconomic disparities and variant evolution, with higher rates in socially vulnerable areas. Findings support targeted interventions and adaptive strategies to protect high-risk populations.

Immortal time bias exaggerates estimates of treatment efficacy in naive analyses of observational data. We developed a tool to estimate the extent of this bias. The benefits of giving intravenous immunoglobulin in streptococcal toxic shock syndrome have likely been overstated.

This subgroup analysis of the prospective, phase 3, open-label study PUNCH CD3-OLS reports that fecal microbiota, live-jslm, was safe and efficacious for the prevention of recurrent Clostridioides difficile infection in participants with mild to moderate immunocompromising conditions.

Patients with Staphylococcus aureus native valve endocarditis may have better outcomes with β-lactam monotherapy (adverse events and drug-drug interactions, 6-month infective endocarditis relapse, and 1-year mortality) as compared with patients receiving combination treatment with adjunctive rifampin and/or gentamicin.

This real-world, multicenter study examined patient characteristics, microbiologic data, prescribing patterns, and clinical outcomes associated with imipenem-cilastatin-relebactam (IMI/REL). Predominantly used to target Pseudomonas aeruginosa, IMI/REL demonstrated a favorable safety and efficacy profile in a cohort with significant comorbid conditions and illness acuity.

Dolutegravir-based antiretroviral therapy treatment regimens lacked pharmacokinetic interactions with tacrolimus and mycophenolic acid in solid organ transplantation recipients with HIV. The treatments were efficacious and mostly safe, but the higher rate of treatment interruptions because of adverse events warrants larger studies.

This study compares short-read (Illumina) and long-read (Oxford Nanopore Technologies, ONT) sequencing technologies for detecting antimicrobial resistance (AMR) genes in ESKAPE pathogens. We highlight the strengths and limitations of each approach and emphasize the utility of hybrid assembly to combine their respective benefits.

Plasma cytokines accurately distinguish pediatric musculoskeletal infections from Lyme or inflammatory arthritis and may assist in initial diagnostic decision-making. A novel plasma 3-cytokine panel (interleukin-6, interleukin-17A, and colony stimulating factor-1) accurately distinguishes pediatric musculoskeletal infections from Lyme had better diagnostic accuracy than 5 traditional plasma biomarkers.

A 50-year-old woman diagnosed with HIV in 2008 developed asthenia, weight loss, and skin macules weeks after reintroducing antiretroviral treatment, which she had abandoned 2 years before. On physical examination, she presented generalized lymphadenopathy and hepatomegaly. Laboratory tests showed low CD4 count and detectable viral load (95 cells/mm³–4.3% and 20 051 copies/mL, respectively). Computed tomography of the chest, abdomen, and neck showed generalized adenopathies, splenomegaly, collection in the right psoas muscle, and a right breast nodule. Surgical approaches of lymph node, psoas collection, and right breast were performed. Histopathology revealed rounded fungal structures, detected by the silver impregnation technique, characteristic of Paracoccidioides brasilienses. Mycological direct examination of lymph nodes aspiration and of psoas abscess disclosed yeast cells with multiple gemulation, characteristic of P brasilienses. Oral treatment was initiated with sulfamethoxazole (400 mg) and trimethoprim (80 mg), 3 tablets every 8 hours. However, the disease was refractory to initial treatment; liposomal amphotericin and corticosteroids were added, antiretroviral regimen was changed, surgical drainage of the psoas collection was performed, and intravenous trimethoprim-sulfamethoxazole plus oral itraconazole were initiated, with a good response.

Time-updated analyses of the REPRIEVE cohort suggest that antiretroviral therapies featuring abacavir backbones increase hazard of major adverse cardiovascular events by at least 40% compared to tenofovir backbones, with little difference between tenofovir alafenamide and tenofovir disoproxil fumarate.

A large-scale review of blood culture-confirmed typhoid cases in Pakistan (2017–2019) revealed a high prevalence of extensively drug-resistant (XDR) Salmonella Typhi, particularly in Sindh, where 57% of isolates were XDR. Alarmingly, most S. Typhi isolates showed resistance to multiple first-line antibiotics, while S. Paratyphi remained largely susceptible. These findings highlight the urgent need for targeted interventions to curb the spread of drug-resistant typhoid.

Injection-related infections are common among people who inject drugs, with prevalence varying by country and coverage of harm reduction services. Enhanced measures to prevent and manage injection-related infections are required to reduce morbidity and mortality rates among this population.

Traditional Lyme disease (LD) surveillance underestimates disease incidence in the United States. We validated claims-based algorithms to identify early localized and disseminated LD in states with high and low incidence. These algorithms can be used to estimate national LD incidence.

Despite investments over several decades to prevent the spread of measles, a new outbreak of the disease began in Afghanistan in July of 2021. Confirmed measles infections in Afghanistan increased by more than 200% since July 2021, Early infancy was a risk factor for confirmed measles during the first two years of the recent outbreak, as compared to two years prior.

In prospective household-based cohort studies in Lima, Peru, we assessed the prevalence of pneumococcal carriage and related antibiotic resistance genes just before and during the COVID-19 pandemic when strict social mitigation measures were in place.

Study findings indicate that hospitalized and ambulatory patients treated for lower respiratory tract illness had elevated rates of mortality (versus matched comparison patients) in both short- and long-term analyses; mortality rates were highest in older adults and those with comorbidities.

We found that group B Streptococcus (GBS) is an important cause of neonatal and young infant disease in Uganda and confirmed that maternally derived antibodies were lower in early-onset GBS cases than in healthy exposed controls.

Stool targeted next-generation sequencing of Mycobacterium tuberculosis, completed within 8 hours using nanopore technology, is an accurate method for the design of effective treatment regimens in patients with pulmonary tuberculosis in resource-limited countries with high burdens of drug-resistant tuberculosis.

We tested human-generated bioaerosol transmission of SARS-CoV-2 via building ventilation by directing ward-extract air to caged hamsters. Over 58% of animals tested showed evidence of transmitted infection, furthering our understanding of viral transmission in the context of the COVID-19 pandemic.

Based on 398 children aged <5 years with presumptive tuberculosis in Uganda, the sensitivity of Xpert MTB/RIF Ultra on 2 consecutive oral swabs collected in a single cryovial for the microbiological diagnosis of pulmonary tuberculosis was 7%.

Nirmatrelvir/ritonavir can prevent severe COVID-19 in individuals infected with SARS-CoV-2 who are at high risk. The study assesses health outcomes and cost-effectiveness through a decision-analytic model. We demonstrate potential cost-effective reductions in hospitalizations and deaths with lower nirmatrelvir/ritonavir price, highlighting the importance of reevaluating current drug pricing.

Following the algorithmic approach, the total cure rate of corynebacterial periprosthetic joint infections was 91%, slightly lower in the polymicrobial compared to the monomicrobial group. When indicated, DAIR procedure appears as an optimal treatment choice, and the antibiotic combination with rifampicin seems to be beneficial when the implant is retained.

People with HIV are at increased risk for cardiometabolic complications. Here, we demonstrate that treatment with the glucagon-like peptide 1 receptor agonist semaglutide reduced levels of pro-inflammatory biomarkers that have been linked to morbidity and mortality in people with HIV.

We observed no significant differences in immune reconstitution (measured by CD4 T cell count and CD4/CD8 ratio) between metformin treated individuals and matched controls over a 2-year follow-up period.

A large retrospective study investigated respiratory syncytial virus or influenza virus infections in patients with lymphoma and multiple myeloma. Risk factors for lower respiratory tract infection and mortality were identified, facilitating better management strategies.

This systematic review and meta-analysis assessed the risk of breakthrough fungal infections in patients with hematologic malignancy and hematopoietic stem cell transplant receiving isavuconazole prophylaxis. This study suggests a high incidence of breakthrough infections, warranting clinical vigilance.

Patients with obesity receiving vancomycin for treatment of severe methicillin-resistant Staphylococcus aureus infections experienced lower rates of acute kidney injury, higher initial target attainment, and decreased overall vancomycin exposure when utilizing area under the concentration–time curve versus a trough-based dosing strategy.

Viral detection by metagenomic next-generation sequencing at predefined timepoints in haploidentical hematopoietic stem cell transplant recipients did not increase compared to patients receiving bone marrow from an HLA-matched donor despite the stronger immunosuppression due to posttransplant cyclophosphamide treatment in the former group.

Limited data exist regarding chronic symptom persistence postdengue in children. Among 6452 children infected with dengue and 260 749 pediatric cases of COVID-19, lower risk of postacute complications was observed after dengue vs COVID-19. Higher risk of appendicitis was reported 31 to 300 days after dengue vs COVID-19.

IVX-A12 is an investigational, combination, protein-based virus-like particle vaccine against respiratory syncytial virus (RSV) and human metapneumovirus (hMPV). IVX-A12 was well-tolerated and elicited RSV- and hMPV-specific antibody responses in adults 60–75 years of age, supporting further clinical evaluation.

Neutralizing antibody levels against measles, mumps, and rubella (MMR) declined over 10 years in 2- and 3-dose MMR vaccinees. Most participants maintained seroprotective levels for measles and rubella, but >25% did not meet the presumed threshold for mumps.