In late August, 13 employees at the Wexner Center signed on to a letter sent to university officials in which they expressed a vote of no confidence in the leadership of executive director Gaëtane Ver...

Listen to this Pretty Comprehensive Pod on PCP. Alyssa and Callum cover:EpidemiologyTaxonomy (PCP vs PJP?)Diagnosis TreatmentNote this pod episode also includes some Positively Jolly Puns on...

Oral samples show promise for tuberculosis (TB) diagnosis, but data from different sample types and sputum-scarce individuals remain limited.

Overdiagnosis of urinary tract infections (UTIs) and unnecessary antibiotics are common. This is particularly true in older adult populations such as Veterans. Diagnostic stewardship can decrease overdiagnosis and overtreatment, but optimal implementation of such interventions has not been fully studied.MethodsThis was a multicenter hybrid type two effectiveness-implementation study of UTI diagnostic stewardship interventions at three participating VA hospitals. Each hospital implemented one intervention at either the ordering, processing (conditional reflex urine culturing) or reporting stage. The primary outcome was inpatient UTI antibiotic days of therapy (DOTs) per admission evaluated using generalized estimating equations. Secondary outcomes included rates of urine cultures ordered and performed and, a safety measure of secondary bacteremia from a uropathogen.Results37,085 hospital admissions occurred in the pre-intervention phase and 17,221 in the post-intervention phase. Of these, 6,914 (12.7%) included UTI antibiotics. Hospital 3, which implemented conditional reflex urine culturing had a 39.5% reduction in UTI DOT (95% confidence interval (CI), 13.9%, 57.5%) in the year following the intervention. Additionally, hospital 3 noted fewer urine cultures ordered (22.8% immediate and 35.7% slope reduction) and performed (38.9% immediate and 38.8% slope reduction). No change in UTI DOT was observed for ordering or results reporting interventions at other hospitals. There was no difference in the safety measure of uropathogen bacteremia.ConclusionsConditional reflex urine culturing had a large decrease on UTI antibiotic DOTs and urine cultures performed. Health-systems or medical centers starting urine culture diagnostic stewardship should implement conditional reflex urine culturing first.

This report describes a Salmonella outbreak linked to ...

Fungal meningitis outbreaks are rare and entail high mortality rates. Beginning May 2023, we investigated fungal meningitis caused by Fusarium solani species complex occurring in U.S. patients who received epidural anesthesia in Matamoros, Mexico.MethodsEarly epidemiological information suggested U.S. patients with suspected fungal meningitis had undergone mostly cosmetic procedures under epidural anesthesia performed in two Matamoros clinics. U.S. patients known to have received surgery at these clinics during January 1–May 13, 2023, (clinic closures date) were identified and notified by public health officials. Epidemiological and clinical data were used to update diagnostic and clinical guidance for outbreak response, including use of the experimental antifungal fosmanogepix. Whole genome sequencing was conducted on outbreak isolates.ResultsU.S. public health officials attempted to contact 233 potentially exposed U.S. residents who underwent surgeries, mostly cosmetic, in Mexico, reaching 170 (73%). Of those, 104 (61%) reported receiving epidural anesthesia and were therefore considered potentially at risk for fungal meningitis. At least 30/104 (29%) at-risk patients received a diagnostic lumbar puncture; 24 (23 women, 17 Hispanic or Latino) were diagnosed with fungal meningitis, and six were not. Twelve (50%) with fungal meningitis died. All cases involved epidural anesthesia administered by the same anesthesiologist in Mexico. Whole genome sequencing showed that patient isolates of Fusarium from the two implicated clinics in Matamoros, Mexico, were genetically closely related.ConclusionsClinicians should maintain suspicion for fungal meningitis in patients with negative bacterial culture, viral culture and molecular testing with a history of epidural anesthesia for any reason.

Millions of households have cats or dogs as pets, and infections due to bites or scratches are increasing, with the most common pathogens being Pasteurella spp., Bartonella spp., Capnocytophaga spp, a...

New and minimally invasive tools to aid the diagnosis of invasive fungal diseases (IFD) are urgently needed as the immunocompromised population at highest risk increases. Advancements in molecular technology have rendered new diagnostics more readily available for clinical use.

We identified age-related differences in antibiotic formulations in a pediatric ED. These findings can inform prescribing practices to optimize medication adherence and treatment effectiveness through...

AbstractThis study describes a cluster of severe Parvovirus B19 associated myocarditis in children across England in the context of an increase in circulating virus. Cases were identified across three large children’s centres. Eight cases presented during 1/1/19–31/12/23 compared with 19 during 1/1/24–31/08/24. Almost all (n=25, 93%) required intensive care and 24 (88%) received inotropes and 4 (15%) ECMO. Myocarditis appears to be temporally associated and a late sequalae of Parvovirus B19 resulting in high rates of ICU admission. Testing (using serology and blood PCR) should be part of syndromic screen for all children with severe myocarditis.

AbstractObjectives. To assess the clinical features, antibiotic therapy and outcomes of carbapenemase-producing Enterobacterales bloodstream infection (CPE