Early Oral Switch to Linezolid for Low-risk Patients WithStaphylococcus aureus Bloodstream Infections: A Propensity-matched Cohort Study     Rein Willekens; Mireia Puig-Asensio; Isabel Ruiz-Camps ; Maria N Larrosa; Juan J González-López ...   Treatment of Staphylococcus aureus bloodstream infections in selected low-risk patients with an early oral switch to linezolid between days 3 and 9 of treatment until completion, yielded similar clinical outcomes as standard parenteral treatment, while reducing hospital stay.     Procalcitonin-guided Antibiotic Treatment in Patients With Positive Blood Cultures: A Patient-level Meta-analysis of Randomized Trials     Marc A Meier; Angela Branche; Olivia L Neeser; Yannick Wirz; Sebastian Haubitz ...   In this patient-level meta-analysis including 523 patients with bacteremia, we found that procalcitonin-guided antibiotic management resulted in significantly lower antibiotic exposure with similar mortality rates.     Comparison of 3 Days Amoxicillin Versus 5 Days Co-Trimoxazole for Treatment of Fast-breathing Pneumonia by Community Health Workers in Children Aged 2–59 Months in Pakistan: A Cluster-randomized Trial     Salim Sadruddin ; Ibad ul Haque Khan; Matthew P Fox; Abdul Bari; Attaullah Khan ...   This cluster-randomized trial compared 3-day oral amoxicillin versus 5-day oral co-trimoxazole for the at-home treatment of fast-breathing pneumonia among children aged 2–59 months by community health workers in Pakistan. Oral amoxicillin treatment was significantly better than oral co-trimoxazole treatment.     Cross-sectional Whole-genome Sequencing and Epidemiological Study of Multidrug-resistant Mycobacterium tuberculosis in China     Hairong Huang; Nan Ding ; Tingting Yang; Cuidan Li; Xinmiao Jia ...   We describe the epidemiological/drug-resistance characteristics, potential drug-resistance genes/intergenic regions/single-nucleotide polymorphisms, and effective population changes of multidrug-resistant (MDR) tuberculosis in China through comprehensive analysis of the epidemiological, drug-resistance, and whole-genome sequencing data of 357 MDR tuberculosis strains from the first Chinese national survey of drug-resistant tuberculosis.     Role of Early De-escalation of Antimicrobial Therapy on Risk ofClostridioides difficile Infection Following Enterobacteriaceae Bloodstream Infections     Megan M Seddon; P Brandon Bookstaver; Julie Ann Justo ; Joseph Kohn; Hana Rac ...   There was a 3-fold increase in the risk of Clostridioides difficile infection in hospitalized adult patients with Enterobacteriaceae bloodstream infections who received >48 hours of antipseudomonal β-lactams compared to those who received these agents for ≤48 hours.     Next-generation Diagnostics for Melioidosis: Evaluation of a Prototype i-STAT Cartridge to Detect Burkholderia pseudomallei Biomarkers     Kevin L Schully; Charles C Young; Mark Mayo; Amy L Connolly; Vanessa Rigas ...   We report on a prototype melioidosis assay cartridge adapting the i-STAT device and technology to detect Burkholderia pseudomallei purified capsular polysaccharide (CPS) using anti-B. pseudomallei CPS antibody. The i-STAT results showed unprecedented sensitivity and specificity for testing blood and urine.     Phylogeographic Analysis Reveals Multiple International transmission Events Have Driven the Global Emergence ofEscherichia coli O157:H7     Eelco Franz; Ovidiu Rotariu; Bruno S Lopes; Marion MacRae; James L Bono ...   Phylogeographic analyses identified 34 major, international transmission events, starting in Europe around 1890, that resulted in the current distribution of Escherchia coli O157:H7. These were likely facilitated by global cattle movements, and will inform policy to reduce this pathogen’s spread.     Short-term Pasteurization of Breast Milk to Prevent Postnatal Cytomegalovirus Transmission in Very Preterm Infants     Sascha Bapistella; Klaus Hamprecht; Wolfgang Thomas; Christian P Speer ; Klaus Dietz ...   In this interventional trial with historic controls, short-term pasteurization (62°C, 5 seconds) of breast milk from cytomegalovirus (CMV)-immunoglobulin G–seropositive mothers significantly decreased CMV infections of very preterm infants from 17/83 in controls to 2/87 in the study group (P = .0003).     Multistate Outbreak of Burkholderia cepacia Complex Bloodstream Infections After Exposure to Contaminated Saline Flush Syringes: United States, 2016–2017     Richard B Brooks; Patrick K Mitchell; Jeffrey R Miller ; Amber M Vasquez; Jessica Havlicek ...   An outbreak of 162 Burkholderia cepacia complex bloodstream infections in 5 states during November 2016–January 2017 was linked to contaminated pre-filled saline flush syringes, highlighting the importance of strong quality control measures in the manufacturing of sterile products.     Transmission of Eastern Equine Encephalitis Virus From an Organ Donor to 3 Transplant Recipients     Stephanie M Pouch; Shalika B Katugaha; Wun-Ju Shieh; Pallavi Annambhotla ; William L Walker ...   We describe the first reported transmission of eastern equine encephalitis virus (EEEV) infection through solid organ transplant. The organ donor was likely infected with EEEV via mosquito-borne transmission. Clinicians should be aware of EEEV as a cause of transplant-associated encephalitis.     Mycoplasma genitalium Infections in Women Attending a Sexually Transmitted Disease Clinic in New Orleans     Rebecca A Lillis; David H Martin; M Jacques Nsuami   Among 400 women attending sexually transmitted disease (STD) clinics, Mycoplasma genitalium was associated with factors typically associated with well-established bacterial sexually transmitted infections; it frequently accompanied most conditions commonly treated in STD clinics and contributed to multiple possible causes of cervicitis.     Risk Factors for Unnecessary Antibiotic Therapy: A Major Role for Clinical Management     Pierre-Marie Roger; Eve Montera; Diane Lesselingue; Nathalie Troadec ; Patrick Charlot ...   This study shows that unnecessary antibiotic therapy is the predominant feature of antimicrobial treatments. The main risk factors are unspecified diagnosis and lack of microbial investigation, implying that antimicrobial stewardship programs should focus on these steps of clinical management.     High Relative Frequency of Enteroaggregative Escherichia coliAmong Patients With Reportable Enteric Pathogens, Minnesota, 2016–2017     Aaron Beczkiewicz; Elizabeth Cebelinski; Marijke Decuir ; Victoria Lappi; Xiong Wang ...   We provide evidence that enteroaggregative Escherichia coli (EAEC) is an important cause of diarrheal illness in Minnesota. Sixty-eight percent of EAEC cases in our study were domestically acquired. Several virulence genes were associated with clinical characteristics.     Blood Schizonticidal Activity and Safety of Tafenoquine When Administered as Chemoprophylaxis to Healthy, Nonimmune Participants Followed by Blood Stage Plasmodium falciparumChallenge: A Randomized, Double-blind, Placebo-controlled Phase 1b Study     James S McCarthy; Bryan Smith; Mark Reid ; Jonathan Berman; Louise Marquart ...   Previous studies show that tafenoquine is effective against Plasmodium liver stages and subsequent erythrocytic asexual stages. Confirmation of blood schizonticidal activity against P. falciparum is warranted in a nonimmune population to confirm the data from African tafenoquine studies.     Investigating the Impact of Early Valve Surgery on Survival inStaphylococcus aureus Infective Endocarditis Using a Marginal Structural Model Approach: Results of a Large, Prospectively Evaluated Cohort     Siegbert Rieg; Maja von Cube; Achim J Kaasch ; Bastian Bonaventura; Wolfgang Bothe ...   This study substantially refines the analytical armamentarium employed to answer the question of early valve surgery in endocarditis. Using a marginal structural model approach, valve surgery within 60 days was not associated with a lower mortality rate in Staphylococcus aureus endocarditis.     Declining Incidence of Invasive Meningococcal Disease in South Africa: 2003–2016     Susan Meiring; Cheryl Cohen; Linda de Gouveia; Mignon du Plessis ; Ranmini Kularatne ...   Despite limited vaccination, from 2003–2016, invasive meningococcal disease (IMD) declined by 76%. Infants had the highest incidence; 36% of cases were human immunodeficiency virus coinfected; and case fatality was 17%. Serogroups W and B caused the majority of IMD.     Epidemiologic and Genotypic Distribution of Noroviruses Among Children With Acute Diarrhea and Healthy Controls in a Low-income Rural Setting     Mohammad Enayet Hossain; Rajibur Rahman; Sk Imran Ali ; Md Muzahidul Islam; Mohammed Ziaur Rahman ...   Norovirus was identified as a key cause of acute diarrhea in children <5 years of age; however, the prevalence and genotype distribution were almost similar to age-matched healthy controls. Genotype II.4 caused higher disease severity than other norovirus genotypes.     Ledipasvir/Sofosbuvir for 8 Weeks to Treat Acute Hepatitis C Virus Infections in Men With Human Immunodeficiency Virus Infections: Sofosbuvir-Containing Regimens Without Interferon for Treatment of Acute HCV in HIV-1 Infected Individuals     Susanna Naggie; Daniel S Fierer; Michael D Hughes ; Arthur Y Kim; Annie Luetkemeyer ...   SWIFT-C assesses 8 weeks of ledipasvir/sofosbuvir treatment for acute hepatitis C virus (HCV) infections in human immunodeficiency virus–infected participants. The high treatment response (100%) suggests direct-acting antiviral therapy can be shortened in early HCV infection.     Clinical and Virologic Outcomes Following Initiation of Antiretroviral Therapy Among Seroconverters in the Microbicide Trials Network-020 Phase III Trial of the Dapivirine Vaginal Ring     Sharon A Riddler; Jennifer E Balkus; Urvi M Parikh ; John W Mellors; Carolyne Akello ...   A vaginal ring containing dapirvirine demonstrated efficacy for human immunodeficiency virus (HIV)-1 prevention. Dapivirine ring use at the time of HIV-1 acquisition did not impact the subsequent HIV-1 disease progression or responses to non-nucleoside reverse transcriptase inhibitor–containing antiretroviral therapy.

BRIEF REPORTS       Clinical Practice Variation Among Adult Infectious Disease Physicians in the Management of Staphylococcus aureusBacteremia     Catherine Liu; Luke Strnad; Susan E Beekmann; Philip M Polgreen; Henry F Chambers     A Cluster of Cefepime-induced Neutropenia During Outpatient Parenteral Antimicrobial Therapy     Kap Sum Foong; Kevin Hsueh; Thomas C Bailey; Lan Luong ; Ayesha Iqbal ...     Human Immunodeficiency Virus (HIV) Viral Suppression After Transition From Having No Healthcare Coverage and Relying on Ryan White HIV/AIDS Program Support to Medicaid or Private Health Insurance     Julia Raifman; Keri Althoff; Peter F Rebeiro ; W Christopher Mathews; Laura W Cheever ...     Discovery of Half-life of Circulating Hepatitis B Surface Antigen in Patients With Chronic Hepatitis B Infection Using Heavy Water Labeling     Rohit Loomba; Martin Decaris; Kelvin W Li; Mahalakshmi Shankaran; Hussein Mohammed ...

VIEWPOINTS       Prevalent Misconceptions About Opioid Use Disorders in the United States Produce Failed Policy and Public Health Responses     Robert Heimer; Kathryn Hawk; Sten H Vermund   The current crisis of illicit opioid use and overdose has its roots in 2 prior epidemics, misconceptions about treatment of chronic pain, and stigma against drug users. Correcting historical inaccuracies and addressing stigma are key to amelioration of the crisis.     The Impact of Antibiotic Stewardship Program Resources on Infection Prevention Programs     Susan C Bleasdale; Marsha Barnden; Sue Barnes   Physician time allocation is needed for infection prevention (IP), similar to antimicrobial stewardship. Regulatory advocacy of IP structure will highlight the need to expand the workforce in IP and in antimicrobial stewardship. Structured IP curriculum is needed in infectious disease fellowship training.

PHOTO QUIZ       A 53-Year-Old Haitian Male Presenting With a Liver Abscess     Frances Ue; Lou Ann Bruno-Murtha; Duncan Kuhn; Linda Shipton

CORRESPONDENCE       Better Guidance on Treating Hepatitis C Virus in Pregnancy: The Time Is Now     James B McAuley; Ryan Close     Reply to McAuley and Close     Ravi Jhaveri; Arthur Y Kim     Risk of Daptomycin-associated Myopathy With Concomitant Statin Use     Justin A Wasko; Eric Dietrich; Kyle Davis     Reply to Wasko et al     Ryan K Dare; Sara L Van Driest; Thomas R Talbot     Cultural Differences Between Surgical and Medical Teams: Is it Time for Comanagement?     Nathan Peiffer-Smadja; Thomas Hanslik; Pierre Mordant; François-Xavier Lescure     Reply to Peiffer-Smadja et al     Esmita Charani; Raheelah Ahmad; Timothy Miles Rawson; Enrique Castro-Sanchèz ; Carolyn Tarrant ...