Τρίτη 22 Οκτωβρίου 2019

Declining Hospitalizations among Persons With HIV; Time to Leave no One Behind
Clinical Infectious Diseases Advance Access
5h
Hospitalization Rates and Outcomes among Persons Living with HIV in the Southeastern United States, 1996–2016
AbstractBackgroundAdvances in antiretroviral therapy, aging, and comorbidities impact hospitalization rates in HIV-infected populations. We examined temporal trends and patient characteristics associated with hospitalization rates and outcomes.MethodsStudy population included patients in the University of North Carolina Center for AIDS Research HIV Clinical Cohort receiving clinical care 1996–2016. We estimated annual hospitalization rates, time to inpatient mortality or live discharge, and 30-day...
Clinical Infectious Diseases Advance Access
5h
Antibiotic prescribing before and after the diagnosis of comorbidity: a cohort study using primary care electronic health records
AbstractBackgroundComorbidities like diabetes or COPD increase patients’ susceptibility to infections, but it is unclear how the onset of comorbidity impacts antibiotic use. We aimed to estimate rates of antibiotic use before and after diagnosis of comorbidity in primary care to identify opportunities for antibiotic stewardship.MethodsWe analysed UK primary care records from the Clinical Practice Research Datalink (CPRD) database. Adults registered between 2008-2015 without prior comorbidity diagnoses...
Clinical Infectious Diseases Advance Access
5h
Incidence and Risk Factors for Invasive Pneumococcal Disease and Community-acquired Pneumonia in Human Immunodeficiency Virus–Infected Individuals in a High-income Setting
AbstractBackgroundAlthough people living with human immunodeficiency virus (PLWH) are at increased risk of invasive pneumococcal disease (IPD) and community-acquired pneumonia (CAP), it is unclear whether this remains the case in the setting of early initiation of combination antiretroviral therapy (cART), at high CD4 cell counts. This is important, as pneumococcal vaccination coverage in PLWH is low in Europe and the United States, despite longstanding international recommendations.MethodsWe identified...
Clinical Infectious Diseases Advance Access
5h
Antimicrobial Resistance Following Azithromycin Mass Drug Administration: Potential Surveillance Strategies to Assess Public Health Impact
AbstractThe reduction in childhood mortality noted in trials investigating azithromycin mass drug administration (MDA) for trachoma control has been confirmed by a recent large randomized controlled trial. Population-level implementation of azithromycin MDA may lead to selection of multiresistant pathogens. Evidence suggests that repeated azithromycin MDA may result in a sustained increase in macrolide and other antibiotic resistance in gut and respiratory bacteria. Current evidence comes from standard...
Clinical Infectious Diseases Advance Access
5h
Pneumocystis Infection Outbreaks in Organ Transplantation Units in France: A Nation-Wide Survey
AbstractThe burden of nosocomial Pneumocystis infections in transplantation units in France was evaluated through a retrospective survey. Over 12 years, 16 outbreaks occurred, including 13 among renal transplant recipients (RTRs). We performed Pneumocystis jirovecii genotyping in 5 outbreaks, which suggested that specific strains may have been selected by RTRs.
Clinical Infectious Diseases Advance Access
5h

Hepatitis C Virus Prevalence and Incidence in a Large Nationwide Sample of Patients in Opioid Substitution Treatment in Germany: A Prospective Cohort Study
AbstractBackgroundHepatitis C virus (HCV) infection is highly prevalent among people who inject drugs (PWID). Accurate data on HCV prevalence and incidence rates among patients receiving opioid substitution treatment (OST) are needed to estimate the current and future burden of HCV infections in this high-risk population.MethodsBaseline data from routine care were collected between October 2014 and June 2016 from randomly selected OST facilities in Germany. The primary outcome measure was the HCV...
Clinical Infectious Diseases Advance Access
5h
Lopinavir-Ritonavir Impairs Adrenal Function in Infants
AbstractBackgroundPerinatal treatment with lopinavir boosted by ritonavir (LPV/r) is associated with steroidogenic abnormalities. Long-term effects in infants have not been studied.MethodsAdrenal-hormone profiles were compared at weeks 6 and 26 between human immunodeficiency virus (HIV)-1–exposed but uninfected infants randomly assigned at 7 days of life to prophylaxis with LPV/r or lamivudine (3TC) to prevent transmission during breastfeeding. LPV/r in vitro effect on steroidogenesis was assessed...
Clinical Infectious Diseases Advance Access
5h
Isoniazid Preventive Therapy and Pregnancy Outcomes In HIV-Infected Women in the Tshepiso Cohort
AbstractBackgroundBoth pregnancy and HIV increase the risk of tuberculosis disease which results in poor maternal, pregnancy, and infant outcomes. Isoniazid preventive therapy (IPT) reduces mortality among HIV-infected individuals in high-burden settings, but has recently been associated with adverse pregnancy outcomes when initiated during pregnancy.MethodsIn this secondary analysis, we used multivariable logistic regression to evaluate the association between IPT exposure and adverse pregnancy...
Clinical Infectious Diseases Advance Access
5h

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