Infectious Disease Topics
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Empiric Anti-MRSA Therapy in Pneumonia May Not Always Be a Good Idea
In a retrospective cohort study, 88,605 patients in the Veterans Administration system who were hospitalized with pneumonia were examined. Thirty-eight percent received empiric anti-methicillin-resistant Staphylococcus aureus (MRSA) treatment. Empiric anti-MRSA treatment was not associated with a reduction in mortality in any subgroup of patients studied and appeared to cause harm in many patients.
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Combination Therapy of MRSA Bacteremia Was Not Beneficial in a Randomized Clinical Trial
In a randomized clinical trial conducted at 27 hospitals in four countries, researchers found that the addition of an antistaphylococcal beta-lactam to vancomycin or daptomycin (99% received vancomycin) did not lead to improved outcomes in MRSA bacteremia. The trial was stopped early because of safety concerns, including a higher risk of acute kidney injury in the combination group.
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Quantifying the Risk of SARS-CoV-2 Transmission in the United States
In the United States, the rate of symptomatic transmission of SARS-CoV-2 to contacts was only 0.45%, but was 10.5% in household contacts; there were tertiary symptomatic transmissions. However, since only symptomatic individuals underwent testing, the actual overall rate of transmission with or without resultant symptomatic illness is likely to be higher.
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Pharmacotherapy Considerations for COVID-19
This article provides a brief summary of selected pharmacotherapy options proposed for COVID-19.
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Infectious Disease Alert Updates
Step-Wise Interventions for Hospital-Onset Clostridioides difficile
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Cefiderocol (Fetroja)
Cefiderocol is a novel siderophore cephalosporin with a wide spectrum of activity against difficult-to-treat gram-negative organisms for which there currently are limited treatment options.
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Temperature Trajectories to Find Sepsis Subphenotypes
The authors of this study used development and validation cohorts to retrospectively identify temperature trajectories over the first 72 hours from presentation in the setting of sepsis. Patients presenting with hyperthermia that resolved quickly (within the first 24 hours) had lower mortality compared to those with slow resolution or those presenting with hypothermia.
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Candida auris Resistant to Azole Antifungals, Amphotericin B, and Echinocandins
Infection with Candida auris resistant to azole antifungals, amphotericin B, and echinocandins was identified in three patients in New York. Resistance to echinocandins was first detected after the patients had received an echinocandin as treatment.
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The Safety and Effectiveness of Pyrethroid Insecticides as the Battle Against Mosquitoes Continues
There is a statistical association between having a urine test suggestive of exposure to pyrethroid insecticides and increased mortality over the subsequent 14 years.
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Neuraminidase Inhibitors Reduce Hospital Length of Stay in Patients With Clinically Suspected or Laboratory-Confirmed Influenza A
A meta-analysis that included more than 18,000 patients from 70 clinical centers in 36 countries found that neuraminidase inhibitors started at the beginning of hospitalization in patients with clinically suspected or laboratory-confirmed influenza A reduced the length of hospitalization by 19%.