Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
-
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) causes Coronavirus disease 2019 (COVID-19). This study aimed to determine if SARS-CoV-2 RNA in serum at admission correlated with clinical outcome in COVID-19. ⋯ The cohort (N=167) consisted of 106 SARS-CoV-2 RNA serum negative and 61 positive patients. Median sampling time for initial SARS-CoV-2 in serum was 1 (IQR 1-2) day after admission corresponding to day 10 (IQR 8-12) after symptom onset. Median ages were 53 (IQR 44-67) and 63 (IQR 52-74) years for the PCR-negative and positive patients, respectively. In the serum PCR negative and positive groups 3/106 and 15/61 patients died, respectively.The hazard ratios for critical disease and all-cause mortality were 7.2 (95% CI 3.0-17) and 8.6 (95% CI 2.4-30), respectively for patients that were serum PCR positive compared to serum PCR negative.Conclusion: SARS-CoV-2 RNA in serum at hospital admission indicates a high-risk of progression to critical disease and death.
-
Randomized Controlled Trial
Modification of Blood Test Draw Order to Reduce Blood Culture Contamination: A Randomized Clinical Trial.
Blood culture contamination leads to unnecessary interventions and costs. It may be caused by bacteria in deep skin structures unsusceptible to surface decontamination. This study was designed to test whether diversion of blood obtained at venipuncture into a lithium heparin tube prior to aspiration of blood culture reduces contamination. ⋯ NCT03966534.
-
Women are underrepresented in human immunodeficiency virus (HIV) research in the United States. To determine if women screening for HIV clinical trials enrolled at lower rates than men, we performed a retrospective, cross-trial analysis. ⋯ In the absence of evidence of significantly higher trial screen-out for women, approaching more women to screen may increase female representation in HIV trials.
-
Treatment of suspected methicillin-resistant Staphylococcus aureus (MRSA) is a cornerstone of many antibiotic regimens; however, there is associated toxicity. The Department of Veterans Affairs (VA) hospitals screen each patient for MRSA nares colonization on admission and transfer. The objective was to determine the negative predictive value (NPV) of MRSA screening in the determination of subsequent positive clinical culture for MRSA. High NPVs with MRSA nares screening may be used as a stewardship tool. ⋯ Given the high NPVs, MRSA nares screening may be a powerful stewardship tool for deescalation and avoidance of empirical anti-MRSA therapy.
-
Although rare, subclinical tuberculosis disease can be missed during evaluations for latent tuberculosis infection, and can manifest with symptoms during latent tuberculosis treatment. Among over 8000 patients treated for latent tuberculosis we found no evidence of acquired drug resistance, underscoring the safety of rifampin monotherapy for latent tuberculosis.