bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-2150. Eosinophilia in Patients with Suspected Parasitic Infection: a Retrospective Analysis
Authors: Filippov Evgenii , Bass Jessica , Blaha Jiana , O’Connell Elise M , KLion Amy 
Published: January 2025

Abstract

Background
Eosinophilia, defined as an absolute eosinophil count (AEC) ≥500 cells/μL, is common in the setting of helminth infection, though the relationship between the degree of eosinophilia and the likelihood of an underlying helminth infection remains unstudied. To begin to address this question, we performed a retrospective analysis of data from a large cohort of patients referred to the National Institutes of Health for parasitic disease screening.

Methods
Patients evaluated at the NIH from September 2001 to March 2021 on clinical protocols designed to study suspected parasitic infections (NCT00001230 and NCT00001645) and for whom clinical and laboratory information was available in a research database were included. Demographic information, clinical manifestations, final diagnosis, and laboratory values were reviewed. Peak AEC was recorded and categorized as mild (500-1499 cells/μL), moderate (1500-4999 cells/μL), or severe (&gt;5000 cells/μL).

Results
A total of 196 of the 459 included participants (43%) had documented eosinophilia, of whom 61% (n=120), 34% (n=66) and 5% (n=10) had mild, moderate, or severe peak AEC elevations, respectively. Most of the eosinophilic patients were diagnosed with one or more helminth infections (n=150). The remaining patients (n=46) were found to have myiasis (n=1), a non-infectious or no cause identified (n=43) or were lost to follow up (n=2). Among the helminth-infected patients, GM AEC was 1412 cells/μL (range 500-12,800). Most patients likely acquired infection in Africa (n=88) or Central America (n=25). Three patients had no history of travel outside the US. Strongyloidiasis (n=64) and loiasis (n=43) were the most common helminth diagnoses, and 29 individuals had multiple helminths identified. Of the 10 patients in the total patient cohort with peak AEC &gt;5000 cells/μL, 5 were diagnosed with helminth infection (loiasis or strongyloidiasis), none of whom had AEC &gt;20,000 cells/μL.

Conclusion
The study underscores that helminths, particularly strongyloidiasis and loiasis, are commonly associated with mild to moderate eosinophilia. Severe eosinophilia (AECs &gt;5000 cells/μL) is less common and extremely high counts (AEC ≥20,000 cell/μL) should prompt investigation of non-helminth etiologies.

Disclosures
All Authors: No reported disclosures
P-2152. Strongyloides stercoralis Seroprevalence among Solid Organ Transplant Candidates and Recipients in a Multicenter Hospital System in Arizona
Authors: Luna Wong Lucia A , Weerasinghe Sanjeeva , Anania Catherine , Trieu Skyler , Al-Obaidi Mohanad , Zangeneh Tirdad 
Published: January 2025

Abstract

Background
Solid organ transplant (SOT) recipients have a higher risk of Strongyloidiasis associated complications. Universal screening for Strongyloides among SOT candidates and recipients is not well defined in the Southwest United States. We assessed our center’s seropositivity rate for pre- and post-SOT using Strongyloides Ab (strAb) test.

Methods
We conducted a multicenter, IRB-approved retrospective study. Data were collected from January 2019 to March 2024 for patients ≥18 years old before and after SOT. Most of the testing at our center was performed utilizing the Strongyloides ELISA IgG test kit, Gold Standard Diagnostics, Davis, CA, USA.

Results
There were 387 patients with a median age of 61 (range 24-85), the majority being white non-Hispanics, 221 (57%) and 241 (62%) males. There were 152 pre-SOT tests performed: kidney (61), liver (54), lung (17), and other (20), in contrast to the 292 post-SOT: kidney (153), liver (45), lung (41), heart (31), and others (22). The majority (248/387) of patients reported historical travel, with 154 (62%) to Strongyloides endemic regions. There were 269 pre-SOT serology, mostly (85%) positive for Epstein Barr virus (EBV), followed by cytomegalovirus (CMV) with 70%, 5% hepatitis C. There was one case of a patient with positive HTLV-I/II serology (negative by confirmatory testing). Of the 283 patients, 24% reported being born outside the US. Of the171 reported gastrointestinal symptoms at the time of strAb testing, 94% were post-SOT. There were 20/387 (5.2%) positive strAb, with 5.3% in pre-SOT and 4.1% in post-SOT. There were 3 cases with negative pre-SOT that seroconverted after transplantation. All of the 93 patients who underwent microscopic stool examinations tested negative. 17/20 patients with a positive strAb received treatment with ivermectin. There was one case of Hyperinfection Syndrome. There was no statistical association between demographics and aforementioned risks, and seropositivity.

Conclusion
The Strongyloides seropositivity rate in our cohort is comparable to other reports. No associated risk factor was identified. Therefore, universal screening may be needed in similar transplant cohorts, as undetected cases can have devastating outcomes.

Disclosures
Tirdad Zangeneh, DO, AiCuris.: Grant/Research Support
P-2154. Cryptosporidium in pregnancy and the impact upon pregnancy outcomes
Authors: Ben David Shirley Shapiro , Orivieto Noam , Segal Yaakov , Adler Limor 
Published: January 2025

Abstract

Background
Cryptosporidiosis, an infectious disease caused by the protozoan parasite Cryptosporidium, poses a significant threat to individuals with compromised immune systems. Over the past four years, a notable rise in the incidence of cryptosporidiosis has been observed in Israel, including among pregnant women. Despite this increase, little is known about the impact of cryptosporidiosis on obstetrical outcomes. The objective of this study was to evaluate the influence of Cryptosporidium infection on pregnancy outcomes.Figure 1Epidemic curve, cryptosporidiosis in pregnant women, Maccabi Healthcare Services

Methods
A retrospective case-control study. Pregnant women with positive results on multiplex real-time PCR stool tests for Cryptosporidium were compared to pregnant women with negative results, matched by age, week of pregnancy during the stool test, and sector. Medical records of the study cohort were reviewed for symptoms, treatments, pregnancy outcomes including termination, gestational age, birth weight, Apgar score, and head circumference. Significance was determined using Fisher's exact or Chi-square tests.Table 1Baseline patient characteristics and symptoms, pregnant women infected with cryptosporidium

Results
Between January 2020 and December 2023, 2512 pregnant women underwent PCR stool testing. Of them, 96 individuals were positive for Cryptosporidium, mostly in 2022 (Figure 1). Their median age was 31 years and ranged 23-42 years with medium-high socioeconomic status (37 and 39 women, respectively) (Table 1). Among those who tested positive, 93 out of 96 (96.7%) reported symptoms of diarrhea, and the infection was self-limiting in all cases, with none requiring specific treatment. In comparison to matched controls, no statistically significant differences were observed in the rates of intrauterine growth retardation, birth weight, delivery week, miscarriage, Apgar score, and head circumferences among the infants born to mothers with Cryptosporidium infection.

Conclusion
This study sheds light on the clinical course of Cryptosporidium infection in pregnant women, emphasizing a generally favorable outcome without the necessity for therapeutic intervention. Further research may be warranted to explore the potential long-term effects and to refine preventive measures for this specific population.

Disclosures
Shirley Shapiro Ben David, MD, GSK: Lecturer|Pfizer: Grant/Research Support|Pfizer: Lecturer
P-2157. Genomic Characterization of Group A Streptococcus Isolates Circulating among Children in Greece during 2023
Authors: Michos Athanasios , Tatsi Elizabeth Barbara , Dourdouna Maria-Myrto , Dellis Charilaos , Rizou Aspasia , Georgakopoulou Theano , Paradeisis Georgios , Stathi Angeliki , Doudoulakakis Anastassios , Kalogeras George , Bozavoutoglou Elisavet , Zachariadou Levantia , Syriopoulou Vasiliki 
Published: January 2025

Abstract

Background
An increase in invasive Group A Streptococcus (iGAS) and non-invasive GAS cases has been reported worldwide, especially among children, since 2022. The aim of this study was the genetic characterization of GAS isolates in the pediatric population of Greece.

Methods
GAS isolates from children with iGAS reported to National Public Health Organization (NPHO) and a representative number of GAS from non-invasive infections were prospectively collected during 01-12/2023. Isolates were examined for antimicrobial susceptibility with Etest and the emm types were determined by Sanger Sequencing. Whole-genome Sequencing (WGS) was performed to selected GAS isolates to detect the toxin profile regarding 47 virulence factors, among them 11 superantigens.

Results
GAS isolates from 511 children [266/467 (57%) males, median (IQR) age: 5.6 (3.8-8.0) years] were tested. iGAS represented 66/511 (12.9%) of isolates and among them 9/66 (13.6%) deaths were recorded. The most common GAS isolation sites were the following: throat (294/511, 57.5%), ear infusion (84/511, 16.4%) and skin lesions (60/511, 11.7%). All isolates were sensitive to penicillin. The resistance rates in erythromycin, clindamycin and tetracycline were 25/511 (4.9%), 18/511 (3.5%), and 61/511 (11.9%), respectively. We detected 29 different emm types, with the most prevalent being emm12 (232/511, 45.4%) and emm1 (135/511, 26.4%). Among the deceased children with iGAS, the emm1 (7/9, 77.8%) and emm12 (2/9, 22.2%) types were detected. Toxins profiles were examined with WGS in 6 non-invasive GAS isolates, 11 iGAS isolates and 7 iGAS isolates from deceased children. All isolates contained the speB gene (24/24, 100%). The speA, speC, ssa genes were detected: in 3/6 (50%), 3/6 (50%), 1/6 (16.6%) non-invasive GAS isolates, in 4/11 (36.4%), 4/11 (36.4%) and 0/11 (0%) iGAS isolates and in 5/7 (71.4%), 2/7 (28.6%) and 1/7 (14.3%) isolates from deceased children.

Conclusion
During 2023, although several emm types caused infections in Greek children, the most prominent types were emm12 and emm1. Continuous clinical and genomic surveillance of GAS is needed to comprehend the GAS disease trends and inform prevention strategies.

Disclosures
All Authors: No reported disclosures
P-2161. Evaluating the Clinical Utility of Next-Generation Sequencing Cell-Free DNA Testing in Pediatric Patients: A Focus on Medical History
Authors: Alkhafaji Hussain , Downey Rachel , Durham Tyler , Karim Zuena , Russo Susan , McGwier Sarah E , Tough Alyssa , Billeaud Joanie , Hauger Sarmistha Bhaduri 
Published: January 2025

Abstract

Background
The Karius test is a noninvasive, cell-free next-generation sequencing (NGS) test that can detect over 1,000 pathogens from a single blood sample. Validating the Karius test's useful clinical applications in pediatric patients is necessary to elucidate its benefits and limitations compared to conventional diagnostic testing. This pilot study aims to expand on existing evidence for Karius indications by investigating its utility among pediatric patients with specific underlying diagnoses.Figure 1:Age Distribution of Patients in Sample

Methods
A retrospective chart review was conducted, consisting of 251 consecutive pediatric patients [03/2018-06/2022] (fig 1) for whom a Karius NGS test was performed at a free-standing 240-bed children’s hospital and affiliated clinic in Central Texas. Statistical analysis was conducted to evaluate whether a child’s underlying diagnosis was associated with clinically useful Karius results.
The Karius result was considered clinically useful if it was the first or only diagnostic test used to make the diagnosis, had negative predictive value essential to the plan of care, or contributed to changes in the antimicrobial regimen. Underlying diagnoses were categorized into ten groups (fig 2). Statistical analysis was conducted using R software via Pearson’s Chi-Squared Test and Fischer’s Exact Test.Figure 2:Distribution of Underlying Diagnosis in Sample

Results
Evaluation of underlying diagnoses and the clinical usefulness of the Karius test revealed a significant association only for patients with an oncologic diagnosis (p=0.038) (Fig 3).Figure 3:Underlying Diagnosis and Reason Karius Result Deemed Clinically Useful

Conclusion
While Karius testing can be useful in specific patients regardless of the underlying diagnosis, this analysis found the most significant utility among patients with an oncology diagnosis. Further investigation through larger sample sizes and prospective designs is essential to validate and extend these findings, shedding light on cost-effectiveness and patient outcomes.

Disclosures
All Authors: No reported disclosures
P-2173. Evaluation of Self/Parent Collected Oral/Nasal Swabs for Respiratory Illness in Symptomatic Children
Authors: Nelson Hannah , Kayda Iryna , Watson Nicole , Kinshella Maggie Woo , Mooder Karen , Cochrane Jennifer , Desai Neil , Hoang Linda , Dittrick Michelle , Goldfarb David M 
Published: January 2025

Abstract

Background
For children under the age of 4 who are unable to reliably gargle, a combined oral/nasal (ON) swab collected by the parent/caregiver may be offered, and is less invasive than the standard nasopharyngeal (NP) swab. We sought to determine the diagnostic yield and acceptability of self-collected ON swab samples compared to healthcare worker-collected NP swabs for respiratory viruses, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza, and respiratory syncytial virus (RSV) in children.

Methods
Symptomatic participants (0-4 years old) were recruited from a pediatric Emergency Department (ED) where they were undergoing clinical testing with an NP swab. Participants provided an additional ON swab using written self-collection instructions. Caregivers were asked to rate acceptability of ON and NP swab collections on a 5-point Likert scale. Both samples were collected with minitip flocked swabs and were tested with the SARS-CoV-2/Influenza A+B/RSV GeneXpert® assay. A portion of matched samples were also tested with the BioFire® RP2.1 respiratory panel.

Results
A total of 121 matched sample pairs were tested with the GeneXpert assay and had similar detection for RSV (28 ON positive vs 26 NP positive), influenza A (17 ON positive vs 17 NP positive), and SARS-CoV-2 (8 ON positive vs 10 NP positive). Median Ct values were higher for matched ON positives vs NP positives (26.2 vs 23.9). 58 pairs were also tested using the RP2.1 assay and showed a similar yield for total respiratory viruses detected (63 positive ON swabs vs 62 positive NP swabs). With either sample positive set as the reference for calculation of sensitivity, the ON and NP swab sensitivities are as follows: RSV (80.0% ON vs 100.0% NP), influenza A (94.4% ON vs 94.4% NP), SARS-CoV-2 (100.0% ON and 92.9% NP), and all other virus targets (82.6% ON vs 82.6% NP). Caregivers rated higher acceptability for ON swabs than HCW-collected NP swabs (median acceptability 2 vs 4).

Conclusion
The performance of self-collected ON swabs was similar to HCW-collected NP swabs for the detection of a range of respiratory viruses across two commercial molecular assays. Given their significantly higher acceptability ratings, self-collected ON swabs should be considered as a potential less-invasive diagnostic option for children.

Disclosures
All Authors: No reported disclosures
P-2183. Collocating HCV Treatment in a Medically Assisted Therapy Clinic in Dar es Salaam, Tanzania
Authors: Mmasa Christina , Kottilil Shyam , Mathur Poonam , Rwegasha John Christian , Maghimbi Abubakar M , Rugemalila Joan J , Masao Frank Aloyce , Roth Brenna M , Haruna Iddi 
Published: January 2025

Abstract

Background
Tanzania’s estimated HCV prevalence is the highest in Africa at 2.7%. Among people with opioid use disorder (OUD) in Dar es Salaam, Tanzania’s most populous city, positive HCV Ab prevalence is estimated to be 16.2% to 50.2%. With limited HCV treatment available, patient-centered service delivery through collocating HCV treatment with other services, task shifting to non-specialists, and streamlined testing and treatment algorithms are needed to lower barriers to HCV treatment. The objective of this study was to determine the effectiveness of collocating HCV treatment in routine medically assisted therapy (MAT) clinic services to cure HCV infection in clinic attendees with OUD.Figure 1:HCV testing and treatment algorithm completed by participants

Methods
From December 2021 to July 2022, we enrolled regular attendees of the MAT clinic in Muhimbili National Hospital (MNH) (Figure 1) who underwent HCV Ab screening. Those with a positive HCV Ab were tested for HCV RNA and offered treatment with ledipasvir/sofosbuvir if this was detectable. Treatment was directly observed therapy, dispensed daily when the participant attended the clinic. Participants were tested for sustained virologic response (SVR), defined as undetectable HCV RNA at 12 weeks following treatment completion. Figure 2. Study participant demographics*Creatinine, Alanine aminotransferase

Results
The study enrolled 724 regular attendees of the MAT clinic, most men (704/723, 97.37%) aged 40-49 (370/680, 51.2%) (Figure 2). Of those enrolled, 721/724 (99.6%) were screened for HCV, 125/721 (17.34%) had a positive HCV Ab, 119/125 (95.2%) underwent HCV RNA testing, 64/119 (53.8%) had detectable HCV RNA, 57/64 (89.1%) started treatment, 56/57 (98.2%) completed treatment, 52/56 (92.9%) were tested for SVR, and 49/52 (94.2%) achieved SVR at completion of the follow-up period, with an overall cure of 49/64 (76.6%) (Figure 3).Figure 3:HCV care and treatment cascade

Conclusion
In this study, 77% of participants with a detectable HCV RNA completed the treatment cascade and achieved SVR. Collaboration with medical staff and patient advocates to adapt the care and treatment model to the MAT clinic was important for success. Study visits and lab work were minimized to lower cost and barriers to adherence. Cost analyses and implementation studies should be done to evaluate the HCV care and treatment cascade in limited resource settings to build evidence for the benefits of these services and bolster government support.

Disclosures
Shyam Kottilil, MD, PhD, Orsobio: Advisor/Consultant|Red Queen: Advisor/Consultant
P-2194. Prevalence of Hepatitis B and Hepatitis A in People with Chronic Active Hepatitis C in New Jersey
Authors: Slim Jihad , Akiki Maria , Tempalski Barbara , Rosmarin-DeStefano Corey , Torres Juan , Leyden Kevin , Duprey Sheena , Levaggi Emily 
Published: January 2025

Abstract

Background
Most current guidelines recommend hepatitis A (HAV) and hepatitis B (HBV) vaccination for people living with hepatitis C (HCV) and lacking immunity to those viruses. We were interested in studying the prevalence of immunity to those 2 viruses in patients with chronic active HCV infection (CAH C) in NJ, to evaluate the resources needed to vaccinate those who are not immune.

Methods
We reviewed prospectively collected data in people with CAH C living in NJ, and retrieved their age, sex, race, ethnicity, HAV IgG, HBV surface antigen, HBV surface antibody, and HBV total core antibody. We calculated the prevalence of immunity to each virus, and specifically targeted the difference for HBV immunity in those born after 1991, when implementation of universal HBV vaccination of newborns started in the US.

Results
Between 09/01/2020 and 12/31/2023 we collected data on 1586 people living with HCV. The overall prevalence of HAV immunity was 46% (726/1586); for HBV, 36% (578/1586) were immune through vaccination (only HBV surface antibody positive), when divided by age group those born in 1991 and earlier had 34 % immunity compared to 52.5% for those born after 1991 (p&lt; .0001). The prevalence of exposure to HBV was 24% (380/1586) with 7 having Hep B s Ag positive, and 126 only Hep B core antibody positive; when divided by the same age group categories, only 7 % of those &lt; 32 years old had HBV exposure, as compared to 26% of those 33 years and older at a p value &lt; .0001. Prevalence of people with all 3 markers negative for HBV (requiring vaccination) is 40% (628/1586); with no statistical difference between the two-age group, 40.5% for &lt; 32 years old, and 39.5% for those 33 years and older.

Conclusion
Our study shows an urgent need to implement hepatitis A and hepatitis B vaccinations in people living with HCV in NJ, almost half of them are not immune to either virus. On the other hand, it also highlights the success of universal vaccination of newborn for HBV, since we found a statistically significant number of those born after 1991 to be immune and have less HBV exposure.

Disclosures
Jihad Slim, MD, FACP, AbbVie: Grant/Research Support|AbbVie: Honoraria|AbbVie: Speaker Bureau|Gilead Sciences, Inc.: Grant/Research Support|Gilead Sciences, Inc.: Honoraria|Gilead Sciences, Inc.: Speaker Bureau|Merck: Grant/Research Support|Merck: Honoraria|Merck: Speaker Bureau|Theratechnologies: Advisor/Consultant|Theratechnologies: Honoraria|ViiV Healthcare: Advisor/Consultant|ViiV Healthcare: Grant/Research Support|ViiV Healthcare: Speaker Bureau
P-2198. High Prevalence of HBeAg negative among People Living with HIV and Hepatitis B ART naïve in Maputo - Mozambique
Authors: Chambal Lucia Mabalane , Nilsson Charlotta , Manjate Elias , Tchavana Corssino , Augusto Orvalho , Comiche Esperanca Sevene 
Published: January 2025

Abstract

Background
About 7.4% of the people living with HIV in the world are co-infected with hepatitis B virus (HBV), and more than 70% of the co-infected reside in Africa. HBeAg-negative chronic hepatitis B (CHB) is associated with persistent low viremia and progression into cirrhosis with a 3-10% yearly rate and with rare spontaneous remissions. We report the frequency of HBeAg among HIV/HBV coinfected recently diagnosed ART naïve patients.

Methods
We analyzed baseline data of a prospective cohort of newly HIV-diagnosed ART naïve patients at Mavalane Health Centre located in a periurban area in Maputo City. Between April 2021 and November 2022, all patients acove 18 years of age were enrolled then screened for HBsAg. All participants had CD4+ T cells count, further serological markers of hepatitis B (anti-HBc IgM, HBeAg, anti-HBe), HIV and HBV viral loads assessed using standard procedures. Quantitative variables were expressed as mean and standard deviation, whereas qualitative ones were expressed as frequency and percentage.

Results
A total of 1,106 participants were included, and HBsAg was reactive in 81 participants, yielding a co-infection rate of 7.3%. Being male (OR = 0.58 and 95%CI: 0.59 to 0.94) or sex worker (OR = 3.69, 95%CI: 1.10 to 10.58) was associated with being co-infected. Overall, 67/81 (80.2%) of the co-infected were HBeAg negative and 14/81 (19.8%) were HBeAg positive. The median APRI was 0.5 (IQR 0.3, 1.1) for the HBeAg negative and 0.7 (0.3, 1.4) for the HBeAg positive. The median HBV-DNA was 258.0 IU (IQR 10.0, 4,974.5) for the HBeAg negative and 746,287.0 IU (IQR 2,720.0, 49,899,213.0) for the HBeAg positive subjects (p &lt; 0.001).Among the HBeAg negative 44 (65.7%) had a detectable HBV-DNA with 20 (29.9%) presenting with HBV-DNA &gt; 2000 IU and 14 (20.9%) with a HBV-DNA &gt; 20 000 UI. Two (3.0%) HBeAg negative participants and one (7.1%) HBeAg positive participants presented with hepatocellular carcinoma (HCC).

Conclusion
These results confirm the high prevalence of HIV and HBV co-infection in Mozambique and brings new data on HBeAg negative frequency. There is a need to test for HBV all HIV infected and integrate the management and monitoring of hepatitis B and liver disease-specific tests in public ART programs to predict and reduce the occurrence of HBV complications and mortality.

Disclosures
All Authors: No reported disclosures