bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-1323. Forecasting the incidence of acute respiratory infections in Uzbekistan, 2022-2023
Authors: Ibragimov Rafail , Nabirova Dilyara , Horth Roberta , Kurbanov Botirjon 
Published: January 2025

Abstract

Background
Acute respiratory infections (ARIs) are a significant cause of morbidity and mortality worldwide, and this is particularly evident in regions such as Uzbekistan within Central Asia. Forecasting ARIs allows public health authorities to anticipate and prepare for surges in cases. This includes ensuring that healthcare facilities have adequate resources, such as hospital beds, ventilators, medicines, and personal protective equipment (PPE). Therefore, we aimed to predict the incidence of ARIs in Uzbekistan and respond to public health threats in a timely and appropriate manner.Figure 1.Short-term prediction of incidence acute respiratory infections in Uzbekistan, 2022-2023

Methods
We conducted a retrospective study using weekly data on the incidence of ARIs reported in Uzbekistan between January 2022 and November 2023. Two models were selected to predict the number of ARIs cases. The first model, based on prediction using the EpiNow2 package, was used for short-term prediction for 2 weeks, and the second model, from the nnetar package, based on neural networks for prediction of univariate time series, was used for prediction for the next 12 weeks. Data analysis was performed in R version 4.3.2.Figure 2.Long term prediction of incidence acute respiratory infections in Uzbekistan, 2022-2023

Results
The short-term forecast for the following 2 weeks showed a possible increase in case numbers (rate of growth = 0.011 (95% CI 0.004 - 0.028)). The model predicts 2,310 (767 - 2,939) new cases by infection date. At the end of the forecast period, the model predicted 5,711 (2,486 - 39,623) new cases of ARIs per week . The long-term model predicted 217,469 (176,261 - 247,929) new infections over the next 12 weeks. At the same time, the peak incidence was predicted to occur in December 2023. In that month, the model predicted 19,817 (17,340 - 22,303) new infections per week. When evaluating the accuracy of the model, we found that the predicted values were lower than the actual number of cases (mean absolute percentage error (MAPE) of the first model = 0.68, MAPE of the second model = 0.39).

Conclusion
The selected models of forecasting make it possible to determine the possible number of cases, although they underestimate values of these cases. The country needs to collect data on risk factors to better predict the incidence of ARIs. However, short- and long-term forecasting models can help to adjust public health response.

Disclosures
All Authors: No reported disclosures
P-1326. Trends in Transgender Sexual Health: New Findings from Syphilis Cases
Authors: Geher Sage W R , Spivak Adam , Sullivan Erika A , Ho Tiffany F 
Published: January 2025

Abstract

Background
Syphilis has been on an alarming rise with worldwide cases in excess of 7 million in 2020 and US case rates tripling over the last 20 years. Sexually transmitted infections disproportionally impact sexually minoritized groups, including transgender and gender diverse (TGD) adults. Yet, syphilis rates among TGD people are relatively understudied. We sought to investigate syphilis trends specifically in the TGD community.

Methods
We performed a retrospective chart review and identified 33 TGD adults diagnosed with syphilis, from a total cohort population of 1,072 transgender persons tested for syphilis from 2010-2023. Persons diagnosed with syphilis were identified by one of the following criteria: International Classification of Diseases-10 (ICD) code, positive treponemal test (Tp), or positive non-treponemal test (NT). Diagnoses were further delineated into individual cases of syphilis to account for re-infections. True cases were defined as having positive Tp and NT, presumed positive as positive Tp or NT, and false positives as having a negative Tp or NT. Variables such as syphilis incidence and prevalence were calculated. Various qualitative aspects of disease progression and case presentation were analyzed via manual chart review.

Results
We identified 22 true cases, 8 presumed positives, and 12 false positives. Syphilis incidence was 2.79% and lifetime prevalence of 1.95%. While the number of syphilis tests increased per year, test positivity rates remained fairly constant at 3-4%. The vast majority of cases presented as primary syphilis (72%), and were most often completely asymptomatic (59%), with chancre (24%) and unexplained headache (14%) being the most common symptoms across all stages. There was only one case (3%) of confirmed neurosyphilis, which is higher than the national incidence (0.8-1.7%). Titers at time of diagnosis spanned a large range of values and was not predictive of stage of presentation, nor was there a clear correlation in titer kinetics and response to treatment.

Conclusion
With a relative paucity of investigations looking at syphilis rates in the TGD community, especially in the United States, understanding the epidemiology of this population could prove critical in prevention efforts.

Disclosures
All Authors: No reported disclosures
P-1328. Contribution of Antimicrobial Resistance Data of NARMS Retail Meat in the Investigation of Persistent Strain of Salmonella Hadar Infections, Tennessee, 2021-2023
Authors: Hanna Samir , Garman Katie , Dunn John R 
Published: January 2025

Abstract

Background
Reoccurring, Emerging, and Persisting (REP) strains of Salmonella have caused illness for several years and are linked to multiple sources. Some REP isolates have been detected in food products like MDR Salmonella Infantis (REPJFX01) in retail chicken. Tennessee participates in the FDA’s National Antimicrobial Resistance Monitoring System (NARMS) Retail Meat Surveillance to monitor the antimicrobial resistance of retail meat enteric bacteria isolates. We reviewed the contribution of TN NARMS data in the investigations of multistate (MS) outbreaks caused by persistent strain of S. Hadar (REPTDK01).

Methods
Tennessee submits every 20thSalmonella isolates from humans statewide, and all Salmonella isolates from retail meat (retail chicken, ground turkey, ground beef and pork products) purchased from 13 counties to NARMS. Sequenced isolates are uploaded to PulseNet, and resistance determinants are monitored. TN responds to CDC/FDA requests on isolates with persisting strains matching MS outbreaks.

Results
REPTDK01 strain was detected in 4 ground turkey (GT) isolates from TN as part of 2 multistate outbreaks in 2021 (2102MLTDK-1) and 2023 (2302MLTDK-1). Over 95% of human and non-human isolates in both outbreaks were resistant to tetracycline, streptomycin, or both, and 0.2-0.4 % to ciprofloxacin and ceftriaxone respectively. Three of the 4 GT samples were purchased from grocery stores in different counties in 2021, and two of them had the same producer establishment number. USDA issued a public health consumer alert for over 211,406 pounds of raw GT products produced by the establishment. An additional GT sample was purchased in 2023 with a different establishment number. Consumption of GT was reported by 20 (60%) of 33 cases in 2021, while no signal of GT consumption among 55 cases in 2023. TN had no human cases in both outbreaks. However, a total of 49 cases from TN were linked to another three MS outbreaks of REPTDK01 associated with backyard poultry contact between 2019 and 2023 with one death in 2022.

Conclusion
NARMS retail meat routine surveillance data contributes to a better understanding of source attributions of REP bacterial strains. Sharing of TN data with federal partners helped in traceback efforts, regulatory actions, and alerting the public.

Disclosures
All Authors: No reported disclosures
P-1343. Extended Spectrum Beta Lactamases (ESBL) and New Delhi Metallo Protein (NDM) genes co-occurrence in Phenotypic ESBL Enterobacteriaceae (ESBL-E) isolates causing community-acquired pyelonephritis
Authors: Kumar Deepak , Khandelwal Lochan , Bohra Gopal Krishna , Tak Vibhor , Meena Durga Shankar , Midha Naresh Kumar , Garg M K , Jain Vidhi , Choudhary Gautam Ram 
Published: January 2025

Abstract

Background
Multidrug resistance Enterobacteriaceae causing community-acquired pyelonephritis is an emerging threat; most isolates are EBSL, as per Indian data. After the results of the MERINO trial, most guidelines favors Carbapenem for treating community-acquired pyelonephritis. Overuse of carbapenem may lead to Carbapenem resistance Enterobacteriaceae (CRE) in the community. We analyzed the ESBL and CRE genes in the clinically significant urinary isolates with phenotypic ESBL -E from patients with community-acquired pyelonephritis.Table 1Demographic characteristics of patients with community-acquired acute pyelonephritis caused by phenotypic ESBL -E.

Methods
Patients with a diagnosis of community-acquired acute pyelonephritis with age ≥ 18 years and urine culture showing the growth of Enterobacteriaceae with phenotypic ESBL-E are included in the study. If urine culture grew more than one organism in Enterobacteriaceae, other GNBs were excluded. The phenotypic ESBL detection was based on resistance to a third-generation cephalosporin (Cefotaxime, Cefpodoxime, Ceftazidime) and a monobactam (Aztreonam). These positive isolates were further processed using the combination disk method. A ≥5mm increase in zone diameter for either antimicrobial agent tested in combination with clavulanate vs the zone diameter of the agent when tested alone was considered ESBL (Clinical and Laboratory Standards Institute (CLSI) Performance standards for antimicrobial susceptibility tests). Simultaneously, multiplexed Real-time PCR (TRUPCR® UTI AST Panel Kit, Europe) was done to detect ESBL genes (CTX-M, TEM, SHV) and CRE genes (OXA-48, KPC, NDM, VIM, IMP) in these isolates.Table 2:Detection of NDM genes with ESBL genes in patients with community-acquired acute pyelonephritis caused by phenotypic ESBL -E.

Results
A total of 38 isolates with phenotypic ESBL in patients diagnosed with community-acquired pyelonephritis were processed for RT-PCR, and 30 were detected with ESBL and CRE genes. The demographic and clinical characteristics are shown in Table 1. The most common ESBL gene was CTX-M 29 (.96.7%) followed by TEM 25 (83.3%). Multiple ESBL genes were detected in 24(80%) isolates. Among CRE genes, the NDM genes were detected in 15 (50%) isolates with other ESBL genes (Table 2).

Conclusion
The presence of CRE genes in phenotypic ESBL -E in community-acquired acute pyelonephritis could be due to the injudicious use of carbapenem. This may imply that CRE will be spread in the community in the future, making it difficult to manage this infection.

Disclosures
All Authors: No reported disclosures
P-1388. Repeat Trichomonas vaginalis Infections Among Pregnant Women in South Africa
Authors: Lim Lindsay S , Mdingi Mandisa , Mukomana Freedom , Gigi Ranjana M S , Low Nicola , Peters Remco , Medina-Marino Andrew , Klausner Jeffrey , Muzny Christina A 
Published: January 2025

Abstract

Background
Trichomonas vaginalis (TV) is the most common non-viral sexually transmitted infection (STI) worldwide. It has been associated with multiple adverse outcomes in pregnancy. The prevalence of repeat TV infections among pregnant women is poorly characterized, especially in resource-limited countries. This study aimed to investigate the prevalence and causes of repeat TV infections in pregnant women in South Africa.

Methods
Women enrolled in a randomized controlled trial investigating optimal STI screening strategies during pregnancy were included. At baseline, TV was diagnosed via the GeneXpert nucleic acid amplification test (NAAT). Demographics, sexual history, and partner characteristics were collected. If positive, women were treated with multi-dose oral metronidazole and randomized to Arm 1 or 2 (test-of-cure at 3 weeks after enrollment or re-testing at 32-34 weeks gestation). At follow-up in both arms, a repeat TV NAAT was obtained and a questionnaire was administered examining adherence to treatment, partner treatment history, and interval sexual activity. Women with confirmed treatment completion and a repeat positive TV NAAT were classified as treatment failure if no interval sexual activity, re-infection if had interval sexual exposure to baseline partners who were not treated as contacts, or new infection if exposed to a new partner.

Results
Baseline TV prevalence was 10% (144/1440) (Figure 1) and 10.4% (15/144) of infected women had a repeat positive test with baseline characteristics shown in Table 1. All 15 women finished their entire course of treatment and partners were notified in 93.3% of cases (Table 2). Based on our definitions, 60% of women (9/15) were classified as treatment failure in the setting of no interval sexual exposure or sexual exposure with partner who was reportedly treated (Figure 2). 26.7% (4/15) were classified as re-infection and 13.3% (2/15) were unable to be classified. There were no new infections.

Conclusion
More than half of repeat TV infections in this cohort of pregnant women in South Africa were determined to be due to treatment failure. Additional studies with larger sample sizes are needed to further investigate potential causes and include drug susceptibility testing on clinical TV isolates in women with repeat infections.

Disclosures
Jeffrey Klausner, MD MPH, Direct Diagnostics: Advisor/Consultant Christina A. Muzny, MD, MSPH, Abbott: Advisor/Consultant|Abbott: Grant/Research Support|BioMed Diagnostics: Advisor/Consultant|BioNTech: Advisor/Consultant|BioNTech: Grant/Research Support|Cepheid: Advisor/Consultant|Cepheid: Honoraria|Elsevier: Honoraria|Gilead: Grant/Research Support|Lupin Pharmaceuticals: Grant/Research Support|Merck Manuals: Board Member|Merck Manuals: Honoraria|UpToDate: Honoraria|Visby: Grant/Research Support
P-1408. Beyond the Transplant: Understanding CMV Disease in Minority Kidney Recipients
Authors: Gabriela Cabanilla M , Dauenhauer Ashlee , John Briana St , Pham Ngoc-Yen , Hill Deirdre , Larson Joshua , Singh Pooja P 
Published: January 2025

Abstract

Background
Disparities in kidney transplant evaluation for minorities raise concerns about post-transplant care access, including cytomegalovirus (CMV) infections and their impact. While CMV significantly affects morbidity and mortality rates, the precise ramifications of these disparities remain unclear. We aimed to evaluate CMV infection patterns in minority kidney transplant recipients.

Methods
We evaluated CMV infection in minority kidney transplant recipients using retrospective analysis and qualitative surveys. Patients aged ≥ 18 years with post-transplant CMV infection were included. Data were collected from University of New Mexico Health Sciences Center records and provider surveys. The primary outcome was CMV disease incidence among minority populations, with secondary outcomes exploring clinical endpoints and barriers to CMV management. Quantitative and qualitative data were analyzed using descriptive statistics, chi-square and Fisher’s exact tests, and thematic analysis.

Results
Among 58 patients (84.5% minorities), CMV disease cumulative incidence was 12.3% in minorities vs. 0% in non-Hispanic whites (p = 0.58), despite similar prophylaxis. No significant CMV disease risk factors were found. Graft failure occurred in 8.6% of patients, mostly minorities, with one graft loss after CMV diagnosis. Mortality appeared higher in minorities (24.4% vs 11.1%, p = 0.67), especially within 90 days of CMV diagnosis, and notably elevated in diabetics (40% vs 9.1%, p = 0.01).
Eight respondents (75% transplant specialists) highlighted CMV management challenges from diagnosis to resource access. Providers acknowledged limitations in current strategies and expressed optimism for newer therapies, such as letermovir. Systematic barriers, including policy gaps and suboptimal multidisciplinary collaboration, were identified as hindrances to comprehensive care delivery.

Conclusion
Our study underscores the CMV disease burden among minority kidney transplant recipients, highlighting disparities in incidence and clinical outcomes compared to non-Hispanic whites. Urgent interventions and policy reforms are required to address systemic barriers and improve post-transplant care equity, ultimately enhancing the health outcomes of minority transplant patients.

Disclosures
M. Gabriela Cabanilla, PharmD, PhC, Merck & Co: Grant/Research Support
P-1410. Oral Antimicrobial Therapy Offers in Hospitalized Persons Who Inject Drugs who Elect for Self-directed Discharge
Authors: Arena Christen J , Vanhorn Bryce , Kenney Rachel M , Parke Dana M , Suleyman Geehan , Davis Susan L , Veve Michael 
Published: January 2025

Abstract

Background
Hospitalized Persons Who Inject Drugs (PWID) who elect for self-directed discharge (SDD) are at an increased risk for poor infection outcomes, but there is limited guidance for infection management in this population. National PWID management guidelines suggest considering oral antimicrobial therapy offers (OATO) as soon as patients are clinically stable to avoid lack of antibiotic therapy at discharge. The study purpose is to evaluate infection management in PWID who elect for SDD and to identify characteristics associated with OATO.
Variables Associated with Oral Antimicrobial Offers at Self-directed Discharge

Methods
Retrospective cohort of hospitalized adult PWID with an injection drug use (IDU)-related infection who elected for SDD between 1/1/14-1/31/24 at Henry Ford Health in Michigan. Patients were excluded if they were hospitalized for &lt; 24-hours or if antimicrobial treatment was completed prior to SDD. The primary outcome was the proportion of patients with OATO at or prior to SDD. Secondary outcomes at 30-days included retreatment, infection-related readmission, and all-cause mortality.

Results
150 patients were included; 55 (37%) were OATO patients, 95 (63%) did not receive an offer. Most patients were white (118, 79%), had prior SDD (90, 60%), and were a median (IQR) age of 34 (30-44) years. Skin infections were most common (81, 54%). Patients that received a source control procedure (27 (49%) vs. 31 (33%), P=0.05) or care from a provider ≤10 years from terminal training (49 [89%] vs. 70 [74%], P=0.04) were more likely to receive an OATO. Patient outcomes were not different between the OATO and no offer groups: infection retreatment 19 (34%) vs. 32 (34%); infection-related readmission 14 (25%) vs. 31 (33%); and all-cause mortality 1 (2%) vs. 3 (3%). Characteristics associated with OATO were prescribing or continuing medications for opioid use disorder during hospitalization, infection source control, and care from providers ≤10 years post-terminal training; infectious diseases consultation had an opposite association (Table 1).

Conclusion
Most hospitalized PWID with IDU-related infections with SDD did not receive an OATO. Early career providers more commonly offered oral antimicrobials in PWID with less complicated infection types. Standardizing OATO in PWID at risk for SDD should be considered as a future direction to improve health outcomes.

Disclosures
Rachel M. Kenney, PharmD, BCIDP, Medtronic Inc: Spouse is an employee, stockholder Dana M. Parke, MA, Pfizer Global Medical Grants & Global Bridges at Mayo Clinic (grant # 70973735): Grant/Research Support|The Kresge Foundation: Grant/Research Support
P-1411. Perinatal Care-Seeking Among Women Living with HIV in Uganda
Authors: Alperin Cora , Atukunda Esther , Harper Cynthia , Baguma Charles , Kembabazi Annet , El Ayadi Alison , Mushavi Rumbidzai , Satinsky Emily , Juliet Mercy , Betty Namara E , Ahereza Phionah , Tsai Alexander , Comfort Alison 
Published: January 2025

Abstract

Background
Inadequate perinatal care uptake in Uganda, as outlined by national guidelines (eight antenatal visits starting before 26 weeks, supervised facility delivery, and at least one postnatal checkup), persists as a significant issue. Factors such as HIV-related stigma further hinder healthcare engagement during this period. This study evaluates differences in antenatal and postnatal care-seeking between women living with HIV (WLHIV) and HIV-negative women in Uganda.

Methods
We performed a cross-sectional study of women 18 years and older (n = 417) living in Nyakabare parish, Southwestern Uganda. The study sample was part of a longitudinal complete population cohort followed since 2014. We collected survey data on care-seeking at most recent pregnancy, including self-reported HIV status and HIV testing, timing of perinatal care, and socio-demographics. Outcomes of interest included antenatal care access (ANC), timing of ANC initiation, ANC visits, and postnatal care (PNC) access. The primary explanatory variable was self-reported HIV status. Analyses were conducted using a binomial logistic regression model with covariate adjustment for age, education, wealth, and village.

Results
On average, women initiated ANC in the second trimester when 4 months pregnant, much later than recommended. Further, women attended half the number of recommended ANC visits (4 of 8 visits). Most women (87%) delivered in a healthcare facility and accessed ANC (98%). There was no significant difference in ANC access, time of initiation of ANC, frequency of ANC visits, or location of delivery by HIV status. WLHIV were 2.6 times more likely to have had a postnatal care visit (adjusted odds ratio [aOR] 2.6, 95% confidence interval [CI]1.1-5.5). 68% of WLHIV sought PNC compared to 40% of women who were HIV-negative.

Conclusion
The data reveal a trend of late ANC initiation and incomplete care among all women regardless of serostatus. However, WLHIV were more likely to access PNC compared to HIV-negative women, potentially indicating effective support and follow-up once initiating ANC. Research exploring why WLHIV more consistently access PNC is needed. Targeted interventions to ensure earlier ANC initiation, including for WLHIV, are crucial and should consider differences in healthcare system engagement.

Disclosures
All Authors: No reported disclosures