bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-2292. The Usual Suspect? Prevalence of Pseudomonas aeruginosa in Diabetic Foot Infections among Kidney Transplant Recipients
Authors: McCort Margaret E , Goyal Rohan , Burack Daniel A , Thwe Phyu , Ward Luz Liriano , Bartash Rachel 
Published: January 2025

Abstract

Background
Diabetic foot infections (DFIs) are a significant cause of morbidity in kidney transplant recipients (KTRs) with underlying diabetes. While empiric antibiotic coverage with an antipseudomonal antibiotic is common practice, recent studies of DFIs in non-transplant patients have found a relatively low prevalence of Pseudomonas aeruginosa (PSA). We hypothesize that the prevalence of PSA in DFIs is also low among KTRs.
Organisms isolated in cultures from diabetic foot infections (DFI) among kidney transplant recipients (KTR)

Methods
We performed a review of all positive microbiologic isolates from clinically relevant DFIs in KTRs requiring hospitalization at an urban transplant center from 1/2018-12/2023. All patients were &gt; 18 years of age and underwent renal transplantation between 2015-2023. Patients could be included for more than 1 DFI if these occurred &gt; 6 months apart or on non-contiguous sites. Patients without cultures or with cultures that yielded negative results were excluded. The primary outcome was the prevalence of PSA in microbiologic cultures, including bone, tissue, and fluid sources. The study was approved by our Institutional Review Board and results were reported using descriptive statistics.
Patient characteristics and demographics

Results
Forty-eight DFIs occurring in 40 KTRs were included. Median age was 62 and 83% (40/48) occurred in men. Average time from transplant to DFI was 1075.5 days. Additional demographic data is shown in Table 1. Eighty organisms were isolated with 42% (20/48) of infections being polymicrobial. PSA represented 5% of organisms isolated (4/80) and was present in cultures from 4 unique patients (10%). Streptococcus species and Staphylococcus aureus were the most commonly isolated organisms, representing 20% (16/80) and 29% (23/80), respectively. Among Staphylococcus aureus isolates, 47% were methicillin-resistant. Additional microbiologic data is shown in Figure 1.

Conclusion
The prevalence of PSA in DFIs was low among KTRs. Typical skin pathogens including Streptococcus species and Staphylococcus aureus were most common. While larger studies are needed to confirm these results, judicious use of antipseudomonal antibiotics should be considered in DFI management.

Disclosures
All Authors: No reported disclosures
P-38. Connecting the Dots: Unveiling Shared Motivations for Mpox Vaccination
Authors: Marshall Maurice , Heisler Shira , Kim Paul , Newman Gretchen , Touleyrou Lauren 
Published: January 2025

Abstract

Background
In 2022, a global outbreak of mpox spurred novel efforts for vaccination among previously unvaccinated individuals in the United States. Between 2022-2023, the United States was home to approximately 1/3 of documented global cases (32,063 cases) and suffered 56 deaths. These cases were concentrated in men-who-have-sex-with-men (MSM) and deaths were concentrated in people with HIV (PWH) and other immunocompromised individuals. Tolan Park Clinic in Detroit, Michigan, the largest HIV clinic in the state, began an intensive effort to vaccinate patients at risk of mpox acquisition. Surveys were provided to patients undergoing vaccination to assess motivations of undergoing vaccination. The objective of the study was to assess reasons for vaccination other than HIV status.

Methods
Surveys were conducted of patients at Tolan Park Clinic who underwent mpox vaccination. During the survey period, 167 surveys were completed. The survey evaluated different motivations to receive vaccination, including exposure to mpox in the last 14 days, attendance at an event with a known case of mpox, MSM or transgender women with greater than two partners in the last year, MSM or transgender women with a partner known to have a STI in the last year, if pt participated in commercial sex work, or plan to attend a ball, sex party, or bath house. Patients could select multiple responses to the survey.

Results
Analysis of results revealed that 49% (82) of surveys reported participants being MSM with greater than 2 partners in the last year as some motivation for undergoing vaccination. Following that, 24% (41) of surveys reported that participant planned to attend a ball, sex party, or bath house as a motivation for vaccination. The third most reported driver was MSM with a partner known to have an STI in the last year. This made of 14% (25) of all surveys reported.

Conclusion
Results demonstrated that the two most common drivers of vaccination included MSM with greater than two partners in the last year and those planning to attend a ball, sex party or bath house. Targeting vaccination efforts toward these groups helped to curb the spread of mpox. Our data will be utilized to better target outreach efforts during future epidemics of mpox.

Disclosures
All Authors: No reported disclosures
P-39. Trends in Pertussis Antibody Titers after DTaP Vaccination of Healthcare Workers at a Tertiary Children's Hospital in Japan
Authors: Furuichi Mihoko , Katsuta Tomohiro , Nakamura Yukitsugu , Suganuma Eisuke , Shimizu Naoki 
Published: January 2025

Abstract

Background
In Japan, diphtheria-tetanus-acellular pertussis (DTaP) is used for adults instead of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine. DTaP vaccinations for healthcare workers in obstetrics and pediatrics have been recommended since 2019 in Japan. However, data on the prevalence rate of pertussis antibodies among health care workers are limited. This study aims to evaluate pertussis antibody titers before and after DTaP vaccination to establish an optimal vaccination schedule for healthcare workers.

Methods
This study was a prospective observational study targeting staff members who received DTaP vaccination at our hospital after 2019. We investigated age, gender, history of pertussis, and history of vaccination with pertussis-containing vaccines at the time of participating in this study. Anti-PT-IgG antibodies (EIA method) were measured once a year in the remaining serum from staff health examinations. We defined 40 EU/mL as the antibody-positive threshold.

Results
There were 1454 subjects, with a median (IQR) age of 33 (26-44) years and 349 (24%) were male. Twenty-one (1.4%) had a history of pertussis, and the reason for diagnosis was antibody testing in 8, symptoms in 7, and unknown in 6. Thirty-one (2%) received a pertussis-containing vaccine within 10 years at the time of participating in this study. Antibody positivity rates were 16% (194/1222), 42% (383/928), 35.3% (226/639), and 25% (105/416) before, one year, two years, and three years after final DTaP vaccination, respectively. Within 1028 seronegative subjects before vaccination, 25% seroconverted after vaccination; during 108 subjects of which who could follow their titer continuously, 48% maintained the antibodies for up to three years. In one case, the person did not seroconvert but developed antibodies up to 100 IU/mL two years after vaccination. During the study period, no pertussis cases were diagnosed, and no outbreaks were observed in our hospital.

Conclusion
In this study, 84% of Japanese healthcare workers did not have sufficient pertussis antibodies before DTaP vaccination. Following a single dose of DTaP vaccination, 25% showed positive pertussis antibody titers, of which 45% maintained effective antibody levels for 3 years.

Disclosures
All Authors: No reported disclosures
P-2315. Clinical outcome of rifabutin-based treatment for pulmonary tuberculosis in solid organ transplant recipients
Authors: Yang Jinyoung , Ko Jae-Hoon , Cho Sun Young , Kang Cheol-In , Chung Doo Ryeon , Peck Kyong Ran , Rhu Jinsoo , Kim Jong Man , Choi Gyu-Seong , Lee Kyo Won , Park Jae Berm , Huh Woo Seong , Kim Darae , Choi Jin-Oh , Huh Kyungmin 
Published: January 2025

Abstract

Background
Rifabutin (Rfb) is commonly administered instead of rifampicin for the treatment of tuberculosis (TB) in SOTR to avoid substantial drug interaction of rifampin. However, evidence of its efficacy is scarce.

Methods
We conducted a retrospective, case-control study at Samsung Medical Center. The SOTR group included SOTR aged ≥ 18 years who were diagnosed with culture-positive pulmonary TB and treated with anti-TB medications that included both isoniazid (INH) and Rfb for &gt; 80% of the total treatment duration. Patients who discontinued immunosuppressants before TB diagnosis and those with rifampin-resistant TB were excluded. The SOTR group was matched with a 1:3 ratio to the non-SOTRs who were treated with rifampin-based regimens. The primary outcome was survival treatment completion without early relapse. Logistic regression with and without overlap weighting was used to evaluate outcome measures.

Results
A total of 40 SOTRs and 120 non-SOTRs were enrolled. There was no difference between the two groups in the presence of cavitary lesions, smear-positivity, or culture-positivity at two months. However, extrapulmonary TB and INH resistance were significantly more frequent in the SOTR group. Most SOTRs had kidney transplants, followed by liver transplants. The proportions of deceased donors and living donors were 50% each. The primary outcome was achieved in 90% vs. 96.7% in SOTRs and controls, respectively (P=0.108). However, the completion of treatment was more frequent in the non-SOTR group (92.5% vs. 100%, P=0.015). There was no difference in recurrence or all-cause mortality within 1 year of completion of treatment, and there was no TB-attributable mortality in both groups. There was no significant difference in primary outcome after overlap weighting (adjusted odds ratio, 0.31; 95% confidence interval, 0.07–1.30). Grade 3 or higher acute kidney injury or hepatotoxicity was significantly more common in the SOTR group. In the SOTR group, allograft rejection requiring anti-rejection therapy within 6 months of TB diagnosis occurred in 10% and allograft failure in 12.5%.

Conclusion
Treating TB using Rfb in SOTR showed a similar treatment outcome compared to rifampin-based treatment in non-SOTR, suggesting its efficacy in this population.

Disclosures
Kyungmin Huh, M.D., Ph.D., bioMérieux: Grant/Research Support|GSK Korea: Advisor/Consultant|Pfizer Korea: Honoraria|Takeda Korea: Advisor/Consultant
P-2337. Contemporary Epidemiology of Infant Mortality Attributable to Cytomegalovirus Infection in the United States, 2007-2021
Authors: Boasiako Ladonna , Obiefuna Ngozika G , Arthur Abigail , Ononogbu Chidinma S , Dapaah-Siakwan Fredrick 
Published: January 2025

Abstract

Background
Cytomegalovirus (CMV) infections are common in infants in the United States (US) but infant mortality due to CMV has been poorly studied and it is unknown if there have been changes in CMV infant mortality rate (CMV-IMR) over time. We described the characteristics of a contemporary national cohort of infants who died from CMV and whether the CMV-IMR changed from 2007 to 2021.Table 1.Characteristics of the national cohort of infants who died from CMV infections and their corresponding CMV-IMR, 2007-2009.

Methods
This was a retrospective serial cross-sectional analysis of the CDC's linked birth and infant death records from 2007-2021. We used ICD-10 codes to identify infants &lt; 1 year of age who had CMV infection listed as the underlying cause of death.The crude CMV-IMR was calculated per 1,000,000 live births and further stratified by gender, birth weight, gestational age, age at death, race, and census region. The Mann-Whitney U test was used to compare two groups and P &lt; 0 .05 defined statistical significance. Trends were evaluated with Joinpoint regressionand expressed as average annual percentage change (AAPC) with 95% confidence intervals (CI).

Results
Out of 59 million live births, 406 infant deaths were attributed to CMV infections (crude CMV-IMR of 6.9 per 1,000,000). This resulted in at least 30,044 years of potential life lost. Notable characteristics of the study cohort were (Table 1): 78.8% low birth weight, 72.4% preterm, 63.8% of the mothers had at least high school education, 14 states had 64% of the CMV deaths, and 45.3% died within 28 days of birth. The CMV-MR was higher in low birth weight and preterm infants and was inversely related to gestational age (Table 1). The CMV-IMR varied by race [highest in Non-Hispanic Black (9.9)], censusregion [highest in the Midwest (8.5)], and by state [4.3 in Illinoisand 12.3 in Alabama]. There was a non-significant decrease in the CMV-IMR from 9.3 to 4.1 (AAPC -2.9%; CI: -6.7 – 1.0%.)which was insignificant at 95%CI.

Conclusion
The ubiquitous nature of CMV and the higher mortality in preterm and low birth weight infants should prompt serious consideration for early and universal CMV screening in these infants. The racial disparities in CMV-IMR suggest differential public health action toward awareness, prevention, and treatment of CMV. Addressing these disparities must be a top priority.

Disclosures
All Authors: No reported disclosures
P-2350. Respiratory Virus Detection among Children, Teachers, and Touch Surfaces in Childcare Centres: Preliminary Results from the DISeases TrANsmission in ChildcarE (DISTANCE) Cohort Study (2022–2024)
Authors: Ye Sheng , Deng Shuyu , Cong Bingbing , Guo Ling , Zhang Tiantian , Xu Xiaoyu , Shi Chao , Wang Xin , Li You 
Published: January 2025

Abstract

Background
Childcare centres are commonly regarded as high-risk settings for respiratory virus transmission. To understand transmission risks within childcare centres, we conducted a prospective cohort study that collected data on respiratory infections in children and teaching staff, contact behaviours of children, and detection of respiratory viruses on touch surfaces (Figure 1).Figure 1.Schematic figure showing data collection and follow-up of the study.

Methods
We reported updated preliminary findings based on data collected from two childcare centres in Wuxi and Nanjing, China between September 26th, 2022, and January 22nd, 2024. Weekly throat swabs were collected from 211 children and 21 teachers. 56 touch surfaces, such as desks, door knobs, and faucets, were sampled on the same day from childcare centres (Table 1). Both respiratory and surface swab samples were tested by multiplex PCR for eight respiratory viruses.Table 1.Basic characteristics of the study and Positive cases of virus among children and teachers (estimate per 1000 person-weeks, 95% CI)

Results
6886 respiratory specimens and 1868 touch surface samples were collected and tested over the reporting period. Respiratory viruses were most detected among children (7.41%, 447/6032), followed by teachers (4.10%, 35/854) and touch surfaces (2.09%, 39/1868). The top four viruses detected among all children were rhinovirus, influenza A virus, RSV, and PIV (Figure 2). Specifically, rhinovirus prevailed mostly in the Nanjing site (60.11 per 1000 person-weeks, 95% CI: 48.69–73.41), while influenza A dominated in the Wuxi site (23.00 per 1000 person-weeks, 18.75–27.92). Teachers had lower viral infections than children except for influenza A, where rates were comparable: teachers (16.39 per 1000 person-weeks, 8.96–27.51) and children (18.24 per 1000 person-weeks, 14.99–21.98). For a given week, influenza A detection was correlated between students and teachers (Spearman correlation coefficient r =0.55) at the Wuxi and Nanjing sites (Table 2). However, for SARS-COV-2, there was a higher correlation between touch surfaces and individuals (children: r = 0.67; teacher: r = 0.82), than between children and teachers in Wuxi.Figure 2.Comparison of incidence/detection rate among children, teachers and touch surfaces in two childcare centres.

Conclusion
Children in childcare centres face higher risks of respiratory viral infections than teachers. There is synchrony in detecting respiratory viruses among teachers, students and touch surfaces, indicating the varied contribution of each component to respiratory virus transmission in childcare centres.Table 2.Correlation coefficients of respiratory virus detection in Nanjing

Disclosures
You Li, Pfizer: Advisor/Consultant
P-2367. Qualitative Analysis of Barriers to Outpatient Antiviral Treatment for COVID-19 and Influenza Patients Observed by Infectious Disease Specialists in North America, 2024
Authors: Louis Souci , Wang Dennis , Singleton Jordan , Smith Dallas J , Lambrou Anastasia S , Beekmann Susan E , Polgreen Philip M , Garg Shikha , Ricaldi Jessica , Uyeki Timothy M , Santibanez Scott S , Patel Pragna 
Published: January 2025

Abstract

Background
Antiviral medications for COVID-19 and influenza can mitigate disease severity in high-risk outpatients if taken early in the course of illness yet are underutilized. We sought to understand barriers to providers prescribing these medications.
Table
Thematic summary from infectious disease specialists outlining barriers to outpatient antiviral treatment for COVID-19 and influenza patients, United States, 2024

Methods
We conducted an on-line survey regarding knowledge, attitudes, and practices of prescribing antiviral treatment for outpatients with COVID-19 and influenza. Respondents were asked about perceived barriers among providers treating COVID-19 and influenza outpatients in their institutions. Questions were structured using a Likert scale and were analyzed using a thematic analysis approach in Microsoft Excel.

Results
Of 1,898 infectious disease specialists across the United States and Canada who received the survey between 1/10/24 to 2/5/24, 565 (30%) responded, of whom 93% were infectious disease physicians and 7% were healthcare professionals. Surveyed physicians worked in university (45%), non-university teaching (24%), community (20%), city/county (4%), outpatient (0.4%), and veteran affairs hospital settings (6%) and 144 (25%) provided free text responses. The primary barrier to prescribing antivirals was provider skepticism (47%), due to patient symptoms deemed too mild for treatment and needing more evidence about effectiveness. This was followed by perceptions of limited accessibility (31%) related to high cost, limited hospital access, and difficulty administering some medications. Pharmacologic limitations (18%) were concerns about drug interactions, side effects, and incomplete medical history. Other barriers were timeliness of treatment within a short therapeutic window (15%) and patient skepticism (13%). Additional free text responses described successful hospital protocols and suggestions for encouraging antiviral prescribing.

Conclusion
These themes demonstrate a need for better education of providers about antiviral risks and benefits as well as improved access and coverage of life-saving medications. Infectious disease specialists provided useful insights which can help to shape clinical recommendations, future research for antiviral therapeutics, and public health messaging for improved patient care.

Disclosures
Philip M. Polgreen, MD, Eli Lily: Advisor/Consultant|Pfizer: Grant/Research Support
P-47. Vaccine Effectiveness Against Influenza-Associated Hospitalizations in Adults with Liver Diseases
Authors: Huang Po-Han , Patricia Nowalk Mary , Zimmerman Richard K , Olson Samantha M , Talbot Keipp , Zhu Yuwei , Gaglani Manjusha , Murthy Kempapura , Monto Arnold , Martin Emily T , Silveira Fernanda , Balasubramani G K 
Published: January 2025

Abstract

Background
Influenza causes 100,000-710,000 hospitalizations annually in the U.S. Patients with liver disease are at higher risk of severe outcomes following influenza virus infection. While vaccination has been shown to be effective in preventing morbidity and mortality, patients with liver disease experience immune dysfunction that may attenuate influenza vaccine effectiveness (VE). Limited influenza VE data for this population are available. This study evaluated VE against influenza-associated hospitalization among adults with liver disease.

Methods
We used a test-negative, case-control study to estimate VE among adults ≥18 years admitted at four sites within the U.S. Hospitalized Adult Influenza Vaccine Effectiveness Network (HAIVEN) for acute respiratory illness (ARI) during 3 influenza seasons (2015-2018). Adults with liver disease were identified by ICD-9/ICD-10-CM codes recorded ≤1 year before enrollment. VE was defined as (1-adjusted odds ratio) *100 by comparing the odds of having laboratory-confirmed influenza-associated hospitalization between vaccinated and non-vaccinated adults using multiple logistic regression models that incorporated inverse probability of treatment weighting with propensity score.

Results
In total, 1208 (12.9%) of 9359 adults hospitalized for ARI had ≥1 liver disease(s). Compared with those without liver disease, adults with liver disease were slightly more likely to have received influenza vaccine (65.4% vs 62.4%; p = 0.046) but not different in their likelihood of influenza illness (16.6% vs 18.0%; p = 0.229). Overall, VE against influenza-associated hospitalization was 27% (95% confidence interval [CI], 18-34%); 30% (95% CI, 22-38%) among patients without liver disease; and -11% (95% CI, -54% to 20%) among those with liver disease. Significant effect modification of VE by the presence of liver disease was found (p = 0.01 for interaction term).

Conclusion
We observed no association of influenza vaccination on influenza-associated hospitalizations among adults with liver disease. Further studies are warranted to evaluate VE in patients with different types of liver disease to better understand if effectiveness varies by specific liver diseases and to investigate potential residual confounding.

Disclosures
Po-Han Huang, MD, MSc, Pfizer: Honoraria Mary Patricia Nowalk, PhD, AstraZeneca - Icosavax: Grant/Research Support|GSK: Advisor/Consultant|Merck & Co.: Grant/Research Support|Sanofi: Grant/Research Support Richard K. Zimmerman, MA;MD;MPH;MS, Sanofi Pasteur: Grant/Research Support Arnold Monto, MD, Roche: Advisor/Consultant Fernanda Silveira, MD, Ansun: Grant/Research Support|GSK: Grant/Research Support|Merck: Grant/Research Support|Viracor Eurofins: Advisor/Consultant