bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-623. Multicentric Prospective Study on Invasive Pneumococcal Disease (IPD) and Community Acquired Pneumonia (CAP) in hospitalized children, Serotype distribution and Antimicrobial Susceptibility Test (ATS) in Argentina after 11 years of Pneumococcal Conjugated Vaccine (PCV13) in National Immunization Program (NIP)
Authors: López Eduardo L , Uriarte Valeria , García Mariel , Gomila Andres , Ezcurra Gustavo Cesar , Vozza Lola , Bertoni Liliana , Morales Adrián , Teplitz Eduardo , Argüello Claudia Diaz , Aguirre Clarisa , Lara Claudia , Corso Alejandra , Contrini María M 
Published: January 2025

Abstract

Background
PCV13 was included in Argentina NIP in 2012 with 2 +1 schedule at 2, 4 and 12-15 mo of age. After 11 yrs program, from May´23-Mar´24 we carried out a multicentric prospective study to evaluate impact of pneumococcal disease, S.pneumoniae (Spn) serotype(S) distribution and AST.

Methods
Study Population: 1 mo to 10 yr old hospitalized children by IPD and/or CAP at 8 pediatric centers; f-up 6 mo. Clinical record was completed for subjects who met inclusion criteria after written Inform Consent from parents/legal guardian was obtained. Spn isolates from normally sterile fluids were sent to National Reference Laboratories for serotyping by Quellung reaction and AST by agar dilution (CSLI 2024).

Results
Subjects: 149; mean age(±SD): 49.2(±34) mo; male 83(55.7%). Age distribution: &lt;1yr: 23(15.4%); 1-2 yr: 36(24.1%); 3-5 yr: 49(32.9%); &gt;5 yr: 41(27.5%). Two main risk factors for IPD/CAP were: smoker at home 51(34.2%) and daycare attendance 41(30.2%). Diagnosis on admission: CAP 97(65.1%); pneumonia with empyema 54(36.2%); bacteremia 22(14.8%); meningitis 7(4.7%); peritonitis 5(3.4%); other 13(8.7%). Spn vaccination status was verified in 137/149(90.5%) subjects; being complete by age in: &lt;1yr: 65.2%; 1-2yr: 80.6%; 3-5yr: 89.8%; &gt;5yr: 87.8% subjects. Among 40 Spn the most prevalent S (72.5%) were (n): 12F(6), 3(4), 19A(3), 24B(3), 38(3), 24F(2), 23B(2), 1(2), 10A(2) and 11A(2). Other S were: 13, 14, 34, 15A, 15B, 16F, 17F, 22F, 23A, 7C and 9N. % No-susceptibility (NS) was: penicillin (PEN) meningitis/no meningitis 35/5, cefotaxime meningitis/no meningitis 7.5/0. All were 100% susceptible to rifampicin, vancomycin, ceftaroline and ceftobiprole. NS-PEN (CIM ≥0.12ug/ml) was associated with S 24B, 24F, 19A, 23B (71.4%). S coverage was 25%(10/40) for PCV13 (S 3, 19A and 14); and 55%(22/40) for PCV20 (S 12F, 3, 19A, 10A, 11A, 14, 15B and 22F).

Conclusion
1. Children &lt; 1yr old have the highest rate of incomplete Spn vaccination rate,then it is needed to improve the vaccine coverage in this age group in Argentina
2. Our preliminary data show an estimated coverage of 25% with PCV13 and 55% with PCV20
3. According to Spn S detected in IPD and CAP, PCV20 could increase the coverage by 30% in children in Argentina

Disclosures
All Authors: No reported disclosures
P-629. The Health and Economic Impact of the PCV15 and PCV20 Priming Series during the First Year of Life in the US
Authors: Rozenbaum Mark , Althouse Benjamin , Tort Maria J , Cane Alejandro D , Farkouh Raymond 
Published: January 2025

Abstract

Background
Two pneumococcal conjugate vaccines, 15- (PCV15) and 20- (PCV20) valent formulations, are currently recommended for US infants in a 3+1 schedule. The first 3 doses are administered during the first year of life (‘priming doses’ at 2, 4, and 6 months) while the booster dose is given at 12 to 15 months. This study evaluated the health and economic impact of priming doses within the first year of life.

Methods
Using a decision-analytic model, we calculated the health outcomes and economic implications from a healthcare payer perspective over a 12-month duration. Our epidemiological data were drawn from peer-reviewed studies. Estimates for vaccine effectiveness on invasive pneumococcal disease (IPD), inpatient and outpatient community-acquired pneumonia (CAP), and otitis media (OM) were extrapolated from established PCV13 effectiveness and PCV7 efficacy studies and adjusted for current serotype coverage of PCV15 and PCV20. Direct medical costs related to the treatment of IPD, CAP and OM were extracted from the literature and inflated to 2024 dollars. Aligned with CDC assumptions, we projected that children would experience 75.6% of the full vaccine effectiveness in their first year of life.

Results
Vaccination of newborns in the United States at 2, 4, and 6 months using PCV20 could potentially prevent an estimated 137 cases of IIPD, 3,150 cases of pneumonia, 54,000 cases of OM, and 38 deaths during the first year of life. This could result in savings of approximately 76M dollars in direct medical costs. When compared to universal administration of PCV15, PCV20 offers greater case prevention due to its broader serotype coverage. Specifically, using PCV15 instead of PCV20 would result in 54 fewer prevented cases of IPD, 26,200 fewer cases of otitis media, 1,526 fewer pneumonia cases, and 16 fewer prevented deaths.

Conclusion
This study showed that, in the US, vaccinating with PCV20 would yield a significantly greater health and economic return during the first 12 months of life compared to PCV15 due to the 5 additional serotypes covered by PCV20.

Disclosures
Mark Rozenbaum, PhD, M.B.A., Pfizer: Stocks/Bonds (Public Company) Benjamin Althouse, PhD, Pfizer: Stocks/Bonds (Public Company) Maria J. Tort, PhD, Pfizer Inc: Stocks/Bonds (Public Company) Alejandro D. Cane, MD, PhD, Pfizer: Employee|Pfizer: Stocks/Bonds (Public Company)|Pfizer: Stocks/Bonds (Public Company) Raymond Farkouh, PhD, Pfizer: Stocks/Bonds (Public Company)
P-635. “Exploring Knowledge and Barriers to HPV Vaccination among Mothers of 9-14 Years Olds - a Descriptive Study in a Tertiary Care Hospital”
Authors: Nair Tara B , Kumar C Dr Shiju , Vishnu Dr B S , Vincent Dr Lizy 
Published: January 2025

Abstract

Background
Human Papillomavirus (HPV) vaccination is pivotal in preventing cervical cancer and other HPV-related diseases. However, uptake remains suboptimal, partly due to parental knowledge gaps and barriers
Association between Knowledge Level & Factors Hindering Vaccination

Methods
This prospective descriptive study was conducted in a tertiary care hospital in Trivandrum, Kerala. A structured preformed questionnaire was administered to total of 268 participants who were mothers of girl children aged 9-14 years attending outpatient pediatric department. The questionnaire assessed knowledge about HPV, the vaccine available for HPV, and factors influencing vaccinations.

Results
Among the 268 study subjects, a significant majority, comprising 91.4%, demonstrated a commendable level of understanding regarding the HPV vaccine. Various factors were identified as barriers to vaccination uptake, with safety concerns being the most prevalent, cited by 91% of respondents. Additionally, a notable percentage (36.9%) expressed uncertainty regarding potential future infertility concerns linked to the vaccine, while 67.2% cited the high costs associated with it as a deterrent. Nevertheless, an overwhelming majority (99.6%) acknowledged the indispensable role of vaccines in disease prevention.

Conclusion
The substantial knowledge observed within our study cohort can be credited to the state's commendable literacy rates and the concerted efforts of governmental and non-governmental entities to fortify healthcare awareness. This study provides valuable insights the gaps in knowledge and measures to augment HPV vaccination rates among adolescents.

Disclosures
All Authors: No reported disclosures
P-667. The Impact of Delay in the Start of Effective Antibiotics on the Course of Pseudomonas aeruginosa Pneumonia: a Retrospective Study
Authors: Ito Takanori , Kanai Osamu , Fujita Kohei , Tanizawa Kiminobu 
Published: January 2025

Abstract

Background
The decision to target up to Pseudomonas aeruginosa at the start of antibiotic treatment of bacterial pneumonia is a major turning point. Since P. aeruginosa itself is a mildly virulent bacterium, we experience that P. aeruginosa pneumonia is improved even targeting P. aeruginosa after its detection. We studied the differences in mortality among P. aeruginosapneumonia cases depending on whether antibiotics with anti-P. aeruginosa activity were administered from the first time (empirical group, group E) or after the detection of P. aeruginosa (definitive group, group D).

Methods
We retrospectively studied patients who received antibiotics with anti-P. aeruginosa activity for P. aeruginosa pneumonia at our hospital from October 2016 to December 2023. The primary endpoint was 30-day mortality, and the secondary endpoints were total duration of treatment, length of hospital stay, and adverse events. This study was conducted with the approval of the Ethics Committee of our hospital (approve number: 23-075).

Results
There were 95 applicable participants. The group E had 62 patients and the group D had 33 patients. In the background between the two groups, clinical frailty scale was significantly worse, and impaired consciousness and hypotension. The 30-day mortality was not significantly different between the two groups (group E vs. group D, 1.6% vs. 3.0%, p &gt; 0.99). And there were also no significant differences in mean total duration of antibiotics treatment, mean length of hospital stays, or incidence of adverse events between the two groups (13.2 days vs. 12.9 days, 83.8 days vs. 58.5 days, 54.8% vs. 63.6% in the group E vs. group D, respectively).

Conclusion
There was no statistical difference in mortality by the delay in targeting P. aeruginosa for treatment of P. aeruginosapneumonia. It was suggested that this could lead to appropriate use of broad-spectrum antibiotics that target even P. aeruginosa.

Disclosures
All Authors: No reported disclosures
P-687. Respiratory Syncytial Virus (RSV) Testing Patterns among Medically Attended Cases of Acute Respiratory Illness from 2016 to 2023
Authors: Singer David , Wang Yan , Wu Aozhou , Horn Emily K , La Elizabeth M , Gerber Susan , Boland Joanna , Betts Keith A 
Published: January 2025

Abstract

Background
Historically, respiratory syncytial virus (RSV) has been an underrecognized cause of acute respiratory illness (ARI) in adults and patients have been infrequently tested for RSV. This study aimed to describe RSV testing patterns among adults over time and by setting of care.

Methods
This was a retrospective cohort study, analyzing the Optum de-identified Electronic Health Record data set (Optum EHR) from October 2015 to June 2023. Medically attended ARIs were identified (using ICD-10-CM codes) in adults aged ≥ 50 years with ≥ 12 months of activity in the Optum EHR. Individuals could have multiple ARIs included over the study period. ARIs were classified by epidemiological year (July 1 to June 30), RSV season, and by most intensive setting of care during the ARI (outpatient, emergency department [ED], or inpatient). The percentage of ARIs tested for RSV was reported by time period and other characteristics. Influenza and SARS-CoV-2 testing patterns were also reported for context.

Results
The study included 22,475,891 ARIs among adults aged ≥50 years. The mean age at the time of ARI was 67.3 years. Key baseline characteristics of ARI episodes are reported in Table 1. The percentage of ARIs tested for RSV generally increased each epidemiological year, from 1.3% in 2016-17 to 5.9% in 2022-23 (Table 2). RSV testing was higher during RSV seasons than outside of seasons prior to the COVID-19 pandemic period. Across epidemiological years, the percentages of medically attended ARIs tested for RSV was highest among ARIs that involved inpatient care (9.5-27.5%), followed by ED visits (1.4-17.9%), and outpatient visits (0.3-1.4%).

Conclusion
Despite increased awareness of the importance of RSV as a pathogen in older adults and adults with comorbidities, RSV testing remains infrequent. RSV testing has increased over time, particularly among ARIs involving inpatient care. These findings suggest that studies relying on recent real-world data could substantially underestimate RSV burden. Future research may further explore ARI or patient characteristics associated with RSV testing.
FUNDING: GSK (study identifier: VEO-000617)

Disclosures
David Singer, PharmD, MS, GSK: employee|GSK: Stocks/Bonds (Public Company) Yan Wang, ScD, Analysis Group: Employee Aozhou Wu, PhD, Analysis Group: Employee Emily K. Horn, MSc, GSK: employee|GSK: Stocks/Bonds (Private Company) Elizabeth M. La, PhD, GSK: employee|GSK: Stocks/Bonds (Private Company) Susan Gerber, MD, GSK: Employee Joanna Boland, PhD, MS, Analysis Group: Employee Keith A. Betts, PhD, Analysis Group: Employee
P-690. Quantifying The Health Equity-Related Public Health Impact of Influenza Vaccination: A Pilot Study for United Kingdom
Authors: Biundo Eliana , Soares Victoria G , Jansen Irshaad , Mrkvan Tomas 
Published: January 2025

Abstract

Background
While influenza vaccination is known to positively impact health equity, vaccination recommendations vary by country and may not always optimize equity considerations. For example, while the US recommends vaccination for everyone aged ≥6 months, the UK’s recommendations are limited to adults aged ≥65 years, those aged &lt; 65 years at higher risk, and specific age groups of children. This pilot study measured the health equity-related impact of broader UK vaccination recommendations.

Methods
Data availability determined that this analysis focused on adults aged ≥50 years in England. Health equity impact was assessed by Index of Multiple Deprivation Quintiles (IMDQ) and age (50–64, ≥65 and ≥50 years). Influenza risk and prevented cases were estimated using influenza hospital admission rates, vaccination effectiveness and coverage (flu season 2022/23). An exploratory analysis was conducted assuming extension of UK national guidance to all ≥50-year-olds with equal vaccine uptake in 50–64-year-olds as in ≥65-year-olds.

Results
This study estimated vaccination currently prevents ∼80% of all preventable cases in ≥65-year-olds vs. 47% in 50–64-year-olds. Influenza risk is highest in IMDQ1 (most deprived group) across age and vaccination status. Influenza prevention from vaccination of 50–64-year-olds (coverage ∼50%) in England is greatest in IMDQ1 (16% of all preventable cases prevented vs. 4% in IMDQ5, least deprived) (Table 1). Assuming extension of UK national guidance to all ≥50-year-olds with similar coverage to ≥65-year-olds (∼80%) may prevent ∼26% of preventable cases in IMDQ1 and ∼8% in IMDQ5 (Tables 1−3).

Conclusion
Expanding influenza vaccination to other age groups can help increase health equity by improved influenza prevention. Greater vaccination coverage would enable the highest reduction in cases, especially in the most socially disadvantaged groups.
Funding: GSK

Disclosures
Eliana Biundo, MSc, GSK: Employee|GSK: Stocks/Bonds (Private Company) Victoria G. Soares, MBA, GSK: Advisor/consultant Irshaad Jansen, MSc, GSK: Employee|GSK: Stocks/Bonds (Private Company) Tomas Mrkvan, PhD, GSK: Employee|GSK: Stocks/Bonds (Private Company)
P-697. Increases in Ages and Bacterial Coinfection in Hospitalized Children with Respiratory Syncytial Virus Infection in Taiwan:2019- 2023
Authors: Yi Gui Jia , Hsing En-Wei , Huang Chong-Wei , Tsao Kuo Chien , Hsieh Yu-Chia , Chen Chih-Ho 
Published: January 2025

Abstract

Background
Efforts to expand RSV epidemiological data are crucial, especially considering upcoming interventions such as long-acting monoclonal RSV-neutralizing antibodies and maternal vaccines for RSV prevention, which have the potential to alter the landscape.

Methods
A retrospective study was conducted at Chang Gung Memorial Hospital, analyzing children hospitalized with RSV infection before, during and after the COVID-19 pandemics from 2019 to 2023. Clinical data were collected and stratified by year for analysis. Plasma microbial free-DNA sequencing (mcfDNA) was performed on selected cases with C-reactive protein &gt; 100 mg/L to enhance diagnostic yields.

Results
A total of 997 children hospitalized for RSV infection was enrolled. In 2019, 2022, and 2023, the incidence of RSV-related hospitalization among children aged 0-4 years remained relatively stable, ranging between 600-700 per 100,000. However, in 2020 during a strict national nonpharmaceutical intervention, there was a notable spike, doubling to reach a peak, followed by an 80% decrease in 2021. In age subgroup analyses comparing 2022 and 2023 to 2019, the incidence of RSV-related hospitalization among children aged &lt; 2 years gradually decreased from 1576 per 100,000 in 2019 to 1212 per 100,000 in 2022 (P=0.03) and 1262 per 100,000 (P=0.07) in 2023. Conversely, the incidence of RSV-related hospitalization among children aged 2-4 years significantly increased from 124 per 100,000 in 2019 to 347 per 100,000 in 2022 (P&lt; 0.001) and 419 per 100,000 in 2023 (P&lt; 0.001). Independent risk factors for CRP &gt;100 mg/L in RSV cases were year 2023 (aOR:4.03, P=0.008) and age 2-4 years (aOR:3.33, P&lt; 0.001). In 2023, among 23 children with CRP &gt;100 mg/L, Hemophilus influenzae was identified in two children receiving bronchoalveolar lavage, and in 73% (11/15) of samples underwent plasma mcfDNA.

Conclusion
Following the COVID-19 pandemic, there was a proportional shift in RSV cases towards children over 2 years of age. Increase in age exhibited a higher rate of bacterial infections, particularly with Haemophilus influenzae. These findings offer critical implication for RSV prevention strategies and treatment of community-acquired pneumonia.

Disclosures
All Authors: No reported disclosures
P-698. Evaluating Modes of Influenza Transmission (EMIT-2): An Ongoing Controlled Human Influenza Virus Infection Transmission Trial (CHIVITT)
Authors: Lai Jianyu , Coleman Kristen K , Tai Sheldon , Hong Filbert , Maldonado Isabel Sierra , Esparza Yi , Sobhani Hamed , Srebric Jelena , Bhattacharya Proma , DeVoe Don L , Chen Wilbur , Milton Donald K 
Published: January 2025

Abstract

Background
The relative importance of inhalation, spray, and touch transmission remains poorly understood. We implemented a randomized controlled trial incorporating community-acquired cases using behavioral, personal protective equipment, and environmental interventions as tools to understand the pathway of influenza transmission.Figure 1.Study design and timeline of cohorts with naturally infected influenza Donors

Methods
We recruited healthy volunteer Recipients and influenza Donors with PCR-confirmed community-acquired infection to a hotel quarantine. We randomized healthy volunteers to Intervention (hand hygiene and face shield) and Control Recipients. Donors and Recipients interacted in an “Event Room” with controlled ventilation (0.2–0.5 air changes per hour) and relative humidity (20-40%). We collected ambient air and personal bioaerosol exposure samples using NIOSH BC-251 samplers. We also deployed a novel cascade to liquid media bioaerosol sampler. Donors provided exhaled breath samples using a Gesundheit-II (G-II) sampler. We analyzed samples using dPCR and florescent focus assay.Figure 2.Viral RNA load in GII samples and MTS

Results
We ran four cohorts (February 2023 and January-February 2024); two with naturally infected influenza Donors (Figure 1). We exposed 11 Recipients (mean age: 36; 55% female) to 5 influenza Donors (mean age: 21; 80% female). Preliminary results show that eleven G-II fine (&lt; 5µm), one G-II coarse (≥5µm) (Figure 2), four NIOSH ambient air (three ≥4µm and one 1-4µm), and three NIOSH personal bioaerosol exposure samples (two 1-4µm and one less than 1µm) were PCR positive. Virus was cultured from an ambient bioaerosol sample. No Recipient developed influenza-like illness or PCR-positive swabs; serology is pending.

Conclusion
We demonstrated that it is feasible to recruit Donors with new onset community-acquired influenza infections and expose Recipients under highly controlled conditions. Although initial experiments did not produce PCR-positive secondary infections, much will be learned by analyzing the immunity of the exposed Recipients and the inhaled dose of virus. This unique randomized controlled trial will provide a definitive assessment of the role of inhalation transmission and critical data on which to build effective interventions to prevent transmission.

Disclosures
Donald K. Milton, MD, DrPH, Lumen Bioscience, Inc: Advisor/Consultant|Lumen Bioscience, Inc: Stocks/Bonds (Private Company)
P-702. Epidemiology of Respiratory Pathogens and the Impact of Seasonality, Patient Demographics, and Diagnostic Testing Approach: A Retrospective Analysis from 2022 to 2023
Authors: Gonzalez Kaisha 
Published: January 2025

Abstract

Background
Respiratory tract infections (RTIs) are a significant concern for public health due to their widespread transmission and high rates of illness and death reported globally. The use of multiplex molecular methods has allowed for the detection of a broad range of respiratory viruses and their subtypes, as well as some bacteria. This study investigates the epidemiology of respiratory pathogens detected in different demographic populations, emphasizing the importance of a flexible diagnostic testing approach to adapt to the complex dynamics of respiratory pathogens during the peak season.
Distribution Rates of Respiratory Targets in Young, Adult, and Elderly Patients (n=1,520)
Analysis of distribution rates of 19 respiratory targets during the respiratory season of 2022-2023, stratified by age.

Methods
During the 2022-23 respiratory disease season, the Diasorin LIAISON PLEX® Respiratory Flex Assay was used to prospectively test 1,520 patients across six clinical sites in the United States. As part of an observational study, retrospective analyses were conducted to compare the detection rates and frequencies of 19 respiratory targets (14 viral and 5 bacterial targets). The results were stratified by age.

Results
Many respiratory pathogens displayed age- and season-specific patterns. Enterovirus/rhinovirus was detected more frequently in patients &lt; 21 years old (27%) than in the adult group (14%) and elderly group (9%), p&lt; 0.01. Flu A prevalence was found to be higher in adults (21-65 y) at 25% and 33% in the elderly ( &gt;65 y) population, p≤0.05. Individuals &lt; 21 years had a lower incidence of SARS-CoV-2 (8%) compared to adults (35%) and the elderly (40%), p&lt; 0.001. The most common viruses found in all three populations were flu A, human coronavirus, SARS-CoV-2, and flu A-H1, while the other pathogens were more population-specific.

Conclusion
The results of the study offer valuable insights into the complex dynamics of respiratory pathogens. They emphasize the importance of flexible multiplex PCR testing strategies that consider the different circulating patterns of these pathogens across different populations. This approach can help customize respiratory testing based on factors such as seasonality, patient demographics, and acceptable costs, and in line with diagnostic stewardship, adapt testing protocols to meet the specific needs of respiratory testing.

Disclosures
All Authors: No reported disclosures