bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-930. Infective Endocarditis and the Role of Oral Pathogens
Authors: Lauriente Tanna J , Leis Benjamin , Takaya Satchan , Wong Chantelle Y G , Spence Cara , Teekasingh Mohan 
Published: January 2025

Abstract

Background
Studies suggest poor oral health increases the risk of infective endocarditis (IE) as 20-53% of cases stem from organisms linked with oral flora. Despite intravenous drug use being a known risk factor for IE, our local data reveals nearly 33% of IE pathogens in individuals who inject drugs (PWID) come from oral microflora. Shockingly, only 9.1% of IE patients received dental consultation during admission.Table 1.Classification of isolated infective endocarditis pathogens by site of origin and injection drug use status.77 participants underwent retrospective chart review with 36.4% identifying as people who inject drugs (PWID). A heat map was used with blue indicating 0 and red indicating higher number of pathogens up to 12. This demonstrates that the majority of pathogens identified from positive blood cultures were from skin, oral cavity, and GI sources. However, among the PWID group, environmental pathogens were more prevalent.

Methods
This is a pre-and-post intervention cohort study. Through retrospective chart review, we established baseline PWID status, pathogen identified in positive blood cultures, dentistry details, and determined origin site of the microorganism. We reviewed all adult IE admissions to our tertiary care hospital in Saskatoon, SK from January 1, 2022 to May 31, 2023 who met the Modified Duke Criteria. Using this data, we designed a Multi-Disciplinary Endocarditis (MENDO) Clinical Pathway to address gaps in dentistry review and intervention at our hospital. This intervention, which began September 25, 2023, has enrolled 35 patients so far.

Results
Among the 77 retrospective participants meeting inclusion criteria, 36.4% were PWID and 31.2% of all IE pathogens were from oral sources. Commonly isolated oral pathogens included Viridans Group Streptococci and Streptococcus anginosis. Notably, 32.1% of IE organisms in PWID were oral pathogens which was similar to non-PWID (p = 1.0). In the retrospective cohort, the baseline rates of dentistry consultation and dental intervention were 9.1% and 7.8% respectively. Since September 2023, 35 patients have been enrolled in the MENDO pathway, 72.1% of which are PWID. Through care standardization and case worker support, our dentistry consultation rate and intervention rates are now 35.5% (p = 0.0115) and 9.7% (p = 0.714) respectively.

Conclusion
In our study, approximately 1 in 3 PWID had IE due to oral pathogens. This was comparable to non-PWID, suggesting equal prevalence of IE due to dental sources in both populations. Our intervention enhanced dentistry access for PWID, and we hypothesize that our longitudinal data will show reduced infection relapse. Integrating oral health assessments and interventions into the care of individuals at risk for IE, including those with PWID, could potentially reduce the burden of this serious condition.

Disclosures
Satchan Takaya, MD FRCPC, Moderna: Advisor/Consultant
P-939. 2-year Follow-up on Patients Who Inject Drugs (PWID) Diagnosed with Infective Endocarditis (IE)
Authors: Patel Kaya , Duffield Olivia , Schultz Sara K , Spivack Stephanie 
Published: January 2025

Abstract

Background
IE is a serious infectious complication of intravenous drug use (IVDU). Treatments include prolonged courses of IV antibiotics, surgical valve repair or replacement, and vacuum-assisted thrombectomy. Herein, we describe a 2-year follow up of outcomes of PWID who presented with IE.
Treatment modalities for IE

Methods
The IRB approved this study. We queried our EMR for patients with documented opioid use disorder (OUD) with injection behavior and positive blood cultures from September 2021 to March 2022. For patients identified to have IE in this time frame, we conducted a retrospective chart review from March 2022- March 2024 to evaluate outcomes.
Outcomes in all treatment groups

Results
We identified 37 patients with definite IE by modified Duke’s criteria. The treatment modalities these patients received are described in Figure 1. Of the 11 patients meeting criteria to receive surgical intervention, only 7 (63%) of these patients received intervention. All 7 (100%) of the patients that received intervention completed their antibiotic course for treatment. None were readmitted for sequela of undertreated endocarditis, but 2 (28%) patients were readmitted within 2 years for repeat endocarditis due to continued injection drug use. The 2-year all-cause mortality in this group was 0%. Of the 4 (37%) patients who required intervention but did not receive it, 1 (25%) was offered intervention but declined, 1 (25%) had an in-hospital death, and 2 (50%) left with a patient directed discharge but received intervention when readmitted within 3 months. The 2-year all-cause mortality rate in this group was 50%.
In the remaining 26 patients who did not require intervention, 7 (27%) completed an antibiotic treatment course, 17 (65%) did not complete antibiotics, and 2 (8%) had an unknown treatment course. Eleven (42%) were readmitted for bacteremia within 2 years. Four (15%) were readmitted with endocarditis (3 within 60 days from untreated endocarditis with worsening vegetation on TTE and 1 with endocarditis from continued injection drug use). The 2-year all-cause mortality in this group was 3 (11%). Table 1.

Conclusion
In a 2-year follow-up of PWID presenting with definite endocarditis, high survival was noted in patients who underwent intervention. In patients receiving antibiotic therapy alone, high rates of incomplete treatment and readmissions occurred.

Disclosures
Sara K. Schultz, MD FACP FIDSA, AbbVie: Advisor/Consultant
P-941. Short- and Long-term Mortality of Infective Endocarditis in the Veteran Population
Authors: Davis Matthew , Mergenhagen Kari A , Chan Arthur , Xu Jiachen , Wattengel Bethany A , O’Leary Ashley 
Published: January 2025

Abstract

Background
The aim of this study was to evaluate the short- and long-term mortality of infective endocarditis within the veteran population.

Methods
This study was a retrospective, national study of veterans &gt; 18 years old between 1/1/2010-3/1/2023 diagnosed with endocarditis. Endocarditis was defined by ICD coding, patients having at least one positive blood culture and having an echocardiogram performed. during admission. The primary objective was to evaluate the rate of 30-day and one-year mortality of the study population.
Secondary endpoints looked at correlation between mortality and other factors such as comorbidities, causative organism, drug/alcohol disorders, smoking status, septic emboli, fever, and the use cardio-protective medications.
Charlson Comorbidity Scores

Results
4,241 hospitalized patients who received care at a Veterans Affairs Hospital and were diagnosed with bacterial endocarditis during the study timeframe were included. The primary outcome of short- and long-term mortality was seen in 658/4,241 patients (15.5%) and 1775/4,241 patients (41.9%) respectively.
Enterococcus faecalis endocarditis was the most prevalent organism (17.2% of infections). MRSA endocarditis was associated with a clinically significant increase in mortality at both 30-days and one-year (p &lt; 0.001). The diagnosis of septic emboli showed a statistically significant increase in short-term mortality with 106/427 patients diagnosed experiencing mortality within 30-days (p &lt; 0.001) Fever during admission showed a statistically significant increase in mortality for both short- and long-term mortality rates (p &lt; 0.001).

Conclusion
Mortality within one-year was found to be 41.9% amongst our patient population. Identifying possible risk factors for increased mortality in this population may assist in decreasing both the short- and long-term mortality of those with infective endocarditis. Future directions for research could include assessing cardio-protective medications in this population on a larger scale to assess potential benefit.

Disclosures
All Authors: No reported disclosures
P-945. “Bug Of The Day”: An Infectious Disease Interest Group Initiative to Provide Weekly Doses of Infectious Education
Authors: Palacios Alfredo A , Pavia Jonathan E , Le Rose , Nicolas Marissa , Roa Kyra , Hornak Joseph Patrik 
Published: January 2025

Abstract

Background
Medical education continues to accommodate advancements in technology. Currently within the social media era students can access vast amounts of information through various platforms. As education evolves with technology, educators must understand social media platforms in order to maximize their impact. The Infectious Disease Interest Group (IDIG) has initiated “Bug of The Day”, a social media initiative to increase medical student exposure to the field of Infectious Disease.

Methods
IDIG formed a committee of 7-10 medical students who collaborate to produce informative posts about microorganisms. These posts include a compelling question, detailed explanations, and facts to assist medical students in solidifying their knowledge of important organisms. Metrics obtained through the study consist of user interaction with posts including likes, comments, shares, amount of votes, and profile interaction. An online survey will be administered assessing student satisfaction of the posts, and to what degree these posts benefit their knowledge of ID.

Results
Sixten “Bug of The Day (BOTD)” posts have been shared on our instagram with posts being published twice a week. The average number of accounts reached by a BOTD post is 148.6, with an average of 76% selecting the right answer. The highest number of profile visits from a BOTD story post was 62 accounts. A survey distributed via instagram revealed that 95% of respondents enjoyed the content (n = 19), while 100% reported that the content not only proved helpful but also increased their appreciation for microbiology (n = 18).

Conclusion
The use of social media in education has been slowly adopted as we’ve delved deeper into the technology era. The field of Infectious Disease spans into many different specialities, making medical students' knowledge of microorganisms essential regardless of their desired career path. BOTD demonstrates that students engage with online Infectious Disease educational material through the use of social media. The survey to be administered will assess student satisfaction with the initiative, and could demonstrate the benefit of utilizing such a platform to build upon student knowledge.

Disclosures
Joseph Patrik Hornak, MD, Innoviva Specialty Therapeutics: Advisor/Consultant|Innoviva Specialty Therapeutics: Advisor/Consultant
P-947. Evaluation of Priorities and Inclusion in Coaching Opportunities for Infectious Disease Advanced Practice Providers (APPs)
Authors: Beieler Alison M , Yoke Leah H , Zimmer Andrea J , Strnad Luke , Riedel David J 
Published: January 2025

Abstract

Background
In line with the Infectious Diseases Society of America (IDSA) mission statement, the IDSA Medical Education of Community Practice launched in 2019 establishing several sub-groups, including a mentoring workgroup. This group successfully started a Clinician Educator Coaching Program for Infectious Disease (ID) in which junior faculty are paired with experienced faculty to meet around IDWeek. Advanced practice providers (APPs) are a growing workforce within ID but have limited access to formal mentoring programs despite expressed desire for mentorship. In response, the IDSA APP interest group developed a survey to identify APP priorities and then developed a pilot coaching program to address some of the mentoring needs identified.Figure 1.Anonymous survey of six APP priorities ranked by score (n = 41)

Methods
An anonymous survey was distributed via email and the IDSA IDea exchange in 2022 to evaluate APP priorities on topics including education, mentorship, inclusion, and IDSA membership. Following that survey, an APP coach/advisee pilot program was created and advertised via email and the IDSA IDea exchange from 8/16/23 – 9/1/23. APP coaches were defined as those with &gt; 6 years ID experience while APP advisees were those in practice &lt; 3 years. Coaches and advisees were paired and encouraged to meet virtually over several sessions.Table 1.Matches for APP Advisee/Coach by area of ID practice. (n=6)BMT: bone marrow transplant, HIV: human immunodeficiency virus, PrEP: Pre-exposure prophylaxis

Results
41 survey responses were returned from APPs in ID with six ranked priorities using calculated scoring (Figure 1). Overall, “mentorship” was the 3rd most common item scored as a number one priority, and 44% of the respondents ranked it as one of their top three priorities. Six APP coach/advisee pairs were matched, based on specialty of ID practice (Table 1). An advisee survey identified individual needs assessment pre-meeting (Table 2). Feedback from participants was limited mostly to coaches by response rates post-meeting (5 coaches, 1 advisee), but suggested the coaching program was beneficial overall (Table 3).Table 2.APP Advisee Pre-Meeting Needs Assessment (n = 6)

Conclusion
APP priorities included IDSA membership, education, inclusion, and mentorship. While formal APP mentorship has not yet been established in ID, a pilot APP ID coaching program launched successfully with six pairs. Additional APP coaching or mentoring opportunities alongside other educational curriculum could be offered within IDSA to meet needs and optimally support APPs in ID.Table 3.APP Coaching Pilot Post-Meeting Survey Results

Disclosures
All Authors: No reported disclosures
P-967. Impact of simulated ID rounds for third year pharmacy students (P3s) in an infectious diseases (ID) elective
Authors: Lee Yuman , Bradley Nicole 
Published: January 2025

Abstract

Background
ID Rounds simulate real-world multidisciplinary ID rounds for P3s enrolled in the ID elective. Two faculty play the ID attending and 4th year pharmacy students on their Advanced Pharmacy Practice Experiences play the roles of the ICU fellow, nurse, microbiologist, and radiologist. An ID consult for a patient with post-influenza pneumonia along with the patient’s general information and basic labs are presented. P3s are guided to navigate the patient care process, collecting and assessing information, and formulating, implementing, and evaluating therapeutic recommendations. Challenges incorporated include a weight discrepancy, altering antimicrobials, monitoring drug levels, following cultures, and discharge planning. The purpose of this study was to assess the impact of ID Rounds on achieving Doctor of Pharmacy educational outcomes and professional activities.

Methods
An anonymous, electronic survey was distributed to P3s to assess the impact of ID Rounds. Survey questions were designed in accordance with the standards set by the American Association of Colleges of Pharmacy Curriculum Outcomes and Entrustable Professional Activities, using a Likert scale. Student perceptions were also collected.

Results
36 P3s responded and all strongly agreed or agreed that ID Rounds helped them learn foundational knowledge of inpatient rounds and enhanced their professional skills by building and maintaining trust among their colleagues. Majority strongly agreed or agreed that ID Rounds helped them understand the role of a pharmacist in optimizing antimicrobial use (94.5%, 34/26), become better communicators (94.5%, 34/36), and support the achievement of shared goals on a team (97.2%, 35/26). Majority rated ID Rounds a 4 out of 5 in difficulty, found the activity as an engaging way of learning about inpatient rounds, and enjoyed participating.

Conclusion
ID Rounds allowed pharmacy students to achieve key standards in Doctor of Pharmacy educational outcomes and professional activities. Students responded positively to ID Rounds, which actively involved them in a real-world scenario, enabling the application of critical skills such as collaborative practice, critical thinking, and effective communication. These competencies are fundamental to the practice of pharmacy.

Disclosures
All Authors: No reported disclosures
375. Back to School Unequal: Neighborhood Disadvantage and Asthma-related Emergency Department Visits in School-Aged Children
Authors: Dunphy Peter , Matsui Elizabeth , Rathouz Paul , Chambliss Sarah , Zárate Rebecca , Balcer-Whaley Susan , Bhavnani Darlene 
Published: January 2025

Abstract

Background
Asthma-related emergency department (ED) visit rates among children in a typical year closely follow the school calendar, with a sharp increase in rates when students return to school. The well-known increase in asthma exacerbations at the start of the school year is largely attributable to increases in respiratory viral infection. Because neighborhood disadvantage is strongly tied to asthma exacerbations, we hypothesized that greater neighborhood disadvantage would be associated with a greater increase in the rate of asthma exacerbations after the start of school.

Methods
We summarized Texas Health Care Information Collective data (2016-2019) on asthma-related ED visits among children (ages 5-17) in four Texas metropolitan statistical areas (Houston, Dallas, Austin, and San Antonio) by week and census tract. Neighborhood disadvantage was characterized at the census-tract level using tertiles of Social Vulnerability Index (SVI), percent uninsured, and percent living below the federal poverty line. Within each tertile, we described population-based incidence rates of asthma-related ED visits per 100,000 person-years in the 6 weeks before and after the week that school started. We also modeled weekly incidence rates and pointwise 95% confidence intervals by week using a locally weighted smoothing model.

Results
Comparing the 6-week periods before and after the week that school started, the incidence rate of asthma-related ED visits in high-, medium-, and low-SVI census tracts increased by 60, 39, and 20 cases per 100,000 person-years, respectively, representing a 3-fold difference between high- and low-SVI census tracts. Census tracts with high SVI had the greatest modeled increase in weekly rates of asthma-related ED visits after the start of school (Figure 1). Results were qualitatively similar for the percent of the population uninsured and below the federal poverty line (Figures 2-3).

Conclusion
Greater neighborhood disadvantage was associated with a greater increase in the rate of asthma related ED visits after the start of school, suggesting that neighborhood disadvantage may contribute to exacerbation risk by increasing the risk of respiratory virus infection.

Disclosures
Paul Rathouz, PhD, Sunovion Pharmaceuticals: DSMB Member
P-1005. Seroepidemiology of Cytomegalovirus, Rubella and Toxoplasma in Women of Childbearing Age in Korea
Authors: Cho Youngmin , Moon Hyejeong , Cho Eun Young , Park Jaemin , Lee Anna , Lee Hyunju 
Published: January 2025

Abstract

Background
This study aimed to assess the seroprevalence of Korean women of childbearing age to define the population susceptible to cytomegalovirus (CMV), rubella, and toxoplasmosis.

Methods
The results of cytomegalovirus, rubella, and toxoplasma antibody tests performed by chemiluminescent microparticle immunoassay in women 15-50 years of age at Seoul Clinical Laboratories from 2012 to 2022 were analyzed based on age, year, and region.

Results
The average positive seroprevalence rate was 92% (256/3,114) for CMV, 91% (405,207/442,998) for rubella, and 5% (819/15,712) for toxoplasma. In the age-group analysis, seroprevalence of CMV increased from 69% in women 15-19 years to ≥98% in 35-50 years of age, whereas seroprevalence of rubella was higher in women 15-39 years (90-93%) than in women 40-50 years (80-89%) of age. There was no change between age groups in seroprevalence of toxoplasma.

Conclusion
During the past 10 years, there was no significant difference of seroprevalence for CMV, rubella, and toxoplasma according to year or region age in reproductive women in Korea. To prevent and manage congenital infections, monitoring for the changes in seroprevalence of women with childbearing age should be continued.

Disclosures
All Authors: No reported disclosures
385. Sepsis-Associated Encephalopathy and Dementia Outcome: A Retrospective Cohort Study of 30,378 Adult Sepsis Inpatient Survivors at a Tertiary Medical Center in Taiwan
Authors: Lin Yu-Chao , Chang Yi-Ching , Lin Che-Chen , Kuo Chin-Chi , Chiang Hsiu-Yin 
Published: January 2025

Abstract

Background
Sepsis-associated encephalopathy (SAE) is commonly observed in critically ill patients without identifiable causes, potentially leading to neurological sequelae. Prior studies have associated the long-term risk of dementia with sepsis or in-hospital infections, or the short-term risk of mortality with SAE, rather than the short-term dementia risk with SAE. We aimed to assess the association between SAE and the 1-year risk of dementia among sepsis survivors.Figure 1.Flowchart of the selection process of adult sepsis inpatient survivors (n = 30,378).

Methods
This cohort included inpatients aged ≥ 18 years with first-time sepsis during 2010-2019, no prior dementia or central nervous system (CNS) infections, Glasgow Coma Scale (GCS) measurements within 7 days of sepsis, and who survived the index hospitalization (Figure 1). Sepsis was identified using Sepsis-3 criteria. SAE was defined as having at least two GCS measurements of either &lt; 7 for patients with endotracheal tubes, tracheostomies, or aphasia, or &lt; 12 for the remaining patients within the 7 days of sepsis. Dementia at 3 months and 1 year was defined by the presence of ICD-9 and ICD-10 diagnosis codes from 7 days to 3 months, and from 3 months to 1 year post-sepsis onset, respectively. Multivariable Cox models were used, considering death as the competing risk.
Demographic, clinical characteristics, and outcomes of adult sepsis inpatient survivors, stratified by SAE status.

Results
Of 30,378 eligible sepsis inpatient survivors, 6.4% developed SAE within 7 days of sepsis onset. Patients with SAE tended to be older, female, and have more comorbidities compared to those without SAE (Table 1). Dementia occurred more frequently in patients with SAE than those without (10.9% vs 3.9% within 3 months; 3.6% vs 2.1% within 1 year). Similar patterns were observed in mortality rate. SAE was significantly associated with an increased risk of dementia for 3-month (adjusted hazard ratio [aHR] 1.81; 95% confidence interval [CI] 1.55-2.12) and for 1-year (aHR 1.54; 95% CI 1.18-2.01), compared to patients without SAE (Table 2). This association was significantly stronger among patients without chronic pulmonary disease, stroke, and with a qSOFA &lt; 2, regarding the 3-month dementia risk (Figure 2).
Risk of dementia and all-cause mortality associated with SAE among adult sepsis inpatient survivors.

Conclusion
Determining whether SAE is a trigger for the disease itself or merely triggers more intensive dementia surveillance requires more studies with standardized SAE diagnostic criteria and post-sepsis follow-up strategies.
Subgroup analyses of the risk of dementia and all-cause mortality associated with SAE.

Disclosures
All Authors: No reported disclosures