bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-1367. Changing Epidemiology of Carbapenemase-producing Carbapenem-resistant Enterobacterales (CRE) in Taiwan
Authors: Lee Susan Shin-Jung , Hsia Hui-Ling , Lee Yi-Ting , Chen Chii-Shiang , Huang Tsi-Shu , Sy Cheng Len , Lin Hsi-Hsun 
Published: January 2025

Abstract

Background
Rapid spread of carbapenemases (CP) among Enterobacterales require prompt identification to enable timely and appropriate treatment. This study aimed to determine the accuracy of NG-Test CARBA 5 for rapid detection of CP and to describe the epidemiology of carbapenem-resistant Enterobacterales (CRE) in Taiwan.Fig 1.Increasing Prevalence of Carbapenemase-producing Carbapenem-resistant Enterobacterales (CRE) in Taiwan (2018-2023)

Methods
316 isolates of CRE were collected from a medical center, Kaohsiung Veterans General Hospital in Taiwan during 2018 to 2023, of which 30.4% were CP producers. The NG-Test CARBA5, PCR for blaKPC, blaVIM-2, blaIMP, blaNDM, and blaOXA-48-like genes were performed on 101 strains. Sequencing and phylogenetic analysis for blaKPC and blaNDM was done.Table 1.Performance of Rapid NG-Test Carba 5 compared to PCR for detecting carbapenemase genes in clinical isolates of carbapenem-resistant Enterobacterales (CRE) in Taiwan (N=101)

Results
A significant increase in the prevalence of CP-producing CRE was observed during this period from 9.9% before 2020 to 29.0% in 2020-2021 and 48.6% in 2022-2023 (OR for trend: 2.46, 95% CI: 1.78-3.38, p&lt; 0.001). CP genes was detected by PCR in 100%, however, the NG-Test CARBA 5 failed in 9 strains, with a detection rate of 91.1%. The agreement between the 2 methods were high (94.4 % for CR-Escherichia coli, 90.6 % for CR-Klebsiella pneumoniae, 87.5 % for CR-Citrobacter freundii and 81.8 % for CR-Enterobacter spp). The major CP genes in CRE was blaKPC 38.6%, blaNDM 34.7%, blaIMP7.6% and blaOXA-48-like 6%. Metallo-β-lactamase (MBL) genes became prevalent over time and accounted for 54.5% of CP genes, which was mainly found in CR-E.coli. Highest expression of CP genes blaKPC and blaOXA-48 was in CR-K.pneumoniae (52.9% and 27.5%, blaNDM was in CR-E.coli (55.6%), and blaIMP in CR-Enterobacter spp. (68.2%). The most common genotype of blaNDM was blaNDM-1 (24/35, 68.6%), following by blaNDM-5 (9/35, 25.7%) and blaNDM-4 (2/35, 5.7%). All 33 blaKPC strains were KPC-2 type.Fig 2.Distribution of Carbapenemase (CP) genes in clinical isolates of CP-producing CRE in Taiwan (N=101)

Conclusion
Our study demonstrated that the NG-Test CARBA 5 was useful for rapid detection of CP genes, and the rising prevalence of MBL genes in Taiwan is a cause of concern due to limited treatment options.

Disclosures
All Authors: No reported disclosures
P-1371. Identifying Occurrences of Plasmid-Borne Antimicrobial Resistance Gene Transfer between Diverse Bacterial Species within Environmental Biofilms Using Proximity-Ligation Sequencing
Authors: Tanner Windy , Tajammul Ayesha , Benson Scott , Ahmed Jamil , VanDerslice James , Brazelton William 
Published: January 2025

Abstract

Background
Antimicrobial resistance is a critical global concern. Pathogens may become resistant through acquisition of mobile genetic elements harboring antimicrobial resistance genes (ARGs). Environmental biofilms provide an excellent venue for ARG transfer via mobile elements. Mobile ARG dissemination pathways in the environment require a better understanding. Here we use proximity-ligation (Hi-C) and metagenomic sequencing to pair plasmids and ARGs to their bacterial hosts and present evidence of plasmid sharing between bacterial species.

Methods
Eight environmental biofilm swabs collected from water sources in Sindh Province, Pakistan were equally aliquoted for preparation by 1) DNA cross-linking for proximity ligation and Hi-C metagenomic sequencing, and 2) traditional shotgun metagenomic sequencing. Metagenomic Hi-C was used to analyze the proximity-ligation and shotgun sequencing data to construct metagenomic-assembled genomes, determine if ARGs were chromosomally- or plasmid-located, and associate mobile genetic elements and ARGs with their host cells.

Results
Actinomycetia, Gammaproteobacteria, and Alphaproteobacteria were the most frequently detected taxa in most samples, with Bacteroidia also being at higher numbers than other taxa in most samples. Multiple classes of ARGs in the sample were identified as being located on plasmids, including aminoglycoside ARGs (e.g. aph(3'), aph(6)), beta-lactam RGs (blaCTX-M-15, blaEC, blaTEM-1, blaOKP-A), macrolide RGs (ere(A), erm(X), mph(A), mef(C), mph(G)), quinolone RG qnrS1, sulfonamide RG sul1, and several tetracycline and metal ARGs. TetC, blaA2, and aac(3)I, were only found on bacterial chromosomes. Analysis of unique assembled ARG-bearing plasmids and taxonomic clusters revealed plasmid sharing between bacterial species, some of which were not closely related taxa.

Conclusion
Mobile ARGs are common in environmental biofilms. These ARGs have the potential to spread within biofilms between species, as evidenced by shared plasmid between different bacterial species. The environment should be considered an important source for mobile ARG dissemination between bacterial species.

Disclosures
All Authors: No reported disclosures
P-1376. Impact of COVID-19 and Mpox on Inpatient Screening of STIs
Authors: Levine Samara , Carpenter Brian , Streifel Amber C , Shonk Alexandria , Varley Cara D 
Published: January 2025

Abstract

Background
Sexually transmitted infections (STIs) continue to pose a considerable public health challenge, with a notable uptick in STI rates over the last few years. Access to care, both inpatient and outpatient, was disrupted during COVID-19 with a subsequent increase in STIs reported in many areas, followed by additional strain on services with the emergence of Mpox in Oregon.
Abbreviations: sexually transmitted infection (STI)
STIs include chlamydia, gonorrhea, syphilis, human immunodeficiency virus (HIV), and hepatitis C

Methods
We conducted a retrospective cohort of hospitalized patients at the Oregon Health & Science University (OHSU) Internal Medicine and Family Medicine services to evaluate STI screening and diagnoses (including chlamydia, gonorrhea, HIV, HCV and syphilis) across distinct periods: pre-COVID-19 pandemic (1/1/2018-2/29/2020), during the COVID-19 pandemic (3/1/2020-7/31/2022), and amidst the Mpox surge (8/1/2022-3/1/2023). We calculated the proportion screened, percent positivity by time and compared proportions between our pre-designated periods using the two-sample test of equal proportions.

Results
During the study period, 5802 patients were admitted to OHSU. Most were White (4705, 81.1%), non-Hispanic (5308, 91.5%) and Female sex (3600, 62.1%). In total, 2151 (37%) were screened for one or more STIs. HIV and syphilis were the most frequently screened STIs at 15.0% and 33.1%. The highest proportion of STI screenings were among those 25-44 years at 40.9% with the highest percent positivity in those 55-64 years at 34.0%. There was a statistically significant increase in proportion screened for all STIs (see Table 2), along with percent positivity for syphilis (P&lt;0.01) between pre-COVID-19 and COVID-19 period, however this trend did not consistently continue after emergence of Mpox.

Conclusion
The proportion of inpatient STI screening is low for patients admitted to internal medicine and family medicine services with percent positivity by age ranging from 5.9-34.0%. We observed an overall increase in proportion screened during the COVID-19 period.

Disclosures
All Authors: No reported disclosures
P-1378. Linezolid For Early Syphilis Treatment: Pilot study
Authors: Stafylis Chrysovalantis , Nguyen Ryan M , Konda Kelika , Reyes-Diaz Michael , Keith Kori , Warren Ebony , Johnson Byron , Creticos Catherine , Stokes Keith , Klausner Jeffrey 
Published: January 2025

Abstract

Background
Syphilis rates have been increasing. At the same time, important shortages of benzathine penicillin G have been reported. Existing alternatives, doxycycline, tetracycline, and azithromycin are inadequate to treat syphilis in all patients due to the absence of safety data in pregnancy and children, or antibiotic resistance, respectively. Linezolid is an FDA-approved, safe, low-cost, oral antibiotic that crosses the blood-brain barrier. It has shown efficacy against Treponema pallidum in vitro and in animal studies. Although a recent clinical study evaluating of 600mg Linezolid once daily for 5 days showed limited success, pharmacological simulations show that a longer regimen may be efficacious. We aimed to assess the efficacy of linezolid 600mg, twice a day for 10 days for the treatment of early syphilis.

Methods
We are conducting a randomized, non-comparative, pilot study enrolling 24 adult patients (18 linezolid, 6 penicillin) with primary, secondary, or early latent syphilis in Chicago, Illinois, and Jackson, Mississippi. The experimental arm receives oral linezolid 600mg twice daily for ten days, while the control arm receives benzathine penicillin G 2.4 million units intramuscularly once. The main outcome is a ≥4-fold RPR titer decline by 6 months after treatment. Linezolid participants are monitored for adherence and adverse events during treatment. Clinical and serological response is evaluated at 1-, 3-, and 6-month follow-up visits.

Results
Currently, six out of 24 participants are enrolled in the study; four in the linezolid arm, and two in the penicillin arm. All participants had early latent syphilis. All participants receiving linezolid adhered 100%. One penicillin participant (enrollment RPR 1:16, 3-month RPR 1:2) and one linezolid participant (enrollment RPR 1:64, 3-month RPR 1:16) have completed their 3-month follow-up. No serious adverse reactions have been reported.

Conclusion
Studies of new treatment options for syphilis are underway

Disclosures
Jeffrey Klausner, MD MPH, Direct Diagnostics: Advisor/Consultant
P-1379. Congenital Syphilis in Southeast Michigan: A Retrospective Case Series
Authors: Cardenas-Maldonado Diana D D , Gudipati Smitha , Santana-Garcés Maria , Maki Gina , Brar Indira 
Published: January 2025

Abstract

Background
Cases of congenital syphilis (CS) have been increasing substantially, but CS is preventable through timely testing and adequate treatment of syphilis during pregnancy. From 2012 to 2021, cases of CS in the United States increased by 755%. Our study aims to describe the demographics of pregnant persons infected with syphilis and outcomes in their infants to identify potential predictors of adverse events.
* Received adequate treatment: Complete Penicillin treatment in pregnant patients, thirty days before delivery
IQR: Interquartile range; HIV: human immunodeficiency virus;

Methods
This is a retrospective case series of pregnant persons diagnosed with syphilis who delivered their babies at Henry Ford Health from January 2020 to January 2024. Charts were reviewed for demographic data, syphilis serology, treatment in mothers and infants, and infant outcomes. Descriptive statistics were used to report the study population’s demographic and clinical characteristics. Chi-squared tests were used to determine the association between receipt of penicillin, prenatal care, prior sexually transmitted infection (STI), and CS diagnosis in neonates. Our chosen significance level was 0.05.
RPR: rapid plasma reagin; CSF: Cerebrospinal fluid; VDRL: Venereal disease research laboratory test.

Results
Forty-three patients were included; 19 (44%) were black; median age 27 years (IQR 24-32.5); 28 (66%) were from Detroit; 18 (53%) reported a history of STI. Eight (18%) did not receive prenatal care. Syphilis was primarily diagnosed during second trimester (34%), and late latent syphilis was reported in 80%. Syphilis treatment was completed 30 days before delivery in 67%. There were 17 early-term deliveries, 1 stillbirth, and 1 elective abortion. Ninety percent of neonates had a normal physical exam. Fifteen lumbar punctures were performed, one positive Venereal Disease Research Laboratory test. Of the 8 placenta studies, 2 had positive immunoperoxidase treponemal stain. Seventeen neonates were treated with 10 days of aqueous Penicillin, 6 neonates had definite/highly probable CS. Using Chi-square analysis, receipt of penicillin treatment by the mother less than 30 days before delivery was significantly associated with CS in the neonate (p &lt; 0.001)

Conclusion
In our analysis, we identified a significant association between CS and appropriate timing of treatment of syphilis in the mother. Further studies are needed with a larger cohort to determine if social determinants of health affect appropriate prenatal care in pregnant persons.

Disclosures
Indira Brar, MD, Gilead: Advisor/Consultant|Gilead: Grant/Research Support|Gilead: Honoraria|Merck: Grant/Research Support|ViiV Healthcare: Grant/Research Support|ViiV Healthcare: Honoraria
P-1387. Barriers to PrEP Implementation in Publicly Funded Family Planning Clinics in Atlanta, Georgia
Authors: Bonadonna Lily , Anderson Katherine M , Er Deja , Sales Jessica , Sheth Anandi N 
Published: January 2025

Abstract

Background
Although Georgia has the highest HIV incidence in the US, uptake of pre-exposure prophylaxis (PrEP) for HIV is inadequate, especially among cisgender (cis) women. The Title X Family Planning Program (FP) provides federal funding for sexual health services to low income or uninsured individuals. We sought to understand clinic interest in and capacity for women-centered PrEP care implementation in Title X FP clinics in metro Atlanta.

Methods
From Jan 2022-Nov 2023, we held focus groups with 47 participants representing 22 FP clinics across four metro Atlanta Ending the HIV Epidemic priority counties (71% of all Title X FP clinics in the area). We used a structured interview guide to assess PrEP implementation strategies across each step of PrEP care; participants included advanced practice providers, medical assistants, nurses, and FP program leaders. Following standard rapid qualitative analytic methods, two trained researchers created a matrix of responses by question, assessed salience of responses by deductive themes, and used memos to summarize themes for narrative description.

Results
Clinics had few-to-no cis women on PrEP. Conversations regarding PrEP eligibility were often patient-initiated, rather than provider-initiated. Many providers expressed unfamiliarity with sexual history taking and assessing HIV risk, especially with cis women. Providers also cited patient barriers to PrEP uptake and persistence, including insurance navigation and follow-up visit costs. All providers expressed a need for time-efficient screening and counseling procedures and trainings covering sexual history taking, destigmatizing PrEP, and medication access. Population-tailored information, such as non-English, youth-focused, and low literacy responsive materials were highly desired (Table 1).

Conclusion
Family planning clinics in Atlanta require comprehensive training across the steps of PrEP care, given limited provider initiation of and comfort with risk assessment and counseling, and perceived barriers to uptake and retention. Multi-pronged implementation strategies are necessary to prevent new HIV infections, particularly among cis women, and to progress toward ending the HIV epidemic.

Disclosures
All Authors: No reported disclosures
P-1390. Anorectal Human Papillomavirus (HPV) Infection in HIV-Positive Men who have Sex with Men (MSM) in Nicaragua
Authors: Meléndez-Avendaño Miguel A , Marenco-Avilés Sunaya , Gavarrete-Rivas Kevin , Porras-Cortés Guillermo D 
Published: January 2025

Abstract

Background
HIV-positive men who have sex with men (MSM) are at increased risk for sexually transmitted infections, including anorectal HPV, with the consequent likelihood of neoplasia at that level. There is a complete lack of information on this situation in Nicaragua. This study explores and establishes for the first time the prevalence of anorectal HPV infection in HIV-positive MSM and its correlation with cytological abnormalities, and some associated behavioral, virological, and immunological factors in Nicaragua.Figure 1.Prevalence of HPV Anorectal Infection in MSM HIV Positive Diagnosed by RT-PCR Xpert HPV.

Methods
A prospective, multicenter cohort study was conducted between January 2023 at December 2023, at Dr. Fernando Vélez Paiz Hospital, Antonio Lenin Fonseca Hospital, and Manolo Morales Hospital in the city of Managua, Nicaragua. HIV-positive MSM patients were enrolled to the study with prior consent. Anorectal swab samples were processed by molecular method for HPV detection (GeneXpert HPV®) of different genotypes individually or grouped into genetic patterns (16, 18/45, P3: 31/32/35/52, P4: 51/59, and P5: 39/56/66/68). In addition, anorectal Pap smears were performed for cytopathology study. All samples were processed in the microbiology and pathology laboratories of the Dr. Fernando Vélez Paiz Hospital, the main center of the research.Figure 2.Different Genotypes Detected by Xpert HPV Anorectal Infection in MSM HIV Positive.

Results
A total of 44 patients were enrolled in the study. A significant proportion of patients declined to participate in the study. The mean age was 35.2 ± 12.4 years. Most of the patients reported having a passive or versatile sexual role. 22.7% were naïve to antiretroviral therapy (ART). The prevalence of anorectal HPV infection was 86.3% (Figure 1). The most frequent genotype was HPV 16 (21.7%) (Figure 2). In the combined genotype patterns, P3 (31/32/35/52) was observed in 40.5% of patients. All patients were infected with more than one genotype. 31.5% of those infected had cytological abnormalities, the most frequent being low-grade squamous intraepithelial lesion (Table 1). HPV-positive patients were younger, had a higher viral load, and a lower CD4+ lymphocyte count (Table 2).Table 1.Abnormalities in Anal Papanicolau in MSM HIV-positive con HPV Infection Diagnosed by Xpert HPV.

Conclusion
The prevalence of anorectal HPV infection in this study is high, with serotype 16 being the most frequent. Almost a third of them have altered cytology, with low-grade squamous intraepithelial lesion being the most frequent finding.Table 2.Differences in Age, HIV Viral Load and Count of Lymphocyte CD4+ in MSM HIV-Positive with and wihtout HPV Infection

Disclosures
All Authors: No reported disclosures
P-1391. Epidemiological Characteristics and Clinical Manifestations of Mpox among People with and without Vaccination: An Institutional Experience
Authors: Kim Minji , Wu En-Ling , Wang Yingbao , Aaby David , Cheung Ying , Krueger Karen M , Bolon Maureen K , Galvin Shannon 
Published: January 2025

Abstract

Background
Since May 2022, there have been over 90,000 cases of mpox, with over 32,000 cases in the US. The smallpox and mpox vaccine modified vaccinia Ankara-Bavarian Nordic (MVA-BN; JYNNEOS), which was approved by the FDA in 2019, is currently the predominant vaccine used to prevent mpox infections. Data on vaccine efficacy varies, ranging from 66% to 86-88% with complete vaccination. This study aims to delineate the epidemiological characteristics, as well as the clinical features and outcomes in those who were unvaccinated and vaccinated in one institution.

Methods
This is a retrospective analysis of data obtained via EHR chart review and managed Research Electronic Data Capture tools with approval by the Northwestern University Institutional Review Board. Key descriptive characteristics included baseline demographics, clinical manifestations, concomitantly diagnosed sexually transmitted infections, and clinical outcomes (including markers of disease severity such as the mpox severity score system, Mpox-SSS). Vaccinated, partially vaccinated, and unvaccinated groups were compared using Fisher’s exact tests (categorical characteristics) and one-way ANOVA (continuous characteristics).

Results
There were 108 individuals with PCR-confirmed mpox at our institution between July 20, 2022 and October 16, 2023. Of these 108 individuals, 14 were fully vaccinated, 24 were partially vaccinated, and 70 were unvaccinated. Baseline demographics are reported in Table 1. Unvaccinated persons differed from vaccinated and partially vaccinated persons in HIV status and with respect to PrEP usage. Clinical outcomes are reported in Table 2. Notably, median Mpox-SSS scores were as follows: 5 in the fully vaccinated group, 5 in the partially vaccinated group, and 7 in the unvaccinated group (p=0.03). There were no hospitalizations, ICU stays, and deaths in the fully vaccinated group but 11 hospitalizations (p=0.27) and 1 death in the unvaccinated group.

Conclusion
Epidemiologically, both the vaccinated and unvaccinated population consisted predominantly of cisgender men who have sex with men (MSM). There were differences in HIV status and PrEP usage. Overall, compared to the unvaccinated group, the vaccinated group appears to have clinical features and outcomes that were less severe.

Disclosures
All Authors: No reported disclosures
P-1403. Measuring Impact of COVID-19 Pandemic using Novel EPII Survey on PLWH in New Orleans
Authors: McGaugh Angela , Meyers Erik , Srinivasan Shruti , Francis Mariza , Zheng Crystal , Grasso Damion , Adams Leah , Adams Suzanne 
Published: January 2025

Abstract

Background
Research has shown that the impacts of the COVID-19 pandemic stretch beyond solely physical health. This study uses the newly developed Epidemic-Pandemic Impacts Inventory (EPII), a 92-item tool designed to quantify the impact of COVID-19 pandemic across several personal and social domains. People living with HIV (PLWH) have an increased morbidity and mortality associated with COVID-19 infection and are overall more vulnerable to social change. The current study uses the EPII to compare pandemic-related experiences of PLWH to those without HIV in New Orleans.

Methods
The Tulane University COVID-19 Antibody and Immunity Network (TUCAIN) maintains a longitudinal cohort of PLWH who provide clinical data and biological specimens for studies on the immune response to COVID-19 infection and vaccination. For the current study, participants were asked to complete the EPII assessing their perception of the pandemic. Participants were invited to complete the survey in person or via phone with a study coordinator. Responses from participants ≥18 years old who completed the survey were reviewed. Survey responses were analyzed using SPSS software.

Results
Both the PLWH (N=54) and control group (N=220) were similar in age; however, the PLWH subset was predominantly male and more racially diverse. PLWH reported more severe impacts of pandemic such as food insecurity (χ2=15.9; df=1; p&lt; 0.01) and loss of employment (χ2=26.9; df=1; p&lt; 0.01) and housing (χ2=6.6; df=1; p=0.01). PLWH reported more interruptions in medical care (χ2=12.6; df=1; p&lt; 0.01) and more health problems unrelated to COVID-19 (χ2=7.2; df=1; p&lt; 0.01). The PLWH subset was also less likely overall to report positive impacts of the pandemic (i.e. increased quality time with loved ones) compared to control group.

Conclusion
Results indicate that the HIV cohort reported greater rates of financial and health ramifications of the pandemic relative to control population. This study further reinforces the notion that this population was more susceptible to the socioeconomic turmoil of the COVID-19 pandemic. The results from this study will help to refine EPII as a survey tool for use in future pandemics and more precisely identify domains of social impact that affect the PLWH population the most.

Disclosures
All Authors: No reported disclosures