bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-1155. Acute Osteomyelitis and Septic Arthritis in Children in Israel: Epidemiology, Microbiology, Clinics and Outcomes
Authors: Grisaru Galia , Lerner Reut Kassif , Elmaleh Yael , Michaan Nadav , Paret Gideon 
Published: January 2025

Abstract

Background
The goal of this study was to characterize the clinical, microbiologic epidemiological characteristics and outcome associated with osteoarticular infections ( OAIs) in hospitalized children in Israel.Figure 1:Annual incidence for each disease per 100,000 hospitalizations during the years of study. SA-septic arthritis, OM-osteomyelitis

Methods
Patients &lt; 18 years old admitted with a diagnosis of acute osteomyelitis (AOM) or septic arthritis ( SA), between January 2007 and December 2019 were included if they had a microbiological and/or radiological findings supporting the diagnosis. Clinical and laboratory data were retrieved from the medical records.

Results
305 children with OAIs were included. The annual incidence among osteomyelitis patients increased by 10.25 cases per 100,000 hospitalizations every year (P=0.019) during the study period. Tibia and knee were the most frequently involved bones and joints. About one-half (47.5%) of the patients were febrile upon admission. Laboratory data analyses showed that 36 (26%) AOM and 74 (48%) SA patients had leukocytosis at presentation. C-reactive protein (CRP) levels ( &gt;5 mg\dL) were elevated in 87% and 71% of patients with SA, and AOM, respectively. The most common isolated pathogens were methicillin susceptible Staphylococcus aureus followed by Kingella Kingae. About 5% of the hospitalized patients due to septic arthritis and 6% of the osteomyelitis patients had complications and underwent a surgical intervention. There were no long term sequelae.

Conclusion
The admission rate for acute osteomyelitis in children increased significantly during the last decade. Fever and WBC, were not sufficiently reliable to diagnose or rule out OAIs. The most common isolated pathogens are methicillin susceptible Staphylococcus aureus followed by Kingella Kingae. Through accurate diagnosis and treatment with appropriate antibiotics and surgical intervention when indicated osteoarticular infections have a favorable outcome and no long term sequelae.

Disclosures
All Authors: No reported disclosures
427. Underlying Medical Conditions and Vaccination Status among U.S. Children Aged ≤17 Years Hospitalized for COVID-19 in COVID-19-Associated Hospitalization Surveillance Network (COVID-NET), January–December 2023
Authors: Free Rebecca J , Patel Kadam , Sachdev Darpun , Alden Nisha B , Meek James , Ryan Patricia A , Falkowski Anna , D’Heilly Paige , Smelser Chad , Engesser Kerianne , Bushey Sophrena , Moran Nancy E , Sutton Melissa , Talbot H Keipp , Swain Ashley , Campbell Angela P , Havers Fiona , Openo Kyle P 
Published: January 2025

Abstract

Background
SARS-CoV-2 infection can result in serious illness in children. We used COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) data to assess characteristics associated with pediatric COVID-19 hospitalizations, including underlying medical conditions and vaccination status.

Percent of COVID-19-Associated Hospitalizations† with Specific Underlying Medical Conditions among U.S. Children Aged ≤17 Years by Age Group — COVID-NET, January–December 2023

Methods
U.S. children aged ≤ 17 years with COVID-19 as the likely primary reason for hospitalization during January–December 2023 were identified in the population-based COVID-NET active surveillance system, which includes patients residing in a catchment area of &gt; 300 acute care hospitals in 13 states with a positive SARS-CoV-2 test result during or ≤ 14 days before admission. Medical records of a random sample of children stratified by age-group and site were abstracted; reported percentages were weighted to account for probability of selection. We assessed patient age, underlying medical conditions, and receipt of vaccine dose within 12 months before illness.

Results
Of 2016 children hospitalized for COVID-19, 1232 (61%) were aged &lt; 2 years (611 aged &lt; 6 months; 621 aged 6–23 months). Overall, 51% had no underlying condition, including 73% of infants aged &lt; 6 months, 58% of children aged 6–23 months, and 24% of children aged 12–17 years (Figure). Among children aged &lt; 2 years, prematurity was the most common underlying condition (17–20%). Neurologic disorders (27–31%) and asthma (21–33%) were most prevalent among children aged ≥ 2 years. Among 1379 children aged ≥ 6 months eligible for vaccination with vaccine data available, only 14% had received ≥ 1 vaccine dose within 12 months before illness, with the lowest frequency (9%) among children aged 6–23 months (Table). Among age-eligible children with neurologic disorders and asthma, only 18% and 16% were vaccinated, respectively.

Conclusion
Most children aged &lt; 2 years hospitalized for COVID-19 during 2023 had no underlying conditions; underlying conditions were more prevalent among older children. More than 85% of age-eligible children had not received a vaccine dose within 12 months, including among children with underlying conditions. Increasing pediatric COVID-19 vaccination, especially among children with underlying medical conditions, could help reduce COVID-19 hospitalizations.

Disclosures
Anna Falkowski, Master of Science, Council of State and Territorial Epidemiologists (CSTE): Grant/Research Support
P-1243. Evaluation of Single and Multiple Dose Safety and Pharmacokinetics of Ledaborbactam Etzadroxil and Ceftibuten-Ledaborbactam Etzadroxil in Healthy Volunteers
Authors: de Oliveira Carlos Fernando , Dorr Mary Beth , Lowe Kathryn , Winchell Gregory A , McGovern Paul 
Published: January 2025

Abstract

Background
Ledaborbactam etzadroxil (LED-E), a novel oral prodrug that converts to the active β-lactamase inhibitor ledaborbactam (LED), is being developed in combination with ceftibuten (CTB) to address the urgent need for new oral (PO) treatments against drug-resistant gram-negative infections.

Methods
In part 1, healthy participants (PT) received single (100mg to 1000mg) or multiple (75mg to 500mg q8h for 10 days) PO doses of LED-E or matching placebo (PBO); PTs in Part 2 received single doses of LED-E 500mg, CBT 400mg, and LED-E+CTB 500mg+400mg; Part 3 PT received LED-E+CTB 300mg+400mg, LED-E+CTB 500mg+400mg or PBO q8h for 10 days. Serial blood and urine samples were obtained to determine single dose and steady-state plasma PK of CTB, LED-E, and LED. Safety was assessed by recording adverse events (AE), and changes in laboratory, vital signs, and ECGs.

Results
AUC of LED-E was ≤ 2% of exposures of LED across the dose range tested, suggesting extensive conversion of the prodrug to the active drug. LED exposures increased in a generally dose proportional manner across single LED-E doses from 100mg to 1000mg and multiple doses from 75mg to 500mg q8h. The terminal half-life of LED in plasma is approximately 11-12 h, with 30-35% accumulation of LED following q8h dosing of LED-E. Excretion in urine of LED-E derived material was 84.4% over the 8-hour dosing interval at steady state. No clinically relevant changes in the pharmacokinetics of CTB, LED, or LED-E occurred when CTB and LED-E were co-administered compared to each administered alone (Table 1).
The number of participants with treatment-emergent AEs (TEAE) was similar in the LED-E (+/- CTB) (81.7%) and PBO (77.8%) groups. Headache and nausea were the most frequently reported TEAEs in LED-E dosed PTs (Table 2). Most events were mild and only 1 TEAE led to drug discontinuation. No serious adverse events or deaths occurred. No clinical relevant changes were noted in clinical labs, ECGs, or vital signs

Conclusion
LED exposure increased in a dose proportional manner. No clinically relevant drug-drug interaction was observed between LED and CTB When LED-E and CTB are co-administered. LED-E was safe and well tolerated when given with CTB at multiple doses up to 1500mg daily for 10 days.

Disclosures
Carlos Fernando de Oliveira, MD, PhD, MS, Venatorx Pharmaceuticals: Stocks/Bonds (Private Company) Mary Beth Dorr, PhD, Merck: Stocks/Bonds (Public Company)|Pfizer: Stocks/Bonds (Public Company)|Venatorx: Stocks/Bonds (Private Company) Kathryn Lowe, MS, Venatorx Pharmaceuticals: Stocks/Bonds (Private Company) Gregory A. Winchell, PhD, Certara: Advisor/Consultant|Merck: Advisor/Consultant|Venatorx: Advisor/Consultant Paul McGovern, MD, Venatorx Pharmaceuticals, Inc.: employee|Venatorx Pharmaceuticals, Inc.: Stocks/Bonds (Private Company)
P-1389. Portrayal of Sexually Transmitted Infections in Popular Films
Authors: Deaney Michael A , McClure Kinsey , Jeffres Meghan N 
Published: January 2025

Abstract

Background
Stigmatization of sexually transmitted infections (STIs) threatens provider-patient relationships and leads to the underutilization of STI services. Media can shape public attitudes toward healthcare topics by perpetuating or reducing stigma. Considering the prevalence of STIs and the widespread consumption of media, healthcare providers must be cognizant of factors influencing societal perceptions of STIs. This study aims to analyze the representation and accuracy of STIs in popular narrative films.

Characteristics of Films and Characters Portraying Sexually Transmitted Infections.
a Other STIs featured in films include HSV (n=11), gonorrhea (n=6), syphilis (n=8), pubic lice (n=4), unspecified STI (n=3), chlamydia (n=2), HPV (n=1), trichomoniasis (n=0).
b Other STIs featured in characters include HSV (n=13), gonorrhea (n=8), syphilis (n=8), pubic lice (n=5), unspecified STI (n=4), chlamydia (n=3), HPV (n=1), trichomoniasis (n=0).

Methods
This study is a descriptive analysis of popular films depicting STIs. Full-length, English-language, narrative films featuring characters with confirmed or suspected STIs were gathered through a keyword search from the Internet Movie Database. Descriptive statistics were used to determine the proportion of characters with accurately portrayed STI clinical variables of symptoms, transmission, diagnosis, and treatment.

Stacked bar graph displaying proportion of accurate (blue) and inaccurate (orange) STIs in individual characters by clinical variable (symptoms, transmission, diagnosis, and treatment). Character counts are presented as data labels within their respective colors.

Results
This study examined 128 characters from 77 films. Human immunodeficiency virus (HIV) was the most commonly portrayed STI in 42 films (55%). HIV was most commonly featured in dramas (62%). Herpes simplex virus, gonorrhea, syphilis, pubic lice, chlamydia, and human papillomavirus were most frequently portrayed in comedies (40%). Other characteristics are displayed in Table 1. Characters with STIs were primarily adult (93%), non-Hispanic White (78%), and male (75%). Figure 1 shows the rates of clinical variable depiction and accuracy by character. Accuracy of each clinical variable was 92% for symptoms, 89% for transmission, 84% for diagnosis, and 85% for treatment. Four (3%) characters represented all clinical variables, 2 (50%) of which were accurately portrayed. Death occurred in 39 characters (30%), with HIV contributing to the majority of deaths (82%).

Conclusion
Films commonly represent accurate symptoms, transmission, diagnosis, and treatment of STIs. However, the frequency of death secondary to STIs is exaggerated and may contribute to STI stigmatization. Understanding the portrayal of STIs in popular films can provide valuable insights for clinicians, enabling them to address patient misconceptions and knowledge gaps.

Disclosures
All Authors: No reported disclosures
P-1393. TikTok Fact or Fiction: Dissecting Misinformation about STIs in the Digital Landscape
Authors: Nicolas Marissa , Pavia Jonathan E , Hornak Joseph Patrik 
Published: January 2025

Abstract

Background
With over 1 billion TikTok users, the platform has seen an unprecedented influx of content. Studies have noted a significant shift in TikTok's role as a source of medical information. While some creators utilize the platform to disseminate scientifically supported content, others unintentionally or deliberately propagate misinformation. Thus, navigating the misinformation surrounding sexually transmitted infections (STIs) becomes crucial for effective infection control.

Methods
Forty TikTok's were analyzed covering the CDC’s eight most common STIs: Gonorrhea, Chlamydia, Syphilis, HIV, Hepatitis B, Trichomonas, HSV, and HPV. Inclusion criteria required English-language videos with &gt;10K likes posted after 2020. Exclusions comprised content from medical professionals, pharmaceutical companies, and non-educational videos. Two graders assessed video accuracy on a scale from 0 being completely accurate to 4 being completely inaccurate using CDC guidelines as reference. A weighted Cohen's kappa score was calculated to determine inter-rater agreement. The two grades for each video were averaged and used to calculate the results.

Results
The forty videos analyzed had an average like-and-share count of 139K and 7.5K, respectively. The average TikTok score was 1.325 indicating that in general, content was not free of inaccuracies. In fact, 65% of the TikTok's analyzed contained at least one inaccuracy and about 28% were graded as mostly inaccurate (score &gt; 2). The top three topics covered were STI transmission, symptoms, and treatment. Among these, 78% of treatment and 69% of transmission videos contained inaccurate information. Further, 44% of videos regarding STI treatment obtained a score of 4 indicating complete inaccuracy. The kappa coefficient was 0.555 indicating moderate agreement between graders.

Conclusion
Today access to educational content is as easy as opening TikTok. Expanding access to STI education has potential to improve public health, but viewers must proceed with caution. Our study found that misinformation is common on TikTok, especially surrounding STI treatment and transmission. Misinformation can fuel stigmas on this sensitive topic, create barriers to those seeking proper care for STIs, and ultimately can lead to poor public health outcomes.

Disclosures
Joseph Patrik Hornak, MD, Innoviva Specialty Therapeutics: Advisor/Consultant|Innoviva Specialty Therapeutics: Advisor/Consultant
572. The Burden of RSV Infections Among Nursing Home Residents, Monroe County, NY, October 2022 to April 2023
Authors: Popham Kevin , St George Katherine , Felsen Christina B , Dumyati Ghinwa , Tesini Brenda L 
Published: January 2025

Abstract

Background
RSV causes significant morbidity and mortality in older adults. Outbreaks are common in nursing home (NH) residents, but little is known about the burden of disease in this vulnerable population. We analyzed population-based data on laboratory-confirmed RSV infections and hospitalizations from the CDC Respiratory Syncytial Virus Hospitalization Surveillance Network to understand the burden of RSV on the NH population compared to community-dwelling older adults.
Weekly Number of Positive RSV Tests Reported by Nursing Homes in Monroe County, NY, October 2022 to April 2023

Methods
We reviewed positive RSV tests from all clinical labs utilized by Monroe County, NY residents from October 2022 to April 2023. Cases in patients ≥65 years of age were attributed to a NH or the community through medical chart review. RSV rates were calculated in NH residents using occupied bed census averaged over the season and in community-dwelling residents using county population data. Incidence and outcomes including hospitalization, ICU admission and in-hospital mortality were calculated weekly and across the season.
Healthcare utilization among nursing home residents with laboratory-confirmed RSV hospitalizations in Monroe County, NY, October 2022 to April 2023

Results
Of 766 laboratory-confirmed RSV cases in patients ≥65 years of age, 134 were among NH residents. Incidence per NH ranged from 25.5 to 3,163.1 per 10,000 residents. NH cases often clustered in time (Figure 1), with a peak weekly attack rate of 17.7% in one facility. Three NHs had a seasonal attack rate &gt;20%.
Of 170 hospitalizations in patients ≥65 years, 24 occurred in NH residents; 18% (24/134) of all NH residents with RSV were hospitalized. NH residents accounted for 295 hospital days (Table 1). Four NH residents required ICU admission, utilizing 20 ICU days, and 6 died in the hospital. NH residents were hospitalized at a rate 5.6 times greater than community dwelling older adults (Table 2).
Rates of laboratory-confirmed RSV infection and hospitalization among adults ≥65 years of age in Monroe County, NY, October 2022 to April 2023

Conclusion
Our data emphasize that NH residents are particularly vulnerable to RSV infection and complications. The tight clustering of laboratory-confirmed cases within facilities likely represents within-facility transmission, the magnitude of which may be underestimated due to NH testing practices. Early recognition of infection and swift implementation of appropriate infection control precautions are needed to limit outbreaks. Additional preventive measures including resident vaccination and policies discouraging working or visiting while ill should be prioritized.

Disclosures
Brenda L. Tesini, MD, Merck: Honoraria
P-1568. Reevaluating Our Urine Culture Clinical Support Tool: Do I Really Need “Other” as an Option?
Authors: Said Mina , Kung Vanessa , Beck Abigail , Nagaro Kristin , Snyder Graham M , Martin Elise , Buehrle Deanna 
Published: January 2025

Abstract

Background
One strategy to reduce non-indicated urine cultures and asymptomatic bacteriuria is an electronic health record tool requiring providers to select an indication, but limited data exist on such tool’s optimal indications and if “other” is a necessary option.Figure 1:Urine culture clinical decision support tool with indication selection at time of ordering.

Methods
In 1/2023, our VA facility developed a urine reflex/culture ordering clinical decision support (CDS) tool requiring an approved indication selection with each order (Figure 1), and audit/feedback emails for non-indicated orders were added in 7/2023. We performed a quality improvement evaluation of the CDS tool’s selected indications to understand ordering trends including appropriate orders (medically indicated with matched chart reviewed clinical scenario), wrong selection (medically indicated but selected indication did not match chart reviewed clinical scenario), non-indicated (no appropriate indication on chart review), and all “other”. We performed a chart review of 1063 orders (44%) from 1/17/23 - 12/30/23 and compared the CDS tool selections to chart review. We analyzed the percentage and distribution of appropriate, wrong selection, and non-indicated orders, and separately analyzed all “other” selections.Table 1:Proportion of selected indications deemed appropriate, wrong selection, and non-indicated, with the most common reasons for each.
UTI: Urinary tract infection, SPC: Suprapubic catheter

Results
Of all urine reflex/culture orders audited, 43% were appropriately ordered, wrong selections were detected in 35%, while 22% were medically non-indicated (Table 1). The indication “other” was selected 357 times (33% of all orders) and only 1 “other” selection was considered appropriate (Table 2). 67% of “other” were selected instead of a medically indicated choice available on the order set. 33% of “other” were selected when a urine culture was not medically indicated, such as leukocytosis (16%), altered mental status without infectious symptoms (14%), or fever without urinary symptoms (11%). “Other” was also selected in 14 patients when ordering providers wanted a different urine test and did not need a culture.Table 2:Assessment of indications when the ordering provider selected “other” for a urine culture or a urinalysis with reflex to culture.
UTI: Urinary tract infection, AKI: Acute kidney injury, DKA: Diabetic keto-acidosis

Conclusion
While CDS tools may be effective in reducing non-indicated urine cultures, wrong selection and bypassing the order tool were common at our facility. Selecting “other” was a common source of bypassing the tool and for medically non-indicated urine cultures. Further research is necessary on whether removing “other” helps to reduce non-indicated urine reflex/cultures.

Disclosures
Graham M. Snyder, MD, SM, Infectious Diseases Connect: Advisor/Consultant
P-1571. Risk Factors for Infections after Urological Procedures among Patients with Negative Urine Culture Screening
Authors: Tantiwattanapaibul Nutnicha , Apisarnthanarak Anucha , Noppakulsatit Patranuch , Liwrotsap Chatchawet , Tangpaitoon Teerayut , Swatesutipun Valeerat , Vanichkarn Dollacha , Tangkaew Natthapitch , Jantarathaneewat Kittiya , Suwantarat Nuntra 
Published: January 2025

Abstract

Background
The increased demand for urological procedures had become significant complications and correlating with an elevated prevalence of multidrug-resistant organisms (MDROs) infections, prolonged hospital stay, and the cost of treatment.
Table 1
Multivariate analysis of risk factors for infection after urological procedures among patients with negative urine culture screening

Methods
We conducted a retrospective cohort study to identify the risks for infections after urological procedures among patients with negative urine culture screening. The patients underwent transrectal ultrasound (TRUS) and biopsy of the prostate, transurethral resection of the prostate (TURP), holmium laser enucleation of the prostate (HoLEP), percutaneous nephrolithotomy (PCNL), ureteroscopy (URS), retrograde intrarenal surgery (RIRS), and transurethral resection of bladder tumor (TURBT) between 2021 and 2023, at Thammasat University Hospital, Thailand.

Results
A total of 441 patients had the procedures. There were 55 patients (12.5%) developed infections including urinary tract infections (UTIs) (55/55; 100%) and sepsis (9/55; 16%). The significant risks of infections were chronic kidney disease (CKD) stage III-V (P=0.005), history of previous UTI within 3 months (P&lt; 0.05), Revised Cardiac Risk Index (RCRI) for preoperative risk &gt; 2 (P=0.002), and PCNL (P&lt; 0.05). The patients received antibiotic prophylaxis with levofloxacin (26.5%) for TRUS and biopsy of the prostate and cefoxitin (73.5%) for other procedures. The most common causative pathogens of UTIs after the procedures were Escherichia coli (27/55; 49%), Pseudomonas aeruginosa (9/55; 16.4%) and Klebsiella pneumoniae (7/55; 12.7%). MDROs were identified including extended-spectrum cephalosporinase (24/55; 43.6%) and fluoroquinolone-resistant Gram-negative bacteria (12/55; 21.8%). The median hospital stay was 12 days (IQR 10-15) VS 3 days (IQR 3-4) for infection VS non-infection.

Conclusion
Our study emphasized the novel significance of CKD and RCRI scores as risk factors and severity indices for preoperative risk assessment, correlating with postoperative infections following urological proceOur study emphasized the novel significance of CKD and RCRI scores as risk factors and severity indices for preoperative risk assessment, correlating with postoperative infections following urological procedures.

Disclosures
All Authors: No reported disclosures