bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-2203. High Rate of False Positives in Military Blood Donors Screening Positive for Hepatitis C Virus
Authors: Izurieta Rafaela , Casleton Brian , Phelps Megan , Gella Melita , Rivera Glorimar , Casey Theresa , Osuna Angela , Jung Ga O , Winkler Erin , Yun Heather , Marcus Joseph , Owen Samuel 
Published: January 2025

Abstract

Background
While the overall rates of Hepatitis C virus (HCV) in military populations are low, positive post-donation screening represents the second most common indication for post-donation infectious deferrals in military blood donors. All donors who screen positive are permanently deferred from blood donation, regardless of follow-up testing in clinical laboratories. There is limited data on the follow-up evaluation of these blood donors. This study describes the confirmatory testing, access to appropriate subspecialty care, and treatment of blood donors who screened positive for HCV at a large military blood bank.

Methods
All military blood donors between 2017-2023 at the Armed Service Blood Bank Center-San Antonio were screened for HCV by both antibody tests and nucleic acid tests, with positive antibody screening tests confirmed with an enzyme-linked immunosorbent assay (ELISA). Donors who screened positive had their medical charts reviewed to determine demographic information, follow-up evaluation, and treatment rates. On follow-up clinical diagnostic tests, patients with positive antibodies were determined to true positives (TP) and those with negative antibodies were determined to be FP.

Results
Of the 100,182 blood donors during the study period, 37 (0.04%) screened positive for HCV, of which follow-up information was available for 27 (73%). Of these 27, only 12 (44%) of donors were found to be TP. TP donors were more likely to be older (median 22 [20-29.5] vs. 20 [18-22], p=0.05) and have higher rates of positive nucleic acid testing (58% vs. 0%, p=0.001) after blood donation (Table 1). There was no difference in linkage to both primary and subspecialty care for TP and FP (Table 2). Of the TP, 7 (58%) were viremic, 3 (43%) of which received anti-viral therapy and 4 (57%) were administratively separated.

Conclusion
While HCV is one of the most common infectious reasons for military service members who donate blood to be deferred from future donations, most positive screenings were FP. Future efforts should be made to re-enter these patients with FP screening tests back into the donor pool.

Disclosures
All Authors: No reported disclosures
P-2204. Design and Pilot Implementation of an ECHO Module to Facilitate Treatment of Hepatitis C Virus Infection During Pregnancy
Authors: Yee Lynn , Aronsohn Andrew , Shah Seema , Lee Karen , Rodriguez Isa , Otero Sebastian , Gower Patrick , Fishbein Joseph D , Johnson Daniel , Jhaveri Ravi 
Published: January 2025

Abstract

Background
Pregnant patients are largely excluded from Hepatitis C virus (HCV) research and treatment. Studies show that pregnant patients want to discuss treatment while providers feel they lack the knowledge and training for these discussions. To bridge this gap, we designed an ECHO module about management of HCV in pregnancy and infancy.
Pre- and Post-surveys of Self Efficacy
Increase in self-efficacy scores after participation in the ECHO module about HCV care during pregnancy

Methods
Content experts from pediatric infectious diseases, hepatology, maternal-fetal medicine, bioethics and members of ECHO-Chicago discussed: prior data, potential topics, target audience and scheduling of sessions. We held 8 one-hour sessions with 20-30 minutes of didactics and 30-40 minutes of solicited case discussion. Participants included those who participated in prior ECHO training and prenatal providers in local and regional practices. A 7-point Likert scale pre- and post-training survey was administered to assess metrics of self-efficacy for management of HCV in pregnancy and childhood.

Results
The sessions were conducted from May-June 2023 on the following topics: HCV screening; HCV pathophysiology/clinical presentations; staging fibrosis in HCV; HCV Treatment in non-pregnant patients; harm reduction; clinical considerations of HCV in pregnancy; shared decision-making for HCV treatment in pregnancy; and HCV screening in infants & treatment for children. Fourteen participants completed pre- and post-surveys. In the pre-survey, participants had low ratings of self-efficacy (average 3.0). In the post-survey, participants reported dramatic increases in all areas (average 5.2, increase of 2.2) with the largest in the following areas: “Ability to discuss and manage timing of hepatitis C treatment in a pregnant person”, average 5.1, increase of 3; “Ability to identify suitable pregnant candidates for treatment for Hepatitis C”, average 5.2, increase of 2.7. For context, a 1-point increase in self-efficacy is considered meaningful. All respondents reported increased ability to address HCV in a preconception, pregnant, postpartum, or neonatal population.

Conclusion
As pivotal studies of pan-genotypic antivirals indicate efficacy and safety during pregnancy, this ECHO module could be distributed to support providers who are discussing therapy initiation.

Disclosures
Ravi Jhaveri, MD, AstraZeneca: Advisor/Consultant|Gilead: Advisor/Consultant|GSK: Grant/Research Support|Pediatric Infectious Diseases Society: editorial stipend|Sanofi: Advisor/Consultant|Seqirus: Advisor/Consultant|UpToDate: royalties
P-2207. HCV Reinfection is Associated with Cocaine Use and Ongoing Injection Drug Use in People with OUD: Outcomes from the ANCHOR and LOOP Studies
Authors: Liu Tina , Omari Habib , Ebah Emade , Eyasu Rahwa , Ogbumbadiugha-Weekes Onyinyechi , Cover Amelia , Davis Ashley , Zoltick Meredith , Silk Rachel , Derenoncourt Meghan , Salifu Dorcas , Ghale Sabina , Bijole Phyllis , Jones Miriam , Kier Randy , Sternberg David , Kattakuzhy Sarah , Rosenthal Elana S 
Published: January 2025

Abstract

Background
Despite achieving sustained virologic response (SVR), people with HCV, opioid use disorder (OUD) and ongoing injection drug use (IDU) remain at risk of reinfection. Identification and retreatment of reinfected individuals is critical to HCV elimination. We sought to evaluate the rate of HCV reinfection, factors associated with reinfection, and retreatment in a cohort of people who inject drugs (PWID).Table 1.Bivariate analysis of baseline sociodemographic characteristics.

Methods
The ANCHOR study provided HCV treatment for 198 people with chronic HCV, OUD, and recent opioid use. Those who achieved SVR underwent screening for HCV reinfection, with retreatment initiated per standard of care. At each visit, surveys were administered to evaluate ongoing risk behaviors and medication for OUD (MOUD) status. Patients were followed for 96 weeks with optional enrollment in a 2-year extension study (LOOP).Table 2.Bivariate (IRR) and multivariable (aIRR) analyses of factors associated with HCV reinfection.

Results
158 individuals achieved SVR and were followed after treatment completion for 353 person-years, median 90 weeks (IQR 84-160 weeks). Subjects were predominantly male (69%), Black (84.2%), middle-aged (58 years), and HIV-negative (94.9%). Twenty individuals (12.7%) were reinfected a median of 77 weeks (IQR 60-105 weeks) after HCV treatment, at a rate of 5.7/100 person-years. Reinfection was associated with cocaine use (p&lt; 0.001) and IDU in the past month (p=0.005).
Of the 20 reinfected individuals, 16 (80%) initiated HCV re-treatment a median of 26 weeks after detection (IQR 4-64 weeks), with 12 (75%) achieving SVR, 1 currently on treatment, and 5 deaths.Figure 1.Kaplan-Meier reinfection free survival curve assessing associations of cocaine use with HCV reinfection.

Conclusion
In this cohort of people with OUD recently cured of HCV, we observed moderate rates of HCV reinfection associated with cocaine use and past month IDU, with high rates of retreatment uptake and SVR. These data highlight that in people with active drug use, longitudinal follow-up for retesting and retreatment is critical for HCV elimination. Enhanced accessibility to and engagement with harm-reduction services – such as syringe service programs - and interventions specifically addressing polysubstance use are crucial to reducing ongoing HCV transmission and reinfection.

Disclosures
Elana S. Rosenthal, MD, Gilead Sciences: Grant/Research Support|Merck: Grant/Research Support
P-2209. Hepatitis B Immune Globulin Utilization in Patients Presenting to the Emergency Department Following Sexual Assault
Authors: Zimmerman David E , Rech Megan A , Acquisto Nicole M , Covvey Jordan R , Howington Gavin T , Woolum Jordan A , Slocum Giles W , Flack Tara , Ray Lance , Porter Blake , Kum Vivian , Faine Brett 
Published: January 2025

Abstract

Background
Sexual assault is an unfortunately common in patients seen in the emergency department (ED). Following sexual assault, patients are at risk of several transmissible infections, including hepatitis B virus (HBV). HBV screening, vaccination, and treatment with hepatitis B immune globulin (HBIG) is recommended in select scenarios by the Centers for Disease Control and Prevention (CDC). HBV vaccine should be administered if the assailant’s HBV status is positive or unknown and the patient has not been previously vaccinated. HBIG administration is recommended if the assailant is known to be HBV positive and the patient has not been previously vaccinated. However, there is a paucity of evidence on compliance with these recommendations in the ED.

Methods
This was a multi-center, retrospective cohort study utilizing the Emergency Medicine Pharmacotherapy Research NETwork (EMPHARM-NET). Patients aged 18 or older were included if they had an ED visit with an ICD-10 diagnosis code corresponding to sexual assault from January 1st, 2021 to January 1st, 2023. The primary endpoint was the number of patients who received HBIG in the ED following sexual assault. Secondary endpoints were the proportion of patients with HBV testing performed and HBV vaccine administration.

Results
A total of 952 patients were included across nine EDs. The HBV status of the assailant(s) was unknown in most patients, 942 (98.9%), negative in 10 (0.1%), and zero confirmed positive assailants. Eight patients (0.8%) received HBIG while in the ED. Regarding HBV vaccination status, 327 (34.3%) patients were previously vaccinated while 108 (11.3%) and 510 (53.5%) did not previously receive or their vaccination status was unknown, respectively. Of the 618 (64.9%) patients who did not have a documented HBV vaccine or the status was unknown, 44 (7.1%) received HBV vaccine while in the ED.

Conclusion
HBIG was rarely administered in the ED due to the difficulty in determining the assailants’ HBV status. The recommendations provided by the CDC guidelines likely result in the restricted adoption of HBIG among sexual assault patients. Opportunities exist to better protect patients affected by sexual assault whose assailants HBV status is unknown and to increase vaccination.

Disclosures
David E. Zimmerman, PharmD, BCCCP, BCEMP, FASHP, AMDA Biologics Inc: Grant/Research Support Nicole M. Acquisto, Pharm.D., FASHP, FCCM, FCCP, BCCCP, Melinda Therapeutics: Grant/Research Support Giles W. Slocum, PharmD, BCCCP, BCEMP, Novo Nordisk: Advisor/Consultant
P-2220. Real-World Utilization of a Multiplex Pneumonia PCR Panel on Antimicrobial Stewardship and Antibiotic Use
Authors: Keil Elizabeth , Chionglo Alyssa , Siddiqui Javeed 
Published: January 2025

Abstract

Background
In October 2022 the Queen of the Valley Medical Center (QVMC) microbiology department implemented the Biofire® Pneumonia Pathogen Panel polymerase chain reaction (PCR) for identification of viral and bacterial pathogens along with resistance genes. This may aid in improved identification of pneumonia pathogens with a quicker turnaround time. In contrast, respiratory cultures take multiple days to return with both the organism and antibiotic susceptibility, which delays the time to achieving targeted therapy.

Methods
This was a retrospective cohort study from October 2022 to April 2023. Patients were included if they were admitted to QVMC and had a positive pneumonia PCR. Patients were excluded if they were receiving antibiotics for an indication other than pneumonia, if they did not receive antibiotics, or if they were discharged, transferred or died prior to the PCR result. The primary outcome was if the patient achieved targeted therapy. Secondary outcomes included time to targeted therapy, actions performed based on the results, and correlation between respiratory culture results and PCR.

Results
Fifty-nine patients were included for analysis. Most patients had a diagnosis of CAP (n = 43, 72%), vs. HAP (n = 8, 14%), and VAP (n = 8, 14%). Targeted therapy was achieved in 41 patients (70%). Seven (12%) of these patients had empiric therapy which was also targeted therapy. The mean time from PCR collection to the start of targeted therapy was 23.11 hours. For patients who had respiratory cultures collected, the mean time to final identification with susceptibilities was 40.6 hours. Therefore, targeted therapy was achieved at least 17 hours sooner than if de-escalation or escalation was solely dependent upon respiratory culture results. There were 47 antimicrobial stewardship recommendations documented, and 31 (66%) were accepted by providers. Forty-four patients (75%) also had respiratory cultures collected, and only 19 (43%) had organism growth.

Conclusion
Utilizing multiplex PCR technology for patients with pneumonia can be useful for antimicrobial stewardship programs by providing higher rates of pathogen identification and resistance data compared to respiratory culture alone. This allows for improved time to targeted therapy.

Disclosures
All Authors: No reported disclosures
P-2240. Metabolomic Approaches to Detect Implant-Associated Infections in Post-Mastectomy Women
Authors: Wildenthal John A , Olsen Margaret A A , Tran Hung , Robinson John I , Warren David K , Henderson Jeffrey P 
Published: January 2025

Abstract

Background
This year, approximately 54,000 women with breast cancer will undergo mastectomy followed by implant-based immediate breast reconstruction. This procedure has high infection rates of up to 20% and a diverse microbiology of infection including both gram-positive and gram-negative organisms. Culture-based diagnostic methods after these procedures suffer from poor sensitivity due to antibiotic administration prior to cultures, infection with fastidious organisms, and sequestration of bacteria in implant-associated biofilms. Culture-independent diagnostic methods may serve as an alternative for fast, more accurate diagnosis of these infections.

Methods
Women undergoing implant-based immediate breast reconstruction were recruited. Seroma fluid was collected from the breast pocket at the time of implant removal due to infectious complications, non-infectious wound complications, or at the time of second stage reconstruction. Samples were analyzed using untargeted liquid chromatography/mass spectrometry (LCMS). Differential Compositional Variation Machine Learning (DiCoVarML) was used to discover metabolic features to differentiate infection status in this population.

Results
80 seroma fluid samples taken at time of implant removal were analyzed. Of these, 37 samples were collected at the time of implant removal due to infection, 7 for non-infectious complications, and 36 were collected at the time of second stage reconstruction. After LCMS, 3663 high-quality features were detected in at least ten samples. Features useful in distinguishing infection status were selected using DiCoVarML. Predictive models were able to reliably distinguish infection status, with an area under the receiver operating characteristic curve of ∼0.85. Many features positively correlated with infection are structurally similar to peptides.

Conclusion
Metabolite-based diagnostic methods appear to be promising tools to diagnose infection in immediate breast reconstruction. Features associated with infection may represent small immune proteins/peptides or degradation products from host or pathogen proteases. Further analysis is ongoing to fully identify metabolites associated with infection.

Disclosures
Margaret A A. Olsen, PhD, MPH, Pfizer: Advisor/Consultant|Rebyota: Advisor/Consultant
P-2246. Diagnostic Performance of a Rapid Host-Protein Test (MeMed BV) In Detecting Bacteremia in Children
Authors: Kellerman Lior , Eden Eran , Gottlieb Tanya , Navon Roy , Stein Michal , Srugo Isaac , Esposito Susanna , Papan Cihan , Tenenbaum Tobias , Bont Louis J , Klein Adi , Bachur Richard 
Published: January 2025

Abstract

Background
The gold standard for detecting infections associated with bacteremia is blood cultures. Blood culture yield is low, contamination is frequent and results take 12-48 hours.
MeMed BV® is a rapid, FDA-cleared, host-protein test to differentiate bacterial and viral infection, with sensitivity and specificity &gt;90%, and negative predictive value &gt;98%. Here, we assessed its performance in detecting bacteremia in children as early detection of invasive infections is paramount.

Methods
Multi-cohort analysis of 7 prospective diagnostic accuracy studies of febrile children with suspected infection at the Emergency Department and inpatients. Eligibility required inclusion in the original study, age 3 months to 5 years and blood culture ordered.
Reference standard infection etiology was adjudicated by 3 experts based on review of comprehensive patient data including clinical outcomes. Experts were blinded to MeMed BV results. Cases with bacterial reference standard and positive blood cultures adjudicated as having non-contaminant growth were defined as bacteremia.

Results
1987 patients were studied. The median age was 1.3 years (interquartile range 0.8-2.4); 54.6% were male and 46.7% were hospitalized. The most common ED discharge diagnoses were viral infection (33.6%), upper respiratory tract infection (20.0%), lower respiratory tract infection (16.1%). The prevalence of bacterial infection was 15.4%. MeMed BV diagnostic performance was evaluated against the reference standard and attained sensitivity of 89.9% (95%CI 85.6-93.0), specificity of 94.3% (95%CI 93.0-95.4), and NPV of 98.1% (95%CI 97.3-98.7) for identifying bacterial infection.
19 (1%) patients had bacteremia; among these, MeMed BV identified 14 with bacterial scores, 2 with equivocal scores, and 3 with viral scores, the latter positive for Kingella kingae (see Table for more details).

Conclusion
MeMed BV can aid in early detection of bacteremia in children.

Disclosures
Lior Kellerman, M.D, MeMed: Employee|MeMed: Stocks/Bonds (Private Company) Eran Eden, PhD, MeMed: Employee|MeMed: Stocks/Bonds (Private Company) Tanya Gottlieb, PhD, MeMed: Employee|MeMed: Stocks/Bonds (Private Company) Roy Navon, MSc, MeMed: Employee|MeMed: Stocks/Bonds (Private Company) Richard Bachur, MD, MeMed: Advisor/Consultant|UpToDate - WoltersKluwer: Advisor/Consultant|UpToDate - WoltersKluwer: Royalties - Editor
P-2252. Bloodstream Infections in Heart Transplant Recipients Following the 2018 OPTN Heart Allocation Policy Change
Authors: Mezochow Alyssa K , Pereira Marcus R , Ortega-Legaspi Juan , Lautenbach Ebbing 
Published: January 2025

Abstract

Background
In 2018, the Organ Procurement and Transplant Network (OPTN) changed the United States’ heart allocation policy to prioritize candidates requiring temporary mechanical circulatory support (tMCS), resulting in more orthotopic heart transplant (OHT) candidates transplanted on tMCS. Use of tMCS is associated with nosocomial infections in non-transplant patients, including bloodstream infections (BSI). However, this is not well studied in the OHT population. This study aimed to explore changes in BSI rate in OHT recipients following the 2018 policy change.

Methods
This was a single center retrospective cohort study of OHT recipients at a large quaternary care medical center from 1/1/2015-12/31/2022. Recipients were followed for 90 days after OHT for initial BSI. BSI organisms were categorized based on microbiology and commensal organisms were classified per the Centers for Disease Control and Prevention definition.

Results
There were 441 OHTs during the study period with 232 (52.6%) OHTs occurring prior to the policy change in 2018. Demographics of recipients did not significantly differ over this period. Overall, 7.5% (N=33) of recipients in the cohort developed a BSI post-transplant. BSI in the cohort were due to 12 unique organisms (Table 1). Nearly half were Gram-positive (48.5%), while Gram-negative and fungal organisms made up a smaller proportion (27.3% vs 24.2%). Recipients in the cohort post policy change had twice the rate of BSI as compared to those transplanted pre-change (10.1% vs 5.2%, P=0.039). Median time to BSI post-transplant in the cohort following the policy change was 11.5 days (IQR 8-18.5), which was similar to prior to the change (14 days, IQR 8-30.5). Fungal infections were more common in the earlier cohort, while Gram-positive infections were more common in the later cohort (Figure 1). Infections with commensal organisms also occurred more frequently in the later cohort (25% vs 48%).

Conclusion
Post-transplant BSI were more common among OHT recipients transplanted after the 2018 allocation policy change. Gram-positive BSI were most common with commensal organisms causing more BSI in the later cohort. Further multivariable analysis and multicenter studies are needed to explore the possible reasons for the increasing BSI rate seen following the policy change.

Disclosures
Marcus R. Pereira, MD, MPH, FAST, Clirnet: Advisor/Consultant|Synklino: Advisor/Consultant|Takeda: Advisor/Consultant Juan Ortega-Legaspi, MD, PhD, Impulse Dynamics: one time paid speaker