bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-961. Preventing HIV Transmission: The Impact of Early HIV Prevention Education on The Road to Residency
Authors: Pavia Jonathan E , Roa Kyra , Hornak Joseph Patrik 
Published: January 2025

Abstract

Background
The emergence of HIV pre-exposure prophylaxis, or PrEP, has been effective and pivotal in reducing HIV transmission and incidence over the past decade. However, its utilization remains relatively low in the United States as barriers to acquiring PrEP persist. Some of these barriers include HIV risk perception, stigma, and provider bias. Therefore, this report investigates how increasing early career awareness of PrEP amongst fourth year medical students (MS4) matriculating into various specialties impacts their confidence around PrEP.

Methods
Anonymous, online, optional, pre- and post-intervention surveys were conducted to MS4s assessing awareness, knowledge, and perceived comfort around HIV prevention and prescribing PrEP. Students received a 1.5-hour lecture regarding statistics, formulations, indications, and side effects of PrEP from an HIV specialist. Additionally, students’ knowledge around the material was gauged through three interactive patient cases regarding HIV prevention throughout lecture material.

Results
Twenty-three pre- and post-intervention surveys were completed assessing familiarization and comfortability around PrEP. Seven (30%) of the students are pursuing internal medicine, five (22%) family medicine, three (13%) psychiatry, two (9%) OBGYN, and five (22%) in various specialties. Prior to attending the lecture, most students were aware of PrEP (91.3%), but most were uncomfortable initiating such a conversation with a patient (56.5%). The primary, initial limitation students cited in starting a PrEP conversation was their own knowledge around HIV prevention tools (39.1%). After the lecture, the primary constraint remained (39.1% vs. 26%), but a new challenge emerged: students’ comfort level in eliciting a comprehensive sexual history (21.7%).

Conclusion
These findings demonstrate the advantages of introducing HIV PrEP education to graduating medical students. To assist in curbing HIV transmission rates, PrEP utilization must be increased across various medical specialties. Integrating PrEP education within medical school curriculum could be vital in achieving broader aims to end the HIV epidemic. Further investigation should explore alternative approaches to bolster HIV PrEP education across all levels of medical education.

Disclosures
Joseph Patrik Hornak, MD, Innoviva Specialty Therapeutics: Advisor/Consultant|Innoviva Specialty Therapeutics: Advisor/Consultant
P-985. Understanding the Effect of Frailty on People Living with HIV- Online CME Improves Knowledge and Confidence
Authors: Thorpe Sara , Uravich Maria B , Mikhael Emily 
Published: January 2025

Abstract

Background
Frailty affects the clinical status of older people living with HIV (PLWH), increasing their risk of adverse outcomes while impacting quality of life and health span. This study evaluated the effect of an online CME curriculum on enhancing awareness and knowledge of contributing factors associated with frailty in PLWH, as well as improving confidence in supporting best practices for screening, management, and guidelines-based care for frail PLWH.

Methods
The CME intervention comprised of a 30- minute online video-based panel discussion between 2 expert faculty. Response to 3 multiple choice, knowledge questions 1 self-efficacy, 5-point Likert scale confidence question were analyzed using a repeated pairs pre-/post-assessment study design. Pre- to post responses were compared using a McNemar’s test to assess statistical significance. The activity posted on 12/8/2023; data were collected through 3/7/2024.

Results
The analysis set consisted of responses of HIV specialists (n=32) and Primary Care Physicians (n=244) who answered all pre/post questions. Analysis demonstrated a significant improvement in knowledge and confidence.50% of HIV specialists (P&lt; .001, 35% v. 52% pre to post) and 37% of primary care physicians (P&lt; .0010, 29% v. 39% pre to post) demonstrated improvement across all learning objectives57% relative increase among HIV specialists (P&lt; .01, 44% v. 69% pre to post) and 47% relative increase among primary care physicians (P&lt; .001, 34% v. 50% pre to post) in knowledge regarding the consequences of frailty in PLWH42% relative increase among HIV specialists (P&lt; .05, 31% v. 44% pre to post) and 22% relative increase among primary care physicians (P&lt; .001 27% v. 33% pre to post) in knowledge regarding screening tools for frailty assessment63% improved confidence in the use of available tools to screen/assess frailty in PLWH aged 50+

Conclusion
This study demonstrated the success of online, video-based panel discussion CME on improving knowledge and confidence related to individualizing and improving care aging populations who are living with HIV. These findings suggest the benefits of education that addresses clinicians’ individual needs across the continuum of their professional development.

Disclosures
All Authors: No reported disclosures
P-986. Integration of the National HIV Curriculum (NHC) into health professions programs: faculty and student/trainee reflections and perspectives
Authors: Schneegans Suyen , Melhado Trisha , Asuelime Eve , Teplitskly Nathaniel , Garcia-Ponce Alejandra , Allison Waridibo 
Published: January 2025

Abstract

Background
Targeted Access Knowledge and Education on HIV for Health Professions Programs (TAKE on HIV for Health Professions Programs) is a Health Resources and Services Administration (HRSA) funded effort to support National HIV Curriculum (NHC) integration into health professions programs (HPPs) to cultivate HIV prevention and care knowledge into student/trainee (learners) practice and build the HIV workforce. We report on faculty and learners perspectives within integrating HPPs.

Methods
Using mixed methodology, faculty and learners were asked about their NHC integration experience which was facilitated by the TAKE on HIV training and technical assistance (TTA) Team. Following an integration cycle, faculty participated in 1:1 structured interviews and a focus group to identify facilitators/challenges of integration and sustainment plans. Learners completed a digital survey about time to complete NHC lessons and ratings of HIV knowledge, confidence, and usability of the NHC platform (Likert scale: 1- strongly disagree to 5=strongly agree). Data were analyzed using rapid qualitative analyses, descriptive statistics and mean Likert scores.

Results
Nine participating faculty were from the following HPP disciplines: 3 from Pharmacy, 1 each from Physician Assistant and Family Medicine Residency, and 4 from Nursing. Integration facilitators included TTA support and guidance and NHC student tracking capability. A barrier was learner difficulty with navigating the platform and suggestion for improvement was providing additional visual learner resources for platform navigation. All faculty reported desire to sustain NHC integration with subsequent cohorts and additional NHC lessons. 46 learners completed the survey (13% response rate). 67% reported taking 15-30 minutes to complete an NHC lesson. Overall learners reported having improved HIV knowledge (mean=4.42), confidence in providing HIV care (mean=4.07), and ease of NHC platform navigation (mean=4.29).

Conclusion
NHC integration into HPPs is sustainable if sufficient resources are provided to faculty. TAKE on HIV effectively provides HPP faculty with free TTA resources to facilitate NHC integration and a framework for replicability. HIV knowledge gain amongst learners within integrating HPPs was demonstrated.

Disclosures
All Authors: No reported disclosures
P-987. Outcomes of a Program to Integrate the National HIV Curriculum into Health Profession Programs
Authors: Melhado Trisha , Teplitskly Nathaniel , Schneegans Suyen , Griner Stacey , Allison Waridibo 
Published: January 2025

Abstract

Background
The HIV epidemic is ongoing, but the HIV-specific workforce is decreasing. Targeted Access Knowledge and Education on HIV for Health Professions Programs (TAKE on HIV for Health Professions Programs) focuses on the integration of the National HIV Curriculum (NHC) into health professions programs (HPPs) to encourage health professional students/trainees (learners) to enter the HIV workforce and incorporate HIV prevention and care into their practice. This study details integration outcomes.

Methods
The NHC consists of six modules: Screening and Diagnosis, Basic HIV Primary Care, Antiretroviral Therapy, Co-Occurring Conditions, Prevention of HIV, and Key Populations. The number and types of HPPs integrating the NHC were assessed along with the number of learners using the NHC. Students were stratified into Learning Groups (LGs) based on their HPP discipline to track NHC module use and capture knowledge scores. Post integration cycle, a survey assessed learners’ intent to apply the knowledge gained from the NHC into their career (Likert scale: 1-not at all to 5-a great deal). Faculty indicated their intent to continue NHC integration from very unlikely to very likely (5-point Likert scale). Data were analyzed using descriptive statistics.

Results
From September 2023 to April 2024, 15 unique student LGs with 591 learners were integrating the NHC overseen by 14 faculty members at 12 HPPs. Learner NHC enrollment by discipline was as follows: 353 Pharmacy students, 72 Physician Assistant students, 50 Nursing students, 103 Medical Residents, and 13 Occupational Therapy students. The Co-Occurring Conditions NHC module was used the most (1,689 lessons completed) whereas the Key Populations module was used the least (342 lessons completed). Overall mean NHC module scores ranged from 88% to 95% with the Antiretroviral Therapy module and Key Populations module scoring highest and lowest, respectively. Mean student score for intent to apply NHC knowledge = 3.80 (N=175). All integrating faculty indicated they were "very likely" to implement the NHC in future courses.

Conclusion
TAKE on HIV program outcomes indicate successful facilitation of NHC integration into HPPs. The NHC is an effective online mechanism to educate health professional learners and to bolster the HIV workforce pipeline.

Disclosures
All Authors: No reported disclosures
P-988. Evaluation of Intramuscular Penicillin Use and Treatment Outcomes in Neonatal Patients
Authors: Rochat Ryan H , Goldensoph Ali L , Stimes Grant T 
Published: January 2025

Abstract

Background
The prevalence of syphilis in the United States has been increasing despite available treatment options. Penicillin (PCN) is the cornerstone of syphilis treatment, and patients who do not have evidence of central nervous system involvement are often recommended a single dose of intramuscular (IM) PCN as treatment. At this time, IM PCN is on shortage nationwide, and is estimated to continue throughout 2024. The purpose of this study was to identify current length of stay trends for neonatal patients who are treated with a single dose of IM PCN with follow up performed within the Texas Children’s Hospital (TCH) healthcare system and compare this to current guidelines. Ultimately this work will help identify patient characteristics and recommend areas for reduced priority of intramuscular PCN usage in situations of drug shortage.
Result Tables
Demographic and Treatment Tables/Figures for infants who received treatment with IM benzathine Penicillin at birth.

Methods
All infants who received a single dose of IM benzathine PCN between 08/2018 and 08/2023 were considered in this study. Demographic (race, ethnicity, sex, age), and treatment data (PCN administration and discharge dates, treponemal/nontreponemal test results for mother-infant dyad, location of follow up, and gestational age (GA) at time of maternal evaluation) were abstracted from the Epic® EHR.

Results
Eighty-one infant received a single dose of IM benzathine PCN between 8/2018 and 8/2023. The average GA at maternal diagnosis was 18 weeks. Pending laboratory/screening results was the largest factor keeping neonates in the hospital 1 day or more past IM PCN administration. Premature infants were the largest population to remain hospitalized for greater than 10 days. Most neonates (71.6%) had a LOS greater than or equal to 1 day while 13 (16.0%) had a LOS of greater than or equal to 10 days. Twenty-six patients (32.1%) completed follow up within the TCH system with more than half being evaluated at TCH.

Conclusion
Neonates with pending laboratory results, prematurity status, and mothers with extended stays should be further evaluated prior to IM PCN administration during times of shortage. Neonatal follow up screening could be improved with a dedicated syphilis clinic/screening program (such a clinic started at TCH in quarter 1 of 2022). Additional research is necessary to optimize inpatient/outpatient IM PCN use when treating congenital syphilis.

Disclosures
Ryan H. Rochat, MD, PhD, MS, Merck Sharpe Dohme: Grant/Research Support
P-995. Increased Red Cell Distribution Width (RDW) is associated with culture positive sepsis and with increased need of escalation in respiratory support in very low birth weight infants more than seven days of life undergoing sepsis workup secondary to vitals instability in the form of multiple episodes of true apneas or bradycardia and desaturations associated with apnea
Authors: Tilak Kedar , Patel Aashka 
Published: January 2025

Abstract

Background
Apnea of prematurity is nearly universal among very low birth weight infants (VLBW). In VLBW infants, changes in clinical status usually occur due to sepsis or non-infectious causes and it is challenging to differentiate between the two. We as clinicians use irregularities in vital signs as an early warning sign of sepsis to facilitate early treatment and improve patient outcomes. Adults have used RDW as a marker of worsening respiratory status and mortality from acute respiratory distress syndrome (ARDS). In this study, we seek to investigate elevations in Red Cell Distribution Width (RDW) as markers for culture positive sepsis and need for escalation of respiratory support in VLBW neonates.
Association between RDW values and positive cultures

Methods
We did a retrospective chart review using the Electronic Medical Records (EMR) of VLBW infants (&lt; 1500g) admitted to the Neonatal Intensive Care Unit (NICU) of a community hospital over 3 years. We included all babies who had True apnea (apnea &gt; 20 seconds) or apnea with bradycardia and desaturations, after day seven of life and had CBC tests sent and were being managed for presumed late onset sepsis secondary to this vital sign instability. Other demographic data was gathered and tabulated. The data was analyzed to check for association between increased red cell distribution width (RDW) and need for escalation of respiratory support. Escalation in respiratory support included an increased need of assisted ventilation to support breathing. We also looked at positive blood / urine cultures and RDW values.
Association between RDW values and change in baseline respiratory support

Results
50 babies matched our inclusion criteria. 31 babies had a positive blood /urine culture. 21 of the 31 had elevated RDW which was statistically significant at p&lt; 0.05 (Table1), hence showing that positive culture late onset sepsis had elevated RDW. Also, we saw increased need for escalation in respiratory support amongst culture positive babies with an elevated RDW at p &lt; 0.05 (Table 2).

Conclusion
We conclude from this, that elevations in RDW is a marker for VLBW babies needing escalation in respiratory support. Elevations were also seen in culture positive sepsis. More studies need to be done as most of the available data is in adults. We can look more associations in babies with RDS (respiratory distress syndrome) and predict respiratory distress and for early interventions and better outcomes.

Disclosures
All Authors: No reported disclosures
P-1056. Association of High-Risk Clones Of P. aeruginosa With MBLs Poses Heightened Treatment Challenge, however there is a Silver Lining
Authors: Nagvekar Vasant , Patel Neha , Gohel Tejas , Hodgar Shailendra , Srinivasan R , Vas Conrad , Veeraraghavan Balaji , gupta Anumeha 
Published: January 2025

Abstract

Background
Globally, ‘high-risk’ clones of P. aeruginosa continue to pose treatment challenges. These clones, in addition to intrinsic non-enzymatic β-lactam resistance mechanisms such as hyper-expressing efflux and down-regulated porins, have been acquiring broad-spectrum β-lactamases including carbapenemases. In India, recent reports indicate that most of carbapenem-resistant isolates carry MBLs in particular NDMs. However, genomic characterization of such isolates is lacking and therefore their relatedness to internationally circulating high-risk clones is not known. Herein, we have genomically characterized 35 P. aeruginosa index isolates collected from hospitalised patients including admitted at our intensive care unit in 2022 - 2024. We also determined their susceptibility to cefepime/zidebactam (Phase 3-stage) and other newer BL/BLIs, for both serine and MBL-producing Gram-negative bacteria.

Methods
The index P. aeruginosa pathogens were isolated from sputum, tracheal secretion, blood and drain fluid and identified by Vitek 2 (one isolate per patient). The whole genome of these isolates were sequenced (WGS) using HiSeq (Illumina 6000 platform). Susceptibilities to cefepime/zidebactam and other antibiotics were determined by reference broth micro-dilution MIC method according to CLSI M07-A11, 2018.

Results
WGS revealed existence of 9 distinct multi-locus sequence types (ST), a high clonal variation despite isolates belonged to a single centre (Figure 1). Among them, 3 were international high-risk clones and nearly half of the isolated belonged to these 3 STs. Three MBL types, NDM, VIM and DIM were detected and none of the isolates carried serine carbapenemase. Mutations were noted in genes encoding efflux and impermeability. Susceptibilities to aminoglycosides and fluoroquinolones were &lt; 30%. Except 5, all isolates were resistant to carbapenems. There was a 100% susceptibility to cefepime/zidebactam

Conclusion
WGS analysis showed multiplicity of resistance mechanisms including MBLs in high-risk clones thus severely limiting treatment options. Investigational antibiotic cefepime/zidebactam may be a potential treatment option for infections caused by such isolates. In India VIM was the most common Carbapenemase resistance is being replaced by MBL(NDM)

Disclosures
All Authors: No reported disclosures
P-1084. Antimicrobial Activity of Aztreonam-Avibactam and Other β-Lactamase Inhibitor Combinations Tested against Enterobacterales Isolates from Pediatric Patients from United States Medical Centers (2019–2023)
Authors: Sader Helio S , Winkler Marisa , Mendes Rodrigo E , Castanheira Mariana 
Published: January 2025

Abstract

Background
We evaluated the activities of aztreonam-avibactam (ATM-AVI), ceftazidime-avibactam (CAZ-AVI), meropenem-vaborbactam (MEM-VAB), imipenem-relebactam (IMI-REL), ceftolozane-tazobactam (C-T), and comparators against Enterobacterales (ENT) isolates causing infection in pediatric (PED) patients.
Activity of β-lactamase inhibitor combinations against Enterobacterales isolates from pediatric patients

Methods
Among 43,325 ENT (1/patient) collected in 2019–2023 via the INFORM Surveillance Program, 5,723 (13.2%) were from PED patients (≤ 17 years old [yo]). The isolates were consecutively collected from 81 US medical centers and susceptibility tested by CLSI broth microdilution method. Susceptibility was stratified by infection type and patient age: ≤1 yo (n=2,275), 2–5 yo (n=1,130), 6–12 yo (n=1,213), and 13–17 yo (n=1,105) and compared to adults (18–64 yo; n=17,712).

Results
PED isolates were mainly from pneumonia (21.8%), bloodstream (BSI; 15.3%), and urinary tract infection (UTI; 51.8%). ATM-AVI inhibited &gt; 99.9% of PED isolates at ≤ 8 mg/L; CAZ-AVI and MEM-VAB were active against &gt; 99.9% and 100.0%, respectively, whereas IMI-REL and ceftolozane-tazobactam (TOL-TAZ) were slightly less active (Table). Meropenem, ceftriaxone (CRO), and gentamicin were active against 99.8%, 87.6%, and 92.1% of PED isolates, respectively. CRO susceptibility ranged from 84.5% (6–12 yo) to 89.2% (2–5 and 13–17 yo) among PED isolates and was 81.5% against adult isolates. CRO was active against 86.0%, 87.3%, and 88.4% of PED isolates from pneumonia, BSI, and UTI, respectively. Multidrug-resistant (MDR; non-susceptible [NS] to ≥ 3 classes) phenotype varied from 14.3% (13–17 yo) to 19.7% (6–12 yo) among PED isolates (15.8% overall) and was 20.7% among adult ENT. Carbapenem resistance rate was markedly lower among PED (0.1%) compared to adult isolates (1.3%). TOL-TAZ and piperacillin-tazobactam (PIP-TAZ) exhibited limited activity against CRO-NS and MDR isolates. Susceptibility rates for most comparators were higher among PED than adult isolates, including CRO (87.6% vs. 81.5%), PIP-TAZ (92.2% vs. 88.0%), TOL-TAZ (96.9% vs. 93.9%), and levofloxacin (90.8% vs. 82.1%).

Conclusion
ATM-AVI, CAZ-AVI, and MEM-VAB were highly active against ENT isolates from PED patients. Susceptibility differences were observed among age groups and infection types.

Disclosures
Marisa Winkler, MD, PhD, Element Iowa City (JMI Laboratories) was contracted to perform services in 2023 for &gt; 30 biotech and pharmaceutical companies: Grant/Research Support Rodrigo E. Mendes, PhD, GSK: Grant/Research Support