bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-763. Assessment of the in vitro potency of anti-mycobacterial agents against clinical Mycobacterium avium complex (MAC) pulmonary isolates: implications of intravenous and inhaled amikacin breakpoint reporting
Authors: Mark Gill Christian , Chamberland Robin R , Abate Getahun 
Published: January 2025

Abstract

Background
MAC pulmonary disease is associated with significant morbidity and requires multi-drug treatment for extended periods. The novel dosage form amikacin liposome inhalation suspension (ALIS) represents a much-needed treatment option and is noted to have success at MICs of ≤64mg/L, higher than the intravenous (IV) amikacin (AMK) breakpoint (≤16 mg/L) due to optimized pulmonary exposure. Herein, we assessed the in vitro potency of AMK utilizing both ALIS and IV breakpoints as well as other standard antimycobacterial agents.

Methods
MAC isolates obtained from sputum, bronchoalveolar lavage, or lung tissue culture between 1/1/2018 - 3/1/24 were assessed. The first isolate per patient per year was assessed. MICs were collected from the medical record as determined by standard methods at one of two reference laboratories. If a single sample had two MIC values reported, the more conservative was used for analysis. MICs to AMK, clarithromycin (CLR), moxifloxacin (MXF), and linezolid (LNZ) were collected. Data were assessed as MIC50/90 (mg/L) and categorized per CLSI breakpoints. Patients were classified as receiving MAC directed treatment based on documentation in the medical record. If treatment data was unknown, patients were classified as indeterminate treatment.

Results
218 samples were included from 178 patients. CLR was the most active agent with 97% of isolates testing as susceptible (MIC50/90, 0.5/2). MXF and LNZ had relatively poor activity with 82% and 66% of isolates susceptible to each agent, respectively. Considering AMK, high susceptibility to the IV breakpoint was observed with 94% of isolates meeting this criterion (MIC50/90, 8/16). Among the 14 isolates that were intermediate or resistant to IV AMK, 13 remained susceptible to ALIS (MIC range 32-64). 54%, 26%, and 20% of patients were treated, untreated, or indeterminate, respectively. The percent of isolates susceptible to each agent between treated and untreated were similar for all agents.

Conclusion
AMK and CLR remain highly active against MAC pulmonary isolates. Amongst isolates intermediate or resistant to IV AMK, most isolates remained susceptible to ALIS. These data highlight the need for laboratories to report susceptibility to both IV and ALIS to avoid clinicians erroneously disregarding a therapeutic option.

Disclosures
Christian Mark Gill, PharmD, BCIDP, Cepheid: Grant/Research Support|Entasis: Grant/Research Support|Everest Medicines: Grant/Research Support|Shionogi: Grant/Research Support
P-764. Epidemiology of Nontuberculosis Mycobacteria (NTM) in Monroe County, NY: 2021-2023
Authors: Myers christopher J , Dumyati Ghinwa 
Published: January 2025

Abstract

Background
Nontuberculosis mycobacteria (NTM) are opportunistic pathogens causing complex infections requiring prolonged multi-drug therapy and/or surgical interventions. The incidence rates of NTM are increasing nationally, however NTM is currently not a reportable in many states, and likely underreported. To provide a better understanding the burden of NTM, we describe the epidemiology over a 3 year surveillance period.

Methods
Active laboratory and population-based surveillance was conducted in Monroe County, NY as part of the CDC Emerging Infections Program. Demographic, clinical, and laboratory data were collected via medical record review. Cases were categorized as pulmonary (PNTM) or extrapulmonary (ENTM) based on source of isolation, with PNTM further categorized into possible or confirmed. A case was defined as incident if NTM was not isolated in the 12 months prior to the positive culture, or prevalent if NTM was present in the prior 12 months. Incidence rates were calculated for 2021-2023 using U.S. Census population estimates, and descriptive analyses were performed to describe demographic and clinical characteristics of PNTM vs ENTM cases.

Results
Incidence rates of PNTM and ENTM increased from 5.3 and 1.06 to 7.88 and 1.74 per 100,000 population between 2021-2023, respectively (Figure 1). PNTM and ENTM cases were both predominantly White (83% vs 73%), Non-Hispanic (90% vs 87%). PNTM cases were older (Median 69 yrs; IQR: 62, 77) than ENTM cases (Median 57yrs, IQR: 39, 69) and more likely to have underlying obstructive airway disease (Table 1). M. avium complex was most common in PNTM cases and rapid growing NTM species in ENTM cases (Table 2). Notably 50% of PNTM cases and 70% of ENTM cases had a clinical diagnosis of NTM disease. ENTM cases had trauma (13%), surgery (17%), medical devices (27%) or injections (13%) at the site of infection.

Conclusion
This study reveals a rising incidence of both PNTM and ENTM infections with variations in species distribution and associated risk factors for ENTM such as surgical procedures and medical devices. These results underscore the need for ongoing monitoring and targeted interventions to address the growing public health burden of NTM infections.

Disclosures
All Authors: No reported disclosures
P-772. Whole Genome Analysis of Mycobacterium intracellulare isolates from Colonic Biopsy In Inflammatory Bowel Disease Patients
Authors: Singh Urvashi B , Deb Sushanta , Kumari Lata , Mahajan Neeraj , Ahuja Vineet 
Published: January 2025

Abstract

Background
A long debate has prevailed over cause of Crohn's disease with published evidence for Mycobacterium paratuberculosis (MAP).Our study was designed to look for mycobacterial pathogens by culture and DNA PCR in patients with inflammatory bowel disease(IBD).
Phylogenetic Analysis of M. intracellulare isolate genomes compared with reference M. intracellular strain ATCC 13950T
Circular representation of four M. intracellulare isolate genomes compared with reference M. intracellular strain ATCC 13950T. Inner to outer four concentric rings show isolates from this study. The information is read from outer circle to inner as follows: genome size, genes on the forward strand, genes on the reverse strand, t-RNA, and r-RNA of reference strain.The percentage similarity is represented by different color codes. Zoomed portion represent absent genetic region in four isolates.

Methods
Colonic biopsy and Blood Buffy coat samples were processed for cultures and DNA detection for mycobacterial pathogens (including MAP) in 889 patients with inflammatory bowel disease; Crohn’s disease (CD)( clinical manifestations, endoscopic,radiological and histological features as per ECCO consensus guidelines), Intestinal tuberculosis,Controls (Adult patients with hemorrhoidal bleeding and no other colonic disease undergoing sigmoidoscopy).

Results
Four cultures from CD patients grew Mycobacterium intracellulare. Whole Genome Sequencing identified deletion regions in the studied isolates, with 156 protein-coding genes absent in all four isolates compared to the reference genome (M. intracellulare Strain ATCC 13950T). Antibiotic resistance and virulence factor analyses indicated resistance to rifampicin and isoniazid and an abundance of virulence factor genes in M. Intracellulare species. Pan and core gene analyses suggested a closed pan-genome in M.intracellulare, with limited distribution of antibiotic resistance genes.

Conclusion
M. Intracellulare is reported in immune-compromised patientsin several studies. The results of the core genome phylogenetic analysis suggest that factors beyond the isolation sources of M.intracellulare strains may contribute to shape their evolutionary trajectory. Functional analysis indicated a gradual decrease in metabolic capacity across clusters, suggesting an ongoing genome streamlining process in M. Intracellulare species. Essential gene prediction identified strain specific essential genes, emphasizing the importance of energy-related processes. Homologous recombination rate analysis suggested recombination in M. intracellulare strains, with specific parameters showing variation compared to other pathogenic species. This comprehensive study contributes valuable information about the genomic characteristics, evolution, and functional profiles of M. intracellulare strains.

Disclosures
All Authors: No reported disclosures
P-776. Value Of Neutrophil/Lymphocyte Ratio In Predicting Relapse In Multifocal Tuberculosis
Authors: Hammami Fatma , Rekik Khaoula , Smaoui Fatma , Chakroun Amal , Marrakchi Chakib , Koubaa Makram , Ben Jemaa Mounir 
Published: January 2025

Abstract

Background
Multifocal tuberculosis remains a life-threatening disease. The involvement of two non-contiguous extrapulmonary sites makes the prognosis difficult to predict. Neutrophil-lymphocyte ratio (NLR) is a useful biomarker for predicting outcome in various clinical setting. We aimed to study the value of NLR in predicting relapse in multifocal tuberculosis.

Methods
We conducted a retrospective study including all patients hospitalized in the infectious disease department for multifocal tuberculosis between 1998 and 2022. The NLR was defined as the number of neutrophils divided by the number of lymphocytes in whole blood. Receiver operating characteristic curves and areas under the curves (AUC) were calculated to evaluate the predictor value of NLR.

Results
We encountered 94 cases, among whom 64 were females (68.1%). Relapse was noted in 9 cases (9.6%). The NLR was significantly higher among relapsing multifocal tuberculosis cases (4.1[2.5-8.5] vs 2.4[1.6-3.7] ; p=0.031). The optimal cut-off of NLR for predicting relapse among multifocal tuberculosis cases was 3.7, with a sensitivity of 62.5% and a speciﬁcity of 75.4%. The AUC was 0.737 and the 95% conﬁdence interval ranged from 0.575 to 0.899.

Conclusion
The NLR was a useful biomarker in predicting relapse among multifocal tuberculosis cases. Such patients require a close follow-up in order to promptly diagnose relapse.

Disclosures
All Authors: No reported disclosures
P-793. Long-term Outcomes of Mycobacterium avim complex Pulmonary Disease in Kyushu, Japan: A Retrospective Multicenter Study
Authors: Ide Shotaro , Takazono Takahiro , Morimoto Shinpei , Yoshida Masataka , Takeda Kazuaki , Iwanaga Naoki , Hosogaya Naoki , Komiya Kosaku , Izumikawa Koichi , Furumoto Akitsugu , Yanagihara Katsunori , Mukae Hiroshi 
Published: January 2025

Abstract

Background
Recently, the number of patients with nontuberculous mycobacterial pulmonary disease (NTM-PD) has increased worldwide. The most common causative organism in Japan is the Mycobacterium avium complex (MAC). The incidence of MAC pulmonary disease (MAC-PD) is higher than that in other countries, and deaths from MAC-PD are increasing. Complex cases involving radiological fibrocavitary patterns and pulmonary aspergillosis have been reported as poor prognostic factors; however, available evidence is limited. To address this gap, we initiated a retrospective, multicenter study in Kyushu, Japan, focusing on the long-term prognosis of patients five years after the diagnosis of MAC-PD. The primary objective of this study was to investigate the factors that influence the outcomes of these patients by employing data accessible at the time of their initial diagnosis.

Methods
This was a retrospective cohort study of patients aged ≥ 18 years with newly diagnosed NTM-PD who visited 18 medical centers in Kyushu, Japan, between 2010 and 2017. Patient data were collected from medical records by respiratory experts and recorded using the EDC.

Results
The study enrolled 1317 patients with NTM-PD, of whom 1214 had MAC-PD. Patients with insufficient information were excluded, and 856 patients were analyzed: 546 (63.8%) with a non-cavitary nodular bronchiectatic (NB) pattern and 194 (22.7%) with a cavitary NB or fibrocavitary pattern. 107 (12.5%) died from all-cause by 5 years after diagnosis and 137 (16.0%) by 10 years; in the group that died after 5 years, the following were detected as risk factors in multivariate analysis: male sex (OR = 2.90, 95% confidential interval 1.84-4.56), age ≥ 70 (OR = 2.20, 95%CI 1.33-3.63), lobes with cavities ≥ 2 lobes (OR = 2.16, 95%CI 1.07-4.36), albumin &lt; 3.5 g/dL (OR = 3.68, 95%CI 2.29-5.91), and oral corticosteroids (OR 1.97, 95%CI 1.04-3.73).

Conclusion
Male sex and fibrocavitary patterns have been reported to be poor prognostic factors for MAC-PD. In our study, we found that cavitary formation in more than two lobes, lower albumin levels, and oral corticosteroids were newly considered poor prognostic factors. We believe that our findings may help determine treatment induction and predict the prognosis of MAC-PD.

Disclosures
Hiroshi Mukae, M.D., Ph.D., AstraZeneca: Lecture fees|Gilead Sciences: Lecture fees|GSK: Lecture fees|MSD: Advisor/Consultant|MSD: Lecture fees|Pfizer: Lecture fees|Shionogi & Co., Ltd.: Advisor/Consultant|Shionogi & Co., Ltd.: Grant/Research Support|Shionogi & Co., Ltd.: Lecture fees
P-794. An eight-year experience of active case-finding for tuberculosis cases using mass chest radiography among prisoners in Songkhla Province, Thailand
Authors: Ruangchan Sujinda , Saengsanga Pornthip , Kiamkan Nongnuch 
Published: January 2025

Abstract

Background
Thailand is classified by the World Health Organization (WHO) as a high tuberculosis-burden country with an expected that there are 120,000 TB incidences per year in 2016. Reported cases of tuberculosis among prisoners may account for 30% of tuberculosis with an incidence of 880-5,803 cases per 100,000 inmates in low- to middle-income countries. Beginning in 2017, an active case–finding strategy for tuberculosis was implemented in all prisons in Thailand. Mass chest radiograph screening is performed on all prisoners to identify and bring into treatment tuberculosis cases as soon as possible.
Incidence of pulmonary tuberculosis among prisoners in Songkhla Province in the South of Thailand 2016-2023

Methods
A retrospective descriptive study was conducted at Songkhla Provincial Hospital between 2016 and 2023. Inmates from four prisons in Songkhla Province were assessed by tuberculosis screening using mass chest radiographs yearly from 2017. If abnormal chest radiography revealed compatibility with tuberculosis, sputum microscopy and sputum GeneXpert were performed. Data were analyzed using descriptive statistics

Results
After implementing the active case-finding strategy in 2017, the incidence of pulmonary tuberculosis in prisons rose from 584 cases per 100,000 inmates in 2016 to 3,483 per 100,000 inmates in 2019. Then the trend declined to 2,264 per 100,000 inmates in 2021 and 1,982 per 100,000 inmates in 2023. Tuberculosis cases in the prisons accounted for 15% in 2016 and continued to rise to 60% in 2019 then decline to 41% in 2023 of all tuberculosis cases in Songkhla Province. Furthermore, sputum microscopy or GeneXpert detected tuberculosis positive between 10% and 16% of all tuberculosis cases in the four prisons. The rates of treatment success were 90%-94% and the case fatality rates were 11-58 cases per 100,000 inmates at the four prisons.

Conclusion
The active case-finding strategy using mass chest radiography increases the early detection of tuberculosis cases and early treatment in prisons. After 3 years of implementing strategies, the incidence of pulmonary tuberculosis has declined

Disclosures
All Authors: No reported disclosures
Anatomical Location of the Bowel in Different Surgical Positions
Authors: Farber S. Harrison , Rudy Robert F. , Zhou James J. , Alan Nima , DiDomenico Joseph D. , O’Neill Luke K. , Williams Gabriella P. , Alhilali Lea M. , Turner Jay D. , Uribe Juan S. 
Published: January 2025

Study Design.
Radiographic analysis.

Objective.
Evaluate the anatomical relationships of the bowel to the lateral surgical corridor and the spine in various surgical positions.

Summary of Background Data.
Retroperitoneal transpsoas lateral lumbar interbody fusion (LLIF) may be performed with patients in the prone position, allowing for lateral and posterior approaches to the spine without repositioning the patient. Few, if any, studies discuss changes of the bowel position during these procedures.

Methods.
Ten healthy volunteers underwent MRI in 3 positions: supine, prone with hips extended (prone-extension), and right lateral decubitus (left side up) with hips flexed (lateral decubitus-flexion). Anatomical relationships of the bowel to fixed spinal landmarks were assessed at L1-5, and the changes among participants’ positions were compared.

Results.
Anterior bowel movement was noted with prone-extension (range: 0.32-1.39 cm) and lateral decubitus-flexion (range: 0.97-2.18 cm) positioning compared with supine positioning. Significant anterior movement of the bowel was observed at L1-2 (P=0.03) and L2-3 (P=0.04) disc levels in participants in the prone position and at L2-3 (P=0.002) and L3-4 (P=0.01) in those in the lateral position when compared with those in the supine position. No differences in bowel movement were found for prone and lateral positioning. The percentages of participants with bowels located in the operative corridor were similar among the surgical positions (all P>0.07). 3D volumetric analysis showed that the magnitude of these changes was greatest for the upper left colon.

Conclusions.
The results showed that the bowel was positioned anteriorly at L1-5 disc levels when participants were in prone-extension and lateral decubitus-flexion positions compared with the supine position. Overall, the magnitude of bowel positional change was small and variable. These findings suggest that the bowel does not fall away from the surgical corridor when performing retroperitoneal access for single-position prone surgery compared with the lateral decubitus-flexion position.
Metabolic effects of heterocyclic amines on insulin‑induced AKT phosphorylation and gluconeogenic gene expression are modified by N-acetyltransferase 2 genetic polymorphism
Authors: Walls Kennedy M. , Joh Jonathan Y. , Martinez Madeline M. , Hong Kyung U. , Hein David W. 
Published: January 2025

Objective
Heterocyclic amines (HCAs) are mutagens and carcinogens primarily generated when cooking meat at high temperatures or until well-done, and their major metabolic pathway includes hepatic N-hydroxylation via CYP1A2 followed by O-acetylation via N-acetyltransferase 2 (NAT2). NAT2 expresses a well-defined genetic polymorphism in humans resulting in rapid and slow acetylators. Recent epidemiological studies reported significant associations between dietary HCA exposure and insulin resistance and type II diabetes.

Methods
We assessed the effect of some of the most common HCAs found in cooked meat, 2-amino-3,4-dimethylimidazo[4,5-f]quinoline, 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline, and 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine, on insulin signaling and gluconeogenic gene expression in cryopreserved human hepatocytes characterized by their NAT2 genotype and phenotype to investigate the role of NAT2 genetic polymorphism in HCA-induced metabolic dysregulation.

Results
HCA treatment significantly reduced insulin-induced protein kinase B phosphorylation and significantly increased expression of genes involved in gluconeogenesis (G6PC, PCK1, FOXO1, and PPARA) in cryopreserved human hepatocytes from rapid but not from slow acetylators.

Conclusion
The findings suggest that NAT2 genetic polymorphism modifies HCA-induced insulin resistance and gluconeogenic gene expression, implying that individuals with rapid acetylator phenotype may be at greater risk of dysregulated glucose homeostasis following exposure to HCAs.
Plastic Surgeon Well-being, Mindfulness, and the Art of Letting Go
Authors: Kim David H. , Chandawarkar Simran K. , Krajewski Aleksandra , DeLuca-Pytell Danielle , Akiki Ronald K. , Asanbe Opeyemi A. , Patel Sameer A. 
Published: January 2025

Summary:
As plastic surgeons, we strive to achieve the best possible outcomes for our patients. However, despite being a good surgeon with a sound plan that was thoughtfully crafted and well executed, complications still happen. As a result, surgeons involved in the care of patients who have complications can experience mental and emotional suffering, including feelings of guilt, sadness, anxiety, and stress. It is important to be aware of these emotions and to acknowledge them. Through recognition and self-acceptance, we can let go of that which no longer serves us and focus on the present. In fact, there are definitive benefits to letting go of negative thoughts, emotions, and maladaptive behaviors by implementing mindfulness-based practices and seeking individualized treatment if needed.
Could less be enough: sublobar resection vs lobectomy for clinical stage IA non-small cell lung cancer patients with visceral pleural invasion or spread through air spaces
Authors: Dai Zhang-Yi , Shen Cheng , Wang Xinwei , Wang Fu-Qiang , Wang Yun 
Published: January 2025

Background:
While recent randomized controlled trials have demonstrated that sublobar resection is non-inferior to lobectomy, the comparative efficacy of these procedures remains uncertain for early-stage non-small cell lung cancer (NSCLC; ≤ 3 cm) exhibiting invasive features postoperatively, such as visceral pleural invasion (VPI) or spread through air spaces (STAS).

Materials and Methods:
To identify eligible studies, a comprehensive search of PubMed, Embase, MEDLINE, the Cochrane Library, and Web of Science was conducted through 25 July 2024. Studies were screened according to predefined criteria in accordance with PRISMA guidelines. The primary endpoints were 5-year overall survival (OS) and recurrence-free survival (RFS). Hazard ratios (HR) and 95% confidence intervals (CI) were used to perform a meta-analysis.

Results:
The final analysis included 14 retrospective studies and 1 randomized controlled trial, encompassing a total of 8,054 patients with NSCLC (tumors ≤3 cm) exhibiting VPI or STAS. The meta-analysis revealed that sublobar resection was associated with impaired 5-year OS (HR: 1.25; 95% CI: 1.10-1.41) and slightly inferior RFS (HR: 1.25; 95% CI: 0.99-1.58) compared to lobectomy for pT2a (VPI) NSCLC patients with tumor ≤3 cm. Similarly, sublobar resection was associated with significantly worse 5-year OS (HR: 2.58; 95% CI: 1.92-3.45) and 5-year RFS (HR: 2.42; 95% CI: 1.69-3.46) compared to lobectomy for stage IA NSCLC patients with STAS. Subgroup analysis revealed that statistically significant differences in 5-year OS (HR: 1.13; 95% CI: 0.92-1.38) and 5-year RFS (HR: 0.87; 95% CI: 0.56-1.36) were not observed between the sublobar resection and lobectomy groups for pT2a (VPI) NSCLC patients with tumor ≤2 cm. Additionally, no statistically significant survival difference was observed between the segmentectomy and lobectomy groups for NSCLC patients (≤3 cm) with VPI (5-year OS: HR: 1.16; 95% CI: 0.89-1.52; 5-year RFS: HR: 1.07; 95% CI: 0.88-1.30) or STAS (5-year OS: HR: 3.88; 95% CI: 0.82-18.31; 5-year RFS: HR: 1.64; 95% CI: 0.70-3.80).

Conclusion:
For early-stage (≤3 cm) NSCLC with VPI or STAS, sublobar resection was associated with worse survival outcomes compared to lobectomy. However, segmentectomy achieved survival outcomes comparable to those of lobectomy. For pT2a (VPI) NSCLC patients with tumor ≤2 cm, the differences in survival outcomes between sublobar resection and lobectomy were not statistically significant.