bluuebunny/crossref_metadata_2025_split huggingface dataset:
1300. Feedback on Abstracts Benefits Both Authors and Reviewers: Results of a Pilot Study at IDWeek 2021
Authors: Melia Michael T , Tackett Sean , Armstrong Wendy S , Blyth Dana M , Bonura Erin , Cutrell James B , Escota Gerome V , Luther Vera , Nematollahi Saman , Person Anna K , Schwartz Brian S 
Published: December 2022

Abstract

Background
Many abstracts are submitted to scientific meetings each year. Scholarly work benefits from peer review, yet specific feedback from abstract reviewers is rarely given to authors. Here reviewers provided feedback to all authors who submitted Medical Education abstracts to IDWeek 2021.

Methods
All IDWeek 2021 abstract reviewers for the Medical Education category were invited to an abstract review instructional webinar and were asked to provide feedback on each assigned abstract in a free text box on the review website. Each submitting author was sent this feedback when informed of their abstract disposition. In October 2021, these authors were sent an email containing a link to a survey soliciting their perspectives on the feedback; the survey included demographic questions and Likert scale questions. Descriptive data analysis was performed. All 10 reviewers participated in one of two virtual, semi-structured focus groups about their experience. Two authors conducted thematic analysis on transcripts.

Results
Among abstract authors, 18/26 (69%) responded to the survey. All respondents found the feedback helpful. Twelve (67%) incorporated the feedback into their IDWeek presentations. All 14 submitters who plan to write a manuscript intend to incorporate the feedback into that work. Most (94%) would want to receive feedback on future abstract submissions (Figure); all wish other scientific meetings would provide feedback on abstracts. Among reviewers, common themes included that they (1) provided more attentive reviews due to a sense of responsibility to provide thoughtful feedback, (2) found the work rewarding, (3) improved their abstract-reviewing skills, (4) planned to use this experience to help trainees write better abstracts, and (5) felt this activity built community within IDSA. While providing feedback required more time than past reviews, all would volunteer to provide feedback in the future.

Conclusion
Authors who submitted Medical Education abstracts to IDWeek valued abstract feedback and used it to strengthen their presentations; reviewers found it to be a positive experience and would do it again. IDSA and other societies should consider providing feedback for all abstract categories.

Disclosures
All Authors: No reported disclosures.
1304. Mission-based Academic Tweeting: Analysis of Content Engagement over One Year
Authors: Xu Teena , Guajardo Emmanuel 
Published: December 2022

Abstract

Background
The Baylor College of Medicine Infectious Diseases Fellowship program (BCM ID) launched a new academic Twitter account during the COVID-19 pandemic with the mission to promote the achievements of fellows and faculty (promotion-based tweets, or PBT) and disseminate original educational material (education-based tweets, or EBT) during a fellowship recruitment season that became virtual due to the pandemic. Account content was developed by both ID fellows and faculty, with the goal of increasing social media engagement with the fellowship program. Currently, the average Twitter engagement rate per tweet is 0.037% across all industries and 0.7% for higher education accounts. We looked at the engagement rate of mission-based tweets during the inaugural year of the BCM ID Fellowship twitter account.

Methods
We conducted a retrospective review of tweets published on the BCM ID Fellowship account during the first year of operations (8/1/20-7/31/21). We reviewed 64 mission-based tweets for impressions (number of times a tweet is shown to users), engagement (number of times users interacted with a tweet), and reach (number of followers). We calculated engagement rate (engagement-to-impression ratio, or E:I) for each tweet and compared the engagement rates between EBT and PBT. We also examined the trend of followers over time. Data were collected in October 2021.

Results
EBT comprised 41% of total tweets, and PBT comprised the remaining 59%. EBT averaged 3,662 impressions and 458 engagements, for an E:I of 9.6%. PBT averaged 2,449 impressions and 130 engagements, for an E:I of 5.3% (p = 0.007). Despite a decrease in total posts per month over this time period, follower count continued to increase, and monthly engagement rate per tweet remained above 1%.

Conclusion
Our experience suggests that user engagement is higher for EBT. Programs planning to launch a new academic Twitter account should consider focusing initial content on education to maximize overall engagement and reach. One limitation of this study is that frequency of tweets also impacts engagement, which may confound data from later in the inaugural year, when tweeting from the account became less frequent.

Disclosures
All Authors: No reported disclosures.
1309. Adherence to Short-Term Antibiotic Therapy in Children – a Blinded, Prospective, Electronically-Monitored Study
Authors: Youngster Ilan , Klainer Hodaya , Gelernter Renana , Kozer Eran , Goldman Michael 
Published: December 2022

Abstract

Background
Non-adherence to short-term antibiotic treatment in children can lead to treatment failure and development of drug resistance. To develop effective interventional programs reliable adherence data is needed, but previous studies are scarce and have mostly used parental self-reports. We aimed to determine true adherence rates of pediatric patients treated for acute infections with antibiotic suspensions. Secondary goals were to evaluate patient and treatment characteristics influencing adherence rates and whether the prescriber can predict adherence rates of patients.

Methods
A prospective, blinded, electronically monitored, observational study. Patients aged 2 months to 5 years diagnosed with an acute bacterial infection requiring short (5-10 days) oral antibiotic monotherapy were enrolled. Parents were told they received a new "childproof" cap for evaluation, but unknowingly were provided with an electronically monitored medication bottle recording every manipulation of the cap. At the end of treatment study purpose was disclosed and, if approved, cap data and patient and treatment information collected.

Results
100 infants (49 boys, mean [range] age 1.87 years [0.2-5.1]) were included in the final analysis. Only 11 participants received all the recommended doses. Overall adherence (defined as administration of &gt;75% of prescribed doses) was 62%, while timing adherence (administration of &gt;75% of doses within ±20% of the prescribed interval) was only 21%. After applying a logistic regression model, the only factor significantly associated with non-adherence was being a single parent [OR=5.7 95%CI (1.07-30.3)]. Prescribers overestimated adherence, defining 49/62 (77.7%) participants as likely adherent. Patient/parent pairs that were predicted to be adherent were not more likely to be overall or timing adherent than those predicted to be non-adherent (31/47 vs. 6/16, p=0.77).

Conclusion
Adherence of children to short-term antimicrobial treatment for an acute infection is suboptimal, with only 62% showing good adherence and 21% with good adherence at proper timing intervals. Providers were unable to predict patient adherence. This data is important when considering recommended treatment durations and developing interventional programs to increase adherence.

Disclosures
All Authors: No reported disclosures.
1320. Incidence and Outcome of Gram Negative Blood Stream Infections in Pediatric Intensive Care Unit: a Real Life Experience in a Pediatric Hospital in Italy
Authors: Labate Laura , Valentino Maria Sole , Bigatti Carolina , Medici Chiara , Palmero Candida , Losurdo Giuseppe , Cristina Emilio , Mariani Marcello , Ugolotti Elisabetta , Franceschi Alessia , Russo Chiara , Tavella Elisa , Bondi Elisabetta , Montalto Shana , Ricci Erica , Moscatelli Andrea , Castagnola Elio , Mesini Alessio 
Published: December 2022

Abstract

Background
Antimicrobial resistance (AMR) among Gram Negative (GN) bacteria is a medical and economic concern. In the pediatric setting there is a paucity AMR data due to a lower surveillance in this population.
Aim of this study is to describe incidence and outcomes of GN bloodstream infections (GN-BSI), especially caused by MDR among children admitted to intensive care unit of Istituto Giannina Gaslini Pediatric Hospital in Genoa from January 2017 to December 2021.

Methods
In this retrospective observational single-center study all pediatric patients admitted to ICU with GN-BSI were enrolled.
We collected demographical and clinical data (such as underlying disease, empiric and targeted therapy, presence of devices, prior colonization due to MDR GN, prior treatments and surgery), and outcome and mortality at 7 and 30 days.

Results
Overall, 97 GN-BSI among 85 children admitted to PICU were included during the study period.
Among all patients 40% (34/85) were male, with median age of 3 months (IQR: 1; 11; range: 0-292) and 75% (64/85) were aged &lt; 1 years). Rates of GN BSI according to 1000 admission are showed in figure 1.
The major causative agent was Klebsiella pneumoniae (28/97, 29%), followed by Escherichia coli (18/97, 18%), while 10 episodes (10%) were due to Pseudomonas aeruginosa (figure 2).
A mechanism of resistance was found in 22/97 (23%), with a prevalence of ESBL producers (13/22, 59%), followed by AmpC (4/22, 18%) and KPC (2/22, 1%). 14/97 patients (14%) had a surveillance swab positive by the same bacteria causing BSI. The susceptibility to the 4 more used drugs for 4 more frequent pathogens are showed in figure 3.
In 40% of GN-BSI the empiric therapy was piperacillin/tazobactam, followed by carbapenem in 28/98, 28% of episodes.
Overall, 18 (21%) patients died, half of whom within 7 days of the BSI, including 3/6 of the onco/hematological patients. Figure 1Rates of GN BSI in PICU according to 1000 admissionFigure 2Species distributionFigure 3Susceptibility to the more used drugs for the more frequent pathogens.

Conclusion
This study confirmed the increasing role of GN in BSI and high mortality among children admitted to PICU, especially the youngest, with an increased rate in our Center. Carbapenem resistance isn’t common, but the empirical treatment with piperacillin/tazobactam often it might be useless.

Disclosures
All Authors: No reported disclosures.
1330. Pediatric infective endocarditis at a referral children’s hospital during 19-year period: Trends and Outcomes
Authors: Shawaqfeh Ahmad , Gupta Shipra , Asmar Basim , Abdel-Haq Nahed M 
Published: December 2022

Abstract

Background
We noted an increase in infective endocarditis (IE) cases in recent years. The purpose of the study was to examine the changes in incidence, risk factors, microbiology, complications and outcome of IE in our patient population.

Methods
Records of children &lt; 18 yrs with discharge diagnosis of IE during 2002-2020 at Children’s Hospital of Michigan, Detroit were reviewed. Modified Duke criteria were used to determine “definite” and “possible” IE cases.

Results
101 patients with IE were identified, representing annual incidence of 4.9/10,000 admissions. During 2002-2011 (early period), the incidence was 2.8/10,000 (33 cases). However, during 2012-2020 (late period), the incidence was 7.0/10,000 (68 cases): a 2.5-fold increase. Males were 53.4%. The age range was 1 mo – 17 yrs (median 6 yrs). Of 101 patients, 37 (36.6%) met criteria for definitive and 64 (63.4%) for possible IE. The most common predisposing conditions included congenital heart disease (CHD) (50.5%), central venous catheter (CVC) (25.7%), and immunosuppression (13.9%). CHD was more frequent in the late period (41/68, 60.3%) compared to early period (10/33, 30.3%) (p = 0.0059). Cardiac surgery had been performed in 28/51 (55%) prior to IE diagnosis. CVC related infections were more frequent in the early period (16/33, 48.5%) than the late period (10/68, 14.7%), (p = 0.0005). Overall, 16 (15.8) cases were culture negative. In culture-positive IE, S. aureus was most common (33/101, 32.7%) followed by streptococci (17), S. epidermidis (10), Gram negative bacilli (8), Enterococci (7), fungi (5) and HACEK group (4). Causative organisms were similar in both periods except for fungal organisms (5) and B. henselae (1) in the late period only. Valve replacement or valvuloplasty were performed in 19 (18.8%) patients. Complications included acute kidney injury (9) and emboli to brain (10) and to lungs (7). Mortality occurred in 15 (14.8%): 8 had CHD, 5 had CVC and 1 had fulminant MRSA infection.

Conclusion
Most of our IE patients had underlying medical conditions. The higher incidence of IE during the late period is likely due to an increase in the number of patients with complex cardiac conditions who underwent surgery at our institution. S. aureus was the predominant pathogen followed by streptococci. Mortality rate in our patients was 14.8%.

Disclosures
All Authors: No reported disclosures.
1337. Stewardship Opportunities for Cervical Lymphadenitis and Deep Neck Space Infections
Authors: Shaw Aaron , Lee Brian R , Kazmaier Lauren , Arnold Sandra , Myers Angela 
Published: December 2022

Abstract

Background
Cervical lymphadenitis (LAD) and deep neck space abscesses (DNSA) are common pediatric infections caused by similar bacteria. We sought to determine differences in presentation, diagnosis, and treatment between LAD and DNSA to identify antimicrobial and diagnostic stewardship opportunities.

Methods
Charts were obtained using ICD9/10 codes for retropharyngeal and parapharyngeal abscessed (DNSA), and LAD between 1/1/10-12/31/20 from two pediatric centers. 1981 charts were identified. Charts were excluded if the diagnosis was not a bacterial infection (e.g. Kawasaki disease), if the LAD was not in the neck, or if caused by less common bacteria (e.g. tuberculosis). Data on presenting signs, symptoms, imaging, microbiology results, antibiotics, and surgical interventions were collected. Statistical analyses between LAD and DNSA groups were performed with Fisher’s exact and Wilcoxon rank-sum tests.

Results
1432 patients met inclusion criteria; 767 patients with LAD, 665 with DNSA. Median age and gender differed between LAD and DNSA, but no difference was seen in race between groups (Table). Presenting symptoms were different between groups (p &lt; 0.0001) (Figure). Almost all patients in the DNSA group received a CT scan, compared to 69% in the LAD group. Only 8% in the DNSA group had an ultrasound, in contrast to 50% in the LAD group. Most patients in both groups had a blood culture obtained; these were negative in ≥ 95% of all cases. Abscess cultures in the LAD group more commonly grew S. aureus, while S. pyogenes was more common in the DNSA group. Clindamycin was the most common antibiotic utilized; 91% of LAD, 87% of DNSA. Most patients received ≥ 2 antibiotics; 81% of DNSA and 63% of LAD (Table).

Conclusion
These data may be used to help target diagnostic and treatment stewardship interventions for DNSA and LAD. Ultrasound alone may be sufficient for some cases of LAD, and CT reserved for DNSA when suspected based on presenting signs and symptoms. Routine blood cultures appear to be unnecessary for these patients. Multiple antibiotics are used to treat LAD when a single antibiotic may be more appropriate, given the prevalence of Gram positive organisms that would likely respond to clindamycin.

Disclosures
Brian R. Lee, PhD, MPH, CDC: Grant/Research Support|Merck: Grant/Research Support.
1349. Lesson Learned from Investigators of Clinical Trials to Identify Therapeutics for COVID-19: Qualitative Study
Authors: Jindai Kazuaki , Saito Hiroki , Horii Satoko , Kamata Kazuhiro 
Published: December 2022

Abstract

Background
Implementation of high-quality clinical trials especially early in the pandemic caused burden on clinical investigators given lack infrastructure, networks and systematic supports. To prepare for future pandemic, we investigated facilitator and obstacles that enable investigators to operate clinical trials for COIVD-19 in Japan.

Methods
We conducted individual semistructured qualitative interviews to assess the process of how clinical trials for COVID-19 were planned and implemented at the early stage of pandemic. Clinical investigators were primarily selected through purposive sampling to ensure that participants involved in the clinical trials were well covered. Additional participants were identified using snowball sampling. Interviews were analyzed using qualitative descriptive method.

Results
Through interviews, we identify factors that can impact on conduct clinical trials in infectious diseases field during health emergency in Japan (Figure). First, there are obstacles in rolling out clinical trials and this theme was further divided into two subthemes: obstacles in system(such as lack of regulatory frameworks to support trials, lack of clinical trial networks/platform, and understanding and attitude of the public to clinical trial); and obstacles in clinical level (such as limited resource for non-academic hospitals to implement clinical trials, and lack of trained experienced researchers and coordinators with regards to clinical trials). Secondary, a few factors that facilitate clinical trials exist. Not only governmental and organizational commitment but also presence of physicians and other healthcare professional interested in conducting trials are the key for facilitate clinical trials.
Facilitators and obstacles to implement clinical trials for COVID-19 therapeutics

Conclusion
In this qualitative study, clinical investigators in Japan who conducted clinical trials recognized both obstacles and facilitators. System level obstacles likely led to the obstacles in clinical level. Our finding emphasizes importance for health care policies to respond to such insight from front line clinical investigators to encourage systemwide efforts to facilitate and develop transparent clinical trials during future pandemic.

Disclosures
All Authors: No reported disclosures.
1653. Transcriptional Variation of Adhesion and Biofilm Genes in CTX-M-15-Expressing Klebsiella pneumoniae
Authors: Maclean Alyssa K W , Hanson Nancy D 
Published: December 2022

Abstract

Background
Klebsiella pneumoniae can produce a number of β-lactamases, including the cefotaximase, CTX-M-15. While classically associated with ST131 Escherichia coli, CTX-M-15 is associated with increased virulence in K. pneumoniae. Clinical isolates of K. pneumoniae have been shown to produce high levels of CTX-M-15 RNA. But, the overall transcriptomic changes due to CTX-M-15 expression are unknown. The purpose of this study was to determine if acquisition of CTX-M-15 altered the global transcriptome of K. pneumoniae in addition to decreasing β-lactam susceptibility.

Methods
The structural gene and native promoter of CTX-M-15 were cloned into a low copy number vector and transformed into Kp 23, a clinical isolate from the 1970s with no known acquired β-lactam resistance genes. CTX-M-15 production was confirmed by qRT PCR and western blot. MICs to cefotaxime, ceftazidime, cefepime, ceftolozane/tazobactam, ceftazidime/avibactam, meropenem, meropenem-vaborbactam, and imipenem-relebactam were determined by E-test according to CLSI guidelines. RNA-Seq analysis and bioinformatics were performed by MiGS.

Results
CTX-M-15 carriage led to non-susceptible MICs to cefotaxime, ceftazidime, and cefepime. CTX-M-15 production was associated with statistically significant upregulation of 204 genes and downregulation of 231 genes. Among these, the biofilm genes mrkA and two copies of mrkB were downregulated by 7.5, 4 and 3.5-fold, respectively. Additionally, ecpA, ecpB, ecpC, and ecpR – components of the E. coli Common Pilus (ECP) – were upregulated by 3, 2, 2, and 3-fold, respectively.

Conclusion
High-level expression of CTX-15 β-lactamase has a significant impact on the transcriptome of K. pneumoniae. These changes include a down regulation of genes associated with biofilm formation with a concomitant increase in the expression of genes associated with adherence. These data indicate that overexpression of CTX-M-15 and perhaps other β-lactamases may help promote the pathogenicity of K. pneumoniae or influence its ability to colonize the tissue it infects. This may be important during urinary tract infections when an increase in adhesion by CTX-M-15 producing isolates may be required over biofilm formation to establish an active infection.

Disclosures
Nancy D. Hanson, PhD, Merck: Grant/Research Support.
1362. Lyme Disease and Neurologic Manifestations in a District Hospital in Portugal
Authors: Batista Clara , Moura Luís , Duarte Frederico , de Abreu Ricardo Correia , Neves Isabel 
Published: December 2022

Abstract

Background
Lyme disease (LD), caused by Borrelia burgdorferi sensu lato’s species, has a wide presentation and severity and is often a neglected diagnosis. Neuroborreliosis (NB) occurs in 10-15% of patients (pts).
This study evaluate NB (clinical manifestations, treatment and evolution) in a district acute hospital in Portugal.

Methods
Pts with Borrelia burgdorferi antibodies detected by ELISA, confirmed by Immunoblot and with neurological manifestations, between January 2015 - April 2022, in Pedro Hispano Hospital, Matosinhos, Portugal.

Results
Twenty-one pts: encephalitis (n=5), optic neuropathy (n=5), peripheral neuropathy (n=5), VII cranial nerve palsy (n=4), meningitis (n=3), myelitis (n=2), III cranial nerve palsy (n=1), meningoradiculitis (n=1), radiculitis (n=1) and stroke (n=1); majority female (71.4%) with mean age 50.8 years old. No cases of erythema migrans or arthralgias were observed. ECG performed in 13 pts and only one intraventricular conduction block detected. Lumbar puncture performed in 15 pts, only two presented inflammatory cerebrospinal fluid. Therapeutic strategies: 28 (n=4), 21 (n=5), 14 (n=3) and 10 (n=1) days of ceftriaxone and 28 (n=4), 21 (n=2) and 14 (n=2) days of doxycycline were applied. Complete clinical resolution observed in 6 pts (28.6%) and clinical improvement in 10 (47.6%). One (4.8%) developed post-treatment Lyme disease syndrome and one death occurred, not related with LD. Three pts had no clinical improvement but there was not disease progression, two treated with doxycycline (28 days) and the other one with ceftriaxone (21 days).

Conclusion
These data show the non-negligible prevalence of NB and the variability of clinical presentations that requires a high suspicion in the differential diagnosis. The heterogeneity of therapeutic regimens reflects the absence of a well-defined treatment and opens this discussion.

Disclosures
All Authors: No reported disclosures.