Infectious Diseases — New This Week

A three-tier view: only a few items are genuinely high-yield / practice-shaping (green, featured); the rest are notable but not featured (gray) or one-liners — all still summarized for awareness. Featured this week: the Andes-virus healthcare-transmission review (CID); and from OFID, OXA-48 surveillance in febrile neutropenia and maternal CMV viral load + valacyclovir. Notable (gray): the dengue V181 phase-2 vaccine RCT (surrogate-only), the Kazakhstan shortened MDR/RR-TB cohort (confirmatory), LA-ART started during viremia, dose-sparing intradermal MVA-BN for mpox, and a postantibiotic Lyme arthritis cohort. The full lists are in the per-journal Markdown summaries.

Clinical Infectious Diseases (CID)

CID

Review · Infection control High yield · ID

Andes Virus Nosocomial Transmission to Healthcare Personnel — Systematic Review

Can a hantavirus spread person-to-person to healthcare workers?

Key takeaway. Prompted by the May 2, 2026 WHO multinational ANDV outbreak. Across 8 studies / 7 events / 17 healthcare-associated cases, of 207 exposed (118 HCP) there were 8 HCP infections and 4 HCP deaths — all with absent/inadequate PPE or delayed transmission-based precautions. Fellow implication: Andes virus is the one hantavirus with documented person-to-person (incl. HCP) transmission — use contact/droplet precautions, not the "rodent-only" hantavirus mental model.

PDF: andes-virus-nosocomial-transmission-hcp-systematic-review.pdf · 10.1093/cid/ciag394 · carded

Notable this week · summarized, not featured

CID

RCT · Dengue vaccine

Notable · surrogate-only

Single-Dose Quadrivalent Dengue Vaccine V181 vs Butantan-DV — Phase 2, Brazil

In mostly dengue-naïve adults, is single-dose V181 immunologically noninferior to Butantan-DV?

Population1,364 healthy adults, Brazil; 93.5% seronegative; 1:1. Int / CompV181 vs Butantan-DV, single 0.5 mL SC. OutcomeDay-28 GMT noninferior for DENV-1/2 but not DENV-3/4; seroconversion noninferior for all 4. No vaccine-related SAEs.

Why notable, not featured. Surrogate-only phase 2 (immunogenicity, no efficacy, no correlate of protection) — not practice-changing. Efficacy is being tested in phase 3 (MOBILIZE-1). Editorial ciag350 makes the "what does a GMT difference mean without a correlate?" point.

10.1093/cid/ciag349 · editorial 10.1093/cid/ciag350

CID

TB · MDR/RR

Notable · confirmatory

Shortened All-Oral MDR/RR-TB Regimen — 0.2% Post-Treatment Recurrence (Kazakhstan)

Prospective cohort; of 578 with a favorable end-of-treatment outcome, only 1 recurrence (0.2%) in second-line-naïve patients. Reassuring durability, but confirmatory of the existing WHO shortened-regimen direction → notable, not featured.

PDF: shortened-all-oral-mdr-rr-tb-low-recurrence-kazakhstan.pdf · 10.1093/cid/ciag391

CID

HIV · Long-acting ART

Notable · observational

Long-Acting CAB/RPV Initiated With vs Without Viremia — Two US Cohorts

n=1,070; 96% of viremic PWH suppressed (median ~4 wk), but blips/failure were more frequent when started viremic. Real-world observational signal — worth knowing, not a discrete durable fact.

PDF: la-art-initiation-viremia-virologic-outcomes.pdf · 10.1093/cid/ciag392

Also new this week (CID) — summary only: Sepsis "Diagnostic Excellence" & mortality (ciag382, 20 hospitals) — jointly minimizing sepsis under- and over-treatment tracked with lower mortality (aOR 0.61), shorter LOS, fewer antibiotic days; 10-year attributable vs contributable mortality of invasive aspergillosis in heme malignancy (ciag393) — attributable mortality fell but all-cause stayed high → gains need host immune augmentation. Screened out (correspondence): the procalcitonin-in-CAP letter/reply pair (ciag396/ciag397) — note that large real-world datasets show PCT does not shorten (and may lengthen) CAP therapy; a contextual prognostic marker, not a stewardship lever.

Open Forum Infectious Diseases (OFID) · open access

OFID

CPE · Febrile neutropenia High yield · ID

OXA-48 Enterobacterales Rectal Colonization in Hematologic Febrile Neutropenia

Should a surveillance swab change your empiric antibiotics in febrile neutropenia?

Key takeaway. CPE (OXA-48) colonization status should steer empiric therapy: a known carrier who turns septic needs early active anti-CPE coverage, while a recent negative surveillance swab argues strongly against OXA-48 infection. Fellow implication: delayed active therapy in true CPE infection is what drives mortality — let surveillance inform the empiric choice. (Single-center cohort; the principle travels, the exact point estimates don't.)

PDF: oxa-48-colonization-febrile-neutropenia-hematologic.pdf · 10.1093/ofid/ofag362 · carded (principle)

OFID

CMV · Pregnancy High yield · ID

Maternal CMV Viral Load Predicts Transmission and Valacyclovir Response in Early Pregnancy

After primary CMV in early pregnancy, who benefits most from high-dose valacyclovir?

Key takeaway. 133 women. A negative maternal viral load → no congenital CMV regardless of treatment; among quantifiable viral load, valacyclovir (8 g/day) cut transmission 21% vs 58%. Fellow implication: maternal CMV DNAemia is a prognostic marker — negative is reassuring, quantifiable marks who benefits from valacyclovir (the durable principle, anchored to the Lancet 2020 RCT).

PDF: maternal-cmv-viral-load-valacyclovir-congenital.pdf · 10.1093/ofid/ofag291 · carded (principle)

Notable this week · summarized, not featured

OFID

Mpox · Vaccine

Notable · small series

Intradermal (Dose-Sparing) MVA-BN Attenuates Breakthrough Mpox — Sweden

n=79; vaccinated (mostly intradermal MVA-BN) had milder disease (severity 5 vs 8), fewer complications, protection ~3 yr. Reassuring and policy-relevant, but a small retrospective series → notable.

PDF: mpox-mva-bn-intradermal-severity-sweden.pdf · 10.1093/ofid/ofag337

OFID

Lyme · Rheum-ID

Notable · known concept

Postantibiotic Lyme Arthritis (PALA) — Retrospective Cohort

~30% of adults develop postantibiotic (noninfectious) Lyme arthritis; IV/longer antibiotics didn't help → treat as immune-mediated, not with more antibiotics. A durable point, but already well covered in the deck → notable, not re-carded.

PDF: lyme-arthritis-clinical-outcomes-pala.pdf · 10.1093/ofid/ofag368

OFID

RCT · LTBI

Notable · negative

Brief Educational Video for LTBI Treatment — Randomized Trial (negative)

A 3-minute video (n≈1,894, KP Southern California) did not improve LTBI initiation (RR 0.95) or completion (RR 0.97). A low-intensity nudge alone doesn't move LTBI completion.

10.1093/ofid/ofag366

OFID Case Report

mNGS-Diagnosed Suppurative Cervical Lymphadenitis as the First Presentation of HIV · HIV / Diagnostics

Notable · single case

Metagenomic next-generation sequencing (mNGS) on pus identified the organism in a newly diagnosed person with HIV presenting with recurrent suppurative cervical lymphadenitis. mNGS can rescue culture-negative atypical/opportunistic lymphadenitis — and unexplained suppurative lymphadenitis should prompt HIV testing. (Organism is in the archived PDF.)

PDF: mngs-cervical-lymphadenitis-newly-diagnosed-hiv-case.pdf · 10.1093/ofid/ofag373

Also new this week (OFID) — summary only: cryptococcal meningitis short vs longer L-AmB induction (ofag342, comparable but confounded by baseline severity); real-world HCV Ab testing strategy/setting (ofag218, Ontario — primary care best for linkage); DST-guided individualized MDR-TB therapy (ofag349, Germany — molecular DST reliable); PJI core outcome set (ofag364, huge definitional heterogeneity); influenza vaccines in the immunocompromised scoping review (ofag360 — limited effectiveness evidence for 2nd-gen); IDSA-EIN survey (ofag330 — low uptake of HPMZ/BPaL for TB disease); serotype-3 dominance in noninvasive pneumococcal disease Belgium (ofag371); CANUHC HCV gender cohort (ofag356 — poor OAT uptake); histoplasmosis-and-fatigue call to investigate (ofag367); and a preclinical mouse STEC/Stx2d nanobody (ofag357).

Personal-study digest — original paraphrases for educational use; figures drawn from the archived full text / PDF. Three tiers: High yield (green, practice-shaping) · Notable (gray, summarized not featured) · Also new (one-liners). Anki cards are gated higher still — this week 3 cards (Andes; OXA-48 & CMV as principles). CID via IDSA/OUP subscription; OFID open access (CC-BY). Window June 24 – July 3, 2026. Key DOIs — CID: 10.1093/cid/ciag394, 10.1093/cid/ciag349 (ed. 10.1093/cid/ciag350), 10.1093/cid/ciag391, 10.1093/cid/ciag392, 10.1093/cid/ciag382, 10.1093/cid/ciag393. OFID: 10.1093/ofid/ofag362, 10.1093/ofid/ofag291, 10.1093/ofid/ofag337, 10.1093/ofid/ofag368, 10.1093/ofid/ofag366, 10.1093/ofid/ofag373.