Infectious Diseases · New This Week

CID & OFID — the ID week in review

Jul 8 – Jul 18, 2026  ·  Clinical Infectious Diseases + Open Forum Infectious Diseases

A stewardship- and HIV-heavy week. CID: antibiotic-timing mortality in sepsis tracks shock, not immune status; ertapenem looks comparable to group-2 carbapenems in ESBL bacteremia regardless of albumin; one negative follow-up culture at 48 h is usually enough in MSSA bacteremia; and the first report of treatment-emergent sulbactam-durlobactam resistance via AdeFGH efflux. OFID: reassuring real-world data on long-acting CAB/RPV with archived NNRTI RAMs and on switching to doravirine/3TC/TDF with archived M184V/I; ceftriaxone comparable to penicillin G for neurosyphilis; and a multicenter CAR-T infection cohort. The curated high-yield view is below; full detail sits in the per-journal Markdown summaries.

Clinical Infectious Diseases (CID)

CID
 Sepsis / Stewardship Major study High yield · ID 

Time to Antibiotics and Mortality in Immunocompromised versus Non-Immunocompromised Patients with Suspected Sepsis

In adults with suspected sepsis, is the mortality cost of antibiotic delay greater in immunocompromised than non-immunocompromised patients?

StudyRetrospective cohort, 39,842 suspected-sepsis ED encounters at 9 US hospitals (2015–24); 19,121 immunocompromised (2,283 severely). Key figureAntibiotics at 1–3 vs 0–1 h were associated with higher in-hospital mortality in NON-immunocompromised (OR 1.33, 95% CI 1.12–1.59) but NOT immunocompromised patients (OR 1.08, 0.94–1.25). Excess risk was confined to septic SHOCK (non-IC OR 1.41; IC OR 1.21); no association in sepsis without shock, including 3–6 vs 0–3 h.
Fellow implication. Antibiotic urgency should track clinical severity (shock), not immune status — argues against reflexively escalating door-to-antibiotic pressure for every immunocompromised patient without shock.
DOI: 10.1093/cid/ciag401
CID
 AMR / Stewardship Major study High yield · ID 

Serum Albumin, Carbapenem Type, and 30-Day Mortality in ESBL E. coli / K. pneumoniae Bacteremia (IPTW cohort)

In ESBL Enterobacterales bacteremia, does hypoalbuminemia make ertapenem inferior to group-2 carbapenems, as IDSA guidance implies?

StudyMulticenter retrospective cohort, 573 adults with ESBL E. coli / K. pneumoniae bacteremia (2013–20), inverse-probability-of-treatment weighting. Key figureNO significant interaction between serum albumin and carbapenem group for 30-day (P=0.92) or 14-day (P=0.36) mortality; ertapenem's efficacy appeared comparable to group-2 carbapenems across the observed albumin range.
Fellow implication. Challenges the IDSA suggestion to avoid ertapenem in hypoalbuminemia — but single, retrospective, observational; hypothesis-generating, not yet practice-changing.
DOI: 10.1093/cid/ciag444
CID
 Diagnostics / Stewardship Major study High yield · ID 

Routine Serial Follow-up Blood Cultures After a Negative Result Within 48 h of MSSA Bacteremia: Low Yield, High Cost

In MSSA bacteremia, is one negative follow-up blood culture within 48 h enough, or does the 'skip phenomenon' mandate serial cultures?

StudyCohort of 1005 S. aureus bacteremia patients, 2 Dutch hospitals; early skip phenomenon (negative FUBC <48 h then later positive) prevalence. Key figureEarly skip phenomenon in only 31/1005 (3.1%); in 27/31 (87%) clinical condition itself prompted repeat cultures. Relying on one negative FUBC <48 h would misclassify just 4 patients (1%) lacking clinical triggers; potential savings ≈ $13,513 per 100 patients.
Fellow implication. In clinically stable, afebrile MSSA bacteremia without metastatic signs, a single negative FUBC within 48 h carries very low risk of missed persistent bacteremia — supports a day-2-focused, clinically guided approach. (Editorial: Tong et al.)
DOI: 10.1093/cid/ciag418
CID
 AMR / New antimicrobials Resistance High yield · ID 

Treatment-Emergent Acinetobacter baumannii Non-Susceptibility to Sulbactam-Durlobactam

Can resistance to sulbactam-durlobactam (Xacduro), a new CRAB agent, emerge on therapy — and by what mechanism?

StudyCarbapenem-resistant A. baumannii CSF isolate recovered after 14 days of sulbactam-durlobactam PLUS meropenem. Key figure8-fold rise in sulbactam-durlobactam MIC; treatment-emergent mutations in the AdeFGH efflux system with a 166-fold increase in adeG expression. Efflux-pump inhibition RESTORED sulbactam-durlobactam susceptibility.
Fellow implication. Sulbactam-durlobactam resistance can emerge via AdeFGH efflux upregulation — a durable resistance mechanism to know as this CRAB agent is deployed. (Carded.)
DOI: 10.1093/cid/ciag436
CID
 HIV / Resistance Major study High yield · ID 

Correlates of Dolutegravir Resistance in Low- and Middle-Income Countries (4-Country Combined Analysis)

On dolutegravir-based regimens in LMIC programs, which clinical markers flag dolutegravir resistance?

StudyCombined drug-resistance surveys, Malawi/Mozambique/Uganda/Ukraine (2020–22), adults on DTG-based regimens with successful genotypes. Key figureDTG resistance associated with male sex (OR 2.13), any NRTI resistance (OR 31.2, 12.9–75.1), any NNRTI resistance (OR 2.56), and zidovudine- vs tenofovir-backbones (OR 5.87). G118R was the most frequent major mutation; M184V had 83% sensitivity / 91% specificity for DTG resistance.
Fellow implication. Concurrent NRTI/NNRTI resistance and ZDV backbones can serve as proxies for prior non-suppression to target DTG-resistance testing where genotyping is scarce.
DOI: 10.1093/cid/ciag427

Also new this week · CID

  • Influenza vaccine effectiveness, US 2024–25 season (Vaccines) — Test-negative outpatient VE against any influenza ≈ 33% (H3N2 27%, H1N1pdm09 37%, B/Victoria 40%) — seasonal/awareness, not durable. DOI
  • HBsAg seroclearance in HIV/HBV on tenofovir ART (HIV / Hepatitis) — Over median 9.4 yr, seroclearance only 0.97/100 py; birth in the universal neonatal-HBV-vaccination era (aHR 13.6) and baseline HBsAg ≤250 IU/mL predicted it. DOI
  • Optimizing HCV screening among MSM (cost-effectiveness) (Hepatitis / Prevention) — Modeling: optimal US strategy = 6-monthly HCV testing for MSM with HIV, 12-monthly for MSM on PrEP, and at HIV testing otherwise (ICER $67,092/QALY) — more frequent than current guidance. DOI
  • HIV-1 RNA assay selection and low-level viremia (HIV / Diagnostics) — Marked cobas 6800 vs RealTime discordance near 50/200 copies/mL thresholds — assay-specific interpretation matters for trial endpoints and care. DOI
  • Ambient PM2.5 air pollution and TB mortality, Delhi (TB) — Brief report: among 61,925 adults starting TB treatment, higher 30-day pre-treatment PM2.5 independently predicted mortality — a modifiable risk factor. DOI
  • Bacteriophage therapy of M. abscessus mastoiditis (Mycobacteria) — Case: macrolide-resistant M. abscessus mastoiditis reached microbiological remission with systemic + local phage added to dual β-lactam therapy. DOI
  • New Vaccine Surveillance Network — 25 years (Vaccines / Surveillance) — Perspective on the CDC pediatric ARI/AGE active-surveillance platform underpinning RSV, rotavirus, influenza, and EV-D68 vaccine/policy evidence. DOI
  • Hantavirus on a cruise ship: what COVID-19 taught us (Viral) — Viewpoint arguing aerosol / person-to-person spread of Andes virus in permissive settings (MV Hondius outbreak) — echoing early-pandemic aerosol lessons. DOI

Open Forum Infectious Diseases (OFID)

OFID
 HIV / Long-acting ART Major study High yield · ID 

Non-nucleoside RAMs and Effectiveness of Long-Acting Cabotegravir + Rilpivirine (RELATIVITY real-world cohort)

Do pre-existing non-RPV NNRTI resistance mutations compromise long-acting CAB + RPV in the real world?

StudyReal-world RELATIVITY cohort; patients with archived non-RPV NNRTI RAMs (47 with K103N) vs a 1247-patient reference group; confirmed virologic failure (CVF) = 2 consecutive VL ≥200. Key figureCVF rates were SIMILAR between the non-RPV NNRTI-RAM group and the reference group.
Fellow implication. Reassuring that archived non-RPV NNRTI RAMs (including K103N) do not clearly compromise LA CAB/RPV — but observational; RPV-specific RAMs remain the key concern.
DOI: 10.1093/ofid/ofag426
OFID
 Syphilis / HIV Major study High yield · ID 

Penicillin or Ceftriaxone for Neurosyphilis in People With HIV (Propensity-Matched, Mexico)

Is ceftriaxone a reasonable alternative to IV penicillin G for neurosyphilis in people with HIV?

StudyRetrospective, propensity-score-matched multicenter cohort; 39 matched pairs (n=78); primary endpoint effective serological response (≥4-fold nontreponemal decline or seroreversion) at 6 months. Key figureIn the matched cohort, ceftriaxone showed COMPARABLE effective serological response to intravenous penicillin G.
Fellow implication. Supports ceftriaxone as a reasonable outpatient-friendly alternative to IV penicillin G for neurosyphilis in PWH — small n=78, hypothesis-generating.
DOI: 10.1093/ofid/ofag387
OFID
 TB / HIV Major study High yield · ID 

3HP (Weekly Rifapentine-Isoniazid ×3 mo) vs 6H Among People Newly in HIV Care, Western Kenya

Does the trial-demonstrated completion advantage of 3HP over 6H hold in a real HIV program?

StudyProgrammatic cohort; 6H (Jan–Sep 2022) vs 3HP (Oct 2022–Sep 2023) initiation/completion; TB incidence per 1000 person-months. Key figureTPT completion was SIMILAR for 3HP and 6H (unlike randomized trials where 3HP completion was higher). TB incidence was substantially lower among TPT completers; noncompletion predicted higher TB.
Fellow implication. Program-level implementation may erode 3HP's trial completion edge — completion of ANY TPT regimen is what drives TB protection; focus on completion, not just regimen choice.
DOI: 10.1093/ofid/ofag416
OFID
 Transplant / CAR-T Major study High yield · ID 

Infectious Complications of CD19-targeted CAR T-cell Therapy (Multicenter Cohort)

What is the burden and timing of infection after CD19 CAR-T across centers?

StudyMulticenter cohort, 311 CD19 CAR-T recipients; 131 infections in 97/311 (31.2%) within 1 year; early (≤90 d) vs late and bacterial vs viral analyzed. Key figure~31% had ≥1 infection within 1 year; 1-year cumulative incidence ≈19% (viral) and ≈20% (bacterial), with bacterial infections concentrated early post-infusion.
Fellow implication. Roughly a third of CAR-T recipients develop infection within a year — multicenter data to anchor prophylaxis and monitoring, beyond small single-center series.
DOI: 10.1093/ofid/ofag423
OFID
 Vaccines / HPV Review High yield · ID 

Real-world Impact of HPV Vaccination on CIN2+ Reduction: Meta-analysis by Age, Coverage, and Vaccine Type

How much does HPV vaccination cut high-grade cervical disease in the real world, and what modifies the effect?

StudyMeta-analysis of observational studies of population-level CIN2+ after HPV vaccination. Key figureHPV vaccination reduced CIN2+, with larger reductions at younger age at vaccination and higher program coverage.
Fellow implication. Real-world confirmation that earlier, higher-coverage HPV vaccination yields the greatest CIN2+ reduction — reinforces existing recommendations (confirmatory).
DOI: 10.1093/ofid/ofag420
OFID
 HIV / Resistance Major study High yield · ID 

Archived M184V/I and Virological Failure After Switching to Doravirine/Lamivudine/TDF (Dat'AIDS)

Does an archived M184V/I mutation predict failure when switching suppressed patients to doravirine/3TC/TDF?

StudyNational observational cohort, 1282 virally suppressed PWH switched to DOR/3TC/TDF (median 81 wk); archived M184V/I in 7.4%. Key figureVirological failure in only 40/1282 (3.1%); archived M184V/I was NOT significantly associated with VF after the switch — though resistance testing at VF was available in only a minority.
Fellow implication. Reassuring signal that archived M184V/I may not compromise a DOR/3TC/TDF switch, but incomplete resistance testing at failure tempers the conclusion.
DOI: 10.1093/ofid/ofag399

Also new this week · OFID

  • Stewardship: institutional 'expected practice' to boost oral / long-acting IV antibiotics (Stewardship) — Low-resource expected-practice intervention to standardize PO/LAIV use for serious bacterial infections. DOI
  • T2Candida & fungal-biomarker differentials for CVC-origin candidemia (Mycology / Diagnostics) — Evaluates catheter-vs-peripheral biomarker/T2Candida differentials to attribute candidemia to a central line. DOI
  • New rapid diagnostic test for dengue, Vientiane, Laos (Diagnostics) — Accuracy/usability of a prototype NS1/IgM/IgG dengue RDT in an endemic setting. DOI
  • Burden of PCV20-serotype pneumococcal disease in adults, France (Vaccines) — Modeling: ~630,000 cases and €3.1 billion over 5 years attributable to pneumococcus in French adults. DOI
  • Clostridioides difficile infection–associated functional bowel disorder (GI / CDI) — 3-year cohort: recurrent diarrhea after CDI is often a post-infectious functional bowel disorder, not recurrent infection. DOI
  • Anal cancer screening in 18–34-year-old MSM with HIV (HIV / Prevention) — 10-year experience screening younger MSM with HIV, below the guideline-endorsed ≥35-year threshold. DOI
  • Extreme CV risk and LDL-C target achievement in people with HIV (HIV / Cardiology) — Many PWH with established ASCVD meet extreme-risk criteria yet markedly under-achieve LDL-C targets. DOI
  • Cerebral small-vessel disease in virologically controlled PWH (HIV / Neurology) — Predictors of CSVD in middle-aged suppressed PWH — a driver of stroke and cognitive decline. DOI
  • Candida auris colonization in hospitalized patients, Saudi Arabia (Mycology) — Clinical characteristics, predictors, and outcomes of C. auris colonization at a Middle-East tertiary center. DOI
  • Candidozyma auris case-cluster molecular epidemiology, North-Central Florida (Mycology) — Diverse strain origins and long-term persistence within a C. auris (Candidozyma auris) cluster. DOI
  • Invasive nontypeable Haemophilus influenzae, Washington DC (Bacterial) — Sharp rise in severe invasive NTHi disease (9 adults/9 months) with both clonal and nonclonal strains. DOI
  • Outcomes of cranial surgical-site infection, UK tertiary center (Bacterial / Neurosurgery) — Cohort addressing the sparse evidence on antimicrobial duration and management of cranial SSIs. DOI
  • Asthma-related pediatric healthcare use after RSV vs other viral LRTI (RSV / Pediatrics) — RSV-LRTI infants had markedly higher acute and long-term respiratory/anti-asthma healthcare use through age 6. DOI
  • AKI and in-hospital mortality in RT-PCR-confirmed Lassa fever, Nigeria (Viral / Global) — Predictors of AKI and death among hospitalized Lassa fever patients at a national treatment center. DOI
  • Missed and asymptomatic Ebola infection after an outbreak, DRC (Viral / Global) — Seroepidemiology in Likati (2017) suggesting subclinical Ebola virus infection is under-detected among contacts. DOI
  • Preparing for the next pandemic: learning from COVID-19 (Viewpoint) — WHO-framed viewpoint on pandemic-preparedness lessons amid avian influenza, hantavirus, and Ebola. DOI

Personal-study digest — original paraphrase with links to each article's DOI; no figures or verbatim text reproduced. Study designs classified from the methods; observational and single-center point estimates are hypothesis-generating. Verify any figure against the source before acting. CID under IDSA/OUP subscription; OFID open-access (CC-BY). Generated 2026-07-18.