Infectious Disease

CASH-75 – Atypical Pneumonia Predictor Score

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Using the CASH-75 score can help predict the absence of atypical pathogens (L. pneumophila or M. pneumoniae) as the causative agents of community acquired pneumonia (CAP) in hospitalized patients.

Source
Accuracy of a score predicting the presence of an atypical pathogen in hospitalized patients with moderately severe community-acquired pneumonia. BMC Infect Dis. 2022 May 3;22(1):424. doi: 10.1186/s12879-022-07423-1.

Do Macrolides Reduce Mortality in Community Acquired Pneumonia?

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Among adults with culture-confirmed bacteremic pneumococcal pneumonia, empiric macrolide therapy was associated with 45% reduction in the odds for mortality, regardless of macrolide treatment duration, an effect was not seen with quinolones.

Source
The Effect of Macrolides on Mortality In Bacteremic Pneumococcal Pneumonia: A Retrospective Nationwide Cohort Study, Israel, 2009-2017. Clin Infect Dis. 2022 Apr20;ciac317. Doi: 10.1093/cid/ciac317.

Recalculating…UTICalc Removes Race as Part of Score

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Race was strongly associated with UTI risk, with non-Black children having 2-4 times greater odds of infection. However, replacement of race with 2 other variable resulted in similar diagnostic accuracy for the UTICalc tool.

Source
Reassessment of the Role of Race in Calculating the Risk for Urinary Tract Infection: A Systematic Review and Meta-analysis. JAMA Pediatr. 2022 Apr 18. doi: 10.1001/jamapediatrics.2022.0700. Online ahead of print.

Does Monoclonal Antibody Work Against the BA.2 Variant?

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This brief report found that certain monoclonal antibodies: imdevimab-casirivimab (also known as REGEN-COV), tixagevimab-cilgavimab (also known as EVUSHELD), and sotrovimab precursor had lower neutralizing ability against the omicron BA.2 variant of COVID-19 than against earlier variants.

Source
Efficacy of Antiviral Agents against the SARS-CoV-2 Omicron Subvariant BA.2. N Engl J Med. 2022 Apr 14;386(15):1475-1477. doi: 10.1056/NEJMc2201933. Epub 2022 Mar 9.

New Outbreak of Acute Hepatitis in Children – Why?

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A new, rare form of acute hepatitis has been seen in children, mostly under age 5 years, that presents with vomiting, diarrhea, and abdominal pain, followed by acute hepatitis with jaundice. If you see a child with a “stomach virus” who has jaundice – check labs!

Source
Acute hepatitis is identified in more children, but cause remains elusive. BMJ. 2022 May 6;377:o1156. doi: 10.1136/bmj.o1156.

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