Invasive Group A Streptococcal Infections in 10 US States

JAMA, Journal Year: 2025, Volume and Issue: unknown

Published: April 7, 2025

Importance Invasive group A Streptococcus (GAS) infections are associated with substantial morbidity, mortality, and economic burden. Objective To update trends in invasive GAS disease incidence rates 10 US states between 2013 2022. Design, Setting, Participants Clinical, demographic, laboratory data for cases were collected as part of population-based surveillance the Active Bacterial Core network covering 34.9 million persons across states. case was defined isolation from a normally sterile site or wound patient necrotizing fasciitis streptococcal toxic shock syndrome January 1, 2013, December 31, Demographic clinical medical record review. From to 2014, available isolates emm typed antimicrobial susceptibilities determined using conventional methods; 2015 onward, whole-genome sequencing used. Main Outcomes Measures Incidence by sex, age, race, selected risk factors; syndromes, outcomes, underlying conditions; isolate characteristics, including susceptibility. Results Surveillance identified 21 312 through 2022, 1981 deaths. The majority (57.5%) males. Among case-patients, 1272 (6.0%) aged 0 17 years, 13 565 (63.7%) 18 64 6474 (30.4%) 65 years older; 5.5% American Indian Alaska Native, 14.3% Black, 67.1% White. rose 3.6 per 100 000 8.2 2022 ( P < .001 trend). highest among however, relative increase over time greatest adults (3.2 8.7 persons). higher Native than other racial ethnic groups. People experiencing homelessness, people who inject drugs, residents long-term care facilities had substantially elevated rates. tested isolates, those nonsusceptible macrolides clindamycin increased 12.7% 33.1% Conclusions during period Accelerated efforts prevent control needed, especially groups at infection.

Language: Английский

---

Serious Bacterial Infections and Hepatitis C Virus Among People Who Inject Drugs: A Syndemic or Intertwined Epidemics?

Tropical Medicine and Infectious Disease, Journal Year: 2025, Volume and Issue: 10(1), P. 17 - 17

Published: Jan. 9, 2025

Limited research has examined the possible synergistic interrelationships between serious bacterial infections (SBIs) of heart (i.e., endocarditis), bone, spine, brain, or joints (e.g., osteomylelitis) and hepatitis C virus (HCV) infections. We whether syndemic interactions existed SBI, HCV, substance-use-related factors in rural communities, hypothesizing that injection-mediated risks elevated likelihood for both SBIs HCV infections, which could be exacerbated by biological-biological biological social interactions. calculated prevalence ratios (PRs) past-year SBI associated with each risk factor separate models. Effect modification among significant was assessed using multiplicative interaction. Among 1936 participants, 57% were male 85% White, a mean age 36 years. Eighty-nine participants (5%) reported hospitalization an year prior to survey. More than half tested HCV-antibody-positive (58%); 62 (5.6%) positive antibody result SBI. Injection behaviors correlated other factors, including multiple injections same injection event (MIPIE), equipment sharing, fentanyl use. In adjusted models, MIPIE (PR: 1.79; 95% confidence interval [CI]: 1.03, 3.11) use 1.68; CI: 1.04, 2.73) significantly Our analyses pointed co-occurring epidemics related cumulative health effects contributing frequent MIPIE. Both present public challenges merit tailored interventions.

Language: Английский

---

Prevalence and Correlates of Hepatitis C Viremia among People with HIV in the Direct-Acting Antiviral Era

Open Forum Infectious Diseases, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 17, 2025

National US data on the burden and risks for hepatitis C virus (HCV) infection in people with human immunodeficiency (HIV) during direct-acting antiviral (DAA) era are limited. These important to understand current progress guide future efforts toward HCV microelimination. We evaluated (1) prevalence (2011-2013, 2014-2017, 2018-2022) using a serial cross-sectional design (2) correlates viremia (2018-2022) adult HIV (PWH) within Centers AIDS Research Network of Integrated Clinic Systems (CNICS) cohort multivariable adjusted relative risk regression. The most recent from each time period were used calculations models. In CNICS cohort, was 8.7% 2011-2013, 10.5% 4.8% 2018-2022. Disparities across demographic groups defined by age, gender, race/ethnicity smaller 2018-2022 than earlier periods. regression, female detectable RNA, higher proportion missed visits (last 18 months), FIB-4 score, depressive symptom severity, use methamphetamine illicit opioids associated DAA this US-based national PWH improved over subgroups but remains those without HIV. Our findings highlight continued importance prioritizing care all PWH, especially certain key, less-reached groups. Proactive, comprehensive engagement, substance use, mental health, other social determinants will be crucial improve reach, prevention, treatment achieve elimination goals.

Language: Английский

---

Naloxone distribution amidst shifting drug use patterns: insights from a needs-based syringe services program

Drug and Alcohol Dependence, Journal Year: 2025, Volume and Issue: 269, P. 112591 - 112591

Published: Feb. 12, 2025

In the context of rising overdose deaths among people smoking opioids and stimulants nationally, we aimed to evaluate naloxone distribution within a needs-based syringe services program in Southern California. Using service delivery data spanning January-June 2024, examined pipes for safer smoking, sterile syringes, naloxone. Modified Poisson regression estimated prevalence ratios (PRs) encounters involving only, syringes together, neither nor whether these included Negative binomial relationships between supplies acquired by participants number overdoses which they responded with past 14 days. Among 1260 encounters, 50 % involved 33 pipes/syringes distributed 11 only 7 syringes. Overall, nearly half (44 %) Compared pipe-only distribution, syringe-only (PR=1.41; 95 confidence interval [CI]: 1.12, 1.78), combined pipe/syringe (PR=1.90; CI: 1.64, 2.20), (PR=2.39; 1.92, 2.99) were more likely include There was no significant relationship supply type 14-day rate responses Harm reduction less involve than other types this setting. To curb communities shifting from injecting unregulated substances, specific strategies may be needed promote uptake.

Language: Английский

---

Safe Injection Self-Efficacy is associated with HCV and HIV seropositivity among people who inject drugs in the San Diego-Tijuana border region

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2024, Volume and Issue: unknown

Published: May 22, 2024

Safe injection self-efficacy (SISE) is negatively associated with risk behaviors among people who inject drugs (PWID) but has not been examined in differing environments. We compared responses to a validated SISE scale between PWID San Diego, California and Tijuana, Mexico, examine correlates of Tijuana.

Language: Английский

---

Safe Injection Self-Efficacy is Associated with HCV and HIV Seropositivity Among People Who Inject Drugs in the San Diego–Tijuana Border Region

AIDS and Behavior, Journal Year: 2024, Volume and Issue: 28(11), P. 3629 - 3642

Published: July 26, 2024

Language: Английский

---

Is San Diego California on Track to Reach HCV Elimination? A Modeling Analysis of Combination Prevention Strategies

Viruses, Journal Year: 2024, Volume and Issue: 16(12), P. 1819 - 1819

Published: Nov. 22, 2024

In 2020, the Eliminate Hepatitis C Initiative in county of San Diego (COSD) was launched, a private–public joint endeavor between COSD and American Liver Foundation. We use epidemic modeling to assess whether is on track reach its elimination targets (80% reduction incidence, 65% hepatitis virus (HCV)-related mortality by 2030 compared 2015) what intervention scale-up may be required. adapted previously developed dynamic, deterministic model HCV transmission disease progression among adults COSD, stratified risk, age, gender, human immunodeficiency (HIV) status. The calibrated detailed historical epidemiological data burden, treatment, COSD. project infections under status quo treatment (65%/year people coinfected with HIV, 0–5%/year others) determine those without HIV required achieve elimination, or concomitant reductions injection risk from 2024 onward. an increase new 2213 [95% C.I.: 1069–3763] 2030, mean 91% relative 2015 2030. HCV-related deaths are expected decrease 246 180–295] 14% 2015. incidence target could achieved through increasing 60%/year, similar level HIV. Combination interventions reduce needed; if injecting reduced 25%, then treating 48%/year elimination. likely not targets, but achieving possible rates overall scaled-up that have been Elimination achievable requires committed funding expansion comprehensive testing, linkage, programs alongside harm initiatives.

Language: Английский

---