Infectious Diseases

LMIC TB programs produce substantial false-positive and false-negative diagnoses

Using WHO data from 111 low- and middle-income countries, investigators evaluated TB case-finding performance across 6.8 million notifications in 2023. They estimated 2.05 million false-positive and 1.00 million false-negative TB diagnoses, assuming 25% TB prevalence among those evaluated. As many as three in ten TB notifications may represent individuals without TB, implying large-scale overtreatment and misclassification. Scaling up PCR-based diagnostics markedly reduced modeled underdiagnosis but only modestly decreased false-positive diagnoses. 1

Meropenem–vaborbactam and ceftazidime–avibactam yield similar outcomes in MDR Gram-negative infections

This meta-analysis pooled five retrospective cohorts including 3,280 hospitalized adults with multidrug-resistant Gram-negative infections. Meropenem–vaborbactam and ceftazidime–avibactam showed no significant differences in all-cause mortality, clinical cure, or microbiologic recurrence. Odds ratios for these outcomes had confidence intervals crossing 1, with low to moderate heterogeneity across studies. Safety appeared comparable between agents based on qualitative assessment. 2

KP.2-updated mRNA-1273 vaccine cuts COVID-19 hospitalizations in an older, high-risk US cohort

This matched cohort study compared 596,248 KP.2-updated mRNA-1273 recipients with equal numbers of adults without 2024–2025 COVID-19 vaccination. Mean age was 63 years, more than half were at least 65 years old, and most had high-risk comorbidities. Interim effectiveness was 52.8% against COVID-19–related hospitalization and 39.4% against medically attended COVID-19 over median 55-day follow-up. With median follow-up extended to 127 days, effectiveness remained 45.2% against hospitalization and 33.1% against medically attended COVID-19. 3

Modified MDRO OPAT regimens increase costs, delays, and length of stay

This retrospective cohort included 120 adults with multidrug-resistant infections deemed medically stable for discharge on advanced OPAT agents. Overall, 29% received a modified regimen, including alternative IV or oral therapy, in-hospital completion, or in-hospital death. Compared with intended OPAT, modified regimens were associated with higher post–medically stable medication costs and more frequent discharge delays of at least one day. Patients with modified regimens had longer median hospital stays and more frequent discharge disposition changes. 4