Time for Precision: A World Without Susceptibility Breakpoints.


:Interpretive criteria for in vitro susceptibility testing criteria, "susceptibility breakpoints," underpin the evaluation and selection of antimicrobial regimens. However, despite their strengths, susceptibility breakpoints are a relatively blunt instrument employed to address an extremely complex question-what is the likelihood of treatment success for individual patients? With regard to evaluating patients on a case-by-case basis, breakpoints merely allow us to account for pathogen susceptibility. This approach precludes consideration of drug exposures achieved in patients, thus overlooking half of the equation for predicting treatment success. Herein, we propose the framework for considering both pathogen- and patient-specific information to provide clinicians a means of evaluating antimicrobial regimens for individual patients through tools automating pharmacokinetic-pharmacodynamic target attainment analyses. Implementing these tools along with their acceptance by professional organizations will allow for a shift in the paradigm for how antimicrobials are selected and dosed-toward patient-centered care through precision medicine.


Open Forum Infect Dis


Bader JC,Lakota EA,Andes DR,Rubino CM,Ambrose PG,Bhavnani SM




Has Abstract


2018-10-31 00:00:00












  • Expanding Spectrum of Toxoplasma gondii: Thymoma and Toxoplasmic Encephalitis.

    abstract::In this brief report, we describe a 76-year-old patient with thymoma who underwent craniotomy for a left parietal lobe mass with pathologic findings consistent with Toxoplasma gondii encephalitis in the absence of any features of thymoma with immunodeficiency/Good's syndrome. His clinical course suggested likely Toxop...

    journal_title:Open forum infectious diseases

    pub_type: 杂志文章


    authors: Chastain DB,Sams JI,Steele GM,Lowder LO,Franco-Paredes C

    更新日期:2018-07-07 00:00:00

  • Disparities in CD4+ T-Lymphocyte Monitoring Among Human Immunodeficiency Virus-Positive Medicaid Beneficiaries: Evidence of Differential Treatment at the Point of Care.

    abstract:BACKGROUND:Monitoring of immune function, measured by CD4 cell count, is an essential service for people with Human Immunodeficiency Virus (HIV). Prescription of antiretroviral (ARV) medications is contingent on CD4 cell count; patients without regular CD4 monitoring are unlikely to receive ARVs when indicated. This st...

    journal_title:Open forum infectious diseases

    pub_type: 杂志文章


    authors: Davis AC,Watson G,Pourat N,Kominski GF,Roby DH

    更新日期:2014-06-05 00:00:00

  • Occurrence of 4 Dengue Virus Serotypes and Chikungunya Virus in Kilombero Valley, Tanzania, During the Dengue Outbreak in 2018.

    abstract:Background:Dengue and Chikungunya viruses can cause large-scale epidemics, with attack rates of up to 80%. In Tanzania, there have been repeated outbreaks of dengue fever, the most recent in 2018 and 2019, mostly affecting the coastal areas. Despite the importance of these viruses, there is limited knowledge on the epi...

    journal_title:Open forum infectious diseases

    pub_type: 杂志文章


    authors: Chipwaza B,Sumaye RD,Weisser M,Gingo W,Yeo NK,Amrun SN,Okumu FO,Ng LFP

    更新日期:2020-12-26 00:00:00

  • Appropriateness of gram-negative agent use at a tertiary care hospital in the setting of significant antimicrobial resistance.

    abstract::Background.  Practicing antimicrobial stewardship in the setting of widespread antimicrobial resistance among gram-negative bacilli, particularly in urban areas, is challenging. Methods.  We conducted a retrospective cross-sectional study at a tertiary care hospital with an established antimicrobial stewardship progra...

    journal_title:Open forum infectious diseases

    pub_type: 杂志文章


    authors: Vora NM,Kubin CJ,Furuya EY

    更新日期:2015-02-19 00:00:00

  • Continuing Decline in Varicella Incidence After the 2-Dose Vaccination Recommendation-Connecticut, 2009-2014.

    abstract::Background.  Varicella is a highly contagious vaccine-preventable illness. In 1996, the Advisory Committee for Immunization Practices recommended 1 dose of vaccine for children, and in 2006 it recommended 2 doses; Connecticut required 1 dose for school entry in 2000 and 2 doses for school entry starting in 2011. Conne...

    journal_title:Open forum infectious diseases

    pub_type: 杂志文章


    authors: Mullins J,Kudish K,Sosa L,Hadler J

    更新日期:2015-10-09 00:00:00

  • Syphilis Reactivates Latent Epstein-Barr Virus Reservoir via Toll-Like Receptor 2 and B-Cell Receptor Activation.

    abstract::Latent Epstein-Barr virus (EBV) infection can clinically reactivate in immunosuppressed individuals causing lymphoproliferative disease and rarely hepatitis. In this study, we provide in vivo and in vitro evidence that Treponema pallidum infection can cause EBV reactivation with hepatitis in an immunocompetent patient...

    journal_title:Open forum infectious diseases

    pub_type: 杂志文章


    authors: Hirsiger JR,Fuchs PS,Häusermann P,Müller-Durovic B,Daikeler T,Recher M,Hirsch HH,Terracciano L,Berger CT

    更新日期:2019-07-03 00:00:00

  • Multiple Influenza Virus Infections in 4 Consecutive Epidemiological Seasons: A Retrospective Study in Children and Adolescents.

    abstract:Background:Recent observations provide evidence for group-specific immunity toward influenza A infections and raise the question of how often we can get the flu. Methods:We retrospectively analyzed 2308 cases of children and adolescents with clinically manifested influenza and a positive PCR-test during the last 4 epi...

    journal_title:Open forum infectious diseases

    pub_type: 杂志文章


    authors: Möst J,Redlberger-Fritz M,Weiss G

    更新日期:2019-04-23 00:00:00

  • Congenital Parvovirus B19 Infection: Persistent Viremia and Red Blood Cell Aplasia.

    abstract::We describe a case of fetal parvovirus B19 infection resulting in preterm birth and leading to hydrops fetalis requiring multiple in utero transfusions. The infant developed chronic postnatal anemia responsive to intravenous immunoglobulin therapy. Serum viral load decreased after immunoglobulin treatment but remained...

    journal_title:Open forum infectious diseases

    pub_type: 杂志文章


    authors: Nadimpalli SS,Miller RS,Kamath VM,Farkouh CR,Nhan-Chang CL,Rathe JA,Collins A,Duchon JM,Neu N,Simpson LL,Ratner AJ

    更新日期:2015-04-15 00:00:00

  • The Yield and Consistency of the Detection of SARS-CoV-2 in Multiple Respiratory Specimens.

    abstract:Background:Few studies have compared the yield of reverse transcription polymerase chain reaction (RT-PCR) assays in nasopharyngeal swabs, oropharyngeal swabs, and sputum for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection. Methods:We conducted an observational study in Beijing Ditan Hospital, C...

    journal_title:Open forum infectious diseases

    pub_type: 杂志文章


    authors: Zhang H,Chen M,Zhang Y,Wen J,Wang Y,Wang L,Guo J,Liu C,Li D,Wang Y,Bai J,Gao G,Wang S,Yang D,Yu F,Yan L,Wan G,Zhang F

    更新日期:2020-08-26 00:00:00

  • Cost of Public Health Response and Outbreak Control With a Third Dose of Measles-Mumps-Rubella Vaccine During a University Mumps Outbreak-Iowa, 2015-2016.

    abstract:Background:The United States is experiencing mumps outbreaks in settings with high 2-dose measles-mumps-rubella (MMR) vaccine coverage, mainly universities. The economic impact of mumps outbreaks on public health systems is largely unknown. During a 2015-2016 mumps outbreak at the University of Iowa, we estimated the c...

    journal_title:Open forum infectious diseases

    pub_type: 杂志文章


    authors: Marin M,Kitzmann TL,James L,Quinlisk P,Aldous WK,Zhang J,Cardemil CV,Galeazzi C,Patel M,Ortega-Sanchez IR

    更新日期:2018-10-04 00:00:00

  • Soluble Tumor Necrosis Factor-α Receptor 2 in Urine Is a Potential Biomarker for Noninvasive Diagnosis of Malaria During Pregnancy.

    abstract::Background.  During pregnancy, the placenta is inaccessible for diagnosis of placental malaria (PM), but soluble tumor necrosis factor-α receptors (sTNFR) are elevated in the plasma of women with PM. Methods.  In this study, sTNFR-1 and sTNFR-2 were quantified in urine of pregnant and nonpregnant Cameroonian women who...

    journal_title:Open forum infectious diseases

    pub_type: 杂志文章


    authors: Tassi Yunga S,Thévenon AD,Leke RG,Taylor DW

    更新日期:2016-04-26 00:00:00

  • Decreased Microvascular Function in Tanzanian Children With Severe and Uncomplicated Falciparum Malaria.

    abstract::Microvascular function and oxygen consumption affect oxygen homeostasis but have not been assessed in African children with malaria. Microvascular function in Tanzanian children with severe malaria (SM) or uncomplicated malaria were 39% and 72%, respectively, of controls (P < .001). Uncomplicated malaria (P = .04), no...

    journal_title:Open forum infectious diseases

    pub_type: 杂志文章


    authors: Yeo TW,Florence SM,Kalingonji AR,Chen Y,Granger DL,Anstey NM,Mwaikambo ED,Weinberg JB

    更新日期:2017-04-22 00:00:00

  • Switch to Raltegravir From Protease Inhibitor or Nonnucleoside Reverse-Transcriptase Inhibitor Does not Reduce Visceral Fat In Human Immunodeficiency Virus-Infected Women With Central Adiposity.

    abstract::Human immunodeficiency virus-infected women with central adiposity switched to raltegravir-based antiretroviral therapy immediately or after 24 weeks. No statistically significant changes in computed tomography-quantified visceral adipose tissue (VAT) or subcutaneous fat were observed, although 48 weeks of raltegravir...

    journal_title:Open forum infectious diseases

    pub_type: 杂志文章


    authors: Lake JE,McComsey GA,Hulgan T,Wanke CA,Mangili A,Walmsley SL,Currier JS

    更新日期:2015-04-26 00:00:00

  • Human Immunodeficiency Virus-Negative Men Who Have Sex With Men Have an Altered T-Cell Phenotype and Bioenergy Metabolism.

    abstract:Background:We recently reported that the levels of activation, exhaustion, and terminal differentiation within the peripheral T-cell compartment were increased in men who have sex with men (MSM) compared with blood bank donors. During activation and differentiation, T cells undergo metabolic changes to maintain their e...

    journal_title:Open forum infectious diseases

    pub_type: 杂志文章


    authors: Kruize Z,Maurer I,van Dort KA,van den Elshout MAM,Hoornenborg E,Booiman T,Prins M,Kootstra NA

    更新日期:2020-07-05 00:00:00

  • A Deeper Dive Into Antibiotic Stewardship Needs: A Multihospital Survey.

    abstract::In a 2016 survey of 46 Michigan hospitals, we identified four key needs for antibiotic stewardship: clinically-relevant antibiotic data, monitoring compliance, syndrome-specific interventions, and discharge stewardship. A stewardship initiative now addresses these needs within the Michigan Hospital Medicine Safety Con...

    journal_title:Open forum infectious diseases

    pub_type: 杂志文章


    authors: Vaughn VM,Petty LA,Flanders SA,Malani AN,Patel T,Bernstein SJ,Hsaiky LM,Thyagarajan R,Osterholzer D,McLaughlin E,Horowitz JK,Gandhi TN

    更新日期:2020-01-11 00:00:00

  • Assessment of Talaromyces Marneffei Infection of the Intestine in Three Patients and a Systematic Review of Case Reports.

    abstract:Background:Hematogenous dissemination of Talaromyces marneffei can result in multiorgan involvement (skin, lung, and reticuloendothelial system involvement); however, few studies have reported intestinal T marneffei infections. We investigated clinical features, management, and patient outcomes concerning Talaromyces-r...

    journal_title:Open forum infectious diseases

    pub_type: 杂志文章


    authors: Pan M,Huang J,Qiu Y,Zeng W,Li Z,Tang S,Wei X,Zhang J

    更新日期:2020-04-27 00:00:00

  • Continued Sensitivity of Plasmodium falciparum to Artemisinin in Guyana, With Absence of Kelch Propeller Domain Mutant Alleles.

    abstract::Because of concerns about possible emergence of artemisinin resistance strains of Plasmodium falciparum in mining areas of the interior of Guyana, a 7-day artesunate trial was conducted from March to December 2014. The day-3 parasite clearance rate, the efficacy of artesunate at day 28, and polymorphism of Kelch 13 (P...

    journal_title:Open forum infectious diseases

    pub_type: 杂志文章


    authors: Rahman R,Martin MJ,Persaud S,Ceron N,Kellman D,Musset L,Carter KH,Ringwald P

    更新日期:2016-08-30 00:00:00

  • Prognostic Role of Bacterial and Fungal Infections in Patients With Liver Cirrhosis With and Without Acute-on-Chronic Liver Failure: A Prospective 2-Center Study.

    abstract:Background:Bacterial and fungal infections (BFIs) are frequent in patients with cirrhosis and often trigger acute-on-chronic liver failure (ACLF). This prospective observational study aims to describe the interactions between BFI and ACLF in terms of mortality and related risk factors. Methods:We performed a 2-center ...

    journal_title:Open forum infectious diseases

    pub_type: 杂志文章


    authors: Bartoletti M,Baldassarre M,Domenicali M,Lewis RE,Giannella M,Antognoli A,Rinaldi M,Zaccherini G,Verucchi G,Marconi L,Tamè M,Berardi S,Napoli L,Siniscalchi A,Fabbri A,Biselli M,Tufoni M,Pavarin RM,Trevisani F,Viale P

    更新日期:2020-11-04 00:00:00

  • Heterogeneity Between States in the Health and Economic Impact of Measles Immunization in the United States.

    abstract:Background:Vaccines have been used successfully for disease elimination programs in many countries. Evidence on the impact of vaccination programs can support decision-making among medical practitioners and policy makers to improve immunization rates. We estimated the health and economic impact of measles vaccination f...

    journal_title:Open forum infectious diseases

    pub_type: 杂志文章


    authors: Paternina-Caicedo A,Driessen J,Roberts M,van Panhuis WG

    更新日期:2018-06-16 00:00:00

  • Emerging Aspergillus Species Almost Exclusively Associated With Primary Immunodeficiencies.

    abstract::Invasive aspergillosis (IA) is the most serious mold infection encountered in patients with iatrogenic immunosuppression. IA is also a major cause of mortality and morbidity in individuals with primary immunodeficiency (PID). Although Aspergillus fumigatus is the most common etiologic agent of IA reported in PID patie...

    journal_title:Open forum infectious diseases

    pub_type: 杂志文章,评审


    authors: Seyedmousavi S,Lionakis MS,Parta M,Peterson SW,Kwon-Chung KJ

    更新日期:2018-09-26 00:00:00

  • Comparative Outcomes of Adults Hospitalized With Seasonal Influenza A or B Virus Infection: Application of the 7-Category Ordinal Scale.

    abstract:Background:The objective of this study was to investigate the difference in disease severity between influenza A and B among hospitalized adults using a novel ordinal scale and existing clinical outcome end points. Methods:A prospective, observational study was conducted over the 2016-2018 influenza seasons in a centr...

    journal_title:Open forum infectious diseases

    pub_type: 杂志文章


    authors: Wang Y,Fan G,Horby P,Hayden F,Li Q,Wu Q,Zou X,Li H,Zhan Q,Wang C,Cao B,CAP-China Network.

    更新日期:2019-02-15 00:00:00

  • Disseminated Mycobacterium abscessus Infection Secondary to an Infected Vascular Stent: Case Report and Review of the Literature.

    abstract::Mycobacterium abscessus is a rapidly growing, multidrug-resistant mycobacteria, commonly associated with pulmonary, skin, and soft tissue infections. We describe a rare case of M abscessus endovascular stent infection; only 3 cases of graft infections have previously been reported. ...

    journal_title:Open forum infectious diseases



    authors: Tejura N,Bontempo G,Chew D

    更新日期:2018-08-23 00:00:00

  • Splenic Infarction: An Under-recognized Complication of Infectious Mononucleosis?

    abstract::Splenic infarction is a rare complication of infectious mononucleosis. We describe 3 cases of splenic infarction attributed to infectious mononucleosis that we encountered within a 2-month period. We underscore the awareness of this potential complication of infectious mononucleosis and discuss the differential diagno...

    journal_title:Open forum infectious diseases

    pub_type: 杂志文章


    authors: Li Y,George A,Arnaout S,Wang JP,Abraham GM

    更新日期:2018-02-17 00:00:00

  • High Kynurenine:Tryptophan Ratio Is Associated With Liver Fibrosis in HIV-Monoinfected and HIV/Hepatitis C Virus-Coinfected Women.

    abstract:Background:Tryptophan catabolism, measured by the kynurenine:tryptophan (kyn/trp) ratio, is associated with gut microbiota alterations in people with HIV (PWH). We examined the association of the kyn/trp ratio with liver fibrosis in women with/without HIV infection. Methods:The plasma kyn/trp ratio was measured in 137...

    journal_title:Open forum infectious diseases

    pub_type: 杂志文章


    authors: Kardashian A,Ma Y,Yin MT,Scherzer R,Nolan O,Aweeka F,Tien PC,Price JC

    更新日期:2019-06-11 00:00:00

  • Point-of-Use Mixing of Influenza H5N1 Vaccine and MF59 Adjuvant for Pandemic Vaccination Preparedness: Antibody Responses and Safety. A Phase 1 Clinical Trial.

    abstract:BACKGROUND:Avian influenza A/H5N1 has threatened human health for nearly 2 decades. Avian influenza A vaccine without adjuvant is poorly immunogenic. A flexible rapid tactic for mass vaccination will be needed if a pandemic occurs. METHODS:A multicenter, randomized, blinded phase 1 clinical trial evaluated safety and ...

    journal_title:Open forum infectious diseases

    pub_type: 杂志文章


    authors: Mulligan MJ,Bernstein DI,Frey S,Winokur P,Rouphael N,Dickey M,Edupuganti S,Spearman P,Anderson E,Graham I,Noah DL,Mangal B,Kim S,Hill H,Whitaker J,Emery W,Beck A,Stephens K,Hartwell B,Ogilvie M,Rimann N,Osinski

    更新日期:2014-11-18 00:00:00

  • Impact of a 24/7 Rapid Molecular Assay for Influenza Detection on the Prescription of Oseltamivir.

    abstract::We assessed the impact of a rapid molecular assay for influenza detection whether outsourced or performed onsite 24/7 in a University Hospital in Paris, France. Shorter median time-to-results (16.8 vs 2.3 hours, P < .05) and an increased rate of adequate prescription of oseltamivir (76.6% vs 95.3%, P < .05) were obser...

    journal_title:Open forum infectious diseases

    pub_type: 杂志文章


    authors: Jacquier H,Péan de Ponfilly G,Chauvin A,Amarsy R,Benmansour H,Hoang-Nguyen DT,Lecorché E,Mesnil C,Mougari F,Munier AL,Salmona M,Berçot B,Le Goff J,Cambau E

    更新日期:2020-08-25 00:00:00

  • Antimicrobial Stewardship Review of Automated Candidemia Alerts Using the Epic Stewardship Module Improves Bundle-of-Care Adherence.

    abstract:Background:Antimicrobial stewardship interventions utilizing real-time alerting through the electronic medical record enable timely implementation of the bundle of care (BOC) for patients with severe infections, such as candidemia. Automated alerting for candidemia using the Epic stewardship module has been in place si...

    journal_title:Open forum infectious diseases

    pub_type: 杂志文章


    authors: Pettit NN,Han Z,Nguyen CT,Choksi A,Charnot-Katsikas A,Beavis KG,Tesic V,Pisano J

    更新日期:2019-10-11 00:00:00

  • Lack of Awareness of Human Immunodeficiency Virus (HIV) Infection: Problems and Solutions With Self-reported HIV Serostatus of Men Who Have Sex With Men.

    abstract:BACKGROUND:Lack of human immunodeficiency virus (HIV) infection awareness may be a driver of racial disparities in HIV infection among men who have sex with men (MSM). Lack of awareness is typically measured by comparing HIV test result to self-reported HIV status. This measure may be subject to reporting bias and alte...

    journal_title:Open forum infectious diseases

    pub_type: 杂志文章


    authors: Sanchez TH,Kelley CF,Rosenberg E,Luisi N,O'Hara B,Lambert R,Coleman R,Frew P,Salazar LF,Tao S,Clarke W,Del Rio C,Sullivan PS

    更新日期:2014-09-13 00:00:00

  • Health-Related Quality of Life in Outpatient Parenteral Antimicrobial Therapy.

    abstract::Health-related quality of life (HRQoL) in outpatient parenteral antimicrobial therapy (OPAT) has not been well characterized in the United States. In an OPAT cohort, the short-form-12's median physical component score and mental component score were 40.3 and 54.4, respectively. HRQoL measures could be helpful in studi...

    journal_title:Open forum infectious diseases

    pub_type: 杂志文章


    authors: Keller SC,Williams D,Levering M,Cosgrove SE

    更新日期:2018-06-20 00:00:00

  • Is It Actionable? An Evaluation of the Rapid PCR-Based Blood Culture Identification Panel on the Management of Gram-Positive and Gram-Negative Blood Stream Infections.

    abstract:Background:There is growing interest in the use of rapid blood culture identification (BCID) in antimicrobial stewardship programs (ASPs). Although many studies have looked at its clinical and economic utility, its comparative utility in gram-positive and gram-negative blood stream infections (BSIs) has not been as wel...

    journal_title:Open forum infectious diseases

    pub_type: 杂志文章


    authors: Tseng AS,Kasule SN,Rice F,Mi L,Chan L,Seville MT,Grys TE

    更新日期:2018-12-11 00:00:00