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Professor of Medicine (Infectious Diseases) at the Icahn School of Medicine at Mount Sinai

Along with a 1 reported case in Massachusetts, the

New Hampshire Department of Health and Human Services (DHHS) has confirmed a person infected with eastern equine encephalitis (EEE) has died. The public health agency said the person was hospitalized due to severe central nervous system disease. The last reported human EEEV infection in New Hampshire was in 2014, when DHHS identified 3 human infections, including 2 fatalities. In the same statement, DHHS mentions there has been 1 confirmed case in Vermont this summer.

On August 16, the Massachusetts Department of Public Health (MDPH) released a statement discussing the confirmation of the first human case of EEE in the state this year. The confirmed case was discovered in an 80 year old man who was exposed to the vector borne disease in Worcester County. As a result, the risk level in the local communities of Douglas, Oxford, Sutton, and Webster has been raised to critical, and in Dudley, Northbridge, and Uxbridge the risk is increased to high.

Additionally, the neighboring communities of Auburn, Charlton, Grafton, Leicester, Mendon, Millbury, Millville, Southbridge, and Upton are now considered at moderate risk according to MDPH.

“This is the first time we have seen a person infected with EEE in Massachusetts since 2020,” Public Health Commissioner Robbie Goldstein, MD, PhD, said in a statement. “EEE is a rare but serious disease and a public health concern. We want to remind residents of the need to protect themselves from mosquito bites, especially in areas of the state where we are seeing EEE activity.

Though very rare, EEE is serious and a potentially fatal disease that can affect people of all ages. EEE is generally spread to humans through the bite of an infected mosquito. There were 12 human cases of EEE in Massachusetts in 2019 with 6 deaths, and 5 human cases with 1 death in 2020. There were no human cases of EEE in Massachusetts in 2021, 2022, or 2023.

EEE has a fatality rate of 33% to 70%, with most deaths occurring 2–10 days after the onset of symptoms.

In addition to a high mortality rate, long-term physical and mental complications, including permanent neurological deficits have been identified in many people who survive EEE.

Plymouth is approximately 40 miles south of Boston along the coast, and Worcester County is in the middle of the state, so the 2 areas are not in close proximity, but due to the elevated risk locally, the town of Plymouth decided to take action in response to outdoor parks. As of last Friday, all town public parks and fields are close daily from dusk until dawn.

“As Mass DPH has now elevated Plymouth’s EEE risk status to high, it is important to take extra precautions when outdoors and follow state and local health guidelines to avoid unnecessary risk to exposure to EEE. The health and safety of our community, residents, and visitors remain our priority,” Plymouth’s Commissioner of Health and Human Services, Michelle Bratti, said in a statement.

According to the Centers for Disease Control and Prevention (CDC) most people who are infected with the virus do not develop symptoms; however, for those that do, the date from the bite to the onset of the illness is 4 to 10 days. EEE can also result in fever or neurologic disease. The type of illness will depend on the age of the person and other factors. Those who are infected can develop meningitis.

There are no FDA-approved treatments for EEE and for patients who develop severe cases, they can be hospitalized to receive supportive treatment.

Over the weekend, MDPH detailed plans of spraying for mosquitos including aerially in areas of Plymouth County, and truck-mounted spraying in parts of Worcester County. As of Saturday, 10 communities in Massachusetts were raised to high or critical risk for EEE virus.

“The risk from EEE is high in parts of Plymouth County and critical in parts of Worcester County,” State Epidemiologist Catherine M. Brown, DVM, said in a statement. “In addition to recommending that people use mosquito repellent with an EPA-registered active ingredient and clothing to reduce exposed skin, we also recommend that evening outdoor events be rescheduled to avoid the hours between dusk and dawn. The mosquitoes most likely to spread EEE are most active during the dusk to dawn hours.”

There are preventative strategies to avoid EEE, and the MDPH has listed such measures 

For those who live in Massachusetts and want more information on EEE, it can be found 

 or by calling the DPH Division of Epidemiology at 617-983-6800.

1.NH DHHS Identifies Person Infected with Eastern Equine Encephalitis Virus in New Hampshire.The New Hampshire Department of Health and Human Services. August 27, 2024. Accessed August 28, 2024.
https://www.dhhs.nh.gov/news-and-media/nh-dhhs-identifies-person-infected-eastern-equine-encephalitis-virus-new-hampshire
2. State health officials announce season’s first human case of Eastern Equine Encephalitis in Massachusetts. MDPH. August 16, 2024. Accessed August 27, 2024.
https://www.mass.gov/news/state-health-officials-announce-seasons-first-human-case-of-eastern-equine-encephalitis-in-massachusetts
3.Plymouth to Close all Public Parks and Fields from Dusk to Dawn. Town of Plymouth. August 23, 2024. Accessed August 27, 2024. PDF.
4. Eastern Equine Encephalitis: Symptoms, Diagnosis, and Treatment. CDC. May 15, 2024. Accessed August 27, 2024.
https://www.cdc.gov/eastern-equine-encephalitis/symptoms-diagnosis-treatment/index.html
5. State officials announce plans to spray for mosquitoes in sections of Worcester and Plymouth counties due to EEE. MDPH. August 24, 2024. Accessed August 27, 2024. 
https://www.mass.gov/news/state-officials-announce-plans-to-spray-for-mosquitoes-in-sections-of-worcester-and-plymouth-counties-due-to-eee



The town of Plymouth decided to prohibit people from using the parks from dusk to dawn due to concerns over eastern equine encephalitis after a man contracted the rare disease in the state.

Concerns Over Mosquito-Borne Illness Causes Massachusetts Town to Create Curfew for Parks, Spraying in Counties

According to the Centers for Disease Control and Prevention (CDC), hepatitis E (HEV) is more common in many parts of the world where sanitation is poor and people have limited access to clean drinking water.

 It is more rare in the US, but it is a leading cause of acute viral hepatitis, particularly in Asia and Africa.

HEV is especially dangerous for pregnant women and people with chronic illnesses, with a mortality rate of up to 10-50 %.

‘Symptoms of hepatitis E are similar to other diseases that cause acute jaundice, making it difficult to detect,” Andrew Azman, PhD, epidemiologist, UNIGE-HUG Centre for Emerging Viral Diseases, Médecins Sans Frontières

, and Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, said in a statement. “While we don’t have precise estimates of the global burden, some have put it at around 50,000 deaths a year.”

Azman led a study examining the Hecolin HEV vaccine in staving off an outbreak in the Bentiu refugee camp came in South Sudan back in 2022.

“The Bentiu camp in South Sudan, home to more than 100,000 people who have been displaced due to civil war, is a regular victim of hepatitis E and other waterborne disease outbreaks, likely due to the poor sanitation conditions and frequent flooding,” he said.

Azman and a team of investigators utilized the vaccine, developed in China. The study's results were published in 

The investigators identified 859 patients with suspected HEV. Of this group, 201 met the eligibility criteria and 21 cases had laboratory confirmed hepatitis E. Among the confirmed cases, 10 (48%) were unvaccinated compared with 33 (27%) of 121 matched controls, between May 10 and Dec 30, 2022.

“In the primary analysis we estimated an unadjusted two-dose vaccine effectiveness of 67.8% (95% CI –28·6 to 91·9), and a 2-dose vaccine effectiveness of 84% (–2085 to 992) after adjustment for potential confounders,” the investigators wrote. “The bias indicator analysis suggested that test-negative cases might have been more likely to have been vaccinated than their matched community controls due to different health-care seeking behaviors, potentially meaning underestimation of effectiveness estimates. The test-negative design, which uses facility-matched controls, led to an adjusted two-dose effectiveness of 89·4% (564 to 98.0).”

The vaccine has previously been recommended by the WHO as a potential prophylaxis strategy. Until this South Sudan outbreak, it had only been utilized in controlled clinical trials and travel medicine in China.

‘‘That’s why it was essential to study the vaccine’s effectiveness on other populations and in regions where the type of virus circulating is different from China, as well as the logistical feasibility of such a campaign,’’ Isabella Eckerle, Professor at the Faculty of Medicine and Director of the UNIGE-HUG Centre for Emerging Viral Diseases said in a statement. ‘‘In particular, it was important to understand its effectiveness after just 2 doses, whereas it is usually administered in three doses 6 months apart.’’

The study confirmed the protection provided by 2 doses during an epidemic, and the reduction of the disease. ‘‘Our results combined with others helped lead to recent approval by WHO’s International Coordinating Group (ICG) on Vaccine Provision of a stockpile of hepatitis E vaccines for emergencies,” Azman said. “This stockpile has the potential to save many lives and we’re looking forward to seeing it in action. These results have also already contributed to the WHO recommendations on the use of a 2-dose schedule.”

References
1.Hepatitis E Basics.CDC. May 14, 2024. Accessed Janaury 27, 2025. https://www.cdc.gov/hepatitis-e/about/index.html
2. Nesbitt RC, Kinya Asilaza V, Alvarez C, et al. The effectiveness of two doses of recombinant hepatitis E vaccine in response to an outbreak in Bentiu, South Sudan: a case-control and bias indicator study. 

. Published online January 8, 2025. doi:10.1016/S1473-3099(24)00657-1
3.Hepatitis E vaccination is effective in an epidemic. Eurkealert. January 14, 2025. Accessed January 27, 2025. 
https://www.eurekalert.org/news-releases/1070407

In a small trial, the Hecolin hepatitis E vaccine demonstrated further utility outside of previous study parameters. 

In Response to Outbreak, 2-Dose Hepatitis E Vaccines Shows High Efficacy

Today, the World Health Organization (WHO) announced it had published 2 reports regarding therapies and diagnostics for fungal diseases. The reports were designed to address the gaps in testing and treatments, especially in low- and middle-income countries (LMICs).

“Invasive fungal infections threaten the lives of the most vulnerable but countries lack the treatments needed to save lives,” Yukiko Nakatani, MD, PhD, WHO assistant director-general for Antimicrobial Resistance 

“Not only is the pipeline of new antifungal drugs and diagnostics insufficient, there is a void in fungal testing in low- and middle-income countries, even in district hospitals. This diagnostic gap means the cause of people’s suffering remains unknown, making it difficult to get them the right treatments.”

What is especially troubling are the mortality rates, which can reach as high as 88% for fungi in the top ‘critical priority’ category of the WHO’s 

. Advancements in treatments mean that more people are likely to be living with immunocompromised conditions, which also could mean increases in cases of invasive fungal diseases. This is a complex challenge to manage due to inaccessibility of diagnostic tools, limited availability of antifungal medicines, and a slow and complex research and development process for new treatments, the authors pointed out.

Antimicrobial resistance remains one of the biggest, ongoing challenges for therapies for certain fungal infections. For example, when looking at 

, first-line therapies are often less susceptible. About 90% of 

isolates have been resistant to fluconazole, about 30% have been resistant to amphotericin B, and less than 2% have been resistant to echinocandins, according to the Centers for Disease Control and Prevention (CDC).2

Antifungal Agents in Clinical and Preclinical Development,

 and in it, the authors point out a lack of newly approved antifungals as well as a limited late-stage development pipeline. They write that in the past decade, only 4 new antifungal drugs have been approved by regulatory authorities in the US, European Union, or China.

There are 9 antifungals in clinical development to use against the most health-threatening fungi, but only 3 candidates are in phase 3. Twenty-two drugs are in preclinical development, an insufficient number to feed a clinical pipeline considering the dropout rates, risks and challenges associated with earlier development stages.

In addition to resistance and limited treatment options, the authors also highlight several other issues with antifungals, including serious side effects, frequent drug-drug interactions, limited dosage forms, and the need for prolonged hospital stays. The authors argue that there is a need for safer antifungal options, which could potentially reduce the need for continuous drug monitoring.¹

Regarding recommendations, the WHO emphasizes the importance of investments in global surveillance, expanding financial incentives for drug discovery and development, funding basic research to identify new and unexploited fungal targets for therapies, and investigating treatments that enhance patients’ immune responses. These efforts are all essential when considering antifungal therapies.¹

Landscape Analysis of Commercially Available and Pipeline in Vitro Diagnostics for Fungal Priority Pathogens.

 The authors point out that although there are commercially available tests for fungal priority pathogens, in (LMICs), there is limited testing availability. They point out that all these countries need faster, more accurate, cheaper and easier testing for a broad range of fungal priority pathogens, but that LMICs are particularly challenged in getting diagnostics that can be used at or near point-of-care.¹

Additionally, other areas that need to be addressed include the limited capabilities of fungi diagnostics, and the lengthy time to obtain testing results. Most of the tests are not well suited to primary and secondary health facilities as certain diagnostics require stable electricity supplies within suitable and equipped laboratories.¹

And health workers often have insufficient knowledge about fungal infections as well as the impact of fungi growing more resistant to treatments, resulting in limited ability to perform the testing needed to determine the appropriate treatment they point out.¹



References
1.WHO issues its first-ever reports on tests and treatments for fungal infections. WHO press release. April 1, 2025. Accessed April 1, 2025.
https://www.who.int/news/item/01-04-2025-who-issues-its-first-ever-reports-on-tests-and-treatments-for-fungal-infections
2. Antifungal Susceptibility Testing for C. auris. CDC. April 24, 2024. Accessed April 1, 2025.
https://www.cdc.gov/candida-auris/hcp/laboratories/antifungal-susceptibility-testing.html



The organization's reports discuss the small number of newly approved treatments, the limited, late-stage antifungal pipeline, and challenges around diagnostics for this class of infections.  

WHO Issues First Reports on Diagnostics, Therapies for Fungal Infections

The FDA has requested that Novavax complete an additional clinical trial for its COVID-19 vaccine, NVX-CoV2601, which it is seeking full approval for after it was granted an emergency use authorization in 2022.

 This news comes just days after the company received communication from the FDA asking for a postmarketing commitment (PMC) to generate additional clinical data.

The company noted in a release on April 23 that it “believe[s] that our Biologics License Application (BLA) is approvable based on conversations with the US Food and Drug Administration, as of our Prescription Drug User Fee Act (PDUFA) date of April 1 and through today,” adding that it sought to move toward approval as soon as possible.

The company was previously awaiting feedback from the agency after the PMC. According to a report from the 

, this update comes after newly appointed members of the Department of Health and Human Services (HHS) intervened in the approval process.

 The agency's request for new data does allow for Novavax to negotiate for a smaller and possibly less expensive study; however, doubts had been sown about the potential approval after the agency missed the April 1 PDUFA deadline. HHS Secretary Robert Kennedy Jr attributed the delay to the vaccine’s composition in an interview with 

spoke with Novavax’s Chief Medical Officer, Robert Walker, MD

, in February 2025, discussing the company’s progress in obtaining full licensure for its COVID-19 vaccine, at which time Walker echoed the sentiment about the company’s hopes for approval, saying, “we’re very much looking forward to obtaining full licensure of our vaccine, achieving parity with the other COVID-19 vaccines available.” He added that the company was “working very closely with the FDA to make sure they get all their questions answered, and that they understand all the data we've provided in the application.”

Walker also issued a reminder about the importance of staying vigilant against COVID, which he said “is still very much with us,” adding that “it’s really important to protect ourselves, our families, and our communities. I encourage everyone to get vaccinated. If you're in a high-risk group, make sure to get your revaccination. And above all, stay healthy.”

Next-Generation Antivirals Outperform Paxlovid in Preclinical Coronavirus Testing

Interim results from a phase 2/3 study of NVX-CoV2601 (NCT05975060) demonstrated significant improvements in immune response, suggesting its potential as an effective booster for adults in the US. The study was conducted between September 2023 and January 2024, showing that, based on a recombinant spike protein from the Omicron XBB15 variant, the updated vaccine induced higher neutralizing antibody responses compared to the original NVX-CoV2373 formulation.

That original NVX-CoV2373 vaccine was based on the first strain of COVID-19, while the updated NVX-CoV2601 was designed to target the Omicron XBB15 variant that was circulating during the study. “Both vaccines should be classified the same—they are both COVID-19 vaccines. One is based on the original, more ‘prototype’ strain, while the other reflects the newer circulating strain at the time of the study,” 

The study involved 332 adults aged 18 years or older who had previously received 3 or more doses of mRNA vaccines, with participants receiving a single dose of NVX-CoV2601 via intramuscular injection. The primary end points were to demonstrate superiority in neutralizing antibody levels and non-inferiority in seroresponse rates compared to NVX-CoV2373. The study’s interim findings suggest that NVX-CoV2601 could serve as an effective booster, particularly for individuals who have received previous mRNA vaccinations.

Data showed a production of a geometric mean neutralizing antibody (nAb) titer of 905.9 at day 28, compared with 156.6 for the original NVX-CoV2373 formulation. The geometric mean titer ratio (GMTR) between the 2 groups was 5.8, indicating that the new vaccine generated significantly higher levels of neutralizing antibodies. As well, 64% of participants in the NVX-CoV2601 group showed a seroresponse, compared with just 7% for NVX-CoV2373.

Safety data from the study also supported the vaccine’s potential as a booster, with the most common adverse events (AEs; occurring within 7 days) included local reactions at the injection site (52% tenderness, 30% pain), fatigue (29%), and muscle pain (29%). Serious AEs were rare, with no deaths or severe events related to the vaccine. Unsolicited adverse events potentially linked to the vaccine occurred in only 2% of participants.

Walker noted that this manageable safety profile aligns with expectations for vaccines targeting new strains. “It’s not surprising that this combination continues to perform well, optimizing the immune response and, therefore, providing better protection over time.”

REFERENCES
1. US FDA asks Novavax to complete new clinical trial for delayed COVID-19 shot, WSJ reports. News release. Reuters. April 25, 2025. Accessed April 25, 2025. https://www.reuters.com/business/healthcare-pharmaceuticals/fda-asks-novavax-complete-new-clinical-trial-delayed-covid-19-shot-wsj-reports-2025-04-25/
2. Latest update on U.S. FDA BLA for Novavax's COVID-19 Vaccine. News release. Novavax. April 23, 2025. Accessed April 25, 2025. https://ir.novavax.com/press-releases/Latest-update-on-U-S-FDA-BLA-for-Novavaxs-COVID-19-Vaccine
3. Watch: RFK Jr.'s first network TV interview as HHS secretary. CBS News. YouTube. April 9, 2025. Accessed April 25, 2025. https://www.youtube.com/watch?v=o2U0csKvqMY
4. Alves K, Kotloff K, McClelland RS, et al. Immunogenicity and safety of a monovalent omicron XBB.1.5 SARS-CoV-2 recombinant spike protein vaccine as a heterologous booster dose in US adults: interim analysis of a single-arm phase 2/3 study. 

. 2025;25(1):1-9. doi:10.1016/S1473-3099(24)00670-4

After delays in the review of the COVID-19 vaccine—which missed its April 1 review deadline—the agency has requested new data.

FDA Requests Additional Trial of Novavax NVX-CoV2601 Vaccine Prior to Approval

Two experimental antiviral compounds developed by researchers at the University of California, San Francisco, and Gladstone Institutes have shown superior performance to Paxlovid in preclinical testing against both SARS-CoV-2 and MERS. The findings, published in 

, suggest the new compounds may offer broad protection against current and future coronaviruses.

The compounds, AVI4516 and AVI4773, target the main protease of the virus, a key enzyme that enables viral replication. In mice, AVI4773 led to a more than one million-fold reduction in viral titers after just three doses and achieved drug concentrations in brain tissue more than one thousand times the effective dose within eight hours of oral administration. Both drugs were well distributed across tissues and appeared safe in animal models.

The molecules showed strong pan-coronavirus activity and minimal off-target effects. AVI4516 did not significantly inhibit human proteases or major cytochrome P450 enzymes. It also worked synergistically with molnupiravir, an existing antiviral that targets RNA polymerase. Related analogs were effective against virus strains resistant to nirmatrelvir, the main component of Paxlovid.

 press release, Charles Craik, PhD, UCSF professor of pharmaceutical chemistry and co-corresponding author of the paper, said, “In three years, we’ve moved as fast as a pharmaceutical company would have, from start to finish, developing drug candidates against a totally new pathogen. These compounds could inhibit coronaviruses in general, giving us a head start against the next pandemic. We need to get them across the finish line and into clinical trials.”

Researchers emphasized the urgency of advancing these compounds to clinical trials, especially given the termination of a key federal grant that supported their development. The team believes these candidates could serve as shelf-stable countermeasures for future coronavirus outbreaks and offer a much-needed backup as new variants emerge.

“COVID was our wake-up call to apply all our resources and know-how toward new therapies and future pandemic preparedness,” said Nevan Krogan, UCSF professor of cellular and molecular pharmacology, co-author of the paper, and a leading expert on the biology of infectious disease. “The AViDD funding, which is now in peril, was poised to help us produce potent and necessary antivirals in record time.”

In other recent news, a phase 2 trial published in 

) showed no statistically significant improvement in physical health outcomes for patients with Long COVID. Although it remains effective in reducing mortality among immunocompromised patients, its limited utility in addressing persistent symptoms and its frequent adverse effects underscore the need for more potent and targeted antiviral options.

In contrast, AVI4516 and AVI4773 are novel main protease inhibitors that show enhanced potency, pan-coronavirus activity, and strong pharmacokinetics, including distribution to critical tissues like the brain. These compounds also remain effective against nirmatrelvir-resistant viral strains and exhibit synergy with molnupiravir, suggesting a next-generation therapeutic approach that could address some of the limitations seen with Paxlovid.

1. Detomasi T, et al. Structure-based discovery of highly bioavailable, covalent, broad-spectrum coronavirus MPro inhibitors with potent in vivo efficacy. 

.11,eadt7836(2025). doi:10.1126/sciadv.adt7836

2. Press Release. Could this molecule be “checkmate” for coronaviruses like SARS-CoV-2? UCSF’s Antiviral Drug Discovery (AViDD) Center develops powerful drug candidates that could head off future coronavirus pandemics. 

 April 23, 2025. Accessed April 22, 2025. 

https://www.eurekalert.org/news-releases/1081239

3. Sawano M, Bhattacharjee B, Caraballo C, et al. Nirmatrelvir–ritonavir versus placebo–ritonavir in individuals with long COVID in the USA (PAX LC): a double-blind, randomised, placebo-controlled, phase 2, decentralised trial. 

. Published April 3, 2025. doi:10.1016/S1473-3099(25)00073-8

The University of California San Francisco and Gladstone Institutes develop compounds with a 1,000,000-fold reduction in viral titers and 1000 times effective concentration in the brain.

This is part of an ongoing series looking at the impact of the COVID-19 pandemic on American public health.

investigators found antimicrobial resistance in hospitals declined from 2012 to 2019, but rose again during the acute COVID-19 pandemic years (2020-2021).

This observational study provided updated rate estimates for hospital-onset and community-onset antimicrobial-resistant infections caused by 6 pathogens in the US between 2012-2022. The CDC and the World Health Organization have identified these pathogens as high priority to be aware of and the need to address with the development of new treatments.

This study focused on the following pathogens:

Extended spectrum cephalosporin-resistant Escherichia coli and Klebsiella spp. (excluding Klebsiella aerogenes) (ESCR-EK) suggestive of extended-spectrum beta-lactamase production

Carbapenem-resistant Enterobacterales (CRE)


“The percentage resistant for MRSA, VRE, CRE, CRAsp, and MDR 

 was stable or decreased from 2012 to 2022,” the investigators wrote. “Among hospital-onset 

 spp, the percentage of ESCR-EK cases in nonsterile body sites increased from 12.2% (95% CI, 10.7%-13.6%) in 2012 to 19.7% (95% CI, 17.7%-21.7%) in 2022; and increased from 17.5% (95% CI, 14.4%-20.7%) to 24.5% (95% CI, 21.5%-27.4%) among normally sterile body sites.”

Lead author of the study, Hannah Wolford, who works in the CDC’s Epidemiology, Research, and Innovations Branch, spoke with 

on the study and the findings behind the increased resistance during the acute pandemic stage.



 How did changes in health care use during the COVID-19 pandemic contribute to the rise in hospital-onset resistant case rates

Antimicrobial-resistant hospital-onset infections increased during the COVID-19 pandemic compared to previous years, peaking in 2021. Changes to health care use during the COVID-19 pandemic, such as decreases in overall admissions, surges in high-risk patients with COVID-19, and higher proportions of very sick patients who did not have COVID-19 may have contributed to increased rates of antimicrobial-resistant hospital-onset infections.



CDC: Hospitals Experiencing Inconsistent Declines in Resistant Infections

Can you elaborate on which patient populations were most affected?
Wolford: 

In the majority of our study time period, rates for hospital-onset cases were highest among patients ages 55 to 74. This age group experienced increased rates of healthcare-associated antimicrobial-resistant infections during the pandemic and had the highest rates for every pathogen in 2020 and 2021. Males had higher antimicrobial-resistant infection rates throughout the study period for hospital-onset methicillin-resistant Staphylococcus aureus, carbapenem-resistant Enterobacterales, carbapenem-resistant Acinetobacter species, and multidrug-resistant Pseudomonas aeruginosa; however, both sexes experienced increased rates during the pandemic

What does the increase in average patient days per hospitalization from 2020 to 2022 indicate about patient health trends during and after the pandemic?
Wolford:

 We found an increase in average patient days per hospitalization in 2020 to 2022 compared with prior years. This suggests an increase in patients with high severity of illness that continued when COVID-19 hospitalizations declined and may reflect larger trends in an aging US population with increased chronic illness or a move to manage less acute patients in outpatient care.

In what ways did the pandemic impact infection control practices, and how might this have influenced antimicrobial resistance rates?
Wolford: 

The pandemic challenged the implementation of infection prevention and control practices. Activities such as contact precautions for patients with some resistant pathogens and monitoring excess antimicrobial use decreased during the pandemic, which may have led to increased antimicrobial resistance.

A Centers for Disease Control and Prevention study looked at the COVID-19 pandemic's effect on hospital-onset infections. Study lead author Hannah Wolford offers insights on it, including what patient populations were most affected, and the significance of infection prevention strategies. 



Daniel S Fierer, MD

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