Top 5 Infectious Disease News Stories Week of September 13-20

Gram-Negative Infections and the Evolving Paradigm for OPAT

Monica V. Mahoney, PharmD, BCPS, BCIDP, reports that outpatient parenteral antibiotic therapy for gram-negative infections is expanding to more clinically stable patients while posing new challenges from newer agents that require prolonged, irregular infusion schedules and have limited stability data for home compounding and weekly delivery. She stresses that stewardship in the outpatient setting begins with simple, feasible regimens that patients or caregivers can administer, since overly complex dosing undermines adherence and outcomes. Successful OPAT depends on formulary access, home infusion capacity, and coordination across sites such as clinics and rehabilitation facilities, with clear monitoring and follow-up. When stability, logistics, or patient factors cannot be managed safely outside the hospital, completing therapy as an inpatient is the appropriate decision.

Adoption of Rapid Diagnostic Tools, Susceptibility Testing for Gram-Negative Infections

Rodney E. Rohde, PhD, summarizes current diagnostics and susceptibility testing for gram-negative infections, noting persistent challenges such as rapid antimicrobial resistance, slower traditional methods, and limits of some rapid tests, while highlighting expanding tools including BioFire FilmArray for blood culture identification, Cepheid GeneXpert for carbapenemase genes, Verigene Blood Culture Gram-Negative, BD MAX Enteric panel, and the growing hospital use of MALDI-TOF for faster organism ID; he also points to emerging approaches like next-generation sequencing, CRISPR-based methods, artificial intelligence analytics, and point-of-care platforms to shorten time to effective therapy. He emphasizes that selecting and interpreting susceptibility tests for newer agents varies by site resources and patient factors, so clinicians should work closely with microbiology laboratories and pharmacists to choose the right profiles and align therapy. Rohde urges a team-based model that integrates providers, lab professionals, pharmacists, and other caregivers with clear communication and shared decision making, and he argues that interprofessional collaboration should be taught routinely in training programs to avoid siloed care.

Bone Changes and Inflammation After Hepatitis C Cure: 18-Month Outcomes

A prospective cohort study of adults cured of chronic hepatitis C with direct-acting antivirals found no significant 18-month changes in bone microarchitecture by HR-pQCT versus uninfected controls, while inflammatory markers IL-18 and TNF-α declined in the cured group, suggesting biologic improvement may precede detectable structural gains. In exploratory analyses, participants cured of HCV without HIV showed radius-site improvements in cortical porosity, stiffness, and failure load with concurrent cytokine declines, whereas those with HIV coinfection did not show consistent HR-pQCT benefits, a finding limited by small numbers. Methods included baseline and 18-month HR-pQCT at the radius and tibia, whole-body DXA for body composition, serum cytokines, and multivariable models adjusting for age, sex, appendicular lean mass index, visceral fat, and smoking. Limitations include modest sample size, withdrawals, peripheral skeletal sites that may not reflect axial changes, and an 18-month follow-up that may be too short to capture structural remodeling. Clinically, bone health surveillance after HCV cure remains important, DXA screening may be considered in at-risk patients, and longer follow-up studies are needed to determine whether inflammatory improvements translate into fracture-relevant structural benefits.

California Child Dies From Rare Measles Neurological Complication

Los Angeles County health officials reported that a school-aged child died of subacute sclerosing panencephalitis, a rare and uniformly fatal late complication of measles acquired in infancy before the child was eligible for vaccination, underscoring the importance of high community vaccination coverage. SSPE typically emerges 7 to 10 years after apparent recovery from measles, progresses with worsening neurologic decline, and leads to death within 1 to 3 years after diagnosis, with risk estimated at about 1 in 10,000 measles cases overall and as high as 1 in 600 after infant infection. The report comes amid the largest US measles surge in 25 years with 1,454 confirmed cases in 2025, highlighting risks to infants too young for routine MMR, individuals who are immunocompromised, and others who depend on herd immunity. Routine MMR is given at 12 to 15 months with a second dose at 4 to 6 years, and infants 6 to 11 months should receive a dose before international travel, while those under 6 months rely on maternal antibodies and community protection.

HHS and CDC Appoint 5 New ACIP Members Ahead of Fall Meeting

HHS and CDC announced five new ACIP appointments on September 15, 2025—Catherine M. Stein, PhD; Evelyn Griffin, MD; Hilary Blackburn, PharmD, MBA; Kirk Milhoan, MD, PhD; and Raymond Pollak, MD, FACS, FRCS—days before the September 18–19 meeting to consider votes on MMRV, Vaccines for Children items, hepatitis B, and a Friday session on COVID-19 epidemiology, effectiveness, safety, implementation, economics, and a vote. The appointees add expertise in epidemiology, obstetrics and gynecology, pharmacy access, pediatric cardiology, and transplant immunobiology. The announcement follows HHS actions in June 2025 to remove 17 ACIP members and install new ones, which prompted calls from professional groups for oversight and adherence to evidence-based processes. Agency statements emphasized transparency, independence, and evidence-based decision making as the panel reconvenes to set vaccine policy.