Editor’s Note: The IDWeek 2023 took place in Boston from October 11 to 15. On the first day during the “What’s Hot in ID + HIV” session, Dr. Patty W. Wright, from Vanderbilt University Medical Center, presented an insightful report on recent significant research in the field of infectious diseases.
Dr. Patty W. Wright, MD
Professor of Medicine at the Vanderbilt University School of Medicine
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IDF: Could you please introduce the presentation you delivered at this year’s IDWeek?
Dr. Patty Wright: At this year’s IDWeek conference, I participated in the “What’s Hot in ID + HIV” session and presented on hot topics in the field of infectious diseases. I discussed some recent important research findings. Firstly, I introduced the TB-PACTECAL study published in NEJM last year. This study indicated that a 24-week all-oral regimen is non-inferior to standard treatment in multidrug-resistant tuberculosis patients and has better safety profiles.
Also, an article published in JAMA compared the antimicrobial prophylactic effect of piperacillin-tazobactam to cefoperazone during pancreaticoduodenectomy and showed that the piperacillin-tazobactam group had a lower postoperative surgical site infection rate.
Of course, we talked about RSV vaccines and their success, as well as how to encourage vaccination for patients aged 65 and older and how pregnant women can prevent severe RSV infections in their babies.
Two articles published in “Clinical Infectious Diseases” discussed the phase 3 trials of sulopenem for treating complicated urinary tract infections. Sulopenem is an oral carbapenem-class drug, and the research showed clinical improvement but no microbiological improvement. As a result, the FDA has not yet approved it, so we are still waiting for oral carbapenems.
The ATTACK study, published in “Lancet Infectious Diseases,” explored the efficacy and safety of sulbactam-durlobactam (SUL-DUR) compared to colistin for treating Baumannii-calcoaceticus complex infections, showing lower 28-day all-cause mortality with SUL-DUR compared to colistin. The FDA has already approved this therapy for severe bacterial infections.
A randomized trial published in JAMA compared letermovir and valganciclovir for prophylactic treatment of CMV infection in high-risk kidney transplant recipients, with non-inferiority demonstrated. Letermovir had previously been approved for CMV prevention in stem cell transplant recipients.
A very interesting study published in JAMA observed children with acute sinusitis, either worsening or with persistent symptoms. The study found that the color of the patients’ nasal secretions did not affect the likelihood of improvement with antibiotics. In fact, the ability to culture pathogens from their nasal swabs was the most significant factor in determining whether antibiotics were beneficial.
There is an excellent article (the PALACE study published in the JAMA Internal Medicine journal) that explores how to determine whether low-risk patients in the PEN-FAST study can use oral antibiotics directly without the need for skin testing.
A great article from the “NEJM” focused on the use of hydrocortisone in treating severe community-acquired pneumonia (sCAP). In patients with sCAP treated in the ICU, the hydrocortisone treatment group had a lower 28-day mortality risk compared to the placebo group. We observed the benefits of this treatment in reducing mortality, so it’s essential to consider using hydrocortisone as adjunct therapy for sCAP.
I believe these studies I mentioned were the true highlights of my presentation.
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IDF: Can you briefly discuss the recent developments in the field of infectious diseases that particularly interest you?
Dr. Patty Wright: From the perspective of clinical events occurring due to climate change in the United States, I think it’s essential to keep an eye on what will happen with malaria and whether we will see a resurgence of malaria in the southern United States. This is definitely something worth monitoring.
Additionally, we can observe that Vibrio vulnificus infections, a bacterium found in marine environments, are spreading from the Gulf of Mexico coastline to the eastern seaboard of the United States. So, in the coming years, it’s crucial to see how climate change impacts and alters infectious diseases.
