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Clinical Topics


Infectious Disease

VA Takes the Lead to Prevent Spread of Multi Drug-Resistant Organisms

The VA is leveraging its position as the country’s largest integrated healthcare system to slow the development and spread of multidrug-resistant organisms (MDRO).

Infectious Disease

VA-Led Study: Absenteeism Drops With Mandatory HCP Influenza Vaccines

New research is raising questions about whether the VA is doing enough to promote influenza vaccination of healthcare personnel.

Infectious Disease

E-consults Drive Increased Involvement of VA Infectious Disease Specialists

By Annette M. Boyle BOSTON—VA physicians in facilities across New England increasingly turn to infectious disease specialists at the VA Boston Healthcare System (VABHS) with questions about antibiotic resistance, Lyme disease and other issues, but... View Article

Infectious Disease

Expedited ART Significantly Lowers Viral Load in HIV Patients

By Brenda L. Mooney BETHESDA, MD—When it comes to treating acute HIV infection, sooner is better, noted a new study led by U.S. military researchers. The study, published in the Journal of the International AIDS... View Article

Infectious Disease

DoD Policies Ensure Sufficient Yellow Fever Vaccine Despite Global Shortage

In mid-2016, Sanofi Pasteur announced that manufacturing issues could produce a YF-VAX shortage that might last for several months.

Infectious Disease

HIV Infection Linked to 40% Increase in Veterans’ Risk of Developing Heart Failure

Antiretroviral therapy has extended the lives of veterans with human immunodeficiency virus (HIV) by decades, but a new threat could cut back their longevity.

Infectious Disease

VA Could Soon Achieve ‘Near Complete Eradication’ of Hepatitis C

Over the next year or so, the remarkable transformation of hepatitis C (HCV) treatment at the VA will likely reach some type of equilibrium, a new study suggested.

Infectious Disease

VA Research: Vancomycin Lowers Death Rates in Severe C. Diff Infection

SALT LAKE CITY — Severe illness caused by the bacteria Clostridium difficile (C. diff) is now the most common hospital-acquired infection in the United States. A new VA-led study suggests, however, that it is not always being treated appropriately.

Infectious Disease

Infectious Disease Specialist Uses Telehealth for Rural Veterans With HIV

Veterans living in rural areas face a lot of challenges, the most common of which is having to travel long distances to access VA medical care.

Infectious Disease

Don’t Forget Leishmaniasis When Servicemembers Have Mysterious Symptoms

Military physicians stumped by a diagnosis might want to consider leishmaniasis in personnel returning from Iraq or Afghanistan, according to a new report.

Infectious Disease

Eight Years Later, VHA’s ‘MRSA Bundle’ Continues to Push Down Infection Rates

When the VHA implemented a nationwide prevention initiative against methicillin-resistant Staphylococcus aureus (MRSA), healthcare facility-associated infections (HAIs) were unacceptably high.

Infectious Disease

Low Vitamin D Doesn’t Explain Low Flu Vaccination Response in HIV Patients

BETHESDA, MD – While vaccination is the most important preventive strategy against influenza, post-vaccination antibody responses are often inadequate, especially among HIV-infected persons, according to a new study. The report, published recently in the journal Vaccine,... View Article

Infectious Disease

Percentage of Flu Vaccines Obtained At Pharmacies Up, Not Overall Rate

In the not-too-distant past, influenza vaccines could only be obtained in clinics or physicians’ offices. That changed over a 14 year period from 1996 to 2010 when 41 states changed statutes to allow pharmacists to provide immunizations.

Infectious Disease

Hospital Stays Drop With Early Antivirals for Pregnant Women With The Flu

How beneficial is early initiation of influenza antiviral treatment administered to pregnant women hospitalized with laboratory-confirmed influenza?

Infectious Disease

Timing of Flu in HIV Patients Vaccinated Early

SAN DIEGO – Past research has shown that patients with HIV infection vaccinated early in the flu season are generally more likely to contract influenza or influenza-like illness (ILI), compared with those receiving late vaccination.... View Article

Infectious Disease

Staph, Influenza Co-Infection Increases Mortality

IOWA CITY, IA – Co-infection with Staphylococcus aureus and influenza more than quadruples the risk of death compared to those without influenza, according to a new study. The article published recently in the national Centers... View Article

Infectious Disease

VA Healthcare Workers Have Relatively Low Flu Vaccine Rates

ANN ARBOR, MI—Multiple national recommendations encourage all healthcare workers to get the influenza vaccination, thereby reducing the chance they will pass the virus on to their patients. Despite a patient population of older and sicker... View Article

Infectious Disease

For Veterans and Armed Forces, Risk Remains Despite Flu Shots

While influenza vaccine is the first line of defense against an infectious disease that can dramatically affect troop readiness, it is far from 100% effective.

Infectious Disease

Despite Legislative Complaints, Media Frenzy, TB Outbreak Never Occurred at VA Facilities

In February, five U.S. representatives from California blasted the VA in a letter to Secretary Robert McDonald, alleging the Palo Alto Medical Center failed to follow public health protocol regarding potential tuberculosis (TB) exposure.

Infectious Disease

Army Research Produces Zika Vaccine Candidate in Record Time

Drawing on deep experience with flaviviruses that started with its namesake’s research on yellow fever in the 1800s, the Walter Reed Army Institute of Research (WRAIR) and collaborators brought two Zika vaccine candidates through early testing in just four months this spring.

Infectious Disease

When Should Physicians Recommend HIV Pre-Exposure Prophylaxis to Patients?

ANN ARBOR, MI — Oral pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) gained Food and Drug Administration approval in 2012, and many commentators hailed the therapy as a “once-in-a-generation” advance.

Infectious Disease

Turning the Tide on Rising VA Hepatocellular Carcinoma Rates

HOUSTON — After a decade of dramatically rising rates of hepatocellular carcinoma (HCC) among veterans, aggressive treatment of hepatitis C infections (HCV) appears poised to turn the tide.

Infectious Disease

VA, DoD Adopting Earlier HIV Treatment to Dramatically Reduce AIDS Risk

Pre-infection Immunological Health Achieved in Some CasesBy Annette M. Boyle SAN ANTONIO — For years, clinicians have not recommended treating human immunodeficiency virus (HIV) patients with antiretroviral therapy (ART) before they saw a significant drop... View Article

Infectious Disease

Hospitals’ Routine Use of PPIs Increases Risk of Inpatient Pneumonia, C. Diff

VA Researchers Recommend Against the Practice in Most CasesBy Brenda L. MooneyANN ARBOR, MI — In a case where the preventive measure might be worse than the avoided outcome, hospitals at the VHA and elsewhere... View Article

Infectious Disease

What Factors Increase Post-Surgical C. Diff Risk at VHA?

New Research Uncovers Some Clues to Aid PreventionBy Brenda L. MooneyWASHINGTON — As the VHA works to reduce the overall post-operative rate of Clostridium difficile infection (CDI), important new research has uncovered some clues to... View Article

Infectious Disease

Cirrhosis Expected to Peak by 2021 in VA; Liver Cancer Epidemic Continues

For the VA, the combination of effective treatment options and much lower prevalence of HCV in younger veterans may offer a light at the end of the tunnel — and a turning point in the steady rise of HCV-associated complications such as cirrhosis and hepatocellular carcinoma (HCC) in only a few years.

Infectious Disease

For Treated Patients, HIV Status No Greater Risk for Surgery Than Older Age

Subhead: Post-operative Mortality Rates Low Among ART UsersBy Annette M. BoyleWEST HAVEN, CT — Historically, high post-operative mortality rates among HIV-infected patients caused many physicians and patients to defer or avoid surgery all together. For... View Article

Infectious Disease

Individual Prescriber Preferences Contribute to VA’s Antibiotic Overuse

By Brenda L. MooneySALT LAKE CITY — A study conducted in the VA health system uncovered a disturbing truth about overuse of antibiotics: A big contributor to the problem is that some clinicians prescribe the... View Article

Infectious Disease

VA Expands Initiatives to Prevent Multi-Drug Resistant Organism Infection

The VA’s methicillin-resistant Staphylococcus aureus (MRSA) prevention initiative reduced healthcare-associated MRSA infections 69% in VA acute care facilities and 81% in spinal cord injury units in five years. The VA hopes to see similar success in preventing infections with Clostridium difficile (CDI) and carbapenem-resistant Enterobacteriaceae (CRE) — and the MRSA bundle itself may help them do that.

Infectious Disease

Air Force Recruits Show Reduced Levels of Immunity to Common Diseases

Lower immunization rates have increased the number of U.S. outbreaks of vaccine-preventable diseases, even of those considered eradicated in this country, such as measles.

Infectious Disease

VA Study Finds High-Dose Flu Vaccine Better Only for Veterans 85 or Older

Research Contradicts Other Recent FindingsBy Brenda L. MooneyPHILADELPHIA — As the latest influenza season finally abates, a new VA study raises questions about how effective the high-dose vaccine really is for the 65 or older... View Article

Infectious Disease

Despite Outcry About Cost, New HCV Therapies Likely to Save Money at VA

Amid all the outcry over the high cost of new hepatitis C therapies, including congressional hearings, a simple fact has been overlooked: The VA expects to save money in the long run because of the... View Article

Infectious Disease

DoD Takes Lead Role in Push for Ebola Vaccine

WASHINGTON — When dozens of patients suffering with fever, severe diarrhea, hemorrhage and vomiting started dying in Guinea in early 2014

Infectious Disease

VA Fails to Follow Guidelines on Hepatitis B Follow-Up Testing Rates, Treatment

By Brenda L. Mooney BOSTON – Rates of serologic testing for hepatitis B (HBV) at the VA fail to meet levels recommended by the American Association for the Study of Liver Diseases (AASLD) practice guideline,... View Article

Infectious Disease

Danger of Pneumonia Increases with Veterans’ Worsened Health Status

Higher Pneumonia Vaccine Rates Urged By Brenda L. Mooney PROVIDENCE, RI – With influenza season each year comes an even greater challenge for VA hospitals — a spate of pneumonia cases in older veterans. Recent... View Article

Infectious Disease

Partnerships, Drive-Throughs Seek to Increase Veterans’ Flu Immunization

Free Shots Available at Walgreen’s Locations By Annette M. Boyle SAN FRANCISCO – The VA typically has influenza vaccination rates well above the national average but is trying some innovative measures to do even better. As part of... View Article

Infectious Disease

Despite High Costs, VA Makes Sure Veterans Have Access to Newest HCV Drugs

By Annette M. Boyle WASHINGTON – While commercial insurers responded to the approval of the breakthrough drug sofosbuvir for hepatitis C (HCV) by implementing prescribing restrictions, limiting use to the sickest patients and charging higher... View Article

Infectious Disease

Evolution of Pioneer DCVAMC Clinic Tracks AIDS/HIV Treatment Through the Years

By Stephen Spotswood WASHINGTON – When the first Infectious Disease Clinic took place at the Washington, DC, VAMC in 1985, only a handful of HIV-infected patients took advantage. In fact, the disease hadn’t even been... View Article

Infectious Disease

Computer Model: HCV, Associated Cancer Will Be Rare by 2036

By Brenda L. Mooney PITTSBURGH – Will hepatitis C become a rare disease over the next two decades or so? The answer is yes, according to a computer simulation conducted by the University of Pittsburgh... View Article

Infectious Disease

After Lackland Bat Infestation, 200 Air Force Trainees Received Rabies Prophylaxis

SAN ANTONIO - The largest ever military investigation of rabies exposure involved more than 900 Air Force personnel interviewed and 200 receiving post-exposure prophylaxis (PEP) at a cost of about $400,000.

Infectious Disease

DoD Plays Role in Helping Contain Ebola Outbreak; Seeks a Cure

WASHINGTON - As the U.S. public health community desperately seeks to help contain what experts say is the largest Ebola outbreak in history and the first in West Africa, DoD also is monitoring the situation closely and has created an internal task force to “further review the situation.”

Infectious Disease

Azithromycin Saves Lives of Older Pneumonia Patients Despite Cardiac Risks

By Brenda L. Mooney DALLAS – The suspected link between azithromycin and an increased incidence of cardiovascular events was borne out in a recent VA study of veterans hospitalized with pneumonia, but that was only... View Article

Infectious Disease

Mostly Preventable Surgical-Site Infections Double VA Treatment Costs

By Brenda L. Mooney IOWA CITY, IA – In addition to increasing mortality and morbidity, surgical-site infections (SSIs) nearly double the cost of treatment of patients at the VA yet usually are preventable with good... View Article

Infectious Disease

Study: VA Clinicians Should Consider Antibiotic Risks Before Prescribing

By Brenda L. Mooney COLUMBIA, SC — Veterans prescribed amoxicillin over a nearly 13-year period were less likely to be diagnosed with potentially fatal heart rhythms than those using either azithromycin or levofloxacin, according to... View Article

Infectious Disease

Universal Screening Key to Continued MRSA Rate Decline at VAMCs

By Brenda L. Mooney LEXINGTON, KY —  The VA requirement to obtain nasal surveillance swabs on all patients at hospital admission, unit-to-unit transfer and discharge appears to be a key component of the continued decline... View Article

Infectious Disease

Few HIV Patients at VA Reduce Risks by Achieving Undetectable Viral Loads

By Annette M. Boyle Jeffery McCombs, PhD LOS ANGELES — While achieving undetectable viral loads reduces the risk of death associated with hepatitis C by 45% and other adverse liver-related complications by 27%, only 4%... View Article

Infectious Disease

VA Clinicians Optimistic about Effectiveness of New HCV Drugs

By Annette M. Boyle David Ross, MD, PhD WASHINGTON — New therapies for hepatitis C (HCV) are pouring out of the pharmaceutical pipeline and promising effective treatment with fewer side effects for many of the... View Article

Infectious Disease

With HIV Treated as Chronic Disease, Adherence Challenges Develop

By Annette M. Boyle Amy Justice, MD, Ph.D NEW HAVEN, CT — With human immunodeficiency virus (HIV) now being treated more like diabetes, hypertension and other chronic diseases, HIV patients face some of the same... View Article

Infectious Disease

DoD Ahead of Curve on Emerging Respiratory Syndrome in Middle East

Annette M. Boyle SILVER SPRING, MD – While no cases of Middle East respiratory syndrome coronavirus (MERS-CoV) have occurred in the United States or among U.S. servicemembers, DoD is taking no chances on missing any... View Article

Infectious Disease

With Wars’ End, Human-Use Protocol Approved for Acinetobacter Antibiotic

By Brenda L. Mooney BETHESDA, MD – After years of red tape, the military finally has received approval to proceed with the human-use protocol for Arbekacin, an antibiotic shown in laboratory tests to be effective... View Article

           

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