Publications by authors named "Mayur Ramesh"

Importance: Respiratory syncytial virus (RSV) vaccines for adults aged 60 years or older became available in 2023. One dose is recommended for all adults aged 75 years or older and those aged 60 to 74 years at increased risk of severe RSV; however, duration of protection is unknown.

Objective: To evaluate RSV vaccine effectiveness against RSV-associated hospitalization among adults aged 60 years or older during 2 RSV seasons.

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Article Synopsis
  • Dalbavancin is a long-lasting intravenous antibiotic that could be a viable alternative to standard treatments for complicated Staphylococcus aureus bacteremia, as it doesn’t require prolonged intravenous access.
  • The study compared the effectiveness and safety of dalbavancin against standard therapy across 23 medical centers and included hospitalized adults who had shown initial improvement.
  • Key outcomes measured included overall treatment success, safety complications, and impacts on quality of life, with preliminary findings suggesting dalbavancin may be as effective as traditional therapies.
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Background: Adults hospitalized with acute respiratory infections, including respiratory syncytial virus (RSV), often have multiple underlying conditions. Few data are available on the combined effect of conditions on risk of severe outcomes from RSV disease.

Methods: We enrolled adults hospitalized with RSV at 26 hospitals in 20 US states admitted January 2022-July 2024.

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Importance: Systemic antibiotic use for patients with a non-Clostridioides difficile infection (CDI) is a major risk factor for recurrent CDI. Increasing use of oral vancomycin for secondary prophylaxis against recurrent CDI in this context has uncertain efficacy.

Objective: To evaluate whether oral vancomycin prophylaxis compared with placebo is effective against recurrent CDI during and 8 weeks after the end of study treatment.

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Background: Despite guidelines recommending pretransplant immunizations for solid organ transplant candidates (SOTc), vaccine uptake is suboptimal. We evaluated the impact of an Infectious Disease Pretransplant (IDPT) clinic for improving vaccinations in SOTc.

Methods: A retrospective quality improvement study of SOTc seen in the IDPT clinic between January 2020 and February 2021 at the Henry Ford Transplant Institute.

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Background: The 2023-2024 influenza season included sustained elevated activity from December 2023-February 2024 and continued activity through May 2024. Influenza A(H1N1), A(H3N2), and B viruses circulated during the season.

Methods: During September 1, 2023-May 31, 2024, a multistate sentinel surveillance network of 24 medical centers in 20 U.

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Importance: In 2023, the first respiratory syncytial virus (RSV) vaccines were recommended for US adults 60 years or older, but few data are available about which patients were most likely to receive vaccine to inform future RSV vaccine outreach efforts.

Objective: To assess patient- and community-level characteristics associated with RSV vaccine receipt and patient knowledge and attitudes related to RSV disease and RSV vaccines.

Design, Setting, And Participants: During the first season of RSV vaccine use from October 1, 2023, to April 30, 2024, adults 60 years or older hospitalized with RSV-negative acute respiratory illness were enrolled in this cross-sectional study from 26 hospitals in 20 US states.

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza, and respiratory syncytial virus (RSV) are highly infectious respiratory viruses that affect people of all ages and are typically associated with mild symptoms and few complications in immunocompetent individuals. However, the risk of severe outcomes (e.g.

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Background: Clinical guidelines recommend initiation of antiviral therapy as soon as possible for patients hospitalized with confirmed or suspected influenza.

Methods: A multicenter US observational sentinel surveillance network prospectively enrolled adults (aged ≥18 years) hospitalized with laboratory-confirmed influenza at 24 hospitals during 1 October 2022-21 July 2023. A multivariable proportional odds model was used to compare peak pulmonary disease severity (no oxygen support, standard supplemental oxygen, high-flow oxygen/non-invasive ventilation, invasive mechanical ventilation, or death) after the day of hospital admission among patients starting oseltamivir treatment on the day of admission (early) versus those who did not (late or not treated), adjusting for baseline (admission day) severity, age, sex, site, and vaccination status.

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Article Synopsis
  • - This study aimed to evaluate the effectiveness of eravacycline (ERV) as an additional treatment for severe or fulminant Clostridioides difficile infection (CDI) in hospitalized patients from 2019 to 2023.
  • - A total of 75 patients were analyzed, with a significant portion suffering from severe or fulminant CDI, and approximately 14.7% required colectomy within 30 days of starting ERV treatment.
  • - The findings suggest that ERV could be a beneficial adjunct therapy for severe CDI, especially in immunocompromised patients, but further research is needed to confirm its effectiveness.
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Background: In test-negative studies of vaccine effectiveness (VE), including patients with co-circulating, vaccine-preventable, respiratory pathogens in the control group for the pathogen of interest can introduce a downward bias on VE estimates.

Methods: A multicenter sentinel surveillance network in the US prospectively enrolled adults hospitalized with acute respiratory illness from September 1, 2022-March 31, 2023. We evaluated bias in estimates of VE against influenza-associated and COVID-19-associated hospitalization based on: inclusion vs exclusion of patients with a co-circulating virus among VE controls; observance of VE against the co-circulating virus (rather than the virus of interest), unadjusted and adjusted for vaccination against the virus of interest; and observance of influenza or COVID-19 against a sham outcome of respiratory syncytial virus (RSV).

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Background: Assessments of COVID-19 vaccine effectiveness are needed to monitor the protection provided by updated vaccines against severe COVID-19. We evaluated the effectiveness of original monovalent and bivalent (ancestral strain and Omicron BA.4/5) COVID-19 vaccination against COVID-19-associated hospitalization and severe in-hospital outcomes.

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  • The study assessed the effectiveness of the updated 2023-2024 COVID-19 vaccine against hospitalization for two variant lineages, XBB and JN, in hospitalized patients across 26 hospitals in the U.S. between October 2023 and March 2024.
  • The results indicated a vaccine effectiveness (VE) of 54.2% against XBB and 32.7% against JN, suggesting that the JN lineage may have some level of immune escape.
  • However, the severity of cases with the JN lineage was not significantly worse compared to those with the XBB lineage, indicating similar risks of severe outcomes like ICU admission and death.
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Objectives: We aimed to assess whether there is a difference between ciprofloxacin and levofloxacin as prophylaxis in hematopoietic stem cell transplant (SCT) recipients.

Methods: This is a prospective, randomized trial in patients receiving SCT at Henry Ford Health in the United States of America. We randomly assigned patients (1:1) to receive ciprofloxacin or levofloxacin.

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Introduction: Recurrent Clostridioides difficile infection (rCDI) often occurs after standard-of-care antibiotics. VOWST oral spores (VOS, previously SER-109), an FDA-approved orally administered microbiome therapeutic, is indicated to prevent rCDI following antibiotics for rCDI.

Objective, Design, And Patients: To evaluate safety and efficacy of VOS from two phase 3 trials, (randomized, placebo-controlled [ECOSPOR III: NCT03183128] and open-label, single arm [ECOSPOR IV: NCT03183141]) of 349 adults with rCDI and prevalent comorbidities.

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Objective: Data evaluating timeliness of antibiotic therapy in infections (CDI) are not well established. The study's purpose was to evaluate the impact of time-to-CDI treatment on disease progression.

Methods: A case-control study was performed among hospitalized patients with CDI from 1/2018 to 2/2022.

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Importance: On June 21, 2023, the Centers for Disease Control and Prevention recommended the first respiratory syncytial virus (RSV) vaccines for adults aged 60 years and older using shared clinical decision-making. Understanding the severity of RSV disease in adults can help guide this clinical decision-making.

Objective: To describe disease severity among adults hospitalized with RSV and compare it with the severity of COVID-19 and influenza disease by vaccination status.

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Background: Exposure to antibiotics predisposes to dysbiosis and Clostridioides difficile infection (CDI) that can be severe, recurrent (rCDI), and life-threatening. Nonselective drugs that treat CDI and perpetuate dysbiosis are associated with rCDI, in part due to loss of microbiome-derived secondary bile acid (SBA) production. Ridinilazole is a highly selective drug designed to treat CDI and prevent rCDI.

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Background: Influenza circulation during the 2022-2023 season in the United States largely returned to pre-coronavirus disease 2019 (COVID-19)-pandemic patterns and levels. Influenza A(H3N2) viruses were detected most frequently this season, predominately clade 3C.2a1b.

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Article Synopsis
  • On June 21, 2023, the CDC recommended RSV vaccination for adults aged 60 and older based on shared clinical decision-making, highlighting the need for understanding RSV disease severity among this group.
  • A study involving 5,784 hospitalized adults aged 60+ with respiratory illnesses from February 2022 to May 2023 showed that although RSV was less common, it was associated with more severe health outcomes compared to COVID-19 and influenza.
  • The findings indicated that older adults hospitalized with RSV were more likely to require intensive oxygen support, ICU admission, and had higher rates of invasive mechanical ventilation or death compared to those hospitalized for influenza.
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Purpose Of Review: The human gut harbors a diverse community of microorganisms known as the gut microbiota. Extensive research in recent years has shed light on the profound influence of the gut microbiome on human health and disease. This review aims to explore the role of the gut microbiome in various clinical conditions and highlight the emerging therapeutic potential of targeting the gut microbiota for disease management.

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Article Synopsis
  • - As of April 2023, the COVID-19 pandemic resulted in 1.1 million deaths in the U.S., with 75% of those being adults aged 65 and older.
  • - A study evaluated the effectiveness of 2-4 doses of monovalent mRNA COVID-19 vaccines on preventing severe outcomes, finding a 62% effectiveness against invasive mechanical ventilation and in-hospital death for adults aged 18+, and 69% for those 65+.
  • - The vaccine effectiveness varied over time: 76% within the first 180 days after the last dose, dropping to 54% after 180-364 days and 56% after a year, emphasizing the importance of staying updated
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Importance: A safe and effective treatment for recurrent Clostridioides difficile infection (CDI) is urgently needed. Antibiotics kill toxin-producing bacteria but do not repair the disrupted microbiome, which promotes spore germination and infection recurrence.

Objectives: To evaluate the safety and rate of CDI recurrence after administration of investigational microbiome therapeutic SER-109 through 24 weeks.

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