IDSA’s Journal of Infectious Diseases provides a monthly roundup of JID papers with direct relevance to clinicians. Read on to learn more about how vaccination decreased the risk of severe COVID-19 in patients with a history of hematologic malignancy, threats to the diagnostic accuracies of MRSA detection and other research ready to inform clinical practice. (Titles and summaries are adapted from the February 2026 issue of JID.)
Optimizing On-Demand Tenofovir Disoproxil Fumarate/Emtricitabine Dosing in Women for HIV Prevention
Companion editorial: On-Demand Dosing of HIV Preexposure Prophylaxis for Women: Has Their Time Finally Come?
Despite the availability of long-acting products for HIV pre-exposure prophylaxis, some women prefer on-demand oral PrEP as a convenient and noninvasive alternative for HIV prevention. This study used an established pharmacokinetic/pharmacodynamic tissue model of tenofovir disoproxil fumarate/emtricitabine for PrEP and found that adding a fourth day of dosing to the three-day PrEP regimen currently approved for men/transgender women who have sex with men will be efficacious for on-demand dosing in cisgender women. The accompanying editorial highlights the importance of moving to fund and conduct efficacy trials of on-demand dosing for women.
COVID-19 Vaccine Effectiveness in Patients With Hematologic Malignancies: A Nationwide Cohort Study
In a Dutch cohort study of 4.6 million people, grouped by hematologic malignancy, solid malignancy or no malignancies, those with hematologic malignancies were at highest risk of severe COVID-19. SARS-CoV-2 vaccine effectiveness was up to 74% (95% confidence interval, 60% to 83%), modified by the SARS-CoV-2 variant period, the number of received vaccinations and the time interval since vaccination. Although COVID-19 vaccination lowered the risk of severe COVID-19 in those with hematologic malignancies, elevated risk remained.
Antimicrobial resistance
It is well-known that carbapenem-resistant Acinetobacter baumannii infections are challenging to treat. Using genotypic and phenotypic resistance profiles combined with static concentration time-kill assays, ampicillin/sulbactam plus ceftazidime/avibactam achieved up to ~ 90% reduction in bacterial burden. Avibactam enhanced sulbactam’s activity, demonstrating promising combined activity against highly resistant CRAB strains. Only three CRAB strains were analyzed, a study limitation.
Xpert (SCCmec) and BCID2 (SCCmec-orfx junction) are rapid molecular assays to detect methicillin-resistant Staphylococcus aureus; sequence variants can disrupt primer binding, yielding false-negative results. Investigation of a missed diagnosis revealed that misdiagnosis was restricted to clonal complex 5, a hospital-associated lineage. These observations underscore a threat to diagnostic accuracy for MRSA.
Non-HIV cryptococcal meningitis
In a small series (N = 13), corticosteroids were associated with improvement in neurological status and neuroinflammation in non-HIV, immunosuppressed patients with post-infectious inflammatory response syndrome following cryptococcal meningoencephalitis. Specifically, corticosteroid therapy was associated with significant improvements in Karnofsky scores at 1-12 months as well as resolution of neurological symptoms and improvement of cerebrospinal fluid inflammatory parameters. No cryptococcal meningoencephalitis relapse was identified.
In seven nonimmunocompromised patients being treated for post-infectious inflammatory response syndrome with high-dose corticosteroids following cryptococcal meningoencephalitis, opening pressures fell 14 cm, but the majority (N = 5) later required a ventriculoperitoneal shunt for pressure control. While clinical trials are needed, these articles support use of corticosteroid therapy for post-infectious inflammatory response syndrome and alert clinicians to the potential need for cerebrospinal fluid pressure control.