IDSA’s Journal of Infectious Diseases provides a monthly roundup of JID papers with direct relevance to clinicians. Read on to learn more about a prospective multicenter study investigating postnatal cytomegalovirus infection in preterm infants, how rates of invasive pneumococcal disease since the COVID-19 pandemic in two American Indian communities shape vaccine recommendations and other research ready to inform clinical practice. (Titles and summaries are adapted from the October 2026 issue of JID.)
pCMV infection is a major concern in extremely preterm infants, but clinical and immune factors involved in transmission are unclear. Among 139 infants, 84 (60%) had seropositive mothers. pCMV occurred in 14 cases of which 13 (15%) were from seropositive mothers. Risk factors included short gestational age, repeated antenatal betamethasone administration, and high breast milk CMV load. Notably, 46% (6/13) of infants with pCMV experienced prolonged premature rupture of membranes (> 1 week), suggesting intrapartum transmission and challenging breast-milk-only transmission. Maternal serum and breast milk neutralizing antibodies were not predictive of pCMV. Modern obstetric management promoting fetal maturation may inadvertently increase pCMV risk.
Previous clinical studies of short-term direct-acting antivirals have yielded suboptimal cure rates. In this study, time to cure with DAAs was mathematically modeled in about 300 individuals with recent (duration <12 months) or chronic infection, yielding 200,000 parameter combinations of viral-host and treatment parameters. Response-guided treatment strategies were assessed based on whether HCV RNA was undetectable on day 7 or day 14 on-treatment and predicted that treatment duration could be shortened to 5 or 7 weeks for people with recent or chronic infection with undetectable HCV RNA at day 7 or day 14 of treatment, respectively. If validated, these results could improve treatment access, facilitate HCV elimination and reduce cost, particularly in key populations most affected by HCV, such as people who inject drugs.
RSV causes excess hospitalizations and deaths in older adults, and prevention is mediated by neutralizing antibodies. The concept of immunity debt (i.e., loss of adequate preventive immunity in a population due to reduced exposure to a pathogen) is controversial. Here the authors asked whether adults lost protective antibodies when RSV was not circulating in Houston during the SARS-CoV-2 pandemic. In a study of 100 adults from a longitudinal cohort (50 SARS-CoV-2 seronegative and 50 SARS-CoV-2 infected, 2020-2021), seronegative and infection groups exhibited similar geometric mean neutralizing antibody titers against RSV/A and RSV/B strains in three blood samples over a mean of 309 days. The absence of antibody waning suggested that protective RSV antibodies are intrinsically stable and do not require frequent recurrent viral exposure for maintenance.
Incidence of IPD in American Indian communities in the Southwest U.S. declined during the COVID-19 pandemic. However, IPD rates increased from 2022 to 2024 to pre-pandemic levels; from 45.9 to 62.1 per 100,000 in the Navajo Nation and 52.9 to 84.4 in the White Mountain Apache tribal lands. Among adults in the Navajo Nation, serotype 4 accounted for 28.5% of cases and occurred primarily among younger unvaccinated males whereas no cases of serotype 4 were identified in the White Mountain Apache tribal lands. These findings can inform vaccine recommendations and highlight the value of surveillance for prevention efforts.
Editor’s note: See also this Editor’s Choice article: Lineage Dynamics and Risk Factors Underlying Serotype 4 Invasive Pneumococcal Disease in Spain. This paper describes a rise in IPD due to serotype 4 that initially affected nonvaccinated young individuals associated with high rates of tobacco smoking, alcohol and inhaled drugs followed by a general distribution through the country in the following years that affected adults ≥ 65 years old.
