Infectious Diseases

SMI associated with higher infection mortality, largest increases for GI and respiratory infections

In a UK primary care cohort of 84,494 people with severe mental illness (SMI) matched to controls, SMI raised adjusted infection mortality risk (aHR 1.58). Cause‑specific risks were increased for respiratory (aHR 1.69), gastrointestinal (aHR 2.01), and renal/urinary infections (aHR 1.70). Authors recommend prioritizing this population for preventive measures including influenza and pneumococcal vaccination. Applicability is to UK population‑based primary care cohorts; residual confounding and healthcare access differences may influence results. 1

3‑month rifapentine+isoniazid non‑inferior to 9H for LTBI in high‑risk rheumatic disease patients

In 536 immunosuppressed adults with high‑risk rheumatic disease and LTBI, the 3‑month 3HP‑PUMCH regimen had 0 of 249 TB events versus 3 of 260 in 9H, meeting non‑inferiority margins. Adverse drug reactions were numerically lower with 3HP (9.6% vs 15.0%) and hepatotoxicity was lower (4.4% vs 10.4%, p=0.010). Treatment completion was high in both arms (89.6% vs 91.2%). The trial was open‑label and multicenter; check for drug‑drug interactions with immunosuppressants before prescribing. 2

Extended‑release buprenorphine linked to lower bacteremia and utilization versus transmucosal formulations

In a large retrospective cohort (weighted N≈437 BUP‑XR vs 118,104 TM‑BUP), BUP‑XR was associated with a 62% reduction in bacteremia incidence (95% CI 26%–81%). BUP‑XR recipients had substantially lower healthcare utilization, including 56% fewer inpatient visits and 22% fewer ED visits during follow‑up. Study used IPTW to adjust for confounding but remains observational and subject to residual confounding. Consider BUP‑XR as part of harm‑reduction and infection‑prevention strategies in people with OUD, while recognizing limited causal inference. 3