Complicated UTI in adults (IDSA 2025 guideline)

A JAMA Clinical Guidelines Synopsis (19 Oct) of the US guideline: a handy exam-revision summary; compare with NICE/UK practice. No new UK SMI, Green Book, NICE infection/AMR or EUCAST changes (EUCAST’s latest news is still the 13 Oct VetCAST and 7 Oct paediatric dosing proposal items; breakpoints remain v16.1).

• CDC Level 1 Ebola travel notice for Kenya (19 Oct): relevant to pre-travel advice and assessing returning travellers (see CDC below).
• Still open: the UKAP consultation on healthcare workers living with HIV who perform exposure-prone procedures (closes 8 Nov 2026).
• Still current: MHRA DSI/2026/014 on echinocandins with CRRT (see UK section).

JAMA synopsis › · UKAP consultation ›

DRC 9,455 / 4,561 (data to 17 Oct); all 8 Kenya cases included

• DRC: +178 cases / +83 deaths since ECDC’s 16 Oct update. Confirms Nord-Ubangi (Wapinda) as the 8th affected province.
• Summarises all 8 Kenya cases, including 1 death.
• ECDC’s modelling still puts the risk of importation into the EU/EEA at very low, with the caveat that returning healthcare workers have substantially higher exposure risk.

The Communicable Disease Threats Report for week 42 (16 Oct) is still the latest; week 43 is expected around 23 Oct. No new Eurosurveillance issue since 15 Oct (next expected Thursday 22 Oct).

ECDC Ebola ›

DRC: 9,552 confirmed, 4,602 deaths (data to 18 Oct, published 19 Oct)

• SitRep 156 (data to 17 Oct, published 18 Oct): 9,455 / 4,561; +40 / +25 on SitRep 155 (9,415 / 4,536).
• SitRep 157: +97 cases / +41 deaths (Nord-Kivu 48, Ituri 42, Haut-Uélé 7); CFR 48.2%. Hotspot zones: Beni 18, Vuhovi 15, Bunia 14. 30 of 41 deaths were in the community. Test positivity 19.4% (97/500).
• Recovered 2,550; 937 patients in Ebola treatment centres. 7-day average 69.6 cases/day, up from 66.0 the week before. Contact follow-up 76.9% (target 85%).
• Nord-Kivu treatment centres are over capacity (450 patients, 410 beds), and decontamination teams were assaulted in Beni.
• Ervebo vaccinations total 8,353 since 26 Aug. No new health zone since 16 Oct: still 66 zones in 8 provinces.

Check before quoting: these figures come from the ebola-tracker.org SitRep summaries and PDF, not from WHO. Ervebo is a vaccine against Zaire ebolavirus, and the digest doesn’t explain its role in this Bundibugyo outbreak.

SitRep 156 summary › · SitRep 157 summary › · PDF › · SitRep archive ›

Kenya: 8 confirmed cases, 1 death

• No ninth case reported at compile time.
• Director-General Patrick Amoth said all seven earlier patients have received monoclonal antibodies and are responding well. The eighth case (a 49-year-old patient attendant) is isolated.
• Officials still say transmission is limited to contacts of the index case. As of 17 Oct, 128 of 130 contacts of the index patient had been traced.
• There is still no approved vaccine or specific treatment for Bundibugyo virus.

Press-reported: from health ministry briefings via the media; no official ministry sitrep was retrieved.

New National Star › · AP ›

No Disease Outbreak News on Kenya’s secondary cases

The latest DON is MERS-CoV, Saudi Arabia (15 Oct); the last Ebola DON was 8 Oct.

WHO DON ›

Oropouche virus infection in pregnancy, Rio de Janeiro (prospective cohort)

544 pregnant women: 130 with confirmed infection, 143 possible and 271 uninfected. Adverse maternal outcomes 18% vs 7% (aRR 2.90). Fetal loss (aRR 3.08) and haemorrhage (aRR 2.79) were about three times more common; aRR for adverse infant outcomes 9.18. CNS abnormalities in 8% of infants of infected mothers vs none in the uninfected group. Symptoms did not predict adverse outcomes. An accompanying comment discusses inequality in these outcomes.

Takeaway: relevant to counselling pregnant travellers to Oropouche-affected areas and to testing in pregnancy.

Article › · Comment ›

Procalcitonin in severe community-acquired pneumonia (12-hospital US cohort)

In 1,553 admissions, PCT testing within 24 h was linked to modestly fewer antibiotic days (6.9 vs 7.4; adjusted difference −0.5 days). The effect was larger in clinically stable patients (−0.8 days), and low PCT (<0.5 µg/L) was linked to 1.1 fewer days than high PCT. Testing was done regardless of clinical stability; the authors suggest reserving it for stable patients.

Article ›

IV-to-oral switch in bloodstream infection (two multicentre cohorts)

Of 2,770 patients, 742 (19.4%) were eligible for IVOS, but only 32.3% were switched by day 7, often on the day of discharge. Diabetes, CKD, Pitt score ≥2 and septic shock were barriers; a urinary source favoured switching. IVOS was linked to a shorter stay (7 vs 12 days) and lower 28-day mortality (observational).

Takeaway: supports building IVOS prompts into AMS rounds.

742 of 2,770 is 26.8%, not 19.4%, so one of these figures may be wrong in the digest. Check the paper before quoting.

Article ›

Carbapenem-resistant Acinetobacter baumannii ICU outbreak (Turkey)

Recognised clinically over 6 days, but index patients had been colonised up to 41 days earlier. CRAB was found on high-touch surfaces; 6 of 7 patients died (4 CRAB-attributable). Prior A. baumannii isolation was the only independent risk factor. The epidemic clone reinfected treated patients up to 3.5 months later.

IPC lessons: extended environmental decontamination and isolation, and long-window typing.

Article ›

Extrapulmonary TB mortality by site (777,512 Indian adults)

In-treatment mortality varied more than tenfold by site. Compared with lymph-node TB, it was highest for TB meningitis (aOR 12.48), miliary TB (5.17) and pericardial TB (3.86).

Article ›

Fleming Fund (UK-funded) AMR surveillance in LMICs

A series reviewing ten years of the £498 million programme across 25 countries (One Health design, data use, governance). Policy background only.

Example paper ›

Successive syphilis episodes in people with HIV (Madrid prospective cohort)

362 episodes in 183 people. The 12-month serological response was similar across episodes (75–83%), but serofast status rose with repeat episodes (33% → 62–64%) and seroreversion fell. Not explained by treatment failure or neurosyphilis.

Takeaway: interpret persistent RPR titres after reinfection with care.

Article ›

Zoster vaccination in immune-mediated inflammatory diseases (meta-analysis, 26 studies)

Recombinant zoster vaccine efficacy 90.5%; disease flares not significantly increased (RR 1.05). Reactogenicity was higher with RZV.

Takeaway: supports Shingrix use in IMID patients on immunosuppression (cf. Green Book shingles chapter).

Article ›