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Background As the COVID-19 pandemic has exhausted the healthcare system and economic infrastructures, controlling measures are directed toward population-based strategies including individual’s hygiene and safe socializing. We conducted this study to identify individual’s factors at the population level which are associated with the risk of infection with SARS-CoV-2 in a middle-to-low income country. Methods A prospective case-control study was conducted to compare the demographics, socioeconomics, and individual’s behavior between patients with COVID-19 and randomly selected healthy controls from the same population referring to a general hospital in northwest Iran. Results Data of 250 patients with a positive RT-PCR test for COVID-19 was compared with 250 healthy controls between March 1st and May 15th (Table1). Higher education, better socioeconomic status, having access to the internet or following relevant news, having an obsession for cleanliness especially regular hands washing with alcohol-based disinfectants, wearing masks in public especially those with an N-95 filter, complying with stay-home orders, and receiving the flu shot over the past season were protective against contracting COVID-19. On the contrary, cigarette smoking or opium consumption, a history of recent travel, having an individual with infection with SARS-CoV-2 within the household, and recent hospitalization were associated with COVID-19. Table1. Comparison of individual’s factors between COVID-19 positive and negative patients Conclusion Individuals’ characteristics at a family or public level can guide healthcare authorities and lawmakers in their ongoing endeavors toward controlling the COVID-19 pandemics, especially in low-to-middle income regions. Disclosures All Authors: No reported disclosures

Objective Diabetic patients have an elevated risk of infection, but the optimal level of glycemic control with the lowest infection risk remains unclear, especially among the elderly. We aimed to investigate the relation between fasting plasma glucose (FPG) level and risk of infection-related morbidity and mortality. Method The participants were from a community-based health screening program in northern Taiwan during 2005–2008 (n = 118 645) and were followed up until 2014. Incidence of hospitalization for infection and infection-related death was ascertained from the National Health Insurance Database and National Death Registry. Cox proportional hazards regression modelling was used to estimate the hazard ratio (HR) between FPG and risk of infection. Results During a median follow-up of 8.1 years, the incidence rate of hospitalization for any infection was 36.33 and 14.26 per 1000 person-years among diabetics and nondiabetics, respectively, in the total study population, but increased to 70.02 and 45.21 per 1000 person-years, respectively, in the elderly. In the Cox regression analysis, the adjusted HR comparing diabetics to nondiabetics was 1.59 (95% confidence interval [CI], 1.52–1.67) for any hospitalization for infection and 1.71 (95% CI, 1.36–2.16) for infection-related mortality. The hazard for infection morbidity and mortality was higher at both extremes (200 mg/dl) of FPG. The excess risk associated with FPG ≤ 90 mg/dl was attenuated after controlling for multiple comorbidities. Conclusions Poor glycemic control (FPG > 200 mg/dl) was associated with a higher risk of infection-related morbidity and mortality, especially in the elderly population where the baseline infection risk was high., Few studies have longitudinally assessed the association between glycemic control and risk of infection mortality. In this study, a U-shaped relation between fasting plasma glucose level and infection-related outcome was observed. After controlling for multiple comorbidities, the increased risk among those with a low fasting glucose level were attenuated, suggesting that comorbidities may play a role in the excess risk associated with low fasting plasma glucose level, in particular among elderly diabetic patients.

Background Vibrio cholerae, the causative agent of cholera, is a major cause of diarrhea worldwide. Children under the age of 5 have the highest disease burden of cholera. Vibriocidal antibody responses following natural infection and oral cholera vaccination (OCV) are associated with protective immunity, but whether this holds uniformly true in young children is not known. Methods Household contacts of cholera patients are at high risk of V cholerae infection. We measured the association between baseline vibriocidal titer and the subsequent risk of infection in 50 household contacts

Background We aimed to assess the risk of subsequent infection among patients colonized by CPE. Methods The Toronto Invasive Bacterial Diseases Network (TIBDN) has conducted population-based surveillance for CPE colonization/infection in Toronto and Peel region, Ontario, Canada, since CPE were first identified (2007). All laboratories report all CPE isolates to TIBDN. Clinical data are collected via patient interview and hospital chart review. Initially colonized patients are followed for 5y; subsequent CPE infection is defined as an episode with onset >3 days after initial detection of CPE colonization that meets National Healthcare Safety Network criteria for infection with a clinical isolate of CPE. Results From 2007 to 2018, 790 persons with CPE colonization/infection were identified. Among 364 cases colonized at identification, 42 (12%) subsequently had at least one clinical isolate, and 23 (6%) had an infection: 8 with bacteremia (primary or secondary), 7 UTI, 5 pneumonia, and 3 other. The median time from identification of colonization to infection was 21 days (IQR 7–38), with a probability of developing an infection of 7% at 3 months, and 18% by 3 years (figure). In 305 cases with data available to date, older persons, those admitted to the ICU, and those with current/recent invasive medical devices were more likely to develop infection (table). Gender, underlying conditions and other procedures were not associated with risk of infection. There was a trend to infections being more likely in patients colonized with K. pneumoniae (52% vs. 35%, P = 0.13). Conclusion The risk of subsequent infection in our cohort was 18%, with highest risk in the first 3 months; most infections occurred in patients requiring intensive care unit admission and invasive medical devices. Disclosures All authors: No reported disclosures.

Background Tuberculosis (TB) remains a major challenge to global health. Healthcare workers (HCWs) appear to be at increased risk of TB compared with the general population, despite efforts to scale up infection control and reduce nosocomial TB transmission. This review aims to provide an updated estimate of the occupational risk of latent TB infection (LTBI) and active TB among HCWs compared with the general population. Methods A systematic review was performed to identify studies published over the last 10 years reporting TB prevalence or incidence among HCWs and a control group. Pooled effect estimates were calculated to determine the risk of infection. Results Twenty-one studies met the inclusion criteria, providing data on 30961 HCWs across 16 countries. Prevalence of LTBI among HCWs was 37%, and mean incidence rate of active TB was 97/100000 per year. Compared with the general population, the risk of LTBI was greater for HCWs (odds ratio [OR], 2.27; 95% confidence interval [CI], 1.61–3.20), and the incidence rate ratio for active TB was 2.94 (95% CI, 1.67–5.19). Comparing tuberculin skin test and interferon-gamma release assay, OR for LTBI was found to be 1.72 and 5.61, respectively. Conclusions The overall risk of both LTBI and TB to HCWs continues to be significantly higher than that of the general population, consistent with previous findings. This study highlights the continuing need for improvements in infection control and HCW screening programs.