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The Advisory Committee on Immunization Practices (ACIP), a group of medical and public health experts who provides expert advice to the Centers for Disease Control and Prevention, normally meets three times per year to develop U.S. vaccine recommendations. The ACIP met on February 22–24, 2023, to discuss mpox vaccine, influenza vaccines, pneumococcus vaccines, meningococci vaccines, polio vaccines, respiratory syncytial virus (RSV) vaccine, chikungunya vaccines, dengue vaccines, and COVID-19 vaccines.

Background Acute hematogenous osteomyelitis (AHO) affects about 2-13 children per 100,000 in developed countries each year. Staphylococcus aureus is the most common causative pathogen of AHO and, due to antibiotic resistant strains of this species, a microbial diagnosis is often desired. Blood and bone cultures may identify causative pathogens and determine antibiotic susceptibilities but obtaining bone cultures carries risks. The benefit to patients of having a pathogen identified is disputed and further research is required to address this question. The objectives of this study were to determine if length of stay differs between culture-negative and culture-positive patients and to determine if odds of receiving 3 or more unique antibiotics differs between culture-negative and culture-positive patients. Methods Data were retrospectively abstracted from medical records of pediatric patients with a clinician’s diagnosis of AHO admitted to Children’s National Hospital (CNH) between January 1, 2010 – June 30, 2020. Baseline characteristics, treatment, and outcomes were described. For culture-negative and culture-positive AHO patients, length of stay and odds of receiving 3 or more unique antibiotics were compared using multiple linear regression and multiple logistic regression, respectively. Results Of 367 included patients, 210 had a positive culture result about 83% of which were identified as S. aureus. Culture-negative patients were associated with a 6.45-day shorter length of stay compared to culture-positive patients, adjusting for age, peak C-reactive protein (CRP), and surgery (p = 0.02). Culture-negative patients had 0.196 times the odds of receiving 3 or more unique antibiotics than culture-positive patients, adjusting for age, peak CRP, and surgery (95% CI: 0.114, 0.336). Conclusion Among AHO patients admitted to CNH, being culture-negative was associated with shorter length of stay and lower odds of receiving 3 or more unique antibiotics. Disclosures All Authors: No reported disclosures.

The Advisory Committee on Immunization Practices (ACIP), a group of medical and public health experts that provides expert advice to the Centers for Disease Control and Prevention, normally meets three times per year to develop US vaccine recommendations. The ACIP increased its meeting frequency over the past 2.5 years to address vaccine-related issues during the severe acute respiratory syndrome coronavirus 2 pandemic. They met to discuss updating coronavirus disease-2019 (COVID-19) booster dose recommendations on September 1, 2022 recommending the use of new bivalent COVID-19 booster vaccines which include equal amounts of ancestral and Omicron BA.4/BA.5 variant mRNA that encodes the spike protein.