The edition · Infectious Diseases
In a high-transmission mpox setting, one in three PCR positives may have been contamination
Environmental viral DNA in clinics may have driven false positives in DR Congo, and a lower Ct cut-off removed most of them. Also: dapagliflozin in early sepsis, PrEP inside family planning clinics, and a community bundle that cut Watch-group antibiotic use.
The edition in brief
A multi-site study of 2,724 people with suspected mpox at treatment centres in DR Congo, using a Bayesian model and serology, estimated that 35% of PCR results with a cycle threshold under 40 reflected environmental viral DNA rather than infection. Lowering the positivity cut-off to under 37 cut the false-positive share to 18%, and under 34 to 5%, with little loss of sensitivity. A single-centre Chinese trial of 100 analysed patients with sepsis found five days of dapagliflozin did not improve organ failure scores; ejection fraction was higher and 28-day mortality numerically lower, but not significantly. In 12 Kenyan family planning clinics delivering oral PrEP, unannounced simulated-client visits found risk assessment in 86% of visits but medical safety assessment in only 43% and unprompted PrEP offers in 29%. A cluster-randomised trial in 44 communities in Burkina Faso and DR Congo, published in June, found a nine-month education and feedback bundle across all local antibiotic providers, built on WHO AWaRe guidance, was associated with a two-thirds lower prevalence of Watch-group antibiotic use, with no worsening of patient management.
Environmental viral DNA produced many false-positive mpox PCR results
Confirm weakly positive mpox PCR results clinically and by repeat testing before acting on them in high-transmission settings.
Dapagliflozin in early sepsis did not improve organ failure scores
Dapagliflozin is not a sepsis treatment on this evidence; the primary outcome was neutral.
PrEP in family planning clinics: respectful care, but safety checks often skipped
Where PrEP is integrated into other services, audit safety assessment and active offering — they are most often missed.
FDA records a supplement to a generic tigecycline application
No change to how tigecycline is used: it remains a reserve antibiotic.
A weak PCR positive is a question, not an answer
Interpret a high-Ct PCR result alongside the patient, and repeat it when it would change management.
A community-wide education bundle cut Watch-group antibiotic use by two thirds
Community stewardship that reaches every antibiotic seller, guided by WHO AWaRe, can cut broad-spectrum antibiotic use substantially.
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