Researchers and clinicians in Michigan have developed new guidance for triage and management of suspected urinary tract infections (UTI) symptoms in patients seeking care via telehealth and virtual visits.

Although guidelines exist for the management of suspected UTIs in patients who make in-person visits to outpatient clinics and can be physically examined, there is limited guidance for the increasing number of patients who seek care for presumed UTIs through video visits, phone visits, and portal requests. 

“These virtual requests present a unique challenge for clinicians who must decide if the patient’s symptoms are consistent enough with a UTI that antibiotics provide more benefit than risk, without performing a physical examination, and whether urine testing is necessary,” clinicians and researchers from the University of Michigan Medical School and the Veterans Affairs Ann Arbor Healthcare System (VAAAHS) wrote yesterday in JAMA Network Open.

To address this gap, they convened a meeting of national experts to develop appropriateness criteria for urine testing, empiric antibiotic use, and triage for additional evaluations in these patients.

The result is two algorithms for uncomplicated UTI management—one for non-pregnant women and one for men—that clinicians can use in any setting to determine whether urine testing, empiric antibiotics, and further examination are needed. The guidance also addresses patients with more complicated health conditions and symptoms that could indicate a more serious health issue.

The authors of the paper say the guidance is needed because UTIs are one of the most common reasons for antibiotic use in outpatient settings, but far fewer patients are being seen in a setting where a urine sample can be collected to confirm an infection.

“We hope that this guide will help both patients and providers be aware that even though they’re now able to take a questionnaire or interact with a provider completely virtually, that alone may not be enough to get the right diagnosis or treatment,” first author Jennifer Meddings, MD, MSc, a clinician and patient safety researcher at VAAAHS and Michigan Medicine, said in a press release.

Enhanced infection-prevention measures introduced in neonatal intensive care units (NICUs) during the COVID-19 pandemic were associated with a substantial decline in viral health care–associated infections (HAIs), but they did not reduce rates of bacterial or fungal infections, according to a large study published this week in JAMA Network Open. 

The researchers, led by a team at the Children’s Hospital of Philadelphia, analyzed data from 48,475 infants admitted to 12 NICUs in the United States and Canada from March 2018 to July 2022. The goal was to compare infection rates before and amid the pandemic, when measures such as universal masking, enhanced hand hygiene, and increased visitor restrictions were introduced. 

Among 41,889 infants evaluated for viral HAIs, rates fell by more than half during the pandemic, from 0.35 to 0.16 infections per 1,000 patient-days. The decline persisted into the second year of the pandemic, even as circulation of respiratory viruses increased.

In contrast, bacterial and fungal HAIs remained the same before and during the pandemic, at  1.70 and 1.78 infections per 1,000 patient-days, respectively.

The findings suggest that infection-prevention strategies like universal masking and enhanced hand hygiene were effective at limiting viral transmission in NICUs during the pandemic but did not curb bacterial or fungal infections. “Preventive interventions beyond those implemented during the pandemic would likely be necessary to further reduce bacterial or fungal HAIs,” conclude the authors. 

French drug company Sanofi yesterday announced it has discontinued development of its next-generation seasonal flu vaccine based on mRNA technology but will continue to pursue a pandemic flu vaccine.

Sanofi reported in its 2025 earnings documents that it was discontinuing its mRNA flu vaccine phase 1 trial. “Sanofi has deprioritized its mRNA-based seasonal flu vaccine program and does not anticipate launching an mRNA-based seasonal flu product in the near term,” a spokesperson told Fierce Biotech, which first reported the news.

Sanofi continues to work on a phase 1/2 study of its mRNA vaccine with an H5 avian flu platform as a tool for preparing for the next influenza pandemic. The firm described preliminary data on that vaccine as “very encouraging.”

In June 2023, Sanofi said it was working on next-gen mRNA seasonal flu vaccines and had brought five different lipids into clinical trials. Its hemagglutinin-based mRNA vaccine candidate performed well against influenza strain A but struggled against B strains—a common problem for first-generation mRNA flu vaccines. Sanofi had hoped the next-generation of mRNA vaccines would also protect against B strains. Hemagglutinin is the “H” in strains like H1N1, H3N2, and H5N1.

Sanofi had acquired Translate Bio, with its focus on mRNA technology, in 2021 for $3.2 billion as part of its multibillion-dollar investment in mRNA vaccines.

“We are focusing on our highly successful high-dose vaccine and our recombinant protein vaccine to deliver protection beyond flu, providing protection not only against flu infection but also flu’s severe complications,” a company spokesperson said.

The person said Sanofi’s Fluzone High-Dose and Flublok vaccines, both approved by the US Food and Drug Administration, continue to demonstrate strong protection against severe outcomes.