Carbapenem-Resistant Enterobacterales: Considerations for Treatment in the Era of New Antimicrobials and Evolving Enzymology
AbstractPurpose of ReviewGram-negative resistance is a growing concern globally. Enterobacterales, formerlyEnterobacteriaceae, have developed resistance mechanisms to carbapenems that leave very few antimicrobial options in the clinician ’s armamentarium.Recent FindingsNew antimicrobials like ceftazidime-avibactam, meropenem-vaborbactam, imipenem-relebactam, cefiderocol, and plazomicin have the potential to overcome resistance mechanisms in Enterobacterales including different classes of carbapenemases.SummaryNovel β-lactam/β-lactamase inhibitors, plazomicin, and cefiderocol give the clinician options that ...
Source: Current Infectious Disease Reports - February 7, 2020 Category: Infectious Diseases Source Type: research

Appropriate Use and Future Directions of Molecular Diagnostic Testing
AbstractPurpose of ReviewMajor technologic advances in two main areas of molecular infectious disease diagnostics have resulted in accelerated adoption or ordering, outpacing implementation, and clinical utility studies. Physicians must understand the limitations to and appropriate utilization of these technologies in order to provide cost-effective and well-informed care for their patients.Recent FindingsRapid molecular testing and, to a lesser degree, clinical metagenomics are now being routinely used in clinical practice. While these tests allow for a breadth of interrogation not possible with conventional microbiology,...
Source: Current Infectious Disease Reports - February 6, 2020 Category: Infectious Diseases Source Type: research

Acute Infectious Diarrhea and Gastroenteritis in Children
AbstractPurpose of ReviewWe aimed to summarize the most current evidence on the main aspects of the diarrheal diseases in children. The following key elements were addressed: definitions, etiology, pathogenesis, diagnosis, dietary management, pharmacological treatments, and prevention. We covered the following questions: What are the most important clinical and laboratory features of the disease? What are the best approaches for the dietary management? What is the best way to classify the hydration status, and to prevent and treat the dehydration? What are the most effective and safe interventions for reducing the diarrhea...
Source: Current Infectious Disease Reports - January 28, 2020 Category: Infectious Diseases Source Type: research

Respiratory Virus Co-infection in Acute Respiratory Infections in Children
AbstractPurpose of ReviewThis investigation aims to understand the role and burden of viral co-infections for acute respiratory illnesses in children. Co-infection can be either viral-viral or viral-bacterial and with new technology there is more information on the role they play on the health of children.Recent FindingsWith the proliferation of multiplex PCR for rapid diagnosis of multiple viruses as well as innovations on identification of bacterial infections, research has been attempting to discover how these co-infections affect each other and the host. Studies are aiming to discern if the epidemiology of viruses seen...
Source: Current Infectious Disease Reports - January 24, 2020 Category: Infectious Diseases Source Type: research

Fluconazole Prophylaxis in Prevention of Symptomatic Candida Vaginitis
AbstractDue to broad spectrum susceptibility ofCandida species to fluconazole, its convenience as an oral agent, and predictable patient tolerance and safety, current practice guidelines recommend the use of long-term suppression regimens of fluconazole as prophylaxis for recurrent vulvovaginal candidiasis (RVVC), as well as in abbreviated doses when known trigger factors emerge and inevitable symptomatic episodes are predictable. However, recent concerns of fluconazole-resistantCandida albicans strains may impact fluconazole use, particularly, concerns of overuse. This literature review discusses current recommendations f...
Source: Current Infectious Disease Reports - January 21, 2020 Category: Infectious Diseases Source Type: research

The Battle Is on: New Beta-Lactams for the Treatment of Multidrug-Resistant Gram-Negative Organisms
AbstractPurpose of ReviewResistant gram-negative infections are becoming increasingly difficult to treat, prompting increased focus on drug development. This review will focus primarily on the new beta-lactam agents developed in the past 5  years that target multidrug-resistant (MDR) gram-negative organisms, including those producing carbapenemases.Recent FindingsFour new agents including ceftazidime-avibactam (CAZ-AVI), meropenem-vaborbactam (MER-VAB), imipenem-relebactam (IMI-REL), and cefiderocol have recently been approved for the treatment of resistant gram-negative infections. CAZ-AVI remains an option forblaOXA...
Source: Current Infectious Disease Reports - January 13, 2020 Category: Infectious Diseases Source Type: research

Molecular Diagnostic Advances in Transplant Infectious Diseases
AbstractPurpose of ReviewThe infectious complications of transplantation can have devastating consequences for patients. Early and accurate diagnosis is essential to good outcomes. This review describes recent advances in pathogen-directed diagnostic testing and discusses the role of new methods for transplant infectious diseases.Recent FindingsSeveral molecular assays have been introduced into clinical practice in recent years. When the results of rapid testing are linked to patient-specific interventions, improved outcomes can be realized. Syndromic testing along with metagenomic next-generation sequencing (mNGS) represe...
Source: Current Infectious Disease Reports - November 26, 2019 Category: Infectious Diseases Source Type: research

Diagnosis and Treatment of Acute Invasive Fungal Sinusitis in Cancer and Transplant Patients
AbstractPurpose of ReviewModern advances in oncologic and end-organ therapies have led to an increase in immunocompromised patients and a corresponding rise in acute invasive fungal sinusitis (AIFS). Here, we present a comprehensive medical and surgical approach to the diagnosis and management of immunocompromised cancer and transplant patients with AIFS.Recent FindingsAspergillus andMucorales are the most common fungi to cause AIFS, though atypical fungal pathogens have been implicated particularly among patients on azole prophylaxis. Symptoms present in the majority of AIFS cases include fever, nasal congestion, and faci...
Source: Current Infectious Disease Reports - November 26, 2019 Category: Infectious Diseases Source Type: research

The Role of Emerging and Neglected Viruses in the Etiology of Hepatitis
AbstractPurpose of ReviewIn this review, we present the overview of emerging and neglected viruses associated with liver involvement.Recent FindingsHepatitis E virus (HEV) emerged in the last two decades, causing hepatitis in many parts of the world. Moreover, liver involvement was also described in some emerging arboviral infections. Many reports showed dengue-associated liver injury; however, chikungunya, West Nile, tick-borne encephalitis, and Zika virus are rarely associated with clinically manifest liver disease. In addition, some neglected highly prevalent viruses such as adenoviruses and parvovirus B19 are capable o...
Source: Current Infectious Disease Reports - November 21, 2019 Category: Infectious Diseases Source Type: research

Ventilator-Associated Pneumonia: Diagnostic Test Stewardship and Relevance of Culturing Practices
AbstractPurpose of ReviewVentilator-associated pneumonia (VAP) is one of the most common infections in the ICU. Prompt diagnosis is vital as mortality increases with delayed antibiotic therapy. However, accurate diagnosis is challenging due to non-specific clinical features in a complicated patient cohort. Microbiological culture data remains a crucial aspect in confirming diagnosis.Recent FindingsLiterature data comparing the benefit of invasive respiratory sampling to non-invasive is inconclusive. Differences in culturing practices translate in overidentification of organisms of unclear significance. Positive culture dat...
Source: Current Infectious Disease Reports - November 21, 2019 Category: Infectious Diseases Source Type: research

Multidrug Resistant Acinetobacter baumannii : Resistance by Any Other Name Would Still be Hard to Treat
AbstractPurpose of ReviewAcinetobacter baumannii (AB) is an infamous nosocomial pathogen with a seemingly limitless capacity for antimicrobial resistance, leading to few treatment options and poor clinical outcomes. The debatably low pathogenicity and virulence of AB are juxtaposed by its exceptionally high rate of infection-related mortality, likely due to delays in time to effective antimicrobial therapy secondary to its predilection for resistance to first-line agents. Recent studies of AB and its infections have led to a burgeoning understanding of this critical microbial threat and provided clinicians with new ammunit...
Source: Current Infectious Disease Reports - November 16, 2019 Category: Infectious Diseases Source Type: research

Tissue Parasites in HIV Infection
AbstractPurpose of ReviewThe purpose of this review is to discuss the current knowledge of HIV and tissue parasite co-infection in the context of transmission enhancement, clinical characteristics, treatment, relapse, and clinical outcomes.Recent FindingsThe pathophysiology and clinical sequelae of tissue parasites in people living with HIV (PLWH) have been well described for only a handful of organisms, primarily protozoa such as malaria and leishmaniasis. Available published data indicate that the interactions between HIV and tissue parasites are highly variable depending on the infecting organism and the degree of host ...
Source: Current Infectious Disease Reports - November 16, 2019 Category: Infectious Diseases Source Type: research

Migration Health: Highlights from Inaugural International Society of Travel Medicine (ISTM) Conference on Migration Health
AbstractPurpose of ReviewInternational migration is a global phenomenon that is growing in scope, complexity and impact. The inaugural International Society of Travel Medicine (ISTM) International Conference on Migration Health provided a forum to discuss scientific evidence on the broad issues relevant to migration health. This review summarises the key health issues, with a focus on infectious diseases, current effective strategies and future considerations presented at this forum and in the recent literature.Recent FindingsMigrants face health disparities for both communicable and non-communicable diseases. Their height...
Source: Current Infectious Disease Reports - November 16, 2019 Category: Infectious Diseases Source Type: research

Antifungal Resistance: a Concerning Trend for the Present and Future
AbstractPurpose of ReviewThe global emergence of antifungal resistance amongCandida spp. andAspergillus spp. is a growing threat to public health, driven largely by the expanding use of antifungals in both the clinical and agricultural settings. As treatment options remain limited, understanding mechanisms and risk factors for antifungal resistance is essential to retaining their clinical utility.Recent FindingsInvasive candidiasis is increasingly caused by non-albicans Candida species with reduced susceptibility to first-line antifungals, making empiric treatment decisions difficult. Echinocandin resistance inC. glabrata ...
Source: Current Infectious Disease Reports - November 16, 2019 Category: Infectious Diseases Source Type: research

CMV Prevention and Treatment in Transplantation: What ’s New in 2019
AbstractPurpose of ReviewTransplant recipients are at risk for cytomegalovirus (CMV) infection and associated morbidity and mortality. We summarize recently introduced or currently investigated modalities for prevention and treatment of CMV infection in hematopoietic cell (HCT) and solid organ transplant (SOT) recipients.Recent FindingsLetermovir was recently approved for CMV prevention in HCT recipients. Data from real world studies support its role to improve outcomes in this population. Letermovir is currently under investigation for broader patient populations and indications. Maribavir is in late stages of development...
Source: Current Infectious Disease Reports - November 15, 2019 Category: Infectious Diseases Source Type: research

Vulvovaginitis Caused by Candida Species Following Antibiotic Exposure
AbstractPurpose of ReviewGoal was to review epidemiology, pathophysiology, and prevention of post-antibioticCandida vulvovaginitis (VVC).Recent FindingsAntibacterial therapy, whether systemic or locally applied to the vagina, represents the single most frequent and predictable cause or triggering mechanism of symptomatic vulvovaginal candidiasis (VVC). Such initiating mechanisms may precipitate sporadic or recurrent episodes of VVC. In spite of this widely recognized association, the exact mechanism whereby antibiotics of all classes cause acute exacerbation of symptomatic vaginal disease remains largely unstudied and ther...
Source: Current Infectious Disease Reports - November 9, 2019 Category: Infectious Diseases Source Type: research

Utility of 8-Aminoquinolines in Malaria Prophylaxis in Travelers
AbstractPurpose of ReviewTo review the current status of 8-aminoquinolines in the prophylaxis of malaria among travelers, in light of the recent approval of tafenoquine.Recent FindingsPrimaquine continues to provide excellent primary prophylaxis against allPlasmodium species. Tafenoquine provides similarly good prophylaxis, with the benefit of weekly dosing. Both agents require glucose-6-phosphate dehydrogenase activity testing before use and are contraindicated in pregnancy. Pharmacodynamic variability relating to CYP2D6 may underlie some cases of primaquine failure; the effects of CYP2D6 on tafenoquine efficacy require f...
Source: Current Infectious Disease Reports - November 7, 2019 Category: Infectious Diseases Source Type: research

Yellow Fever in Travelers
AbstractPurpose of ReviewThis decade has seen a resurgence of yellow fever (YF) that has also affected travelers with a record number of international travelers infected by YF virus including the first documented importation of YF into Asia.Recent FindingsThe recent resurgence of YF has been attributed largely to sub-optimal vaccination coverage along with waning population-level immunity. New lessons have been learnt with regard to the clinical management of severe YF as a result of the Brazilian outbreak. With increasing YF cases in travelers, travel medicine providers need to familiarize themselves with the diagnosis an...
Source: Current Infectious Disease Reports - October 31, 2019 Category: Infectious Diseases Source Type: research

The Current and Future Use of Telemedicine in Infectious Diseases Practice
AbstractPurpose of ReviewNovel technologies, such as high-definition cameras, encryption software, electronic stethoscopes, microfluidic diagnostic systems, and widely available broadband Internet have expanded the potential for telemedicine. This narrative review presents current and future uses of telemedicine in the prevention, diagnosis, treatment, stewardship, and management of infectious disease.Recent FindingsBeginning in the 1990s, early approaches to telemedicine in infectious disease focused largely on treatment of HIV/AIDS, hepatitis C, and tuberculosis. However, recent innovations allow for targeting of additio...
Source: Current Infectious Disease Reports - October 19, 2019 Category: Infectious Diseases Source Type: research

Algorithms for Managing Vulvovaginal Symptoms —a Practical Primer
AbstractPurpose of ReviewTo present a comprehensive systematic approach for diagnosing correctly the cause(s) of bothersome genital symptoms.Recent FindingsWe searched the PUBMED for practical clinical guidelines, written by a multidisciplinary team of healthcare providers directed for diagnosing bothersome genital symptoms. This search was performed by a professional information specialist using the keywords “vulvovaginal,” “vulvar,” “multidisciplinary diagnosis,” “interdisciplinary consultation,” and “vulvology.” We found numerous publications defining the crite...
Source: Current Infectious Disease Reports - October 8, 2019 Category: Infectious Diseases Source Type: research

Recognizing and Overcoming Resistance to New Beta-Lactam/Beta-Lactamase Inhibitor Combinations
AbstractPurpose of ReviewTo describe the mechanisms and clinical relevance of emergent resistance to three recently introduced beta-lactamase inhibitor combinations (BLICs) active against resistant Gram-negative organisms: ceftolozane-tazobactam, ceftazidime-avibactam, and meropenem-vaborbactam.Recent FindingsDespite their recent introduction into practice, clinical reports of resistance to BLICs among typically susceptible organisms have already emerged, in some cases associated with therapeutic failure. The resistance mechanisms vary by agent, including mutations in beta-lactamase active sites, upregulation of efflux pum...
Source: Current Infectious Disease Reports - September 9, 2019 Category: Infectious Diseases Source Type: research

Simplifying ARV Therapy in the Setting of Resistance
AbstractPurpose of ReviewHIV treatment simplification is typically indicated for virologically suppressed patients with no baseline resistance-associated mutations (RAMs) or prior virologic failure (VF) to the simplification regimen. Simplification can occur to minimize pill burden, toxicities, drug-drug interactions, or costs. As most studies for treatment simplification excluded patients with baseline RAMs or prior VF, this review is aimed to critically analyze data regarding treatment simplification in treatment-experienced patients.Recent FindingsAntiretroviral (ARV) regimens containing three-, two-, and one-drug(s) ha...
Source: Current Infectious Disease Reports - September 7, 2019 Category: Infectious Diseases Source Type: research

Treatment of Methicillin-Resistant Staphylococcus aureus (MRSA) Infections in Children: a Reappraisal of Vancomycin
AbstractPurpose of ReviewIn the last 50  years, vancomycin has been the agent of choice to treat infections due to methicillin-resistantStaphylococcus aureus (MRSA). However, vancomycin treatment failure is not uncommon, even when MRSA strains are fully susceptible to vancomycin. Treatment with vancomycin requires careful monitoring of drug levels as there is a potential for nephrotoxicity. Resistance to clindamycin is not infrequent, which also limits therapeutic options for treating infections due to MRSA in children. This paper reviews the current data on pharmacokinetics and pharmacodynamics and clinical efficacy ...
Source: Current Infectious Disease Reports - September 5, 2019 Category: Infectious Diseases Source Type: research

Antimicrobial Stewardship Interventions to Combat Antibiotic Resistance: an Update on Targeted Strategies
AbstractPurpose of ReviewOverutilization of antimicrobials is a known contributor to the development of antimicrobial resistance, which is a threat to global health. The goal of antimicrobial stewardship programs (ASPs) is to implement targeted interventions to reduce inappropriate antimicrobial prescribing and prevent development of antimicrobial resistance. We aim to review recently published literature focused on five categories of ASP interventions that have demonstrated success in optimizing appropriate antimicrobial use, improving patient outcomes, and fighting antimicrobial resistance.Recent FindingsIn the past year...
Source: Current Infectious Disease Reports - August 31, 2019 Category: Infectious Diseases Source Type: research

Lessons from Suppressive Therapy and Periodic Presumptive Treatment for Bacterial Vaginosis
AbstractPurpose of ReviewSuppressive therapy and periodic presumptive treatment (PPT) are distinct but related strategies that have been used to reduce the incidence of bacterial vaginosis (BV). Here, we review clinical trial evidence of the effectiveness of suppressive therapy and PPT to reduce BV, and discuss their roles for women who frequently experience symptomatic or asymptomatic BV.Recent FindingsAmong women who were recently and successfully treated for symptomatic BV, suppressive therapy with twice-weekly metronidazole gel for 16  weeks reduces the likelihood of recurrent symptomatic BV and is currently recom...
Source: Current Infectious Disease Reports - August 31, 2019 Category: Infectious Diseases Source Type: research

Infectious Complications of Transplant Tourism
AbstractPurpose of ReviewTo outline the impact of transplant tourism on the type and severity of post-transplant infections that may be seem in returning transplant tourists. This review outlines infections that might be expected and provides recommendations on screening tests that may assist in the diagnosis and management of such patients.Recent FindingsTransplant tourists may develop unusual or resistant infections that pose a public health risk in their home country.SummaryThe practice of transplant tourism is associated with a significantly increased risk of surgical and infectious complications after transplant. Retu...
Source: Current Infectious Disease Reports - August 31, 2019 Category: Infectious Diseases Source Type: research

Pre-operative Decolonization as a Strategy to Reduce Surgical Site Infection
AbstractPurpose of ReviewTo identify the most common strategies currently used forS. aureus decolonization and surgical site infection (SSI) prevention.Recent FindingsPre-operative colonization withStaphylococcus aureus increases SSI risk. Screening and decolonization with intra-nasal mupirocin and pre-operative chlorhexidine bathing remains the most common and effective strategy, especially for orthopedic and cardiovascular surgery. Intra-nasal povidone-iodine immediately before surgery appears effective in preliminary studies, is less expensive, and may be easier to implement in the clinical setting. Future well-designed...
Source: Current Infectious Disease Reports - August 31, 2019 Category: Infectious Diseases Source Type: research

Electronic Health Record Use in Public Health Infectious Disease Surveillance, USA, 2018 –2019
AbstractPurpose of ReviewElectronic health records (EHRs) are an excellent source of data for disease symptoms, laboratory results, and medical treatments. Thus, EHR data may improve the completeness of notifiable disease case reporting and enable longitudinal collection of disease data. The purpose of this review is to examine the current state of EHR use in public health infectious disease surveillance in the USA.Recent FindingsA wide variety of EHR data is used in infectious disease surveillance. EHR data were used to assess the incidence of Lyme disease and identify newly diagnosed HIV infections. EHR disease detection...
Source: Current Infectious Disease Reports - August 26, 2019 Category: Infectious Diseases Source Type: research

Management of Resistant Trichomoniasis
AbstractPurpose of ReviewTrichomonas vaginalis is the most prevalent sexually transmitted parasite in the USA; resistant infection is emerging. New drug therapies and dosing regimens of standard therapies are being studied to treat resistant infection.Recent FindingsDiagnosis of trichomoniasis has become more sensitive, specific, and widely available with the advent of nucleic acid amplification tests (NAATs). Women with resistant trichomoniasis should be treated with high-dose regimens of metronidazole or tinidazole. Alternative treatment options have been described, and there has been some success particularly with high-...
Source: Current Infectious Disease Reports - August 6, 2019 Category: Infectious Diseases Source Type: research

Contribution of Epithelial Cells to Defense Mechanisms in the Human Vagina
AbstractPurpose of ReviewThe vaginal milieu in women differs from that of other mammals, including non-human primates, in composition of secretions, the endogenous microbiota, and level of acidity. These changes apparently reflect evolutionary variations that maximized productive responses to a uniquely human vaginal environment. This review will highlight recent findings on properties of human vaginal epithelial cells that contribute to maintenance of a healthy vaginal environment.Recent FindingsVaginal epithelial cells are responsive to the composition of the vaginal microbiome even in women who are in apparently good he...
Source: Current Infectious Disease Reports - August 1, 2019 Category: Infectious Diseases Source Type: research

Clinical Decision Support Systems and Their Role in Antibiotic Stewardship: a Systematic Review
AbstractPurpose of ReviewThe purpose of this article is to perform a systematic review over the past 5  years on the role and effectiveness of clinical decision support systems (CDSSs) on antibiotic stewardship.Recent FindingsCDDS interventions found a significant impact on multiple outcomes relevant to antibiotic stewardship. There are various types of CDSS implementations, both active and passive (provider initiated). Passive interventions were associated with more significant outcomes; however, both interventions appeared effective. In the reviewed literature, CDSSs were consistently associated with decreasing anti...
Source: Current Infectious Disease Reports - July 24, 2019 Category: Infectious Diseases Source Type: research

Updates on Nocardia Skin and Soft Tissue Infections in Solid Organ Transplantation
AbstractPurpose of ReviewDue to their immunocompromised status, solid organ transplant (SOT) recipients are at risk forNocardia infections. These infections often necessitate early invasive diagnostics alongside prolonged, often combination antimicrobial therapy. This review summarizes the importance of this pathogen in skin and soft tissue infections (SSTIs) in SOT recipients inclusive of recently reported cases in the literature and an update on the epidemiology, diagnostics, and management.Recent FindingsSix studies with 13 isolated SSTIs due toNocardia have been published in the last 5  years in SOT recipients. Th...
Source: Current Infectious Disease Reports - June 21, 2019 Category: Infectious Diseases Source Type: research

Update on HIV Preexposure Prophylaxis: Effectiveness, Drug Resistance, and Risk Compensation
AbstractPurpose of ReviewIn 2019, the US government launched an initiative to decrease new HIV infections by 90% over the next decade. Studies have demonstrated the efficacy of HIV preexposure prophylaxis (PrEP) for high-risk populations, and the United States Preventative Services Task Force has issued a grade A recommendation for PrEP, indicating substantial net benefit. However, questions have been raised about the effectiveness of PrEP in clinical settings and whether PrEP use might promote antiretroviral drug resistance and increased sexual risk behaviors, which could increase transmission of bacterial sexually transm...
Source: Current Infectious Disease Reports - June 21, 2019 Category: Infectious Diseases Source Type: research

Carbapenem-Resistant Enterobacteriaceae in Solid Organ Transplantation: Management Principles
AbstractPurpose of ReviewCarbapenem-resistantEnterobacteriaceae (CRE) have emerged as a worldwide problem. Given their degree of immunosuppression and the level of contact with the healthcare system, solid organ transplant (SOT) recipients are at a disproportionately higher risk of acquisition, colonization, and infection with CRE, and outcomes from infection tend to be worse compared to non-transplant patients. Therapeutic options are limited for CRE infections although several newer agents have recently been approved for use. How well these agents perform in the setting of immunosuppression and SOT is unclear. We sought ...
Source: Current Infectious Disease Reports - June 10, 2019 Category: Infectious Diseases Source Type: research

Management of Fulminant Hepatitis B
AbstractPurpose of ReviewAcute HBV infection and acute exacerbations of chronic HBV infection can cause acute liver injury (ALI) or fulminant hepatitis (FH). At this stage, spontaneous survival is poor, less than 25%. The purpose of this review is to provide an overview of specific management of patients with HBV-ALI/FH.Recent FindingsAcute HBVinfection and acute exacerbations of chronic HBVinfection can cause acute liver injury (ALI) or fulminant hepatitis (FH). Spontaneous survival at this stage is poor. It is urgent to distinguish between these two entities so that antiviral therapy can be initiated rapidly. Although th...
Source: Current Infectious Disease Reports - June 4, 2019 Category: Infectious Diseases Source Type: research

Challenges and Clinical Implications of the Diagnosis of Cytomegalovirus Lung Infection in Children
AbstractPurpose of ReviewPulmonary cytomegalovirus (CMV) infection is a potential lethal disease in children, but it remains a diagnostic challenge. The differentiation between latent CMV infections with viral shedding and active infections is difficult and may lead to false positives in bronchoalvolar lavage (BAL) PCR detection. This review summarizes current diagnostic approaches for CMV lung infection in children including progress in the identification of underlying immune defects linked to this condition.Recent FindingsThere is increasing literature supporting that the combined assessment of host risk factors and lung...
Source: Current Infectious Disease Reports - May 30, 2019 Category: Infectious Diseases Source Type: research

Diagnosis and Management of Infectious Arthritis in Children
AbstractPurpose of ReviewSeptic arthritis is limb and life-threatening condition which necessitates rapid diagnosis and treatment. It is important for a medical practitioner to be familiar with this condition. This review summarizes the epidemiology, risk factors, diagnosis and differential diagnosis, complications, as well as treatment and the following-up of this condition.Recent FindingsDifferent causative organisms require unique diagnostic and treatment approaches. Establishing the diagnosis often requires multiple diagnostic modalities, some of which are new and innovative. Differential diagnosis requires excluding n...
Source: Current Infectious Disease Reports - May 29, 2019 Category: Infectious Diseases Source Type: research

Novel Strategies for the Management of Vancomycin-Resistant Enterococcal Infections
AbstractPurpose of ReviewVancomycin-resistant enterococci (VRE) are important nosocomial pathogens that commonly affect critically ill patients. VRE have a remarkable genetic plasticity allowing them to acquire genes associated with antimicrobial resistance. Therefore, the treatment of deep-seated infections due to VRE has become a challenge for the clinician. The purpose of this review is to assess the current and future strategies for the management of recalcitrant deep-seated VRE infections and efforts for infection control in the hospital setting.Recent FindingsPreventing colonization and decolonization of multidrug-re...
Source: Current Infectious Disease Reports - May 22, 2019 Category: Infectious Diseases Source Type: research

The Epidemiology and Prevention of Candida auris
AbstractPurpose of ReviewCandida auris has recently emerged as a pathogen with the potential for nosocomial transmission and outbreaks. The aim of this review is to summarize the global dissemination of this pathogen, characterize patient and facility characteristics associated with infection and outbreaks, and outline evidence to support interventions to prevent of transmission in the healthcare setting.Recent FindingsC. auris has emerged separately in four clades, with international spread within a decade of its first identification and report. Acquisition and infection have predominantly been identified as healthcare-as...
Source: Current Infectious Disease Reports - May 1, 2019 Category: Infectious Diseases Source Type: research

Impact of Socio-Economic Factors on Increased Risk and Progression of Rheumatic Heart Disease in Developing Nations
AbstractPurpose of ReviewRheumatic heart disease (RHD) is a global health concern especially in low-income settings. Morbidity and mortality data from the World Health Organization (WHO) and global burden studies emphasizes on the prioritization of RHD on a global platform. Genetic, environmental, and socio-economic factors determine the sustainability and progression of RHD in various populations. In developing countries, low socioeconomic status (SES) is a vast and inevitable challenge in combating RHD. Concurrence between low SES and RHD has been well documented by several studies, but there is a paucity of data to unde...
Source: Current Infectious Disease Reports - May 1, 2019 Category: Infectious Diseases Source Type: research

Advances in Diagnostic Testing that Impact Infection Prevention and Antimicrobial Stewardship Programs
AbstractPurpose of ReviewThe primary purpose of this review is to provide a summary of new and emerging laboratory technologies and testing platforms that impact infection prevention and antimicrobial stewardship programs. This review also summarizes available data describing the clinical impact of implementing these new technologies.Recent FindingsWhile there is ample evidence that rapid organism identification technologies for positive blood cultures can ameliorate antimicrobial utilization, an assay that also provides expedited antimicrobial susceptibility testing results is now available and its clinical impact is unde...
Source: Current Infectious Disease Reports - May 1, 2019 Category: Infectious Diseases Source Type: research

Mucocutaneous Features of Zika —a Review
AbstractPurpose of ReviewWe review the range of dermatological signs seen in Zika infection and the possible relationship between the rash and viremia. We also hoped to explore the utility of mucocutaneous manifestations in narrowing the differential diagnosis from other similar flaviviruses.Recent FindingsClinical manifestations of Zika infection share many similarities with other mosquito-borne viruses such as dengue. These include non-specific symptoms such as a fever, rash, arthralgia, myalgia, and conjunctivitis. The morphology of the rash in Zika infection is not very specific and commonly described as maculopapular ...
Source: Current Infectious Disease Reports - April 30, 2019 Category: Infectious Diseases Source Type: research

Outpatient Parenteral Antimicrobial Therapy in Children
AbstractPurpose of ReviewOver recent years, there has been a marked increase in the number of centres delivering paediatric outpatient parenteral antimicrobial therapy (pOPAT). Various factors have fuelled this drive, including the significant economic pressures faced by high-income countries to contain the cost of healthcare, resulting in a significant reduction of in-patient beds over the past 20  years. It is essential that pOPAT services have formal clinical governance structures in place to ensure the safe and effective management of children being ambulated on intravenous antibiotics. They also require oversight...
Source: Current Infectious Disease Reports - April 16, 2019 Category: Infectious Diseases Source Type: research

Health Considerations for HIV-Infected International Travelers
AbstractPurpose of the ReviewInternational travel continues to steadily increase, including leisure travel, travel to one ’s country of origin to visit friends and relatives, travel for service work, and business travel. Travelers with HIV may have an increased risk for travel-associated infections. The pre-travel medical consultation is an important means of assessing one’s risk for travel-related health issues. T he aim of this review is to provide an update on key health considerations for the HIV-infected traveler.Recent FindingsLike all travelers, the HIV-infected traveler should adhere to behavioral preca...
Source: Current Infectious Disease Reports - April 12, 2019 Category: Infectious Diseases Source Type: research

Outpatient Pediatric Antibiotic Use: a Systematic Review
AbstractPurpose of ReviewThe majority of pediatric antibiotic use occurs in outpatients. However, the optimal strategies for antimicrobial stewardship in this setting are unknown. We sought to identify studies relevant to pediatric outpatient stewardship that have been published in the past decade. The details of this systemic review are presented along with targets for future stewardship efforts and discussion regarding effective outpatient stewardship strategies.Recent FindingsIn 2016, the CDC released the “Core Elements of Outpatient Antibiotic Stewardship” that serve as practical guidelines to develop impac...
Source: Current Infectious Disease Reports - March 20, 2019 Category: Infectious Diseases Source Type: research

Safe Travel Preparation for HIV-Infected Patients
AbstractPurpose of ReviewInfectious diseases are a risk when traveling internationally, and it is important to know the potential disease burden of a region and take appropriate preventative actions before traveling. For individuals with HIV, there are special considerations and contradictions for various vaccines and medications as well as interactions with likely antiviral drugs. The purpose of this review is to summarize the vaccine and medication recommendations for travelers with HIV infection. We also review recent studies to update these recommendations.Recent FindingsThe recommendation for yellow fever vaccine has ...
Source: Current Infectious Disease Reports - March 20, 2019 Category: Infectious Diseases Source Type: research

Self-Collection and Molecular Diagnosis for Detection of Human Papillomavirus: Why Incorporate It?
AbstractPurpose of ReviewCervical cancer, the third cause of death by cancer among Brazil ’s women, is associated with human papillomavirus (HPV) infection. In some countries of South America, North America, Europe, and Oceania, initial screening for HPV DNA and subsequent follow-up with HPV-positive patients using colposcopy and cytological testing are used as preventative measures.Recent FindingsFor HPV DNA detection, it is necessary to obtain cervical cells by conventional clinical collection method or self-collection of the cells that flake off from the uterine cervix and vaginal canal. Self-collection has been s...
Source: Current Infectious Disease Reports - March 19, 2019 Category: Infectious Diseases Source Type: research

Prevention Strategies for Recurrent Community-Associated Staphylococcus aureus Skin and Soft Tissue Infections
AbstractPurpose of ReviewStaphylococcus aureus skin and soft tissue infections (SSTI) are a major source of morbidity. More than half of patients experiencing SSTI will have at least one recurrent infection. These infections frequently cluster in households. Given the burden these infections pose to patients and healthcare, prevention strategies are of major clinical importance and represent an active area of research. Bacterial colonization is frequently an early and critical step in the pathogenesis of infection. As such, strategies to prevent reinfection have aimed to decrease staphylococcal colonization of the skin and...
Source: Current Infectious Disease Reports - March 11, 2019 Category: Infectious Diseases Source Type: research

Advances and Challenges in the Diagnosis and Treatment of Urinary Tract Infections: the Need for Diagnostic Stewardship
AbstractPurpose of ReviewUrinary tract infections (UTIs), including catheter-associated UTIs, are among the most common bacterial infections in both inpatient and outpatient settings. Diagnosis of true UTI remains a clinical challenge, and excessive antimicrobial treatment of asymptomatic bacteriuria (ASB) or contaminated urine cultures is common.Recent FindingsChallenges with the appropriate diagnosis of UTIs include the lack of specific signs and symptoms, no definitive diagnostic criteria, high incidence of ASB, contamination of samples, and frequent lack of indications for ordering urine cultures. Promising interventio...
Source: Current Infectious Disease Reports - March 5, 2019 Category: Infectious Diseases Source Type: research

Mortality Predictive Scores for Community-Acquired Pneumonia in Children
AbstractPurpose of ReviewThe use of severity score for the staging of pneumonias has emerged as a necessity for the physician caring for this disease. Although there are several established prognostic scoring systems for community-acquired pneumonia in adults, the availability for children are scarce.Recent FindingsRecently, scoring system for risk stratification of children with pneumonia were developed in low- and middle-income countries. They use clinical variables that represent known risk factors for severe outcomes of respiratory illness in children, such as hypoxemia, chest indrawing, refusal to feed, malnutrition, ...
Source: Current Infectious Disease Reports - March 5, 2019 Category: Infectious Diseases Source Type: research