COVID-19 in the Pediatric Population —Review and Current Evidence
AbstractPurpose of ReviewCoronavirus disease 2019 (COVID-19) pandemic has major health and economic impacts. We review disease characteristics in children.Recent FindingsChildren comprise 1 –2% of the diagnosed cases, and typically suffer mild disease. The median age of infected children is 3.3–11 years, and male/female ratio is 1.15–1.55. Common symptoms in children include upper respiratory symptoms (26–54%), cough (44–54%), fever (32–65%), and gastrointestinal (15–30% ) symptoms. Substantial proportion (4–23%) are asymptomatic. Death rates are up to 0.7%. Risk factors...
Source: Current Infectious Disease Reports - September 19, 2020 Category: Infectious Diseases Source Type: research

Updates on Combination Therapy for Methicillin-Resistant Staphylococcus aureus Bacteremia
AbstractPurpose of ReviewMethicillin-resistantStaphylococcus aureus (MRSA) bacteremia is associated with a large clinical burden and high rates of treatment failure with first-line treatment options. Literature for combination antimicrobial therapies for initial treatment or salvage therapy in the setting of persistent bacteremia is developing.Recent FindingsVarious combination strategies have emerged for the treatment of MRSA bacteremia, including vancomycin or daptomycin in combination with either anti-staphylococcal penicillins, early- and late-generation cephalosporins, ceftaroline, trimethoprim-sulfamethoxazole, or fo...
Source: Current Infectious Disease Reports - September 9, 2020 Category: Infectious Diseases Source Type: research

Adenovirus Infections in Immunocompetent Children
AbstractPurpose of ReviewThe focus of this review is on human adenovirus (HAdV) infections in immunocompetent children.Recent FindingsHAdV infections are ubiquitous among children under 5  years of age. To date, over 100 different HAdV genotypes have been identified using genomic and bioinformatic analyses. While the vast majority of infections are mild or asymptomatic, severe, life-threatening manifestations including respiratory failure, meningoencephalitis, myocarditis, and disse minated disease can occur in otherwise healthy infants and children. Neonates are at highest risk of severe or disseminated infection, es...
Source: Current Infectious Disease Reports - August 21, 2020 Category: Infectious Diseases Source Type: research

Cytolytic Vaginosis: a Critical Appraisal of a Controversial Condition
AbstractPurpose of ReviewCytolytic vaginosis is a controversial condition that some clinicians have traditionally included as a potential cause of vulvovaginal symptoms despite the lack of scientific evidence.Recent FindingsRecent articles have focused on the evaluation of patients once they carry the diagnosis of cytolytic vaginosis, rather than on diagnostic criteria.SummaryOur review revealed inadequate criteria for excluding other causes of vulvovaginal symptoms, especially VVC, when diagnosing women with cytolytic vaginosis. Treatment recommendations have remained stagnant with no single case report or case series wit...
Source: Current Infectious Disease Reports - August 12, 2020 Category: Infectious Diseases Source Type: research

Clinical Utility of Lefamulin: If Not Now, When?
AbstractPurpose of ReviewThe looming threat of antimicrobial resistance requires robust stewardship and new developments in infectious diseases pharmacotherapy. This review discusses the pertinent spectrum and clinical data of lefamulin (Xenleta ®), with a focus on potential real-world use.Recent FindingsLefamulin is a novel pleuromutilin antibiotic that obtained Food and Drug Administration labeling for community-acquired bacterial pneumonia (CABP) in 2019. Lefamulin is available in both intravenous and oral formulations, and it inhibits bacterial protein synthesis inhibition through interactive binding to unique site...
Source: Current Infectious Disease Reports - July 9, 2020 Category: Infectious Diseases Source Type: research

Desquamative Inflammatory Vaginitis as an Extraintestinal Manifestation of Crohn ’s Disease
AbstractPurpose of ReviewTo report the association between desquamative inflammatory vaginitis and Crohn ’s disease in 4 women.Recent FindingsExtraintestinal manifestations of inflammatory bowel disease (IBD) are a result of a complex interplay of multiple factors and these may or may not follow an independent course. Vulvar sequelae of Crohn ’s disease have been described in the literature, but the impact of IBD on vaginal health is not well known.SummaryIn all 4 patients, Crohn ’s disease diagnosis was known to the patients, all of whom were managed by experienced gastroenterologists. However, the assoc...
Source: Current Infectious Disease Reports - July 3, 2020 Category: Infectious Diseases Source Type: research

Antimicrobial Stewardship at the Core of COVID-19 Response Efforts: Implications for Sustaining and Building Programs
We describe traditional antimicrobial stewardship program (ASP) activities with a discussion of how these activities can be refocused in the setting of the COVID-19 pandemic. Additionally, we discuss possible adverse consequences of ASP attention diversion on COVID-19 response efforts and overall implications for future pandemic planning. We also discuss ASP in collaboration with other groups within health systems and how COVID-19 may affect these relationships long term. Despite the paucity of literature on Antimicrobial Stewardship and COVID-19, the potential contributions of ASPs during a pandemic are numerous. ASPs can...
Source: Current Infectious Disease Reports - July 3, 2020 Category: Infectious Diseases Source Type: research

Follow your Gut: Microbiome-Based Approaches in the Developmental Pipeline for the Prevention and Adjunctive Treatment of Clostridioides difficile Infection (CDI)
AbstractPurpose of ReviewAntibiotic use is the most important modifiable risk factor for the development ofClostridioides difficile infection (CDI). In addition, up to a quarter of patients treated with standard-of-care antibiotics experience disease recurrence. Until 2016, when bezlotoxumab was approved by the U.S. Food and Drug Administration (FDA), antibiotics were the only medication class approved for use in CDI. A growing knowledge of the roles that the gut microbiome and immune system play in CDI progression and recovery demands new approaches to treatment. As a result, there are many agents, including adjunctive bi...
Source: Current Infectious Disease Reports - June 22, 2020 Category: Infectious Diseases Source Type: research

Role of Antifungal Therapy in Complicated Intra-abdominal Infections
AbstractPurpose of ReviewIn this narrative review, we discuss key questions about the antifungal treatment of complicated intrabdominal infections (cIAI).Recent FindingsAlthough less common than bacteria,Candida spp. are not an infrequent cause of cIAI. Considering that invasive abdominal candidiasis (IAC) may be accompanied by septic shock in up to 40% of cases, empirical antifungal treatment should be considered while waiting for rapid tests and cultures results, and it should be guided by the presence of risk factors for invasive candidiasis in patients with consistent signs and symptoms. Early antifungal therapy before...
Source: Current Infectious Disease Reports - June 10, 2020 Category: Infectious Diseases Source Type: research

Antibiotic Treatment Pipeline for Clostridioides difficile Infection (CDI): A Wide Array of Narrow-Spectrum Agents
AbstractPurpose of ReviewClostridioides difficile infection (CDI) represents a major burden on the U.S. healthcare system. Despite the U.S. Food and Drug Administration (FDA) approval of fidaxomicin in 2011, observed rates of clinical cure and CDI recurrence suggest there is room to improve. As a result, there are many antibiotic treatments in the developmental pipeline for CDI. The purpose of this focused review is to summarize these antibiotic therapies in all stages of development.Recent FindingsHere, we discuss 10 antibiotics in development, including three that have completed phase II trials, five in phase II trials, ...
Source: Current Infectious Disease Reports - June 10, 2020 Category: Infectious Diseases Source Type: research

Latent Tuberculosis and HIV Infection
AbstractPurpose of ReviewTuberculosis is the number one infectious killer of people with HIV worldwide, but it can be both prevented and treated. Prevention of tuberculosis by screening for and treating latent tuberculosis infection (LTBI), along with the initiation of antiretroviral therapy (ART), is the key component of HIV care.Recent FindingsWhile access to ART has increased worldwide, uptake and completion of LTBI treatment regimens among people living with HIV (PWH) are very poor. Concomitant TB-preventive therapy and ART are complex because of drug –drug interactions, but these can be managed. Recent clinical ...
Source: Current Infectious Disease Reports - June 5, 2020 Category: Infectious Diseases Source Type: research

Fatty Liver in HIV-Infected Persons
AbstractAbstractThe high efficacy of new antiretroviral regimens has deeply improved survival of patients living with HIV (PLWH), and currently as the population ages, the focus has shifted to comorbidities especially metabolic disorders which includes nonalcoholic fatty liver disease (NAFLD).Recent FindingsMetabolic syndrome is often associated with increased cardiovascular risk that, in turn, is becoming one of the leading causes of death in PLWH. Another important consequence of metabolic syndrome is NAFLD where there is an increasing incidence among PLWH and if progresses could evolve in terminal chronic liver failure....
Source: Current Infectious Disease Reports - June 5, 2020 Category: Infectious Diseases Source Type: research

Weighing in on the Role of Integrase Strand Transfer Inhibitors (INSTIs) on Weight Gain: Fact or Fiction?
AbstractPurpose of ReviewThe goal of this manuscript was to review the growing body of evidence examining the relationship between integrase strand inhibitors (INSTIs) and weight gain in treatment-na ïve and treatment-experienced populations of people living with HIV. INSTIs have proven to be efficacious in virologic suppression in combination with other antiretrovirals (ARVs); however, recent data has demonstrated a potential link between weight gain and INSTIs, causing concern for risk of dev eloping further metabolic complications. The intent of this review was to understand the magnitude of the weight gain and whe...
Source: Current Infectious Disease Reports - June 5, 2020 Category: Infectious Diseases Source Type: research

Expanding Use of New Technology Creates New Challenges in Preventing and Managing Infections: a Review of Diagnostic and Management Considerations for Infections Among Patients with Long-Term Invasive Devices for Advanced Heart Failure
AbstractPurpose of the ReviewAlthough still a relatively new technology, long-term left ventricular assist devices (LVADs) for management of advanced heart failure is rapidly increasing. Initially designed as a bridge to transplant, these invasive devices are increasingly used as a destination therapy, creating unique and long-term infection risks. The aim of this comprehensive review is to highlight current evidence about the prevention, diagnosis, and management of LVAD-specific infections.Recent FindingsThere are two recent, major societal guidelines (The International Society for Heart and Lung Transplantation, 2017, a...
Source: Current Infectious Disease Reports - June 2, 2020 Category: Infectious Diseases Source Type: research

Diagnostic Stewardship for Comprehensive Gastrointestinal Pathogen Panel Tests
AbstractPurpose of ReviewSyndromic gastrointestinal (GI) panels are molecular tests that evaluate stool specimens for multiple enteric pathogens simultaneously, including viruses, bacteria, and parasites. The Luminex xTAG GI panel includes 14 microbial targets and the Biofire FilmArray GI panel includes 22. The purpose of this scoping review was to describe clinical use of these two commercially available syndromic GI panels.Recent FindingsCompared with conventional testing, syndromic panels increase the number of potential pathogens identified by two- to fivefold. Syndromic panels were associated with non-reproducible res...
Source: Current Infectious Disease Reports - May 29, 2020 Category: Infectious Diseases Source Type: research

To Tweet or Not to Tweet —a Review of the Viral Power of Twitter for Infectious Diseases
AbstractPurpose of ReviewWith real-time communication crucial to both healthcare professionals (HCPs) and the public in infectious diseases (ID), social media networking sites has become even more important. Twitter is the most popular form of social media used for ID communication. We will review the power of Twitter in ID.Recent FindingsTwitter allows for real-time sharing of educational resources at ID scientific conferences, enabling individuals that are not able to attend conferences to follow conferences anytime anywhere and stimulate discussion around topics of interest with experts from across the globe. Further, T...
Source: Current Infectious Disease Reports - April 24, 2020 Category: Infectious Diseases Source Type: research

Coxiella burnetti Infection in Children
AbstractPurpose of ReviewThe epidemiology, clinical manifestations, and management ofCoxiella burnetti infection in children have not been summarized and updated since 2002.Recent FindingsAerosolization from the birth process of infected mammals accounts for almost all cases. Diagnosis requires a compatible clinical picture and serology that meets the criteria for acute or for persistent focal (chronic) infection. Acute disease is rarely diagnosed in children but it is not clear whether this is because infection is rare, infection is usually asymptomatic, or the diagnosis is usually missed. Fever is the main manifestation ...
Source: Current Infectious Disease Reports - April 2, 2020 Category: Infectious Diseases Source Type: research

Improving Antimicrobial Use in Adult Outpatient Clinics: the New Frontier for Antimicrobial Stewardship Programs
AbstractPurpose of ReviewAntimicrobial stewardship (AS) programs are expanding efforts across the entire healthcare continuum. Antimicrobials are commonly overused in outpatient care locations, which have not received the same intensity of AS intervention as inpatient settings. Guidance for AS programs is needed on how to implement interventions and monitor for improvement.Recent FindingsAntimicrobials prescribed in the outpatient setting are inappropriate in 23 –76% of cases. Factors associated with inappropriate prescribing include older adult patients, advanced practice practitioner prescribers, and urgent care cl...
Source: Current Infectious Disease Reports - April 2, 2020 Category: Infectious Diseases Source Type: research

Role of Multiplex Molecular Diagnosis for Acute Gastroenteritis
AbstractPurpose of ReviewTo understand the role of multiplex nucleic acid enteric pathogen panels in the diagnosis and care of patients with acute gastroenteritis.Recent FindingsThe ability to give a comprehensive result in 1 to 3  hours, depending on the enteric panel, has helped clinicians to administer appropriate medical care promptly. However, the syndromic panels for enteric pathogens have only been available for the past 4–5 years, and it is still not always clear when and how the enteric molecular panels should be incorporated into the management of patients with acute infectious gastroenteritis.Sum...
Source: Current Infectious Disease Reports - March 18, 2020 Category: Infectious Diseases Source Type: research

Travel, Diarrhea, Antibiotics, Antimicrobial Resistance and Practice Guidelines — a Holistic Approach to a Health Conundrum
AbstractPurpose of ReviewGiven the recent interest in the interface between travelers ’ diarrhea (TD) management guidelines and antimicrobial resistance from both the patient and population perspectives, we have undertaken a review of the evidence with an aim towards practical and pragmatic recommendations.Recent FindingsAntimicrobial resistance continues to be an existential threat. Therefore, an update is needed on the pathogens that cause TD, the role of antibiotics, the potential changes in microbiome and acquisiton of multi-drug resistant (MDR) bacteria, and lastly the impact of MDR acquisition of the traveler o...
Source: Current Infectious Disease Reports - March 18, 2020 Category: Infectious Diseases Source Type: research

Pediatric Q Fever
AbstractPurpose of ReviewThe non-specific presentation of acute Q fever makes it difficult to diagnose in children, but untreated Q fever can result in chronic infections that have severe complications.Recent FindingsPediatric Q fever cases continue to be infrequently reported in the literature, and primarily document cases of persistent infections withCoxiella burnetii. Standardized treatment protocols for chronic Q fever in children still do not exist. Doxycycline and hydroxychloroquine are the treatment combination most utilized by healthcare providers to treat Q fever endocarditis or osteomyelitis in children, but a va...
Source: Current Infectious Disease Reports - March 18, 2020 Category: Infectious Diseases Source Type: research

Tuberculous Meningitis in Children: a Review Article
AbstractPurpose of ReviewTuberculous meningitis (TBM) in children may mimic bacterial meningitis in the early stages. Being a subacute illness, early symptoms may be missed leading to clinical deterioration and late presentation. This review helps to highlight the clinical manifestations, newer diagnostic tests, and newer treatment guidelines of TBM in children.Recent FindingsNewer tests like nuclei acid amplification tests (NAATs), line probe assays (LPAs), MGIT, antigen detection, and biomarkers are now available on cerebrospinal fluid (CSF) to aid diagnosis to help provide early management and prevent complications. Rec...
Source: Current Infectious Disease Reports - March 18, 2020 Category: Infectious Diseases Source Type: research

The Role of Diagnostic Stewardship in Clostridioides difficile Testing: Challenges and Opportunities
AbstractPurpose of ReviewAccurate and timely diagnosis ofClostridioides difficile infection (CDI) is imperative to preventC. difficile transmission and reduce morbidity and mortality due to CDI, but CDI laboratory diagnostics are complex. The purpose of this article is to review the role of laboratory tests in the diagnosis of CDI and the role of diagnostic stewardship in optimization ofC. difficile testing.Recent FindingsResults fromC. difficile diagnostic tests should be interpreted with an understanding of the strengths and limitations inherent in each testing approach. Use of highly sensitive molecular diagnostic tests...
Source: Current Infectious Disease Reports - February 17, 2020 Category: Infectious Diseases Source Type: research

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