Racial/Ethnic Inequities in Healthcare-associated Infections Under the Shadow of Structural Racism: Narrative Review and Call to Action
AbstractPurpose of ReviewThe purpose of this study is to review racial and ethnic inequities in the incidence and prevention of healthcare-associated infections (HAIs) in the USA, identify gaps in the literature, and recommend future directions to mitigate these inequities.Recent FindingsWhile some existing literature has identified the presence of racial/ethnic inequities in HAI incidence and outcomes, few studies to date have evaluated whether HAI prevention efforts have mitigated these inequities. Factors contributing to inequities in HAI prevention may include unconscious bias of healthcare professionals towards minori...
Source: Current Infectious Disease Reports - August 27, 2021 Category: Infectious Diseases Source Type: research
Quality Improvement Interventions and Implementation Strategies for Urine Culture Stewardship in the Acute Care Setting: Advances and Challenges
AbstractPurpose of ReviewThe goal of this article is to highlight how and why urinalyses and urine cultures are misused, review quality improvement interventions to optimize urine culture utilization, and highlight how to implement successful, sustainable interventions to improve urine culture practices in the acute care setting.Recent FindingsQuality improvement initiatives aimed at reducing inappropriate treatment of asymptomatic bacteriuria often focus on optimizing urine test utilization (i.e., urine culture stewardship). Urine culture stewardship interventions in acute care hospitals span the spectrum of quality impro...
Source: Current Infectious Disease Reports - August 26, 2021 Category: Infectious Diseases Source Type: research
Infection Prevention and Antimicrobial Stewardship Program Collaboration During the COVID-19 Pandemic: a Window of Opportunity
We describe the similarities between antimicrobial stewardship programs (ASPs) and infection prevention programs (IPPs), and we discuss how these similarities lend themselves to synergy between programs. We also discuss how the COVID-19 pandemic has generated further opportunities for future collaborations that could benefit both programs.Recent FindingsThe COVID-19 pandemic has created new needs, such as real-time data and access to personnel important to both programs, such as information technologists and infectious diseases specialists. It has also increased concerns about rising rates of antimicrobial resistance and h...
Source: Current Infectious Disease Reports - August 18, 2021 Category: Infectious Diseases Source Type: research
Tuberculosis in Solid Organ Transplantation: Insights from TB Endemic Areas
AbstractPurpose of ReviewThe incidence of tuberculosis (TB) is many fold higher in transplant recipients than in the general population with the highest risk in first year post-transplant. The purpose of this review is to describe the epidemiology, clinical characteristics, management, and outcomes of TB in organ transplant recipients from TB endemic regions and highlight the challenges faced in their management.Recent FindingsTB can be increasingly difficult to diagnose and manage in transplant recipients. Clinical manifestations are often atypical leading to delay in diagnosis and available diagnostic modalities are limi...
Source: Current Infectious Disease Reports - July 13, 2021 Category: Infectious Diseases Source Type: research
Applying Antimicrobial Pharmacokinetic Principles for Complex Patients: Critically Ill Adult Patients Receiving Extracorporeal Membrane Oxygenation and Renal Replacement Therapy
The objective of this review is to discuss the available literature to support clinicians in navigating dosing challenges in this clinical scenario.Recent FindingsThe number of antimicrobial pharmacokinetic (PK) studies in patients on RRT and ECMO is growing. However, very few studies have been designed to describe the combined effects of the concurrent use of two extracorporeal circuits. Currently available literature consists of studies with small sample sizes and provides inconsistent findings. Nevertheless, it is clear that it is not a simple sum of the independent RRT- and ECMO-induced PK changes in addition to the PK...
Source: Current Infectious Disease Reports - July 11, 2021 Category: Infectious Diseases Source Type: research
New Microbiological Techniques for the Diagnosis of Bacterial Infections and Sepsis in ICU Including Point of Care
AbstractPurpose of ReviewThe aim of this article is to review current and emerging microbiological techniques that support the rapid diagnosis of bacterial infections in critically ill patients, including their performance, strengths and pitfalls, as well as available data evaluating their clinical impact.Recent FindingsBacterial infections and sepsis are responsible for significant morbidity and mortality in patients admitted to the intensive care unit and their management is further complicated by the increase in the global burden of antimicrobial resistance. In this setting, new diagnostic methods able to overcome the l...
Source: Current Infectious Disease Reports - June 16, 2021 Category: Infectious Diseases Source Type: research
Correction to: 2021 Update on the Clinical Management and Diagnosis of Kawasaki Disease
A Correction to this paper has been published:https://doi.org/10.1007/s11908-021-00754-1 (Source: Current Infectious Disease Reports)
Source: Current Infectious Disease Reports - June 3, 2021 Category: Infectious Diseases Source Type: research
Infectious Challenges with Novel Antibody –Based Therapies
AbstractPurpose of ReviewThe development of new antibody-based therapies has changed the landscape of the treatment of malignancies and improved post-transplant outcomes for transplant recipients. Use of these new therapies has led to recognition of unintended, potentially serious infectious complications. This review seeks to provide an overview of the infectious risks of these agents and assist clinicians in how to address them.Recent FindingsDue to its profound depletion of B- and T-lymphocytes, alemtuzumab increases the risk of viral reactivation and other intracellular pathogens. Anti-CD20 agents increase the risk of ...
Source: Current Infectious Disease Reports - May 7, 2021 Category: Infectious Diseases Source Type: research
Status Report on COVID-19 Vaccines Development
AbstractPurpose of ReviewThe emergence of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has affected lives of billions of individuals, globally. There is an urgent need to develop interventions including vaccines to control the ongoing pandemic.Recent FindingsDevelopment of tools for fast-tracked testing including small and large animal models for vaccine efficacy analysis, assays for immunogenicity assessment, critical reagents, international biological standards, and data sharing allowed accelerated development of vaccines. More than 300 vaccines are under development and 9 of them are approved for eme...
Source: Current Infectious Disease Reports - April 14, 2021 Category: Infectious Diseases Source Type: research
Unnecessary Antibiotic Prescribing in Dental Practices and Associated Adverse Effects
AbstractPurpose of the ReviewDentists prescribe 10% of outpatient antibiotics in the USA; we discuss recent data evaluating antibiotic use in dentistry and opportunities for improvement.Recent FindingsWe review the indications for antibiotics in dentistry, recent data highlighting frequent unnecessary use of antibiotic prophylaxis prior to dental procedures, adverse effects associated with antibiotic use in dentistry, and examples of successful stewardship interventions in the dental setting.SummaryAntimicrobial stewardship in dentistry is nascent and current data suggest antibiotic use can be significantly improved in thi...
Source: Current Infectious Disease Reports - April 14, 2021 Category: Infectious Diseases Source Type: research
Evidence Regarding Rapid Initiation of Antiretroviral Therapy in Patients Living with HIV
AbstractPurpose of ReviewRapid initiation of antiretroviral therapy (ART) is increasingly more common among clinics serving people living with human immunodeficiency virus (PLWH). It is recommended by major guidelines and is especially important in achieving the Getting to Zero (GTZ) goals by 2030. Patients should be offered the option to initiate ART as soon as possible, preferably at time of HIV diagnosis, with the goal of reducing transmission, morbidity, and mortality.Recent FindingsThree published randomized controlled trials, and several other observational, prospective, and retrospective studies, demonstrated superi...
Source: Current Infectious Disease Reports - April 2, 2021 Category: Infectious Diseases Source Type: research
Challenges to Reporting the Global Trends in the Epidemiology of ICU-Treated Sepsis and Septic Shock
AbstractPurpose of ReviewIt is widely believed that the epidemiology of sepsis and septic shock treated in the intensive care unit (ICU) is changing. However, quantifying changes in occurrence and outcomes of ICU-treated sepsis and septic shock are challenged by a number of factors related to study designs as well as varied local resource availability and practices. The authors conducted a structured literature review to examine contemporary studies reporting trends in the prevalence, incidence and case-fatality rates of ICU-treated sepsis and septic shock around the world and further attempted to extrapolate the recent ep...
Source: Current Infectious Disease Reports - March 15, 2021 Category: Infectious Diseases Source Type: research
Syndromic Multiplex Polymerase Chain Reaction (mPCR) Testing and Antimicrobial Stewardship: Current Practice and Future Directions
AbstractPurpose of ReviewSyndromic multiplex polymerase chain reaction (mPCR) panels offer the antimicrobial steward a rapid tool for optimizing and de-escalating antimicrobials. In this review, we analyze the role of syndromic mPCR in respiratory, gastrointestinal, and central nervous system infections within the context of antimicrobial stewardship efforts.Recent FindingsFor all mPCR syndromic panels, multiple studies analyzed the pre-and-post implementation impact of mPCR on antimicrobial utilization. Prospective studies and trials of respiratory mPCR stewardship interventions, including diagnostic algorithms, education...
Source: Current Infectious Disease Reports - February 26, 2021 Category: Infectious Diseases Source Type: research
Host Diagnostic Biomarkers of Infection in the ICU: Where Are We and Where Are We Going?
AbstractPurpose of ReviewEarly identification of infection in the critically ill patient and initiation of appropriate treatment is key to reducing morbidity and mortality. On the other hand, the indiscriminate use of antimicrobials leads to harms, many of which may be exaggerated in the critically ill population. The current method of diagnosing infection in the intensive care unit relies heavily on clinical gestalt; however, this approach is plagued by biases. Therefore, a reliable, independent biomarker holds promise in the accurate determination of infection. We discuss currently used host biomarkers used in the intens...
Source: Current Infectious Disease Reports - February 12, 2021 Category: Infectious Diseases Source Type: research
