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 21, 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 9, 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 9, 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 tria...
Source: Current Infectious Disease Reports - June 4, 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 4, 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 whether...
Source: Current Infectious Disease Reports - June 4, 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 1, 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 28, 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 23, 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 1, 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 clinic...
Source: Current Infectious Disease Reports - April 1, 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.SummaryThe intr...
Source: Current Infectious Disease Reports - March 17, 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 on in...
Source: Current Infectious Disease Reports - March 17, 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 17, 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 17, 2020 Category: Infectious Diseases Source Type: research
