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 14, 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 8, 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 6, 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 30, 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 18, 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 criteria for diagnosing specific disorders, b...
Source: Current Infectious Disease Reports - October 7, 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 8, 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 6, 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 of v...
Source: Current Infectious Disease Reports - September 4, 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 30, 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 recommend...
Source: Current Infectious Disease Reports - August 30, 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 30, 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 30, 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 25, 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 5, 2019 Category: Infectious Diseases Source Type: research
