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 - July 31, 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 antibiot...
Source: Current Infectious Disease Reports - July 23, 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. The mo...
Source: Current Infectious Disease Reports - June 20, 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 20, 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 9, 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 3, 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 29, 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 28, 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 21, 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 - April 30, 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 - April 30, 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 - April 30, 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 29, 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 of ...
Source: Current Infectious Disease Reports - April 15, 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 precautions, ...
Source: Current Infectious Disease Reports - April 11, 2019 Category: Infectious Diseases Source Type: research
