Outpatient Pediatric Antibiotic Use: a Systematic Review
AbstractPurpose of ReviewThe majority of pediatric antibiotic use occurs in outpatients. However, the optimal strategies for antimicrobial stewardship in this setting are unknown. We sought to identify studies relevant to pediatric outpatient stewardship that have been published in the past decade. The details of this systemic review are presented along with targets for future stewardship efforts and discussion regarding effective outpatient stewardship strategies.Recent FindingsIn 2016, the CDC released the “Core Elements of Outpatient Antibiotic Stewardship” that serve as practical guidelines to develop impactful and...
Source: Current Infectious Disease Reports - March 19, 2019 Category: Infectious Diseases Source Type: research
Safe Travel Preparation for HIV-Infected Patients
AbstractPurpose of ReviewInfectious diseases are a risk when traveling internationally, and it is important to know the potential disease burden of a region and take appropriate preventative actions before traveling. For individuals with HIV, there are special considerations and contradictions for various vaccines and medications as well as interactions with likely antiviral drugs. The purpose of this review is to summarize the vaccine and medication recommendations for travelers with HIV infection. We also review recent studies to update these recommendations.Recent FindingsThe recommendation for yellow fever vaccine has ...
Source: Current Infectious Disease Reports - March 19, 2019 Category: Infectious Diseases Source Type: research
Self-Collection and Molecular Diagnosis for Detection of Human Papillomavirus: Why Incorporate It?
AbstractPurpose of ReviewCervical cancer, the third cause of death by cancer among Brazil ’s women, is associated with human papillomavirus (HPV) infection. In some countries of South America, North America, Europe, and Oceania, initial screening for HPV DNA and subsequent follow-up with HPV-positive patients using colposcopy and cytological testing are used as preventative measures.Recent FindingsFor HPV DNA detection, it is necessary to obtain cervical cells by conventional clinical collection method or self-collection of the cells that flake off from the uterine cervix and vaginal canal. Self-collection has been shown...
Source: Current Infectious Disease Reports - March 18, 2019 Category: Infectious Diseases Source Type: research
Prevention Strategies for Recurrent Community-Associated Staphylococcus aureus Skin and Soft Tissue Infections
AbstractPurpose of ReviewStaphylococcus aureus skin and soft tissue infections (SSTI) are a major source of morbidity. More than half of patients experiencing SSTI will have at least one recurrent infection. These infections frequently cluster in households. Given the burden these infections pose to patients and healthcare, prevention strategies are of major clinical importance and represent an active area of research. Bacterial colonization is frequently an early and critical step in the pathogenesis of infection. As such, strategies to prevent reinfection have aimed to decrease staphylococcal colonization of the skin and...
Source: Current Infectious Disease Reports - March 10, 2019 Category: Infectious Diseases Source Type: research
Advances and Challenges in the Diagnosis and Treatment of Urinary Tract Infections: the Need for Diagnostic Stewardship
AbstractPurpose of ReviewUrinary tract infections (UTIs), including catheter-associated UTIs, are among the most common bacterial infections in both inpatient and outpatient settings. Diagnosis of true UTI remains a clinical challenge, and excessive antimicrobial treatment of asymptomatic bacteriuria (ASB) or contaminated urine cultures is common.Recent FindingsChallenges with the appropriate diagnosis of UTIs include the lack of specific signs and symptoms, no definitive diagnostic criteria, high incidence of ASB, contamination of samples, and frequent lack of indications for ordering urine cultures. Promising interventio...
Source: Current Infectious Disease Reports - March 4, 2019 Category: Infectious Diseases Source Type: research
Mortality Predictive Scores for Community-Acquired Pneumonia in Children
AbstractPurpose of ReviewThe use of severity score for the staging of pneumonias has emerged as a necessity for the physician caring for this disease. Although there are several established prognostic scoring systems for community-acquired pneumonia in adults, the availability for children are scarce.Recent FindingsRecently, scoring system for risk stratification of children with pneumonia were developed in low- and middle-income countries. They use clinical variables that represent known risk factors for severe outcomes of respiratory illness in children, such as hypoxemia, chest indrawing, refusal to feed, malnutrition, ...
Source: Current Infectious Disease Reports - March 4, 2019 Category: Infectious Diseases Source Type: research
Enterotoxigenic Escherichia coli Infections
AbstractPurpose of ReviewReview recent developments pertaining to the epidemiology, molecular pathogenesis, and sequelae of enterotoxigenicEscherichia coli (ETEC) infections in addition to discussion of challenges for vaccinology.Recent FindingsETEC are a major cause of diarrheal illness in resource poor areas of the world where they contribute to unacceptable morbidity and continued mortality particularly among young children; yet, precise epidemiologic estimates of their contribution to death and chronic disease have been difficult to obtain. Although most pathogenesis studies, and consequently vaccine development have f...
Source: Current Infectious Disease Reports - March 3, 2019 Category: Infectious Diseases Source Type: research
Biofilm Formations in Pediatric Respiratory Tract Infection Part 2: Mucosal Biofilm Formation by Respiratory Pathogens and Current and Future Therapeutic Strategies to Inhibit Biofilm Formation or Eradicate Established Biofilm
AbstractPurpose of ReviewThe purpose of this review is to discuss the unique pathways of biofilm formation utilized by respiratory pathogens and current and future therapeutic strategies to inhibit biofilm formation or eradicate established biofilm in the context of these pathogens. Both nonselective and selective strategies for inhibiting biofilm formation or disrupting established biofilm are discussed.Recent FindingsNumerous strategies are being actively pursued to inhibit biofilm formation or eradicate established biofilm in respiratory pathogens. These can be broadly categorized by the stage of biofilm formation (adhe...
Source: Current Infectious Disease Reports - March 1, 2019 Category: Infectious Diseases Source Type: research
Biofilm Formations in Pediatric Respiratory Tract Infection
AbstractPurpose of ReviewBiofilm represents an organized structure of microorganisms within an extracellular matrix attached to a surface. While the importance of biofilm in prosthetic heart valve and catheter-related infections has been known since the 1980s, the role of mucosal biofilm in human disease pathogenesis has only recently been elucidated. It is now clear that mucosal biofilm is present in both healthy and pathologic states. The purpose of this review is to examine the role of mucosal biofilm in pediatric respiratory infections.Recent FindingsMucosal biofilm has been implicated in relationship to several pediat...
Source: Current Infectious Disease Reports - February 28, 2019 Category: Infectious Diseases Source Type: research
Antiretroviral Resistance Patterns in Children with HIV Infection
AbstractPurpose of ReviewTo provide an update on the patterns of HIV drug resistance in children, including pretreatment drug resistance (PDR) and acquired drug resistance (ADR), focusing on children in low- and middle-income countries (LMICs) for whom empiric first-line (FL) and second-line (SL) antiretroviral regimens are usually recommended.Recent FindingsHigh levels of PDR, particularly to non-nucleoside reverse transcriptase inhibitors (NNRTIs), and poor treatment outcomes on NNRTI-based FL antiretroviral therapy (ART) have been widely reported among infants and young children. There is a paucity of recent data on the...
Source: Current Infectious Disease Reports - February 28, 2019 Category: Infectious Diseases Source Type: research
Diagnosis and Management of CMV Colitis
AbstractPurpose of ReviewCytomegalovirus (CMV) colitis is a relatively common end-organ infectious complication in immunocompromised hosts which negatively affects clinical outcomes. This paper presents the contemporary approaches to the diagnosis and management of CMV colitis and discusses some of the controversies of this condition, focusing on methods of diagnosis.Recent FindingsWhile certain risk factors for CMV colitis are well recognized, the clinical as well as endoscopic features of this condition are nonspecific. Rapid diagnosis and management are usually needed, especially in critically ill patients, which necess...
Source: Current Infectious Disease Reports - February 15, 2019 Category: Infectious Diseases Source Type: research
Recent Innovations in Diagnosis and Treatment of Pediatric Tuberculosis
AbstractPurpose of ReviewTuberculosis is leading cause of global morbidity and mortality and a significant proportion of the burden of disease occurs in children. In the past 5 years, a number of innovations have improved the diagnosis and treatment for children with both latent tuberculosis infection and active disease.Recent FindingsThis review discusses three key areas of innovation. First, we assess utilization and performance of interferon-gamma release assays (IGRAs) in different clinical and epidemiologic scenarios. Recent literature has demonstrated good performance of IGRAs for diagnosis of latent tuberculosis i...
Source: Current Infectious Disease Reports - February 15, 2019 Category: Infectious Diseases Source Type: research
Zika Virus-Associated Aseptic Meningitis and Guillain –Barre Syndrome in a Traveler Returning from Latin America: a Case Report and Mini-Review
AbstractZIKV-associated Guillain –Barré syndrome presents with an accelerated clinical course compared to classic post-infectious Guillain–Barré syndrome. Clinicians should anticipate and screen patients with ZIKV infection for neurologic complications bearing in mind that these may manifest during the acute viremic phase or during early convalescence. (Source: Current Infectious Disease Reports)
Source: Current Infectious Disease Reports - February 15, 2019 Category: Infectious Diseases Source Type: research
Hospital Infection Prevention: How Much Can We Prevent and How Hard Should We Try?
AbstractPurpose of ReviewTo summarize the extent to which hospital-acquired infections (HAIs) are preventable and to assess expectations, challenges, and barriers to improve patient outcomes.Recent FindingsHAIs cause significant morbidity and mortality. Getting to zero HAIs is a commonly stated goal yet leads to unrealistic expectations. The extent to which all HAIs can be prevented remains debatable and is subject to multiple considerations and barriers. Current infection prevention science is inexact and evolving. Evidence-based infection prevention practices are often incompletely implemented and at times controversial....
Source: Current Infectious Disease Reports - February 2, 2019 Category: Infectious Diseases Source Type: research
Clostridioides difficile – Associated Diarrhea: Infection Prevention Unknowns and Evolving Risk Reduction Strategies
AbstractPurpose of ReviewNew controversies in the diagnosis and prevention ofClostridiodes difficile are challenging and at times changing infection control practice at many medical centers.Recent FindingsMolecular epidemiologic studies are changing our understanding ofC. difficile and its spectrum of disease.C. difficile as a hospital-acquired infection is likely largely overdiagnosed given overly sensitive molecular testing and widespread colonization of ill or debilitated patients.SummaryClostridiodes difficile infection continues to challenge infection prevention programs. Shifts in our understanding of the epidemiolog...
Source: Current Infectious Disease Reports - January 23, 2019 Category: Infectious Diseases Source Type: research
