Arboviral central nervous system infections
Purpose of review This review provides an overview of arthropod-borne virus (arbovirus) infections that are important causes of human neurological infections world-wide. As many of the individual viruses in a specific genus or family cause overlapping clinical syndromes, this review discusses important viruses in groups to highlight some of the similarities and differences in groups of neuroinvasive arbovirus infections. Recent Findings Arboviruses that cause neurological infections in humans continue to emerge and distribute to new regions. The geographic range of the vectors, the hosts and subsequent arbovirus...
Source: Current Opinion in Infectious Diseases - May 2, 2021 Category: Infectious Diseases Tags: CNS INFECTIONS: Edited by Adarsh Bhimraj Source Type: research

Antimicrobial use in central nervous system infections
Purpose of review Central nervous system (CNS) infections are associated with high rates of morbidity and mortality. The purpose of this review is to summarize current antimicrobial therapies, as well as, updates in the management of community-acquired meningitis and healthcare-associated meningitis and ventriculitis. Recent findings Due to the increasing rates of multidrug resistant and extensively-drug resistant organisms, available antimicrobials are limited. Novel treatment options include newer systemic antimicrobials and antimicrobials that have previously limited data in the management of CNS infections. ...
Source: Current Opinion in Infectious Diseases - May 2, 2021 Category: Infectious Diseases Tags: CNS INFECTIONS: Edited by Adarsh Bhimraj Source Type: research

The returned traveler with neurologic manifestations: could my patient have a parasite?
Purpose of review The present review focuses on parasitic infections of the central nervous system (CNS) that can affect the international traveler. Recent findings The epidemiology of imported parasitic infections is changing and clinicians are treating increasing numbers of returned travelers with parasitic infections in the CNS with which they are not familiar. Summary The epidemiology, life cycle, clinical manifestations, diagnosis, and treatment of parasites that affect the CNS will be discussed. (Source: Current Opinion in Infectious Diseases)
Source: Current Opinion in Infectious Diseases - May 2, 2021 Category: Infectious Diseases Tags: CNS INFECTIONS: Edited by Adarsh Bhimraj Source Type: research

Central nervous system infections associated with neurologic devices
Purpose of review To review recent data on the epidemiology, microbiology, diagnosis, and management of central nervous system (CNS) infections associated with neurologic devices. Recent findings The increasing use of implanted neurologic devices has led to an increase in associated infections. Cerebrospinal fluid (CSF) inflammation may be present after a neurosurgical procedure, complicating the diagnosis of CNS infection. Newer biomarkers such as CSF lactate and procalcitonin show promise in differentiating infection from other causes of CSF inflammation. Molecular diagnostic tests including next-generation or...
Source: Current Opinion in Infectious Diseases - May 2, 2021 Category: Infectious Diseases Tags: CNS INFECTIONS: Edited by Adarsh Bhimraj Source Type: research

Neuroradiology of infectious diseases
Purpose of review Early diagnosis of central nervous system (CNS) infections is crucial given high morbidity and mortality. Neuroimaging in CNS infections is widely used to aid in the diagnosis, treatment and to assess the response to antibiotic and neurosurgical interventions. Recent findings The Infectious Diseases Society of America (IDSA) guidelines have clear recommendations for obtaining a computerized tomography of the head (CTH) prior to lumbar puncture (LP) in suspected meningitis. In the absence of indications for imaging or in aseptic meningitis, cranial imaging is of low utility. In contrast, cranial...
Source: Current Opinion in Infectious Diseases - May 2, 2021 Category: Infectious Diseases Tags: CNS INFECTIONS: Edited by Adarsh Bhimraj Source Type: research

Neurologic aspects of coronavirus disease of 2019 infection
Purpose of review Central and peripheral nervous system manifestations of coronavirus disease 2019 (COVID-19) have been frequently reported and may cause significant morbidity and mortality. This review details the latest evidence on the neuropathogenesis and neurologic complications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Recent findings Commonly reported neurologic complications include toxic-metabolic encephalopathy, acute cerebrovascular disorders, seizures, and anoxic-brain injury. These complications represent secondary injury due to COVID-19 related hypoxia, sepsis, hype...
Source: Current Opinion in Infectious Diseases - May 2, 2021 Category: Infectious Diseases Tags: CNS INFECTIONS: Edited by Adarsh Bhimraj Source Type: research

Central nervous system infections after solid organ transplantation
Purpose of review Significant advances to our understanding of several neuroinfectious complications after a solid organ transplant (SOT) have occurred in the last few years. Here, we review the central nervous system (CNS) infections that are relevant to SOT via a syndromic approach with a particular emphasis on recent updates in the field. Recent findings A few key studies have advanced our understanding of the epidemiology and clinical characteristics of several CNS infections in SOT recipients. Risk factors for poor prognosis and protective effects of standard posttransplant prophylactic strategies have been...
Source: Current Opinion in Infectious Diseases - May 2, 2021 Category: Infectious Diseases Tags: CNS INFECTIONS: Edited by Adarsh Bhimraj Source Type: research

Editorial: What's hot in neurologic infections?
No abstract available (Source: Current Opinion in Infectious Diseases)
Source: Current Opinion in Infectious Diseases - May 2, 2021 Category: Infectious Diseases Tags: CNS INFECTIONS: Edited by Adarsh Bhimraj Source Type: research

The intracellular phase of extracellular respiratory tract bacterial pathogens and its role on pathogen-host interactions during infection
Purpose of review An initial intracellular phase of usually extracellular bacterial pathogens displays an important strategy to hide from the host's immune system and antibiotics therapy. It helps the bacteria, including bacterial pathogens of airway diseases, to persist and eventually switch to a typical extracellular infection. Several infectious diseases of the lung are life-threatening and their control is impeded by intracellular persistence of pathogens. Thus, molecular adaptations of the pathogens to this niche but also the host's response and potential targets to interfere are of relevance. Here we discuss exam...
Source: Current Opinion in Infectious Diseases - May 2, 2021 Category: Infectious Diseases Tags: PATHOGENESIS AND IMMUNE RESPONSE: Edited by Dennis L. Stevens and Dimitri Diavatopoulos Source Type: research

Bacterial RTX toxins and host immunity
Purpose of review RTX toxin action often defines the outcome of bacterial infections. Here, we discuss the progress in understanding the impacts of RTX toxin activities on host immunity. Recent findings Bordetella pertussis CyaA activity paralyzes sentinel phagocytic cells by elevating cellular cAMP levels and blocks differentiation of infiltrating monocytes into bactericidal macrophages, promoting also de-differentiation of resident alveolar macrophages into monocyte-like cells. Vibrio cholerae multifunctional autoprocessing repeats-in-toxins (MARTX), through Rho inactivating and α/β-hydrolase (ABH) ...
Source: Current Opinion in Infectious Diseases - May 2, 2021 Category: Infectious Diseases Tags: PATHOGENESIS AND IMMUNE RESPONSE: Edited by Dennis L. Stevens and Dimitri Diavatopoulos Source Type: research

Mucosal immunity to severe acute respiratory syndrome coronavirus 2 infection
Purpose of review Despite its crucial role in protection against viral infections, mucosal immunity has been largely understudied in the context of coronavirus disease 2019 (COVID-19). This review outlines the current evidence about the role of mucosal immune responses in the clearance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, as well as potential mucosal mechanisms of protection against (re-)infection. Recent findings The angiotensin-converting enzyme 2 cellular entry receptor for SARS-CoV-2 is most highly expressed in the upper respiratory tract and most SARS-CoV-2 shedding occ...
Source: Current Opinion in Infectious Diseases - May 2, 2021 Category: Infectious Diseases Tags: PATHOGENESIS AND IMMUNE RESPONSE: Edited by Dennis L. Stevens and Dimitri Diavatopoulos Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Infectious Diseases)
Source: Current Opinion in Infectious Diseases - May 2, 2021 Category: Infectious Diseases Tags: EDITORIAL INTRODUCTIONS Source Type: research

Applying the lessons learned from coronavirus disease 2019 to improve pneumonia management
Purpose of review Coronavirus disease 2019 (COVID-19) has produced an extraordinary amount of literature in a short time period. This review focuses on what the new literature has provided in terms of more general information about the management of community-acquired pneumonia (CAP). Recent findings Measures taken to reduce the spread of COVID-19 have caused a significant drop in influenza worldwide. Improvements in imaging, especially ultrasound, and especially in the application of rapid molecular diagnosis are likely to have significant impact on the management of CAP. Therapeutic advances are so far limited...
Source: Current Opinion in Infectious Diseases - March 11, 2021 Category: Infectious Diseases Tags: RESPIRATORY INFECTIONS: Edited by Michael S. Niederman Source Type: research

When should we use corticosteroids in severe community-acquired pneumonia?
Purpose of review This review aims to evaluate the evidence and recommendations for the prescription of corticosteroids as adjunctive therapy in patients with severe community-acquired pneumonia. Recent findings Corticosteroids have been prescribed with the objective to attenuate the marked and persistent activation of the immune system. However, some causes of community-acquired pneumonia, namely viral, are associated with unexpected low levels of cytokines and depressed cellular immunity. As a result, several recent randomized controlled trials and large prospective observational studies repeatedly showed that...
Source: Current Opinion in Infectious Diseases - March 11, 2021 Category: Infectious Diseases Tags: RESPIRATORY INFECTIONS: Edited by Michael S. Niederman Source Type: research

Nebulized antibiotics for ventilator-associated pneumonia: methodological framework for future multicenter randomized controlled trials
Purpose of review Although experimental evidence supports the use of nebulized antibiotics in ventilator-associated pneumonia (VAP), two recent multicenter randomized controlled trials (RCTs) have failed to demonstrate any benefit in VAP caused by Gram-negative bacteria (GNB). This review examines the methodological requirements concerning future RCTs. Recent findings High doses of nebulized antibiotics are required to reach the infected lung parenchyma. Breath-synchronized nebulizers do not allow delivery of high doses. Mesh nebulizers perform better than jet nebulizers. Epithelial lining fluid concentrations d...
Source: Current Opinion in Infectious Diseases - March 11, 2021 Category: Infectious Diseases Tags: RESPIRATORY INFECTIONS: Edited by Michael S. Niederman Source Type: research

Novelty and nuance in the intensive care unit: new options to combat multidrug resistant pneumonia
Purpose of review To describe the increasing burden of multidrug resistant (MDR) Gram-negative pathogens in severe pneumonia and to examine the clinical trials supporting a role for novel agents for the treatment of this infection. Recent findings MDR Gram-negative bacteria cause an increasing proportion of severe pneumonias. Although the epidemiology of resistance varies across the globe, all regions have seen an evolution in resistance, especially among Enterobacterales spp, Pseudomonas aeruginosa, and Acinetobacter bumannii. Fortunately, several clinical trials have established the role for multiple new antib...
Source: Current Opinion in Infectious Diseases - March 11, 2021 Category: Infectious Diseases Tags: RESPIRATORY INFECTIONS: Edited by Michael S. Niederman Source Type: research

Noninvasive ventilation and high-flow oxygen therapy for severe community-acquired pneumonia
Purpose of review We review the evidence on the use of noninvasive respiratory supports (noninvasive ventilation and high-flow nasal cannula oxygen therapy) in patients with acute respiratory failure because of severe community-acquired pneumonia. Recent findings Noninvasive ventilation is strongly advised for the treatment of hypercapnic respiratory failure and recent evidence justifies its use in patients with hypoxemic respiratory failure when delivered by helmet. Indeed, such interface allows alveolar recruitment by providing high level of positive end-expiratory pressure, which improves hypoxemia. On the ot...
Source: Current Opinion in Infectious Diseases - March 11, 2021 Category: Infectious Diseases Tags: RESPIRATORY INFECTIONS: Edited by Michael S. Niederman Source Type: research

Pneumonia in older adults
Purpose of review The purpose of this review is to address the relevant issues surrounding older adults with community-acquired pneumonia (CAP) today. Recent findings Approximately 1 million people>65 years have CAP in the US per year, which is more than previously reported (or realized). Older adults are vulnerable to the increasing prevalence of viral CAP, as the SARS-CoV-2 pandemic emphasizes, but pneumococcus is still the most common pathogen to cause CAP. Racial disparities continue to need to be addressed in order to improve early and late outcomes of older adults with CAP. Summary The epidemio...
Source: Current Opinion in Infectious Diseases - March 11, 2021 Category: Infectious Diseases Tags: RESPIRATORY INFECTIONS: Edited by Michael S. Niederman Source Type: research

Biomarkers in sepsis: can they help improve patient outcome?
Purpose of review Biomarkers, mainly procalcitonin, are commonly used in sepsis diagnosis, prognosis and treatment follow-up. This review summarizes the potential benefit of their use for the critically ill. Recent findings Increased clinical evidence from randomized clinical trials of biomarker-guided treatment suggests a trend for appropriate but short antimicrobial treatment for the critically ill. Procalcitonin (PCT) is the most studied biomarker; in the majority of randomized clinical trials, the use of a stopping rule of antibiotics on the day when PCT is below 80% from baseline or less than 0.5 ng/ml wa...
Source: Current Opinion in Infectious Diseases - March 11, 2021 Category: Infectious Diseases Tags: RESPIRATORY INFECTIONS: Edited by Michael S. Niederman Source Type: research

Molecular diagnostic methods for pneumonia: how can they be applied in practice?
Purpose of review Pneumonia represents a major burden in clinical practice. A rapid etiological diagnosis is critical for optimizing the antibiotic use. Owing to the variety of possible pathogens and the time needed for bacterial cultures or usual polymerase chain reaction (PCR) assays, timely and precise diagnosis is a huge challenge. Several new rapid multiplex assays have been developed in the last decade to resolve these issues. This review aims to provide an overview of recent evidence on improvements and limitations of new rapid molecular assays for pneumonia. Recent findings Several rapid multiplex-PCR as...
Source: Current Opinion in Infectious Diseases - March 11, 2021 Category: Infectious Diseases Tags: RESPIRATORY INFECTIONS: Edited by Michael S. Niederman Source Type: research

Potential role of new-generation antibiotics in acute bacterial skin and skin structure infections
Purpose of review To summarize the available results of primary analyses from high-quality randomized studies of either recently approved or possible future agents for the treatment of acute bacterial skin and skin structure infections (ABSSSI). Recent findings In the last 2 decades, several novel agents have been approved for the treatment of ABSSSI, that are also active against methicillin-resistant Staphylococcus aureus (MRSA). In addition to already available agents, further molecules are in clinical development that could become available for treating ABSSSI in the forthcoming future. Summary The cur...
Source: Current Opinion in Infectious Diseases - March 11, 2021 Category: Infectious Diseases Tags: SKIN AND SOFT TISSUE INFECTIONS: Edited by Matteo Bassetti Source Type: research

Role or oritavancin and dalbavancin in acute bacterial skin and skin structure infections and other potential indications
Purpose of review To discuss the currently available evidence about the use oritavancin and dalbavancin for the treatment of acute bacterial skin and skin structure infections (ABSSSI) and for other potential indications. Recent findings In this review, we briefly summarize the available data on efficacy (from randomized controlled trials) and on effectiveness and cure rates (from observational studies) pertaining to the use of oritavancin and dalbavancin either for ABSSSI or for other indications. Summary Oritavancin and dalbavancin are valid options for outpatient therapy and early discharge in patients...
Source: Current Opinion in Infectious Diseases - March 11, 2021 Category: Infectious Diseases Tags: SKIN AND SOFT TISSUE INFECTIONS: Edited by Matteo Bassetti Source Type: research

Current management of necrotizing soft-tissue infections
Purpose of review The aim of the article is to present recent epidemiological, microbiological, and clinical data for the surgical, antimicrobial, and adjunctive management of necrotizing soft-tissue infections (NSTI). Recent findings NSTI can be caused by a broad variety of organisms. Reports about NSTI caused by multidrug-resistant bacteria are increasing. Owing to the rareness of NSTI, general clinical awareness is low and prompt diagnosis is often delayed. New diagnostic instruments (scoring systems, MRI) have either a low accuracy or are time consuming and cannot guide clinicians reliable currently. The val...
Source: Current Opinion in Infectious Diseases - March 11, 2021 Category: Infectious Diseases Tags: SKIN AND SOFT TISSUE INFECTIONS: Edited by Matteo Bassetti Source Type: research

The eternal dilemma of antitoxin antibiotics for skin and soft tissue infection
Purpose of review In standard clinical practice, combined antibiotic treatment is used to treat severe skin and soft tissue infections (SSTIs), whereby one of the drugs is usually a protein synthesis inhibitor antibiotic. However, evidence for this practice is only based on data from ‘in vitro’ studies, animal models and case reports. There are no randomized controlled trials. In the light of several new drugs marketed for the treatment of these infections, there is a need to revise the state of the art. Recent findings New reviews and systematic appraisals of the literature exist on the use of prote...
Source: Current Opinion in Infectious Diseases - March 11, 2021 Category: Infectious Diseases Tags: SKIN AND SOFT TISSUE INFECTIONS: Edited by Matteo Bassetti Source Type: research

Skin manifestations of Pseudomonas aeruginosa infections
Purpose of review Pseudomonas aeruginosa is an opportunistic pathogen with considerable morbidity and mortality, particularly in vulnerable hosts. Skin manifestations are common, either representing local inoculation or secondary skin seeding following bloodstream infections. As patients with various predisposing conditions are expanding, we sought to review the most recent published evidence regarding epidemiology, risk factors and diagnosis of skin manifestations of P. aeruginosa. Recent findings New data exist on epidemiology and diagnosis of skin infections; systemic infections are impacted by multidrug-resi...
Source: Current Opinion in Infectious Diseases - March 11, 2021 Category: Infectious Diseases Tags: SKIN AND SOFT TISSUE INFECTIONS: Edited by Matteo Bassetti Source Type: research

Cotrimoxazole and clindamycin in skin and soft tissue infections
Purpose of review The aim of this study was to present recent microbiological, experimental, clinical and tolerance data for cotrimoxazole and clindamycin in the specific field of skin and soft tissue infections (SSTIs). Recent findings Staphylococcus aureus and streptococci remain the leading cause of SSTIs. Cotrimoxazole is a good anti-Gram-positive agent with preserved activity against methicillin-susceptible and methicillin-resistant S. aureus (MRSA) and streptococci. Although clindamycin has good methicillin-susceptible S. aureus activity, a growing number of resistant MRSA and streptococci have been report...
Source: Current Opinion in Infectious Diseases - March 11, 2021 Category: Infectious Diseases Tags: SKIN AND SOFT TISSUE INFECTIONS: Edited by Matteo Bassetti Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Infectious Diseases)
Source: Current Opinion in Infectious Diseases - March 11, 2021 Category: Infectious Diseases Tags: EDITORIAL INTRODUCTIONS Source Type: research

Potential and demonstrated impacts of the COVID-19 pandemic on sexually transmissible infections
Purpose of review This review considers the potential and demonstrated impacts of SARS-CoV-2 on the sexually transmissible infection (STI)/HIV transmission. Recent findings COVID-19 increases the vulnerability of those at highest risk of acquiring STI/HIV. Altered health-seeking behaviour, reductions in STI/HIV clinic capacity, service disruptions and redeployment of human resources to assist COVID-19 control efforts have impacted on STI/HIV control programmes. Reports of reduced STI incidence are emerging, but it is hard to determine whether this is real or due to decreased testing during COVID-19 lockdown peri...
Source: Current Opinion in Infectious Diseases - December 26, 2020 Category: Infectious Diseases Tags: STD: Edited by Joseph A. Duncan Source Type: research

Effects of HIV voluntary medical male circumcision programs on sexually transmitted infections
Purpose of review Evidence of the protective effect of voluntary medical male circumcision (VMMC) against HIV is well established. However, evidence of the protective effect of VMMC against other sexually transmitted infections (STIs) has been inconsistent or scarce across different populations and settings. This review summarizes the current evidence on the effect of VMMC for HIV prevention on acquisition and transmission of other STIs in heterosexual men, women, and men who have sex with men (MSM). Recent findings Recent findings continue to strongly support the protective effect of male medical circumcision a...
Source: Current Opinion in Infectious Diseases - December 26, 2020 Category: Infectious Diseases Tags: STD: Edited by Joseph A. Duncan Source Type: research

Nonviral sexually transmitted infections in pregnancy: current controversies and new challenges
Purpose of review This review provides an update of nonviral, curable sexually transmitted infections (STIs) in pregnancy and summarizes our understanding of the current issues and controversies surrounding risk factors, screening, and treatment of STIs in pregnancy primarily in high-income countries (using the United States and the United Kingdom as examples). The infections covered in this review are syphilis, gonorrhea, chlamydia, trichomoniasis, and Mycoplasma genitalium infections. Recent findings Overall, limited modern data is available to update researchers and clinicians on the epidemiology and care of ...
Source: Current Opinion in Infectious Diseases - December 26, 2020 Category: Infectious Diseases Tags: STD: Edited by Joseph A. Duncan Source Type: research

Emergence of a novel urogenital-tropic Neisseria meningitidis
Purpose of review Neisseria meningitidis (Nm) is primarily associated with asymptomatic nasopharyngeal carriage and invasive meningococcal disease (sepsis and meningitis), but like N. gonorrhoea (Ng), Nm can colonize urogenital and rectal mucosal surfaces and cause disease. First noted in 2015, but with origins in 2011, male urethritis clusters caused by a novel Nm clade were reported in the USA (the US_NmUC). This review describes research developments that characterize this urogenital-tropic Nm. Recent findings The US_NmUC evolved from encapsulated Nm serogroup C strains. Loss of capsule expression, lipooligos...
Source: Current Opinion in Infectious Diseases - December 26, 2020 Category: Infectious Diseases Tags: STD: Edited by Joseph A. Duncan Source Type: research

New management approaches to tuberculosis in people living with HIV
Purpose of review People living with HIV (PLWH) are commonly coinfected with Mycobacterium tuberculosis, particularly in high-transmission resource-limited regions. Despite expanded access to antiretroviral therapy and tuberculosis (TB) treatment, TB remains the leading cause of death among PLWH. This review discusses recent advances in the management of TB in PLWH and examines emerging therapeutic approaches to improve outcomes of HIV-associated TB. Recent findings Three recent key developments have transformed the management of HIV-associated TB. First, the scaling-up of rapid point-of-care urine-based tests f...
Source: Current Opinion in Infectious Diseases - December 26, 2020 Category: Infectious Diseases Tags: HIV INFECTIONS AND AIDS: Edited by David Dockrell Source Type: research

Risks of metabolic syndrome and diabetes with integrase inhibitor-based therapy
This article comprehensively reviews recent available evidence weight gain and the risks of metabolic syndrome and diabetes associated with INSTIs. Recent findings Recent evidence continues to contribute to the evidence for weight gain associated with INSTIs, especially when used with newer nucleoside reverse transcriptase inhibitor, tenofovir alafenamide (TAF). Although the literature suggests a neutral effect on lipids, there is evidence that INSTIs are associated with metabolic syndrome due to treatment-emergent obesity. The literature for short-term treatment-emergent diabetes and insulin resistance remains inco...
Source: Current Opinion in Infectious Diseases - December 26, 2020 Category: Infectious Diseases Tags: HIV INFECTIONS AND AIDS: Edited by David Dockrell Source Type: research

Long-acting injectable HIV therapies: the next frontier
Purpose of review There has been significant development of long-acting injectable therapy for the management of HIV in recent years that has the potential to revolutionise HIV care as we know it. This review summarises the data and outlines the potential challenges in the field of long-acting antiretroviral therapy (ART). Recent findings In recent years, monthly and two monthly long-acting injectable ART in the form of cabotegravir and rilpivirine has shown safety and efficacy in large-scale phase 3 randomised control trials. Also, agents with novel mechanisms of action, such as Lenacapavir, have been tested in...
Source: Current Opinion in Infectious Diseases - December 26, 2020 Category: Infectious Diseases Tags: HIV INFECTIONS AND AIDS: Edited by David Dockrell Source Type: research

Conjunctival cancer in people living with HIV
Purpose of review Historically, conjunctival cancer has been associated with HIV particularly in sub-Saharan Africa. The human papilloma virus (HPV) has been implicated as a potential causative agent without conclusive evidence. This review covers recent evidence of the epidemiology, diagnosis and treatment of conjunctival cancer in people living with HIV (PLWH). Recent findings HIV infection has been attributed to 33% of squamous cell carcinoma of the conjunctiva in sub-Saharan Africa. Although clear evidence of the effect of immunodeficiency on conjunctival cancer risk has been demonstrated, the role of HPV on...
Source: Current Opinion in Infectious Diseases - December 26, 2020 Category: Infectious Diseases Tags: HIV INFECTIONS AND AIDS: Edited by David Dockrell Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Infectious Diseases)
Source: Current Opinion in Infectious Diseases - December 26, 2020 Category: Infectious Diseases Tags: EDITORIAL INTRODUCTIONS Source Type: research

The infant pharyngeal microbiomes: origin, impact and manipulation
Purpose of review There has been an exponential increase in research into infant microbiome evolution, and it appears that pharyngeal microbiota are associated with clinical phenotypes (e.g. infection and asthma). Although broad consensus views are emerging, significant challenges and uncertainties remain. Recent findings Infant pharyngeal microbiome research is limited by low biomass, high temporal diversity and lack of agreed standards for sampling, DNA sequencing and taxonomic reporting. Analysis of amplicon sequence variants and improved cost and availability of whole-genome sequencing are promising options ...
Source: Current Opinion in Infectious Diseases - November 7, 2020 Category: Infectious Diseases Tags: PAEDIATRIC AND NEONATAL INFECTIONS: Edited by Saul N. Faust Source Type: research

COVID-19 in children: current evidence and key questions
Purpose of review SARS-CoV-2 infection in children has been less well characterized than in adults, primarily due to a significantly milder clinical phenotype meaning many cases have gone undocumented by health professionals or researchers. This review outlines the current evidence of the epidemiology of infection in children, the clinical manifestations of disease, the role of children in transmission of the virus and the recently described hyperinflammatory syndrome observed later during the first phase of the pandemic. Recent findings International seroprevalence studies have found younger children to have lo...
Source: Current Opinion in Infectious Diseases - November 7, 2020 Category: Infectious Diseases Tags: PAEDIATRIC AND NEONATAL INFECTIONS: Edited by Saul N. Faust Source Type: research

Clinical application of non-coding RNAs in sepsis
Purpose of review Studies indicating that non-coding RNAs (ncRNAs) play a regulatory role in sepsis are increasing rapidly. This present review summarizes recent publications on the role of microRNAs and long non-coding RNAs (lncRNAs) in sepsis. Recent findings MicroRNAs (miRNAs) and lncRNAs are being identified as potential sepsis biomarkers and therapeutic targets. Experimental studies have examined the biological mechanisms that might underpin the regulatory role of these ncRNAs in sepsis. Summary Clinical applications of miRNAs and lncRNAs in sepsis are on the horizon. These data could lead to the ide...
Source: Current Opinion in Infectious Diseases - November 7, 2020 Category: Infectious Diseases Tags: PAEDIATRIC AND NEONATAL INFECTIONS: Edited by Saul N. Faust Source Type: research

The current state of immunization against Gram-negative bacteria in children: a review of the literature
Purpose of review Gram-negative bacteria (GNB) are a major cause of infection worldwide and multidrug resistance in infants and children. The major pathogens include Klebsiella pneumoniae, Escherichia coli, Enterobacter spp., Pseudomonas aeruginosa and Acinetobacter baumannii. With new antibiotic options limited, immunization is likely to play a critical role in prevention. This review discusses their epidemiology, the current state of vaccine research and potential immunization strategies to protect children. A comprehensive review of the literature, conference abstracts along with web searches was performed to identi...
Source: Current Opinion in Infectious Diseases - November 7, 2020 Category: Infectious Diseases Tags: PAEDIATRIC AND NEONATAL INFECTIONS: Edited by Saul N. Faust Source Type: research

Duration of antimicrobial therapy for Gram-negative infections
Purpose of review The potential benefits on antimicrobial resistance emergence, incidence of antibiotic-related adverse effects, and health costs have pushed to shorten therapeutic courses for Gram-negative bacilli (GNB) infections. However, the safety of this approach is still under investigation. This review gathers recent contributions to the evaluation of the impact on antimicrobial resistance and clinical outcome of shorter therapeutic courses against GNB infections, and highlights data on the modern approach of adjustable antibiotic duration. Recent findings Recent advances include data on the safety of 7-...
Source: Current Opinion in Infectious Diseases - November 7, 2020 Category: Infectious Diseases Tags: GRAM-NEGATIVE INFECTIONS: Edited by Matteo Bassetti Source Type: research

Prolonged infusion of beta-lactam antibiotics for Gram-negative infections: rationale and evidence base
Purpose of review The aim of this review is to discuss the rationale of and current evidence for prolonged beta-lactam infusion in the management of Gram-negative infections. Recent findings Pharmacokinetic/pharmacodynamic (PK/PD) data from various in-vitro and in-vivo experimental studies conclusively support prolonged infusion over intermittent infusion in terms of achieving effective beta-lactam exposure for maximal bacterial killing. Superior PK/PD target attainment has been demonstrated with prolonged beta-lactam infusion in patient populations that are more likely to have less susceptible Gram-negative inf...
Source: Current Opinion in Infectious Diseases - November 7, 2020 Category: Infectious Diseases Tags: GRAM-NEGATIVE INFECTIONS: Edited by Matteo Bassetti Source Type: research

The role of new antimicrobials for Gram-negative infections in daily clinical practice
Purpose of review To discuss a possible clinical reasoning for treating resistant Gram-negative bacteria (GNB) infections in daily clinical practice, as well as developing a research agenda for the field. Recent findings Novel agents, both belonging to β-lactams and to other classes of antimicrobials, have recently become available, likely replacing polymyxins or polymyxin-based combination regimens as the preferred choices for the first-line treatment of severe resistant GNB infections in the near future. Summary The peculiar characteristics of novel agents for severe resistant GNB infections have a...
Source: Current Opinion in Infectious Diseases - November 7, 2020 Category: Infectious Diseases Tags: GRAM-NEGATIVE INFECTIONS: Edited by Matteo Bassetti Source Type: research

Unresolved issues in the identification and treatment of carbapenem-resistant Gram-negative organisms
Purpose of review Carbapenem-resistant organisms (CROs), including Pseudomonas aeruginosa, Acinetobacter baumannii and Enterobacterales, are a threat worldwide. This review will cover mechanisms of resistance within CROs and challenges with identification and treatment of these organisms while pointing out unresolved issues and ongoing challenges. Recent findings The treatment of CROs has expanded through newer therapeutic options. Guided utilization through genotypic and phenotypic testing is necessary in order for these drugs to target the appropriate mechanisms of resistance and select optimal antibiotic ther...
Source: Current Opinion in Infectious Diseases - November 7, 2020 Category: Infectious Diseases Tags: GRAM-NEGATIVE INFECTIONS: Edited by Matteo Bassetti Source Type: research

Treatment of extended-spectrum β-lactamases infections: what is the current role of new β-lactams/β-lactamase inhibitors?
Purpose of review The widespread diffusion of extended-spectrum β-lactamases (ESBLs)-producing Enterobacteriales currently represents a major threat for public health worldwide. Carbapenems are currently considered the first-line choice for serious ESBL infections. However, the dramatic global increase in ESBL prevalence has led to a significant overuse of carbapenems that has promoted the selection and spread of carbapenemases, which might further prejudicated our ability to treat infections due to multidrug-resistant pathogens. Therefore, strategies to limit the use of carbapenems should be implemented. Recen...
Source: Current Opinion in Infectious Diseases - November 7, 2020 Category: Infectious Diseases Tags: GRAM-NEGATIVE INFECTIONS: Edited by Matteo Bassetti Source Type: research

Current choices of antibiotic treatment for Pseudomonas aeruginosa infections
Purpose of review Pseudomonas aeruginosa is one of the most feared nosocomial pathogens. Treatment of P. aeruginosa infections is challenging because of the limited choices of antibiotics and the emergent resistance of the pathogen. The present review aims at addressing the management of P. aeruginosa infections and highlighting the novel antibiotics that show a future promising role. Recent findings Novel fluoroquinolones have been recently introduced and show favorable activity. New combinations of β-lactams/β-lactamase inhibitors have been studied in various indications of infections because of P. a...
Source: Current Opinion in Infectious Diseases - November 7, 2020 Category: Infectious Diseases Tags: GRAM-NEGATIVE INFECTIONS: Edited by Matteo Bassetti Source Type: research

Clinical and economic impact of bacterial resistance: an approach to infection control and antimicrobial stewardship solutions
Purpose of review The aim of this study was to describe the clinical and economic burden of bacterial antimicrobial resistance (AMR) and to provide an expert opinion on different approaches to fight it. Recent findings For several decades now, it has been known that AMR among human pathogens is related to high clinical and economic burden. Different strategies have been implemented to control the clinical and economic burden of AMR. Antimicrobial stewardship programmes (ASP), environmental cleaning and infection source control have been reported as the most effective interventions. There is a potential role f...
Source: Current Opinion in Infectious Diseases - November 7, 2020 Category: Infectious Diseases Tags: GRAM-NEGATIVE INFECTIONS: Edited by Matteo Bassetti Source Type: research

Infections after anti-CD19 chimeric antigen receptor T-cell therapy for hematologic malignancies: timeline, prevention, and uncertainties
Purpose of review Data on the infectious complications of anti-CD19 chimeric antigen receptor-modified T-cell (CAR-T-cell) therapies are scant. The approaches to preventing and managing infections among CAR-T-cell recipients are extrapolated from those of patients with other hematological malignancies. Understanding the incidence and risk factors of infections in these patients will improve clinical outcomes. Recent findings Infections occur in 23–42% of CAR-T-cell recipients and are most frequent in the first month after infusion, declining sharply thereafter. Risk factors include preinfusion (e.g., prior...
Source: Current Opinion in Infectious Diseases - November 7, 2020 Category: Infectious Diseases Tags: ANTIMICROBIAL AGENTS: BACTERIAL/FUNGAL: Edited by Monica A. Slavin Source Type: research

Mind the gaps: challenges in the clinical management of invasive candidiasis in critically ill patients
Purpose of review Strict adherence to clinical practice guidelines is recognized to improve outcomes but the inconvenient truth is that only a small subset of what is done in medicine has been tested in appropriate, well designed studies. In this article, we aim to review controversial aspects of the clinical management of invasive candidiasis recommended by guidelines. Recent findings Despite still being recommended by guidelines, we fail to identify a single randomized clinical trial documenting that the use of antifungal drugs in high-risk critically ill patients without microbiologic documentation of Candida...
Source: Current Opinion in Infectious Diseases - November 7, 2020 Category: Infectious Diseases Tags: ANTIMICROBIAL AGENTS: BACTERIAL/FUNGAL: Edited by Monica A. Slavin Source Type: research

Antibiotic treatment of common infections: more evidence to support shorter durations
Purpose of review Although there is increasing recognition of the link between antibiotic overuse and antimicrobial resistance, clinician prescribing is often unnecessarily long and motivated by fear of clinical relapse. High-quality evidence supporting shorter treatment durations is needed to give clinicians confidence to change prescribing habits. Here we summarize recent randomized controlled trials investigating antibiotic short courses for common infections in adult patients. Recent findings Randomized trials in the last five years have demonstrated noninferiority of short-course therapy for a range of cond...
Source: Current Opinion in Infectious Diseases - November 7, 2020 Category: Infectious Diseases Tags: ANTIMICROBIAL AGENTS: BACTERIAL/FUNGAL: Edited by Monica A. Slavin Source Type: research