New therapies for nontuberculous mycobacterial lung infection
Purpose of review Although nontuberculous mycobacterial pulmonary disease is increasing in incidence, outcomes remain less than optimal highlighting the unmet need for developing novel therapies. Recent findings Several new antibiotic formulations, novel antibiotics, and novel nonantibiotic treatments have recently demonstrated positive results in treating nontuberculous mycobacterial pulmonary disease. Summary Promising novel therapies are currently under investigation fueling much needed interest and enthusiasm in the nontuberculous mycobacterial pulmonary disease space and will hopefully lead to improv...
Source: Current Opinion in Infectious Diseases - March 10, 2022 Category: Infectious Diseases Tags: RESPIRATORY INFECTIONS: Edited by Michael S. Niederman Source Type: research

How common is ventilator-associated pneumonia after coronavirus disease 2019?
Purpose of review The first studies on COVID-19 patients with acute respiratory distress syndrome (ARDS) described a high rate of secondary bacterial ventilator-associated pneumonia (VAP). The specificity of VAP diagnoses in these patients are reviewed, including their actual rate. Recent findings Published studies described high rates of bacterial VAP among COVID-19 patients with ARDS, and these VAP episodes are usually severe and of specifically poor prognosis with high mortality. Indeed, Severe acute respiratory syndrome - coronavirus disease 19 (SARS-CoV2) infection elicits alterations that may explain a hig...
Source: Current Opinion in Infectious Diseases - March 10, 2022 Category: Infectious Diseases Tags: RESPIRATORY INFECTIONS: Edited by Michael S. Niederman Source Type: research

Invasive aspergillosis in coronavirus disease 2019: a practical approach for clinicians
Purpose of review Invasive pulmonary aspergillosis (IPA) can affect patients with severe coronavirus disease 2019 (COVID-19), but many questions remain open about its very variable incidence across the world, the actual link between the viral infection and the fungal superinfection, the significance of Aspergillus recovery in a respiratory sample, and the management of such cases. This review addresses these questions and aims at providing some clues for the practical diagnostic and therapeutic approaches of COVID-19-associated pulmonary aspergillosis (CAPA) in a clinical perspective. Recent findings Definitions...
Source: Current Opinion in Infectious Diseases - March 10, 2022 Category: Infectious Diseases Tags: RESPIRATORY INFECTIONS: Edited by Michael S. Niederman Source Type: research

Methicillin-resistant Staphylococcus aureus lung infection in coronavirus disease 2019: how common?
Purpose of review Some patients with coronavirus disease 2019 (COVID-19) may develop pulmonary bacterial coinfection or superinfection, that could unfavorably impact their prognosis. Recent findings The exact burden of methicillin-resistant Staphylococcus aureus (MRSA) lung infection in peculiar populations such as patients with COVID-19 remains somewhat elusive, possibly because of wide heterogeneity in methods and endpoints across studies. Summary There was important heterogeneity in the retrieved literature on the epidemiology of MRSA lung infection in patients with COVID-19, both when considering all ...
Source: Current Opinion in Infectious Diseases - March 10, 2022 Category: Infectious Diseases Tags: RESPIRATORY INFECTIONS: Edited by Michael S. Niederman Source Type: research

How to use new antibiotics in the therapy of ventilator-associated pneumonia
Purpose of review Ventilator-associated pneumonia (VAP) is a common nosocomial infection in critically ill patients requiring endotracheal intubation and mechanical ventilation. Recently, the emergence of multidrug-resistant Gram-negative bacteria, including carbapenem-resistant Enterobacterales, multidrug-resistant Pseudomonas aeruginosa and Acinetobacter species, has complicated the selection of appropriate antimicrobials and contributed to treatment failure. Although novel antimicrobials are crucial to treating VAP caused by these multidrug-resistant organisms, knowledge of how to optimize their efficacy while minim...
Source: Current Opinion in Infectious Diseases - March 10, 2022 Category: Infectious Diseases Tags: RESPIRATORY INFECTIONS: Edited by Michael S. Niederman Source Type: research

Choosing antibiotic therapy for severe community-acquired pneumonia
Purpose of review Community-acquired pneumonia (CAP) is known as a major worldwide health concern considering it has been shown to account for 78% of infection-related deaths in the USA. It is a common cause for hospitalization with a continued incidence rise in the elderly, high mortality rate and long-term sequelae in critically ill patients. Severe CAP (sCAP) is an accepted terminology used to describe ICU admitted patients with CAP. The aim of this review is to further report on the major advances in treatment for patients with sCAP including new antibiotic treatments despite macrolide resistance as seen in the ICU...
Source: Current Opinion in Infectious Diseases - March 10, 2022 Category: Infectious Diseases Tags: RESPIRATORY INFECTIONS: Edited by Michael S. Niederman Source Type: research

New testing guidelines for community-acquired pneumonia
Purpose of review The purpose of this article is to review diagnostic testing recommendations outlined in the current American Thoracic Society (ATS)/Infectious Diseases Society of America (IDSA) community-acquired pneumonia (CAP) guideline and the 2021 ATS guideline for noninfluenza respiratory viruses. Recent findings Diagnostic testing in CAP with gram stain, lower respiratory and blood cultures, Streptococcal and Legionella urinary antigens are not routinely recommended unless identified as severe CAP or with risk factors for Methicillin-resistant Staphylococcus aureus (MRSA) or Pseudomonas aeruginosa infect...
Source: Current Opinion in Infectious Diseases - March 10, 2022 Category: Infectious Diseases Tags: RESPIRATORY INFECTIONS: Edited by Michael S. Niederman Source Type: research

Antibiotic treatment of acute bacterial skin and skin structure infections
Purpose of review Acute bacterial skin and skin structure infections (ABSSSI) are a leading cause of morbidity, with a considerable variety of clinical presentation and a wide range of etiological pathogens. Of importance, the spread of multidrug-resistant (MDR) strains (i.e. methicillin-resistant Staphylococcus aureus or Gram-negative bacteria) is increasingly reported in some regions. in this review, we summarize the current clinical approach to patients with ABSSSI. Recent findings Accurate diagnosis and identification of risk factors for MDR pathogens are key determinants for administering appropriate therap...
Source: Current Opinion in Infectious Diseases - March 10, 2022 Category: Infectious Diseases Tags: SKIN AND SOFT TISSUE INFECTIONS: Edited by Matteo Bassetti Source Type: research

New drugs for methicillin-resistant Staphylococcus aureus skin and soft tissue infections
Purpose of review Staphylococcus aureus is a pathogen incriminated in skin and soft tissue infections (SSTIs), with methicillin-resistant S. aureus (MRSA) becoming the predominant cause and representing a significant burden to the healthcare system. The last updated Infectious Diseases Society of America (IDSA) guidelines concerning MRSA infections and SSTIs management were published in 2011 and 2014, respectively. The UK updated guidelines for MRSA infection treatment were published in 2021. Older treatment options may be associated with toxicity and require frequent dosing. There is a paucity of recent reviews on the...
Source: Current Opinion in Infectious Diseases - March 10, 2022 Category: Infectious Diseases Tags: SKIN AND SOFT TISSUE INFECTIONS: Edited by Matteo Bassetti Source Type: research

Recent concepts in fungal involvement in skin and soft tissue infections
As the at-risk population expands and new antifungal resistance patterns develop, it is critical to understand and recognize cutaneous manifestations of old and emerging fungal diseases. Purpose of review The aim of this review is to provide an overview of the most frequent and emerging deep cutaneous fungal infections following either primary inoculation or secondary spread after haematogenous seeding in disseminated infections in different geographical areas. Recent findings Fungal skin and soft tissue infections (SSTIs) encompass a variety of pathological conditions based on the site of the infection, rout...
Source: Current Opinion in Infectious Diseases - March 10, 2022 Category: Infectious Diseases Tags: SKIN AND SOFT TISSUE INFECTIONS: Edited by Matteo Bassetti Source Type: research

The role of Gram-negative bacteria in skin and soft tissue infections
Purpose of review Skin and soft tissue infections (SSTIs) are a leading cause of morbidity, emergency department visits and hospitalization. In recent years, the spread of carbapenem-resistant gram-negative bacteria (GNB) is also increasing in SSTIs. However, the armamentarium of available drugs is recently expanding as well. In this review, we reported the most recent data and about management and treatment of SSTIs caused by GNB, mainly for the treatment of carbapenem-resistant Enterobacterales (CRE), Pseudomonas spp and Acinetobacter spp. Recent findings The increasing incidence of carbapenem-resistant GNB is...
Source: Current Opinion in Infectious Diseases - March 10, 2022 Category: Infectious Diseases Tags: SKIN AND SOFT TISSUE INFECTIONS: Edited by Matteo Bassetti Source Type: research

Skin manifestations in patients with coronavirus disease 2019
Purpose of review Coronavirus disease 2019 (COVID-19) is a well established respiratory tract illness. Recent studies in adults and children have shown an increasing number of patients reporting polymorphic cutaneous manifestations during COVID-19, including different types of rashes, from maculopapular, vascular, vesicular to atypical forms. Recent findings Although pathogenesis of skin manifestations is still not fully understood, it has been proposed that cutaneous involvement during COVID-19 may be the results of the activation of the immune response against severe acute respiratory syndrome coronavirus-2, t...
Source: Current Opinion in Infectious Diseases - March 10, 2022 Category: Infectious Diseases Tags: SKIN AND SOFT TISSUE INFECTIONS: Edited by Matteo Bassetti Source Type: research

Mycobacterial skin infection
Purpose of review The aim of this article is to review the most recent evidences concerning mycobacterial skin infections, limiting the period of literature research to 2020--2021. Recent findings Mycobacterial skin infections include a heterogeneous group of cutaneous diseases. Cutaneous tuberculosis is usually the result of hematogenous dissemination or spread from underlying foci and it must be distinguished from tuberculids, resulting from the immunological reaction to Mycobacterium tuberculosis antigens. Leprosy prevalence was drastically reduced after introduction of multidrug therapy in the 1980 s, b...
Source: Current Opinion in Infectious Diseases - March 10, 2022 Category: Infectious Diseases Tags: SKIN AND SOFT TISSUE INFECTIONS: Edited by Matteo Bassetti Source Type: research

Novel techniques in the treatment of skin and soft tissue infection
Purpose of review Global antibiotic resistance is compromising the management of soft tissue infection and Acute Bacterial Skin and Skin Structure Infection (ABSSI). This review describes a novel topical treatment Reactive Oxygen (RO) gel which could compliment and in some situations replace systemic antibiotics. Recent findings A novel topical treatment RO gel could have an important role in treatment, infection prevention and antimicrobial stewardship. RO is highly antimicrobial against Gram positive and negative bacteria, by slow release of oxygen radicals over a prolonged period of up to 72 h. It prevents ...
Source: Current Opinion in Infectious Diseases - March 10, 2022 Category: Infectious Diseases Tags: SKIN AND SOFT TISSUE INFECTIONS: Edited by Matteo Bassetti Source Type: research

Current international and national guidelines for managing skin and soft tissue infections
Purpose of review Skin and soft tissue infections account for a significant percentage of both community and nosocomial infections. Several nosological entities are included in this concept. However, there is a very scarce body of doctrine for their treatment based on randomised trials. Therefore, we considered it necessary to review current treatment guidelines to bring new recommendations and improvements to our colleagues. In this review of recent literature, we identified updated guidelines in this area by searching the databases PubMed, evidence-based medicine online, York University reviewers group, Cochrane, MBE...
Source: Current Opinion in Infectious Diseases - March 10, 2022 Category: Infectious Diseases Tags: SKIN AND SOFT TISSUE INFECTIONS: Edited by Matteo Bassetti Source Type: research