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 protein synth...
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