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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

An infectious diseases perspective on the microbiome and allogeneic stem cell transplant
Purpose of review The gut microbiome presents a novel source of diagnostic and therapeutic potential to modify post allogeneic stem cell transplant complications. There is an explosion of interest in microbiome research, mostly in the form of single-centre prospective time-series cohorts utilizing a variety of sampling frequencies and metagenomic technologies to sequence the microbiome. The purpose of this review is to summarize important recent publications and contextualize them within what has already been described in this rapidly growing field. Recent finding Results from observational human cohort and anim...
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

Asymptomatic bacteriuria and urinary tract infections in kidney transplant recipients
Purpose of review Urinary tract infection (UTI) is the most common infection in kidney transplant recipients (KTRs). Several elements increase the risk of UTI and/or modify its clinical presentation among KTRs (e.g. immunosuppressive therapy, kidney allograft denervation, and use of urinary catheters). Also, KTRs may have UTIs because of difficult-to-identify and/or difficult-to-treat organisms. We provide an overview of the current knowledge regarding bacterial UTIs in KTRs, with a focus on recent findings. Recent findings There is accumulating evidence from clinical trials that screening for and treating asymp...
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

Editorial introductions
No abstract available (Source: Current Opinion in Infectious Diseases)
Source: Current Opinion in Infectious Diseases - November 7, 2020 Category: Infectious Diseases Tags: EDITORIAL INTRODUCTIONS Source Type: research

Updates on the epidemiology, pathogenesis, diagnosis, and management of postinfectious irritable bowel syndrome
The objective of the current review is to provide an update on recent evidence published in the past 2 years describing advances in our understanding of the epidemiology, pathogenesis, diagnosis, and treatment of PI-IBS. Recent findings Significant proportion of research in the recent past was preclinical in nature. Epidemiological studies continue to highlight the risk of IBS after infection, with recent studies documenting postprotozoal effects. Advances in pathogenic mechanisms included clinical studies, which documented micro-RNA down-regulation and Peroxiredoxin-1 up-regulation in colonic mucosa of PI-IBS patients....
Source: Current Opinion in Infectious Diseases - September 11, 2020 Category: Infectious Diseases Tags: GASTROINTESTINAL INFECTIONS: Edited by James A. Platts-Mills Source Type: research

Final frontiers of the polio eradication endgame
Purpose of review Focusing on the key developments since January 2019, this review aims to inform policymakers and clinical practitioners on the latest on evolving global polio epidemiology and scientific advancements to guide strategies for eradication. Recent findings An upsurge in wild poliovirus type 1 cases in Pakistan and Afghanistan and an expansion of type 2 circulating vaccine-derived poliovirus transmission in multiple countries threaten the remarkable progress made over past several decades by the global eradication program. These challenges have also spurred innovation on multiple fronts, including earlier...
Source: Current Opinion in Infectious Diseases - September 11, 2020 Category: Infectious Diseases Tags: GASTROINTESTINAL INFECTIONS: Edited by James A. Platts-Mills Source Type: research

Pediatric acute gastroenteritis associated with adenovirus 40/41 in low-income and middle-income countries
Purpose of review To review the roles of enteric adenovirus types 40 and 41 and nonenteric adenoviruses in the global burden of pediatric diarrhea. Recent findings Large studies using highly sensitive, type-specific molecular diagnostics have demonstrated a substantial and previously under-estimated burden of pediatric diarrheal disease because of enteric infections with adenovirus types 40/41. However, the true epidemiology of adenovirus 40/41 remains incompletely understood. Similarly, additional adenovirus types may also be implicated as agents of community-acquired pediatric gastroenteritis but current data are to...
Source: Current Opinion in Infectious Diseases - September 11, 2020 Category: Infectious Diseases Tags: GASTROINTESTINAL INFECTIONS: Edited by James A. Platts-Mills Source Type: research

Sapovirus: an emerging cause of childhood diarrhea
Purpose of review Sapovirus, a genus in the Caliciviridae family alongside norovirus, is increasingly recognized as an important cause of childhood diarrhea. Some challenges exist in our ability to better understand sapovirus infections, including the inability to grow sapovirus in cell culture, which has hindered diagnosis and studies of immunity. Another challenge is that individuals with sapovirus infection are commonly coinfected with other enteric pathogens, complicating our ability to attribute the diarrhea episode to a single pathogen. Recent findings Development of molecular methods for sapovirus detection has...
Source: Current Opinion in Infectious Diseases - September 11, 2020 Category: Infectious Diseases Tags: GASTROINTESTINAL INFECTIONS: Edited by James A. Platts-Mills Source Type: research

Update on nonantibiotic therapies for acute gastroenteritis
Purpose of review The aim of this review is to provide an update of nonantibiotic therapies for acute gastroenteritis (AGE), focusing on antiemetics and probiotics. Recent findings The mainstay of therapy for nonsevere AGE remains oral rehydration therapy (ORT). Recent randomized controlled trials and metaanalyses have further strengthened the evidence-base supporting single-dose ondansetron administration in emergency departments to facilitate ORT based on evidence that it safely reduces intravenous fluid administration and hospitalization rates. Intravenous ondansetron administration and multiple-dose use should be ...
Source: Current Opinion in Infectious Diseases - September 11, 2020 Category: Infectious Diseases Tags: GASTROINTESTINAL INFECTIONS: Edited by James A. Platts-Mills Source Type: research

Updates on defining and detecting diarrheagenic Escherichia coli pathotypes
Purpose of review Several types of Escherichia coli cause acute diarrhea in humans and are responsible for a large burden of disease globally. The purpose of this review is to summarize diarrheagenic Escherichia coli (DEC) pathotype definitions and discuss existing and emerging molecular, genomic, and gut microbiome methods to detect, define, and study DEC pathotypes. Recent findings DEC pathotypes are currently diagnosed by molecular detection of unique virulence genes. However, some pathotypes have defied coherent molecular definitions because of imperfect gene targets, and pathotype categories are complicated by hy...
Source: Current Opinion in Infectious Diseases - September 11, 2020 Category: Infectious Diseases Tags: GASTROINTESTINAL INFECTIONS: Edited by James A. Platts-Mills Source Type: research

Scrub typhus: a reemerging infection
Purpose of review Scrub typhus, caused by Orientia tsutsugamushi, is a widely neglected disease which is gaining global momentum because of its resurgence patterns. The disease is now being reported in newer regions as well as areas previously endemic areas. In this review, we aim to comprehensively review the data available to assist physicians in making an accurate diagnosis and appropriate management of the disease. Recent findings Several diagnostic tests have been developed for confirming scrub typhus. However, there is lack of clarity on which tests are most appropriate in a given clinical scenario. A recent stu...
Source: Current Opinion in Infectious Diseases - September 11, 2020 Category: Infectious Diseases Tags: TROPICAL AND TRAVEL-ASSOCIATED DISEASES: Edited by Christina M. Coyle Source Type: research

Giardiasis treatment: an update with a focus on refractory disease
Purpose of review Giardiasis remains a common cause of diarrhea and intestinal enteropathy globally. Here we give an overview of clinical treatment studies and discuss potential mechanisms and molecular targets for in-vitro testing of drug resistance. Recent findings Giardia is a cause of disease both in diarrheal and nondiarrheal cases. The prevalence of treatment refractory giardiasis is increasing. Recent studies reveal 5-nitroimidazole refractory infection occurs in up to 50% of cases. Mechanisms of drug resistance are not known. Placebo controlled studies of drug efficacy, taking the self-limiting course of giard...
Source: Current Opinion in Infectious Diseases - September 11, 2020 Category: Infectious Diseases Tags: TROPICAL AND TRAVEL-ASSOCIATED DISEASES: Edited by Christina M. Coyle Source Type: research

Drug resistance in Salmonella Typhi: implications for South Asia and travel
Purpose of review Recent attempts at mapping Typhoid epidemiology have revealed an enormous burden of disease in developing countries. Countries hitherto believed to have a low incidence, such as the African subcontinent, on accurate mapping were found to have a significant burden of disease. Drug resistance, because of rampant overuse of antibiotics, has driven selection pressure to extensively drug-resistant typhoid becoming a reality in the Indian subcontinent. With widespread travel, importation of this variety of typhoid to nonendemic countries is likely to lead to outbreaks in a nonimmune population. Recent findin...
Source: Current Opinion in Infectious Diseases - September 11, 2020 Category: Infectious Diseases Tags: TROPICAL AND TRAVEL-ASSOCIATED DISEASES: Edited by Christina M. Coyle Source Type: research

Subarachnoid neurocysticercosis: emerging concepts and treatment
Purpose of review Subarachnoid neurocysticercosis (SUBNCC) is caused by a morphologically unique proliferative form of Taenia solium involving the subarachnoid spaces. Prolonged therapy based upon the pathophysiology of SUBNCC and long-term follow-up have shed light on the course of disease and led to highly improved outcomes. Recent findings SUBNCC has a prolonged incubation period of between 10 and 25 years characterized by cyst proliferation and growth and invasion of contiguous spaces leading to mass effect (Stage 1). With induction of the host-immune responses, cysts degenerate leading to a predominately inflamma...
Source: Current Opinion in Infectious Diseases - September 11, 2020 Category: Infectious Diseases Tags: TROPICAL AND TRAVEL-ASSOCIATED DISEASES: Edited by Christina M. Coyle Source Type: research