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Acute infectious myelopathies
We present a syndromic approach to infectious myelopathies, focusing on clinical patterns that help narrow the diagnostic possibilities. (Source: Current Opinion in Infectious Diseases)
Source: Current Opinion in Infectious Diseases - May 1, 2020 Category: Infectious Diseases Tags: CNS INFECTIONS: Edited by Adarsh Bhimraj Source Type: research

Update on group A streptococcal vaccine development
Purpose of review There is a global need for well tolerated, effective, and affordable vaccines to prevent group A streptococcal infections and their most serious complications. The aim of this review is to highlight the recent progress in the identification of promising vaccine antigens and new approaches to vaccine design that address the complexities of group A streptococcal pathogenesis and epidemiology. Recent findings Combination vaccines containing multiple shared, cross-protective antigens have proven efficacious in mouse and nonhuman primate models of infection. The development of complex multivalent M protei...
Source: Current Opinion in Infectious Diseases - May 1, 2020 Category: Infectious Diseases Tags: PATHOGENESIS AND IMMUNE RESPONSE: Edited by Dennis L. Stevens and Dimitri A. Diavatopoulos Source Type: research

Anatomical site-specific immunomodulation by bacterial biofilms
Purpose of review The human body plays host to bacterial biofilms across diverse anatomical sites. The treatment of pathogenic biofilm infection is confounded by their high rate of antibiotic resistance. Therefore, it is critical to understand the interplay between these biofilms and the host immune system to develop new tactics to combat these infections. Recent findings Bacterial biofilms and the components they produce affect and are affected by the host immune system. Host anatomical sites represent distinct niches in which defined bacterial biofilms are able to form and interact with the host immune system. For p...
Source: Current Opinion in Infectious Diseases - May 1, 2020 Category: Infectious Diseases Tags: PATHOGENESIS AND IMMUNE RESPONSE: Edited by Dennis L. Stevens and Dimitri A. Diavatopoulos Source Type: research

Unraveling Haemophilus influenzae virulence mechanisms enable discovery of new targets for antimicrobials and vaccines
Purpose of review The human upper respiratory tract is colonized with a variety of bacterial microorganisms including Haemophilus influenzae. The species H. influenzae consists of typeable and nontypeable H. influenzae (NTHi) variants. Typeable H. influenzae are subdivided into types a through f, based on the polysaccharide capsule, whereas the NTHi strains do not express a polysaccharide capsule. In this review, we highlight the current advances in the field of H. influenzae, with the focus on bacterial virulence mechanisms that facilitate bacterial colonization and disease, particularly for NTHi. Recent findings In ...
Source: Current Opinion in Infectious Diseases - May 1, 2020 Category: Infectious Diseases Tags: PATHOGENESIS AND IMMUNE RESPONSE: Edited by Dennis L. Stevens and Dimitri A. Diavatopoulos Source Type: research

Antibody glycosylation in pregnancy and in newborns: biological roles and implications
Purpose of review Glycosylation patterns have the potential to affect the function of antibody, antibody half-life and transplacental transfer from mother to foetus. Here, we review recent advances in our understanding of how glycosylation patterns of antibodies may be altered during pregnancy, vaccination and infection. Recent findings During pregnancy, there is preferential transplacental transfer of natural killer (NK) cell-activating antibodies that are galactosylated and sialylated, against both bacterial and viral antigens. Markers of NK cell function are also associated with a higher abundance of galactosylatio...
Source: Current Opinion in Infectious Diseases - May 1, 2020 Category: Infectious Diseases Tags: PATHOGENESIS AND IMMUNE RESPONSE: Edited by Dennis L. Stevens and Dimitri A. Diavatopoulos Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Infectious Diseases)
Source: Current Opinion in Infectious Diseases - May 1, 2020 Category: Infectious Diseases Tags: EDITORIAL INTRODUCTIONS Source Type: research

New treatment options for multiresistant gram negatives
Purpose of review Multidrug-resistant (MDR) Gram-negative bacteria infections are listed among the top public health threats of the current era. As a result, there has been an increase in efforts to develop new therapeutic agents against MDR Gram-negatives. The purpose of this review is to summarize the clinical and preclinical findings associated with recently approved drugs and the drugs in clinical development against ESBL and carbapenemase-producing Enterobacterales, carbapenem-resistant Pseudomonas aeruginosa and carbapenem-resistant Acinetobacter baumannii infections. Recent findings There are a number of ESBL a...
Source: Current Opinion in Infectious Diseases - March 6, 2020 Category: Infectious Diseases Tags: SPECIAL COMMENTARY Source Type: research

Pulmonary infections in the hematopoietic cell transplant patient
Purpose of review Despite progress in the management of pulmonary infections in the hematopoietic cell transplant (HCT) population, substantial diagnostic, and therapeutic uncertainty remains. Recent findings A growing HCT population reflects more transplants and improved long-term survival. We continue to learn about the epidemiologic and prognostic significance of posttransplant pulmonary infections. Mold-active triazoles have removed invasive fungal pneumonia as a barrier to transplant eligibility. Ibrutinib and respiratory viruses are newly recognized risk factors for invasive fungal disease. Prophylaxis has eleva...
Source: Current Opinion in Infectious Diseases - March 6, 2020 Category: Infectious Diseases Tags: RESPIRATORY INFECTIONS: Edited by Michael S. Niederman Source Type: research

Optimizing aerosol delivery of antibiotics in ventilated patients
Purpose of review The aim of the article is to review the evidence to select ventilated patients most likely to benefit from inhaled antibiotic therapy and summarize the optimal implementation setup to favor clinical success. Recent findings Although a large body of literature describes the optimal ventilator circuit and settings to implement to favor a high amount of inhaled antibiotic delivery to ventilated patients, recent clinical trials failed to show a significant benefit on patient-centered outcomes. Currently, inhaled antibiotic therapy can only be recommended as a therapeutic modality of last resort after cas...
Source: Current Opinion in Infectious Diseases - March 6, 2020 Category: Infectious Diseases Tags: RESPIRATORY INFECTIONS: Edited by Michael S. Niederman Source Type: research

Managing and preventing exacerbation of bronchiectasis
Purpose of review Pulmonary exacerbations are key events in the natural history of bronchiectasis given their impact on quality of life, prognosis, and their contribution to healthcare costs. Preventing and managing exacerbations is a priority for clinicians and in this review, we discuss measures that should be utilized to achieve this aim. Recent findings Experts have proposed a focus on phenotyping and endotyping the bronchiectasis population to overcome the heterogeneity of this condition. Recent large studies of inhaled antibiotics and smaller studies of macrolides, which included exacerbation measures as their p...
Source: Current Opinion in Infectious Diseases - March 6, 2020 Category: Infectious Diseases Tags: RESPIRATORY INFECTIONS: Edited by Michael S. Niederman Source Type: research

Ventilator-associated pneumonia: new principles guiding empiric antibiotic therapy
Purpose of review Ventilator-associated pneumonia (VAP) is a serious event in critically ill patients. We aim to review the most recent evidences about VAP, including its cause, the main differences between the American and European guidelines in the definition of risk factors for multidrug-resistant pathogens, the main principles guiding empirical antibiotic treatment, and the potential role of molecular diagnostic tests. Recent findings The 2016 ATS/IDSA and the 2017 ERS/ESICM/ESCMID/ALAT guidelines provide different approaches for the management of VAP. Both guidelines highlight the need to use local epidemiolo...
Source: Current Opinion in Infectious Diseases - March 6, 2020 Category: Infectious Diseases Tags: RESPIRATORY INFECTIONS: Edited by Michael S. Niederman Source Type: research

Community-acquired pneumonia in chronic obstructive pulmonary disease
Purpose of review The aim of this study was to discuss the literature on community-acquired pneumonia (CAP) in patients with chronic obstructive pulmonary disease (COPD). Recent findings Well designed studies show that COPD is the strongest risk factor for development of CAP. Lung microbiome, abnormal lung immunity and pathogen virulence are important components of the pathogenesis of CAP in COPD. The cause of CAP in patients with COPD is similar to that of non-COPD patients. However, patients with COPD are at an increased risk of infection by Gram-negative bacilli, including Pseudomonas aeruginosa. Empiric treatment ...
Source: Current Opinion in Infectious Diseases - March 6, 2020 Category: Infectious Diseases Tags: RESPIRATORY INFECTIONS: Edited by Michael S. Niederman Source Type: research

Advances in the diagnosis and treatment of latent tuberculosis infection
Purpose of review This review describes the major developments in the rationale for treating latent tuberculosis infection; new approaches to identifying persons with latent infection who are most likely to progress to active disease; and the development of novel short-course regimens for treatment of latent tuberculosis. Recent findings As many as one-third of the world's population has latent infection with Mycobacterium tuberculosis. Models demonstrate that tuberculosis will not be eliminated without large-scale treatment of persons with latent TB. Current tools for identifying persons at risk for active tuberculos...
Source: Current Opinion in Infectious Diseases - March 6, 2020 Category: Infectious Diseases Tags: RESPIRATORY INFECTIONS: Edited by Michael S. Niederman Source Type: research

The interplay between acute bacterial skin and skin structure infections and depression: a vicious circle of major clinical importance
Purpose of review Previous studies suggest an association between depression and increased risk of various type of infections, including acute bacterial skin and skin structure infections (ABSSSI). Here, we review the latest advancement in our understanding of immunity in patients with depression and its relevance to disease management and diagnosis, with a special focus on patients suffering from ABSSSI. Recent findings Recent studies have highlighted the role of hypothalamic–pituitary–adrenal axis, neuro-endocrine stress signaling pathways and behavioral attitudes (substance abuse and homelessness) in the pathog...
Source: Current Opinion in Infectious Diseases - March 6, 2020 Category: Infectious Diseases Tags: SKIN AND SOFT TISSUE INFECTIONS: Edited by Matteo Bassetti Source Type: research

Treatment of multidrug-resistant Gram-negative skin and soft tissue infections
Purpose of review The increase in skin and soft tissue infections (SSTI) because of multidrug-resistant (MDR) pathogens is a global concern. Although MDR Gram-negative bacteria (GNB) are often overlooked as a cause of SSTIs, their burden on the morbidity of many subgroups of patients is high. There is a paucity in the available treatment options and guidelines on how to treat these pathogens. This manuscript reviews the management of SSTIs caused by carbapenem-resistant Enterobacteriaceae (CRE), Pseudomonas aeruginosa (CRPA), Acinetobacter baumannii (CRAB), and Stenotrophomonas maltophilia. We also highlight a few novel ...
Source: Current Opinion in Infectious Diseases - March 6, 2020 Category: Infectious Diseases Tags: SKIN AND SOFT TISSUE INFECTIONS: Edited by Matteo Bassetti Source Type: research