Risk stratification for multidrug-resistant bacteria in patients with skin and soft tissue infection
This article summarizes the available evidence enabling a stratification of risk for multidrug-resistant bacteria (MDRB) in patients with skin and soft tissue infection (SSTI). Recent findings MDRB are increasingly reported in both healthcare-associated (HCA) and community-acquired (CA)-SSTI, including in patients with life-threatening presentations for whom early initiation of adequate antimicrobial therapy is pivotal to improve outcomes. Community-associated methicillin-resistant Staphylococcus aureus (MRSA) is now endemic in several geographical areas and may cause outbreaks in frail populations or other at-risk clus...
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

Fungal infections of the skin and soft tissue
Purpose of review This review aims to update on recent findings about epidemiology, risk factors and therapeutic options for fungi causing skin and soft tissue infections. The latest data on emerging antifungal resistance are also discussed. Recent findings In parallel with increased use of immunosuppression, the incidence of fungal infections is also on rise. This increase involves not only systemic infections but also infections with primary and secondary skin involvement. Antifungal resistance has become a major issue and covers several fungal pathogens including dermatophytes, Candida spp. and, Aspergillus fumigat...
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

Parasitic skin infections: neglected diseases or just challenging for diagnosis?
Purpose of review The aim of the article is to review the most recent evidence concerning parasitic skin infections. Recent findings Parasitic skin infections are increasingly reported worldwide. Special at-risk categories are migrants, returning travelers, and immunocompromised individuals, who are at higher risk to present disseminated disease. The number of reported cases is growing even outside the endemic areas as a consequence of international travels, migration flows, increasing immunocompromised population, climate change, and natural disasters. Summary Skin parasitoses are neglected infections. Funding ass...
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

Role of new antibiotics in the treatment of acute bacterial skin and skin-structure infections
Purpose of review To summarize the available efficacy and safety data of novel agents for treating acute bacterial skin and skin-structure infections (ABSSSI), focusing on those active against methicillin-resistant Staphylococcus aureus (MRSA). Recent findings There are now several agents active against MRSA that are approved for the treatment of ABSSSI, including tedizolid, ceftaroline, dalbavancin, telavancin, oritavancin, delafloxacin, and omadacycline. In addition, iclaprim has completed phase-3 randomized clinical trials (RCTs). Summary Considering the similar efficacy that arose from direct comparisons in pha...
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

The skin and soft tissue infections in hematological patients
Purpose of review Skin and soft tissue infections (SSTIs) in patients with hematological malignancies are frequent, but dedicated epidemiological studies are limited. The aim of this review is to provide updated description of the main etiological agents, differential diagnosis, and treatment. Recent findings In addition to common causes of bacterial skin infections in any kind of patients, such as streptococci and staphylococci (the letter frequently resistant to methicillin), Pseudomonas aeruginosa is a frequent agent in patients with hematological malignancies, with high virulence and typical infection presenting a...
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

The role of multidrug and extensive-drug resistant Gam-negative bacteria in skin and soft tissue infections
Purpose of review Whereas Staphylococcus aureus remains the leading cause of skin and soft tissue infections (SSTI), Gram-negative bacilli (GNB) are increasingly reported as a cause of monomicrobial or polymicrobial infections. This review examines the expanding role of GNB in SSTI and discusses the risks for and the frequency of multidrug-resistance (MDR) and extensive drug-resistance (XDR) and the implications with regard to outcome and therapy. Recent findings Although the global epidemiology and role of GNB in SSTIs have not been studied systematically, complicated SSTIs caused by resistant GNB are increasing part...
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

Editorial introductions
No abstract available (Source: Current Opinion in Infectious Diseases)
Source: Current Opinion in Infectious Diseases - March 6, 2020 Category: Infectious Diseases Tags: EDITORIAL INTRODUCTIONS Source Type: research

Carbapenem use in critically ill patients
Purpose of review To review available data on carbapenem use in ICU. Carbapenem is a broad spectrum well tolerated antibiotic family that keep an excellent activity to extended spectrum β-lactamases and AmpC hyperproducer and in susceptible Pseudomonas aeruginosa and Acinetobacter baumannii. It becomes a drug of choice for empirical therapy of suspected sepsis in known or presumably known ESBLE carriers. Recent findings Carbapenems remained the drug of choice for severe ESBLE infections. In severe critically ill patients, high off-label dose is necessary especially in patients with sepsis and glomerular hyperfiltrati...
Source: Current Opinion in Infectious Diseases - January 3, 2020 Category: Infectious Diseases Tags: SPECIAL COMMENTARIES Source Type: research

Current evidence for therapy of ceftriaxone-resistant Gram-negative bacteremia
This article aims to give a state-of-the-art assessment of treatment options for bloodstream infection because of ceftriaxone-resistant Gram-negative bacilli, especially those caused by extended-spectrum beta-lactamase (ESBL) or AmpC-producing Enterobacteriaceae. In particular, this review assesses whether current data support ‘carbapenem-sparing options’ for treatment of these serious infections. Recent findings The MERINO trial refuted earlier observational studies some of which showed equivalence in outcomes between beta-lactam/beta-lactamase inhibitor combinations and carbapenems for treatment of bloodstream inf...
Source: Current Opinion in Infectious Diseases - January 3, 2020 Category: Infectious Diseases Tags: SPECIAL COMMENTARIES Source Type: research

Updates in trichomonas treatment including persistent infection and 5-nitroimidazole hypersensitivity
Purpose of review The purpose of this review is to update information on treatment of Trichomonas vaginalis. T. vaginalis is estimated to be the most common treatable sexually transmitted infection. In the world and is associated with poor birth outcomes, cervical cancer, sperm motility and morphology issues, and HIV acquisition and transmission. Recent findings The efficacy of the recommended 2-g oral single-dose metronidazole (MTZ) for the treatment of T. vaginalis in women has recently been challenged. Two recent multicentered randomized trials and a meta-analysis have demonstrated that the 7-day dose of MTZ 500 ...
Source: Current Opinion in Infectious Diseases - January 3, 2020 Category: Infectious Diseases Tags: STD: Edited by Joseph A. Duncan Source Type: research

Ocular and neurosyphilis: epidemiology and approach to management
This article reviews the current epidemiology, manifestations, and approach to management and treatment. Recent findings Although studies continue investigating alternate approaches and new diagnostic tests for ocular and neurosyphilis, few data exist to change current diagnostic algorithms and approaches to diagnosis, management, or follow up. Summary The diagnosis of neurologic and eye/ear involvement with syphilis may be delayed because of a lack of specificity of findings, low suspicion for syphilis, fluctuation in symptoms, and/or similarities in presentation to other diseases. A high index of suspicion for syph...
Source: Current Opinion in Infectious Diseases - January 3, 2020 Category: Infectious Diseases Tags: STD: Edited by Joseph A. Duncan Source Type: research

Host–vaginal microbiota interactions in the pathogenesis of bacterial vaginosis
Purpose of review The cause of bacterial vaginosis, the most common cause of vaginal discharge in women, remains controversial. We recently published an updated conceptual model on bacterial vaginosis pathogenesis, focusing on the roles of Gardnerella vaginalis and Prevotella bivia as early colonizers and Atopobium vaginae and other bacterial vaginosis-associated bacteria (BVAB) as secondary colonizers in this infection. In this article, we extend the description of our model to include a discussion on the role of host–vaginal microbiota interactions in bacterial vaginosis pathogenesis. Recent findings Although G. v...
Source: Current Opinion in Infectious Diseases - January 3, 2020 Category: Infectious Diseases Tags: STD: Edited by Joseph A. Duncan Source Type: research

Facing increased sexually transmitted infection incidence in HIV preexposure prophylaxis cohorts: what are the underlying determinants and what can be done?
Purpose of review The combined incidence of chlamydia, gonorrhoea and syphilis in MSM PrEP (preexposure prophylaxis) cohorts now frequently exceeds 100 per 100 person years. The efficacy of antiretroviral PrEP in reducing HIV transmission has led to efforts to find similar biomedical ways reduce sexually transmitted infection (STI) incidence. We review the recent evidence for these and other strategies. Recent findings Doxycycline PrEP/postexposure prophylaxis has been shown to reduce the incidence of syphilis and chlamydia but not gonorrhoea. A meningococcal vaccine has been found to result in a lower incidence of go...
Source: Current Opinion in Infectious Diseases - January 3, 2020 Category: Infectious Diseases Tags: STD: Edited by Joseph A. Duncan Source Type: research

Digital health for sexually transmitted infection and HIV services: a global scoping review
Purpose of review The current study aimed to review how digital health has been used for sexually transmitted infection (STI)/HIV prevention, testing, and treatment. Recent findings A scoping review was conducted by searching five databases for peer-reviewed literature published between March 2018 to August 2019. 23 out of 258 studies met the inclusion criteria and were assessed. Six studies used digital platform to enhance STI/HIV prevention messaging; four studies found that digital health can provide vivid promotional information and has been instrumental in increasing the accessibility and acceptability of STI/HIV...
Source: Current Opinion in Infectious Diseases - January 3, 2020 Category: Infectious Diseases Tags: STD: Edited by Joseph A. Duncan Source Type: research

Probiotics to manage inflammation in HIV infection
Purpose of review To evaluate the current scientific basis for administering probiotics to people living with HIV (PLHIV) to alleviate chronic inflammation and subsequently improve their prognosis. Recent findings The gut microbiome is a potential contributing factor to low-grade inflammation in HIV infection, and there is a scientific rationale for attempting to attenuate inflammation by administering probiotics. Sixteen reports from clinical studies in antiretroviral therapy (ART)-treated PLHIV assessing inflammation after probiotic intervention have been identified; half of them randomized control trials (RCT). Som...
Source: Current Opinion in Infectious Diseases - January 3, 2020 Category: Infectious Diseases Tags: HIV INFECTIONS AND AIDS: Edited by David Dockrell Source Type: research