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BK polyomavirus-specific antibody and T-cell responses in kidney transplantation: update
Purpose of review BK polyomavirus (BKPyV) has emerged as a significant cause of premature graft failure after kidney transplantation. Without effective antiviral drugs, treatment is based on reducing immunosuppression to regain immune control over BKPyV replication. The paradigm of high-level viruria/decoy cells, BKPyV-DNAemia, and proven nephropathy permits early interventions. Here, we review recent findings about BKPyV-specific antibody and T-cell responses and their potential role in risk stratification, immune monitoring, and therapy. Recent finding Kidney transplant recipients having low or undetectable BKPyV-sp...
Source: Current Opinion in Infectious Diseases - November 4, 2019 Category: Infectious Diseases Tags: ANTIMICROBIAL AGENTS: VIRAL: Edited by Roy F. Chemaly Source Type: research

Resistant or refractory cytomegalovirus infections after hematopoietic cell transplantation: diagnosis and management
Purpose of review Refractory or resistant cytomegalovirus (CMV) infections are challenging complications after hematopoietic cell transplantation (HCT). Most refractory or resistant CMV infections are associated with poor outcomes and increased mortality. Prompt recognition of resistant or refractory CMV infections, understanding the resistance pathways, and the treatment options in HCT recipients are imperative. Recent findings New definitions for refractory and resistant CMV infections in HCT recipients have been introduced for future clinical trials. Interestingly, refractory CMV infections are more commonly encoun...
Source: Current Opinion in Infectious Diseases - November 4, 2019 Category: Infectious Diseases Tags: ANTIMICROBIAL AGENTS: VIRAL: Edited by Roy F. Chemaly Source Type: research

Candida auris: what have we learned so far?
Purpose of review The increasing prevalence of fungal infections due to Candida species has been well described in critically ill patient populations, but in recent years a new species, Candida auris has received attention from the medical community worldwide. We aim to summarize the current knowledge related to C. auris, as new identification techniques, novel antifungal agents and more experience with outbreak management have been published in the past few years. Recent findings C. auris has been described in several countries, arising independently in separate clades. Its resistance to multiple antifungals and pers...
Source: Current Opinion in Infectious Diseases - November 4, 2019 Category: Infectious Diseases Tags: ANTIMICROBIAL AGENTS: BACTERIAL/FUNGAL: Edited by Monica Slavin Source Type: research

Antibiotics and adverse events: the role of antimicrobial stewardship programs in ‘doing no harm’
Purpose of review Antimicrobial resistance (AMR) is a global threat worldwide, with deaths associated with AMR infections projected to exceed 10 million per year by the year 2050. The overuse and misuse of antibiotics is the primary driver of this resistance, with up to 50% of antibiotics prescribed in the hospital setting being either unnecessary or inappropriate. Antimicrobial stewardship (AMS) programs (ASPs) can mitigate some of this resistance, with the benefits well recognized; however, if we are to truly advance the state of AMS, the principles and practices should align with patient safety. Recent findings In ...
Source: Current Opinion in Infectious Diseases - November 4, 2019 Category: Infectious Diseases Tags: ANTIMICROBIAL AGENTS: BACTERIAL/FUNGAL: Edited by Monica Slavin Source Type: research

Rapid diagnosis of invasive candidiasis: ready for prime-time?
Purpose of review We review the performance of culture-independent diagnostic tests (CIDTs), including β-D-glucan (BDG), polymerase chain reaction (PCR) and T2Candida, in diagnosing invasive candidiasis, their potential roles in patient management, and unintended consequences of testing. Recent findings In a recent multicenter trial, T2Candida was 90% sensitive and 98% specific for diagnosing candidemia. A new study provided the first data for T2Candida in diagnosing deep-seated candidiasis, demonstrating sensitivity/specificity of 45%/96%. Two studies showed that ongoing T2Candida-positivity is associated with poor ...
Source: Current Opinion in Infectious Diseases - November 4, 2019 Category: Infectious Diseases Tags: ANTIMICROBIAL AGENTS: BACTERIAL/FUNGAL: Edited by Monica Slavin Source Type: research

Azole antifungals and new targeted therapies for hematological malignancy
Purpose of review With the introduction of new targeted therapies for hematological malignancies comes the challenges of both assessing the risk of developing an IFD while being treated with these agents, as well as managing the drug--drug interactions between azole antifungals and the agents. Recent findings New targeted therapies for hematological malignancy include chimeric antigen receptor T cells (CAR T cells), Bi-specific T-cell Engager (BiTE) blinatumomab, and the antibody–drug conjugate (ADC) of calicheamicin inotuzumab ozogamicin for acute lymphoblasic leukemia (ALL) and lymphoma; the Bruton's tyrosine kina...
Source: Current Opinion in Infectious Diseases - November 4, 2019 Category: Infectious Diseases Tags: ANTIMICROBIAL AGENTS: BACTERIAL/FUNGAL: Edited by Monica Slavin Source Type: research

Primary immunodeficiencies and invasive fungal infection: when to suspect and how to diagnose and manage
Purpose of review Invasive fungal infections (IFIs) most often occur secondary to acquired immunodeficiency states such as transplantation, AIDS or immune-modulatory treatment for neoplastic and autoimmune disorders. Apart from these acquired conditions, several primary immunodeficiency disorders (PIDs) can present with IFIs in the absence of iatrogenic immunosuppression. This review highlights recent advances in our understanding of PIDs that cause IFIs, which may help clinicians in the diagnosis and management of such infections. Recent findings A growing number of PIDs that cause varying combinations of invasive in...
Source: Current Opinion in Infectious Diseases - November 4, 2019 Category: Infectious Diseases Tags: ANTIMICROBIAL AGENTS: BACTERIAL/FUNGAL: Edited by Monica Slavin Source Type: research

Anaerobic resistance: should we be worried?
Purpose of review Anaerobic bacteria are implicated in a broad range of infections and can cause significant morbidity and mortality. As such, development of antimicrobial resistance (AMR) increases the risk of worse clinical outcomes and death. Recent findings Anaerobe AMR is highly variable according to region and species included in the survey. The overall trend is to increasing resistance, particularly in Europe and Asia, and in the Bacteroides fragilis group and Clostridium sp. Conversely, with the decline in RT027, resistance in Clostridiodes difficile is decreasing. Resistance to moxifloxacin and clindamycin ha...
Source: Current Opinion in Infectious Diseases - November 4, 2019 Category: Infectious Diseases Tags: ANTIMICROBIAL AGENTS: BACTERIAL/FUNGAL: Edited by Monica Slavin Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Infectious Diseases)
Source: Current Opinion in Infectious Diseases - November 4, 2019 Category: Infectious Diseases Tags: EDITORIAL INTRODUCTIONS Source Type: research

Surgical site infections: current management and role of new antibiotics
Purpose of review Management of SSI comprises prevention, extensive diagnosis, and appropriate treatment as well as follow-up. All these are interrelated matters. This review gives a brief update on the latest developments in the field, specifically on new antibiotics that may find a place in this complex field. Recent findings Avibactam and dalbavancin are novel antiinfectives. Although randomized controlled trials in SSI are lacking to date, preliminary data show that new drugs may be alternatives to existing treatment. Currently, they should be used only on the ground of susceptibility testing, and if standard drug...
Source: Current Opinion in Infectious Diseases - September 7, 2019 Category: Infectious Diseases Tags: SPECIAL COMMENTARY: Edited by Matteo Bassetti Source Type: research

Meningitis vaccines in children: what have we achieved and where next?
Purpose of review This review highlights the recent impacts of vaccines against the major bacterial causes of meningitis in children, and the challenges for further prevention of bacterial meningitis, with a focus on Streptococcus pneumoniae, Neisseria meningitidis and group B Streptococcus. Recent findings Conjugate vaccines against S. pneumoniae and N. meningitidis have resulted in dramatic reductions in bacterial meningitis globally where they have been used. Recent licensure and use of capsular group B meningococcal protein vaccines have further reduced meningococcal meningitis in infants, young children and adole...
Source: Current Opinion in Infectious Diseases - September 7, 2019 Category: Infectious Diseases Tags: PAEDIATRIC AND NEONATAL INFECTIONS: Edited by Saul N. Faust Source Type: research

Diagnosis and treatment of biofilm infections in children
Purpose of review Biofilm-associated infections cause difficulties in the management of childhood chronic infections and other diseases, due to the invasive nature of interventions which are often necessary for definitive management. Despite their importance, there are challenges in diagnosing biofilm infections and gaps in clinicians’ understanding regarding the significance of biofilms. Recent findings Many chronic infections associated with biofilms remain difficult or impossible to eradicate with conventional therapy. Surgical intervention, implant removal or long-term intermittent or suppressive antimicrobial t...
Source: Current Opinion in Infectious Diseases - September 7, 2019 Category: Infectious Diseases Tags: PAEDIATRIC AND NEONATAL INFECTIONS: Edited by Saul N. Faust Source Type: research

Paediatric sepsis
Purpose of review Sepsis remains among the leading causes of childhood mortality worldwide. This review serves to highlight key areas of knowledge gain and ongoing controversies pertinent to sepsis in children. Recent findings Several recent publications describe the epidemiology of paediatric sepsis, demonstrating the impact on child health in terms of mortality and morbidity, and the shortcomings of current paediatric sepsis definitions. Although emerging data support the importance of organ dysfunction as a hallmark of paediatric sepsis, the understanding of host susceptibility to sepsis and to sepsis severity rema...
Source: Current Opinion in Infectious Diseases - September 7, 2019 Category: Infectious Diseases Tags: PAEDIATRIC AND NEONATAL INFECTIONS: Edited by Saul N. Faust Source Type: research

The nonpathogenic commensal Neisseria: friends and foes in infectious disease
Purpose of review Nonpathogenic commensal Neisseria are rarely considered in the clinical setting despite evidence that they can cause invasive opportunistic infections. In contrast, they may offer protection against pathogenic Neisseria, and such relationships are being actively explored in experimental studies. Recent findings Recent case reports are presented of invasive infection caused by nonpathogenic Neisseria in patients on novel biologic therapies. On the other hand, Neisseria lactamica, a nonpathogenic commensal, has been shown in human challenge studies to inhibit colonization by Neisseria meningitidis. Exp...
Source: Current Opinion in Infectious Diseases - September 7, 2019 Category: Infectious Diseases Tags: PAEDIATRIC AND NEONATAL INFECTIONS: Edited by Saul N. Faust Source Type: research

Prevention and treatment of recurrent Clostridioides difficile infection
Purpose of review Clostridioides difficile infection (CDI) is a significant burden on the health system, especially due to high recurrence rates. Since the beginning of the CDI epidemic in early 2000s, many strategies for combatting recurrence have been explored, with moderate success so far. This review will focus on the most recent developments in recurrent CDI prevention and treatment. Recent findings There are two main mechanisms of CDI recurrence: alteration in microbiome and poor antibody response. Development of new antibiotics aims to minimize damage to the microbiome. Fecal transplant or other microbiome repl...
Source: Current Opinion in Infectious Diseases - September 7, 2019 Category: Infectious Diseases Tags: GASTROINTESTINAL INFECTIONS: Edited by Gagandeep Kang and Eric R. Houpt Source Type: research