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Dose optimisation of antibiotics used for meningitis
Purpose of review Central nervous system (CNS) infections such as ventriculitis and meningitis are associated with significant morbidity and mortality. In part, this may be due to increased difficulties in achieving a therapeutic antibiotic concentration at the site of infection due to both the pharmacokinetic (PK) changes observed during critical illness and the reduced antibiotic penetration through the blood brain barrier. This paper reviews the pharmacodynamics (PD) and CNS PKs of antibiotics used for Gram-negative bacterial CNS infections to provide clinicians with practical dosing advice. Recent findings R...
Source: Current Opinion in Infectious Diseases - November 22, 2021 Category: Infectious Diseases Tags: ANTIMICROBIAL AGENTS: BACTERIAL/FUNGAL: Edited by Monica A. Slavin Source Type: research

Diagnosis of invasive fungal disease in coronavirus disease 2019: approaches and pitfalls
Purpose of review This review will comment on the current knowledge for the diagnosis of the main causes of COVID-19-associated invasive fungal disease (IFD); it will discuss the optimal strategies and limitations and wherever available, will describe international recommendations. Recent findings A range of secondary IFDs complicating COVID-19 infection have been described and while COVID-19-associated pulmonary aspergillosis was predicted, the presentation of significant numbers of COVID-19-associated candidosis and COVID-19-associated mucormycosis was somewhat unexpected. Given the range of IFDs and prolonged...
Source: Current Opinion in Infectious Diseases - November 22, 2021 Category: Infectious Diseases Tags: ANTIMICROBIAL AGENTS: BACTERIAL/FUNGAL: Edited by Monica A. Slavin Source Type: research

Antifungal hypersensitivity reactions and cross-reactivity patterns
Purpose of review The goal of this article is to provide an updated understanding and evidence-based approach where possible for antifungal hypersensitivity. This includes recognition of clinical phenotype, implications for cross-reactivity and diagnostic, and management strategy for immediate and delayed hypersensitivity reactions. Recent findings Antifungal hypersensitivity reactions can be classified according to their latency (immediate or delayed) and clinical phenotype. The majority of the cases described in the literature are delayed T-cell mediated reactions of various severities but immediate reactions ...
Source: Current Opinion in Infectious Diseases - November 22, 2021 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 22, 2021 Category: Infectious Diseases Tags: EDITORIAL INTRODUCTIONS Source Type: research

Host transcriptional signatures as predictive markers of infection in children
Purpose of review Analyses of the host transcriptional response to infection has proved to be an alternative diagnostic strategy to standard direct pathogen detection. This review summarizes the value of applying blood and mucosal transcriptome analyses for the diagnosis and management of children with viral and bacterial infections. Recent findings Over the years, studies have validated the concept that RNA transcriptional profiles derived from children with infectious diseases carry a pathogen-specific biosignature that can be qualitatively and quantitively measured. These biosignatures can be translated into ...
Source: Current Opinion in Infectious Diseases - September 19, 2021 Category: Infectious Diseases Tags: PAEDIATRIC AND NEONATAL INFECTIONS: Edited by Scott H. James and David W. Kimberlin Source Type: research

Prevention strategies for congenital cytomegalovirus infection
Purpose of review Cytomegalovirus (CMV) is the most common viral cause of congenital infection, occurring in approximately 1–2% of live births worldwide. Given our increasing knowledge of risk, advances in the identification of maternal infection, and the extremely limited options for the treatment of fetal infection, the prevention is a promising direction for research efforts. Recently, there have been several exciting studies assessing different ways of preventing congenital infection in the fetus and one in particular has focused on the use of valaciclovir. Recent findings A recent study reported a 71% red...
Source: Current Opinion in Infectious Diseases - September 19, 2021 Category: Infectious Diseases Tags: PAEDIATRIC AND NEONATAL INFECTIONS: Edited by Scott H. James and David W. Kimberlin Source Type: research

Congenital Chagas disease: progress toward implementation of pregnancy-based screening
Purpose of review Lack of recognition of congenital Chagas disease in infants of mothers from endemic regions who are living in countries nonendemic for Trypanosoma cruzi infection suggests a high rate of underdiagnosis. Pregnancy is the optimal access point for identifying Chagas disease in at-risk mothers and their infants. In this review, we update progress toward implementation of pregnancy-based screening for congenital Chagas disease in nonendemic settings. Recent findings International organizations have updated recommendations for diagnosis, treatment and prevention of congenital Chagas disease. Reports ...
Source: Current Opinion in Infectious Diseases - September 19, 2021 Category: Infectious Diseases Tags: PAEDIATRIC AND NEONATAL INFECTIONS: Edited by Scott H. James and David W. Kimberlin Source Type: research

Neonatal bloodstream infections
Purpose of review Neonatal bloodstream infections (BSI) are a major contributor to morbidity and mortality within neonatal intensive care units. BSI, including central line-associated BSI, have decreased over the past 15 years but remain common in extremely preterm infants. The purpose of this review is to highlight recent advances in the causes, diagnosis, management, and prevention of neonatal BSI. Recent findings Continued quality improvement efforts and bundles have reduced BSI incidence, and novel approaches are highlighted. An update of emerging pathogens as well as traditional pathogens with novel antim...
Source: Current Opinion in Infectious Diseases - September 19, 2021 Category: Infectious Diseases Tags: PAEDIATRIC AND NEONATAL INFECTIONS: Edited by Scott H. James and David W. Kimberlin Source Type: research

Recent advances in Clostridioides difficile infection epidemiology, diagnosis and treatment in children
Purpose of review The US Centers for Disease Control and Prevention (CDC) classified Clostridioides difficile as an ‘urgent’ public health threat that requires ‘urgent and aggressive action’. This call to action has led to new discoveries that have advanced C. difficile infection (CDI) epidemiology, diagnosis and treatment, albeit predominantly in adults. In 2017, the Infectious Diseases Society of America and Society for Healthcare Epidemiology of America published clinical practice guidelines for both adults and children. At that time, recommendations in children were generally limited to relatively low-quali...
Source: Current Opinion in Infectious Diseases - September 19, 2021 Category: Infectious Diseases Tags: PAEDIATRIC AND NEONATAL INFECTIONS: Edited by Scott H. James and David W. Kimberlin Source Type: research

Parental vaccine hesitancy: scope, causes, and potential responses
Purpose of review We reviewed the literature about parental vaccine hesitancy, focusing on publications from October 2019 to April 2021 to describe patterns and causes of hesitancy and interventions to address hesitancy. Recent findings Recent studies expand understanding of the prevalence of vaccine hesitancy globally and highlight associated individual and contextual factors. Common concerns underlying hesitancy include uncertainty about the need for vaccination and questions about vaccine safety and efficacy. Sociodemographic factors associated with parental vaccine hesitancy vary across locations and context...
Source: Current Opinion in Infectious Diseases - September 19, 2021 Category: Infectious Diseases Tags: PAEDIATRIC AND NEONATAL INFECTIONS: Edited by Scott H. James and David W. Kimberlin Source Type: research

Staphylococcus aureus infections in children
Purpose of review Staphylococcus aureus is the most common invasive bacterial pathogen infecting children in the U.S. and many parts of the world. This major human pathogen continues to evolve, and recognition of recent trends in epidemiology, therapeutics and future horizons is of high importance. Recent findings Over the past decade, a relative rise of methicillin-susceptible S. aureus (MSSA) has occurred, such that methicillin-resistant S. aureus (MRSA) no longer dominates the landscape of invasive disease. Antimicrobial resistance continues to develop, however, and novel therapeutics or preventive modalities...
Source: Current Opinion in Infectious Diseases - September 19, 2021 Category: Infectious Diseases Tags: PAEDIATRIC AND NEONATAL INFECTIONS: Edited by Scott H. James and David W. Kimberlin Source Type: research

Coronavirus disease 2019 in children
Purpose of review Over the course of the coronavirus disease 2019 (COVID-19) pandemic, it has become clear that the clinical features, epidemiology, and outcomes of COVID-19 are distinct in children relative to adults. In this review, we will present recent pediatric studies informing our current understanding of COVID-19 in children, and review pediatric considerations surrounding disease transmission, currently available therapies, and vaccination. Recent findings Recent studies have shed light on the clinical epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children, identifying...
Source: Current Opinion in Infectious Diseases - September 19, 2021 Category: Infectious Diseases Tags: PAEDIATRIC AND NEONATAL INFECTIONS: Edited by Scott H. James and David W. Kimberlin Source Type: research

Bacteriophages against enteropathogens: rediscovery and refinement of novel antimicrobial therapeutics
Purpose of review Alarming rates of antibiotic resistance in bacteria and gastrointestinal dysbiosis associated with traditional antimicrobial therapy have led to renewed interests in developing bacteriophages as novel therapeutics. In this review, we highlight some of the recent advances in bacteriophage therapeutic development targeting important enteropathogens of the gastrointestinal tract. Recent findings Bacteriophages are viruses that infect bacteria, either to utilize the bacterial machinery to produce new progeny or stably integrate into the bacterial chromosome to ensure maintenance of the viral genome...
Source: Current Opinion in Infectious Diseases - September 19, 2021 Category: Infectious Diseases Tags: GASTROINTESTINAL INFECTIONS: Edited by James A. Platts-Mills Source Type: research

The future of Clostridioides difficile diagnostics
Purpose of review Although the epidemiology of Clostridioides difficile has changed, this organism continues to cause significant morbidity and mortality. This review addresses current and future approaches to the diagnosis of C. difficile disease. Recent findings Over the last several years, large prospective studies have confirmed that there is no single optimal test for the diagnosis of C. difficile disease. The pendulum has swung from a focus on rapid molecular diagnosis during the years of the ribotype 027 epidemic, to a call for use of algorithmic approaches that include a test for toxin detection. In addi...
Source: Current Opinion in Infectious Diseases - September 19, 2021 Category: Infectious Diseases Tags: GASTROINTESTINAL INFECTIONS: Edited by James A. Platts-Mills Source Type: research

The impact of alteration in gut microbiome in the pathogenesis of nonalcoholic fatty liver disease
Purpose of review We have increasing evidence that alterations of the intestinal microbiome have a strong influence on human health. Previous work has demonstrated the association between changes in the microbiome and metabolic risk factors. One related area of interest is the relationship between dysbiosis and nonalcoholic fatty liver disease (NAFLD), as the global prevalence of NAFLD, and its resultant complications, increases. Recent findings In this review, we summarize the hypothesized pathophysiology of dysbiosis-mediated progression of NAFLD, including promotion of an inflammatory intestinal environment, ...
Source: Current Opinion in Infectious Diseases - September 19, 2021 Category: Infectious Diseases Tags: GASTROINTESTINAL INFECTIONS: Edited by James A. Platts-Mills Source Type: research