Challenges in Implementing Surveillance Tools of High-Income Countries (HICs) in Low Middle Income Countries (LMICs )
AbstractPurpose of ReviewSurveillance of communicable diseases is essential in all countries to prevent and control infections, to detect outbreaks and also to see the effects of interventions. The data should be reliable, and collection, analysis and feedback as well as the action based on this data should be fast. In this article, author discusses the limitations the Low Middle income Countries (LMICs) have in implementing disease surveillance and some suggestions for improvement.Recent FindingsIntegrated Disease Surveillance and Response (IDSR) has been implemented successfully through most of the countries in Africa th...
Source: Current Treatment Options in Infectious Diseases - August 28, 2020 Category: Infectious Diseases Source Type: research

Hepatitis C Virus in the Elderly in the Direct-Acting Antiviral Era: from Diagnosis to Cure
AbstractPurpose of reviewHepatitis C (HCV) is the most common cause of viral hepatitis in elderly individuals. This patient population previously experienced suboptimal outcomes with interferon-based regimens. Unfortunately, patients aged 65  years and older were underrepresented in phase 2 and 3 clinical trials with newer direct acting antiviral (DAA) therapies. Since the advent of second-generation DAA in 2013, numerous robust real-world experiences highlighting the efficacy and safety of DAA in the elderly have been published. This review article summarizes the cascade of care for hepatitis C from diagnosis to cure...
Source: Current Treatment Options in Infectious Diseases - August 11, 2020 Category: Infectious Diseases Source Type: research

A Review of the Diagnosis and Management of Hepatitis E
AbstractPurpose of reviewWe aim to provide the readers an up-to-date knowledge of the structure, epidemiology, and transmission followed by a detailed discussion on testing, diagnostics and management of hepatitis E virus infection. We have also included a comprehensive review of hepatitis E in pregnancy.Recent findingsEuropean Association for the Study of the Liver established clinical practice guidelines for testing and treatment of suspected hepatitis E virus infections in 2018. Evidence suggests chronic hepatitis E may follow a course similar to hepatitis B/C with progression to cirrhosis and possibly hepatocellular ca...
Source: Current Treatment Options in Infectious Diseases - July 17, 2020 Category: Infectious Diseases Source Type: research

Bloodstream Infections Caused by Waterborne Bacteria
We describe the mechanisms and risk factors related to non-gastrointestinal waterborne hospital-acquired infections, including bloodstream infections. Included are some characteristics of the main bacteria described in the literature.Recent FindingsIn the last two decades, the number of water living bacteria that had been identified as causing healthcare-associated waterborne infections has expanded. Among these,Legionella,Enterobacteriaceae,Pseudomonas aeruginosa, other non-fermenting bacteria, and nontuberculous mycobacteria are included. We describe some of the main characteristics of the bacteria associated with the in...
Source: Current Treatment Options in Infectious Diseases - July 11, 2020 Category: Infectious Diseases Source Type: research

Vaccination and Therapeutics: Responding to the Changing Epidemiology of Yellow Fever
AbstractPurpose of ReviewAt the turn of the nineteenth century, yellow fever (YF) was considered the most dangerous infectious disease with high case fatality. Subsequent, mass vaccination campaigns coupled with widespread elimination of the YF mosquito vector significantly decreased YF cases and reduced outbreaks to the tropical and subtropical forested regions of Africa and South America.Recent FindingsHowever, recent (2016) large outbreaks in Angola, Democratic Republic of Congo (DRC), and South-Eastern Brazil, where previously had been demarcated as low-risk regions, have highlighted the possibility of a rapidly changi...
Source: Current Treatment Options in Infectious Diseases - July 10, 2020 Category: Infectious Diseases Source Type: research

Barrier Precautions in the Era of Multidrug Pathogens
AbstractPurpose of reviewThere is a continuing debate regarding contact precaution (CP) usage for endemic multidrug-resistant organisms (MDROs). In this review, we examine current recommendations for CP and highlight differences in CP use between endemic and non-endemic MDROs.Recent findingsThe discontinuation of CP had no effect on the incidence of methicillin-resistantStaphylococcus aureus and vancomycin-resistantEnterococci. The evidence regarding CP for extended-spectrum beta-lactamase producing Enterobacteriaceae is inconclusive, highlighting the need for more research to determine best infection control strategies. C...
Source: Current Treatment Options in Infectious Diseases - June 29, 2020 Category: Infectious Diseases Source Type: research

Diagnosis and Management of Syphilis in Patients With HIV Co-infection
AbstractPurpose of reviewSyphilis cases are on the increase especially in men who have sex with men (MSM) in urban areas of high-income countries. There is a strong association between syphilis and HIV infections. We review the more recent literature regarding the epidemiology, clinical manifestations, diagnostic investigations, treatment and follow-up of syphilis in HIV infection.Recent findingsAlthough the clinical manifestations of syphilis in people living with HIV (PLHIV) and HIV-uninfected patients are broadly similar, differences have been described in PLHIV. Asymptomatic primary syphilis and secondary syphilis are ...
Source: Current Treatment Options in Infectious Diseases - June 11, 2020 Category: Infectious Diseases Source Type: research

Neurologic Complications of Acute HIV Infection
AbstractPurpose of reviewThis review focuses on the pathophysiology of acute HIV infection (AHI) and related central nervous system (CNS) pathology, the clinical characteristics of neurologic complications of AHI, and the implications of the CNS reservoir and viral escape for HIV treatment and cure strategies.Recent findingsRecent studies in newly seroconverted populations show a high prevalence of peripheral neuropathy and cognitive dysfunction in AHI, even though these findings have been classically associated with chronic HIV infection. HIV cure strategies such as the “shock and kill” strategy are currently ...
Source: Current Treatment Options in Infectious Diseases - June 8, 2020 Category: Infectious Diseases Source Type: research

Engaging Internal Medicine Hospitalists in Antimicrobial Stewardship —a Systematic Review
AbstractPurpose of reviewThe purpose of this article is to critically assess the literature on engaging internal medicine hospitalists in antimicrobial stewardship.Recent findingsFew studies exist that describe hospitalist-led antimicrobial stewardship initiatives. Most studies in this review employed quasi-experimental or quality improvement methods. Across the studies included in our analysis, those with interventions that focused on single disease processes (e.g., pneumonia, UTI, SSTI) had a more robust impact on their selected outcomes. In the reviewed literature, engaging internal medicine hospitalists in antimicrobia...
Source: Current Treatment Options in Infectious Diseases - May 29, 2020 Category: Infectious Diseases Source Type: research

Vancomycin-Resistant Enterococcus in Hematology-Oncology Patients: a Review on Colonization, Screening, Infections, Resistance, and Antimicrobial Stewardship
This article summarizes current literature on the epidemiology of VRE in hematology-oncology patients. It examines the associations between infection control practices, prescribing behavior, colonization, and infections due to VRE in patients with acute leukemia and stem cell transplant recipients. It also explores opportunities for antimicrobial stewardship and future research.Recent findingsVRE colonization is associated with VRE infections, but the progression from colonization to infection is not well defined. Colonization pressure may be associated with infection control practices at the patient unit level. Although p...
Source: Current Treatment Options in Infectious Diseases - May 26, 2020 Category: Infectious Diseases Source Type: research

Diagnostic Stewardship Approaches to Clostridioides difficile Infection in the Era of Two-Step Testing: a Shifting Landscape
AbstractPurpose of reviewTo discuss the current strategies and impact of diagnostic stewardship forClostridioides difficile infection.Recent findingsThe diagnosis ofC. difficile infection is challenging due to complex epidemiology and the limitations of a single assay that is adequate for diagnosis. Overdiagnosis with sensitive molecular assays is common due to the prevalence of colonization withC. difficile. To overcome these challenges, multiple diagnostic stewardship strategies have been successfully deployed to optimizeC. difficile testing.SummaryDiagnostic stewardship strategies should be implemented at every stage of...
Source: Current Treatment Options in Infectious Diseases - May 23, 2020 Category: Infectious Diseases Source Type: research

The Growing Threat of Vaccine Resistance: a Global Crisis
This article discusses the causes and consequences of major vaccine controversies, starting with the introduction of the smallpox vaccine to the more recent scandals regarding the DPT, MMR, and tetravalent dengue vaccines. It also discusses the current evidence regarding vaccine-related serious adverse events and analyzes the possible factors that contribute to the anti-vaccine movement, such as the dissemination of false information on social media platforms.Recent findingsThe dissemination of false information and the lack of an effective strategy to engage individual patients, communities, and the anti-vaccine movement ...
Source: Current Treatment Options in Infectious Diseases - May 15, 2020 Category: Infectious Diseases Source Type: research

Review: Evaluation and Management of the HIV/HCV Co-Infected Kidney or Liver Transplant Candidate
AbstractPurpose of reviewUntil recently, human immunodeficiency virus (HIV) was considered a contraindication to solid organ transplant (SOT) as there were concerns about poor outcomes given the high degree of immunosuppression needed to successfully transplant and retain an allograft. Emerging data has shown positive outcomes in HIV-infected solid organ transplants but a less well-explored area in the literature is SOT in those co-infected with HIV and hepatitis C virus (HCV). Kidney and liver transplantation remain the focus of this review as data on outcomes from other organs remains largely limited to case series and o...
Source: Current Treatment Options in Infectious Diseases - May 12, 2020 Category: Infectious Diseases Source Type: research

Host Lipid Response in Tropical Diseases
AbstractPurpose of reviewHerein, we summarize recent findings of novel lipid interactions between hosts and pathogens with the hope that further research is pursued in this emerging area of tropical disease lipidomics.Recent findingsHard-to-treat tropical diseases may be viral, parasitic, or bacterial in origin. Primarily caused in regions with high population densities, the lack of rapid diagnostic methods, effective long-term treatment regimens, and a high transmission rate results in major public health burdens. Intracellular niches occupied by the various pathogens in the human host further complicates treatment, as th...
Source: Current Treatment Options in Infectious Diseases - May 12, 2020 Category: Infectious Diseases Source Type: research

Ushering in Diagnostic Stewardship: a Step Towards Antibiotic Stewardship
AbstractPurpose of reviewIn recent years, there have been significant developments in rapid diagnostic techniques (RDTs) in microbiology for the diagnosis of infectious diseases. By providing a more rapid diagnosis, RDTs have the potential to affect diagnostic algorithms and therapeutic decisions. In addition to “antibiotic stewardship,” the term “diagnostic stewardship” has recently been coined in clinical practice and denotes the promotion of a rational implementation of diagnostic tests with a view to improving the quality of care and safely reducing cost. This review explores the advancement of ...
Source: Current Treatment Options in Infectious Diseases - May 11, 2020 Category: Infectious Diseases Source Type: research

How Far We ’ve Come, How Far We Have to Go: a Review of Advances in Antimicrobial Stewardship in the Veterans Health Administration
AbstractPurpose of reviewThis review highlights several of the successes in antimicrobial stewardship seen in the largest integrated healthcare system in the USA, the Veterans Health Administration.Recent findingsSince deploying antimicrobial stewardship programs on a national scale in the Veterans Health Administration, decreases in overall antimicrobial use andClostridioides difficile infections have been observed. Concurrent infection prevention initiatives have also contributed to these improvements in the Veterans Health Administration.SummaryBy embracing multidisciplinary stewardship teams, focusing on education and ...
Source: Current Treatment Options in Infectious Diseases - May 8, 2020 Category: Infectious Diseases Source Type: research

Evaluation of OPAT in the Age of Antimicrobial Stewardship
AbstractPurpose of reviewAntimicrobial stewardship and outpatient parenteral antimicrobial therapy (OPAT) collide with the newest Joint Commission requirements for outpatient antimicrobial stewardship. The purpose of this paper was to present key stewardship areas applicable to OPAT and review the data behind them.Recent findingsData on these topics is emerging. Long treatment durations are being challenged and oral routes are garnering evidence for treatment of traditionally intravenous-only regimens. Stability information and incorporation of pharmacokinetic and pharmacodynamic properties may lead to use of continuous in...
Source: Current Treatment Options in Infectious Diseases - April 29, 2020 Category: Infectious Diseases Source Type: research

Using Technology to Enhance Antimicrobial Stewardship Impact in the Acute Care Setting
AbstractPurpose of ReviewThere are numerous opportunities for antimicrobial stewardship programs (ASPs) to utilize technology to maximize their impact on patient care. Herein we describe different technology platforms, strengths and limitations of each, and provide some examples of their use in clinical settings.Recent FindingsElectronic medical record (EMR) upgrades and clinical decision support tools can enhance existing stewardship functions such as audit and feedback, de-escalation, “time-outs” among others. Antimicrobial utilization and resistance data reporting enables a deeper understanding of local tren...
Source: Current Treatment Options in Infectious Diseases - April 23, 2020 Category: Infectious Diseases Source Type: research

Improving Diagnostic and Laboratory Capacity Helps in Control of Infection: an Indian Perspective
AbstractPurpose of ReviewTo appraise the evidence and recommendations from published medical literature about the importance of clinical microbiology laboratory services in the prevention and control of infection in community and in the healthcare setting especially from the Indian perspective.Recent FindingsEffective infection prevention and control (IPC) is not possible without a functioning microbiology laboratory. Basic microbiology services in a biosafety level 2 facility consisting of light microscopy, blood culture, bacteriology, serology, and tests for certain fungus and mycobacteria (with standard facilities with ...
Source: Current Treatment Options in Infectious Diseases - March 28, 2020 Category: Infectious Diseases Source Type: research

Using Artificial Intelligence in Infection Prevention
AbstractPurpose of ReviewArtificial intelligence (AI) offers huge potential in infection prevention and control (IPC). We explore its potential IPC benefits in epidemiology, laboratory infection diagnosis, and hand hygiene.Recent FindingsAI has the potential to detect transmission events during outbreaks or predict high-risk patients, enabling development of tailored IPC interventions. AI offers opportunities to enhance diagnostics with objective pattern recognition, standardize the diagnosis of infections with IPC implications, and facilitate the dissemination of IPC expertise. AI hand hygiene applications can deliver beh...
Source: Current Treatment Options in Infectious Diseases - March 19, 2020 Category: Infectious Diseases Source Type: research

Endemic Fungi in Transplant and Immunocompromised Hosts: Epidemiology, Diagnosis, Treatment, and Prevention
AbstractPurpose of Review:Dimorphic endemic fungi exist as mold and yeast forms at room and body temperature within the host, respectively. Primary infection can arise from new environmental exposure and less frequently through organ transplantation. Reactivation of latent infection can occur when immunosuppression is introduced or intensified. Transplant and immunocompromised hosts (ICH) represent important populations at risk for complicated and disseminated forms of endemic mycoses (EM). Diagnosis is challenging as immunosuppression contributes to insidious clinical presentations resulting in diagnostic and treatment de...
Source: Current Treatment Options in Infectious Diseases - February 26, 2020 Category: Infectious Diseases Source Type: research

Influenza Vaccination and Healthcare Personnel Compliance
AbstractPurpose of ReviewWe reviewed the benefit of influenza vaccination in healthcare personnel (HCP), rates of vaccine coverage, and practices used to try to boost vaccine coverage among HCP.Recent FindingsInfluenza vaccination in HCP provides benefits to both HCP and patients, including reductions in patient morbidity and mortality and decreases in HCP absenteeism. Despite these benefits, influenza vaccine coverage among HCP still falls short of the Healthy People 2020 goal of 90%. As a result, healthcare institutions have used various practices to boost vaccination, including mandatory vaccine policies and requiring n...
Source: Current Treatment Options in Infectious Diseases - February 24, 2020 Category: Infectious Diseases Source Type: research

What Is New in Candida Infections? T2Candida, Antifungal Stewardship, and Candida auris
AbstractPurpose of reviewWe review T2Candida panel performance in diagnosing invasive candidiasis, potential roles of T2Candida, and other culture-independent tests in patient management and antifungal stewardship, and diagnosis and treatment of infections byCandida auris, which has emerged globally as a cause of nosocomial outbreaks.Recent findingsIn 2 multicenter trials, T2Candida was 90% sensitive and 98% specific for diagnosing candidemia directly from whole blood samples. A subsequent study demonstrated T2Candida sensitivity/specificity of 45%/96% for diagnosing deep-seated candidiasis. Other studies have shown that o...
Source: Current Treatment Options in Infectious Diseases - February 5, 2020 Category: Infectious Diseases Source Type: research

Prophylaxis and Treatment of Invasive Aspergillosis: Who and How of Prophylaxis, Treatment, and New Therapies
AbstractPurpose of reviewTo discuss the approach to antifungal prophylaxis and treatment for invasive aspergillosis in immunocompromised patients with hematologic malignancies, hematopoietic stem cell transplant, and solid organ transplant recipients.Recent findingsPrimary prophylaxis againstAspergillus is recommended for patients with acute myelogenous leukemia receiving remission-induction chemotherapy. Posaconazole or voriconazole are appropriate antifungal agents. A new formulation of itraconazole (SUBA-itraconazole) is an alternative option. Breakthrough infections on isavuconazole prophylaxis have been recently repor...
Source: Current Treatment Options in Infectious Diseases - January 30, 2020 Category: Infectious Diseases Source Type: research

Up-to-Date Infection Control Practices for Febrile Neutropenic Patients
AbstractPurpose of reviewNeutropenia and its related infections are still a significant challenge in the treatment of patients with onco-hematological diseases, impacting increased mortality and morbidity. In this review, we compiled up-to-date scientific evidence on infection control in neutropenic patients and discussed the potential role of new technologiesRecent findingsTraditional measures such as hand hygiene (HH), patient ’s skincare, central venous catheter care, environment protection, and contact isolation are the cornerstone of infection prevention in neutropenic patients while antibiotic prophylaxis is st...
Source: Current Treatment Options in Infectious Diseases - January 24, 2020 Category: Infectious Diseases Source Type: research

Cryptococcal Immune Reconstitution Inflammatory Syndrome: a Paradoxical Response to a Complex Organism
AbstractPurpose of reviewTo describe the host-pathogen factors that impact the management of cryptococcal meningitis (CM) in immunosuppressed patients that lead to the development of cryptococcal immune reconstitution inflammatory syndrome (C-IRIS).Recent findingsThe pre-screening of HIV-infected patients in resource-poor countries with the lateral flow cryptococcal antigen assay could prevent C-IRIS. Delaying ART by 4  weeks is associated with improved survival and recommended by guidelines; this approach remains controversial in wealthier areas as there is limited data. A 5-flucytosine-based combination regimen and ...
Source: Current Treatment Options in Infectious Diseases - January 24, 2020 Category: Infectious Diseases Source Type: research

Metabolic Syndrome in HIV/HCV Co-infected Patients
AbstractPurpose of reviewWe review the scope and burden of metabolic syndrome in HIV/HCV co-infected patients, risk factors, and potential mechanisms driving the increased cardio-metabolic risk in this population, and discuss relevant clinical considerations for management in the era of highly effective antiretroviral therapy (ART) and curative anti-HCV direct-acting antivirals.Recent findingsHIV/HCV co-infected patients are at elevated risk of metabolic syndrome, attributed to (1) patient-specific factors, (2) viral-mediated effects, and (3) ART exposure. Risk factors for cardio-metabolic disorders are common in this popu...
Source: Current Treatment Options in Infectious Diseases - December 2, 2019 Category: Infectious Diseases Source Type: research

New Options in Antifungal Therapy: New Drugs, Inhaled Antifungals, and Management of Resistant Pathogens
AbstractPurpose of reviewThis review aims to update the reader on recent information related to available antifungal pharmacotherapy and inform on agents that may be available for clinical use in the near future. Additionally, alternate drug delivery of existing agents, therapeutic drug monitoring, and management of resistant fungal pathogens will be discussed.Recent findingsRezafungin (a once-weekly echinocandin) and ibrexafungerp (an oral glucan synthase inhibitor) appear to be the investigational agents that are nearest to widespread use in clinical practice. Emerging information on isavuconazole (mean inhibitory concen...
Source: Current Treatment Options in Infectious Diseases - November 26, 2019 Category: Infectious Diseases Source Type: research

Update on Adverse Effects of HIV Integrase Inhibitors
AbstractPurpose of reviewThe goal of this paper is to provide an up-to-date review of adverse events related to the class of integrase strand transfer inhibitors (INSTIs), which became the class of choice in few years. We sought answers specifically to issues pertaining to neuropsychiatric adverse events, as well as weight gain, which were the two most important categories of adverse events raised in recent studies based on real-life experience. The primary focus of this paper is on adults with a brief summary on pregnant women and children/adolescents.Recent findingsDolutegravir (DTG) bears the heaviest burden of neuropsy...
Source: Current Treatment Options in Infectious Diseases - November 16, 2019 Category: Infectious Diseases Source Type: research

Evolution, Trends, and Potential Explanations of the Increase in the Incidence of Tuberculosis: the Case of Uruguay
AbstractPurpose of reviewA descriptive analysis of the trend of tuberculosis incidence in Uruguay between 1995 and 2018.Recent findingsIn 2015, World Health Organization (WHO) proposed The END TB Strategy; the Latin American countries that implemented these strategies at the first level of care have had successful outcomes in terms of the reduction in the incidence, morbidity, and mortality of the disease.SummaryUruguay is a striking case in the regional environment regarding tuberculosis epidemiology. The trend of tuberculosis had a turning point in 2006, which defines two clearly different periods. The first period cover...
Source: Current Treatment Options in Infectious Diseases - November 14, 2019 Category: Infectious Diseases Source Type: research

Treatment of Non- Aspergillus Mold Infections: a Focus on Mucormycosis and Fusariosis
AbstractPurpose of reviewMucormycosis and fusariosis are associated with severe morbidity and high fatality rate. This review will discuss the challenges associated with the treatment of mucormycosis and fusariosis with a focus on recent data on antifungal susceptibility, novel therapeutic modalities, and combination therapy. Overall, the review aims to provide guidance to optimize management of these difficult-to-treat infections.Recent findingsIsavuconazole has comparable efficacy with liposomal amphotericin B for the treatment of mucormycosis. Treatment of fusariosis remains challenging, but voriconazole has been associ...
Source: Current Treatment Options in Infectious Diseases - November 8, 2019 Category: Infectious Diseases Source Type: research

Special Topics in the Care of Older People with HIV
AbstractPurpose of reviewAntiretroviral therapy has enabled many people with HIV to live long lives with their infection, but the literature suggests that long-term survivors are developing comorbidities and aging-related syndromes at earlier ages than their non-infected counterparts. In addition, there is evidence of sex-based differences in comorbidity risk.Recent findingsHow to best care for people aging with HIV is not known, but the tools of comprehensive geriatric assessment can identify people at risk for decline. Newer antiretroviral therapies offer promise of fewer side effects and drug interactions. We will also ...
Source: Current Treatment Options in Infectious Diseases - November 8, 2019 Category: Infectious Diseases Source Type: research

Bacterial Pyomyositis Associated with Human Immunodeficiency Virus: Diagnosis, Management, and Review of the Recent Literature
We present a case and provide a review of all the confirmed cases of pyomyositis in human immunodeficiency virus (HIV)-positive patients in the literature after the last published case series, from September 16, 2004 to February 1, 2019. The goal of this review is to examine recent trends in causative organisms, diagnostic modalities, and duration of therapy for patients with HIV and pyomyositis in the antiretroviral therapy (ART) era.Recent findingsPyomyositis affects predominately the lower extremities and can have extra-muscular manifestations. Magnetic resonance imaging is the gold standard for diagnosis but computed t...
Source: Current Treatment Options in Infectious Diseases - July 29, 2019 Category: Infectious Diseases Source Type: research

Opportunities to Overcome Implementation Challenges of Infection Prevention and Control in Low-Middle Income Countries
AbstractPurpose of reviewHealthcare-associated infections (HAIs) and rising antimicrobial resistance (AMR) have posed a major challenge in patient care across the globe, more so in lower-middle-income countries (LMICs). Studies have shown that implementation of an effective infection prevention and control (IPC) program reduces incidence of HAI to a large extent. However, implementation of such a program in low-resource setting has many challenges. Research have shown that gaps exist due to absence of political will, trained manpower, and alternate healthcare priorities.Recent findingsWith progress in science of healthcare...
Source: Current Treatment Options in Infectious Diseases - July 27, 2019 Category: Infectious Diseases Source Type: research

Diagnosis and Treatment of Carbapenemase-Producing Organisms —an Update
AbstractPurpose of reviewCarbapenem-producing organisms (CPO) have become important clinical pathogens in nosocomial infections causing increases in hospital stay, mortality, and costs. We sought to summarize recent findings related to the commonly encountered types of carbapenemases and their detection and review recent findings related to therapeutic options.Recent findingsMany new rapid and reliable methods of identifying carbapenem resistance have become available, underscoring the necessity to have the laboratory capacity for phenotypic and/or genotypic detection of carbapenemases to facilitate optimal therapy accordi...
Source: Current Treatment Options in Infectious Diseases - July 23, 2019 Category: Infectious Diseases Source Type: research

HIV-2 Infection: Latest Advances
AbstractHIV-2, despite being less common than HIV-1, is an important cause of morbidity and mortality. As more data are published on HIV-2 infection, it is clear that despite lower viral loads and higher CD4 cell counts than those seen in HIV-1, it is important to treat these patients with antiretroviral therapy to prevent progression of disease and early mortality.Purpose of reviewTo summarize the background characteristics of HIV-2, diagnostic and treatment considerations, and recent updates in treatment of HIV-2.Recent findingsProspective cohort studies of people with HIV-2 infection have shown that they have a signific...
Source: Current Treatment Options in Infectious Diseases - July 19, 2019 Category: Infectious Diseases Source Type: research

An Overview of Surgical Site Infection in Low- and Middle-Income Countries: the Role of Recent Guidelines, Limitations, and Possible Solutions
AbstractPurpose of reviewThe purpose of this manuscript is to review preventive strategies for surgical site infection (SSI) in low- and middle-income countries (LMIC) and how the recent World Health Organization (WHO) guidelines, along with the Centers for Disease Control (CDC) recommendations on SSI prevention, may be implemented on these settings, considering frequent limitations and possible solutions.Recent findingsSurgical site infection (SSI) is the most common postoperative complication and in LMIC is the first cause among healthcare-associated infections (HAI). SSIs are largely preventable if there is a standardiz...
Source: Current Treatment Options in Infectious Diseases - July 13, 2019 Category: Infectious Diseases Source Type: research

The Real Scenario in Infection Prevention and Control in Low- and Middle-Income Countries: the Challenge of “Starting From Scratch”
AbstractPurpose of reviewInfection control and prevention (the routine use of infection prevention and control policies, procedures, and interventions in healthcare institutions) is fundamental to improving patient care outcome while ensuring the health and safety of healthcare workers, patients, and visitors.Healthcare facilities with an effective infection prevention and control (IPC) program have demonstrated a decrease in healthcare-associated infections, a common complication of interaction with healthcare, through adherence to IPC guidelines resulting in safer clinical care environments and impacting patient morbidit...
Source: Current Treatment Options in Infectious Diseases - July 5, 2019 Category: Infectious Diseases Source Type: research

Antifungal Stewardship in Low- and Middle-Income Countries
AbstractPurpose of reviewAntifungal stewardship refers to coordinated interventions designed to improve and measure the appropriate use of antifungals by promoting the selection of the optimal antifungal drug regimen, dose, duration of therapy, and route of administration.Recent findingsThe high mortality associated with invasive fungal diseases (IFDs), combined with suboptimal diagnostic tools, has driven the overuse of antifungal drugs. High drug costs and the toxicities of antifungal agents are the principal rationale for antifungal stewardship, while antifungal resistance is an emerging but less prevalent issue.Summary...
Source: Current Treatment Options in Infectious Diseases - July 5, 2019 Category: Infectious Diseases Source Type: research

Ivermectin for the Treatment of Soil-Transmitted Helmithiases
AbstractPurpose of reviewTo present ivermectin as a transformational tool for the control of neglected tropical diseases (NTDs) such as onchocerciasis and the drug of choice for the treatment of strongyloidiasis. Ivermectin is being re-discovered as a candidate drug for a variety of new indications among NTDs. In this review, new data are analyzed and put in context of current research interest as well as of the un-addressed issues for the treatment of soil-transmitted helminths (STH) infections.Recent findingsThe addition of ivermectin to the benzimidazole drugs appears as the most promising solution for three key issues ...
Source: Current Treatment Options in Infectious Diseases - July 3, 2019 Category: Infectious Diseases Source Type: research

Tropical Diseases in HIV
This article reviews existing data on coinfections of the most common tropical diseases and HIV, as well as current strategies for their treatment and control. (Source: Current Treatment Options in Infectious Diseases)
Source: Current Treatment Options in Infectious Diseases - July 1, 2019 Category: Infectious Diseases Source Type: research

Therapeutics for Dengue
AbstractPurpose of reviewDengue virus (DENV) infections are a global health emergency. Humans can experience multiple DENV infections, owing to the presence of four antigenically distinct DENV serotypes, DENV1 –4. DENV infection results in a spectrum of disease, ranging from mild and self-limiting to severe and life-threatening illness. Currently, one dengue vaccine is approved, although with modest efficacy, so dengue-directed therapeutics are still needed to minimize the disease burden. The current st andard-of-care treatment for dengue is only supportive but there is a pipeline of therapeutic treatments that are i...
Source: Current Treatment Options in Infectious Diseases - June 27, 2019 Category: Infectious Diseases Source Type: research

A Review of Safety and Effectiveness of Intravenous and Intraventricular Tigecycline in Healthcare-Associated Acinetobacter baumannii Meningitis and Ventriculitis
ConclusionDespite the limited studies, IV and IVT tigecycline has been used successfully and safely for the treatment of healthcare-associatedA. baumannii meningitis and ventriculitis. However, large randomized controlled trials are necessary to clearly evaluate the safety and effectiveness of IV and IVT tigecycline in healthcare-associatedA. baumannii meningitis and ventriculitis. (Source: Current Treatment Options in Infectious Diseases)
Source: Current Treatment Options in Infectious Diseases - June 27, 2019 Category: Infectious Diseases Source Type: research

Basic, Advanced, and Novel Metrics to Guide Antibiotic Use Assessments
AbstractPurpose of reviewThis review illustrates relevant and current antibiotic use (AU) metrics and demonstrates their differences. The authors also highlight novel, increasingly complex AU metrics proposed for use in antibiotic stewardship research.Recent findingsMany common antibiotic use metrics (e.g., days of therapy, length of therapy) are well defined, widely generalizable, and commonly used by antimicrobial stewardship programs. Multiple measures are required to comprehensively capture real-world AU, though utilization metrics often lack important contextual information needed to inform antibiotic stewardship stra...
Source: Current Treatment Options in Infectious Diseases - May 28, 2019 Category: Infectious Diseases Source Type: research

Antibiotics in the Pipeline for Treatment of Infections due to Gram-Negative Organisms
AbstractPurpose of reviewWe systematically review the literature on antibiotics approved by the Food and Drug Administration since 2015 or that are in development through phase III trials for the treatment of infections due to gram-negative organisms.Recent findingsThe crisis of antimicrobial resistance creates a dire need for the development of novel antimicrobials with enhanced activity against resistant bacteria. Of the agents that are currently in the pipeline or recently approved, few are from new classes and most represent modifications of preexisting agents. There continues to be a lack of treatment options especial...
Source: Current Treatment Options in Infectious Diseases - May 8, 2019 Category: Infectious Diseases Source Type: research

Antimicrobial Stewardship in Patients with Hematological Malignancies: Key Considerations
AbstractPurpose of reviewThis review establishes current evidence supporting antimicrobial stewardship programs for malignant hematology and hematopoietic stem cell transplant patients. It describes best practices and identifies opportunities for research. It examines metrics relevant to the patient population, and new approaches to the management of high-risk febrile neutropenia.Recent findingsThere is an urgent need for antimicrobial stewardship programs to optimize antimicrobial use in malignant hematology and stem cell transplant patients. Audit and feedback is effective and safe. Febrile neutropenia is a key area to o...
Source: Current Treatment Options in Infectious Diseases - May 7, 2019 Category: Infectious Diseases Source Type: research

Are We Overlooking the Use of Oral Ribavirin for Respiratory Syncytial Virus Infection Following Hematopoietic Stem Cell Transplantation?
We describe our experience using oral ribavirin (RBV) for RSV infections in HSCT recipients.MethodsRetrospective cohort analysis of HSCT recipients diagnosed with RSV infection and treated with either oral RBV or supportive care between September 2014 and April 2015.ResultsTwenty-six HSCT recipients were identified as RSV-positive in this study. Oral RBV (mean daily dose 16.7  mg kg) was prescribed to 14 (54%) patients. A higher proportion of patients in the RBV group had lower respiratory tract infection (RTI) (p = 0.007) and were inpatient (p 
Source: Current Treatment Options in Infectious Diseases - May 2, 2019 Category: Infectious Diseases Source Type: research

Beta-lactam Allergy Review: Implications for Antimicrobial Stewardship Programs
AbstractPurpose of reviewBeta-lactam allergies, and specifically penicillin allergies, result in receipt of therapy that is not considered first line in many instances. Being labeled as allergic many times comes via subjective history from the patient. Carrying this label can cause a patient to receive broad-spectrum therapy with increased side effects and resistance. Antimicrobial stewardship programs can play a role in allergy evaluation and intervention based on resources. This review provides an update on beta-lactam allergies and emphasizes incorporation of evaluating these patients as a core tenant of antimicrobial s...
Source: Current Treatment Options in Infectious Diseases - May 1, 2019 Category: Infectious Diseases Source Type: research

The Present and Future State of Antimicrobial Stewardship and Rapid Diagnostic Testing: Can One Ideally Succeed Without the Other?
AbstractPurpose of reviewThe growth and development of rapid diagnostic technologies (RDTs) in infectious diseases (ID) have grown significantly over the past several years. The aim of these platforms is to identify causative pathogens more quickly and target antimicrobial therapy earlier, ultimately improving patient outcomes. Use of RDT specifically from blood specimens to optimize antimicrobial therapy and improve patient outcomes is a recommendation by the most recent antimicrobial stewardship (AMS) guidelines. In this review, we aim to highlight currently available FDA-approved RDTs for clinicians, data supporting the...
Source: Current Treatment Options in Infectious Diseases - May 1, 2019 Category: Infectious Diseases Source Type: research

Do We Need Antifungal Stewardship?
AbstractPurpose of reviewInvasive fungal infections (IFIs) are recognized as a significant health problem worldwide. Inappropriate use of antifungals contributes to antifungal resistance and emerging fungi. There is an urgent clinical need to limit inappropriate antifungal usage through judicious antifungal stewardship (AFS).Recent findingsThe main goals of AFS are optimized care, de-escalation or withdrawal of antifungal therapy when appropriate, reduced costs, and reduced fungal resistance, with no negative impact in terms of morbidity or mortality. AFS should be tailored for each institution and health-care system, and ...
Source: Current Treatment Options in Infectious Diseases - April 17, 2019 Category: Infectious Diseases Source Type: research