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Tele-antimicrobial Stewardship in Action
AbstractPurpose of reviewSummarize the latest literature and our own clinical experience in the emerging technique of tele-antimicrobial stewardship, and provide practical advice for those considering providing or consuming this service.Recent findingsThe need for tele-antimicrobial stewardship is high and rising. Although the benefits of antimicrobial stewardship are well documented, tele-antimicrobial stewardship is a recent advance, and there is a relative lack of peer-reviewed clinical trials substantiating the impact of telehealth techniques in antimicrobial stewardship.SummaryAntimicrobial stewardship is more importa...
Source: Current Treatment Options in Infectious Diseases - April 24, 2018 Category: Infectious Diseases Source Type: research

Enterococci as Increasing Bacteria in Hospitals: Why Are Infection Control Measures Challenging for This Bacteria?
AbstractPurpose of the reviewEnterococci are emerging threatening multidrug-resistant bacteria.Enterococcus faecium is a common pathogen associated with severe hospital-acquired infections. The goal of this report is to analyze the evolution of this nosocomial pathogen and study the state of adequate infection control measures.Recent findingsEvolution over millions of years has allowed enterococci to develop into a persistent hospital pathogen, an environment where it thrives. Vancomycin-resistant enterococci (VRE) continues to obtain antibiotic resistance elements. Enterococci assemble multiple virulence factors. VRE inte...
Source: Current Treatment Options in Infectious Diseases - April 20, 2018 Category: Infectious Diseases Source Type: research

Current Treatment Options for HIV Elite Controllers: a Review
AbstractOpinion statementInitiating antiretroviral therapy (ART) in human immunodeficiency virus (HIV) elite controllers remains controversial, because current evidence does not definitively demonstrate that the benefits of ART outweigh risk in this patient population. However, it is the opinion of the authors that in developed countries, where first-line ART regimens have minimal toxicities, treatment of elite controllers should be strongly considered. Treatment of elite controllers has the potential to minimize the size of the HIV reservoir, which benefits elite controllers who choose to pursue future cure, dampen immune...
Source: Current Treatment Options in Infectious Diseases - April 16, 2018 Category: Infectious Diseases Source Type: research

Effective Strategies for Improving Hand Hygiene in Developing Countries
Opinion statementHand hygiene (HH) is the most important infection control intervention that has proved to decrease the risk of hospital-acquired infections in medical care [Jarvis WR, Lancet 344(8933):1311 –1312,1994]. However, ensuring consistent adequate HH in healthcare institutions remains a challenge in many healthcare settings. The World Health Organization (WHO) has launched the SAVE LIVES program targeting HH through a multimodal implementation strategy to improve HH compliance worldwide [Pittet D et al., Infect Control Hosp Epidemiol 30(7):611 –622,2009]. To be successfully implemented, the program needs (1) ...
Source: Current Treatment Options in Infectious Diseases - March 24, 2018 Category: Infectious Diseases Source Type: research

Solid Organ Transplantation for HIV-Infected Individuals
AbstractPurpose of reviewThe prevalence of end-stage organ disease is increasing among HIV-infected (HIV+) individuals. Individuals with well-controlled HIV on antiretroviral therapy (ART), without active opportunistic infections or cancer, and with specified minimum CD4 cell counts are appropriate transplant candidates. Infectious disease clinicians can improve access to transplantation for these patients and optimize management pre- and post-transplant.Recent findingsClinical trials and registry-based cohort studies demonstrate excellent outcomes for select HIV+ kidney and liver transplant recipients with patient and gra...
Source: Current Treatment Options in Infectious Diseases - March 5, 2018 Category: Infectious Diseases Source Type: research

Innovative Methods of Hospital Disinfection in Prevention of Healthcare-Associated Infections
AbstractPurpose of ReviewThe purpose of this review is to give the reader an update on recent studies and developments regarding the hospital environment role in transmission of healthcare-associated infections (HAIs), and novel strategies to obtain a cleaner, safer patient environment. Hospital patient rooms are increasingly recognized as a reservoir of multi-drug-resistant organisms that contribute to HAIs. In simulated environments, surfaces can easily be adequately disinfected of pathogenic bacteria. However, translation into real healthcare settings has been less reliable and efficacious, with barriers to implementati...
Source: Current Treatment Options in Infectious Diseases - February 23, 2018 Category: Infectious Diseases Source Type: research

Transmission-Based Precautions for Multidrug-Resistant Organisms: What to Prioritize When Resources Are Limited
Opinion statementIsolation precautions are infection control precautions intended to be used in healthcare settings to decrease the probability of transmission of multidrug-resistant pathogens through the hands of healthcare workers. It consists of the use of gown and gloves when touching the patient or his surroundings. The effectiveness of isolation precaution could be enhanced by the use of surveillance cultures which are cultures collected for the identification of colonized patients who had not been identified previously. To guarantee its cost-effectiveness, it is important to apply contact precautions in situations w...
Source: Current Treatment Options in Infectious Diseases - February 17, 2018 Category: Infectious Diseases Source Type: research

Controlling infectious disease outbreaks in low-income and middle-income countries
AbstractWhen an infectious disease outbreak is detected or suspected, a healthcare facility ’s infection control personnel should be notified and an outbreak control team formed that is pertinent to the size and severity of the outbreak and healthcare facility. Management of an infectious disease outbreak in a middle- or low-income country is challenging. Cost-effective recommendations t hat are easy to carry out and that have been stratified according to the type of infection and prevention and control intervention used are provided in this paper and constitute basic practices. (Source: Current Treatment Options in Infectious Diseases)
Source: Current Treatment Options in Infectious Diseases - February 15, 2018 Category: Infectious Diseases Source Type: research

Optimal Management of Drug-Resistant Tuberculosis and Human Immunodeficiency Virus: an Update
AbstractPurpose of ReviewRifampicin-resistant tuberculosis (RR-TB) in a growing global health crisis. RR-TB and HIV co-infection is common, and this dual infection brings with it unique diagnostic and treatment challenges. Here, we review the most recent developments in the epidemiology, prevention, diagnoses, and treatment —including the use of novel antituberculosis drugs—for these diseases. We also review strategies to combat stigma and support adherence for people living with HIV and RR-TB.Recent FindingsAdvances in RR-TB diagnosis include genotypic tests, most notably Xpert MTB/RIF. Novel therapeutic advances in t...
Source: Current Treatment Options in Infectious Diseases - February 13, 2018 Category: Infectious Diseases Source Type: research

Antimicrobial Stewardship in Low- and Middle-Income Countries
AbstractPurpose of reviewAntimicrobial stewardship (AMS) is one of the core elements of infection prevention and control, but in many resource-limited countries its implementation is absent or suboptimal. There is inadequate information on the best model for an AMS program. AMS should be adapted to each region according to sociocultural dimensions, financing, and antimicrobial resistance.Recent findingsMany of antimicrobials prescribed in hospitals are inappropriate or unnecessary, increasing the risk of adverse reactions and antimicrobial resistance. AMS programs are of essential benefits in low- and middle-income countri...
Source: Current Treatment Options in Infectious Diseases - February 13, 2018 Category: Infectious Diseases Source Type: research

Antimicrobial Stewardship Efforts to Improve Management of Uncomplicated Urinary Tract Infections in the Ambulatory Care Setting: a Review
AbstractPurpose of the ReviewOutpatient practice sites prescribe more antibiotics than any other healthcare setting contributing to the increasing rate of drug-resistant infections in the USA. Until the release of the Centers for Disease Control and Prevention ’s Core Elements in 2016, outpatient antimicrobial stewardship (AMS) was largely overlooked. The current review seeks to discuss recent AMS interventions for uncomplicated urinary tract infection (UTI) in the outpatient setting and how they relate to the core elements.Recent FindingsEvidence-based methods for UTI in the outpatient setting include pharmacist-review ...
Source: Current Treatment Options in Infectious Diseases - February 13, 2018 Category: Infectious Diseases Source Type: research

Role of Antimicrobial Stewardship Programs in Decreasing Hospital-Associated Clostridium difficile Infections
Opinion statementPurpose of reviewTo provide a review of literature that discusses some of the most successful antimicrobial stewardship interventions reported across institutions worldwide in response to increasedClostridium difficile infection (CDI) rates.Recent findingsAlthough many different types of antimicrobial reduction practices have been proven effective, differences in resources across varying sizes of institutions may make some interventions more attainable than other. Regardless of available resources, an initial assessment of the correlation of positive laboratory tests to clinical disease is necessary to qua...
Source: Current Treatment Options in Infectious Diseases - February 9, 2018 Category: Infectious Diseases Source Type: research

A Timeout on the Antimicrobial Timeout: Where Does It Stand and What Is Its Future?
Opinion statementPurpose of reviewTo summarize literature describing the antimicrobial timeout, its rationale for use as an antimicrobial stewardship program (ASP) strategy, and its potential role in overall ASP strategy.Recent findingsStudies have correlated a formal antimicrobial timeout process with increased rates of therapy modification and reductions in use of select broad-spectrum antibiotics. There remains a need for further guidance on how to best implement a system-wide antimicrobial timeout.SummaryThe antimicrobial timeout is a stewardship tool that protocolizes review of objective clinical data and encourages s...
Source: Current Treatment Options in Infectious Diseases - February 7, 2018 Category: Infectious Diseases Source Type: research

Building Capacity in Infection Prevention and Antimicrobial Stewardship in Low- and Middle-Income Countries: the Role of Partnerships Inter-countries
Opinion statementAntimicrobial resistance is increasing globally at a rapid pace, and patients in low- and middle-income countries are at high risk. The need for inter-country partnerships with the ultimate goal of building capacity in the fields of infection prevention and antimicrobial stewardship in these settings is of utmost importance. Reciprocal, long-term, supported relationships between collaborators from low- and middle-income countries and high-income countries will have high benefit to all partners. This paper looks at recent literature in antimicrobial stewardship and infection prevention and offers recommenda...
Source: Current Treatment Options in Infectious Diseases - February 6, 2018 Category: Infectious Diseases Source Type: research

New Interventions Targeting Healthcare-Associated Infections
AbstractPurpose of reviewHealthcare-associated infections (HCAIs) are still a major cause of patient morbidity and mortality nowadays and there are evidences that these infections are highly preventable. Although many efforts have been made to prevent them, we live with a global burden of HCAIs and low- and middle-income countries reported HCAIs rates higher than in high-income countries accompanied by the problem of multidrug resistant microorganisms.Recent findingsBasic measures for infection control and prevention must be put into practice and new techniques and methodologies have to be incorporated into HCAI control pr...
Source: Current Treatment Options in Infectious Diseases - January 27, 2018 Category: Infectious Diseases Source Type: research