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The Role of Clinical Virology Laboratory and the Clinical Virology Laboratorian in Ensuring Effective Surveillance for Influenza and Other Respiratory Viruses: Points to Consider and Pitfalls to Avoid
Opinion statement Influenza and respiratory viruses have a global impact on public health. Clinical virology laboratories and laboratorians play an important role in not only the diagnosis but also the surveillance of these pathogens. Surveillance for influenza and other respiratory pathogens is important, as it informs public health decision making in terms of influenza vaccine and antiviral effectiveness, informs clinicians and public health practitioners about the pathogenicity of specific viral strains, guides clinical practice, and supports laboratory panning activities. Key background issues include...
Source: Current Treatment Options in Infectious Diseases - July 4, 2016 Category: Infectious Diseases Source Type: research

Review of Laboratory Tests used in Monitoring Hepatitis B Response to Pegylated Interferon and Nucleos(t)ide Analog Therapy
Opinion statement There are only two currently approved classes of hepatitis B virus (HBV) antiviral agents, pegylated interferon (Peg-IFN), and nucleos(t)ide analogs (NAs) for chronic HBV infection. Although Peg-IFN is used for a finite 48-week duration and offers a greater chance of sustained off-treatment virological response, it is poorly tolerated and can only be offered to selected patients. The NAs are well tolerated but require prolonged therapy due to risk of relapse with treatment cessation. There is evolving data that novel virological assays (e.g., quantitative hepatitis B surface antigen, qua...
Source: Current Treatment Options in Infectious Diseases - July 1, 2016 Category: Infectious Diseases Source Type: research

Sustaining Hospital Readiness for Ebola
(Source: Current Treatment Options in Infectious Diseases)
Source: Current Treatment Options in Infectious Diseases - June 29, 2016 Category: Infectious Diseases Source Type: research

The Legislative Momentum of Antimicrobial Stewardship: An International Perspective
This article will review international antimicrobial stewardship legislation and point out gaps or areas still needing attention. (Source: Current Treatment Options in Infectious Diseases)
Source: Current Treatment Options in Infectious Diseases - April 19, 2016 Category: Infectious Diseases Source Type: research

Antimicrobial Resistance and Stewardship in National Action Plans
Opinion statement Tackling Antimicrobial resistance has global focus due to the significant threat resistance poses to human and animal health and its potential impact on the global economy as a result of reduced productivity caused by sickness and higher treatment costs. Therefore, the importance of strengthening health systems ensuring antimicrobial agents are used and accessed appropriately has never been more important. A potential solution to combating antimicrobial resistance globally is implementing comprehensive and sustainably resourced national plans based on a multi-sector approach. In May 201...
Source: Current Treatment Options in Infectious Diseases - April 13, 2016 Category: Infectious Diseases Source Type: research

Managing Cardiovascular Risk in People Living with HIV
Opinion statement People living with HIV (PLHIV) are at increased risk for cardiovascular disease (CVD) due to bi-directional interactions between traditional cardiovascular risk factors, HIV-associated inflammation and immune activation, and the prothrombotic and dyslipidemic side effects of antiretroviral therapy (ART). As in the general population, prevention of disease is the key to reducing the significant morbidity and mortality associated with cardiovascular disease. All PLHIV should be screened for cardiovascular risk factors such as hypertension and dyslipidemia. Regardless of their perceived lev...
Source: Current Treatment Options in Infectious Diseases - April 11, 2016 Category: Infectious Diseases Source Type: research

The Role of Mathematical Modeling in Designing and Evaluating Antimicrobial Stewardship Programs
Opinion statement Antimicrobial agent effectiveness continues to be threatened by the rise and spread of pathogen strains that exhibit drug resistance. This challenge is most acute in healthcare facilities where the well-established connection between resistance and suboptimal antimicrobial use has prompted the creation of antimicrobial stewardship programs (ASPs). Mathematical models offer tremendous potential for serving as an alternative to controlled human experimentation for assessing the effectiveness of ASPs. Models can simulate controlled randomized experiments between groups of virtual patients, ...
Source: Current Treatment Options in Infectious Diseases - April 10, 2016 Category: Infectious Diseases Source Type: research

The Legislative Momentum of Antimicrobial Stewardship: the US Perspective
Opinion statement The aim of this review is to describe new and evolving legislation concerning antimicrobial stewardship at both the state and national level. Antimicrobial resistance is a challenge to health worldwide. Recently, the US federal government has issued reports recognizing it as a serious threat to public health and national security acknowledging the need for judicious antimicrobial use. California has been a pioneer in mandating and implementing antimicrobial stewardship initiatives in healthcare institutions. With the White House Executive Order 13676, a number of health...
Source: Current Treatment Options in Infectious Diseases - April 3, 2016 Category: Infectious Diseases Source Type: research

Educational Antimicrobial Stewardship Strategies
Opinion statement Educational interventions to improve prescriber and patient knowledge of appropriate antibiotic use are a key component of successful antimicrobial stewardship campaigns in diverse healthcare settings. Provider education may be an impactful strategy for reducing unnecessary prescribing of antibiotics for respiratory tract infections and asymptomatic bacteriuria. Educational interventions designed to improve adherence to prescribing guidelines are more consistently able to impact prescribing of a specific class of medications (e.g., third generation cephalosporins, fluoroquinolones) than ...
Source: Current Treatment Options in Infectious Diseases - April 1, 2016 Category: Infectious Diseases Source Type: research

Antimicrobial Stewardship Strategies in Nursing Homes: Urinary Tract Infections
Opinion statement Deciding if a nursing home resident should receive an antimicrobial for a suspected urinary tract infection is challenging. One of the most frequently reported reasons nursing home staff suspect presence of a urinary tract infection (UTI) is change in a resident’s mental status. However, a change in mental status may be due to numerous causes, such as presence of underlying conditions like dementia, or reaction to a new medication. The evaluation for a UTI when a resident experiences change in mental status is further confounded by the high prevalence of asymptomatic bacteriuria, which...
Source: Current Treatment Options in Infectious Diseases - March 30, 2016 Category: Infectious Diseases Source Type: research

A US View on Antimicrobial Stewardship in Animal Agriculture
Opinion statement Antimicrobial resistance was declared a serious threat to global public health by the World Health Organization. Actions have been taken to improve antimicrobial use, especially in settings such as hospitals. However, a large amount of antimicrobials are administered to food-producing animals, posing a risk of spread of antibiotic-resistant organisms to humans through contaminated retail meat, or by direct contact with animals. In the USA, efforts are in place to limit the use of antimicrobials for growth enhancement as opposed to disease prevention or treatment purposes. Additionally, t...
Source: Current Treatment Options in Infectious Diseases - March 30, 2016 Category: Infectious Diseases Source Type: research

Treatment of Tropical and Travel Related Rickettsioses
Opinion statement Infections with organisms of the genera Rickettsia and Orientia are undifferentiated in regard to their manifesting signs and symptoms. Hence, a high degree of suspicion is required when a patient has a compatible illness coupled with exposure to potential vectors. Confirmatory diagnosis is usually retrospective, as it is obtained through serologic methods to determine seroconversion or a fourfold increase in antibody titers from acute to convalescent phase sera. Since many of these infections are associated with considerable morbidity and mortality, empiric treatment is imperative when ...
Source: Current Treatment Options in Infectious Diseases - February 10, 2016 Category: Infectious Diseases Source Type: research

New Technologies for Prevention of Catheter Associated Urinary Tract Infection
Opinion statement Catheter-associated urinary tract infection (CAUTI) is one of the most common nosocomial infections. Patients with indwelling urinary catheters (IUC) for more than a month are sure to develop bacteriuria. Bacteria form biofilms on IUC, and encrustations develop due to deposition of mineral salts. Together, these block the flow of urine through the catheter and cause severe complications. Completely avoiding the use of urinary catheters is not always possible for certain patients. Systemic use of antibiotics has not been successful in controlling these infections. Coating the urinary cath...
Source: Current Treatment Options in Infectious Diseases - February 4, 2016 Category: Infectious Diseases Source Type: research

Using New Technology to Prevent Healthcare-Associated Infection in Pediatric Patients
The objective of this study is to present and discuss the technological innovations in the prevention of healthcare-associated infections. The following data bases were accessed: PUBMED, EMBASE, Scielo, Scopus, and Cochrane, using the key words: healthcare-associated infections, prevention, innovations, innovative, ventilator-associated pneumonia (VAP), catheter-related bloodstream infection (CRBSI). The evidence degree from the Canadian Task Force on Preventive Health Care was used. For every item, the recommendation degree from the Society for Healthcare Epidemiology of America (SHEA/IDSA) was used. Telemedicine, compute...
Source: Current Treatment Options in Infectious Diseases - February 2, 2016 Category: Infectious Diseases Source Type: research

New Strategies to Prevent Ventilator-Associated Pneumonia: What to Do for Your Patients
Abstract The current rates of ventilator-associated pneumonia (VAP) are falling, in large part, as a result of effective prevention strategies. However, the application and efficacy of VAP prevention is being challenged by efforts to replace VAP surveillance with monitoring for ventilator-associated complications (VAC), which include many non-infectious processes. VAP prevention is based on interrupting pneumonia pathogenesis by avoiding the inoculation of contaminated oral secretions into the lower respiratory tract. This starts by using non-invasive ventilation in place of endotracheal intubation whenev...
Source: Current Treatment Options in Infectious Diseases - February 1, 2016 Category: Infectious Diseases Source Type: research