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Treatment Options for Mucormycosis
Opinion statement Mucormycosis, which occurs primarily in immunosuppressed patients and patients with diabetes mellitus, remains one of the most difficult fungal infections to treat. In part, this is due to the poor immune response of those patients who have hematological malignancies or have received a hematopoietic cell or solid organ transplant, but also very important is the paucity of available non-toxic effective antifungal agents. Correction of underlying risk factors is helpful, but this is possible mostly in those with diabetes. Surgical debridement of all necrotic tissue is crucially important i...
Source: Current Treatment Options in Infectious Diseases - July 8, 2015 Category: Infectious Diseases Source Type: research

Utilizing Rapid Diagnostics for Detection of Candida Species
Opinion statement Rapid diagnostic tests are now available to aid in the detection of invasive candidiasis (IC) and promise significant advantages to conventional detection and identification methods. The most progress has been made on rapid species identification when blood culture bottles turn positive and/or when isolated pure colonies are available, while the diagnosis of IC directly from a clinical specimen (e.g., the patient’s blood) remains problematic. For the latter, nucleic acid-based tests (PCR, PCR/electrospray ionization-mass spectrometry (PCR/ESI-MS), and T2 magnetic resonance) and immunol...
Source: Current Treatment Options in Infectious Diseases - June 25, 2015 Category: Infectious Diseases Source Type: research

Therapeutic Approaches for New World Hantaviruses
Opinion statement New World Hantaviruses are characterized by a fairly non-specific viral prodrome, usually followed by a precipitous decline in cardiopulmonary function leading to circulatory collapse and multiorgan failure. Combined with a sporadic nature and unclear epidemiology, the development and use of specific treatments for Hantavirus infection are difficult. The underpinning of any therapeutic approach to Hantavirus disease is providing supportive care long enough for the elaboration of a curative immune response on the part of the patient. At this time, this is best accomplished by a combinatio...
Source: Current Treatment Options in Infectious Diseases - June 17, 2015 Category: Infectious Diseases Source Type: research

Therapeutic Options for Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Infection: How Close Are We?
Abstract Over 1100 cases of MERS-CoV have been reported since it was first identified in June 2012. Clinical presentation ranges from asymptomatic or mild illness to rapidly progressive disease with multi-organ failure and high mortality. Treatment has been largely supportive. A large number of compounds have been shown to have significant in vitro inhibitory activity against MERS-CoV. Until recently, macaques were the only suitable animal models for animal studies, hindering further clinical development of MERS-CoV therapy. However, the recent successful development of MERS-CoV infection model in transdu...
Source: Current Treatment Options in Infectious Diseases - June 12, 2015 Category: Infectious Diseases Source Type: research

Acute HCV Infection: Diagnosis, Epidemiology and Current Treatment Options
Opinion statement Acute hepatitis C is traditionally defined as the first 6-month period after infection with hepatitis C virus (HCV). This acute phase is characterized by peculiar features: although it is commonly asymptomatic, HCV-RNA and transaminases peak to very high values; a spontaneous clearance of the infection is achievable in 25 % of the cases; if a standard treatment with pegylated interferon is undertaken, high rates of sustained virologic response may be obtained irrespective of the viral genotype. Even though an early diagnosis is not always easy, current epidemiology in Western countries ...
Source: Current Treatment Options in Infectious Diseases - March 27, 2015 Category: Infectious Diseases Source Type: research

Clinical Treatment Options Infectious Diseases: Update on PrEP Implementation, Adherence, and Advances in Delivery
Opinion statement Pre-exposure prophylaxis (PrEP) is an effective and evidence-based HIV prevention option and is recommended for individuals with substantial risk for HIV infection [1]. Randomized controlled trials have demonstrated that daily oral PrEP dramatically reduces the risk of HIV infection when it is taken as directed. Concerns regarding widespread emergence of antiretroviral resistance attributable to PrEP and behavioral disinhibition have to date not been observed in clinical trials and open-label demonstration projects. PrEP has great potential as part of an HIV risk reduction strategy, and ...
Source: Current Treatment Options in Infectious Diseases - March 18, 2015 Category: Infectious Diseases Source Type: research

MALDI-TOF and Antimicrobial Stewardship
Opinion statement The emergence of rapid diagnostic tests for use in clinical microbiology laboratories is revolutionizing the ability to efficiently identify pathogens and resistance mechanisms. Optimizing time to appropriate therapy is crucial and linked to significant improvements in mortality. Matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) utilizes mass spectrometry to provide rapid and reliable identification of organisms 1–1.5 days sooner than traditional methods. Further, the literature suggests that involvement of antimicrobial stewardship program initiatives in combinat...
Source: Current Treatment Options in Infectious Diseases - February 26, 2015 Category: Infectious Diseases Source Type: research

Use of Electronic Health Record Clinical Decision Support Tools in Antimicrobial Stewardship Activities
Opinion Statement The Society for Healthcare Epidemiology of America and the Infectious Disease Society of America (SHEA/IDSA) released guidelines outlining the strategies of antimicrobial stewardship program (ASP) activities in 2006. These strategies have been supported by advances in technology, beginning with the novel use of clinical decision support systems (CDSS) at LDS Hospital in Salt Lake City, UT. This sophisticated home-grown program allowed for timely and tailored information to be exchanged between the electronic medical record (EMR) and physicians, resulting in reduced drug costs and improve...
Source: Current Treatment Options in Infectious Diseases - February 20, 2015 Category: Infectious Diseases Source Type: research

Cutaneous Leishmaniasis: Current Treatment Practices in the USA for Returning Travelers
Opinion statement Leishmaniasis, a protozoal infection transmitted by sandfly bite, produces a clinical spectrum of disease ranging from asymptomatic infection to ulcerative skin and mucosal lesions to visceral involvement. Leishmaniasis is endemic in regions of Africa, the Middle East, south Asia, southern Europe, northern South America, and Central America. There has been an increase in imported leishmaniasis into developed, non-endemic countries due to increasing global travel. While pentavalent antimonials have been the mainstay of antileishmanial treatment for decades, newer therapeutic options have ...
Source: Current Treatment Options in Infectious Diseases - February 10, 2015 Category: Infectious Diseases Source Type: research

Acute Traveler’s Diarrhea: Initial Treatment
Opinion statement Diarrhea is the most common health issue affecting travelers to destinations across the world. This paper reviews the options for initial treatment of acute traveler’s diarrhea (TD). Its prevention, including but not limited to vaccines and safe travel and eating habits, is an important consideration but is beyond the scope of this paper. Treatment of TD has three arms: volume repletion, antibiotics, and antimotility/antisecretory agents. Patients should be advised to continue a diet that they can tolerate and maintain adequate fluid intake. In most cases, neither oral rehydration ther...
Source: Current Treatment Options in Infectious Diseases - February 2, 2015 Category: Infectious Diseases Source Type: research

Translational Research in Hand Hygiene Compliance
Opinion statement Hand hygiene is considered to be the most important measure to prevent healthcare-associated infections, which represent a big concern in the world and are considered as priority by the World Health Organization, which proposed a multimodal strategy that has been implemented in several settings. However, many studies demonstrate that the overall compliance for hand hygiene practice remains low, and the most effective strategy or group of strategies are still unclear. We reviewed original articles reporting implemented strategies in order to improve hand hygiene adherence rates in healthc...
Source: Current Treatment Options in Infectious Diseases - February 2, 2015 Category: Infectious Diseases Source Type: research

Decontamination of the Hospital Environment: New Technologies for Infection Control
Opinion statement Environmental contamination is being increasingly recognised as a significant source of healthcare-associated infection (HAI). Cross-contamination of the patient from the environment can result from the direct transfer of organisms from the air and surfaces or indirectly from the hospital environment via contact with healthcare workers or equipment. Traditional methods of environmental decontamination, including cleaning with disinfectants, and the standard infection control procedures implemented by modern health services are critical to controlling the spread of potentially pathogenic ...
Source: Current Treatment Options in Infectious Diseases - January 30, 2015 Category: Infectious Diseases Source Type: research

Occupational Exposures among Healthcare Workers: New Methods for Prevention and Recommended Postexposure Prophylaxis for HIV and Hepatitis B and C
Opinion statement Occupational injuries and exposure to blood and body fluids continue to be commonplace in virtually every healthcare setting. Primary prevention of these injuries and exposure is the most important component of preventing occupational infection with any blood-borne pathogen. Should primary prevention fail, secondary prevention consists of post-exposure prophylaxis customized for the specific exposure. The 2013 U.S. Public Health Service recommendations for post-exposure prophylaxis following exposure to HIV include a “preferred” regimen of combined raltegravir, tenofovir, and emtrici...
Source: Current Treatment Options in Infectious Diseases - January 26, 2015 Category: Infectious Diseases Source Type: research

Molecular Diagnosis in Fungal Infection Control
Opinion statement Fungal infections have been increasingly concerned because of their substantial morbidity and mortality especially among immunocompromised individuals. Early diagnosis is crucial and shown to improve treatment outcomes. The current goal standard methods including fungal culture and pathology are far from ideal due to their poor sensitivity, time consuming and invasive procedures often required. Molecular techniques have been developed as new diagnostic methods in many infectious disease conditions including fungal infection. These molecular approaches are available for variety of fungal ...
Source: Current Treatment Options in Infectious Diseases - January 25, 2015 Category: Infectious Diseases Source Type: research

Epidemiology of Tuberculosis and the Rise of XDR-TB
Opinion statement The global spread of multidrug-resistant strains of tuberculosis (TB) mycobacteria was one of the main reasons leading the World Health Organisation to launch the Stop TB program worldwide. In spite of a slow decline of TB incidence and mortality worldwide, multidrug-resistant TB (MDR-TB) has increased in several countries. MDR-TB is caused by organisms that are resistant to at least isoniazid and rifampicin. The most drug-resistant forms of TB are the extensively drug-resistant TB (XDR-TB) strains caused by organisms that are resistant also to fluoroquinolones and any of the second-line...
Source: Current Treatment Options in Infectious Diseases - October 28, 2014 Category: Infectious Diseases Source Type: research