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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 10, 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 being st...
Source: Current Treatment Options in Infectious Diseases - June 7, 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 28, 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 25, 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 22, 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 14, 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 11, 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 11, 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 diagnostic and a...
Source: Current Treatment Options in Infectious Diseases - May 10, 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 7, 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 28, 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 trends in th...
Source: Current Treatment Options in Infectious Diseases - April 22, 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 27, 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 18, 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 25, 2020 Category: Infectious Diseases Source Type: research