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Antimicrobial Resistance in Organ Transplant Recipients
The overall burden of the main clinically relevant bacterial multidrug-resistant organisms (MDROs) (eg, methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, extended-spectrum β-lactamase producing or extended-spectrum cephalosporin-resistant Enterobacterales, carbapenem-resistant or carbapenemase-producing Enterobacterales, MDR Pseudomonas aeruginosa, and carbapenem-resistant Acinetobacter baumannii) in solid organ transplant (SOT) populations is summarized showing prev alence/incidence, risk factors, and impact on graft/patient outcome according to the type of SOT. The role of such bacteria in d...
Source: Infectious Diseases Clinics of North America - May 25, 2023 Category: Infectious Diseases Authors: Maddalena Giannella, Matteo Rinaldi, Pierluigi Viale Source Type: research

Updates in Molecular Diagnostics in Solid Organ Transplantation Recipients
Advances in molecular diagnostics have the potential to improve patient care among solid organ transplant recipients by reducing time to pathogen identification and informing directed therapy. Although cultures remain the cornerstone of traditional microbiology, advanced molecular diagnostics, such as metagenomic next-generation sequencing (mNGS), may increase detection of pathogens. This is particularly true in the settings of prior antibiotic exposure, and when causative organisms are fastidious. mNGS also offers a hypothesis-free diagnostic method of testing. This is useful in  situations whereby the differential is br...
Source: Infectious Diseases Clinics of North America - May 25, 2023 Category: Infectious Diseases Authors: James Everhart, Nancy G. Henshaw Source Type: research

Immunization of Solid Organ Transplant Candidates and Recipients
Immunizations are a relatively safe and cost-effective intervention to prevent morbidity and mortality associated with vaccine preventable infection (VPIs). As such, immunizations are a critical part of the care of pre and posttransplant patients and should be prioritized. New tools are needed to continue to disseminate and implement the most up-to-date vaccine recommendations for the SOT population. These tools will help both primary care providers and multi-disciplinary transplant team members taking care of transplant patients to stay abreast of evidence-based best practices regarding the immunization of the SOT patient...
Source: Infectious Diseases Clinics of North America - May 2, 2023 Category: Infectious Diseases Authors: Hannah Bahakel, Amy G. Feldman, Lara Danziger-Isakov Source Type: research

Current Concepts in the Diagnosis and Management of Pneumocystis Pneumonia in Solid Organ Transplantation
Pneumocystis infection manifests predominantly as an interstitial pneumonia in immunocompromised patients. Diagnostic testing in the appropriate clinical context can be highly sensitive and specific and involves radiographic imaging, fungal biomarkers, nucleic acid amplification, histopathology, and lung fluid or tissue sampling. Trimethoprim-sulfamethoxazole remains the first-choice agent for treatment and prophylaxis. Investigation continues to promote a deeper understanding of the pathogen ’s ecology, epidemiology, host susceptibility, and optimal treatment and prevention strategies in solid organ transplant recipient...
Source: Infectious Diseases Clinics of North America - May 2, 2023 Category: Infectious Diseases Authors: Paul A. Trubin, Marwan M. Azar Source Type: research

Challenges in Managing Gonorrhea and New Advances in Prevention
Gonorrhea is the second most common bacterial sexually transmitted infection in the United States. Rates are increasing, and multiple challenges compound management, including worsening antimicrobial resistance. New therapeutics, enhanced screening and partner notification, and treatment through point-of-care testing and expedited partner therapy, as well as primary prevention efforts provide opportunities for success in combating these trends. (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - April 26, 2023 Category: Infectious Diseases Authors: Evan C. Ewers, John M. Curtin, Anuradha Ganesan Source Type: research

Sexually Transmitted Human Papillomavirus
This review presents the epidemiology, pathophysiology, prevention, and management of sexually transmitted human papillomavirus (HPV) and its associated diseases. HPV is the most common sexually transmitted infection worldwide. Prevalence varies regionally. Low-risk strains cause anogenital warts, which can be managed with patient- or provider-applied therapies. High-risk strains cause lower anogenital cancers. Primary and secondary prevention strategies include vaccination and screening for precancerous lesions, respectively. Management of abnormal screening results vary by test result, anatomic site, and individual cance...
Source: Infectious Diseases Clinics of North America - April 26, 2023 Category: Infectious Diseases Authors: Rosalyn E. Plotzker, Akanksha Vaidya, Utsav Pokharel, Elizabeth A. Stier Source Type: research

Update in Epidemiology and Management of Mycoplasma genitalium Infections
Mycoplasma genitalium is a frequent cause of urogenital syndromes in men and women and is associated with adverse sequelae in women. M genitalium also infects the rectum, and may cause proctitis, but rarely infects the pharynx. Diagnosis requires nucleic acid amplification testing. Antibiotic resistance is widespread: more than half of infections are resistant to macrolides and fluoroquinolone resistance is increasing. Resistance-guided therapy is recommended for symptomatic patients, involving initial treatment with doxycycline to reduce organism load followed by azithromycin for macrolide-sensitive infections or moxiflox...
Source: Infectious Diseases Clinics of North America - April 26, 2023 Category: Infectious Diseases Authors: Gwendolyn E. Wood, Catriona S. Bradshaw, Lisa E. Manhart Source Type: research

Sexual Transmission of Viral Hepatitis
Ongoing sexual transmission presents a significant barrier to viral hepatitis control. Endemic transmission of hepatitis A virus continues through communities of men with male sex partners, despite vaccine availability. Increased incidence of hepatitis B virus from 2014-2018 prompted expanded vaccination guidelines, but uptake and physician awareness remain poor. Hepatitis C virus while strongly associated with injection drug use, is also transmitted by high-risk sexual contact. Despite universal screening recommendations and curative treatment, incidence continues to increase. Even with safe and highly effective vaccinati...
Source: Infectious Diseases Clinics of North America - April 26, 2023 Category: Infectious Diseases Authors: Audrey R. Lloyd, Ricardo A. Franco Source Type: research

Genital Herpes Infection
Genital herpes (GH) is a sexually transmitted infection causing recurrent, self-limited genital, buttock, and thigh ulcerations. Symptoms range from unrecognized or mild to severe with frequent recurrences. Herpes simplex viruses (HSV) type-1 or type-2 cause GH. HSV establishes latency in sacral ganglia and causes lifelong infection. Viral reactivation leads to genital ulceration or asymptomatic shedding which may lead to transmission. HSV infection during pregnancy can cause fulminant hepatitis and neonatal transmission. Severe and atypical manifestations are seen in immunocompromised people. Guanosine analogs treat sympt...
Source: Infectious Diseases Clinics of North America - April 26, 2023 Category: Infectious Diseases Authors: Nicholas Van Wagoner, Fuad Qushair, Christine Johnston Source Type: research

Sexually Transmitted Infections
INFECTIOUS DISEASE CLINICS OF NORTH AMERICA (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - April 26, 2023 Category: Infectious Diseases Authors: Jeanne Marrazzo Source Type: research

Copyright
Elsevier (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - April 26, 2023 Category: Infectious Diseases Source Type: research

Contributors
HELEN W. BOUCHER, MD, FACP, FIDSA (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - April 26, 2023 Category: Infectious Diseases Source Type: research

Contents
Jeanne Marrazzo (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - April 26, 2023 Category: Infectious Diseases Source Type: research

Forthcoming Issues
Transplant-Related Infections (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - April 26, 2023 Category: Infectious Diseases Source Type: research

Trichomoniasis
is the most common nonviral sexually transmitted infection worldwide. It has been associated with a variety of adverse sexual and reproductive health outcomes for both men and women. In this review, the authors discuss updates in its epidemiology, pathophysiology, clinical significance, diagnosis, and treatment. (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - March 31, 2023 Category: Infectious Diseases Authors: Olivia T. Van Gerwen, Skye A. Opsteen, Keonte J. Graves, Christina A. Muzny Source Type: research