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Infectious Disease Clinics of North America

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https://www.readbyqxmd.com/read/30241718/intravascular-catheter-related-bloodstream-infections
#1
REVIEW
Mark E Rupp, Rajendra Karnatak
Despite recent gains, intravascular catheter-related bloodstream infection (CRBSI) remains an important clinical problem resulting in significant morbidity, mortality, and excess economic cost. Successful prevention of CRBSI requires careful attention to insertion and maintenance protocols as well as judicious application of innovative technologic advancements. Appropriate treatment of CRBSI depends on a well-considered diagnosis, correct antimicrobial choice, removal of the offending device in many circumstances, and careful patient selection and application of antimicrobial lock therapy in patients in whom catheter salvage is attempted...
September 18, 2018: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/30241717/prosthetic-joint-infection-update
#2
REVIEW
Elena Beam, Douglas Osmon
Prosthetic joint infection occurs in a minority of arthroplasties performed; however, it brings a large burden to both the individual and society in terms of morbidity, mortality, and health care expenditure. Although prevention of prosthetic joint infection is becoming more effective, the number of total arthroplasties in patients with increasing comorbidities continues to rise, and the total number of diagnosed and managed prosthetic joint infections is expected to rise accordingly. Management is complex and involves a multispecialty approach...
September 18, 2018: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/30241716/vascular-graft-infections-an-update
#3
REVIEW
Amal Gharamti, Zeina A Kanafani
Vascular graft infection is a devastating complication of vascular reconstructive surgery. The infection can occur early in the postoperative period and is largely due to intraoperative contamination or by contiguous extension from a nearby infection. It can also occur years after implantation. Staphylococci remain the most common organisms and biofilm production makes eradication difficult. Factors commonly reported to predispose to vascular graft infection are periodontal disease, nasal colonization with Staphylococcus aureus, bacteremia, certain graft characteristics, diabetes mellitus, postoperative hyperglycemia, location of the incision, wound infection, and emergency procedure...
September 18, 2018: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/30241715/understanding-biofilms-and-novel-approaches-to-the-diagnosis-prevention-and-treatment-of-medical-device-associated-infections
#4
REVIEW
Yu Mi Wi, Robin Patel
Treatment of medical device-related infections is challenging and recurrence is common. The main reason for this is that microorganisms adhere to the surfaces of medical devices and enter into a biofilm state in which they display distinct growth rates, structural features, and protection from antimicrobial agents and host immune mechanisms compared with their planktonic counterparts. This article reviews how microorganisms form biofilms and the mechanisms of protection against antimicrobial agents and the host immune system provided by biofilms...
September 18, 2018: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/30241714/breast-implant-infections-an-update
#5
REVIEW
Tahaniyat Lalani
Prosthetic breast implantation is a common surgical procedure for augmentation and reconstruction after mastectomy. The incidence of implant infection is 1% to 2.5% and is higher for reconstruction following mastectomy compared with augmentation. Most infections are caused by gram-positive pathogens, such as coagulase-negative staphylococci, Cutibacterium species, Staphylococcus aureus, and streptococci. Acute infections are usually associated with fever and breast pain, erythema, and drainage. Subacute infections may present with chronic pain, persistent drainage, failed healing of the incision site, or migration of the implant...
September 18, 2018: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/30241713/new-developments-in-the-prevention-of-gastrointestinal-scope-related-infections
#6
REVIEW
Jonathan D Grein, Rekha K Murthy
Gastrointestinal endoscopes are used for diagnostic and therapeutic purposes and are the most common medical device implicated in health care-associated outbreaks. Infections can be divided into endogenous or exogenous. Exogenous infections were associated with lapses in reprocessing. Recent outbreaks have occurred despite compliance with reprocessing guidelines and highlight the challenges with clearance of all organisms from the duodenoscopes and the potential role of biofilms in hindering adequate reprocessing...
September 18, 2018: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/30241712/urinary-catheter-associated-infections
#7
REVIEW
Emily K Shuman, Carol E Chenoweth
Catheter-associated urinary tract infection remains one of the most prevalent, yet preventable, health care-associated infections. General prevention strategies include strict adherence to hand hygiene and antimicrobial stewardship. Duration of urinary catheterization is the most important modifiable risk factor. Targeted prevention strategies include limiting urinary catheter use; physician reminder systems, nurse-initiated discontinuation protocols, and automatic stop orders have successfully decreased catheter duration...
September 18, 2018: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/30241711/cardiovascular-implantable-electronic-device-infections
#8
REVIEW
Christopher J Arnold, Vivian H Chu
Infections associated with cardiac implantable electronic devices are increasing and are associated with significant morbidity and mortality. This article reviews the epidemiology, microbiology, and risk factors for acquisition of these infections. The complex diagnostic and management strategies associated with these serious infections are reviewed with an emphasis on recent updates and advances, as well as existing controversies. Additionally, the latest in preventative strategies are reviewed.
September 18, 2018: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/30241710/ventricular-assist-device-associated-infection
#9
REVIEW
Tee K Teoh, Margaret M Hannan
The prevalence of heart failure is increasing worldwide due to an aging population and advances in therapeutic innovations for heart failure treatment resulting in increased survival. Heart failure remains a major contributor to morbidity and mortality worldwide. It is estimated that the total number of patients in the United States with heart failure is 5.1 million. Cardiac transplantation is a potential life-saving treatment for patients with end-stage disease but relies on a very limited number of suitable donors...
September 18, 2018: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/30241709/neurosurgical-device-related-infections
#10
REVIEW
Jessica Seidelman, Sarah S Lewis
In this review article, we discuss the epidemiology, microbiology, diagnosis, treatment and prevention of infections associated with cerebrospinal fluid shunts, cerebrospinal fluid drains, and deep brain stimulators. We also briefly discuss prevention strategies with appropriate antibiotics, devices, and operating room practices to decrease the risk of these infections.
September 18, 2018: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/30146034/management-of-strongyloides-in-solid-organ-transplant-recipients
#11
REVIEW
Justin Hayes, Anoma Nellore
Strongyloides stercoralis is a threadworm parasite with the unique capacity to complete its entire life cycle in a human host. Although asymptomatic in normal hosts, S stercoralis infection in solid organ transplant recipients is often severe, disseminated, and fatal. Risk factors for disease acquisition include travel to endemic regions. Antihelminth therapy should be instituted before transplantation for optimal clinical outcomes. Herein we review the epidemiology, biology, immune response, and diagnostic and screening strategies, as well as treatment modalities for S stercoralis in the solid organ transplant population...
September 2018: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/30146033/prevention-and-treatment-of-clostridium-difficile-associated-diarrhea-in-solid-organ-transplant-recipients
#12
REVIEW
Stephanie M Pouch, Rachel J Friedman-Moraco
Clostridium difficile infection is a significant cause of morbidity and mortality in solid organ transplant recipients. Risk factors in this population include frequent hospitalizations, receipt of immunosuppressive agents, and intestinal dysbiosis triggered by several factors, including exposure to broad-spectrum antimicrobials. The incidence and potential for significant adverse outcomes among solid organ transplant recipients with C difficile infection highlight the evolving need for strategic C difficile infection risk factor modification and novel approaches to disease management in this patient population...
September 2018: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/30146032/management-of-mycobacterium-other-than-tuberculosis-in-solid-organ-transplantation
#13
REVIEW
Maricar F Malinis
Mycobacteria other than tuberculosis are important pathogens to consider in solid organ transplant recipients. Delay in recognition and treatment may incur significant morbidity and mortality. Management of mycobacteria other than tuberculosis requires a knowledge of treatment specific for each species and drug-drug interactions between antimicrobial and immunosuppressive drugs. Therapy in solid organ transplant can be prolonged and may require a reduction in immunosuppression to improve outcomes.
September 2018: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/30146031/prevention-and-management-of-tuberculosis-in-solid-organ-transplant-recipients
#14
REVIEW
David J Epstein, Aruna K Subramanian
Solid organ transplant recipients are at an increased risk of tuberculosis and transplant candidates should be screened early in their evaluation with a detailed history, tuberculin skin test or tuberculosis interferon-gamma release assay, and chest radiograph. For latent tuberculosis treatment, isoniazid and rifamycin-based regimens have advantages and disadvantages; treatment decisions should be customized. Tuberculosis after solid organ transplantation generally occurs after months or years; early infections should raise the possibility of donor-derived infections...
September 2018: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/30146030/mold-infections-in-solid-organ-transplant-recipients
#15
REVIEW
Tracy L Lemonovich
Mold infections carry a substantial clinical and economic burden in solid organ transplant (SOT) recipients with a high overall mortality of near 30%. The most important pathogens include Aspergillus, the Zygomycetes, Fusarium, Scedosporium/Pseudallescheria, and the dematiaceous (dark) molds. Risk factors for the infections vary by transplant type but include degree of immune suppression and loss of skin or mucosal integrity. Correct diagnosis usually requires histopathology and/or culture. Management often requires a multidisciplinary team approach with combined antifungal and surgical therapies...
September 2018: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/30146029/endemic-mycoses-in-solid-organ-transplant-recipients
#16
REVIEW
Jeremy S Nel, Luther A Bartelt, David van Duin, Anne M Lachiewicz
The endemic mycoses are a group of thermally dimorphic fungal pathogens occupying a specific geographic range. In North America, the chief endemic mycoses are histoplasmosis, coccidioidomycosis, and blastomycosis. Endemic fungi can cause serious infections in solid organ transplant recipients from primary infection, reactivation of latent disease, or donor-derived infection.
September 2018: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/30146028/yeast-infections-in-solid-organ-transplantation
#17
REVIEW
Sarah Taimur
Invasive candidiasis (IC) remains the most common invasive fungal infection following solid-organ transplant (SOT), but risk factors are evolving. Current challenges include infection due to drug resistant non-albicans and emerging novel species such as Candida auris. Preventive antifungal use in SOT needs to be re-examined in light of these current challenges. Cryptococcosis is the second most common IFI following SOT. Cryptococcus gattii is an emerging pathogen that can have reduced in-vitro susceptibility to antifungal agents...
September 2018: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/30146027/management-of-viral-hepatitis-in-solid-organ-transplant-recipients
#18
REVIEW
Elizabeth Buganza-Torio, Karen Elizabeth Doucette
With potent nucleos(t)ide analogue (NA) therapy, hepatitis B virus (HBV) is now an uncommon indication for liver transplant (LT) in North America. NA therapy, with or without hepatitis B immunoglobulin, results in low recurrence rates and excellent outcomes after LT. Direct-acting antiviral therapy for hepatitis C virus (HCV), results in cure in most patients, either before or after transplant. There are now descriptions of good clinical outcomes of transplant from HBV and HCV infected donors, as treatments are so effective and well tolerated...
September 2018: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/30146026/human-immunodeficiency-virus-organ-transplantation
#19
REVIEW
Alan J Taege
Human immunodeficiency virus (HIV) has become a chronic disease with a near normal life span resulting in increased risk of organ failure. HIV organ transplantation is a proven and accepted intervention in appropriately selected cases. HIV-positive organ transplantation into HIV-positive recipients is in its nascent stages. Hepatitis C virus, high rates of organ rejection, and immune dysregulation are significant remaining barriers to overcome. This article provides an overview of the transplantation needs in the HIV population focusing on kidney and liver transplants...
September 2018: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/30146025/management-of-bk-polyomavirus-infection-in-kidney-and-kidney-pancreas-transplant-recipients-a-review-article
#20
REVIEW
Nissreen Elfadawy, Masaaki Yamada, Nagaraju Sarabu
BK virus (BKV) can cause graft dysfunction or failure in kidney transplant recipients and hemorrhagic cystitis in allogeneic hematopoietic stem cell transplant patients. BKV-associated nephropathy (BKVAN) emerged as a common complication in the late 1990s, probably due to the introduction of potent immunosuppressive agents. BKVAN occurred in up to 5% of kidney transplant recipients, with graft failure in up to 70%. Since universal implementation of effective screening and treatment strategies, BKV is no longer a common cause of graft failure; reported graft loss is only 0% to 5%...
September 2018: Infectious Disease Clinics of North America
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