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Current Opinion in Infectious Diseases

Lona Mody
PURPOSE OF REVIEW: The present review describes our research experiences and efforts in advancing the field of infection prevention and control in nursing facilities including postacute and long-term care settings. RECENT FINDINGS: There are over two million infections in postacute and long-term care settings each year in the United States and $4 billion in associated costs. To define a target group most amenable to infection prevention and control interventions, we sought to quantify the relation between indwelling device use and microbial colonization in nursing facility patients...
June 13, 2018: Current Opinion in Infectious Diseases
Katja Saris, Jacques F Meis, Andreas Voss
PURPOSE OF REVIEW: To give an update on the recent emergence of Candida auris. RECENT FINDINGS: C. auris is a pathogen, that evades present therapeutic options, that is highly virulent, causes disease in all types of patients, and spreads easily in the environment and among patients, thereby posing an imminent threat to our patients. The fact that C. auris, in addition, is more resilient to environmental disinfection and frequently misclassified during microbiological diagnostics only heightens its potential as a 'perfect villain...
June 6, 2018: Current Opinion in Infectious Diseases
Raymund R Razonable
PURPOSE OF REVIEW: Cytomegalovirus (CMV) infection is a common opportunistic infection after allogeneic haematopoietic stem cell transplantation (HSCT). CMV surveillance-preemptive therapy is the current preferred approach for preventing CMV disease after HSCT. In contrast, antiviral prophylaxis is not commonly used due to myelosuppressive effects of valganciclovir. In this article, the role of the newly approved antiviral compound, letermovir, is reviewed. RECENT FINDINGS: Letermovir inhibits CMV by interfering viral terminase complex...
May 8, 2018: Current Opinion in Infectious Diseases
Kiran Gajurel, Reshika Dhakal, Stan Deresinski
PURPOSE OF REVIEW: Unlike immunocompetent hosts, solid organ transplant (SOT) recipients with posttransplant histoplasmosis (PTH) often present with disseminated disease and have an attributable mortality of approximately 10%. In this review, we discuss currently available diagnostic tests and treatment strategies in PTH. RECENT FINDINGS: None of the available tests have a 100% diagnostic accuracy. Histoplasma antigen assays are the most sensitive commercially available tests...
May 5, 2018: Current Opinion in Infectious Diseases
Andrés F Henao-Martínez, Daniel B Chastain, Carlos Franco-Paredes
PURPOSE OF REVIEW: Cryptococcosis has become a common opportunistic infection among non-HIV immunocompromised hosts. Recent reports have shown the incidence of Cryptococcosis among HIV-negative immunocompromised patients reaches close to half of the overall cases reported in the USA. Management of this infection in this population carries unique challenges. We aim to review relevant and recent research findings to develop treatment recommendations for this type of population. RECENT FINDINGS: Most of the recommendations for the management of non-HIV immunocompromised host are extrapolated from HIV studies...
May 5, 2018: Current Opinion in Infectious Diseases
José G Montoya, Carlos A Gomez, Roy Lee
No abstract text is available yet for this article.
August 2018: Current Opinion in Infectious Diseases
Ashrit Multani, Carlos A Gomez, José G Montoya
PURPOSE OF REVIEW: Good syndrome is a profoundly immunocompromising condition with heterogeneous immune deficits characterized by the presence of thymoma, low-to-absent B-lymphocyte counts, hypogammaglobulinemia, and impaired cell-mediated immunity. Opportunistic infectious diseases associated with Good syndrome represent a diagnostic and therapeutic challenge, given their protean clinical manifestations. Although these infectious complications have been reviewed in prior publications, recommendations regarding their prevention have been lacking...
August 2018: Current Opinion in Infectious Diseases
Geeta Sood, Cynthia Argani, Khalil G Ghanem, Trish M Perl, Jeanne S Sheffield
PURPOSE OF REVIEW: Cesarean sections are common surgical procedures performed in a healthy population and are unique because of a relatively high rate of postoperative infection. There have been many important advances in understanding the pathogenesis of infection and evaluation of interventions to prevent post cesarean section infections in the last few years. Our purpose in this review is to analyze these new data, discuss unanswered questions, and propose changes in standard of care...
August 2018: Current Opinion in Infectious Diseases
John A Sellick, Thomas A Russo
PURPOSE OF REVIEW: Two pathotypes of Klebsiella pneumoniae cause human infections, classical (cKp) and hypervirulent (hvKp) K. pneumoniae. The present understanding of genetic elements, the need for an accurate test to identify hvKp, the clinical implications of infection, the knowledge gap on how and why hvKp colonization transitions to infection, and potential infection prevention and control issues for hvKp are discussed. RECENT FINDINGS: Infections because of hvKp are increasingly recognized worldwide...
August 2018: Current Opinion in Infectious Diseases
Vageesh Jain, Adriano Duse, Daniel G Bausch
PURPOSE OF REVIEW: Less than two decades into the 21st century, the world has already witnessed numerous large epidemics or pandemics. These events have highlighted inadequacies in both national and international capacity for outbreak prevention, detection, and response. Here, we review some of the major challenges from a policy perspective. RECENT FINDINGS: The most important challenges facing policymakers include financing outbreak preparedness and response in a complex political environment with limited resources, coordinating response efforts among a growing and diverse range of national and international actors, accurately assessing national outbreak preparedness, addressing the shortfall in the global biomedical workforce, building surge capacity of both human and material resources, balancing investments in public health and curative services, building capacity for outbreak-related research and development, and reinforcing measures for infection prevention and control...
August 2018: Current Opinion in Infectious Diseases
Jesse T Jacob, Loreen A Herwaldt, Francis T Durso
PURPOSE OF REVIEW: Human factors engineering (HFE) approaches are increasingly being used in healthcare, but have been applied in relatively limited ways to infection prevention and control (IPC). Previous studies have focused on using selected HFE tools, but newer literature supports a system-based HFE approach to IPC. RECENT FINDINGS: Cross-contamination and the existence of workarounds suggest that healthcare workers need better support to reduce and simplify steps in delivering care...
August 2018: Current Opinion in Infectious Diseases
Loreen A Herwaldt, Alexandre R Marra
PURPOSE OF REVIEW: The present review summarizes new knowledge about Legionella epidemiology, clinical characteristics, community-associated and hospital-based outbreaks, molecular typing and molecular epidemiology, prevention, and detection in environmental and clinical specimens. RECENT FINDINGS: The incidence of Legionnaire's disease is rising and the mortality rate remains high, particularly for immunocompromised patients. Extracorporeal membrane oxygenation may help support patients with severe respiratory failure...
August 2018: Current Opinion in Infectious Diseases
Patricia S Fontela, Shauna O'Donnell, Jesse Papenburg
PURPOSE OF REVIEW: We aim to review recent literature about the use of biomarkers to guide the initiation and duration of antibiotic treatments for suspected bacterial infections. RECENT FINDINGS: Several good quality meta-analyses show that procalcitonin can be safely used to guide antibiotic-related decisions, especially for respiratory infections, thereby decreasing unnecessary antibiotic exposure. Furthermore, the use of CRP-based algorithms to guide antibiotic initiation in primary care patients with acute respiratory infections is associated with a reduction in antibiotic use without an increase in adverse events...
August 2018: Current Opinion in Infectious Diseases
Cédric Hirzel, Deepali Kumar
PURPOSE OF REVIEW: The aim of this study was to highlight recent evidence on important aspects of influenza vaccination in solid organ transplant recipients. RECENT FINDINGS: Influenza vaccine is the most evaluated vaccine in transplant recipients. The immunogenicity of the vaccine is suboptimal after transplantation. Newer formulations such as inactivated unadjuvanted high-dose influenza vaccine and the administration of a booster dose within the same season have shown to increase response rates...
August 2018: Current Opinion in Infectious Diseases
Katherine A Baugh, Ifigeneia Tzannou, Ann M Leen
PURPOSE OF REVIEW: Allogeneic hematopoietic stem cell transplantation has proven curative for a range of malignant and nonmalignant disorders. However, the clinical success of this therapy is marred by the morbidity associated with viral infections, which are frequent (cytomegalovirus 15.6-28%, adenovirus 3-21%, BK virus 18.5-20.7%) post-transplant. These infections occur as a consequence of transplant conditioning regimens designed to eliminate not only malignant cells but also host immune cells that might interfere with stem cell engraftment...
August 2018: Current Opinion in Infectious Diseases
Andrew J McArdle, Anna Turkova, Aubrey J Cunnington
PURPOSE OF REVIEW: Advances in diagnostic methods mean that co-infections are increasingly being detected in clinical practice, yet their significance is not always obvious. In parallel, basic science studies are increasingly investigating interactions between pathogens to try to explain real-life observations and elucidate biological mechanisms. RECENT FINDINGS: Co-infections may be insignificant, detrimental, or even beneficial, and these outcomes can occur through multiple levels of interactions which include modulation of the host response, altering the performance of diagnostic tests, and drug-drug interactions during treatment...
June 2018: Current Opinion in Infectious Diseases
José L Blanco, Anne-Geneviéve Marcelin, Christine Katlama, Esteban Martinez
PURPOSE OF REVIEW: Dolutegravir (DTG) is a second-generation integrase strand transfer inhibitor (InSTI) with an outstanding antiviral potency, good tolerability, good pharmacokinetic profile with a lack of major drug-drug interactions, and a barrier to resistance higher than the other compounds of the class (raltegravir and elvitegravir) and allegedly as high as that of boosted protease inhibitors. For these reasons, DTG, after successful results in a context of triple therapy in various clinical scenarios, has been investigated mostly by independent investigators in less-drug regimens, including dolutegravir monotherapy, in the context of a growing clinical interest for adjusting successful antiretroviral therapy to the increasing number of limitations for standard antiretroviral therapy in some HIV-infected patients...
June 2018: Current Opinion in Infectious Diseases
Jay R Radke, James L Cook
PURPOSE OF REVIEW: To provide an update on recent studies of human adenoviral (HAdV) infections and to explore the mechanisms of viral persistence and the role of persistent infection in disseminated disease in immunocompromised patients. RECENT FINDINGS: Human adenoviruses continue to be a problem in ophthalmology clinics and to cause periodic, limited, global outbreaks of respiratory disease. Ad14p1 remains in worldwide circulation and continues to result in miniepidemics of severe respiratory infections...
June 2018: Current Opinion in Infectious Diseases
Anne Botteaux, Isolda Budnik, Pierre R Smeesters
PURPOSE OF REVIEW: Recent findings have open new perspectives on group A Streptococcus (GAS) virulence understanding with special focus on the carrier stage and new hopes for an efficient vaccine against this important pathogen. RECENT FINDINGS: Understanding of carriage state, transmission and role of virulence factors in invasive infections have been recently active research fields questioning the link between carriage and infections and highlighting the potential to prevent invasive diseases...
June 2018: Current Opinion in Infectious Diseases
Jennifer L Edwards, Michael P Jennings, Kate L Seib
PURPOSE OF REVIEW: Neisseria gonorrhoeae is one of the most common causes of sexually transmitted infections, with an estimated more than 100 million cases of gonorrhea each year worldwide. N. gonorrhoeae has gained recent increasing attention because of the alarming rise in incidence and the widespread emergence of multidrug-resistant gonococcal strains. Vaccine development is one area of renewed interest. Herein, we review the recent advances in this area. RECENT FINDINGS: Vaccine development for N...
June 2018: Current Opinion in Infectious Diseases
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