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Current Opinion in Infectious Diseases

Paola Del Giacomo, Angela Raffaella Losito, Mario Tumbarello
PURPOSE OF REVIEW: Skin and soft tissue infections (SSTIs) with a wide spectrum of disease severity ranging from uncomplicated to potentially lethal are still a leading cause of morbidity and mortality. The burden of carbapenem-resistant gram-negative bacteria (CR-GNB) in SSTIs is increasing. Luckily, the armamentarium of drugs available is recently expanding as well. The present review looks at data on the role CR-GNB in SSTIs and on the old and new drugs available for the treatment of carbapenem-resistant Enterobacteriaceae (CRE), Pseudomonas, and Acinetobacter...
January 14, 2019: Current Opinion in Infectious Diseases
Angela Branche, Olivia Neeser, Beat Mueller, Philipp Schuetz
PURPOSE OF REVIEW: There is convincing evidence linking antibiotic-stewardship efforts which include the infection marker procalcitonin (PCT) to more rational use of antibiotics with improvements in side-effects and clinical outcomes. This is particularly true in the setting of respiratory infection and sepsis. Yet, some recent trials have shown no benefit of PCT-guided care. Our aim was to discuss the benefits and limitations of using PCT for early infection recognition, severity assessment and therapeutic decisions in individual patients based on most the recent study data...
January 14, 2019: Current Opinion in Infectious Diseases
José-Artur Paiva, José M Pereira
PURPOSE OF REVIEW: The incidence of lung fungal infections, namely invasive pulmonary aspergillosis (IPA) and mucormycosis, is increasing in neutropenic and nonneutropenic patients. As they are a major cause of death, early diagnosis and antifungal therapy are crucial for outcome. The role of biomarkers in the management of this infections is the scope of this review. RECENT FINDINGS: Galactomannan in bronchoalveolar lavage shows the best discriminatory power for IPA diagnosis...
January 11, 2019: Current Opinion in Infectious Diseases
Marin H Kollef, Kevin D Betthauser
PURPOSE OF REVIEW: This review provides the rationale for the development of new antibiotics to treat community-acquired pneumonia (CAP). It also provides an overview of the new antibiotics targeting CAP that have recently received approval by the regulatory agencies, and those antibiotics that are in the development pipeline. RECENT FINDINGS: CAP is one of the most common reasons for hospitalization and carries a significant morbidity and risk of mortality. Increasing antibiotic resistance amongst the common bacterial pathogens associated with CAP, especially staphylococci and Streptococcus pneumoniae, has made the empiric treatment of this infection increasingly problematic...
January 11, 2019: Current Opinion in Infectious Diseases
Ian Lockart, Gail V Matthews, Mark Danta
PURPOSE OF REVIEW: The scale-up of direct-acting antiviral (DAA) therapy and introduction of preexposure prophylaxis (PrEP) has changed the epidemiology of sexually acquired hepatitis C virus (HCV) amongst HIV-positive and HIV-negative MSM. RECENT FINDINGS: Sexually acquired HCV continues to occur predominantly amongst HIV-positive MSM. Despite an increased uptake of DAA therapy the incidence of acute HCV has not declined consistently amongst HIV-positive MSM, likely a result of high infection and reinfection rates...
December 10, 2018: Current Opinion in Infectious Diseases
Henry J C de Vries
PURPOSE OF REVIEW: Lymphogranuloma venereum (LGV) is a serious sexually transmitted infection caused by Chlamydia trachomatis. If left untreated LGV can cause irreversible late sequelae. LGV is endemic among a high-risk population of men who have sex with men (MSM), and largely reported in Western metropoles. RECENT FINDINGS: Although the majority of LGV patients are HIV positive, in recent years the proportion of HIV-negative MSM with LGV is rising. This could indicate a shift toward lower risk populations...
November 30, 2018: Current Opinion in Infectious Diseases
Nadia Ahmed, Carey Pike, Linda-Gail Bekker
PURPOSE OF REVIEW: Pre-exposure prophylaxis (PrEP) is highly efficacious for preventing HIV. Demonstrations worldwide show growing acceptability with nonoral formulations in the pipeline. Despite these successes, oral PrEP scale-up in sub-Saharan Africa (SSA), the region hardest hit by HIV, remains sub-optimal. This review details emerging practises and addresses challenges in PrEP scale-up and delivery within SSA. RECENT FINDINGS: PrEP scale-up varies across SSA...
November 16, 2018: Current Opinion in Infectious Diseases
Tess E Peterson, Jason V Baker
PURPOSE OF REVIEW: This article describes the use of biomarkers in expanding our understanding of chronic non-AIDS comorbidities among persons living with HIV (PLWH) receiving antiretroviral therapy (ART). RECENT FINDINGS: We review current evidence that biomarkers of chronic immune activation and inflammation associate with a broad spectrum of end-organ diseases in PLWH. We discuss how ART may impact inflammation associated with HIV infection and the degree to which inflammation persists despite effective suppression of viral replication in plasma...
November 15, 2018: Current Opinion in Infectious Diseases
Lisa Hamzah, Rachael Jones, Frank A Post
PURPOSE OF THE REVIEW: To identify recent data that inform the management of individuals with HIV and chronic kidney disease. RECENT FINDINGS: Several nonnucleoside reverse transcriptase, protease, and integrase strand transfer inhibitors inhibit tubular creatinine secretion resulting in stable reductions in creatinine clearance of 5-20 ml/min in the absence of other manifestations of kidney injury. Progressive renal tubular dysfunction is observed with tenofovir disoproxil fumarate in clinical trials, and more rapid decline in estimated glomerular filtration rate in cohort studies of tenofovir disoproxil fumarate and atazanavir, with stabilization, improvement or recovery of kidney function upon discontinuation...
November 15, 2018: Current Opinion in Infectious Diseases
Anjali Patel, Rajul Patel
PURPOSE OF REVIEW: Technology to rapidly determine the partial or full genomic sequences of large viruses has developed rapidly in the last few years. Required sample sizes have diminished and sequencing of directly collected patient samples is now possible. Using banked samples from a number of clinical studies researchers have investigated how genomic variation may determine pathogenicity and answering important questions around the limits of vaccine therapy. RECENT FINDINGS: The natural variation in HSV-1 and HSV-2 geographically has been determined...
February 2019: Current Opinion in Infectious Diseases
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No abstract text is available yet for this article.
February 2019: Current Opinion in Infectious Diseases
Sanjeet S Dadwal
PURPOSE OF REVIEW: Cytomegalovirus infection (CMVi) has been the troll of allogeneic hematopoietic cell transplantation (allo-HCT). Over the last 4 decades various approaches have been adopted to minimize the burden from CMVi. There has been major advancement in the management of CMVi in HCT within the last few years that is poised to change the approaches employed in preventing and managing CMVi. This review will summarize recent advances and potential future development in the management of CMV in HCT...
February 2019: Current Opinion in Infectious Diseases
Karen E Rogstad
PURPOSE OF REVIEW: The present review considers recent evidence on travel-associated sexual intercourse and sexually transmitted infection (STI) risks and travel with regards to risk behavior and implications of travel on communities. It highlights the lack of research in this area and topics for consideration. RECENT FINDINGS: A population-based study, and others, shows significant levels of sex abroad and risk behavior with inconsistent condom use despite increasing travel advice about risks...
February 2019: Current Opinion in Infectious Diseases
José Garnacho-Montero, Jean-François Timsit
PURPOSE OF REVIEW: We reviewed recent data about epidemiology of Acinetobacter baumannii, resistance mechanisms, and therapeutic options for severe infections caused by multidrug-resistant strains. RECENT FINDINGS: A. baumannii is a major cause of nosocomial infections affecting mainly to debilitating patients in the ICU, although the spread to regular wards and to long-term care facilities is increasing. It is characterized by its great persistence in the environment and to have an extraordinary capability to develop resistance to all antimicrobials...
February 2019: Current Opinion in Infectious Diseases
Hans Verstraelen, Alexander Swidsinski
PURPOSE OF REVIEW: Bacterial vaginosis is conventionally appreciated as a temporary community disturbance of the vaginal microbiota, though really involving self-organization as a resilient biofilm community. We will briefly review here how recent findings on this matter may affect practice and research in this field. RECENT FINDINGS: The rapidly expanding literature base on the vaginal microbiome is largely based on 16S ribosomal ribonucleic acid (rRNA) and cpn60 gene sequencing, with few studies accounting thus far for spatial microbiota organization...
February 2019: Current Opinion in Infectious Diseases
David S Lawrence, Timothée Boyer-Chammard, Joseph N Jarvis
PURPOSE OF REVIEW: HIV-associated cryptococcal meningitis remains a significant contributor to AIDS-related mortality despite widened access to antiretroviral therapy. Even in clinical trial settings 10-week mortality is roughly 40%. A number of important clinical trials have either recently concluded or are actively recruiting. RECENT FINDINGS: Global burden of disease estimates suggest cryptococcal meningitis causes 181 100 deaths annually. Screening blood for cryptococcal antigen in HIV-infected individuals with CD4 cell counts less than 100 cells/μl and preemptive antifungal treatment for those with detectable cryptococcal antigen reduces the incidence of cryptococcal meningitis and is likely to reduce mortality...
February 2019: Current Opinion in Infectious Diseases
Jan J De Waele, Ignacio Martin-Loeches
PURPOSE OF REVIEW: Whilst many guidelines recommend limiting the use of antibiotics because of the increase in antimicrobial resistance (AMR), this strategy becomes challenging when dealing with severe infections in critically ill patients. Moreover, some Gram-negative bacilli (GNB) can exhibit mechanisms of resistance that make the patient more vulnerable to recurrence of infections. We reviewed recent data on the optimal duration of antibiotic therapy in these patients. RECENT FINDINGS: Apart from having no additional clinical benefit at a certain point after initiation, antibiotics might have negative effects...
December 2018: Current Opinion in Infectious Diseases
Mario Tumbarello, Angela Raffaella Losito, Helen Giamarellou
PURPOSE OF REVIEW: In the absence of randomized clinical trial data, questions remain regarding the optimal treatment of carbapenem-resistant Enterobacteriaceae (CRE) infections. CRE have historically been susceptible to polymyxins, tigecycline or aminoglycosides (mostly gentamicin), and these antibiotics have long been considered the drugs of choice for CRE infections, although varying rates of resistance to all have been reported. This review looks at data from clinical studies assessing the outcomes of CRE infections treated with different antibiotic regimens...
December 2018: Current Opinion in Infectious Diseases
Efthymia I Matthaiou, Gabriele Sass, David A Stevens, Joe L Hsu
PURPOSE OF REVIEW: Aspergillus fumigatus is a ubiquitous saprophytic fungus that can cause life-threatening invasive aspergillosis in immunocompromised patients. Apart from the immune status of the host only a few characterized virulence factors have been identified. In this review, we describe the role of iron in the manifestation of A. fumigatus virulence. RECENT FINDINGS: We gathered recent clinical evidence suggesting that tissue iron overload increases the risk of invasive aspergillosis occurrence...
December 2018: Current Opinion in Infectious Diseases
Roy F Chemaly, Tristan W Clark
No abstract text is available yet for this article.
December 2018: Current Opinion in Infectious Diseases
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