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Expert Review of Anti-infective Therapy

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https://www.readbyqxmd.com/read/28803496/management-of-multidrug-resistant-pseudomonas-aeruginosa-in-the-intensive-care-unit-state-of-the-art
#1
Alberto Enrico Maraolo, Marco Cascella, Silvia Corcione, Arturo Cuomo, Salvatore Nappa, Guglielmo Borgia, Francesco Giuseppe De Rosa, Ivan Gentile
Pseudomonas aeruginosa (PA) is one of the most important causes of healthcare-related infections among Gram-negative bacteria. The best therapeutic approach is controversial, especially for multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains as well as in the setting of most severe patients, such as in the intensive care unit (ICU). Areas covered: This article addresses several points. First, the main microbiological aspects of PA, focusing on its wide array of resistance mechanisms. Second, risk factors and the worse outcome linked to MDR-PA infection...
August 14, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28783385/candida-auris-a-worrisome-globally-emerging-pathogen
#2
Bhagyashri D Navalkele, Sanjay Revankar, Pranatharthi Chandrasekar
Candida auris is a recently discovered, rapidly emerging fungal pathogen. Infections due to C. auris are hospital-acquired, multidrug resistant and associated with high mortality. Areas covered: This review highlights epidemiology, pathogenesis, microbiological characteristics, clinical presentation, diagnostic challenges and treatment options of C. auris infections. Infection prevention measures to prevent spread of C. auris and special measures during an outbreak situation have also been reviewed. Expert commentary: Rapid emergence of hospital onset C...
August 7, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28782390/treatment-of-pneumocystis-jirovecii-pneumonia-in-hiv-infected-patients-a-review
#3
Yu-Shan Huang, Jen-Jia Yang, Nan-Yao Lee, Guan-Jhou Chen, Wen-Chien Ko, Hsin-Yun Sun, Chien-Ching Hung
Pneumocystis pneumonia is a potentially life-threatening pulmonary infection that occurs in immunocompromised individuals and HIV-infected patients with a low CD4 cell count. Trimethoprim-sulfamethoxazole has been used as the first-line agent for treatment, but mutations within dihydropteroate synthase gene render potential resistance to sulfamide. Despite advances of combination antiretroviral therapy (cART), Pneumocystis pneumonia continues to occur in HIV-infected patients with late presentation for cART or virological and immunological failure after receiving cART...
August 5, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28730858/management-of-children-with-persistent-group-a-streptococcal-carriage
#4
Maria E Zacharioudaki, Emmanouil Galanakis
Chronic GAS carrier state is best defined as the prolonged presence of group A β-haemolytic Streptococcus (GAS) in the pharynx without evidence of infection or inflammation. Chronic GAS carriers have a low risk of immune mediated complications. Persistent pharyngeal carriage often raises management issues. In this study, we review the evidence on the management of persistent GAS carriage in children and propose a management algorithm. Areas covered: Chronic GAS pharyngeal carriage is quite common affecting 10-20% of school-aged children...
July 31, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28730853/dengue-in-the-elderly-a-review
#5
Ray Junhao Lin, Tau Hong Lee, Yee Sin Leo
Changing dengue epidemiological trends have resulted in a shift in the disease burden to the adult population. Older adults suffer from poorer outcomes as compared to their younger counterparts, making clinical management of this sub-population particularly challenging. Areas covered: We present a review of the current literature on the changing epidemiology of dengue in the elderly, the atypical features of the clinical disease in this population with emphasis on severe disease presentations and challenges in the current management strategies...
July 28, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28728447/corrigendum
#6
(no author information available yet)
No abstract text is available yet for this article.
July 20, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28696154/extrahepatic-manifestations-of-hcv-the-role-of-direct-acting-antivirals
#7
María Laura Polo, Natalia Laufer
Hepatitis C virus (HCV) represents a major health concern, as nearly 3 million people become newly infected by this pathogen annually. The majority of infected individuals fail to clear the virus, and chronicity is established. Chronic HCV patients are at high risk for liver disease, ranging from mild fibrosis to cirrhosis and severe hepatocellular carcinoma. Over the last few years, the development of multiple direct acting antivirals (DAA) have revolutionized the HCV infection treatment, demonstrating cure rates higher than 90%, and showing less side effects than previous interferon-based regimens...
July 17, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28692316/h7n9-avian-influenza-a-virus-in-china-a-short-report-on-its-circulation-drug-resistant-mutants-and-novel-antiviral-drugs
#8
Bao Danqi, Zejun Li, Qinfang Liu, Juergen A Richt
The first human H7N9 avian influenza virus case was reported in Shanghai in 2013. Shortly thereafter, this virus spread to other regions in China. Molecular analysis indicated that the H7N9 virus is a reassortant virus containing internal genes from the H9N2 virus and previously described mammalian adaption markers, which could allow the virus to adapt efficiently to a mammalian host. Fortunately, there is no evidence of sustained person-to-person spread. Most of the human H7N9 cases have a history of exposure to live poultry markets (LPMs)...
July 17, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28692305/fight-fire-with-fire-gene-therapy-strategies-to-cure-hiv
#9
Jon Huyghe, Sips Magdalena, Linos Vandekerckhove
Human Immunodeficiency Virus (HIV) to date remains one of the most notorious viruses mankind has ever faced. Despite enormous investments in HIV research for more than 30 years an effective cure for HIV has been elusive. Areas covered: Combination antiretroviral therapy (cART) suppresses active viral replication, but is not able to eliminate the virus completely due to stable integration of HIV inside the host genome of infected cells and the establishment of a latent reservoir, that is insensitive to cART...
July 14, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28659026/colonization-and-infection-with-extended-spectrum-beta-lactamase-producing-enterobacteriaceae-in-patients-with-malignancy
#10
Michail Alevizakos, Eleftherios Mylonakis
Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) constitute a global threat and are prevalent in both nosocomial and community settings. These pathogens have been associated with delays in initiation of appropriate antimicrobial therapy and worse clinical outcomes. Patients with solid or hematologic malignancy represent a high-risk population for both colonization and infection with ESBL-PE. Areas covered: A description of the microbiology and epidemiology of the ESBL-PE is presented...
July 6, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28657373/extended-infusion-of-beta-lactam-antibiotics-optimizing-therapy-in-critically-ill-patients-in-the-era-of-antimicrobial-resistance
#11
Nesrine A Rizk, Zeina A Kanafani, Hussam Z Tabaja, Souha S Kanj
Beta-lactams are at the cornerstone of therapy in critical care settings, but their clinical efficacy is challenged by the rise in bacterial resistance. Infections with multi-drug resistant organisms are frequent in intensive care units, posing significant therapeutic challenges. The problem is compounded by a dearth in the development of new antibiotics. In addition, critically-ill patients have unique physiologic characteristics that alter the drugs pharmacokinetics and pharmacodynamics. Areas covered: The prolonged infusion of antibiotics (extended infusion [EI] and continuous infusion [CI]) has been the focus of research in the last decade...
July 3, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28661199/respiratory-microbiota-and-lower-respiratory-tract-disease
#12
Miguel Lanaspa, Quique Bassat, Marcia Melo Medeiros, Camen Muñoz-Almagro
The respiratory airways harbor a complex succession of ecological niches with distinct but related bacterial communities. Particular challenges of respiratory microbiome research have led to limited scientific output compared to other human microbiomes. Areas covered: In this review, we summarize the current state of knowledge of the bacterial respiratory microbiome, with a particular focus on associations between the respiratory microbiome and lower respiratory tract conditions. Expert commentary: There is growing evidence that the respiratory microbiome is associated with lower respiratory infectious diseases and related conditions...
June 29, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28580804/burden-of-antimicrobial-resistance-in-an-era-of-decreasing-susceptibility
#13
Glenn S Tillotson, Stephen H Zinner
Antimicrobial resistance has become a global problem. Many pathogens are becoming multidrug-resistant with the attendant increased risk of failure of standard therapies and the under-recognised outcomes such as increased morbidity, mortality, length of hospitalization and costs of treatment. Areas covered: We undertook a review of the literature using standard search engines including PubMed, Google Scholar, Scopus and internet sources. Key search terms included antimicrobial resistance, antibiotic resistance, bacterial resistance, clinical outcomes, economic consequences, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Streptococcus pneumoniae and Staphylococcus aureus...
June 13, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28524748/an-unwanted-guest-neisseria-meningitidis-carriage-risk-for-invasive-disease-and-the-impact-of-vaccination-with-insight-on-italy-incidence
#14
Elena Gianchecchi, Giulia Piccini, Alessandro Torelli, Rino Rappuoli, Emanuele Montomoli
Invasive Meningococcal Disease (IMD) represents a potentially life-threatening condition caused by Neisseria meningitidis. The disease is characterized by a case fatality rate of 5-10% whereas serious clinical sequelae can develop in survivors within 12-24 h from the first symptoms. However, IMD infection only occurs rarely, in fact, most of the interactions established between N. meningitidis and the host are harmless, and an estimated 10% of the population asymptomatically carries the bacterium in the nasopharynx...
May 29, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28756716/impact-of-hepatitis-c-virus-infection-on-health-related-quality-of-life-before-and-after-liver-transplantation-a-multidisciplinary-point-of-view
#15
Lucia Golfieri, Stefano Gitto, Maria Cristina Morelli, Antonio Daniele Pinna, Silvana Grandi, Pietro Andreone
Hepatitis C negatively changes patient quality of life even in the absence of advanced liver disease. The specific patterns of quality of life of hepatitis C positive patients waiting for transplant or after surgery are not widely studied. Areas covered: A significant percentage of infected patients show cognitive impairment, fatigue, and/or a 'brain fog', that cannot be explained by the liver disease. Depression can be diagnosed in one third of hepatitis C positive patients. Conflicting data are available regarding the possible role of Model for End-Stage Liver Disease score as predictor of impaired quality of life...
August 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28726558/epidemiology-and-clinical-relevance-of-staphylococcus-aureus-intestinal-carriage-a-systematic-review-and-meta-analysis
#16
Julie Gagnaire, Paul O Verhoeven, Florence Grattard, Josselin Rigaill, Frédéric Lucht, Bruno Pozzetto, Philippe Berthelot, Elisabeth Botelho-Nevers
Recent data highlight the importance of screening more than one site for improving the detection of S. aureus colonization. Intestinal carriage is frequently under-investigated and its clinical impact ought to be defined a better way. Areas covered: This review and meta-analysis provide an updated overview of prevalence, characteristics and clinical significance of S. aureus intestinal carriage in different populations, both for methicillin-susceptible and -resistant S. aureus strains. Expert commentary: Intestinal S...
August 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28571493/optimizing-%C3%AE-lactams-treatment-in-critically-ill-patients-using-pharmacokinetics-pharmacodynamics-targets-are-first-conventional-doses-effective
#17
Isabelle K Delattre, Fabio S Taccone, Frédérique Jacobs, Maya Hites, Thierry Dugernier, Herbert Spapen, Pierre-François Laterre, Pierre E Wallemacq, Françoise Van Bambeke, Paul M Tulkens
The pharmacokinetic/pharmacodynamic index determining β-lactam activity is the percentage of the dosing interval (%T) during which their free serum concentration remains above a critical threshold over the minimum inhibitory concentration (MIC). Regrettably, neither the value of %T nor that of the threshold are clearly defined for critically-ill patients. Areas covered: We review and assess the targets proposed for β-lactams in critical illness by screening the literature since 1997. Depending on the study intention (clinical cure vs...
July 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28443391/atazanavir-sulfate-cobicistat-for-the-treatment-of-hiv-infection
#18
Francisco Antunes
During last two decades several drugs were developed to offer long-term benefits in terms of virologic efficacy, favourable tolerability and toxicity profiles in treatment of HIV infection. Pharmacokinetics boosting of protease inhibitor allows a higher genetic barrier, as few or no drug-resistant mutations are detected in patients with virologic failure. Areas covered: Atazanavir sulfate + cobicistat (ATV/c) was recently approved for the treatment of HIV-1 infection. Bioequivalence between cobicistat (COBI) and ritonavir (RTV) as a pharmacoenhancer of ATV was established...
June 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28395551/use-of-tigecycline-in-pediatric-clinical-practice
#19
Maria Vincenza Mastrolia, Luisa Galli, Maurizio De Martino, Elena Chiappini
Tigecycline, a derivative of minocycline, is an extended-spectrum antimicrobial agent. It has a restricted approval field in children and the experience of its adoption in clinical practice is reserved for cases of challenging infections. The aim of this review was to summarize evidence regarding the use of tigecycline in infants and children, focusing on the drug's clinical efficacy data and tolerability profile. Areas covered: We have conducted a literature search of the Cochrane Library, EMBASE, and MEDLINE databases, from their inception through 5 January 2017, using the following terms: tigecycline, newborn, infant, child, pediatrics, adolescent, human, clinical trial, and case report...
June 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28375030/aminoglycosides-against-carbapenem-resistant-enterobacteriaceae-in-the-critically-ill-the-pitfalls-of-aminoglycoside-susceptibility
#20
Alexandre P Zavascki, Brandon O Klee, Jürgen B Bulitta
The emergence of carbapenem-resistant Enterobacteriaceae (CRE) has brought aminoglycosides to the frontline since an aminoglycoside may be the only antimicrobial to which CRE isolates show in vitro susceptibility. The appropriateness of aminoglycoside-based therapies for severe infections by CRE is discussed considering the current breakpoints and recent pharmacokinetic (PK) studies in critically ill patients. Areas covered: Many aminoglycoside-susceptible CRE isolates present minimal inhibitory concentrations (MICs) at or slightly below the breakpoint of amikacin or gentamicin...
June 2017: Expert Review of Anti-infective Therapy
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