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Expert Review of Anti-infective Therapy

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https://www.readbyqxmd.com/read/28730858/management-of-children-with-persistent-group-a-streptococcal-carriage
#1
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 21, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28730853/dengue-in-the-elderly-a-review
#2
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 21, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28728447/corrigendum
#3
(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/28726558/epidemiology-and-clinical-relevance-of-staphylococcus-aureus-intestinal-carriage-a-systematic-review-and-meta-analysis
#4
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...
July 20, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28692305/fight-fire-with-fire-gene-therapy-strategies-to-cure-hiv
#5
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/28696154/extrahepatic-manifestations-of-hcv-the-role-of-direct-acting-antivirals
#6
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 11, 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
#7
Juergen A Richt, Li Zejun, Bao Danqi, Liu Qinfang
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 10, 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
#8
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
#9
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
#10
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
#11
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
#12
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/28481651/the-alternate-effects-of-anti-tnf%C3%AE-therapeutics-and-their-role-in-mycobacterial-granulomatous-infection-in-crohn-s-disease
#13
Ahmad Qasem, Abed Elrahman Naser, Saleh A Naser
Crohn's disease is an inflammatory bowel disease that has been debated to be associated with bacterial triggers such as Mycobacterium avium subspecies paratuberculosis (MAP). Standard treatment of Crohn's disease (CD) patients includes a family of immunomodulators and biologics such as Anti-Tumor Necrosis Factor alpha (Anti-TNFα). This cytokine in particular has been known to play vital roles in fighting microbial infections through formation and maintenance of granulomas. Areas covered: This perspective is focused on elucidating the negative effects of using Anti-TNFα therapeutic agents as a treatment option in CD patients who are more likely suspected to have MAP infection, and the role of other immunomodulators in MAP infection...
May 17, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28481638/impact-of-total-body-weight-on-30-day-mortality-in-patients-with-gram-negative-bacteremia
#14
Ronald G Hall, Eunice D Yoo, Andrew C Faust, Terri Smith, Edward L Goodman, Eric M Mortensen, Steven Richardson, Carlos A Alvarez
BACKGROUND: The impact of total body weight (TBW) on 30-day mortality associated with gram-negative bacteremia has not been previously evaluated. METHODS: The cohort included 323 patients >/ = 18 years old with gram-negative bacteremia (1/1/2008-8/31/2011) who received >/ = 48 hours of antibiotics. We compared 30-day mortality of TBW <70 kg vs. >/ = 70 kg with a multivariable stepwise logistic regression adjusting for age >/ = 70 years, cancer diagnosis, and Pitt bacteremia score of >/ = 4...
May 17, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28480779/use-of-human-immunoglobulins-as-an-anti-infective-treatment-the-experience-so-far-and-their-possible-re-emerging-role
#15
Jordi Bozzo, Juan I Jorquera
Pooled human immunoglobulins (IGs) are prepared from plasma obtained from healthy donors as a concentrated antibody-containing solution. In addition, high-titer IGs (hyperimmune) against a specific pathogen can be obtained from vaccinated or convalescing donors. Currently, IGs can be used for the treatment of a variety of infections for which no specific therapy exists or that remain difficult to treat. Moreover, the recent pathogen outbreaks for which there is no approved treatment have renewed attention to the role of convalescent plasma and IGs...
May 15, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28480775/drug-development-challenges-and-strategies-to-address-emerging-and-resistant-fungal-pathogens
#16
Matthew W McCarthy, Thomas J Walsh
Invasive fungal infections represent an expanding threat to public health. The recent emergence of Candida auris, which is often resistant to existing antifungal agents and is associated with a high mortality rate, underscores the urgent need for novel drug development strategies. Areas covered: In this paper, we examine both challenges and opportunities associated with antifungal drug development and explore potential avenues to accelerate the development pipeline, including data sharing, surrogate endpoints, and the role of historical controls in clinical trials...
May 15, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28277820/influenza-and-other-respiratory-viruses-standardizing-disease-severity-in-surveillance-and-clinical-trials
#17
Barbara Rath, Tim Conrad, Puja Myles, Maren Alchikh, Xiaolin Ma, Christian Hoppe, Franziska Tief, Xi Chen, Patrick Obermeier, Bron Kisler, Brunhilde Schweiger
Influenza-Like Illness is a leading cause of hospitalization in children. Disease burden due to influenza and other respiratory viral infections is reported on a population level, but clinical scores measuring individual changes in disease severity are urgently needed. Areas covered: We present a composite clinical score allowing individual patient data analyses of disease severity based on systematic literature review and WHO-criteria for uncomplicated and complicated disease. The 22-item ViVI Disease Severity Score showed a normal distribution in a pediatric cohort of 6073 children aged 0-18 years (mean age 3...
May 12, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28440679/cervical-cancer-in-sub-saharan-africa-a-preventable-noncommunicable-disease
#18
Ralph-Sydney Mboumba Bouassa, Thierry Prazuck, Thérèse Lethu, Mohammad-Ali Jenabian, Jean-François Meye, Laurent Bélec
Infections caused by high-risk human papillomavirus (HPV) are responsible for 7.7% of cancers in developing countries, mainly cervical cancer. This disease is steadily increasing in sub-Saharan Africa, with more than 75,000 new cases and 50,000 deaths yearly, further increased by HIV infection. Areas covered: The current status of cervical cancer associated with HPV in sub-Saharan Africa has been systematically revised. The main issues discussed here are related to the public health burden of cervical cancer in sub-Saharan Africa and predictions for the coming decades, including molecular epidemiology and determinants of HPV infection in Africa, and promising prevention measures currently being evaluated in Africa...
May 5, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28425828/compliance-to-guidelines-for-the-prescribing-of-antibiotics-in-acute-infections-at-namibia-s-national-referral-hospital-a-pilot-study-and-the-implications
#19
S Nakwatumbah, D Kibuule, B Godman, V Haakuria, F Kalemeera, A Baker, M Mubita
BACKGROUND: Sub-optimal antibiotic prescribing remains a public health concern in Namibia. The objective was to determine the level and predictors of compliance to guidelines in the prescribing of antibiotics in acute infections at a national referral hospital in Namibia to improve future prescribing. METHODS: An analytical cross-sectional survey design. The clinical records of patients receiving care were reviewed. Prescribing practices were assessed using a self- administered questionnaire with reference to Namibia Standard Treatment Guidelines (NSTG)...
May 5, 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
#20
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
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