Current Opinion in Infectious Diseases最新文献_第2页

Corticosteroids for viral central nervous system infections. 皮质类固醇治疗病毒性中枢神经系统感染。

IF 3.6 3区医学

Current Opinion in Infectious Diseases Pub Date : 2025-06-01 Epub Date: 2025-04-01 DOI: 10.1097/QCO.0000000000001106

Jacob Bodilsen, Lærke Storgaard Duerlund, Henrik Nielsen

{"title":"Corticosteroids for viral central nervous system infections.","authors":"Jacob Bodilsen, Lærke Storgaard Duerlund, Henrik Nielsen","doi":"10.1097/QCO.0000000000001106","DOIUrl":"10.1097/QCO.0000000000001106","url":null,"abstract":"Purpose of review: Viruses are frequent causes of central nervous system (CNS) infection. Lacking specific antiviral treatment or inadequate clinical response may lead to treatment with corticosteroids. This review describes the rationale for and clinical experience with the use of adjunctive corticosteroids for viral CNS infections.Recent findings: Corticosteroids display anti-inflammatory, immunosuppressive, antiproliferative, and vasoconstrictive effects by genomic and nongenomic regulation of human cells. Recent population-based studies consistently show that empiric dexamethasone during diagnostic work-up for meningitis has neither been associated with improved outcome nor adverse effects in viral meningitis. Myelitis is most often due to noninfectious causes and standard empiric treatment includes high-dose methylprednisolone. There are no convincing data on viral myelitis to support a change of this approach. Corticosteroids have occasionally been employed in different types of viral encephalitis. Observational data and a few randomized clinical trials have not documented any substantial beneficial effects of adjunctive corticosteroids in viral encephalitis. Risks of harm with current treatment regimens remained low in published studies.Summary: Except for myelitis, there are no data to support routine use of corticosteroids for viral CNS infections. Large, multidisciplinary syndromic platform trials of all-cause encephalitis may be a viable way to inform treatment guidelines.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"271-279"},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The power of story: what Victorian novels can teach us about public health. 故事的力量：维多利亚时代的小说教给我们的关于公共卫生的知识。

IF 3.6 3区医学

Current Opinion in Infectious Diseases Pub Date : 2025-06-01 Epub Date: 2025-03-27 DOI: 10.1097/QCO.0000000000001103

Andrea Kaston Tange

{"title":"The power of story: what Victorian novels can teach us about public health.","authors":"Andrea Kaston Tange","doi":"10.1097/QCO.0000000000001103","DOIUrl":"10.1097/QCO.0000000000001103","url":null,"abstract":"Purpose of review: The recent uptick in outbreaks of infectious diseases once firmly under control in North America and the UK (including measles, tuberculosis, scarlet fever, and whooping cough) concerns public health professionals in light of increasing vaccine skepticism. Because disease prevention and cure have evolved slowly, the general public may misunderstand the potential impact of rejecting vaccines and need stories that will clarify the risks.Recent findings: Studying history and literature reveals that modern citizens of wealthy, industrialized nations have forgotten the emotional cost of widespread child mortality. Examples from nineteenth-century novels offer vivid reminders of the agonies created by communicable diseases in an age before vaccines and antibiotics. Better understanding both the causes of child mortality - which hovered near 50% in North America and the UK in the 1840s - and the shared cultural grief such losses produced is a powerful reminder of why no one would want to return to that public health moment.Summary: Medical health professionals might usefully complement their scientific understanding with history, in order to be better equipped to reach those who are vaccine hesitant.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"228-233"},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Complexities of cardiomyopathy in septic shock. 感染性休克心肌病的复杂性。

IF 3.6 3区医学

Current Opinion in Infectious Diseases Pub Date : 2025-06-01 Epub Date: 2025-03-24 DOI: 10.1097/QCO.0000000000001102

Dennis L Stevens, Amy E Bryant

{"title":"Complexities of cardiomyopathy in septic shock.","authors":"Dennis L Stevens, Amy E Bryant","doi":"10.1097/QCO.0000000000001102","DOIUrl":"10.1097/QCO.0000000000001102","url":null,"abstract":"Purpose of review: This review highlights the complex pathophysiology of myocardial dysfunction in septic shock and emphasizes the need for early and repeated hemodynamic assessments to improve outcome.Recent findings: Septic cardiomyopathy is a complex, dynamic process driven by multiple mechanisms such as direct myocardial depression induced by host immune mediators (e.g., cytokines, nitric oxide) and/or bacterial toxins, and mitochondrial metabolic dysfunction. Recent echocardiography studies have described multiple unique hemodynamic clusters (phenotypes) that correlated with clinical outcomes. Similarly, serial echocardiography findings and mean arterial pressure abnormalities in patients with Streptococcal Toxic Shock Syndrome (StrepTSS) yielded three distinct hemodynamic groups that predicted mortality and morbidity. Because excessive use of fluids and/or vasopressors can be detrimental, especially in patients with microvascular injury or cardiomyopathy, application of the cardiovascular performance criteria of these different phenotypes could better inform management decisions in real time and improve outcome.Summary: Septic cardiomyopathy is a dynamic, multidimensional response of the myocardium to infection involving both normal and dysregulated immune responses in which the measurable changes in myocardial function predict outcomes. This current paradigm mandates that functional parameters of cardiac performance be measured early and repeatedly throughout the disease course using echocardiography to guide treatment and improve outcome.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"214-221"},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A role for genomics-based studies of Bordetella pertussis adaptation. 百日咳博德泰拉适应基因组学研究的作用。

IF 3.6 3区医学

Current Opinion in Infectious Diseases Pub Date : 2025-06-01 Epub Date: 2025-04-21 DOI: 10.1097/QCO.0000000000001109

Sarah K Cameron, Andrew Preston

{"title":"A role for genomics-based studies of Bordetella pertussis adaptation.","authors":"Sarah K Cameron, Andrew Preston","doi":"10.1097/QCO.0000000000001109","DOIUrl":"10.1097/QCO.0000000000001109","url":null,"abstract":"Purpose of review: Cases of whooping cough (pertussis) have rebounded strongly from the very low incidence observed during the pandemic. This re-emergence is characterized by changes in epidemiology. Here we describe the importance of genomics to monitor and understand the drivers to these changes.Recent findings: Changes in the genotype of strains isolated during recent outbreaks suggests that the pandemic disturbed the global Bordetella pertussis population structure. The emergence of dominant and antibiotic-resistant clones in China is of concern even though the source of antibiotic selection pressure on B. pertussis is unclear. A recent study illustrates how to use genomic data to go beyond just surveillance, inferring the relative fitness of genotypes and the identification of specific mutations distinguishing such lineages. Such approaches are required to understand the forces driving adaptation.Summary: Pertussis is resurgent in many countries, involving changes in epidemiology and strong suggestions of strain adaptation. The continued use of vaccination, and design of new interventions, to control pertussis requires an understanding of these changes. Genomic analyses will be key to this, involving integration of more complete host and pathogen parameters than have been used to date.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"201-207"},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Updates on the neurological manifestations of SARS-CoV-2 infection. SARS-CoV-2感染的神经学表现的最新进展。

IF 3.6 3区医学

Current Opinion in Infectious Diseases Pub Date : 2025-06-01 Epub Date: 2025-04-01 DOI: 10.1097/QCO.0000000000001110

Ferron F Ocampo, Kathryn B Holroyd

{"title":"Updates on the neurological manifestations of SARS-CoV-2 infection.","authors":"Ferron F Ocampo, Kathryn B Holroyd","doi":"10.1097/QCO.0000000000001110","DOIUrl":"10.1097/QCO.0000000000001110","url":null,"abstract":"Purpose of review: Since its emergence in 2020, the COVID-19 pandemic has created a global surge of survivors experiencing neurologic effects from SARS-CoV-2 infection. This review aims to provide an updated synthesis of the acute and chronic neurological manifestations of COVID-19, and to outline the current therapeutic strategies for these conditions.Recent findings: Epidemiological studies have shown that COVID-19 patients with neurological symptoms during acute infection tend to have poorer hospital and functional outcomes. While the risk of adverse neurologic symptoms including cognitive dysfunction, headache, autonomic dysfunction, and chronic fatigue are thought to be greatest following infection with the original SARS-CoV-2 strain and its alpha variant, they remain prevalent after infection with subsequent less virulent strains as well. Some recent work has also found a link between SARS-CoV-2 and structural brain changes. However, ongoing trials show promising results for pharmacologic and nonpharmacologic treatments targeting the postacute neurological sequelae of COVID-19.Summary: Lingering neurological manifestations after COVID-19 still pose considerable individual, healthcare system, and socioeconomic repercussions. Both preventive and multimodal treatment approaches are necessary to address these conditions. Further research is required to assess the lasting impacts of SARS-CoV-2 on the nervous system, particularly its potential contribution to the development of neurodegenerative diseases.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"234-241"},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Powassan and other emerging neuroinvasive arboviruses in North America. 波瓦桑病毒和其他在北美出现的神经侵入性虫媒病毒。

IF 3.6 3区医学

Current Opinion in Infectious Diseases Pub Date : 2025-06-01 Epub Date: 2025-03-28 DOI: 10.1097/QCO.0000000000001108

Reece M Hass, Michel Toledano

{"title":"Powassan and other emerging neuroinvasive arboviruses in North America.","authors":"Reece M Hass, Michel Toledano","doi":"10.1097/QCO.0000000000001108","DOIUrl":"10.1097/QCO.0000000000001108","url":null,"abstract":"Purpose of review: Arthropod-borne viruses (arboviruses) represent a group of pathogens with increasing global relevance, some of which cause neuroinvasive disease. Transmitted by arthropod vectors and maintained by a variety of primary and amplifying hosts, epidemics are dependent on numerous environmental and anthropogenic factors. This review serves to highlight several important neuroinvasive arboviruses relevant to North America and discuss the neurologic presentations, diagnosis, outcomes, and future trends.Recent findings: Recent shifts in the epidemiology and ecology of arboviruses in North America include the divergence of arboviruses such as dengue and chikungunya from dependence on enzootic cycles, the geographical expansion of Oropouche virus, and the increasing incidence of some established North American arboviruses such as Powassan virus. Accurate identification of the factors contributing to arboviral outbreaks is critical to improve preventive public health measures. Similarly, further elucidating the relevant pathogen and host factors that determine neuroinvasiveness, neurotropism, and neurovirulence will be key to the development of successful vaccines and targeted therapeutics.Summary: Arboviruses are an important pathogen relevant to human disease. Familiarity with the presentations, diagnostic workup, treatment and preventive strategies, and expected course is critical for clinicians caring for these patients.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"242-251"},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Editorial introductions. 编辑介绍。

IF 3.6 3区医学

Current Opinion in Infectious Diseases Pub Date : 2025-06-01 Epub Date: 2025-05-01 DOI: 10.1097/QCO.0000000000001111

引用次数: 0

2025: new infectious diseases and the re-emergence of vaccine-preventable infections. 2025年：新的传染病和疫苗可预防感染的重新出现。

IF 3.6 3区医学

Current Opinion in Infectious Diseases Pub Date : 2025-06-01 Epub Date: 2025-05-01 DOI: 10.1097/QCO.0000000000001104

Dennis Stevens

引用次数: 0

Host-directed immunotherapy for viral infections. 病毒感染的宿主定向免疫疗法。

IF 3.6 3区医学

Current Opinion in Infectious Diseases Pub Date : 2025-05-21 DOI: 10.1097/QCO.0000000000001116

Donald C Vinh

引用次数: 0

Preventing respiratory viral transmission in healthcare settings. 在卫生保健环境中预防呼吸道病毒传播。

IF 3.6 3区医学

Current Opinion in Infectious Diseases Pub Date : 2025-05-05 DOI: 10.1097/QCO.0000000000001115

Marie-Céline Zanella, Chanu Rhee, Michael Klompas

{"title":"Preventing respiratory viral transmission in healthcare settings.","authors":"Marie-Céline Zanella, Chanu Rhee, Michael Klompas","doi":"10.1097/QCO.0000000000001115","DOIUrl":"https://doi.org/10.1097/QCO.0000000000001115","url":null,"abstract":"Purpose of review: The COVID-19 pandemic catalyzed new insights into respiratory viral transmission mechanisms and prevention. We review the most practical and impactful measures to prevent SARS-CoV-2 and other nosocomial respiratory viral infections in healthcare.Recent findings: Nosocomial respiratory viral infection rates mirror viral activity levels in the surrounding community. During peak periods ∼15-20% of hospitalized patients with respiratory viral infections may have acquired their virus in the hospital. Nosocomial respiratory viral infections are associated with increased lengths-of-stay, risk of respiratory failure, and hospital death. Most procedures contribute minimally to aerosol production compared to labored breathing, coughing, and forced expiration. Masking for source control and exposure control both decrease transmission risk, respirators more so than masks. Likewise, vaccinating healthcare workers decreases transmission risk and is associated with lower patient mortality rates, particularly in long-term care facilities. Increasing air changes, ultraviolet irradiation, and portable HEPA filtration units may also decrease transmission rates but their marginal benefit relative to current healthcare ventilation standards has yet to be established.Summary: Practical strategies to prevent nosocomial respiratory viral infections include maximizing staff and patient influenza and SARS-CoV-2 vaccination rates and implementing routine masking during patient interactions when community incidence is high.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0