Current Opinion in Infectious Diseases最新文献

{"title":"New World screwworm: a re-emerging parasitic threat.","authors":"Rebecca J Chancey, Paul Cantey","doi":"10.1097/QCO.0000000000001218","DOIUrl":"10.1097/QCO.0000000000001218","url":null,"abstract":"<p><strong>Purpose of review: </strong>New World screwworm (NWS) is an emerging parasitic threat in Central America and Mexico, which is spreading northward into the southern United States. Here we highlight the changing epidemiology, lifecycle of the NWS fly, clinical presentation, identification, treatment, and potential complications of NWS myiasis.</p><p><strong>Recent findings: </strong>Despite decades of successfully containing NWS flies south of the Darien Gap in southern Panama, NWS flies reemerged in the Central America region in 2023 and have continued to spread northward ever since. On 3 June 2026, United States Department of Agriculture (USDA) confirmed the identification of an NWS infestation in a young calf in southern Texas. In addition to describing the current epidemiology of the NWS outbreak, we present information about clinical presentation and management of NWS myiasis in patients and include representative cases of patients who experienced NWS myiasis.</p><p><strong>Summary: </strong>This review provides important epidemiologic and clinical updates to an emerging parasitic threat so clinicians can understand the risks and clinical management for patients with suspected NWS myiasis.</p>","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"396-403"},"PeriodicalIF":4.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497171","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}

{"title":"Unresolved questions in pediatric dengue: from disease mechanisms to prevention.","authors":"Eduardo Lopez-Medina","doi":"10.1097/QCO.0000000000001219","DOIUrl":"10.1097/QCO.0000000000001219","url":null,"abstract":"<p><strong>Purpose of review: </strong>Despite recent advances in understanding dengue infection, substantial gaps remain in its epidemiology, pathogenesis, diagnosis, and prevention, including vaccine development and its long-term impact. This review summarizes recent findings and highlights the most pressing research needs to advance the field and reduce individual and public health burden.</p><p><strong>Recent findings: </strong>Dengue burden has increased, particularly among children and adolescents, and it has expanded into previously unaffected regions. Still, current data likely underestimates the true burden due to suboptimal surveillance systems. Improving control will require a better understanding of severe dengue pathogenesis, where key gaps remain, alongside reassessment of diagnostic limitations in the context of increasing vaccine availability. Vaccines represent an important complementary tool, with several candidates under study and two currently in use, each with distinct strengths, limitations, and unresolved questions.</p><p><strong>Summary: </strong>More extensive research and investment are needed to address the growing burden of dengue, including severe outbreaks and geographic spread. Meanwhile, stronger regulatory engagement in the development and evaluation of innovative therapeutic and preventive measures is essential, particularly in low-income and middle-income regions that bear the highest burden. Clear communication and education on dengue, its impact, and available preventive measures proven to be well tolerated and effective are also critical to strengthen trust, improve uptake, and maximize public health impact.</p>","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"480-490"},"PeriodicalIF":4.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13566362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497141","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}

{"title":"Adenovirus infection after cellular therapy: diagnostic and therapeutic challenges.","authors":"Natalie Yap, Nelson Y Wang, Michelle K Yong, Gabrielle M Haeusler","doi":"10.1097/QCO.0000000000001245","DOIUrl":"https://doi.org/10.1097/QCO.0000000000001245","url":null,"abstract":"<p><strong>Purpose of review: </strong>To review recent advances in the epidemiology, diagnosis, and management of human adenovirus (HAdV) infection following haematopoietic cell transplantation (HCT) and other cellular therapies, with emphasis on risk stratification, molecular surveillance, and emerging therapies.</p><p><strong>Recent findings: </strong>Recent studies have improved understanding of the interplay between viral burden, immune reconstitution, and progression to invasive HAdV disease following HCT. International consensus definitions of HAdV infection and disease have recently been proposed and may improve consistency in the reporting of clinical and research outcomes. Increasing evidence supports the gastrointestinal tract as a reservoir for viral persistence, with rising stool viral loads often preceding invasive infection. Intravenous brincidofovir has emerged as a promising alternative to cidofovir, demonstrating preliminary antiviral activity without the nephrotoxicity associated with cidofovir or the gastrointestinal toxicity observed with oral brincidofovir. HAdV-specific cytotoxic T-lymphocyte therapies have also shown encouraging efficacy in refractory infection.</p><p><strong>Summary: </strong>HAdV remains an important cause of morbidity and mortality following HCT, particularly in patients with impaired T-cell immunity. Key challenges include optimal surveillance strategies, treatment thresholds, and management of high-risk patients. Advances in molecular diagnostics, standardized disease definitions, brincidofovir, and virus-specific T-cell therapies may facilitate higher quality clinical research and support more standardized, evidence-based approaches to HAdV management.</p>","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988707","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}

{"title":"Endemic Mycoses in 2026: can we keep the pace of redrawing maps?","authors":"Marcela Araujo de Oliveira Santana, Julio C Zuniga-Moya, Cody Cunningham, Adriana M Rauseo, Andrej Spec","doi":"10.1097/QCO.0000000000001244","DOIUrl":"https://doi.org/10.1097/QCO.0000000000001244","url":null,"abstract":"<p><strong>Purpose of review: </strong>The dimorphic fungal infections were classically grouped as endemic mycoses due to their restricted geographic distribution. However, their original geographic distribution dates from the twentieth century and true prevalence and distribution of these infections is limited by subclinical presentations, lack of healthcare provider awareness, lack of diagnostic capacity, and incomplete reporting. In this review, we discuss the new geographic distribution of endemic mycoses and the factors influencing its expansion.</p><p><strong>Recent findings: </strong>There has been an increase in incidence and reports of endemic mycoses diagnosed outside their classic geographic locations. Evidence shows expansion of the classic endemic areas and new areas of risk likely due to climate change, human mobility, and socioeconomic factors.</p><p><strong>Summary: </strong>Climate change, human mobility, socioeconomic disparities, and a growing immunosuppressed patient population affected the geographic distribution of dimorphic fungal infections and will challenge mycologist to keep up with the pace of redrawing the maps for these infections. There is a need for more research and public health initiatives in this field. Clinicians should have a high index of suspicion for dimorphic fungal infections, and all patients with compatible syndromes should receive appropriate testing, even in historically nonendemic areas.</p>","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988757","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}

{"title":"Fungal diseases in burn and blast-injured patients: tensions are rising, and awareness must keep pace.","authors":"Emmanuel Dudoignon, Rania Mhenni, Sarah Dellière","doi":"10.1097/QCO.0000000000001241","DOIUrl":"https://doi.org/10.1097/QCO.0000000000001241","url":null,"abstract":"<p><strong>Purpose of review: </strong>Invasive fungal diseases (IFD) are severe complications of burn injury and are associated with substantial morbidity and mortality. Despite increasing recognition of their clinical impact, evidence guiding diagnosis, prevention, and management remains limited. This review summarizes recent advances in the understanding of host susceptibility, diagnostic approaches, and therapeutic strategies for IFD in burn patients.</p><p><strong>Recent findings: </strong>Recent literature converges on three major themes: the characterization of burn-induced immunosuppression, the need to associate conventional diagnostics and molecular tools, including quantitative PCR and the central role of comprehensive source control, to which systemic antifungal therapy must be systematically added and pharmacokinetically optimized to account for the profound physiological alterations inherent to severe burn injury.</p><p><strong>Summary: </strong>Optimal management of IFD in burn patients requires a multidisciplinary approach combining immune risk stratification, refined diagnostic algorithms, and individualized antifungal therapy. Consensus on case definitions and prospective multicentre data are urgently needed to consolidate the evidence base and meaningfully improve outcomes in this vulnerable population.</p>","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879454","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}

{"title":"Using bacteriophage cocktails in MDR Gram-negative infections: a practical manual.","authors":"Jennifer M Dan","doi":"10.1097/QCO.0000000000001237","DOIUrl":"https://doi.org/10.1097/QCO.0000000000001237","url":null,"abstract":"<p><strong>Purpose of review: </strong>Bacteriophage therapy is a promising treatment on the horizon for multidrug resistant (MDR) and difficult-to-treat infections.</p><p><strong>Recent findings: </strong>There have been a number of case reports and case series using bacteriophages to treat MDR infections. This has sparked interest by many patients and providers in accessing this treatment. However, the timeline from start of screening for phages to quality control in manufacturing to regulatory applications and the actual administration can be quite long. It is therefore important to be realistic with persons seeking treatment. Bacteriophage therapy is in its infancy. We are only beginning to understand the pharmacokinetics and pharmacodynamics of phages and how the development of phage-specific immune response may impact efficacy. Patients do develop neutralizing antibodies against bacteriophages. This is akin to someone receiving a first-time vaccination or first-time exposure to a viral infection. These neutralizing antibodies have the potential to impede efficacy, particularly if treatment extends past the 14-day window during which a patient first seroconverts from an IgM response to an IgG response. Finally, bacteriophages are useful tools to disrupt biofilms in patients with recurrent urinary tract infections, pulmonary infections, and those with retained hardware.</p><p><strong>Summary: </strong>Understanding the protocol for phage therapy in addition to the potential setbacks is essential to eventually formulating \"off-the-shelf\" therapy.</p>","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879248","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}

{"title":"Rates of azole resistance in aspergillosis: a worldwide overview.","authors":"Nathan P Wiederhold","doi":"10.1097/QCO.0000000000001235","DOIUrl":"https://doi.org/10.1097/QCO.0000000000001235","url":null,"abstract":"<p><strong>Purpose of review: </strong>Triazole-resistant Aspergillus fumigatus is a growing clinical problem. Resistance can develop with clinical exposure and with environmental exposure to azole and azole-like compounds used as fungicides in agriculture. The purpose of this review is to provide an update of our current understanding of the epidemiology and prevalence of this emerging problem.</p><p><strong>Recent findings: </strong>Triazole-resistant A. fumigatus is now a worldwide problem. Resistant isolates have been found in clinical and environmental samples collected from many countries on all inhabitable continents. The most commonly identified mechanisms of resistance are those associated with environmental exposure. Although the prevalence of triazole-resistant Aspergillus has been most extensively studied in Europe, hotspots have emerged in other countries, both in the environment and in clinical settings. However, the true extent of the problem is not well understood secondary to limitations with small studies of limited duration and the lack of comprehensive surveillance programs.</p><p><strong>Summary: </strong>Triazole-resistant A. fumigatus is an emerging issue both clinically and in the environment. Greater attention and more resources are needed to better understand the extent of the problem.</p>","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879264","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}

{"title":"Machine learning to differentiate colonization from infection in multidrug-resistant Gram-negative bacteria: implications for further research.","authors":"Daniele Roberto Giacobbe, Elena Ceccardi, Lucia Scarfone, Marco Muccio, Maurizio Fedriga, Antonio Vena, Matteo Bassetti","doi":"10.1097/QCO.0000000000001240","DOIUrl":"https://doi.org/10.1097/QCO.0000000000001240","url":null,"abstract":"<p><strong>Purpose of review: </strong>Machine learning has emerged as a promising tool to support antimicrobial decision-making in infectious diseases. In colonized patients, distinguishing multidrug-resistant Gram-negative bacteria (MDR-GNB) colonization from true infection remains a major clinical challenge, as both delayed appropriate therapy in severe infections and unnecessary broad-spectrum antimicrobial use may adversely affect patient outcomes and antimicrobial stewardship. This review discusses the current evidence on machine learning models for predicting or detecting MDR-GNB infection in colonized patients, highlights key methodological limitations of the available literature, and outlines future research priorities.</p><p><strong>Recent findings: </strong>Current evidence specifically evaluating machine learning models beyond logistic regression in MDR-GNB-colonized patients remains limited. Overall, while machine learning may achieve encouraging discriminatory performance, important methodological limitations persist. Most notably, predictive models are frequently developed in heterogeneous populations that do not reflect the clinically relevant populations of colonized patients in which treatment decisions are made. Furthermore, improvements in predictive performance remain modest, possibly reflecting limited sample sizes and data granularity rather than insufficient algorithmic complexity. In our opinion, future advances could require multicenter datasets enriched with longitudinal clinical, microbiological, and genomic information, together with automated feature extraction from electronic health records.</p><p><strong>Summary: </strong>The main challenge for machine learning in predicting MDR-GNB infection in colonized patients may lie not in developing increasingly sophisticated algorithms, but in generating clinically representative datasets and adopting rigorous methodological standards for model development, validation, calibration, and implementation. Future research should prioritize clinically meaningful target populations and demonstrate improvements in patient outcomes and antimicrobial stewardship beyond conventional measures of predictive performance.</p>","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148954856","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}

{"title":"Antiviral targets in the prevention and treatment of measles.","authors":"Sebastian Ortiz Colmenares, Cole Sher-Jan, Christian K Pfaller","doi":"10.1097/QCO.0000000000001239","DOIUrl":"https://doi.org/10.1097/QCO.0000000000001239","url":null,"abstract":"<p><strong>Purpose of review: </strong>Despite the efforts of national and international health agencies to eradicate measles virus (MeV), the causative agent of measles, progress has stagnated and cases are rising. Since 1963, a well tolerated and efficacious live-attenuated vaccine has been used to remarkable success, leading to the near eradication of measles virus. Nevertheless, increased vaccine hesitancy has led to a resurgence in the past decade. The development of specific antiviral therapeutics to combat measles is lagging but increased efforts are justified considering the current measles resurgence and needs to protect vulnerable populations.</p><p><strong>Recent findings: </strong>While no specific therapeutics have been approved to date, major advances in the development of measles-specific small molecule antivirals and biologics have been made recently. In this review, we provide an update on their development covering three major areas: drugs targeting viral entry; drugs targeting viral replication; and drugs targeting host factors utilized by MeV. Finally, we identify critical gaps and novel approaches that may enhance our current repertoire of antivirals targeting MeV.</p><p><strong>Summary: </strong>The recent advances in the development and preclinical testing of MeV-targeting antivirals offer multiple independent avenues for their clinical evaluation.</p>","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879413","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}

{"title":"Novel antifungal agents for treating endemic mycoses: hope on the horizon?","authors":"Nathan C Bahr, Alessandro C Pasqualotto, George R Thompson","doi":"10.1097/QCO.0000000000001225","DOIUrl":"https://doi.org/10.1097/QCO.0000000000001225","url":null,"abstract":"<p><strong>Purpose of review: </strong>Current treatments for endemic mycoses are limited by toxicity, drug-drug interactions, the need for therapeutic drug monitoring, and suboptimal penetration to sequestered sites. At the same time, several new antifungal strategies and agents are nearing clinical availability and may change practice.</p><p><strong>Recent findings: </strong>Current literature highlights limitations of standard therapy for histoplasmosis, coccidioidomycosis, blastomycosis, paracoccidioidomycosis, talaromycosis, sporotrichosis, and emergomycosis, which often rely on amphotericin B-based induction regimens followed by triazole antifungals. Emerging studies are evaluating single high-dose liposomal amphotericin B, shorter treatment durations for histoplasmosis, and flucytosine combined with amphotericin B-based induction for talaromycosis. Novel antifungals such as olorofim, fosmanogepix, and turletricin are especially promising, and treatment strategies guided by patient phenotypes and immune endotypes are also beginning to emerge.</p><p><strong>Summary: </strong>Growing evidence suggests therapy for endemic mycoses may change substantially in the near future. New drugs and alternative treatment approaches have the potential to improve safety, tolerability, oral availability, drug-drug interaction profiles, and treatment duration, with important implications for both clinical care and future research.</p>","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148688612","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}