Current Opinion in Infectious Diseases最新文献_第4页

Harnessing next-generation microbial diagnostics to optimize infection management in immunocompromised hosts. 利用下一代微生物诊断优化免疫功能低下宿主的感染管理。

IF 4.5 3区医学

Current Opinion in Infectious Diseases Pub Date : 2026-08-01 Epub Date: 2026-06-17 DOI: 10.1097/QCO.0000000000001208

Danielle Lee, Nicholas J Norton, Adam P Dale

{"title":"Harnessing next-generation microbial diagnostics to optimize infection management in immunocompromised hosts.","authors":"Danielle Lee, Nicholas J Norton, Adam P Dale","doi":"10.1097/QCO.0000000000001208","DOIUrl":"10.1097/QCO.0000000000001208","url":null,"abstract":"Purpose of review: Conventional microbiological tests have limitations in the microbial diagnosis of immunocompromised patients. Next-generation sequencing (NGS) technologies have the potential to overcome some of these challenges by enabling rapid, comprehensive, and hypothesis-free pathogen detection, potentially improving the speed and accuracy of microbial diagnosis and subsequent clinical outcomes. This review summarizes current evidence for the use of NGS technologies in immunocompromised populations, highlights areas of demonstrated clinical impact, and identifies key priorities for broader clinical integration.Recent findings: Case reports and series have demonstrated the utility of NGS in diagnosing unusual or atypical infections amongst immunocompromised patients that were initially missed by conventional methods. Retrospective observational studies indicate that NGS can achieve higher sensitivity and greater pathogen detection rates than conventional diagnostics, although performance may be limited for certain pathogens, such as Aspergillus and Mycobacterial species. The clinical impact of NGS-guided interventions varies, reflecting both differences in study design and challenges in interpreting metagenomic data.Summary: NGS technologies have the potential to enhance microbial diagnosis in immunocompromised patients, particularly in complex, polymicrobial, or atypical infections where conventional methods fail. However, widespread clinical adoption is limited by high costs, complex workflows, and the need for advanced bioinformatics infrastructure and expertise. Further research is required to define clinical impact, cost-effectiveness, and to standardize workflows and guide optimal time for implementation, in order to inform evidence-based integration of NGS into routine clinical practice.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"334-341"},"PeriodicalIF":4.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148263490","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

Donor-derived latent viral and parasitic infections in solid organ transplant recipients: old foes and emerging challenges. 实体器官移植受者供体来源的潜伏病毒和寄生虫感染：老敌人和新挑战。

IF 4.5 3区医学

Current Opinion in Infectious Diseases Pub Date : 2026-08-01 Epub Date: 2026-04-10 DOI: 10.1097/QCO.0000000000001197

Robert C Wright, Sara Belga

{"title":"Donor-derived latent viral and parasitic infections in solid organ transplant recipients: old foes and emerging challenges.","authors":"Robert C Wright, Sara Belga","doi":"10.1097/QCO.0000000000001197","DOIUrl":"10.1097/QCO.0000000000001197","url":null,"abstract":"Purpose of review: Anticipated donor-derived infections following solid organ transplantation are a unique type of iatrogenic infection where a transplant recipient is knowingly infected with a potential pathogen, where the overall benefit of transplantation is felt to outweigh the risk of infection or infection-related complication. This review summarizes recent updates in our understanding of the safety and ongoing challenges of common donor-positive-to-recipient-negative transplantation.Recent findings: Registry analyses, case series, and cohort studies comprise the most recent publications on donor-derived infections. Changing patient populations, treatments, diagnostics, and awareness of rare disease presentations are associated with changes in the reported incidence, prevalence, and severity of donor-derived infections.Summary: Donor-positive to recipient-negative transplantation continues to be an overwhelmingly safe approach to optimize donor utilization rates, improve transplant-related outcomes, and minimize waitlist mortality. Changes to donor/recipient demographics, immunosuppressive and antiinfective regimens, as well as evolving pathogen endemicity, are associated with changes in the prevalence and severity of donor-derived infectious outcomes.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"296-302"},"PeriodicalIF":4.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812001","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

Managing multidrug resistant Gram-negative bacteraemia in immunocompromised hosts. 在免疫功能低下的宿主中管理多重耐药革兰氏阴性菌血症。

IF 4.5 3区医学

Current Opinion in Infectious Diseases Pub Date : 2026-08-01 Epub Date: 2026-05-07 DOI: 10.1097/QCO.0000000000001205

Cecilia Bonazzetti, Alice Toschi, Maddalena Giannella

{"title":"Managing multidrug resistant Gram-negative bacteraemia in immunocompromised hosts.","authors":"Cecilia Bonazzetti, Alice Toschi, Maddalena Giannella","doi":"10.1097/QCO.0000000000001205","DOIUrl":"10.1097/QCO.0000000000001205","url":null,"abstract":"Purpose of review: Multidrug-resistant Gram-negative bloodstream infections (MDR-GNBSI) are increasingly frequent in immunocompromised hosts, particularly solid organ transplant (SOT) recipients and patients with haematological malignancy (HM) receiving intensive chemotherapy and/or cellular therapies. We summarize current evidence and practical approaches across empirical, quasi-targeted and targeted management.Recent findings: Contemporary cohorts show rising rates of MDR-GNBSI in both SOT and HM patients. Appropriate therapeutic management is key to ensure good clinical outcome while minimizing ecological impact. Risk-adapted empirical therapy usually incorporates prior colonization and local epidemiology plus individual risk factors, thus screening could play central role. Rapid diagnostic testing can reduce time to appropriate and proportionate therapy, but currently the majority of them provide genotypic resistance that in Gram negatives can be difficult to interpret, in addition off-target resistance mechanisms should be considered mainly in nonfermenter bacteria. Thus, machine-learning models and structured BSI bundles are emerging tools to support early decision-making and stewardship. For targeted therapy, novel β-lactam/β-lactamase inhibitor combinations and cefiderocol expand options for carbapenem-resistant strains; pharmacokinetics/pharmacodynamics (PK/PD) optimization may improve target attainment and mitigate resistance selection. Evidence supporting oral step-down and shorter courses is growing, whereas routine follow-up blood cultures remain controversial due to observational bias.Summary: MDR-GNBSI management in immunocompromised patients requires individualized, data-driven strategies integrating risk stratification, rapid microbiology, and PK/PD optimization. Pursuing antimicrobial stewardship principles in these populations remains a priority.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"281-295"},"PeriodicalIF":4.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147867212","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

Increasing threat to the healthcare setting: Candida auris. 对卫生保健环境的威胁日益增加：耳念珠菌。

IF 4.5 3区医学

Current Opinion in Infectious Diseases Pub Date : 2026-08-01 Epub Date: 2026-06-15 DOI: 10.1097/QCO.0000000000001210

April N McDougal, Luis Ostrosky-Zeichner

引用次数: 0

Understanding challenges to prevention of healthcare related infections. 了解预防医疗保健相关感染的挑战。

IF 4.5 3区医学

Current Opinion in Infectious Diseases Pub Date : 2026-08-01 Epub Date: 2026-06-25 DOI: 10.1097/QCO.0000000000001207

Jason E Bowling

引用次数: 0

Live vaccines in solid organ transplant recipients. 活体器官移植受者的活疫苗。

IF 4.5 3区医学

Current Opinion in Infectious Diseases Pub Date : 2026-08-01 Epub Date: 2026-04-15 DOI: 10.1097/QCO.0000000000001196

Rebecca Sturgis, Lara Danziger-Isakov, Amy Feldman

{"title":"Live vaccines in solid organ transplant recipients.","authors":"Rebecca Sturgis, Lara Danziger-Isakov, Amy Feldman","doi":"10.1097/QCO.0000000000001196","DOIUrl":"10.1097/QCO.0000000000001196","url":null,"abstract":"Purpose of review: Vaccine preventable infections (VPIs) contribute substantially to morbidity and mortality in solid organ transplant (SOT) recipients. Recent outbreaks and declining herd immunity have brought attention to optimizing vaccination pre and posttransplant, as many patients remain incompletely immunized at the time of transplant. This review summarizes modern evidence and evolving recommendations regarding live vaccination in SOT candidates and recipients.Recent findings: Vaccination coverage at the time of transplant remains suboptimal, although targeted interventions have shown improvements in uptake. Accumulating data, largely from pediatric liver and kidney SOT cohorts, support the safety and immunogenicity of posttransplant measles, mumps, rubella (MMR) and varicella (VAR) vaccination under defined clinical and immunologic criteria. These findings have informed updated guidance and clinical practice for select pediatric SOT recipients, and multicenter experience with posttransplant live vaccination continues to expand.Summary: Growing evidence suggests that live vaccine administration may be feasible in carefully selected pediatric SOT recipients and may reduce susceptibility to VPIs. Important knowledge gaps remain, particularly for adult SOT recipients, nonliver transplant populations, and other live vaccines. Further research and prospective studies are needed to better define safety, immunogenicity, and optimal vaccination timing in these populations.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"327-333"},"PeriodicalIF":4.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812090","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

Antiviral prophylaxis against herpesviruses (herpes simplex virus, varicella-zoster virus and cytomegalovirus) among patients with cancer. 癌症患者对疱疹病毒（单纯疱疹病毒、水痘带状疱疹病毒和巨细胞病毒）的抗病毒预防。

IF 4.5 3区医学

Current Opinion in Infectious Diseases Pub Date : 2026-08-01 Epub Date: 2026-04-15 DOI: 10.1097/QCO.0000000000001198

Alice J Liu, Violet Z Zhu, Benjamin W Teh, Michelle K Yong

{"title":"Antiviral prophylaxis against herpesviruses (herpes simplex virus, varicella-zoster virus and cytomegalovirus) among patients with cancer.","authors":"Alice J Liu, Violet Z Zhu, Benjamin W Teh, Michelle K Yong","doi":"10.1097/QCO.0000000000001198","DOIUrl":"10.1097/QCO.0000000000001198","url":null,"abstract":"Purpose of review: Patients diagnosed with cancer are at risk of viral reactivation, namely herpes simplex virus (HSV), varicella-zoster virus (VZV) and/or cytomegalovirus (CMV). However, the risk varies significantly with underlying malignancy and treatment regimen. We review the latest evidence for antiviral prophylaxis strategies, focusing on novel immune therapies and future directions.Recent findings: Antiviral prophylaxis is indicated for all high-risk patients. The approval of letermovir for CMV prophylaxis has significantly reduced the burden of clinically significant infections in allogeneic hematopoietic stem cell transplant (alloHCT) recipients, and recent data now supports use up to 200 days posttransplant. For intermediate-risk regimens such as myeloma therapies and autologous hematopoietic stem cell transplant (autoHCT), antiviral prophylaxis is also a cornerstone of VZV prevention. Newer chimeric antigen receptor (CAR) T-cell and bispecific antibody (BsAb) therapies are increasingly available; while HSV/VZV prophylaxis has been incorporated into trial and real-world treatment protocols, optimal duration is unclear and data on CMV reactivation is still emerging. Solid tumours are a lower risk cohort, but high-dose steroids, immune checkpoint inhibitors and radiotherapy can increase the risk of viral reactivation and, therefore, close clinical monitoring is warranted.Summary: As the cancer treatment landscape evolves, ongoing research into optimal antiviral prophylaxis approaches is necessary to improve patient outcomes.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"303-315"},"PeriodicalIF":4.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811916","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

Isolation precautions: special considerations for immunocompromised hosts. 隔离注意事项：免疫功能低下宿主的特殊注意事项。

IF 4.5 3区医学

Current Opinion in Infectious Diseases Pub Date : 2026-08-01 Epub Date: 2026-06-15 DOI: 10.1097/QCO.0000000000001209

Yoojin Kim, Lynne Strasfeld

{"title":"Isolation precautions: special considerations for immunocompromised hosts.","authors":"Yoojin Kim, Lynne Strasfeld","doi":"10.1097/QCO.0000000000001209","DOIUrl":"10.1097/QCO.0000000000001209","url":null,"abstract":"Purpose of review: To summarize current approaches to isolation precautions and infection prevention and control (IPC) practices in immunocompromised hosts, including patients with hematologic malignancies, those receiving cellular therapies, and transplant recipients, with attention to variability in evidence and practice.Recent findings: Standard and transmission-based precautions remain foundational but often require adaptation for immunocompromised populations due to increased infection severity, prolonged pathogen shedding, and heightened transmissibility. Protective environments, including HEPA (high-efficiency particulate air) filtration and positive pressure rooms, may be of benefit for the highest risk populations but are resource-intensive and inconsistently applied. Emerging data support strategies such as universal masking to reduce respiratory viral infections (RVIs) and tailored transmission-based precautions. The role of multidrug-resistant organism (MDRO) screening and isolation continues to evolve, with mixed evidence and reconsideration of prior practices. Enhanced environmental cleaning and no-touch disinfection technologies hold potential but lack consistent outcome data. Several long-standing practices, including the neutropenic diet, are increasingly being re-evaluated.Summary: IPC in immunocompromised patients is complex and multifaceted, with limited high-quality evidence guiding practice resulting in significant practice variability. A shift toward individualized, risk-adapted strategies - balancing risk mitigation, resource utilization, and patient-centered care - will ultimately optimize outcomes.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"359-367"},"PeriodicalIF":4.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257571","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

Prevention is all you need: generative artificial intelligence for infection prevention and healthcare epidemiology. 预防就是你所需要的：用于感染预防和保健流行病学的生成式人工智能。

IF 4.5 3区医学

Current Opinion in Infectious Diseases Pub Date : 2026-08-01 Epub Date: 2026-06-10 DOI: 10.1097/QCO.0000000000001215

Guillermo Rodriguez-Nava, Jorge L Salinas

{"title":"Prevention is all you need: generative artificial intelligence for infection prevention and healthcare epidemiology.","authors":"Guillermo Rodriguez-Nava, Jorge L Salinas","doi":"10.1097/QCO.0000000000001215","DOIUrl":"10.1097/QCO.0000000000001215","url":null,"abstract":"Purpose of review: Generative artificial intelligence, particularly large language models, has emerged as a promising tool for processing the vast amounts of unstructured clinical data generated in healthcare. Infection prevention and control relies heavily on manual review of clinical text for surveillance, reporting, and risk assessment, making it a natural application area. We examine the current evidence for these technologies in infection prevention workflows.Recent findings: Large language models have been evaluated for healthcare-associated infection surveillance, including central line-associated bloodstream infections, surgical site infections, and catheter-associated urinary tract infections, with pooled sensitivities exceeding 90% across studies. These tools have also been applied to diagnostic stewardship, risk assessment for multidrug-resistant organism exposure, public health surveillance for avian influenza, and central line necessity auditing. Across applications, models performed best when used to augment rather than replace expert review. Common limitations included reduced specificity, sensitivity to prompt framing, and dependence on the completeness of clinical data provided to the model.Summary: Generative artificial intelligence applications show the greatest promise when aligned with their core capability: natural language processing of unstructured clinical text. While current evidence supports their use as screening and decision-support tools with human oversight, further validation across diverse settings and integration within electronic health records are needed before widespread adoption.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"350-358"},"PeriodicalIF":4.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257595","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

Epidemiology, treatment and outcomes of antimicrobial-resistant infections in hematopoietic stem cell transplant recipients. 造血干细胞移植受者抗菌素耐药感染的流行病学、治疗和结局。

IF 4.5 3区医学

Current Opinion in Infectious Diseases Pub Date : 2026-08-01 Epub Date: 2026-06-18 DOI: 10.1097/QCO.0000000000001206

Estela Carvalho de Sousa, Monica Melchio, Malgorzata Mikulska

{"title":"Epidemiology, treatment and outcomes of antimicrobial-resistant infections in hematopoietic stem cell transplant recipients.","authors":"Estela Carvalho de Sousa, Monica Melchio, Malgorzata Mikulska","doi":"10.1097/QCO.0000000000001206","DOIUrl":"10.1097/QCO.0000000000001206","url":null,"abstract":"Purpose of review: To provide an overview of the current epidemiology of resistant bacterial infections in hematopoietic cell transplant (HCT) recipients, evaluate recent outcome data, and discuss available treatment strategies in this population.Recent findings: Recent studies report an increasing incidence of infections caused by multidrug-resistant bacteria among HCT recipients, with marked geographical variability and a significant impact on morbidity and mortality. Several novel agents, including new β-lactam/β-lactamase inhibitors and cefiderocol, have expanded treatment options for resistant Gram-negative infections. However, most evidence supporting their efficacy derives from studies conducted in the general population, as immunocompromised and HCT patients are frequently underrepresented in clinical trials.Summary: In recent years, growing real-world and observational data have become available specifically in immunocompromised patients, supporting treatment approaches largely consistent with those recommended for the general population, while highlighting important clinical considerations, such as empirical therapy in patients at risk for resistant infections. Ceftolozane-tazobactam is a preferred option for difficult-to-treat Pseudomonas aeruginosa , with combination therapy reserved for selected severe cases. Cefiderocol should be considered in specific scenarios, particularly infections caused by susceptible metallo-β-lactamase-producing organisms. For resistant Gram-positive infections, optimized daptomycin dosing is recommended. Antimicrobial stewardship strategies, including de-escalation and shorter treatment courses for Gram-negative bloodstream infections, are essential to preserve the efficacy of novel agents.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"316-326"},"PeriodicalIF":4.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148263448","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