Current Opinion in Infectious Diseases最新文献_第7页

Current challenges in acute bacterial skin infection management. 急性细菌性皮肤感染管理目前面临的挑战。

IF 3.9 3区医学

Current Opinion in Infectious Diseases Pub Date : 2024-04-01 Epub Date: 2024-01-03 DOI: 10.1097/QCO.0000000000000989

Almudena Burillo, Ana Pulido-Pérez, Emilio Bouza

{"title":"Current challenges in acute bacterial skin infection management.","authors":"Almudena Burillo, Ana Pulido-Pérez, Emilio Bouza","doi":"10.1097/QCO.0000000000000989","DOIUrl":"10.1097/QCO.0000000000000989","url":null,"abstract":"Purpose of review: There are aspects of skin and soft tissue infections (SSTIs) that remain unresolved, such as current numbers, classification criteria, how best to define severity and predict the outcome, what diagnostic tests to perform, what new treatment options are available, or what the duration of antibiotic treatment should be. We have reviewed the literature over the last 18 months to clarify these issues and provide our opinion.Recent findings: SSTIs are common and among the top 10 most frequent infections worldwide. They represent a burden on the healthcare system and have a major impact on the quality of life of patients. Regarding classification, the Infectious Diseases Society of America (IDSA) provides a practical guide that distinguishes between uncomplicated and complicated infections, acute and chronic wound infections, and necrotising and nonnecrotizing infections based on skin extension and tissue necrosis. With new microbiological and imaging diagnostic techniques, SSTIs can now be better diagnosed. New PCR techniques are available, and mass spectrometry can be applied to samples collected in liquid transport media. Moreover, new treatment methods such as photodynamic therapy, reactive oxygen, and phages are emerging. SSTI patients can be treated with shorter antibiotic courses if they receive an active drug with good tissue penetration. Antibiotic treatment in necrotizing infections can be shortened to 48 h after the last debridement.Summary: SSTIs remain a challenge regarding rapid and accurate diagnosis and clinical management.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"71-79"},"PeriodicalIF":3.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139097459","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

Pneumocystis jirovecii in solid organ transplant recipients: updates in epidemiology, diagnosis, treatment, and prevention. 实体器官移植受者中的肺孢子虫：流行病学、诊断、治疗和预防方面的最新进展。

IF 3.9 3区医学

Current Opinion in Infectious Diseases Pub Date : 2024-04-01 Epub Date: 2024-01-17 DOI: 10.1097/QCO.0000000000001002

Tirajeh Saadatzadeh, Michael Angarone, Valentina Stosor

{"title":"Pneumocystis jirovecii in solid organ transplant recipients: updates in epidemiology, diagnosis, treatment, and prevention.","authors":"Tirajeh Saadatzadeh, Michael Angarone, Valentina Stosor","doi":"10.1097/QCO.0000000000001002","DOIUrl":"10.1097/QCO.0000000000001002","url":null,"abstract":"Purpose of review: This review highlights the epidemiology of Pneumocystis jirovecii pneumonia in solid organ transplant recipients, advancements in the diagnostic landscape, and updates in treatment and prevention.Recent findings: The increasing use of immune-depleting agents in the context of solid organ transplantation has given rise to P. jirovecii pneumonia in this population. The use of prophylaxis has dramatically reduced risk of infection; however, late-onset infections occur after cessation of prophylaxis and in the setting of lymphopenia, advancing patient age, acute allograft rejection, and cytomegalovirus infection. Diagnosis requires respiratory specimens, with PCR detection of Pneumocystis replacing traditional staining methods. Quantitative PCR may be a useful adjunct to differentiate between infection and colonization. Metagenomic next-generation sequencing is gaining attention as a noninvasive diagnostic tool. Trimethoprim-sulfamethoxazole remains the drug of choice for treatment and prevention of Pneumocystis pneumonia. Novel antifungal agents are under investigation.Summary: P. jirovecii is a fungal opportunistic pathogen that remains a cause of significant morbidity and mortality in solid organ transplant recipients. Early detection and timely treatment remain the pillars of management.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"121-128"},"PeriodicalIF":3.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139477252","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

Current treatment options for pneumonia caused by carbapenem-resistant Acinetobacter baumannii. 耐碳青霉烯类鲍曼不动杆菌引起的肺炎的现有治疗方案。

IF 3.9 3区医学

Current Opinion in Infectious Diseases Pub Date : 2024-04-01 Epub Date: 2024-01-03 DOI: 10.1097/QCO.0000000000001001

John P Franzone, Natalie A Mackow, David van Duin

{"title":"Current treatment options for pneumonia caused by carbapenem-resistant Acinetobacter baumannii.","authors":"John P Franzone, Natalie A Mackow, David van Duin","doi":"10.1097/QCO.0000000000001001","DOIUrl":"10.1097/QCO.0000000000001001","url":null,"abstract":"Purpose of review: The purpose of this review is to briefly summarize the challenges associated with the treatment of pneumonia caused by carbapenem-resistant Acinetobacter baumannii (CRAB), discuss its carbapenem-resistance, and review the literature supporting the current treatment paradigm and therapeutic options.Recent findings: In a multicenter, randomized, and controlled trial the novel β-lactam-β-lactamase inhibitor sulbactam-durlobactam was compared to colistin, both in addition to imipenem-cilastatin. The drug met the prespecified criteria for noninferiority for 28-day all-cause mortality while demonstrating higher clinical cure rates in the treatment of CRAB pneumonia. In an international, randomized, double-blind, placebo controlled trial colistin monotherapy was compared to colistin combined with meropenem. In this trial, combination therapy was not superior to monotherapy in the treatment of drug-resistant gram-negative organisms including CRAB pneumonia.Summary: CRAB pneumonia is a preeminent public health threat without an agreed upon first line treatment strategy. Historically, there have been drawbacks to available treatment modalities without a clear consensus on the first-line treatment regimen. CRAB pneumonia is a top priority for the continued development of antimicrobials, adjuvant therapies and refinement of current treatment strategies.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"137-143"},"PeriodicalIF":3.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10922681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139097460","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

Skin and soft tissue infections in solid organ transplants. 实体器官移植中的皮肤和软组织感染。

IF 3.9 3区医学

Current Opinion in Infectious Diseases Pub Date : 2024-04-01 Epub Date: 2023-12-04 DOI: 10.1097/QCO.0000000000000998

Maddalena Peghin, Elena Graziano, Paolo Antonio Grossi

引用次数: 0

Epidemiology of community-acquired pneumonia caused by S treptococcus pneumoniae in older adults: a narrative review. 老年人由肺炎链球菌引起的社区获得性肺炎流行病学：叙述性综述。

IF 3.9 3区医学

Current Opinion in Infectious Diseases Pub Date : 2024-04-01 Epub Date: 2024-02-05 DOI: 10.1097/QCO.0000000000001005

Christelle Elias, Marta C Nunes, Mitra Saadatian-Elahi

{"title":"Epidemiology of community-acquired pneumonia caused by S treptococcus pneumoniae in older adults: a narrative review.","authors":"Christelle Elias, Marta C Nunes, Mitra Saadatian-Elahi","doi":"10.1097/QCO.0000000000001005","DOIUrl":"10.1097/QCO.0000000000001005","url":null,"abstract":"Purpose of review: This review covers updated perspectives on different aspects of pneumococcal community-acquired pneumonia (pCAP), including the epidemiology, clinical presentation, risk factors, antibiotic treatment, and existing preventive strategies in older adults.Recent findings: pCAP remains the most prevalent condition among lower respiratory tract infections in the older adults according to Global Burden of Diseases 2019. Older adults can display atypical symptoms such as confusion, general clinical deterioration, new onset of and exacerbation of underlying illness that might trigger clinical suspicion of pCAP. Older adults with pCAP often experience increased disease severity and a higher risk of pulmonary complications compared with younger individuals, owing to age-related changes in immunity and a higher prevalence of comorbidities. Vaccination stands fundamental for prevention, emphasizing the need for effective immunization strategies, specifically tailored for older adults. There is a pressing need to reinforce efforts aimed at boosting pneumococcal vaccination rates.Summary: Despite a high morbidity and mortality, the burden of pCAP, in particular hospital admission and occurrence of invasive infections, among the elderly population is not sufficiently documented. This review findings emphasize the substantial burden of pCAP in this vulnerable population, driven by factors such as advancing age and underlying comorbidities. The emergence of antibiotic-resistant pneumococcal strains further complicates treatment decisions and highlights the importance of tailored approaches for managing pCAP in older adults.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"144-153"},"PeriodicalIF":3.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139697114","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

Necrotizing fasciitis: an update on epidemiology, diagnostic methods, and treatment. 坏死性筋膜炎:流行病学、诊断方法和治疗的最新进展。

IF 3.9 3区医学

Current Opinion in Infectious Diseases Pub Date : 2024-04-01 Epub Date: 2023-11-30 DOI: 10.1097/QCO.0000000000000988

Fatima Allaw, Saliba Wehbe, Souha S Kanj

{"title":"Necrotizing fasciitis: an update on epidemiology, diagnostic methods, and treatment.","authors":"Fatima Allaw, Saliba Wehbe, Souha S Kanj","doi":"10.1097/QCO.0000000000000988","DOIUrl":"10.1097/QCO.0000000000000988","url":null,"abstract":"Purpose of review: The aim of this review is to discuss the latest evidence of epidemiology, diagnostic methods, and treatment of necrotizing soft tissue infections (NSTIs) with a particular focus on necrotizing fasciitis (NF).Recent findings: NSTIs have been historically referred to as NF but encompass a broader range of infections, with variable rates ranging from 0.86 to 32.64 per 100 000 person-years, influenced by factors such as climate and seasonal variations. They have diverse microbiological profiles categorized into different types based on the involved pathogens, including polymicrobial or monomicrobial infections caused by organisms such as group A streptococcus (GAS), Staphylococcus aureus , some Gram-negative pathogens, and filamentous fungi following trauma and natural disasters. Diagnosis relies on clinical symptoms and signs, laboratory markers, and imaging. However, the gold standard for diagnosis remains intraoperative tissue culture. Treatment involves repeated surgical debridement of necrotic tissues in addition to intravenous antibiotics. Adjuvant therapies with intravenous immunoglobulin (IVIG) and hyperbaric oxygen therapy (HBOT) might have a role. Soft tissue reconstruction may be necessary following surgery.Summary: Prompt diagnosis and proper medical and surgical management of NSTI will improve outcomes.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"105-111"},"PeriodicalIF":3.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138458470","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 disease burden of respiratory syncytial virus in older adults. 老年人呼吸道合胞病毒的疾病负担。

IF 3.6 3区医学

Current Opinion in Infectious Diseases Pub Date : 2024-04-01 Epub Date: 2024-01-10 DOI: 10.1097/QCO.0000000000001000

Sebastien Kenmoe, Harish Nair

{"title":"The disease burden of respiratory syncytial virus in older adults.","authors":"Sebastien Kenmoe, Harish Nair","doi":"10.1097/QCO.0000000000001000","DOIUrl":"10.1097/QCO.0000000000001000","url":null,"abstract":"Purpose of review: To highlight the respiratory syncytial virus (RSV) disease burden and the current developments and challenges in RSV prevention for older adults ≥60 years through analysis of RSV epidemiology and the effectiveness of emerging vaccines.Recent findings: In industrialized countries, RSV incidence rates and hospitalization rates among older adults are estimated to be 600.7 cases per 100 000 person-years and 157 hospitalizations per 100 000 person-years, respectively. Yet, accurately determining RSV morbidity and mortality in older adults is challenging, thus resulting in substantially under-estimating the disease burden. The in-hospital fatality rates vary substantially with age and geographies, and can be as high as 9.1% in developing countries. Two promising RSV vaccines for the elderly have been approved, demonstrating efficacies of up to 94.1%, signifying considerable advancement in RSV prevention. However, concerns over potential side effects remain.Summary: RSV is associated with a significant burden in older adults. While the landscape of RSV prevention in older adults is promising with the licensure of vaccines from two companies, current trial data underscore the need for additional studies. Addressing the real-world effectiveness of these vaccines, understanding potential rare side effects, and ensuring broad inclusivity in future trials are crucial steps to maximize their potential benefits.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"129-136"},"PeriodicalIF":3.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10911257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139402231","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

The microbiome as a biomarker of anal precancerous lesions in people with HIV. 微生物组作为HIV感染者肛门癌前病变的生物标志物。

IF 3.9 3区医学

Current Opinion in Infectious Diseases Pub Date : 2024-02-01 Epub Date: 2023-10-27 DOI: 10.1097/QCO.0000000000000985

Raquel Ron, Elena Moreno, Marta Rosas Cancio-Suárez, Sergio Serrano-Villar

引用次数: 0

Editorial introductions. 编辑介绍。

IF 3.9 3区医学

Current Opinion in Infectious Diseases Pub Date : 2024-02-01 Epub Date: 2023-12-20 DOI: 10.1097/QCO.0000000000000996

引用次数: 0

Infant feeding: emerging concepts to prevent HIV transmission. 婴儿喂养：预防艾滋病毒传播的新概念。

IF 3.9 3区医学

Current Opinion in Infectious Diseases Pub Date : 2024-02-01 Epub Date: 2023-10-27 DOI: 10.1097/QCO.0000000000000986

Alasdair Bamford, Caroline Foster, Hermione Lyall

{"title":"Infant feeding: emerging concepts to prevent HIV transmission.","authors":"Alasdair Bamford, Caroline Foster, Hermione Lyall","doi":"10.1097/QCO.0000000000000986","DOIUrl":"10.1097/QCO.0000000000000986","url":null,"abstract":"Purpose of review: HIV screening in pregnancy, universal suppressive antiretroviral therapy (ART) and breastfeeding avoidance can almost completely prevent vertical transmission of HIV. Breastfeeding is associated with an additional risk of transmission, although this risk is extremely low with suppressive maternal ART. This minimal risk must be balanced with the benefits of breastfeeding for women living with HIV (WLHIV) and their infants. Guidance in high-income countries has evolved, moving towards supported breast feeding for women on suppressive ART.Recent findings: Breastmilk transmission accounts for an increasing proportion of new infant infections globally. The majority of transmission data comes from studies including women not on suppressive ART. Breastmilk transmissions in the context of undetectable viral load have rarely occurred, although risk factors remain unclear. Outcome data on supported breastfeeding are accumulating, providing evidence for guidelines and informing infant feeding decisions. Long-acting ART for maternal preexposure prophylaxis or treatment, and infant postnatal prophylaxis are promising future options.Summary: Breastfeeding on suppressive ART has a very low risk of vertical transmission and can have multiple benefits for WLHIV and their infants. However, caution is advised with relaxation of breastfeeding guidance so as not to jeopardise the global goal of elimination of vertical transmission by 2030.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"8-16"},"PeriodicalIF":3.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10734781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61561388","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