Current Opinion in Infectious Diseases最新文献

{"title":"Cutaneous manifestations associated with HIV preexposure prophylaxis: what to expect and when to worry.","authors":"Lorenzo Costacurta, Antonio Di Biagio, Lucia Taramasso","doi":"10.1097/QCO.0000000000001178","DOIUrl":"10.1097/QCO.0000000000001178","url":null,"abstract":"<p><strong>Purpose of review: </strong>Preexposure prophylaxis (PrEP) represents a cornerstone in HIV prevention, yet its broader clinical implications are less frequently explored. This review summarises current evidence on dermatological manifestations associated with PrEP use, including drug-induced reactions, sexually transmitted and contact-acquired infections, and cutaneous effects related to recreational substance use and chemsex practices.</p><p><strong>Recent findings: </strong>Antiretroviral agents approved for PrEP exhibit excellent dermatologic tolerability, with cutaneous adverse drug reactions rarely reported in clinical trials. When present, these typically manifest as mild maculopapular or urticarial rashes, though rare hypersensitivity syndromes have also been described. Doxycycline, increasingly used as postexposure prophylaxis against bacterial sexually transmitted infections, can induce photosensitivity and fixed drug eruptions. In parallel, the expansion of chemsex practices - commonly involving methamphetamine, mephedrone, and cocaine - has introduced a new spectrum of dermatological conditions, including infectious complications, traumatic lesions, vasculitic or necrotic reactions, and severe toxic-allergic responses.</p><p><strong>Summary: </strong>Cutaneous findings in PrEP users often arise from a complex interplay of pharmacologic exposure, infectious risk, and behavioural factors. Recognizing these dermatologic clues during PrEP follow-up offers an opportunity for early diagnosis, appropriate management, and targeted harm-reduction interventions in populations at a high risk for both HIV and other sexually transmitted or contact-transmitted diseases.</p>","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"128-136"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145762476","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 therapies for respiratory syncytial virus infection: current expectations.","authors":"María Alvarez de Toledo, Jeanette I Taveras, Octavio Ramilo, Asuncion Mejias","doi":"10.1097/QCO.0000000000001184","DOIUrl":"10.1097/QCO.0000000000001184","url":null,"abstract":"<p><strong>Purpose of review: </strong>Respiratory syncytial virus (RSV) remains a leading cause of bronchiolitis in infants and young children, of pneumonia in children under 5 years of age and is also associated with significant mobility and mortality in immunocompromised patients and older adults. As RSV epidemiology evolves and our preventive strategies expand, developing safe and effective antivirals have the potential to significantly change the trajectory of RSV infections in children.</p><p><strong>Recent findings: </strong>The landscape of RSV prevention has undergone substantial progress in recent years, and early reductions in burden of acute disease has already been observed among infants who have received these preventive interventions. Nonetheless, RSV continues to pose significant challenges, particularly in regions where prophylactic measures have not yet been implemented, in older children who remain vulnerable beyond their first RSV season and in special patient populations with a weakened immune system. Therapeutic options remain limited: ribavirin is currently the only approved antiviral for severe RSV-LRTI, and despite modest efficacy, its use is largely restricted to immunocompromised patients. Several antivirals with distinct mechanisms of action, have been evaluated in the past decade, but many were discontinued due to limited clinical benefits or concerns with safety. Nonetheless, three major classes of antivirals (fusion inhibitors, polymerase inhibitors and N-protein inhibitors) are now in development with promising results.</p><p><strong>Summary: </strong>This review provides an updated overview of current antivirals against RSV, highlighting the need to develop new therapeutic drugs to reduce both acute disease severity and associated long-term respiratory morbidity.</p>","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"153-159"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146060774","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":"Skin and soft tissue infections: swab or biopsy? A diagnostic dilemma.","authors":"Almudena Burillo, Emilio Bouza, Patricia Muñoz","doi":"10.1097/QCO.0000000000001185","DOIUrl":"10.1097/QCO.0000000000001185","url":null,"abstract":"<p><strong>Purpose of review: </strong>Skin and soft tissue infections (SSTIs) are frequent clinical conditions in which microbiological investigation is selectively indicated. When an etiological diagnosis is pursued, the optimal sampling method - superficial swab vs. deep tissue biopsy or aspirate - remains controversial. This review critically examines the diagnostic performance, clinical impact, and limitations of different sampling strategies in SSTIs.</p><p><strong>Recent findings: </strong>Evidence consistently shows that deep tissue biopsy or aspirate provides a higher microbiological yield and better correlation with clinical infection than superficial swabs, particularly in chronic or complex SSTIs such as diabetic foot infections and pressure ulcers. Studies including the CODIFI and CODIFI2 trials demonstrate that tissue samples identify more clinically relevant pathogens and fewer contaminants. However, this improved microbiological accuracy does not necessarily translate into better clinical outcomes or faster healing. Swab cultures remain widely used due to their simplicity and low invasiveness, but are limited by contamination and poor representation of deep infection. Emerging molecular techniques applied to swabs, including rapid PCR and 16S/18S rRNA sequencing, show high sensitivity for selected pathogens and offer faster results, although interpretation is challenging in polymicrobial or colonized wounds.</p><p><strong>Summary: </strong>Deep tissue sampling or aspirates remain the microbiological gold standard for complex SSTIs, while superficial swabs may be appropriate in selected, mild infections or when invasive procedures are not feasible. Future diagnostic strategies should integrate clinical assessment, optimized sampling techniques, and molecular diagnostics within a tiered, stewardship-oriented approach to improve accuracy while avoiding unnecessary invasiveness and antibiotic overuse.</p>","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"108-114"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146060830","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":"Tropical infectious diseases and skin manifestations: a diagnostic framework.","authors":"Gaia Cologgi, Marianna Giurco, Rebecca Donadoni, Chiara Sepulcri, Matteo Bassetti","doi":"10.1097/QCO.0000000000001183","DOIUrl":"10.1097/QCO.0000000000001183","url":null,"abstract":"<p><strong>Purpose of review: </strong>Cutaneous manifestations of tropical and subtropical infections represent a significant clinical and public health concern, affecting both populations in endemic regions and international travelers with significant socioeconomic burden and social stigma. In light of contemporary climate change, increased human mobility and urbanization, these infections have increased in incidence and gained a broader geographical distribution.Nevertheless, achieving a diagnosis remains challenging due to overlapping clinical presentations, often limited access to advanced diagnostic tools, and a lack of experience among clinicians in nonendemic regions.</p><p><strong>Recent findings: </strong>This narrative review outlines a pragmatic diagnostic flowchart based on the most common cutaneous manifestations of tropical infections, offering clinicians a practical tool to recognize lesions and to select the most appropriate investigations to support the diagnostic process.</p><p><strong>Summary: </strong>Tropical cutaneous infections still represent an expanding global challenge, and early recognition is essential to mitigate morbidity. This review seeks to enhance diagnostic confidence and improve clinical management primarily in nonendemic settings.</p>","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"97-107"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12955981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146156513","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":"Recent advances in the management of skin and soft tissue infections.","authors":"Asimina Valsamaki, Konstantinos Mantzarlis, George Dimopoulos","doi":"10.1097/QCO.0000000000001164","DOIUrl":"10.1097/QCO.0000000000001164","url":null,"abstract":"<p><strong>Purpose of review: </strong>Skin and soft tissue infections (SSTIs) are one of the most frequent infections that need management either in outpatient setting or as inpatient. The present review of the literature will present recent developments in the diagnosis and treatment of SSTIs.</p><p><strong>Recent findings: </strong>Regarding SSTIs diagnosis, point of care ultrasound (POCUS), PCR, MALDI-TOF mass spectroscopy, along with the usage of novel biomarkers, such as procalcitonin, can help in the accurate and timely diagnosis of SSTIs in a cost-effective manner. Artificial intelligence applications may be the next step in the field. In terms of treatment, the use of newly approved antibiotics, such as oritavalcin and dalbavancin, in combination with innovative methods of their delivery based on nanotechnology applications, can offer targeted and localized action, minimizing the antibiotics' microbial inhibition concentration.</p><p><strong>Summary: </strong>Even if SSTIs remain a difficult condition to treat, causing significant morbidity, mortality and economic burden on healthcare systems, ongoing scientific research is attempting to improve both diagnostic methods and treatment. More developments are expected in the near future in the areas of innovative diagnostic techniques, innovative drugs, nanotechnology applications, and antigen-based therapies.</p>","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"122-127"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145631007","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":"Managing skin infections in burn patients: principles and pitfalls.","authors":"Giusy Tiseo, Sara Occhineri, Marco Falcone","doi":"10.1097/QCO.0000000000001173","DOIUrl":"10.1097/QCO.0000000000001173","url":null,"abstract":"<p><strong>Purpose of review: </strong>Burn wound infections pose a major challenge in both critical care and surgical settings, owing to the complex interplay of host immune dysfunction, altered pharmacokinetics, surgical wound dynamics, and the high prevalence of multidrug-resistant (MDR) organisms. This review summarizes current evidence on diagnosis, antimicrobial therapy, and multidisciplinary management of burn wound infections, highlighting common pitfalls and strategies to mitigate them.</p><p><strong>Recent findings: </strong>Burn patients display a distinct microbiological profile that evolves over time: Gram-positive cocci initially predominate, whereas nonfermenting Gram-negative bacilli such as Pseudomonas aeruginosa and Acinetobacter baumannii become increasingly prevalent during hospitalization. Differentiating colonization from infection remains a major diagnostic challenge. Although tissue biopsy is the gold standard for confirming wound infection, it is not uniformly implemented across centers. Therefore, a comprehensive clinical and microbiological evaluation involving infectious disease specialists, intensivists, and surgeons is essential for accurate interpretation of wound status. Antimicrobial stewardship interventions, including pharmacokinetic/pharmacodynamic optimization, therapeutic drug monitoring, carbapenem-sparing regimens, shorter antibiotic courses, and avoidance of redundant combination therapies, are key components of burn infection management. New agents, such as β-lactam/β-lactamase inhibitor combinations and novel tetracyclines, show promise against MDR nonfermenting Gram-negative pathogens.</p><p><strong>Summary: </strong>A structured, multidisciplinary team offers the most effective framework for improving outcomes in burn wound infections. Optimizing diagnostics, individualizing antimicrobial therapy, and aligning surgical timing with infection control measures are fundamental pillars. Future research should focus on prospective validation of integrated care pathways and on evaluating the real-world effectiveness of novel antimicrobial agents in burn-injured patients.</p>","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"115-121"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12955953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145721553","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":"Antibodies to combat melioidosis: bridging immune mechanisms with diagnostics and therapeutic potential.","authors":"Prasanjit S Paul, Roos I Frölke, W Joost Wiersinga, Emma Birnie","doi":"10.1097/QCO.0000000000001174","DOIUrl":"10.1097/QCO.0000000000001174","url":null,"abstract":"<p><strong>Purpose of review: </strong>Melioidosis, caused by the Gram-negative soil bacterium Burkholderia pseudomallei , is a frequently fatal (sub)tropical infection with a substantial global burden. This review summarizes current insights into antibody-mediated immunity in melioidosis and its clinical potential.</p><p><strong>Recent findings: </strong>Antibodies against B. pseudomallei polysaccharides and protein antigens promote bacterial clearance through opsonophagocytosis and complement activation, reducing intracellular spread. People who survive melioidosis develop broader and more durable antibody repertoires than nonsurvivors. Protective antibody responses vary by antigen class and are influenced by host factors, notably diabetes, a main risk factor for melioidosis. Diagnostic serology has advanced from low-performing indirect hemagglutination to single-antigen tests and multiplex platforms. Performance, however, is specimen-dependent, limited by cross-reactivity with related Burkholderia spp., and by cost and resource constraints in endemic settings. In preclinical models of melioidosis, monoclonal antibodies against B. pseudomallei confer passive protection and are being developed for prophylaxis, adjunctive therapy, and as platforms for antibody-antibiotic conjugates or vaccine design.</p><p><strong>Summary: </strong>Antibody responses to key virulence factors correlate with disease course and are increasingly studied for diagnostic and therapeutic applications. This review aids in informing novel diagnostics and guide antibody-based therapies offering new directions for clinical management and prevention of this high-burden but underrecognized infection.</p>","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"167-175"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145762433","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":"Sexually transmitted dermatophytosis - what do we know about epidemiology, transmission, and treatment of this emerging class of STI?","authors":"Gentiane Monsel, Arnaud Jabet","doi":"10.1097/QCO.0000000000001171","DOIUrl":"10.1097/QCO.0000000000001171","url":null,"abstract":"<p><strong>Purpose of review: </strong>Sexually transmitted dermatophytosis represents an emerging and underrecognized clinical entity within the broader context of sexually transmitted infections.</p><p><strong>Recent findings: </strong>Traditionally transmitted through direct or indirect contact, certain dermatophyte species - particularly Trichophyton mentagrophytes ITS-genotype VII and Trichophyton indotineae - are increasingly implicated in infections among sexually active populations, especially men who have sex with men. These infections often present with atypical and highly inflammatory lesions, mimic common dermatoses, and pose significant diagnostic and therapeutic challenges due to frequent misidentification and sometimes antifungal resistance.</p><p><strong>Summary: </strong>This review synthesizes current data on the epidemiology, clinical features, management strategies, and public health implications of sexually transmitted dermatophytosis. As global reports rise, heightened clinical awareness is imperative for early detection, accurate diagnosis, and effective treatment.</p>","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"51-60"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145767343","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":"\"O for KP\": an evidence review on recentering HIV prevention and PrEP delivery for key populations and the underserved.","authors":"Warittha Tieosapjaroen, Cheryl C Johnson, Jason J Ong","doi":"10.1097/QCO.0000000000001169","DOIUrl":"10.1097/QCO.0000000000001169","url":null,"abstract":"<p><strong>Purpose of review: </strong>Despite the proven efficacy of preexposure prophylaxis (PrEP), global coverage remains far below targets, with the greatest gaps among key and underserved populations. This review is timely as it highlights how inequitable access undermines progress toward ending AIDS by 2030 and introduces the \"O for KP\" framework - a preferential option for key populations and the underserved . This equity-focused principle redefines program success by how well services reach and sustain those most structurally excluded.</p><p><strong>Recent findings: </strong>We synthesized evidence on persistent barriers faced by men who have sex with men, transgender people, migrants, people who inject drugs, and others disproportionately affected by HIV. Effective strategies include community-led and peer-driven approaches, integration of gender-affirming and harm reduction services, digital and self-care innovations, task-sharing, and supportive policy reforms. Methods such as human-centred design, preference research, behavioural science frameworks, and implementation science tools have been critical in tailoring and scaling interventions.</p><p><strong>Summary: </strong>Adopting an O for KP lens requires shifting beyond pilots and aggregate coverage metrics to approaches that centre the most underserved. Embedding community leadership, diversifying delivery models, and reforming restrictive policies are essential to maximize PrEP's impact and ensure progress toward global HIV prevention goals.</p>","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"22-29"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12746775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145676718","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":"Managing cognitive impairment in people with HIV: Erratum.","authors":"","doi":"10.1097/QCO.0000000000001167","DOIUrl":"https://doi.org/10.1097/QCO.0000000000001167","url":null,"abstract":"","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":"39 1","pages":"82"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145833241","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}