Current Opinion in Infectious Diseases最新文献_第9页

How to treat severe Acinetobacter baumannii infections. 如何治疗严重的鲍曼不动杆菌感染。

IF 3.9 3区医学

Current Opinion in Infectious Diseases Pub Date : 2023-12-01 Epub Date: 2023-09-26 DOI: 10.1097/QCO.0000000000000974

Emilio Bouza, Patricia Muñoz, Almudena Burillo

{"title":"How to treat severe Acinetobacter baumannii infections.","authors":"Emilio Bouza, Patricia Muñoz, Almudena Burillo","doi":"10.1097/QCO.0000000000000974","DOIUrl":"10.1097/QCO.0000000000000974","url":null,"abstract":"Purpose of review: To update the management of severe Acinetobacter baumannii infections (ABI), particularly those caused by multi-resistant isolates.Recent findings: The in vitro activity of the various antimicrobial agents potentially helpful in treating ABI is highly variable and has progressively decreased for many of them, limiting current therapeutic options. The combination of more than one drug is still advisable in most circumstances. Ideally, two active first-line drugs should be used. Alternatively, a first-line and a second-line drug and, if this is not possible, two or more second-line drugs in combination. The emergence of new agents such as Cefiderocol, the combination of Sulbactam and Durlobactam, and the new Tetracyclines offer therapeutic options that need to be supported by clinical evidence.Summary: The apparent limitations in treating infections caused by this bacterium, the rapid development of resistance, and the serious underlying situation in most cases invite the search for alternatives to antibiotic treatment, the most promising of which seems to be bacteriophage therapy.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71479192","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

Endemic mycoses - are we making progress in management? 地方性真菌病——我们在管理方面取得了进展吗？

IF 3.9 3区医学

Current Opinion in Infectious Diseases Pub Date : 2023-12-01 Epub Date: 2023-09-26 DOI: 10.1097/QCO.0000000000000971

Nathan C Bahr, George R Thompson

{"title":"Endemic mycoses - are we making progress in management?","authors":"Nathan C Bahr, George R Thompson","doi":"10.1097/QCO.0000000000000971","DOIUrl":"10.1097/QCO.0000000000000971","url":null,"abstract":"Purpose of review: The endemic fungi are a significant cause of morbidity and mortality in effected patients. The range of endemicity for these are expanding with infections observed outside of traditional locations. Enhanced diagnostic and treatment practices may significantly alter patient outcomes.Recent findings: Recently completed clinical trials have focused on an assessment of improving efficacy while minimizing patient toxicity. Practice changing trials have been completed in histoplasmosis showing the utility of a single up-front liposomal amphotericin B dose followed by standard itraconazole dosing. The recent evaluation of several antifungal options including isauvconazole in the treatment of coccidioidomycosis also show promise for additional therapeutic agents. A recently conducted trial has also shown the superiority of amphotericin B therapy over itraconazole in the treatment of talaromycosis.Summary: The increased range of endemic mycoses coupled with the growing immunocompromised patient population mandates continued investigation of improved diagnostic and therapeutic options. Advances in these areas have led to more rapid diagnosis and more efficacious antifungal therapy.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10840811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41114373","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

Antibiotic therapy for nonfermenting Gram-negative bacilli infections: future perspectives. 非发酵性革兰氏阴性杆菌感染的抗生素治疗：未来展望。

IF 3.9 3区医学

Current Opinion in Infectious Diseases Pub Date : 2023-12-01 Epub Date: 2023-10-16 DOI: 10.1097/QCO.0000000000000984

Matteo Bassetti, Nadia Castaldo, Alberto Fantin, Daniele Roberto Giacobbe, Antonio Vena

{"title":"Antibiotic therapy for nonfermenting Gram-negative bacilli infections: future perspectives.","authors":"Matteo Bassetti, Nadia Castaldo, Alberto Fantin, Daniele Roberto Giacobbe, Antonio Vena","doi":"10.1097/QCO.0000000000000984","DOIUrl":"10.1097/QCO.0000000000000984","url":null,"abstract":"Purpose of review: Serious infections caused by nonfermenting Gram-negative bacteria (NF-GNB) pose a significant challenge for clinicians due to the limited treatment options available, which are frequently associated with issues of toxicity and unfavourable pharmacokinetic profiles. The aim of this review is to provide a brief overview of the existing data concerning the ongoing development of antiinfective agents targeting NF-GNB.Recent findings: Several agents exhibiting efficacy against NF-GNB are under clinical investigation. Durlobactam-sulbactam and cefepime-taniborbactam emerge as promising therapeutic avenues against carbapenem-resistant Acinetobacter baumanii . Cefepime-zidebactam may serve as a suitable treatment option for urinary tract infections caused by a wide range of NF-GNB. Cefepime-enmetazobactam demonstrates potent in vitro activity against various NF-GNB strains; however, its role as an anti- Pseudomonal agent is inadequately substantiated by available data. Xeruborbactam is a wide β-lactamase inhibitor that can be associated with a range of agents, enhancing in-vitro activity of these against many NF-GNB, including those resistant to newer, broader spectrum options. Lastly, murepavadin appears to be a potential pathogen-specific solution for severe Pseudomonas infections; however, additional investigation is necessary to establish the safety profile of this compound.Summary: Each of the novel molecules reviewed possesses an interesting range of in-vitro activity against NF-GNB. In addition, some of them have already been proved effective in vivo, underscoring their potential as future treatment options.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41233102","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

CMV antiviral stewardship in transplantation - the next frontier. 移植中的巨细胞病毒抗病毒管理——下一个前沿。

IF 3.9 3区医学

Current Opinion in Infectious Diseases Pub Date : 2023-12-01 Epub Date: 2023-11-02 DOI: 10.1097/QCO.0000000000000978

Michelle K Yong

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 : 2023-12-01 Epub Date: 2023-11-02 DOI: 10.1097/QCO.0000000000000980

引用次数: 0

Duration of antifungal treatment in mold infection: when is enough? 霉菌感染的抗真菌治疗持续时间：什么时候足够？

IF 3.9 3区医学

Current Opinion in Infectious Diseases Pub Date : 2023-12-01 Epub Date: 2023-09-19 DOI: 10.1097/QCO.0000000000000972

Vera Portillo, Dionysios Neofytos

{"title":"Duration of antifungal treatment in mold infection: when is enough?","authors":"Vera Portillo, Dionysios Neofytos","doi":"10.1097/QCO.0000000000000972","DOIUrl":"10.1097/QCO.0000000000000972","url":null,"abstract":"Purpose of review: Although invasive mold infections (IMI) are a major complication in high-risk populations, treatment duration has not yet been well defined.Recent findings: Guidelines suggest documenting clinical/radiological resolution and immunological recovery before stopping antifungal treatment, after a minimum duration of treatment of 3 months for invasive pulmonary aspergillosis, while longer (up to 6 months) duration is proposed for the treatment of invasive mucormycosis. However, data on and definitions of clinical/radiological resolution and immune recovery remain scarce. Limited real-life data suggest that often much longer courses of treatment are given, generally in the context of continuous immunosuppression, occasionally defined as secondary prophylaxis. However, clearcut definition and distinction of secondary prophylaxis from antifungal treatment remain to be defined.Summary: Decisions to stop antifungal treatment are based on poorly defined treatment responses and immune reconstitution and experts' opinions. More evidence is needed to determine the optimal duration of treatment of IMI. Well designed, easy to use, and realistic algorithms to help clinicians decide when to stop antifungal treatment are urgently needed.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41113593","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

Emerging infections in vulnerable hosts: Stenotrophomonas maltophilia and Elizabethkingia anophelis. 脆弱宿主的新发感染:嗜麦芽窄养单胞菌和按蚊伊丽莎白。

IF 3.9 3区医学

Current Opinion in Infectious Diseases Pub Date : 2023-12-01 Epub Date: 2023-08-02 DOI: 10.1097/QCO.0000000000000953

Yu-Lin Lee, Po-Ren Hsueh

{"title":"Emerging infections in vulnerable hosts: Stenotrophomonas maltophilia and Elizabethkingia anophelis.","authors":"Yu-Lin Lee, Po-Ren Hsueh","doi":"10.1097/QCO.0000000000000953","DOIUrl":"10.1097/QCO.0000000000000953","url":null,"abstract":"Purpose of review: This systematic review aimed to explore the recent trends in the epidemiology, risk factors, and antimicrobial susceptibility of two emerging opportunistic pathogens, Stenotrophomonas maltophilia and Elizabethkingia anophelis .Recent findings: Since 2020, numerous outbreaks of S. maltophilia and E. anophelis have been reported worldwide. Most of these outbreaks have been associated with healthcare facilities, although one outbreak caused by E. anophelis in France was considered a community-associated infection. In terms of antimicrobial susceptibility, trimethoprim/sulfamethoxazole (TMP-SMZ), levofloxacin, and minocycline have exhibited good efficacy against S. maltophilia . Additionally, cefiderocol and a combination of aztreonam and avibactam have shown promising results in in vitro susceptibility testing. For E. anophelis , there is currently no consensus on the optimal treatment. Although some studies have reported good efficacy with rifampin, TMP-SMZ, piperacillin/tazobactam, and cefoperazone/sulbactam, minocycline had the most favourable in vitro susceptibility rates. Cefiderocol may serve as an alternative due to its low minimum inhibitory concentration (MIC) against E. anophelis . The role of vancomycin in treatment is still uncertain, although several successful cases with vancomycin treatment, even with high MIC values, have been reported.Summary: Immunocompromised patients are particularly vulnerable to infections caused by S. maltophilia and E. anophelis , but the optimal treatment strategy remains inconclusive. Further research is necessary to determine the most effective use of conventional and novel antimicrobial agents in combatting these multidrug-resistant pathogens.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9943949","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 microbiology and pathogenesis of nonfermenting Gram-negative infections. 非发酵性革兰氏阴性感染的微生物学和发病机制。

IF 3.9 3区医学

Current Opinion in Infectious Diseases Pub Date : 2023-12-01 Epub Date: 2023-09-21 DOI: 10.1097/QCO.0000000000000969

Vincenzo Di Pilato, Edward Willison, Anna Marchese

{"title":"The microbiology and pathogenesis of nonfermenting Gram-negative infections.","authors":"Vincenzo Di Pilato, Edward Willison, Anna Marchese","doi":"10.1097/QCO.0000000000000969","DOIUrl":"10.1097/QCO.0000000000000969","url":null,"abstract":"Purpose of review: This review provides an overview of most recent evidence about pathogenesis traits and virulence factors contributing to successful colonization or infection by P. aeruginosa , A. baumannii , S. maltophilia and B. cepacia complex, among the most clinically relevant nonfermenting Gram-negative bacteria (NFGNB).Recent findings: The growing clinical importance of NFGNB as important opportunistic pathogens causing difficult-to-treat infections in a fragile patients' population in stressed by numerous studies. Identification of novel virulence factors and deciphering of their mechanisms of action have greatly furthered our understanding of NFGNB pathogenesis, revealing that each pathogen-specific armamentarium of virulence factors (adhesins, motility, capsule, biofilm, lipopolysaccharide, exotoxins, exoenzymes, secretion systems, siderophores) can be likely responsible for the difference in the pathophysiology even in the context of a similar infection site. Emerging evidence of the immunomodulatory effect of some virulence factors is also acknowledged.Summary: NFGNB continue to be a serious global problem as cause of life-threatening opportunistic infections, owing to a highly heterogeneous content of virulence factors and their extensive number of intrinsic resistance mechanisms. Further efforts in development of novel effective antimicrobials and of alternative strategies targeting key virulence factors are warranted.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10624403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41095343","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 next frontier: cytomegalovirus antiviral stewardship programs in solid organ transplant. 下一个前沿领域：实体器官移植中的巨细胞病毒抗病毒管理项目。

IF 3.9 3区医学

Current Opinion in Infectious Diseases Pub Date : 2023-12-01 Epub Date: 2023-10-10 DOI: 10.1097/QCO.0000000000000963

Hanna L Kleiboeker, Christopher M Saddler, Margaret R Jorgenson

{"title":"The next frontier: cytomegalovirus antiviral stewardship programs in solid organ transplant.","authors":"Hanna L Kleiboeker, Christopher M Saddler, Margaret R Jorgenson","doi":"10.1097/QCO.0000000000000963","DOIUrl":"10.1097/QCO.0000000000000963","url":null,"abstract":"Purpose of review: Cytomegalovirus (CMV) is a driver of negative patient and allograft outcomes after solid organ transplantation (SOT) and new tools are needed to circumvent these outcomes. We will review key elements of CMV antiviral stewardship in SOT, discuss the available evidence for CMV antiviral stewardship programs and feature areas for expansion in the current landscape of CMV management.Recent findings: CMV remains a common complication after SOT. While consensus guidelines provide recommendations for the prevention and treatment of CMV, a one-size-fits-all approach is not necessarily appropriate for all unique patients and posttransplant courses, types of SOT recipients and transplant centers. Additionally, consensus guidelines have not been updated since the approval of two new antiviral therapies for the treatment of CMV after SOT or emerging evidence for the incorporation of immune functional assays into clinical practice.From the models provided in recent literature, CMV antiviral stewardship programs have demonstrated efficacy by increasing successful treatment of viremia, optimizing and reducing unnecessary use of (val)ganciclovir for both prophylaxis and treatment, and preventing development of ganciclovir-resistant CMV infections. These models highlight the multidisciplinary approach required of CMV antiviral stewardship programs to provide standardization of management, including incorporation of new therapies and diagnostic tools.Summary: CMV antiviral stewardship programs represent a promising avenue to considerably improve the management of CMV after SOT. Future studies are needed to evaluate a potential positive impact on graft outcomes and patient survival.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41182274","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: 1

Current viewpoint on the epidemiology of nonfermenting Gram-negative bacterial strains. 非发酵性革兰氏阴性菌的流行病学现状。

IF 3.9 3区医学

Current Opinion in Infectious Diseases Pub Date : 2023-12-01 Epub Date: 2023-09-26 DOI: 10.1097/QCO.0000000000000977

Despoina Koulenti, Kalwaje Eswhara Vandana, Jordi Rello

{"title":"Current viewpoint on the epidemiology of nonfermenting Gram-negative bacterial strains.","authors":"Despoina Koulenti, Kalwaje Eswhara Vandana, Jordi Rello","doi":"10.1097/QCO.0000000000000977","DOIUrl":"https://doi.org/10.1097/QCO.0000000000000977","url":null,"abstract":"Purpose of review: This article aims to review the epidemiology of nonfermenting Gram-negative bacilli (NFGNB) based on recent literature reports, particularly, of the less common, but with emerging clinical significance species.Recent findings: The reported frequency of multidrug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa is increasing, with very significant variability, however, between different countries. Apart from the major NFGNB, that is, A. baumannii and P. aeruginosa, already recognized as of critical importance healthcare risks, several other NFGNB genera have been increasingly associated with diverse severe infections, such as Stenotrophomonas maltophilia, Burkholderia spp., Elizabethkingia spp., Chryseobacterium spp., Achromobacter spp., Alcaligenes spp., Sphingomonas spp., Shewanella spp. and Ralstonia spp., among others.Summary: The exploration of the epidemiology, as well as the pathogenic potential of the of the less frequent, but emerging and increasingly reported NFGNB, is crucial, not only for immunocompromised patients, but also for critically ill patients without overt immunosuppression. As we are heading fast towards a postantibiotic era, such information would contribute to the optimal antimicrobial management, that is, providing prompt, appropriate antimicrobial coverage when needed and, at the same time, avoiding overuse and/or inappropriate use of antimicrobial therapy. Also, it would help to better understand their transmission dynamics and to develop effective prevention strategies.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71479189","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