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Current Opinion in Infectious Diseases

Jae Hyun Shin, Cirle A Warren
PURPOSE OF REVIEW: Clostridioides difficile infection (CDI) is a significant burden on the health system, especially due to high recurrence rates. Since the beginning of the CDI epidemic in early 2000s, many strategies for combatting recurrence have been explored, with moderate success so far. This review will focus on the most recent developments in recurrent CDI prevention and treatment. RECENT FINDINGS: There are two main mechanisms of CDI recurrence: alteration in microbiome and poor antibody response...
July 31, 2019: Current Opinion in Infectious Diseases
Josef A Brejt, Linnie M Golightly
PURPOSE OF REVIEW: Malaria threatens the lives of over 200 million individuals with the disease each year. Plasmodium falciparum is the predominant cause of severe malaria which may be lethal and result in neurocognitive sequelae despite appropriate treatment. We review recent advances regarding the pathophysiology of severe malaria and treatment recommendations for severe disease in the United States. RECENT FINDINGS: Infected red blood cell (iRBC) sequestration in microvascular beds is a critical factor in the development of severe malaria syndromes...
July 31, 2019: Current Opinion in Infectious Diseases
Sibylle C Mellinghoff, Christina Otto, Oliver A Cornely
PURPOSE OF REVIEW: Management of SSI constitutes prevention, extensive diagnosis, and appropriate treatment as well as follow-up. All these are comprises interrelated matters. This review gives a brief update on the latest developments in the field, specifically on new antibiotics that may find a place in this complex field. RECENT FINDINGS: Avibactam and dalbavancin are novel antiinfectives. Although randomized controlled trials in SSI are lacking to date, preliminary data show that new drugs may be alternatives to existing treatment...
July 31, 2019: Current Opinion in Infectious Diseases
Philippe Colson, Claire Decoster
PURPOSE OF REVIEW: Hepatitis E virus (HEV) has gained increased global recognition in recent years, particularly in developed countries. We summarized here a selection of the literature published since the 1st of June, 2017. RECENT FINDINGS: Longitudinal studies are increasingly conducted in Europe, to determine trends in HEV prevalence. The spectrum of mammals infected with HEV and potentially capable to transmit it to humans has widened. New virological data on HEV repCon and pathogenicity have been reported and clinical features of HEV infections have been precised or newly described...
July 29, 2019: Current Opinion in Infectious Diseases
Lorne Schweitzer, Bhagteshwar Singh, Priscilla Rupali, Michael Libman
PURPOSE OF REVIEW: Traveller's diarrhea, though not life-threatening. is often a vexing problem, which impacts overall function of the traveller while on holiday. Increasing data is available regarding molecular diagnostic techniques, which may help obtain an early etiologic diagnosis. Use of antibiotics for traveller's diarrhea is controversial in this era of multidrug resistance and microbiome disruption. RECENT FINDINGS: Travel to the tropics promotes gut colonization with drug-resistant bacteria and this risk increases after treatment with antibiotics, leading to potential ecological impacts in the country of residence...
July 29, 2019: Current Opinion in Infectious Diseases
Phillip P Santoiemma, Michael G Ison, Michael P Angarone
PURPOSE OF REVIEW: This review will focus on the epidemiology and cause of diarrheal illness in solid organ transplant and stem-cell transplant population recipients with a specific focus on the role of advanced multiplex technology in the diagnosis of diarrhea within this patient population. RECENT FINDINGS: A wide range of infectious and noninfectious causes of diarrhea have been described in immunocompromised patients. The most common infections noted are Clostridioides difficile, norovirus, and cytomegalovirus, whereas immunosuppressive drugs and mucositis are the most common noninfectious causes of diarrhea...
July 26, 2019: Current Opinion in Infectious Diseases
Robert B Dorey, Anastasia A Theodosiou, Robert C Read, Christine E Jones
PURPOSE OF REVIEW: Nonpathogenic commensal Neisseria are rarely considered in the clinical setting despite evidence that they can cause invasive opportunistic infections. In contrast, they may offer protection against pathogenic Neisseria, and such relationships are being actively explored in experimental studies. RECENT FINDINGS: Recent case reports are presented of invasive infection caused by nonpathogenic Neisseria in patients on novel biologic therapies. On the other hand, Neisseria lactamica, a nonpathogenic commensal, has been shown in human challenge studies to inhibit colonization by Neisseria meningitidis...
July 26, 2019: Current Opinion in Infectious Diseases
Alasdair P S Munro, Callum J Highmore, Jeremy S Webb, Saul N Faust
PURPOSE OF REVIEW: Biofilm-associated infections cause difficulties in the management of childhood chronic infections and other diseases, due to the invasive nature of interventions which are often necessary for definitive management. Despite their importance, there are challenges in diagnosing biofilm infections and gaps in clinicians' understanding regarding the significance of biofilms. RECENT FINDINGS: Many chronic infections associated with biofilms remain difficult or impossible to eradicate with conventional therapy...
July 22, 2019: Current Opinion in Infectious Diseases
Luregn J Schlapbach
PURPOSE OF REVIEW: Sepsis remains among the leading causes of childhood mortality worldwide. This review serves to highlight key areas of knowledge gain and ongoing controversies pertinent to sepsis in children. RECENT FINDINGS: Several recent publications describe the epidemiology of paediatric sepsis, demonstrating the impact on child health in terms of mortality and morbidity, and the shortcomings of current paediatric sepsis definitions. Although emerging data support the importance of organ dysfunction as a hallmark of paediatric sepsis, the understanding of host susceptibility to sepsis and to sepsis severity remains very limited...
July 22, 2019: Current Opinion in Infectious Diseases
Leonardus G Visser
PURPOSE OF THE REVIEW: Climate change, deforestation, urbanization, and increased population mobility have made the risk of large outbreaks of yellow fever more likely than ever. Yellow fever vaccine production barely meets demands. In this review, we address the causes of the recent yellow fever outbreaks, why fractional dose yellow fever vaccination works, the role of virus neutralizing antibodies in the protection against yellow fever, and the need for revaccination. RECENT FINDINGS: Human activities have profoundly changed the epidemiology of yellow fever...
July 22, 2019: Current Opinion in Infectious Diseases
Alastair McAlpine, Manish Sadarangani
PURPOSE OF REVIEW: This review highlights the recent impacts of vaccines against the major bacterial causes of meningitis in children, and the challenges for further prevention of bacterial meningitis, with a focus on Streptococcus pneumoniae, Neisseria meningitidis and group B Streptococcus. RECENT FINDINGS: Conjugate vaccines against S. pneumoniae and N. meningitidis have resulted in dramatic reductions in bacterial meningitis globally where they have been used...
July 22, 2019: Current Opinion in Infectious Diseases
Sasirekha Ramani, Sidhartha Giri
PURPOSE OF REVIEW: Gastroenteritis results in substantial morbidity and mortality worldwide, especially in young children in low-and-middle-income settings. Rotavirus and norovirus are the leading causes of viral gastroenteritis. Although introduction of rotavirus vaccines into childhood immunization programmes has reduced disease burden, vaccine effectiveness remains low in developing countries. Norovirus is replacing rotavirus as the most common cause of diarrhea hospitalization in settings where rotavirus vaccines are highly effective...
July 22, 2019: Current Opinion in Infectious Diseases
Sapha Barkati, Momar Ndao, Michael Libman
PURPOSE OF REVIEW: Despite modern advances in molecular diagnostic tools and a better understanding of its complex pathophysiology, cutaneous leishmaniasis, a neglected tropical disease, remains a major global health problem. Laboratory methods to inform prognosis and treatment are not widely available, the therapeutic options are limited and have significant adverse effects, and emergence of drug resistance is a further complication. New advances in the understanding of the role of Leishmania RNA virus (LRV) as a prognostic factor, speciation methods and antimicrobial resistance testing and their limitations will be discussed...
July 16, 2019: Current Opinion in Infectious Diseases
Jorge A Cortés, Álvaro Roncancio, Luis Guillermo Uribe, Carlos Fernando Cortés-Luna, José G Montoya
PURPOSE OF REVIEW: To discuss available information on the effectiveness of anti-toxoplasma therapy for ocular toxoplasmosis and to provide clinicians with a practical approach to the disease. RECENT FINDINGS: Only eleven randomized studies were identified. In the three studies for acute retinitis, there was a clear trend in favor of treatment. In the two studies for the prevention of recurrences, trimethoprim-sulfamethoxazole prophylaxis was superior to placebo...
July 15, 2019: Current Opinion in Infectious Diseases
Francesca Schiaffino, James Platts-Mills, Margaret N Kosek
PURPOSE OF REVIEW: To review recent findings regarding the control and treatment of campylobacteriosis. RECENT FINDINGS: The application of improved diagnostics has led to an upward shift in the attributable burden of Campylobacter infections, in both the United States and Europe as well as in resource-poor settings. Increased focus has brought a fundamental feature of campylobacteriosis -- the ability to cause relapsing disease back into focus, and expanding data on antimicrobial resistance has lead from a switch in first-line therapy for severe diarrhea from quinolones to azithromycin in most contexts, even as evidence of expanding macrolide resistance emerges...
July 11, 2019: Current Opinion in Infectious Diseases
Amrita Pattanaik, Reeta S Mani
PURPOSE OF REVIEW: Rabies is virtually always fatal; however, it is nearly 100% preventable with timely and appropriate prophylactic immunization. This review summarizes the recently revised WHO guidelines for rabies prophylaxis published in 2018, following a scientific review by a strategic advisory group of experts on immunization. The scientific basis for the major changes and its implications for countries with high disease burden are also discussed. RECENT FINDINGS: The key changes in the updated WHO 2018 guidelines for rabies prophylaxis include abbreviated vaccination regimens for pre and postexposure prophylaxis...
July 11, 2019: Current Opinion in Infectious Diseases
Victor Chen, Johanna P Daily
PURPOSE OF REVIEW: This is a review of tafenoquine, a new antimalarial drug. Here we examine the recent literature supporting the use of tafenoquine and summarize the opportunities and challenges for its well tolerated use worldwide. RECENT FINDINGS: Tafenoquine was recently approved by the US Food and Drug Administration for the treatment of dormant liver stage (hypnozoite) in Plasmodium vivax and for malaria prophylaxis. Single-dose tafenoquine provides equivalent efficacy to 14 days of primaquine for radical cure in P...
July 11, 2019: Current Opinion in Infectious Diseases
Annelies Wilder-Smith
PURPOSE OF REVIEW: The first dengue vaccine (Dengvaxia) was endorsed by the European Medicine Agency and the US Food and Drug Administration. Given the excess risk of severe dengue in seronegative vaccinees, use is restricted to seropositive individuals. Dengvaxia confers high protection against severe dengue in seropositive vaccinees. RECENT FINDINGS: With increasing global travel, the probability of travelers being seropositive increases. Such seropositive travelers may be at increased risk of severe dengue as a result of a second dengue infection during repeat travel...
July 9, 2019: Current Opinion in Infectious Diseases
Lin H Chen, Mary E Wilson
PURPOSE OF REVIEW: Zika virus (ZIKV) swept through the Americas and led to recognition of its neurotropism. Zika circulation elsewhere in the world, nonvector transmission including maternal-fetal/sexual/transfusion routes, and additional reports on congenital Zika syndrome (CZS) and Guillain-Barré syndrome (GBS) have been published. RECENT FINDINGS: In 2018-2019, ZIKV transmission occurred in Cuba, India, and is suspected to appear sporadically in other countries...
July 9, 2019: Current Opinion in Infectious Diseases
Rachel M Burke, Jacqueline E Tate, Carl D Kirkwood, A Duncan Steele, Umesh D Parashar
PURPOSE OF REVIEW: As of 2019, four rotavirus vaccines have been prequalified by the WHO for use worldwide. This review highlights current knowledge regarding rotavirus vaccines available, and provides a brief summary of the rotavirus vaccine pipeline. RECENT FINDINGS: Data generated from use of currently available products supports their effectiveness and impact in diverse settings. Rotavirus vaccines have a favorable risk-benefit profile, but previous associations of rotavirus vaccination with intussusception necessitate continued monitoring for this rare but serious adverse event...
July 9, 2019: Current Opinion in Infectious Diseases
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