Current opinion in infectious diseases
-
Curr. Opin. Infect. Dis. · Feb 2010
ReviewManagement of catheter-associated urinary tract infection.
The aim of this article is to review recent publications concerning the management of catheter-associated urinary tract infection (CAUTI), including the issues of diagnosis and prevention. Articles reviewed include the various guidelines concerning CAUTI released recently by multiple organizations. ⋯ Interpretation of many studies of CAUTI is impeded by the failure to distinguish between symptomatic CAUTI and asymptomatic bacteriuria in the study outcomes. This distinction currently relies on clinical symptoms and is not easily made, even with the help of various guidelines. Many aspects of the management of CAUTI merit further study, and the current interest in CAUTI is likely to lead to exciting advances in this field.
-
Curr. Opin. Infect. Dis. · Feb 2010
ReviewSexual risk behaviour of men who have sex with men: emerging patterns and new challenges.
Antiretroviral treatment means that an increasing number of men who have sex with men (MSM) are living with HIV. The present review focuses on continuing transmission of HIV, risk factors for HIV infection in HIV-negative MSM, risk behaviour and risk reduction interventions among HIV-positive MSM, sexually transmitted infections, HIV and ageing and new and emerging populations of MSM communities. ⋯ Strategies other than exclusive condom use have emerged in communities of MSM to reduce the risk of HIV transmission, including serosorting and strategic positioning. 'Combination prevention' - using social structural, behavioural and biomedical approaches in tandem - could reduce the risk of HIV transmission, and may be particularly suited to HIV-positive MSM.
-
This review provides an overview of progress of the development of group A streptococcal (GAS) vaccines with a focus on recent advances. ⋯ Several vaccine candidates against GAS infection are in varying stages of preclinical and clinical development. Although there is great hope that one of these vaccine candidates will reach licensure in the next decade, only one, the multivalent N-terminal vaccine, has entered clinical trials in the last 30 years. Although strong advocacy for GAS vaccine development is important, there remains an urgent need to institute available public health control measures against GAS diseases globally, particularly in developing countries.
-
Colistin is a 50-year-old antibiotic that is being used increasingly as a 'last-line' therapy to treat infections caused by multidrug-resistant Gram-negative bacteria, when essentially no other options are available. Despite its age, or because of its age, there has been a dearth of knowledge on its pharmacological and microbiological properties. This review focuses on recent studies aimed at optimizing the clinical use of this old antibiotic. ⋯ Because few, if any, new antibiotics with activity against multidrug-resistant Gram-negative bacteria will be available within the next several years, it is essential that colistin is used in ways that maximize its antibacterial efficacy and minimize toxicity and development of resistance. Recent developments have improved use of colistin in the 21st century.