Abstract:
:Introduction: Among the multidrug resistant pathogens, extended-spectrum beta-lactamase (ESBL-E) or carbapenemase-producing Enterobacteriaceae (CPE) are currently considered the main threat due to the scarcity of therapeutic options and their rapid spread around the globe. In addition to developing new antibiotics and stopping transmission, recent research has focused on 'decolonization' strategies to eradicate the carriage of ESBL-E/CPE before infection occurs. Areas covered: In this narrative review, we aim to describe the current evidence of decolonization strategies for ESBL-E or CPE intestinal carriage. We first define decolonization and highlight the issues related to the lack of standardized definitions, then we summarize the available data on the natural history of colonization. Finally, we review the strategies assessed over the past 10 years for ESBL and CPE decolonization: oral antibiotics, probiotics and more recently fecal microbiota transplantation. We conclude by presenting the risks and uncertainties associated with these strategies. Expert opinion: The evidence available today is too low to recommend decolonization strategies for ESBL-E or CPE in routine clinical practice. The potential increase of resistance and the impact of microbiome manipulation should not be underestimated. Some of these decolonization strategies may nevertheless be effective, at least in temporarily suppressing colonization, which could be useful for specific populations such as high-risk patients. Effectiveness and long-term effects must be properly assessed through well-designed randomized controlled trials.
journal_name
Expert Rev Anti Infect Therjournal_title
Expert review of anti-infective therapyauthors
Catho G,Huttner BDdoi
10.1080/14787210.2019.1645007subject
Has Abstractpub_date
2019-08-01 00:00:00pages
557-569issue
8eissn
1478-7210issn
1744-8336journal_volume
17pub_type
杂志文章,评审abstract:INTRODUCTION:Drug-resistant tuberculous meningitis has been reported worldwide. Isoniazid mono-resistance is the most frequent cause of drug-resistant tuberculous meningitis, a life-threatening disease. Extensive drug-resistant tuberculous meningitis has also been reported in some isolated case reports. Areas covered: ...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1080/14787210.2018.1540930
更新日期:2018-11-01 00:00:00
abstract::The use of combination antiretroviral therapy for the prevention of mother to child transmission of HIV infection has achieved vertical HIV transmission rates of <1%. The use of these drugs is not without risk to the mother and infant. Pregnant women with HIV-infection are at high risk of preterm birth (PTB <37 weeks)...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.2014.885837
更新日期:2014-03-01 00:00:00
abstract::Reversing the spread of HIV infection and the incidence of malaria constitute two of the Millenium Development Goals. However, despite recent achievements, both diseases still entail global heath problems. Furthermore, their overlapping geographical distribution raises concerns and challenges for potential immunologic...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/eri.11.167
更新日期:2012-02-01 00:00:00
abstract::Chronic hepatitis B is a worldwide health problem. Research interests have focused on the development of potent and safe antiviral agents with low resistance rates. Among these, telbivudine is an oral nucleoside analogue with specific activity against hepatitis B virus DNA polymerase. Various prospective, randomized c...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/eri.09.6
更新日期:2009-04-01 00:00:00
abstract::Hepatitis C virus (HCV) infection spreads primarily via contact with infected blood and can establish a persistent infection in 80% of infected individuals, progressively causing chronic liver disease that can lead to hepatocellular carcinoma or end-stage liver disease requiring a transplant. There is no vaccine, and ...
journal_title:Expert review of anti-infective therapy
pub_type: 评论,杂志文章
doi:10.1586/eri.10.86
更新日期:2010-09-01 00:00:00
abstract::In susceptible patients, invasive aspergillosis has a high incidence and a mortality of up to 80%. The diagnosis of this condition is difficult, especially in the early stages of the disease and, as a consequence, antifungal therapy, despite its expense and toxicity, is often initiated empirically. Until recently, the...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.3.4.613
更新日期:2005-08-01 00:00:00
abstract:INTRODUCTION:Microorganisms of clinical importance frequently develop resistance to drug therapy, now a growing problem. The experience with Mycobacterium tuberculosis is a representative example of increasing multi-drug resistance. To avoid reaching a crisis in which patients could be left without adequate treatment, ...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章
doi:10.1080/14787210.2021.1839418
更新日期:2020-10-26 00:00:00
abstract::Despite the constantly increasing need for new antimicrobial agents, antibiotic drug discovery and development seem to have greatly decelerated in recent years. Presented with the significant problem of advancing antimicrobial resistance, the global scientific community has attempted to find alternative solutions; one...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.6.5.593
更新日期:2008-10-01 00:00:00
abstract::Human cytomegalovirus is a large DNA virus that is well-equipped to evade both innate and adaptive host immune responses and to establish lifelong latency. It is a major opportunistic pathogen in immunocompromised hosts. Following allogeneic transplantation, immune responses are often inadequate to inhibit viral react...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.2.4.559
更新日期:2004-08-01 00:00:00
abstract::Chagas disease affects 7.7 million people and 28 million people are at risk of acquiring the disease in 15 endemic countries of Latin America. Benznidazole and nifurtimox are drugs that have been used to treat the disease. However, both drugs induce severe side effects. Treatment with benznidazole has been recommended...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/eri.11.31
更新日期:2011-05-01 00:00:00
abstract::The emergence of multidrug-resistant tuberculosis strains and the coinfection with HIV, together with advances in immunology, have led to renewed interest regarding ways to exploit the immune responses against Mycobacterium tuberculosis therapeutically. Here we review the fundamentals of tuberculosis therapy in view o...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.5.3.461
更新日期:2007-06-01 00:00:00
abstract::Diarrhea is the second largest cause of mortality worldwide in children from the perinatal period to the age of 5 years. Rotavirus has been the most commonly identified viral cause of diarrhea in children. Norovirus is now recognized as the second most common viral pathogen. Adenovirus, astrovirus and sapovirus are th...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/eri.10.1
更新日期:2010-02-01 00:00:00
abstract::Bacteremias represent severe infectious complications following hematopoietic stem cell transplantation (HSCT). Frequency is highest during the pre-engraftment period, both in autologous and in allogeneic HSCT, when patients are granulocytopenic. In the postengraftment period, bacteremias are also frequent in the abse...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/eri.09.35
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:Hospital antibiotic use is rising. We aimed to evaluate the antibiotic-use prevalence and length of stay. METHODS:We conducted a single-center retrospective study of patients < 18-years-old admitted to general pediatric services who received ≥ 1 antibiotic over six months. Demographics, culture results and ...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章
doi:10.1080/14787210.2020.1787833
更新日期:2020-11-01 00:00:00
abstract::Malaria is a curable disease, provided timely access to efficacious drugs is sought. Poor quality and, in particular, falsified antimalarial drugs harm the population of malaria endemic areas; they put lives in peril, cause economic losses to patients, families, industry, and generally undermine the trust in health sy...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.2015.1015990
更新日期:2015-04-01 00:00:00
abstract::In 2013, an estimated 1.5 million HIV-positive pregnant women gave birth, with 240,000 children worldwide acquiring HIV. More than 90% of new pediatric infections occurred in Sub-Saharan Africa. The latest WHO guidelines recommended efavirenz (EFV)-based antiretroviral therapy as the first-line regimen for prevention ...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.2016.1116383
更新日期:2016-01-01 00:00:00
abstract::The fixed dose combination of abacavir with lamivudine represents a new treatment option for patients infected with HIV. Fixed dose combination abacavir/lamivudine has the convenience of one pill and once-daily dosing. It achieves comparable suppression of plasma HIV RNA with the pill's individual components dosed twi...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.3.6.871
更新日期:2005-12-01 00:00:00
abstract::Nitazoxanide (Alinia, Romark Laboratories) was synthesized based on the structure of niclosamide. In vitro studies have demonstrated activity against a broad range of parasites as well as some bacteria. Three controlled trials demonstrated efficacy in cryptosporidiosis, however, the efficacy in advanced AIDS patients ...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.2.1.43
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND:Carbapenem-resistant Enterobacteriaceae (CRE) infection is associated with intensive care admissions, morbidity, and mortality. Our study aimed to determine the incidence, risk factors, and patient outcomes of CRE in the ICU units. METHODS:This was a retrospective matched case-control study of patients admi...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章
doi:10.1080/14787210.2020.1822736
更新日期:2020-09-20 00:00:00
abstract::Management of anaerobic infections encompasses surgical procedures, antibacterial therapy and adjuncts. At present, metronidazole, penems, beta-lactam/beta-lactamase inhibitor combinations and chloramphenicol have the highest activity against obligate anaerobes. Tigecycline is a promising new agent. Other antibacteria...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.5.4.685
更新日期:2007-08-01 00:00:00
abstract::Hospital infection due to multidrug-resistant Gram-positive bacteria may often represent a life-threatening challenge; thus, to appropriately combat them, clinicians should be confident and systematically apply several important pharmacodynamic concepts. The concept of 'correct antibiotic treatment' should include, in...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.5.2.255
更新日期:2007-04-01 00:00:00
abstract:INTRODUCTION:The nervous system is involved in 10-15% of patients infected with B. burgdorferi, B. afzelii and B. garinii. This review will address widespread misconceptions about the clinical phenomenology, diagnostic approach and response to treatment of neuroborreliosis. Areas covered: Improvements in diagnostic tes...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1080/14787210.2018.1417836
更新日期:2018-01-01 00:00:00
abstract::The vicious cycle is that hyperglycemia (≥11.1 mmol/l) or other diabetes-associated factors facilitate or worsen the development of infections and vice versa, the infections deteriorate the glycemic control of the patients. Diabetic patients are prone to some infections, infection recurrences and poor outcomes. Immuno...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/eri.13.19
更新日期:2013-04-01 00:00:00
abstract::Although penicillin remains the first-choice treatment for Streptococcus pyogenes infection, macrolides are important alternatives for allergic patients and lincosamides are recommended together with β-lactams in invasive infections. S. pyogenes may exhibit macrolide resistance because of active efflux (mef genes) or ...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.2015.1023292
更新日期:2015-05-01 00:00:00
abstract:INTRODUCTION:Monkeypox is a re-emerging viral zoonosis that occurs naturally in heavily forested regions of West and Central Africa. Inter-human transmission of monkeypox virus, although limited, drives outbreaks, particularly in household and health-care settings. But the available evidence suggests that without repea...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1080/14787210.2019.1567330
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:The coronavirus disease 2019 (COVID-19) pandemic has affected almost 2.5 million people worldwide with almost 170,000 deaths reported to date. So far, there is scarce evidence for the current treatment options available for COVID-19. Vitamin C has previously been used for treatment of severe sepsis and septi...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章
doi:10.1080/14787210.2020.1794819
更新日期:2020-12-01 00:00:00
abstract::Invasive aspergillosis (IA) is currently an important cause of morbidity and mortality in hematopoietic stem cell transplant and solid organ transplant recipients. A high index of suspicion and careful clinical and radiological examinations are the keys to identifying infected patients early. Chest computerized axial ...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/eri.11.13
更新日期:2011-03-01 00:00:00
abstract:INTRODUCTION:The management of latent tuberculosis (LTBI) in children represents an important issue for paediatricians because of the disease burden, the lack of a gold standard for the diagnosis and the high annual risk of progression to active disease. Areas covered: A review of English language articles on LTBI in c...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1080/14787210.2017.1279541
更新日期:2017-04-01 00:00:00
abstract::Introduction: Helicobacter Pylori (H.Pylori) is a pathogen that infects about 50% of the world's population and is known to be responsible for gastroduodenal diseases such as atrophic gastritis, peptic ulcer and stomach cancer. Nowadays, there is no treatment that ensures complete eradication. In addition, resistance ...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1080/14787210.2019.1677464
更新日期:2019-10-01 00:00:00
abstract::A current focus in HIV management is improving adherence by minimizing pill burden with convenient formulations, including fixed-dose combinations (FDCs). Darunavir, a HIV protease inhibitor, co-administered with low-dose ritonavir (800/100 mg once daily), is recommended in guidelines in combination with other antiret...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.2015.1033400
更新日期:2015-06-01 00:00:00