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- Babiker, Hamza A., et al.
(author)
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Impaired fitness of drug-resistant malaria parasites : evidence and implication on drug-deployment policies
- 2009
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In: Expert review of anti-infective therapy. - 1478-7210. ; 7:5, s. 581-593
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Research review (peer-reviewed)abstract
- Malaria, a leading parasitic disease, inflicts an enormous toll on human lives and is caused by protozoal parasites belonging to the genus Plasmodium. Antimalarial drugs targeting essential biochemical processes in the parasite are the primary resources for management and control. However, the parasite has established mutations, substantially reducing the efficacy of these drugs. First-line therapy is faced the with the consistent evolution of drug-resistant genotypes carrying these mutations. However, drug-resistant genotypes are likely to be less fit than the wild-type, suggesting that they might disappear by reducing the volume of drug pressure. A substantial body of epidemiological evidence confirmed that the frequency of resistant genotypes wanes when active drug selection declines. Drug selection on the parasite genome that removes genetic variation in the vicinity of drug-resistant genes (hitch-hiking) is common among resistant parasites in the field. This can further disadvantage drug-resistant strains and limit their variability in the face of a mounting immune response. Attempts to provide unequivocal evidence for the fitness cost of drug resistance have monitored the outcomes of laboratory competition experiments of deliberate mixtures of sensitive and resistant strains, in the absence of drug pressure, using isogenic clones produced either by drug selection or gene manipulation. Some of these experiments provided inconclusive results, but they all suggested reduced fitness of drug-resistant clones in the absence of drug pressure. In addition, biochemical analyses provided clearer information demonstrating that the mutation of some antimalarial-targeted enzymes lowers their activity compared with the wild-type enzyme. Here, we review current evidences for the disadvantage of drug-resistance mutations, and discuss some strategies of drug deployment to maximize the cost of resistance and limit its spread.
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- Dahlén, Gunnar, 1944, et al.
(author)
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Necrobacillosis in humans.
- 2011
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In: Expert review of anti-infective therapy. - : Informa UK Limited. - 1744-8336 .- 1478-7210. ; 9:2, s. 227-36
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Journal article (peer-reviewed)abstract
- Necrobacillosis, often used synonymously with Lemierre's syndrome, is a form of abscess infection in the peritonsillar area associated with a thrombophlebitis and caused by the strict anaerobic species Fusobacterium necrophorum. The thrombosis formed affects the internal jugular vein, from which the bacteria are seeded out in the bloodstream and cause bacteremia. Septicemia is a common complication with an often fatal outcome. Necrobacillosis is very rare and is referred to as the 'forgotten disease'. It is probably frequently overlooked in clinical practice in its early and milder forms such as tonsillitis (sore throat) and peritonsillar abscess. F. necrophorum frequently participates in these infections and is thus suspected to have an etiological role in Lemierre's syndrome. Similarly, F. necrophorum seems to play an important role in noma (cancrum oris) and this disease is also included in the necrobacillosis complex. Diagnosis of infections of the necrobacillosis complex seeks to disclose F. necrophorum in swab samples or blood culture. The most commonly used therapy is metronidazole in combination with penicillin or amoxicillin. Clindamycin is also an option, especially in cases of penicillin allergy.
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- Klingström, Jonas, et al.
(author)
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Hantavirus protein interactions regulate cellular functions and signaling responses
- 2011
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In: Expert Review of Anti-Infective Therapy. - : Informa UK Limited. - 1478-7210 .- 1744-8336. ; 9:1, s. 33-47
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Journal article (peer-reviewed)abstract
- Rodent-borne pathogenic hantaviruses cause two severe and often lethal zoonotic diseases: hemorrhagic fever with renal syndrome (HFRS) in Eurasia and hantavirus cardiopulmonary syndrome (HCPS) in the Americas. Currently, no US FDA-approved therapeutics or vaccines are available for HFRS/HCPS. Infections with hantaviruses are not lytic, and it is currently not known exactly why infections in humans cause disease. A better understanding of how hantaviruses interfere with normal cell functions and activation of innate and adaptive immune responses might provide clues to future development of specific treatment and/or vaccines against hantavirus infection. In this article, the current knowledge regarding immune responses observed in patients, hantavirus interference with cellular proteins and signaling pathways, and possible approaches in the development of therapeutics are discussed.
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- Olofsson, Sigvard, 1948, et al.
(author)
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PCR for detection of respiratory viruses: seasonal variations of virus infections
- 2011
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In: EXPERT REVIEW OF ANTI-INFECTIVE THERAPY. - 1478-7210. ; 9:8, s. 615-626
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Research review (peer-reviewed)abstract
- Real-time PCR and related methods have revolutionized the laboratory diagnosis of viral respiratory infections because of their high detection sensitivity, rapidness and potential for simultaneous detection of 15 or more respiratory agents. Results from studies with this diagnostic modality have significantly expanded our knowledge about the seasonality of viral respiratory diseases, pinpointed the difficulties to make a reliable etiologic diagnosis without the aid of an unbiased multiplex molecular assay for respiratory viruses, and revealed previously unknown details as to possible infections with multiple agents as aggravating factors. The scope of this article is to review and discuss this new knowledge and its implications for diagnostic strategies and other measures essential for the clinical management of respiratory viral infections and for epidemiological surveillance of seasonal respiratory infections.
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- Sköld, Ola
(author)
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Sulfonamides and trimethoprim
- 2010
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In: Expert review of anti-infective therapy. - : Informa UK Limited. - 1744-8336 .- 1478-7210. ; 8:1, s. 1-6
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Journal article (other academic/artistic)
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- Tozan, Yesim, et al.
(author)
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Transmission dynamics of dengue and chikungunya in a changing climate : do we understand the eco-evolutionary response?
- 2020
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In: Expert Review of Anti-Infective Therapy. - : Taylor & Francis. - 1478-7210 .- 1744-8336. ; 18:12, s. 1187-1193
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Journal article (peer-reviewed)abstract
- Introduction: We are witnessing an alarming increase in the burden and range of mosquito-borne arboviral diseases. The transmission dynamics of arboviral diseases is highly sensitive to climate and weather and is further affected by non-climatic factors such as human mobility, urbanization, and disease control. As evidence also suggests, climate-driven changes in species interactions may trigger evolutionary responses in both vectors and pathogens with important consequences for disease transmission patterns.Areas covered: Focusing on dengue and chikungunya, we review the current knowledge and challenges in our understanding of disease risk in a rapidly changing climate. We identify the most critical research gaps that limit the predictive skill of arbovirus risk models and the development of early warning systems, and conclude by highlighting the potentially important research directions to stimulate progress in this field.Expert opinion: Future studies that aim to predict the risk of arboviral diseases need to consider the interactions between climate modes at different timescales, the effects of the many non-climatic drivers, as well as the potential for climate-driven adaptation and evolution in vectors and pathogens. An important outcome of such studies would be an enhanced ability to promulgate early warning information, initiate adequate response, and enhance preparedness capacity.
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| 37. |
- Unemo, Magnus, 1970-, et al.
(author)
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Challenges with gonorrhea in the era of multi-drug and extensively drug resistance -are we on the right track?
- 2014
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In: Expert Review of Anti-Infective Therapy. - : Expert reviews. - 1478-7210 .- 1744-8336. ; 12:6, s. 653-656
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Journal article (peer-reviewed)abstract
- Neisseriagonorrhoeae has retained antimicrobial resistance to drugs previously recommended for first-line empiric treatment of gonorrhea, and resistance to ceftriaxone, the last option for monotherapy, is evolving. Crucial actions to combat this developing situation include implementing response plans; considering use of dual antimicrobial regimens; enhancing surveillance of gonorrhea, gonococcal antimicrobial resistance, treatment failures and antimicrobial use/misuse and improving prevention, early diagnosis, contact tracing and treatment. The ways forward also include an intensified research to identify novel antimicrobial resistance determinants and develop and evaluate appropriate use of molecular antimicrobial resistance testing, ideally point-of-care and with simultaneous detection of gonococci, to supplement culture-based methods and ideally guide tailored treatment. It is crucial with an enhanced understanding of the dynamics of the national and international emergence, transmission and evolution of antimicrobial-resistant gonococcal strains. Genome sequencing combined with epidemiological metadata will detail these issues and might also revolutionize the molecular antimicrobial resistance testing. Ultimately, novel antimicrobials are essential and some antimicrobials in development have shown potent in vitro activity against gonococci. Several of these antimicrobials deserve further attention for potential future treatment of gonorrhea.
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| 38. |
- Unemo, Magnus, 1970-
(author)
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Holistic actions are essential to combat the global public health burden of non-viral sexually transmitted infections : challenges and future perspectives
- 2014
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In: Expert Review of Anti-Infective Therapy. - : Expert reviews. - 1478-7210 .- 1744-8336. ; 12:6, s. 649-651
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Journal article (peer-reviewed)abstract
- Sexually transmitted infections (STIs) represent a significant international public health burden. These infections result in substantial morbidity, mortality and economic costs globally, and require more attention and resources internationally. This special focus issue of Expert Review of Anti Infective Therapy invited key opinion leaders to review and discuss the challenges associated with the diagnosis and treatment of non-viral STIs. The issue also elucidates the future perspectives, ways forward and holistic actions imperative to effectively combat these STIs.
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