Weekly Digest: Antibiotic resistant bacteria in Beijing smog; insecticide-treated nets not effective against malaria everywhere

2 Dec 2016
Author: Ellyse Stauffer

A weekly roundup of news on drug resistance and other topics in global health.   

Will 10 million people per year die due to antimicrobial resistance by 2050? An essay in PLOS Medicine challenges the oft-cited estimate originally published by AMR Review, that antimicrobial resistance could cause 10 million deaths per year in 2050 if the world continues down its current path. Based on a review of the methodology and the information base, the authors caution that the existing data cannot support such long-range predictions with any reliability. They make a plea for improved surveillance so that we can see more clearly into the future. The essay concludes by evoking the CDDEP-organized CARA: The Conscience of Antimicrobial Resistance Accountability: “Hopefully, these renewed national commitments and the positive influence from CARA will result in invigorated initiatives for accurate, population-based AMR surveillance, including burden of disease monitoring on a global scale.” [PLOS Medicine, CARA]

Experts call for international collaboration in antibiotic stewardship. In a Lancet Infectious Diseases personal view, experts call for international collaboration on antibiotic stewardship efforts to limit the development of antibiotic resistance. Five international collaborations—in the United States, South Africa, Colombia, Australia, and the United Kingdom—exemplify antibiotic stewardship models that have evolved from infection specialist-based teams to involve a broad spectrum of healthcare professionals including pharmacists, nurses, and community health workers. [Lancet ID summary]

Outbreaks of highly-pathogenic H5 influenza strains in Nigeria, Japan, India, Iran, and European nations. According to the World Organization for Animal Health (OIE), outbreaks of H5N1 influenza occurred in the north-central Nigerian states of Bauchi and Kano. Finland, France, and Romania have reported outbreaks of H5N8, which is linked to migratory birds from Russia, bringing to 13 the number of European nations affected. November outbreaks of H5N8 have also occurred in India and Iran. Japan has seen two outbreaks of an H5 strain, for which the N-type has not yet been identified. [CIRAP Flu Scan Nov. 29, CIDRAP H5N8 report]

Big Data for infectious disease surveillance and modelling, focus of The Journal of Infectious Diseases current issue. The current issue of The Journal of Infectious Diseases focuses on the utility of high-volume electronic data to improve disease surveillance, monitoring medical events, informing transmission models, and tracking patient sentiments and mobility. Individual papers cover a range of topics, including an online platform for describing antimicrobial resistance called “ResistanceOpen.”  Introducing the collection, the organizers state: “we are optimistic that the big-data revolution will vastly improve the granularity and timeliness of available epidemiological information, with hybrid systems augmenting rather than supplanting traditional surveillance systems, and better prospects for accurate infectious diseases models and forecasts.” [JID, JID abstract]

Insecticide-treated bed nets not effective everywhere. ITNs have contributed significantly to the massive decline in malaria in Kenya and elsewhere in Africa, where vectors bite primarily indoors starting in late evening. But places like Haiti, where malaria-transmitting mosquitoes bite outdoors and earlier in the evening, have also employed mass ITN campaigns. To determine whether ITNs prevent transmission under those conditions, researchers conducted a case-control study, published in The Lancet, of febrile illness patients throughout Haiti. They concluded that the nets provided little or no protection, even though the vectors were susceptible to the insecticide.  An accompanying comment made the point that malaria control demands more than a “one-size-fits-all solution.” ”[Lancet GH, Lancet GH Comment]

Antibiotic resistant bacteria identified in Beijing smog. A study published in Microbiome reports on 864 samples of DNA from humans, animals, and different environments worldwide, indicating the presence of resistant bacteria in the smog of Beijing. According to researcher Joakim Larsson, the study does not indicate whether the bacteria were alive in the air and says very little, if anything, about risks of acquiring an infection from breathing the polluted air. He writes, “We studied only a small number of air samples, so to generalize, we need to examine the air from more places. But the air samples we did analyze showed a wide mix of different resistance genes. Of particular concern is that we found a series of genes that provide resistance to carbapenems, a group of last resort antibiotics...” [New York Times, U of Gothenberg, Microbiome]

Education key to managing antimicrobial resistance. Professor Dilip Nathwani, OBE, writes in the Huffington Post UK, of the usefulness of educational tools like massive open online courses (MOOCs) in widespread education for antimicrobial stewardship. The British Society for Antimicrobial Chemotherapy and the University of Dundee MOOC, “Antimicrobial Stewardship: Managing Antibiotic Resistance“ covers antibiotic prescribing within all health economies internationally. “The MOOC has provided a valuable beginning for extending education on antimicrobial stewardship and the broader agenda of prevention, diagnosis and treatment of infectious disease.” [Huffington Post UK. Antibiotic Stewardship MOOC]


Image via Kentaro IEMOTO (CC BY-SA 2.0)