Weekly Digest: Only half of U.S. patients receive recommended first-line antibiotic for three common infections; El Niño cycle linked to increased infectious disease

30 Oct 2016
Author: Ellyse Stauffer

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

CDDEP and ReAct - Action on Antibiotic Resistance conclude MoU to support AMR policy development in Africa through Global Antibiotic Resistance Partnership. CDDEP and ReAct will provide technical assistance and financial support to improve policy making related to antibiotic use in selected countries. According to CDDEP Associate Director Hellen Gelband, “GARP and ReAct both have strong track records in assisting countries build local antibiotic resistance policy capacity while developing national action and implementation plans. Joining together brings the out the strengths of each organization for an even more effective program, and it also allows us to stretch our resources to more countries.”

Only half of U.S. patients received the recommended first-line antibiotic for three common infections. New research from the Centers for Disease Control and Prevention (CDC) and the Pew Charitable Trusts finds that 52 percent of patients prescribed outpatient antibiotics for sinus infections, middle-ear infections, and pharyngitis, get the first-line antibiotics. Instead of narrow-spectrum penicillin or amoxicillin, nearly half of patients were prescribed a broad-spectrum antibiotic such as azithromycin or another macrolide, which can increase the risk of adverse effects, including antibiotic resistance in a serious infection in the future and Clostridium difficile infection. According to co-author and a senior officer for Pew's antibiotic resistance project, David Hyun, "This tells us that there's a lot of room for improvement. When you don't use a first-line agent, the benefit-to-risk ratio changes.” [CIDRAP, JAMA Internal Medicine]                                                                       

Precipitation and warm climate associated with El Niño cycle linked to increased infectious disease. The impact of the El Niño Southern Oscillation (ENSO) on infectious diseases requiring hospitalization was studied in four regions in the United State and reported in the Proceedings of the National Academy of Sciences. Researchers grouped diseases into: 1) vector-borne diseases, 2) pneumonia and influenza, 3) enteric disease, 4) zoonotic bacterial disease, and (5) fungal infections. The most striking finding was a three-fold increase in the incidence of vector-borne diseases (rickettsioses and other tick-borne infections) in the Western region. [PNAS]

Poor understanding of Zika transmission among Americans; Wolbachia-infected mosquitoes to be released in Brazil and Colombia. A New York University College of Global Public Health survey (in spring 2016) reveals that 80 percent of Americans are aware of the Zika virus, but only 40 percent understand how the virus is transmitted. According to NYU’s Dan Abramson, "People [have to] understand that it's not just pregnant woman [who are] the focus; they are the final step in a multistep process. Until people understand that [the] disease can be sexually transmitted in asymptomatic hosts, Zika will likely remain circulating in a community for some time." More Wolbachia-infected mosquitoes will be released in Brazil and Colombia to control Zika, dengue, and other viruses, under an $18 million funding expansion. The bacteria reduces the likelihood of mosquitoes passing on these viruses. The mosquito release will be managed by The Eliminate Dengue Program (EDP) and is supported by the Wellcome Trust and the Bill & Melinda Gates Foundation. [CIDRAP, NYU report, CIDRAP, EDP]

Hospitals installed sinks to stop infections—then they increased. Handwashing is a bedrock recommendation for hospital infection control, but now, several studies have pointed to sinks as the cause of healthcare-associated infection outbreaks. The explanation appears to be bacterial biofilms, which form and attach to the surfaces of sink parts—and are near-impossible to prevent. Experts have been working to design safer sinks with fewer contact surfaces, such as sensor-activated faucets, but because they have more internal valves than manual faucets, they may just provide more places for biofilms to grow. According to infection control expert Dr. Trish Perl, “We need to start insisting on studies so that we understand the implications of introducing novel technologies before we do it.” [STAT]

Global Disease Halloween Costumes. Take National Public Radio’s Goats and Soda quiz!  [NPR Goats and Soda]