February 08, 2019
New data added to CDDEP’s ResistanceMap (ResistanceMap.org). Antimicrobial resistance data was updated for 30 countries in the European Antimicrobial Resistance Surveillance Network, 10 countries in the Central Asian and Eastern European Surveillance of Antimicrobial Resistance, and 11 other countries including Australia, India, Malawi, China, Korea, Malaysia, and Pakistan. CDDEP researchers also updated the ResistanceMap platform with data for seven countries for which data was not previously available; these countries include Japan, Montenegro, Nigeria, Oman, Saudi Arabia, Sri Lanka, and the United Arab Emirates. Country profiles and trends are available online on the platform, the largest, most comprehensive repository of country-level, global resistance and antibiotic consumption data. [ResistanceMap]
Oral antibiotics noninferior to IV antibiotics for orthopedic infections. A total of 1,054 patients being treated for complex bone or joint infection at one of twenty-six UK health facilities were randomly assigned to receive a six-week course of either intravenous or oral antibiotics. Treatment failure within one year after randomization occurred in 74 of 506 participants in the intravenous group and 67 of 509 in the oral antibiotic group demonstrating that oral antibiotic therapy was noninferior to intravenous antibiotic therapy. There was no significant difference in the number of serious adverse events between the study groups, but catheter complications were more common in the intravenous group. [NEJM]
Flu vaccine 90 percent effective among Hong Kong children. The 2018/2019 influenza season in Hong Kong began in October 2018, reached peaked epidemic levels during the last week of December, and was predominated by influenza A viruses. Between September 2, 2018 and January 2019, just over 2,000 children aged 6 months to 17 years were hospitalized in one of three public hospitals with catchment areas representing 17 percent of all children in Hong Kong. Of the hospitalized children, 17.1 percent tested positive for influenza A or B, and only 2.9 percent of those who tested positive had been vaccinated. Among vaccinated children, 88.9 percent received the quadrivalent inactivated influenza vaccine and 5.6 percent reported receiving the trivalent inactivated vaccine. Vaccine effectiveness was 90 percent against influenza A or B and 92 percent against the predominant influenza A (H1N1) pdm09 strain. [Journal of Eurosurveillance]
Gross domestic R&D expenditure on health and medical sciences versus global targets. The World Health Organization’s Global Observatory on Health Research and Development released new analysis that compared gross domestic expenditure on research and development (R&D) in the health and medical sciences to global targets. 31 of the 75 countries analyzed met their health and medicine R&D spending targets, according to the most recent data available. Five countries from three income groups including Singapore and the Netherlands exceeded global expenditure targets set forth for high-income countries. Bulgaria, Kenya, South Africa, and Turkey exceeded expenditure targets set for their respective income levels while Russia and Colombia did not meet their targets. Several high-income countries in the Eastern Mediterranean region did not meet targets of spending between 0.15 and 0.20 percent of their gross domestic product on health R&D. [WHO]
Surgical-site infections after pediatric surgery. Between June 2012 and December 2015, there were 8,502 surgical procedures performed on children younger than 18 years at three ambulatory surgical facilities and one hospital-based facility. Together, soft tissue excision, hernia repair, and scrotal/testicular surgeries accounted for 56 percent of procedures during this period. Of all surgeries performed, 21 resulted in surgical-site infections (SSI) that met the 2010 National Healthcare Safety Network definition for a rate of 2.5 SSIs per 1,000 surgical encounters. There was no significant difference between SSI rates at ambulatory and hospital-based facilities. Using a broader definition of SSI that extended to infectious events associated with surgery up to 60 days post-operation, researchers identified 404 possible infections giving a rate of 48 SSIs per 1,000 surgical encounters. Using this broader definition, older age and black race were associated with a reduced risk of SSI. [ICHE]
Role of enterovirus D68 in acute flaccid myelitis cases in Arizona. Four confirmed, one probable, and six additional suspected cases of pediatric acute flaccid myelitis (AFM) were identified in Maricopa County in Phoenix, Arizona in September 2016. Nasopharyngeal swabs were available for three of the four confirmed AFM cases, and genomic analysis of the samples detected enterovirus D68, a common cause of respiratory and gastrointestinal illness most recently thought to be linked to neurologic disease include AFM. No other etiological causes for AFM were identified through analysis of stool and cerebrospinal fluid samples, according to researchers, strengthening the likelihood that enterovirus D68 is a cause of AFM. [mBio]
FDA grants breakthrough designation for 15-valent pneumococcal vaccine. The US Food and Drug Administration (FDA) granted Breakthrough Therapy Designation to Merck’s investigational 15-valent pneumococcal conjugate vaccine, V114, for the prevention of invasive pneumococcal disease caused by vaccine serotypes among pediatric patients aged 6 weeks to 18 years, according to a press release. The Breakthrough Therapy Designation is reserved for drugs that treat serious or life-threatening conditions and demonstrate substantial improvement over currently available therapies in preliminary studies. The FDA’s decision was based on two phase 1 and 2 trials that demonstrated tolerability and immunogenicity among adult and pediatric patient populations. [Merck Press Release]
Oxford and Blue Water Vaccines partner to develop universal flu vaccine. Oxford University Innovation and the US-based company Blue Water Vaccines entered into an agreement to develop a universal influenza vaccine which will cover recipients against all influenza A and B strains and will avoid the need to be updated each year. Blue Water Vaccines is raising $15 million to support ongoing vaccine development at Oxford University. Clinical trials for the vaccine may begin by the end of 2019, according to an Oxford University press release. [Oxford Press Release]
Listeria outbreak tied to pasteurized chocolate milk in Canada. In Ontario, Canada, a Listeria monocytogenes outbreak that resulted in 34 cases, 32 hospitalizations, and 4 deaths between November 2015 and June 2016 was linked to bagged, pasteurized chocolate milk, researchers reported. Most listeriosis cases in Canada, which number around 50 per year, are associated with consumption of raw or unpasteurized dairy products. Samples collected from an unnamed but common chocolate milk distributor tested positive for the outbreak strain of L. monocytogenes which led to a national recall of products, replacement of equipment used in manufacturing, and corrective measures to prevent reoccurrence. [Emerging Infectious Diseases]
Resurgence of vaccine-preventable diseases in Venezuela. Venezuela’s economic and governance crises have caused ripple effects across the country’s health system. There is an acute shortage of qualified healthcare professionals and biomedical scientists as many flee the country. Vaccination rates have declined, and disease surveillance systems have been weakened. Meanwhile, arthropod-borne and vaccine-preventable diseases, including measles and diphtheria, have re-emerged causing nation-wide epidemics. Researchers warn that re-emergence of poliomyelitis and other vaccine-preventable diseases poses a regional and global health security threat. [Emerging Infectious Diseases]
Vaccine-derived and wild polio in 2018. In 2018, there were 29 reported cases of wild poliovirus, up from 22 cases in 2017, all of which were reported in Afghanistan and Pakistan. There were also 101 cases of circulating vaccine-derived poliovirus across countries in Africa and the Middle East, including Kenya, Niger, Nigeria, Somalia, and the Democratic Republic of the Congo. It was the second year in a row that circulating vaccine-derived poliovirus cases exceeded wild polio cases. [The Lancet]
Syphilis in Canada. In 2018, the incidence rate of syphilis in Winnipeg, Canada was four times higher than in 2017, according to the Winnipeg Regional Health Authority. The majority of people infected lived in the downtown and Point Douglas regions and almost half reported using drugs, according to media reports. [Global News]
Photo Credit: CDDEP’s ResistanceMap.org
