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Weekly Digest: Researchers highlight global AMR progress over the last six years; Misinformation and xenophobia spread alongside COVID-19.

Weekly Digest: Researchers highlight global AMR progress over the last six years; Misinformation and xenophobia spread alongside COVID-19.

Researchers highlight global AMR progress over the last six years. In a CDDEP-led review published in The Lancet Infectious Diseases, researchers detail global progress in addressing antimicrobial resistance (AMR) over the last six years. Since 2013, when The Lancet Infectious Diseases published a commission report on AMR, national and global initiatives have been implemented to reduce the burden of resistance, including a ban on irrational drug combinations in India and prohibited use of last-resort antibiotic colistin as a growth promoter in animals. Funding to address AMR has increased and barriers to antibiotic development have been overcome, although more comprehensive efforts across all countries are needed for optimal progress. [The Lancet Infectious Diseases]

 Misinformation and xenophobia spread alongside COVID-19. The novel coronavirus, which the World Health Organization (WHO) has officially named COVID-19, has infected more than 70,000 individuals and caused 1,775 deaths across 25+ countries worldwide (as of February 17, 2020). Misinformation and xenophobia against Asians have also spread alongside the pneumonia-like virus. [WHO]

  • False information and rumors regarding the novel coronavirus outbreak are quickly spreading across the internet, creating an “infodemic,” and prompting the WHO to work with large tech companies to hide false content. [NYTimes]
  • Although the WHO purposely avoided creating a virus name that refers to a geographical location, animal, individual, or group of people in an attempt to prevent stigma, Asians across the world are sharing their experiences with xenophobia and anti-Chinese sentiment related to COVID-19on social media. [The Lancet, NBC News]

Decreasing trends of drug resistance tied to stewardship programs in Japanese hospitals. Researchers at Hokkaido University in Japan found that an antimicrobial stewardship program (ASP) was linked to a significant reduction in the proportion of methicillin-resistant Staphylococcus aureus (MRSA) and drug-resistant Pseudomonas aeruginosa cultures at four Japanese hospitals. Decreasing trends in MRSA rates at the four study hospitals accelerated by 50 to 150 percent following ASP introduction. [International Journal of Infectious Diseases]

Antibiotic resistance genes found in Chicago waterways match clinical isolates. In a pilot study, researchers identified 37antimicrobial resistance genes isolated from Enterobacteriaceaein Chicago waterways, including genes of clinical concern that confer resistance to colistin, quinolones, beta-lactams, and aminoglycosides. Resistance genes found in 15 of the isolates taken from water samples were also identified in clinical isolates from children in surrounding areas, which suggests that recreational waterways may serve as a potential source of community-acquired multidrug-resistant Enterobacteriaceae. [Antimicrobial Agents and Chemotherapy, CIDRAP]

Next-generation sequencing of sewage could improve global AMR surveillance. An article published in Science highlights the benefits of using sewage for global surveillance and monitoring of antimicrobial resistance (AMR). AMR surveillance systems are useful for tracking rates of resistance, identifying outbreaks of drug-resistant infections, informing global and national priorities/guidelines, and investigating emerging resistant pathogens. Current surveillance systems are based on small samples of clinical isolates and can be difficult and expensive to establish in low- and middle-income countries. However, the authors note that sewage-based surveillance using next-generation sequencing is an affordable addition to current AMR surveillance systems that would better represent the current state of resistance across the world. [Science]

Resistance genes are more abundant in the mouth, but more diverse in the gutA study conducted by researchers at King’s College London found differences between the antimicrobial resistance microbiomes of the mouth and the gut. The study compared the resistome of oral and stool samples collected from 788 individuals around the world and found that resistance genes were more abundant in the mouth, but more diverse in the gut. The prevalence of resistance genes, classes, and mechanisms also varied by country. [Nature Communications]

Zika-related birth defects quadrupled in the US between 2016 and 2017. In a Morbidity and Mortality Weekly Report (MMWR), researchers assessed the change in prevalence of birth defects potentially related to Zika virus infection in 22 US states and territories between January-March 2016 and January-March 2017. The study identified a fourfold increase in the prevalence of birth defects potentially related to Zika in areas with widespread local transmission of the virus (prevalence ratio= 4.1). The highest prevalence occurred in February 2017, with 7.0 birth defects per 1,000 live births. [CDC MMWR]

Measles outbreaks in the US cost an estimated $150,000+. In a literature review of 10 studies on the costs of measles outbreaks in the United States during the post-elimination era (2001-2018), researchers from the US Centers for Disease Control and Prevention (CDC)found that the median cost per measles outbreak was $152,308, ranging from $9,862 to $1,063,936. The literature review also found that the median cost per measles case was $32,805, ranging from $7,396 to $76,154, and the median cost per measles case contact was $223, ranging from $81 to $746.The researchers note that data on the direct and indirect costs of measles outbreaks in the US was limited in the 10 studies they reviewed. [Clinical Infectious Diseases]

Highly pathogenic avian flu wipes out poultry farm in Saudi Arabia. The World Organization for Animal Health (OIE) reported an outbreak of highly pathogenic avian influenza on a poultry farm in Riyadh, the capital province of Saudi Arabia. The outbreak of H5N8, which started on January 30, 2020, killed 22,700 birds, and 385,300 additional birds were killed and disposed of in an attempt to control the spread of the virus. [OIE, CIDRAP]

Oral flu vaccine proves efficacious and well-tolerated in phase 2 trial. In a phase 2 clinical trial, an oral influenza vaccine (VXA-A1.1) was well-tolerated and produced an immune response similar to that of a licensed intramuscular flu vaccine among healthy adults. After participants were challenged with the influenza virus, flu was detected in 29 percent of individuals randomized to receive VXA-A1.1, 35 percent of those randomized to receive the licensed quadrivalent inactivated influenza vaccine (IIV) via intramuscular injection, and 48 percent of those in the control group. No serious adverse events occurred among individuals in the VXA-A1.1 group. [The Lancet Infectious Diseases]

US flu vaccine coverage is flat and continues to fall short of Healthy People 2020 goal. [CDDEP]