January 04, 2019
Extensively drug resistant typhoid fever in Pakistan. Between November 1, 2016 and December 9, 2018, there were 5,274 cases of extensively drug resistant (XDR) typhoid fever in Sindh Province, Pakistan, the World Health Organization (WHO) reported. Almost 70 percent of XDR cases occurred in Karachi, the country’s capital. The currently circulating XDR strain of Salmonella Typhi is haplotype 58 and is resistant to first- and second-line antibiotics and third-generation cephalosporins. [WHO]
Free testing and pay-it-forward strategy increased gonorrhea and chlamydia testing among Chinese men. During a three-month pay-it-forward pilot program in Guangzhou, China, 203 men who visited an STD clinic or community-based organization for men who have sex with men were offered free gonorrhea and chlamydia testing and given the option to donate money toward testing for future participants. Overall, 109 (54 percent) men who received the pay-it-forward program benefits underwent gonorrhea and chlamydia testing compared to only 12 of the 205 (6 percent) men who paid the standard patient price of 150 yen for the same testing services in a three-month period. Of the 121 men tested, 5 (4 percent) were diagnosed with gonorrhea and 15 (12 percent) were diagnosed with chlamydia. It was the first gonorrhea test for 80 percent of men and the first chlamydia test for 86 percent. Among those who received free testing under the pay-it-forward program, 89 percent donated money toward testing for future participants. [The Lancet Infectious Diseases]
FDA approves vaccine effective against six childhood diseases. The US Food and Drug Administration (FDA) approved the three-dose hexavalent combination vaccine VAXELIS for use in children aged six weeks to four years. The vaccine was developed jointly by Sanofi and Merck and provides active immunization against diphtheria, tetanus, pertussis, poliomyelitis, hepatitis B, and invasive disease caused by influenza type B. [Sanofi Press Release]
Malaria infection during pregnancy impedes placental vascular development. Malaria is known to have a detrimental impact on the fetus when pregnant mothers experience an infection. Researchers found malaria infection can impede vascular development in the placenta; compared to controls, placentas from Tanzanian women infected with malaria before the gestational age of 15 weeks had smaller transport villi, a greater diffusion distance in diffusion vessels, and compensatory increases in the diffusion vessel surface. Diffusion vessel surface and transport vessel length were positive predictors of birth weight and gestational age at delivery. [Journal of Infectious Diseases]
Topical ointment decolonizes Staphylococcus aureus in NICU infants. Between April 2014 and May 2016, 66 infants aged 23 months or younger and admitted to one of eight neonatal intensive care units (NICUs) in the US were randomly assigned to receive five days of treatment with the topical ointment mupirocin to decolonize Staphylococcus aureus and prevent clinical infection; 64 NICU infants admitted to the same facilities did not receive mupirocin treatment and served as controls. Primary decolonization on day eight occurred in 93.9 percent of infants treated with mupirocin compared to 4.7 percent of control infants. Persistent decolonization on day 22 was observed for 45.7 percent of treated infants compared to 2.1 percent of controls. Mupirocin was generally well-tolerated, according to researchers, but mild rashes were more common among treated infants compared to untreated infants. [Pediatrics]
Flu activity rising in northern hemisphere and south Asia. Between November 26 and December 9, 2018, overall influenza activity increased but remained low in the northern hemisphere, the World Health Organization (WHO) reported. Influenza activity also increased in southern and southeastern Asia. Worldwide, just over 10,000 specimens tested positive for influenza, and 94.8 percent of those samples were typed as influenza A. H1N1 accounted for 84.1 percent of the influenza A viruses tested. [WHO]
Antibiotic use on dairy farms in Pennsylvania. Antibiotic consumption across 235 dairy farms in Pennsylvania was 24,444 animal-defined daily doses (ADD) and 19,029 days of therapy (DOT) corresponding to treatment incidences of 4.2 ADD and 3.3 DOT per 1,000 animal-days, according to an analysis of self-reported survey data. Antibiotics were most commonly used to treat mastitis. First-generation cephalosporins were the most commonly used class of antibiotic followed by penicillin and third-generation cephalosporins. [Journal of Dairy Science]
Neurodevelopment in infants exposed to Zika Virus in utero. Brain imaging of 115 children aged 12 to 18 months who were exposed to Zika virus in utero revealed abnormal findings in 34 percent of children. 12 percent of these children had abnormal hearing tests, and 6 percent had abnormal vision tests. 94 children who underwent neuroimaging were further assessed for cognitive, language, and motor function by the Bayley Scales of Infant and Toddler Development, where scores range from 55 to 145 and lower scores indicate higher levels of development delay. Of children with abnormal brain imaging results, 16 percent had Bayley-III scores higher than 85, 12 percent had scores between 85 and 71, and in 10 percent had scores of 70 or less in one or more of the assessment areas. [NEJM]
AHRQ’s Four Moments Framework for antibiotic prescribing and stewardship. The Four Moments Framework, developed by the US Agency for Healthcare Research and Quality (AHRQ) Safety Program for Improving Antibiotic Use, informs clinical decision making in antibiotic prescribing and stewardship. In the acute care setting, the framework can be incorporated into daily clinical practice. Moment one encourages health care providers to consider noninfectious causes of abnormal vital signs prior to prescribing an antibiotic. Moment two asks clinicians to obtain necessary cultures and to prescribe an appropriate antibiotic according to the results. Moments three and four remind health care providers to monitor the impact of antibiotics and to consider shorter durations of antibiotic therapies. [JAMA]
Photo: Influenza virus as seen through an electronic microscope. Credit: Alain Grillet. Copyright: Sanofi Pasteur (CC BY-NC-ND 2.0).
