July 11, 2019
Experts warn that citrus spraying may fuel the spread of AMR. To prevent citrus greening, a bacterial infection that harms crops and places a financial burden on citrus growers, the Environmental Protection Agency (EPA) approved the spraying of citrus trees in Florida with 388,000 pounds of oxytetracycline per year. The EPA also recently proposed allowing an additional 650,000 pounds of streptomycin, another medically important antibiotic, to be sprayed per year. Experts cited in The Lancet Infectious Diseases news article, including CDDEP director Ramanan Laxminarayan, warned that mass spraying of medically important antibiotics among citrus crops in Florida could fuel antimicrobial resistance (AMR). [The Lancet Infectious Diseases]
Trends of latent MDR tuberculosis across the globe. Researchers from the London School of Hygiene & Tropical Medicine used drug-resistant tuberculosis surveillance and survey data from the World Health Organization (WHO) to estimate trends in the global burden of latent multidrug-resistant tuberculosis (MDR-TB). An estimated 19.1 million people were infected with latent MDR-TB in 2014, which translates to 3 in every 1000 people globally. Multidrug-resistant strains were about ten times more prevalent among children under 15 compared to those older than 15. [The Lancet Infectious Diseases]
Interventions linked with improved vaccination rates among California kindergartners. An observational study to assess the effect of three California interventions on kindergarten vaccination rates found that between 2000 and 2013, the rate of kindergartners without up-to-date vaccines increased from 7.80 percent to 9.84 percent. Following the implementation of two legislative bills and an educational intervention between 2014 and 2016, the rate of kindergartners without up-to-date vaccinations decreased to 4.87 percent in 2017. The interventions were also associated with a decrease in chance of contact with under-vaccinated kindergartners (a drop from 26.02 to 4.56 percent during 2013 and 2017). [JAMA]
Public health leaders release guidelines to address vaccine misinformation. Earlier this month, the World Health Organization’s International Working Group on Vaccination and Public Health Solutions, alongside a group of public health leaders, signed the Salzbug Statement of Vaccination Acceptance. The statement provides a set of guidelines to address vaccine misinformation, calling upon search engines and social media, governments, educators, and parents. Specifically, the authors recommend that websites limit anti-vaccination statements and that governments mandate vaccination, while educating the public on vaccine safety. [Journal of Health Communication]
Outcomes of surgical management for cervical cancer in LMICs. Researchers in Australia assessed patient morbidity following primary surgical management of cervical cancer across 11 low- and middle-income countries (LMICs). The most common surgical complications across the 10,847 patients in the study included blood transfusion, infection, vascular injury, and fistula (pooled estimates= 29 percent, 8 percent, 2 percent, and 2 percent, respectively). Overall survival was 85 percent for laparotomy cases and 80 percent for laparoscopy cases. [PLOS ONE]
Risk of avian flu transmission increases along poultry supply chain. A team of researchers from China evaluated the risk of avian influenza virus (AIV) transmission across poultry supply chains in Guangzhou, China. The study found that AIV transmission risk increases at each step along the poultry supply chain, from farm to sale, with the highest detection rates occurring during wholesale and retail live poultry markets (30.3 and 51.2 percent, respectively). Poultry workers were seropositive for AIV in 5.2 percent of farms, 8.3 percent of wholesale settings, and 12.8 percent of retail live poultry markets. [Journal of Infection]
Mutations in MDR E. coli clone occurred simultaneously. Scientists at the University of Washington found that Escherichia coli ST1193, a pandemic multidrug-resistant clone, emerged from three concurrent mutations in DNA gyrase (GyrA) and topoisomerase IV (ParC).This is the first evidence of mutation acquisition occurring all at once; evolutionary pathways to resistance are traditionally assumed to be gradual and stepwise. [PNAS]
Evaluation of IDSR implementation in Africa. The World Health Organization (WHO) conducted an evaluation on the implementation of the Integrated Disease Surveillance and Response (IDSR) strategy, which was adopted by the WHO Africa region in 1998 to improve public health surveillance and response systems. Findings showed that 94 percent of the 47 African countries were implementing IDSR through 2017. Of these countries, 85 percent had implemented subnational IDSR training and 68 percent had implemented community-based surveillance. Only 26 percent of the countries achieved the strategy’s goal of at least 90 percent IDSR implementation coverage. [BMJ Global Health]
Triple and quadruple combination ARTs equally effective in treating HIV. Scientists at the Chinese University of Hong Kong compared the effectiveness of quadruple versus triple drug combination antiretroviral therapies (ART) as a treatment for treatment-naïve patients with human immunodeficiency virus (HIV). Following a systematic review and meta-analysis on 12 randomized trials, findings showed that both ART combinations had similar effectiveness and safety outcomes. Undetectable HIV-1 RNA, virological failure, new AIDS defining events, and death (RR= 0.99, 1.00, 1.17, 1.23) were all similar for triple and quadruple combination ARTs, when triple combination ART was analyzed as the reference group. [BMJ]
CDDEP Awards in Antimicrobial Resistance. CDDEP Awards in Antimicrobial Resistance will sponsor two individuals for the best-accepted abstracts addressing AMR in low- or middle-income countries for the 19th International Congress on Infectious Diseases (ICID). The awards consist of reimbursement of travel, accommodation, and registration expenses for the 19th ICID in Kuala Lumpur, February 20-23, 2020. Submit your abstract addressing AMR in LMICs by Oct. 25, 2019. [ICID]
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