July 29, 2019
India bans last-resort antibiotic for use in food animals. The Union Ministry of Health and Family Welfare in India issued a ban on the use of last-resort antibiotic, colistin in food-producing animals last week. The ban prohibits the manufacture, sale, and distribution of colistin for growth promotion in food-producing animals, poultry, fish farming, and feed-supplements. A previous CDDEP study found high levels of antibiotic-resistant pathogens in chickens raised for both meat and eggs on farms in India’s Punjab state. These results drew attention from the government on the widespread resistance in animals associated with antibiotics used for growth promotion. [Deccan Herald, CDDEP]
CRP testing reduces unnecessary antibiotic use in COPD patients. A team of researchers conducted a randomized controlled trial to evaluate the impact of C-reactive protein (CRP) point-of-care testing compared to the standard of care on unnecessary antibiotic use in patients with chronic obstructive pulmonary disease (COPD). CRP testing measures levels of inflammation and can be used to determine whether an infection is likely to be bacterial or not and will therefore not respond to antibiotic treatment. Findings indicate that patients who received CRP testing had lower odds of reporting antibiotic use (aOR= 0.31) and lower odds of receiving an antibiotic prescription at the initial consultation or during 4 weeks of follow-up (aOR= 0.31, 0.30). [NEJM]
Disinfectants fail to prevent transmission of C. diff spores. Researchers from the UK evaluated the transmissibility of Clostridium difficile spores across hospital surfaces and measured the response of the spores following standard surface disinfection. The study found that the transfer of C. diff spores from hospital surfaces to surgical gowns occurred within 10 seconds of contact, and the spores remained viable following disinfection. [Applied and Environmental Microbiology]
Involving pharmacists in ASP decreases antibiotic consumption. Researchers in France conducted a retrospective study across 77 hospitals to assess the impact that antimicrobial stewardship teams have on antibiotic consumption. The study found that pharmacists were the antibiotic advisor in 25 percent of hospitals, and these hospitals were associated with significantly lower rates of overall antibiotic consumption (p=0.003). Pharmaceutical review covering over 80 percent of hospital beds and the use of a computerized prescription order entry system in more than 80 percent of prescriptions were also associated with a decrease in antibiotic consumption (p=0.004, 0.04). [Journal of Global AMR]
WHO declares DRC Ebola outbreak a public health emergency. Earlier this month, the World Health Organization (WHO) declared the Ebola outbreak in the Democratic Republic of Congo (DRC) a Public Health Emergency of International Concern (PHEIC). The declaration comes following the emergence of Ebola cases in Goma, a large city near the Rwanda border, as well as Uganda. [WHO]
OTC antibiotics commonly dispensed for Ethiopian children. A study conducted by researchers at Addis Ababa University in Ethiopia simulated patient visits at private medicine retail outlets to calculate the rate of non-prescription antibiotic dispensary for children who depict symptoms of common illnesses. Over 60 percent of the simulated verbal requests resulted in the dispense of over-the-counter antibiotics. Patient requests for more than one antibiotic, oral antibiotics for acute diarrhea in children, and parental antibiotics for patients who claimed to receive pneumonia care were all associated with increased odds of antibiotics being dispensed over-the-counter (aOR= 2.988, 3.297, 4.516). [AMR and Infection Control]
Spillover effect of probiotics from farms to humans. Chinese researchers took isolates from 92 brands of animal-use probiotics to assess their safety and to examine the spillover effects in humans and the environment. Of the probiotics tested, 36.6 percent showed signs of antibiotic resistance, and 33.7 percent were polluted with life-threatening pathogens. The researchers identified the transfer of an anthrax toxin from a probiotic product at a chicken farm to nearby groundwater and to a fish farm. The same anthrax toxin-positive strain of Bacillus cereus was also transmitted from farms to humans. [Clinical Infectious Diseases]
Short-course malaria treatment could improve treatment adherence in LMICs. In a study across eight health clinics in Afghanistan, Ethiopia, Indonesia, and Vietnam, researchers assessed the effectiveness of short-course primaquine for the treatment of uncomplicated Plasmodium vivax malaria.There was not a significant difference in the incidence rate of symptomatic recurrent P. vivax malaria between patients treated with 7-day therapies versus those treated with 14-day therapies (p=0.3405). Both therapies were effective in treating malaria symptoms compared to placebo, but the 7-day therapy may improve treatment adherence. [The Lancet]
Recent increase in Candida auris cases. In a case-count update, the US Centers for Disease Control and Prevention (CDC) reported that as of May 31, 2019, there have been a total of 685 confirmed Candida auris cases in the United States. Since June, the case count of the multidrug-resistant fungus has risen by 12. In addition to clinical cases, targeted screening across ten states has identified 1341 patients colonized with C. auris. The fungus is estimated to kill more than one-third of patients with invasive C. auris infections. [CDC, CIDRAP]
Mortality rates among patients treated for TB. According to a systematic review and meta-analysis between 1997 and 2018, the pooled standardized all-cause mortality ratio (SMR) for patients with tuberculosis was 2.91 compared to the general population. The SMR among patients who were treated or cured for TB was even higher, at 3.76, compared to controls. [The Lancet Infectious Diseases]
Blog: Data for action, not complacency, is needed to stop dangerous pathogens. In a new CDDEP blog post, Kevin Kavanagh of Health Watch USA details what should be done to stop the rise of drug-resistant superbugs. [CDDEP]
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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