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Weekly Digest: Measles vaccination tied to health & schooling benefits among children in LMICs; Global variation in use of WHO AWaRe antibiotics; First colistin-resistant strain of Salmonella seen in US patient.

Weekly Digest: Measles vaccination tied to health & schooling benefits among children in LMICs; Global variation in use of WHO AWaRe antibiotics; First colistin-resistant strain of Salmonella seen in US patient.

Measles vaccination tied to health, cognition, and schooling benefits among children in LMICs. CDDEP-led research published in the journal Vaccine explores the associations between measles vaccination status and anthropometric, cognitive, and schooling outcomes among measles-vaccinated and unvaccinated children in Ethiopia, India, and Vietnam. The study found that at ages 7-8 years, measles-vaccinated children had significantly higher height-for-age Z scores in India (an increase of 0.13 points, P=0.05), and significantly higher BMI-for-age and weight-for-age z scores in Vietnam (an increase of 0.18 and 0.23 points, P=0.04, 0.01) compared to matched measles-unvaccinated children. Measles-vaccinated children scored 2.3, 2.5, and 2.7 points more on early grade reading assessments in Ethiopia, India, and Vietnam, respectively. Vaccinated children also attained significantly higher schooling grades across all ages and countries compared to their unvaccinated counterparts. Measles vaccination at 6-18 months of life was found to be associated with long-term health, cognition, and schooling benefits among children in all three countries. [Vaccine, CDDEP]

 Global variation in the use of WHO Access, Watch, and Reserve antibiotics. Researchers from St. George’s University of London measured pediatric antibiotic use stratified by the World Health Organization’s (WHO) Essential Medicines List, Access, Watch, and Reserve (AWaRe) classifications. Among hospitalized children across 56 countries, the researchers found the highest prevalence of Access antibiotic use in Slovenia (61.2 percent) and the highest prevalence of Watch antibiotic use in Iran (77.3 percent). The use of Reserve antibiotics was low in all countries. [The Lancet Global Health]

First multidrug- and colistin-resistant strain of Salmonella found in US patient. Researchers at North Carolina State University identified the mcr-3.1 gene in a US patient for the first time. The gene confers Salmonella with resistance to last-resort antibiotic, colistin. The infected patient had traveled to China 2 weeks before the onset of diarrhea, suggesting that this is the first known importation of the gene from Asia to the US. [Journal of Medical Microbiology]

Oral antibiotic use among preschool children linked to increase in resistance genes in the gut. Researchers from the University of California, San Francisco and the Centre de Recherche en Sante de Nouna conducted a randomized controlled trial to assess the effect of antibiotics on the gut resistome (the collection of resistance gene determinants in the gut) of children in Burkina Faso. The 124 children aged 6 to 59 months old who participated in the study were randomly assigned to receive amoxicillin, azithromycin, cotrimoxazole, or placebo. Compared to placebo, children who received azithromycin were 2.61 times as likely to have genetic markers of resistance to macrolides (p=0.0003), and those who received cotrimoxazole were 3.29 times as likely to have genetic markers of resistance to trimethoprim (p=0.04). Findings suggest that a single course of antibiotics can alter the gut resistome. [CID]

Review of AMR policy evaluations to guide governments. To guide governments in implementing evidence-based policies to reduce antimicrobial resistance (AMR), researchers from York University and the University of Ottawa reviewed 69 policy intervention evaluations across the world. They identified 17 policy options for reducing antimicrobial use in humans including public awareness campaigns and antimicrobial guidelines. Other policy options included professional regulation, restricted reimbursement, and pay for performance. [PLOS Medicine]

FDA issues safety alert following deadly fecal transplant. The US Food and Drug Administration (FDA) issued a safety alert earlier this month following two invasive infections linked to investigational fecal microbiota transplants (FMT) that contained strains of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (E.coli). Both immunocompromised patients received FMTs from the same donor, and one patient died. The stool used in the transplants had not previously been tested for ESBL-producing E.coli.  [FDA]

WHO: Ebola still not an international health emergency. The World Health Organization’s (WHO) emergency committee met last week in response to a cluster of Ebola cases that spread from the Democratic Republic of the Congo (DRC) to Uganda. For the third time since the beginning of the DRC’s Ebola outbreak in August 2018, the committee claimed that the situation does not constitute a public health emergency of international concern (PHEIC). Although the risk of international spread is low, the WHO experts expressed concerns over the current outbreak and its potential spread to neighboring regions, as well as a lack of funds and resources for outbreak control. [WHO]

Candida auris outbreak in Colombia. Scientists at the US Centers for Disease Control and Prevention (CDC) and partners conducted an investigation into a hospital-associated multicenter outbreak of Candida auris in Colombia between 2015-2016. The researchers identified 40 cases of the emerging drug-resistant fungus across 4 hospitals in 3 Colombian cities. Findings revealed a 43 percent 30-day mortality rate, and temporal and spatial clustering suggested evidence of person-to-person spread. [CDC Emerging Infectious Diseases]

Child flu vaccination offers direct and indirect protection in resource-poor areas of India. To investigate the effect of child flu vaccination on direct and indirect influenza protection in India, researchers randomly assigned children in households across 3 villages in India to either intramuscular trivalent inactivated influenza vaccine (IIV3) or a control of inactivated poliovirus vaccine (IPV) once a year for 3 years. Overall vaccine efficacy against influenza B was 32.5, 4.9, and 76.5 percent in years 1, 2, and 3, respectively. Indirect protection was statistically significant in year 3, at 38.1 percent, when direct vaccine protection was highest. [The Lancet Global Health]

New PrEP recommendation for HIV prevention. In a recommendation statement published in JAMA earlier this month, the US Preventive Services Task Force (USPSTF) recommends that providers offer pre-exposure prophylaxis (PrEP) along with antiretroviral therapy for individuals who are at high risk of contracting HIV. The USPSTF concluded that there is substantial evidence proving the safety and effectiveness of PrEP in reducing the risk of HIV infection. [JAMA]

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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