Antibiotics have become less effective at preventing surgical site infections after colorectal surgery. CDDEP researchers reviewed results from 74 randomized control trials conducted between 1980 and 2015 to assess trends in the efficacy of antibiotic prophylaxis regimens in preventing infection following four surgical procedures: appendectomy, cesarean section, colorectal surgery, and transrectal prostate biopsy. For colorectal surgeries, antibiotic prophylaxis is becoming less effective at preventing surgical site infections following the procedure. Efficacy remained unchanged for the three other surgical procedures studied, but the number of studies were too small to draw definitive conclusions.    [Infection Control and Hospital Epidemiology]

WHO World Malaria Report 2018 shows stalled progress in reducing global malaria burden. Between 2016 and 2017, the estimated number of malaria cases increased from 217 million to 219 million, according to the World Health Organization (WHO). During this period, the number of deaths due to malaria decreased from 451,000 to 435,000. The global incidence rate of malaria in 2017 was 59 per 1,000 people, a rate that has not changed in three years, indicating that progress in reducing the global malaria burden has plateaued. Ninety-two percent of the global burden was in WHO’s African region, with a quarter of cases in Nigeria alone. Elsewhere, efforts to control malaria have proven effective: Paraguay was certified by WHO as malaria free in 2018; Algeria, Argentina, and Uzbekistan have made formal requests for certification; and in 2017 China and El Salvador reported zero indigenous cases. [WHO, ABC News]

Status of antibacterial resistance in China. In China, infections due to carbapenem-resistant Klebsiella pneumoniae have been increasing since 2005 while the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) infections decreased between 2005 and 2017, according to data collected by two national bacterial resistance surveillance systems in the country. In addition, researchers found that the prevalence of vancomycin-resistant Enterococcus species is low. [Clinical Infectious Diseases]

Drug-resistant gonorrhea on the rise and a possible vaccine solution. Cases of drug-resistant gonorrhea are on the rise in the US and across the globe posing serious health risks. Between 2009 and 2017, there has been a 75.2 percent increase in the number of reported gonorrhea cases in the US, according to the Centers for Disease Control and Prevention (CDC); meanwhile Neisseria gonorrhoeae has developed resistance to all but one recommended drug combination treatment. A vaccine developed by GlaxoSmithKline that is used to treat meningococcal infections may offer at least partial cross protection against gonorrhea, but further research is needed to assess the vaccine’s efficacy. [CDC, Bloomberg]

Antibiotic stewardship efforts in LMICs. Ahead of its second global Call to Action conference in Ghana, the Wellcome Trust published an article that highlights initiatives in low- and middle-income countries (LMICs) that aim to tackle the growing burden of antibiotic resistance. In India, the government is accelerating antibiotic development by investing in technology campuses. The Tanzanian Pharmacy Council is implementing accredited drug dispensaries and training pharmacists to sell appropriate antibiotics. And in Colombia, researchers are teaming up with farmers to establish surveillance systems for antibiotic-resistant bacteria in poultry. [Wellcome]

Prescription drug spending rising in the US. Between 2010 and 2017, total prescription drug spending increased 10 percent annually among Blue Cross and Blue Shield (BCBS) insurance members, according to the company’s analysis of drug use and spending data. Prescription drug spending accounted for over $100 billion, or 20 percent, of overall health expenditures, with the majority of this spending being on branded specialty and patent-protected drugs. Branded drugs account for only 17 percent of total prescriptions but represent 79 percent of total spending. In 2017, top medications by total spending were Humira, Remicade, and Enbrel, all of which are used to treat rheumatoid arthritis, psoriatic arthritis, and other autoimmune conditions. [BCBS Association, NBC News]

Non-antibiotic drugs contribute to the spread of antibiotic resistance. High levels of the non-antibiotic epilepsy drug, carbamazepine, in the environment contribute to antimicrobial resistance by promoting the transfer of resistance genes between bacteria, researchers at The University of Queensland found. Carbamazepine triggered bacterial cells to increase cell membrane permeability and produce pili which are used during the gene transfer process to connect cells and pass genes between different bacteria. This is the first study to explore the role of non-antibiotic pharmaceuticals in facilitating the transfer of resistance between bacteria in this way. [ISME Journal, Phys.org]

 ASA bans Facebook ad claiming that vaccines can kill. A social media watchdog organization, Advertising Standards Authority (ASA), banned a Facebook advertisement that warned parents that vaccines can kill children. The ad, which was paid for by the US-based group Stop Mandatory Vaccination, breached rules regarding harm and offense and contained misleading and unsubstantiated information, according to ASA. The ruling comes on the heels of increased media attention on the role of social media in the anti-vaccine movement.  [ASA, The Independent, The BMJ, Washington Post]

USDA launches poultry biosecurity campaign. The US Department of Agriculture (USDA) launched a new biosecurity campaign, “Defend the Flock,” aimed at reducing the spread of infectious diseases in chickens. The agency developed a new web page with resources for those in the poultry sector and will hold a webinar later in November. [USDA, Defend the Flock Webpage]

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