November 30, 2018
Reduction in prevalence of healthcare-associated infections in US hospitals. Between 2011 and 2015, the prevalence of health care-associated infections (HAIs) decreased from 4.0 percent (452 of 11,282) of surveyed patients to 3.2 percent (394 of 12,299), according to point prevalence surveys carried out in 10 US states. This was driven by decreased prevalence of surgical-site and urinary tract infections. After adjusting for patient age, hospital size, use of medical devices, and days from admission to survey, the risk of contracting an HAI was 16 percent lower in 2015 than in 2011. [NEJM]
Probiotic use widespread despite minimal efficacy and safety evidence. In the United States, probiotic use doubled between 2002 and 2012 with 3.5 percent of college-educated adults reporting consumption. Despite increased popularity, scientific evidence supports the efficacy of only certain probiotic strains for the treatment of a limited number of diseases, namely diarrheal diseases associated with antibiotic consumption. Probiotic supplements are not subject to the same safety and efficacy requirements as pharmaceutical drugs, and while the US Food and Drug Administration (FDA) requires probiotic manufactures follow current good manufacturing practices, many are not compliant further increasing safety concerns of probiotic supplements. [JAMA, Nutrition, The New York Times]
Pharmaceutical companies continue to improve access to drugs in LMICs. GlaxoSmithKline, Novartis, Johnson & Johnson, Merck, and Takeda Pharmaceutical Company topped the 2018 Access to Medicine Index which ranks pharmaceutical companies in seven areas of corporate behavior including general access to medicine in low- and middle-income countries, market influence and compliance, research and development, pricing and distribution, and pharmaceutical and health systems capacity building. Globally two billion people still live without access to some essential medicines, and of the 20 companies evaluated, only 70 percent of key drugs – on-patent, first-line therapies designated as essential medicine by the World Health Organization – are included in access initiatives and most are limited in scope. [Access to Medicine Index]
Global meningitis burden remains high. Between 1990 and 2016, global meningitis deaths decreased by 21 percent from 403,012 to 318,400, according to the Global Burden of Diseases, Injuries, and Risk Factors 2016 study. In that same period, the number of meningitis cases increased from 2.5 million to 2.82 million. Meningitis burden was significantly associated with Socio-demographic Index. Peri-Sahelian countries in sub-Saharan Africa had the overall highest meningitis burden. In 2016, meningitis incidence ranged from 207.4 per 100,000 people in South Sudan to 0.5 per 100,000 people in Australia. [The Lancet]
Multi-drug resistant Enterobacter bugandensis species isolated from the International Space Station. In ongoing efforts to catalogue the microbial communities of crew-associated environments on the International Space Station (ISS), 105 bacterial samples were isolated from different locations on the ISS and underwent molecular phylogeny and whole genome analysis. Five isolates were identified as Enterobacter bugandensis with more than 100 genes involved in virulence, pathogenicity, defense, or multi-drug resistance. Genomic analysis showed all five isolates had a greater than 79 percent chance of being a human pathogen, according to the PathogenFinder algorithm. [BMC Microbiology, ScienceAlert]
Access to high-impact mutations constrains the evolution of antibiotic resistance in soft agar. When researchers exposed Escherichia coli to antibiotic gradients in soft agar plates, the bacteria rapidly underwent high-impact genetic mutations to develop resistance to drugs from every antibiotic class proven to be active against Gram-negative bacteria. The success of high impact, resistance-conferring mutations determined evolution rates suggesting that E. coli may rapidly develop antibiotic resistance through the temporary evolution of rapidly mutating bacterial strains which are replaced by strains with lower mutation rates in the absence of antibiotics. [Nature]
DRC begins first-ever multi-drug Ebola trial. The first-ever multi-drug randomized control trial to evaluate the efficacy and safety of drugs used to treat Ebola patients is underway in the Democratic Republic of the Congo, the country’s Ministry of Health announced. The trial is part of a larger multi-country project led by the World Health Organization. [WHO]
Most countries performing poorly on childhood physical activity. The Active Healthy Kids Global Alliance compared global trends in childhood physical activity across 49 countries from six continents. Overall, most countries received “C-,” “D,” and “F” grades indicating that interventions to increase physical activity are successful in fewer than half of the countries’ youth populations. Slovenia rated the highest with an “A-” grade for overall physical activity. Other “A” grades were for Japan in the physical fitness category, Nepal in the family and peers category, and Finland in the school and government categories. The US received “C” and “D” grades for every category. [Active Healthy Kids]
New US government report on climate change. Barring significant mitigation interventions, global temperatures could rise by nine degrees Fahrenheit (5 Celsius) or more by the end of the century, according to the fourth National Climate Assessment written by 13 federal agencies participating in the US Global Change Research Program. Using higher temperature change projections, extreme heat may result in the loss of two billion labor hours, or $160 billion in lost wages, annually, will severely reduce productivity across agricultural sectors, and may result in 2,000 additional premature deaths in the Midwest alone. [NCA, Nature, CNN]
In China, avian flu cases in humans and poultry. In China’s Jiangsu province, a 10-year old girl was diagnosed with H5N6 avian influenza, the Center for Health Protection announced. Since 2014, there have been over 20 cases of avian influenza in humans. Since late October 2018, three outbreaks of H5N6 influenza among poultry have resulted in thousands of animal deaths, according to notifications from the World Organization for Animal Health (OIE). [OIE Report 1, OIE Report 2, Center for Health Protection]
PACCARB calls for public comment on AMR priorities. The US Presidential Advisory Council on Combating Antimicrobial Resistant Bacteria (PACCARB) is requesting comments from the public on future priority areas as it updates its National Action Plan. In its first three years, PACCARB has focused its efforts on slowing the emergence and spread of resistant bacteria, strengthening national One Health surveillance systems, and accelerated drug research and development. Comments can be submitted online here until January 7, 2019. [PACCARB, Federal Register Notice]
Postdoctoral position at UC Berkeley for CDDEP-Berkeley project on Vaccines and AMR. There is an immediate opening for a postdoctoral researcher to study the impact of existing and future vaccines on the epidemiology of childhood infections, antimicrobial consumption, and antimicrobial resistance in the US and in several low- and middle-income countries. Applicants must have (or be nearing completion of) a doctoral degree, with strong quantitative and computational skills. Application materials can be sent to Joseph Lewnard. [IDD Jobs]
Photo: Global comparison of ISS E. bugandensis with other Enterobacter WGS from NCBI Microbial Genomes Resource. Credit: Singh, et al. (CC 4.0)
