August 30, 2019
Antibiotic use associated with colorectal cancer risk. A matched case-control study conducted by researchers in the UK and the US using data from 1989-2012 found that oral antibiotics were associated with an increased risk of colon cancer, even after minimal use, as well as a decreased risk of rectal cancer (p<0.001, 0.003). In particular, exposure to ampicillin/amoxicillin was linked with increased colon cancer risk, while exposure to tetracyclines was linked with decreased rectal cancer risk (aOR= 1.09, 0.90). These results suggest a link between antibiotic use and changes in the digestive tract, which affect the development of chronic diseases. [BMJ Gut]
New antibiotic approved for community-acquired pneumonia. The US Food and Drug Administration (FDA) recently approved a new drug, Xenleta (lefamulin), for the treatment of community-acquired bacterial pneumonia in adults. Researchers found comparable rates of clinical efficacy in Xenleta compared to moxifloxacin with or without linezolid in two clinical trials. [FDA]
Multidrug-resistant Salmonella outbreak tied to beef and soft cheese. The US Centers for Disease Control and Prevention (CDC) has identified a multidrug-resistant outbreak of Salmonella enterica serotype Newport infections that showed decreased susceptibility to azithromycin, a recommended treatment for the infection. Between June 2018 and March 2019, 255 cases of the infection were reported across 32 states and 60 patients were hospitalized. The infections were linked to soft cheese originating from Mexico and beef originating in the US. The CDC recommends that consumers avoid unpasteurized soft cheeses regardless of origin, and ensure beef is fully cooked. [CDC MMWR]
Increased taxes on sugary beverages in South Africa to save lives and money. A cost-effectiveness analysis found that a 10 percent tax increase on sugar-sweetened beverages in South Africa would prevent 8000 premature deaths related to type 2 diabetes mellitus and save the country $140 million USD in healthcare costs over a 20-year span. The excise tax would also produce a $450 million USD increase in tax revenue per year. [BMJ Global Health]
Single-bed hospital rooms lead to decreased MDRO colonization. Researchers in Canada conducted a time-series analysis to measure the effect of a hospital’s move from multi-patient ward-type rooms to single-patient rooms on transmission rates of multidrug-resistant organisms (MDROs) and healthcare-associated infections. The Montreal hospital’s move to a facility with exclusively single-patient rooms was associated with a decrease in nosocomial vancomycin-resistant Enterococcus (VRE) colonization, methicillin-resistant Staphylococcus aureus (MRSA) colonization, and VRE infections (incident rate ratio: 0.25, 0.57, 0.30 respectively). However, the move did not have an impact on rates of Clostridioides difficile or MRSA infections. [JAMA Internal Medicine]
Controlling the transmission of ESBL-producing Enterobacteriaceae in hospitals. Scientists in the Netherlands assessed the impact of applying contact precautions in single-bed rooms versus multiple-bed rooms on the control of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae in 16 Dutch hospitals. They found that transmission of the Gram-negative bacteria to at least one wardmate occurred in 7 percent of index patients who underwent the multiple-bed room strategy, compared to 4 percent of patients who underwent the single-bed room strategy. [The Lancet Infectious Diseases]
ESBL–producing Enterobacterales spreads rapidly among hospitalized neonates in Kenya. Researchers estimated the incidence of extended-spectrum β-lactamase–producing Enterobacterales (ESBL-E) acquisition and related risk factors among neonates admitted to Kilifi County Hospital in Kenya between 2013 and 2014. At hospital admission, 10 percent of neonates carried ESBL-E, and 55 percent acquired the pathogen during their stay. Risk factors for neonatal acquisition included delivery by Cesarean section and ward density of other neonatal patients known to be ESBL-E carriers. [Clinical Infectious Diseases]
Drug-resistant malaria genes are spreading across Africa. The Plasmodium Diversity Network Africa along with the Wellcome Sanger Institute conducted a genomic surveillance study of Plasmodium falciparum parasites across 15 countries in sub-Saharan Africa to track drug-resistant strains of malaria. The analysis identified genetically distinct populations of the parasite in regions including West Africa, Central Africa, South Central Africa, East Africa, and Southeast Africa. The subpopulations mirrored parasite origin and human migration patterns, and shared genetic material in multiple directions across the continent. The parasites shared genes that confer resistance to antimalarial drugs, and 12 isolates had strong genetic signatures that raise concerns over the development of resistance to artemisinin-based combination therapies (ACTs). [Science]
ASPs in nursing homes improve following new regulation. According to a nationally-representative survey among 861 nursing homes in the US, antibiotic stewardship programs (ASPs) have become more comprehensive in nursing homes following updated regulations from the Centers for Medicare and Medicaid which require the establishment of ASPs. The survey found that one-third of the nursing homes had “comprehensive” ASP policies, which were associated with participation in Quality Innovation Network-Quality Improvement Organization activities, and more than 40 percent had “moderately comprehensive” policies. Moderate and comprehensive ASPs were associated with infection preventionist training and high nursing home occupancy. [American Journal of Infection Control]
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