Weekly Digest: Nobel Prize awarded for antiparasitics, California expected to ban antibiotics for growth promotion

Needed: Greater Surveillance, New Norms in the Fight Against Antibiotic Resistance. In a post on the CDDEP blog, physician Kevin Kavanagh discusses the promising opportunity of a new antibiotic combination drug to target carbapenem-resistant Enterobacteriaceae (CRE), but points out that lack of a surveillance system that tracks CRE in the United States limits our ability to detect outbreaks, much less curb its spread. He also argues that new antibiotics alone won’t solve the problem—and that the lack of stewardship focus in the 21st Century Cures Act could promote unnecessary antibiotic use. Writes Kavanagh, “We should take the opportunity afforded by new antibiotics from BARDA (and other sources) to mend our ways and adopt new norms for antibiotic use.” [CDDEP]

CDDEP’s Global Antibiotic Resistance Partnership (GARP)-Uganda Working Group featured in a Voice of America article on antibiotic resistance in Uganda. According to Professor Denis Byarugaba, GARP-Uganda working group chair:

The article focused on the growing threat of antibiotic resistance in the country, and how a lack of pharmacists frequently leads to patients self-prescribing antibiotics. [Voice of America]

California is set to become the first U.S. state to pass legislation banning antibiotics for agricultural growth promotion. The legislation prohibits the use of medically important antimicrobial drugs in livestock solely for the purpose of growth promotion, and for other purposes, requires a veterinarian’s prescription. CA Governor Jerry Brown is expected to sign the bill into law on Sunday. If signed, the law will go into effect January 1, 2018. [San Francisco Chronicle, California Legislature]

The Nobel Prize for Physiology or Medicine was awarded this week to three researchers for the development of antiparasitic drugs, including Youyou Tu for identifying artemisinin for malaria. Tu, a Chinese researcher, worked on the isolation of artemisinin from the sweet wormwood plant, Artemesia annua. Artemisinin is the mainstay of all first-line falciparum malaria treatments, paired with another antimalarial in “artemisinin-combination therapies” or ACTs. The other two winners, William Campbell and Satoshi Omura, discovered avermectin, which is used to treat lymphatic filiariasis and river blindness. As a Reuters article noted, around 3.4 billion people—nearly half the world’s population—are at risk of contracting one of the three diseases. [Reuters]

CDC has assessed the prevalence of carbapenem-resistant Enterobacteriaceae (CRE) in seven metropolitan areas of the United States.  The assessment, the results of which were published in the Journal of the American Medical Association, used data from CDC’s Emerging Infections Program (EIP) collected in 2012 and 2013 in Colorado, Georgia, Maryland, Minnesota, New Mexico, New York, and Oregon. The overall incidence rate of CRE in the seven areas was 2.93 per 100,000 people. [JAMA]

Zero cases of Ebola were recorded last week in West Africa. This is the first Ebola-free week since March 2014, near the beginning of the outbreak. The last recorded cases of the virus were on September 3, 27 and 28 in Liberia, Guinea and Sierra Leone, respectively. [Reuters]

Antibiotics are used for myriad nonmedical purposes, from bee-keeping to ethanol production—and all contribute to the global problem of antibiotic resistance.  A perspective in PLOS Biology details the wide range of antibiotic uses, which include animal husbandry, bee-keeping, fish farming and other forms of aquaculture, ethanol production, horticulture, antifouling paints and food preservation. The authors conclude that the growing threat of antibiotic resistance demands an examination of all such uses and that all but essential uses be phased out. [PLOS Biology]

Influenza vaccination could prevent more than half of influenza-related pneumonia hospitalizations, according to a study published in the Journal of the American Medical Association. Researchers assessed records of more than 2,000 patients hospitalized for community-acquired pneumonia in four American cities between January 2010 and June 2012, and found that 29 percent of the non-influenza pneumonia group had been given a flu vaccine, whereas 17 percent of those with influenza-related pneumonia had received the vaccine. The researchers noted that the study adds to evidence that flu vaccines reduce hospitalizations, and urged individuals to receive the vaccine. Said lead author Carlos Grijalva, “This is an excellent time to get vaccinated.” [JAMA, Vanderbilt University]

The U.S. Food and Drug Administration has required three duodenoscopes manufacturers to complete new studies on the proper cleaning of the medical devices. Duodenoscopes made by the three companies were tied to outbreaks of “superbug” carbapenem-resistant Enterobacteriaceae (CRE) in California hospitals, which contributed to two deaths. Olympus Medical Systems, Fujifilm and the Pentax division of Hoya were issued warning letters by the FDA in August for failing to report infections and ineffective sterilization and cleaning recommendations. [Washington Post, CDDEP]