October 23, 2015
A weekly roundup of news on drug resistance and other topics in global health.
The incidence of carbapenem-resistant Enterobacteriaceae (CRE) in children increased in the United States between 1999 and 2012, but is still relatively low, according to a study co-authored by CDDEP researchers and published in Emerging Infectious Diseases. The results are based on more than 300,000 isolates tested in laboratories participating in The Surveillance Network. Even with the increase, CRE is less common than extended-spectrum β-lactamase–producing Enterobacteriaceae. The increases were greatest for Enterobacter species, blood culture isolates and isolates from intensive care units. [Emerging Infectious Diseases, CBS News]
CDDEP Associate Director Hellen Gelband was interviewed on Africa54, Voice of America’s daily television news program, about CDDEP’s State of the World’s Antibiotics, 2015 report and ResistanceMap. The segment focused on the report’s findings on antibiotic resistance in low- and middle-income countries, especially in sub-Saharan Africa. Says Gelband, “We’ve found that contrary to what you often hear, there really are good data—nobody has gone out and tried to scour and find them [before], and that’s what we’ve done …everywhere you look, antibiotic resistance is increasing and antibiotic use is increasing.” The segment is available online here; the segment covering the State of the World’s Antibiotics, 2015 begins at 14:30. [Voice of America, CDDEP]
An editorial in The Lancet Infectious Diseases asks what can be done about the growing global problem of antibiotic resistance, and cites CDDEP’s State of the World’s Antibiotics, 2015 to answer the question. The editorial argues that in order to effectively address the problem, “rapid action is needed gather comprehensive information on antimicrobial resistance, optimise hygiene standards in hospitals and farming, limit the use of antibiotics to cases where there is a medical or veterinary prescription, and enhance the awareness of resistance among the general public and the policy makers.” [The Lancet Infectious Diseases]
CDDEP researchers’ Lancet Infectious Diseases paper on surgical and cancer chemoprophylaxis, published last week, has continued to receive media attention, including a discussion on Fox News’ medical segment, Sunday Housecall. CDDEP Director Ramanan Laxminarayan was also featured on The Lancet Infectious Diseases podcast, where he discussed the implications of the study on the future of surgical procedures and cancer chemotherapy. CDDEP Associate Director Hellen Gelband puts the study in perspective on the CDDEP blog, “From Boilerplate to Lives Lost: Surgery, Cancer and Antibiotics.”
Fast food giant Subway announced this week that it is phasing out antibiotics from all of its meat products. According to a press release from the restaurant chain—the largest in the United States, with more than 27,000 locations—the phaseout will include chicken, turkey, beef and pork. They will serve “only protein from animals that have never received antibiotics.” Prior to this announcement, Subway previously had a plan in place to remove all antibiotics used in human medicine from its chicken products, which should be completed by the end of 2016. [Subway Restaurants, NPR]
Invasive methicillin-susceptible Staphylococcus aureus (MSSA) causes more infections and deaths in hospitalized infants than methicillin-resistant Staphylococcus aureus (MRSA), and the two infections have similar mortality rates. The study, published in JAMA Pediatrics, included nearly 4,000 infants treated in 348 neonatal intensive care units in the United States from 1997 through 2012. Commentary on the study published on the blog Controversies in Hospital Infection Prevention argued that hospitalists should focus on preventing both, instead of buying into “MRSA exceptionalism.” Writes Mike Edmond in the blogpost, “We need to quit chasing pathogen-based approaches (vertical strategies) to infection prevention and focus on horizontal strategies that reduce infections from all pathogens.” [JAMA, Controversies in Hospital Infection Prevention]
Outbreaks of dengue fever are overwhelming the health systems of many Asian countries. In addition to a major outbreak in New Delhi—its worst in two decades—Malaysia, Myanmar, the Philippines, Taiwan, Thailand and Vietnam have all experienced a spike in dengue cases this season. According to the WHO, for several countries the combination of heavy flooding and a rise in people living in dense urban areas has contributed to the spread of the mosquito-borne virus. Dengue was present in a handful of countries in the 1950s but has now spread to more than 125. [Reuters]
Repeated antibiotic use in childhood may be connected to weight gain and higher BMI later in life. Researchers at Johns Hopkins University assessed medical records of more than 160,000 children aged 3 to 18 and found that “at age 15, children who had taken antibiotics seven or more times during childhood weighed about three pounds more than those who received no antibiotics.” The effect was dose-related: the more antibiotics a child received, the more weight they gained by the end of childhood—a trend that the researchers suspect may continue into adulthood. [Johns Hopkins University, International Journal of Obesity]
An international team of scientists discovered antibiotic-resistance genes in a 1000-year-old Andean mummy. The researchers identified a variety of genes that indicate resistance to broad-spectrum antibiotics—fosfomycin, chloamphenicol, tetracycline, quinolones and vancomycin—in the 11th century mummy, according to findings published in PLOS ONE. The findings suggest that resistance to these drugs was present in genes long before antibiotics use began in the 20th century.
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