May 31, 2019
The role of international travel in the spread of AMR. Researchers at CDDEP and the Swiss Federal Institute of Technology Zurich reviewed the role of international travel in the spread of antimicrobial resistance (AMR). Prevalence of AMR varies by country depending on antibiotic consumption levels, vaccination coverage, and access to clean water, sanitation, and healthcare. Travelers who visit areas with a high prevalence of AMR are likely to be exposed and return home colonized with resistant bacteria. To reduce the spread of AMR, researchers recommend that travelers are up to date on vaccines, informed on safe sexual practices, and consider antibiotics as a last resort in the prevention and treatment of traveler’s diarrhea. [Journal of Travel Medicine]
Using rapid diagnostics to reduce antibiotic resistance. Researchers at Duke, Harvard, and the Georgia Institute of Technology used a mathematical model to evaluate the use of rapid point-of-care resistance diagnostics (POC-RD) in reversing the rise of antibiotic resistance. Their model predicts the spread of resistance in pathogen strains, which could allow doctors to individualize treatments for patients and avoid inappropriate antibiotic prescribing. To reduce and reverse resistance, POC-RD should be used to screen both symptomatic and asymptomatic patients who may be carriers for drug-resistant bacteria strains. [PLOS Biology]
New vaccine storage method could save lives. A team of researchers in Ontario developed a vaccine storage method which could allow vaccines to stay viable for 2-3 months at 40 degrees Celsius, without refrigeration. The researchers dried DNA and RNA vaccines in a mixture of compounds that are commonly used to improve agent stability and extend the shelf life of food. This process successfully provided the vaccines with thermal protection. The development of this method is essential for increasing access and viability of life-saving vaccines in low-resource areas around the world. [Scientific Reports]
Engaging pharmacies in TB screenings improves case detection. A pilot study implemented across 105 pharmacies in Patna, India sought to evaluate the effectiveness of pharmacy engagement in tuberculosis screening services on improved case detection. The intervention consisted of TB screening training for pharmacies, referrals, incentives, text reminders, and field support. Throughout the 18-month intervention, a total of 255 TB cases were diagnosed, and there were 25 times more TB diagnoses in the intervention group than in the control group. These findings indicate that engaging pharmacies in TB screening services could be feasible in improving case detection for tuberculosis control. [BMJ Global Health]
Antibiotic prophylaxis reduces maternal infection following operative vaginal delivery. Researchers in the UK conducted a randomized controlled trial to assess the effect of antibiotic prophylaxis on incident maternal infections following operative vaginal delivery. The study found significantly fewer maternal infections in women who received a single dose of prophylactic antibiotic following delivery, compared to women who received the placebo (risk ratio: 0.58, p<0.0001). These findings should be used as evidence for WHO recommendations on antibiotic prophylaxis in operative vaginal deliveries, which are currently lacking. [The Lancet]
Interventions to improve antibiotic stewardship programs in hospitals. Experts and stakeholders came together last May to discuss steps to improve antibiotic stewardship programs in hospitals. The expert panel identified two interventions that exceed typical AS practices- diagnostic and handshake stewardship. Diagnostic stewardship involves addressing errors in antibiotic prescribing, and handshake stewardship involves regularly educating and actively engaging with providers on antibiotic stewardship. [The Joint Commission Journal of Quality and Patient Safety]
Unnecessary testing and antibiotic use in US children with community-acquired pneumonia. Although routine diagnostic testing and antibiotic use are not recommended for children with community-acquired pneumonia (CAP), a US sample of more than 6 million children with CAP found that a majority were given antibiotics (73.9 percent). The 2008-2015 sample also found that 43 percent of children received radiography, and 8.6 percent received a complete blood count. [Journal of the Pediatric Infectious Diseases Society]
HIV infects almost 500 children in Pakistani city. In late April, several children tested positive for HIV in Larkana, Pakistan, sparking outrage among parents and prompting free HIV screenings as part of a government intervention effort. As of late May, over 10,000 individuals had been screened for HIV, and 607 have tested positive (494 of which are children). The outbreak is thought to be caused by unsafe injection and blood transfusion practices among clinicians in the region. Approximately 150 medical facilities in Larkana have been shut down for further investigation and 600 have received government warnings. [NPR]
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