A weekly roundup of news on drug resistance and other topics in global health.
More medicine doesn’t necessarily mean better health, writes CDDEP visiting fellow Dan Morgan in an op-ed in the Baltimore Sun. Morgan cites a recent New England Journal of Medicine Perspective describing preliminary results of the Maryland All-Payer Model, which pays hospitals a standard amount for each Medicare patient, rather than paying for each service. After one year, the State reported a 26 percent drop in preventable conditions, such as infections and surgical errors, while the State’s per-capita Medicare costs decreased slightly. Morgan goes on to describe historical and present-day examples of costly and unnecessary medical procedures and calls for both clinicians and patients to educate themselves about overuse. [Baltimore Sun, New England Journal of Medicine]
Zika virus has gone from “a mild threat to one ­­of alarming proportions,” according to the World Health Organization (WHO), in a statement this week delivered by WHO Director Margaret Chan. WHO has predicted that the outbreak could grow to 3 to 4 million cases before it is over, up from current estimates of 1 million. CDC has linked Zika infection in pregnant women to cases of microcephaly, a serious birth defect, in Brazil. Not as sure is a link to Guillain-Barré syndrome, which can cause paralysis in those infected. Local transmission of Zika has now been reported in 22 countries in North and South America, and the Pan-American Health Organization expects that number to rise to all countries in the region with the vector, Aedes mosquitoes, including the United States. Zika virus disease typically causes mild symptoms, including aches, inflammation, joint pain and fever. There is currently no specific treatment or vaccine for the infection. [NPR, Infection Control Today, BBC]
Use of macrolide antibiotics in children is associated with weight gain and asthma later in life due to changes in the gut microbiome, according to research published in Nature Communications. The study, which examined 236 Finnish preschoolers, confirmed previous research indicating a positive correlation between antibiotic use early in life and higher BMI and increased risk of asthma. Specific changes in the gut bacteria of the children included depleted Actinobacteria, increases in the Bacteroidetes family and Proteobacteria, and an increase in macrolide-resistant bacteria. They also concluded that early use of macrolides causes more distinct and pronounced changes in gut microbiota than use of penicillins at similar levels. [The Guardian, Nature Communications]
Resistance to tenofovir, widely used to prevent and treat HIV infections, has been detected nearly 60 percent of patients in parts of sub-Saharan Africa. University College London researchers reported findings of a four-year study in The Lancet Infectious Diseases that examined more than 2000 patients in 36 countries in Europe and Africa for two genes that confer tenofovir resistance. In sub-Saharan Africa, resistance rates were around 57 percent, and in Europe, near 20 percent. Ravi Gupta, the study’s lead author, called the results “extremely concerning,” commenting that patients taking doses of the drug that were too low or improperly maintained can lead to resistance. [BBC, Lancet Infectious Diseases]
A rapid susceptibility test for Staphylococcus aureus infections has been developed by researchers at UC San Diego. The diagnostic works on recently killed bacterial cells, avoiding the need to culture the bacteria, which can take a day or longer. To the surprise of the research team, the method also distinguished between two subgroups of MRSA strains, one of which could be treated with an available antibiotic combination. The researchers hope to develop similar antibiotic susceptibility tests for other bacterial species, such as Pseudomonas aeruginosa. [UC San Diego, eBioMedicine]
An antimicrobial developed from lactoferrin, a protein found in breast milk, may be useful in fighting antibiotic-resistant bacteria. UK researchers at University College London and National Physical Laboratory identified and isolated a “miniscule fragment” of the protein that gives it antimicrobial properties, which helps protect infants from disease. Using the isolated fragment, they engineered virus-like antimicrobial nanoparticles that can be precisely delivered to a bacterial site and “elicit rapid and localized membrane-disrupting responses,” halting the spread of bacteria. [The Guardian, Chemical Science]
Low-cost prevention measures applied to relief workers might have avoided the fall 2010 cholera epidemic in Haiti. If relief workers had been screened for cholera, given antibiotic prophylaxis at departure, or vaccinated and given prophylaxis one week before departure, the model predicted that the risk of cholera infections could have been reduced by 82 percent, 50 percent, 61 percent and 91 percent, respectively. The research, published in PLOS Medicine, also found that combining vaccination and one week of pre-departure prophylaxis reduced the probability of cases by 98 percent. They concluded that though all of the strategies studied were effective, antibiotic prophylaxis was the lowest cost approach. [PLOS Medicine, Yale School of Public Health]
CDDEP is hiring a Communications Intern for the Washington, D.C. office. For more information and to apply, visit cddep.org/jobs.More medicine doesn’t necessarily mean better health, writes CDDEP visiting fellow Dan Morgan in an op-ed in the Baltimore Sun. Morgan cites a recent New England Journal of Medicine Perspective describing preliminary results of the Maryland All-Payer Model, which pays hospitals a standard amount for each Medicare patient, rather than paying for each service. After one year, the State reported a 26 percent drop in preventable conditions, such as infections and surgical errors, while the State’s per-capita Medicare costs decreased slightly. Morgan goes on to describe historical and present-day examples of costly and unnecessary medical procedures and calls for both clinicians and patients to educate themselves about overuse. [Baltimore Sun, New England Journal of Medicine]
Zika virus has gone from “a mild threat to one ­­of alarming proportions,” according to the World Health Organization (WHO), in a statement this week delivered by WHO Director Margaret Chan. WHO has predicted that the outbreak could grow to 3 to 4 million cases before it is over, up from current estimates of 1 million. CDC has linked Zika infection in pregnant women to cases of microcephaly, a serious birth defect, in Brazil. Not as sure is a link to Guillain-Barré syndrome, which can cause paralysis in those infected. Local transmission of Zika has now been reported in 22 countries in North and South America, and the Pan-American Health Organization expects that number to rise to all countries in the region with the vector, Aedes mosquitoes, including the United States. Zika virus disease typically causes mild symptoms, including aches, inflammation, joint pain and fever. There is currently no specific treatment or vaccine for the infection. [NPR, Infection Control Today, BBC]
Use of macrolide antibiotics in children is associated with weight gain and asthma later in life due to changes in the gut microbiome, according to research published in Nature Communications. The study, which examined 236 Finnish preschoolers, confirmed previous research indicating a positive correlation between antibiotic use early in life and higher BMI and increased risk of asthma. Specific changes in the gut bacteria of the children included depleted Actinobacteria, increases in the Bacteroidetes family and Proteobacteria, and an increase in macrolide-resistant bacteria. They also concluded that early use of macrolides causes more distinct and pronounced changes in gut microbiota than use of penicillins at similar levels. [The Guardian, Nature Communications]
Resistance to tenofovir, widely used to prevent and treat HIV infections, has been detected nearly 60 percent of patients in parts of sub-Saharan Africa. University College London researchers reported findings of a four-year study in The Lancet Infectious Diseases that examined more than 2000 patients in 36 countries in Europe and Africa for two genes that confer tenofovir resistance. In sub-Saharan Africa, resistance rates were around 57 percent, and in Europe, near 20 percent. Ravi Gupta, the study’s lead author, called the results “extremely concerning,” commenting that patients taking doses of the drug that were too low or improperly maintained can lead to resistance. [BBC, Lancet Infectious Diseases]
A rapid susceptibility test for Staphylococcus aureus infections has been developed by researchers at UC San Diego. The diagnostic works on recently killed bacterial cells, avoiding the need to culture the bacteria, which can take a day or longer. To the surprise of the research team, the method also distinguished between two subgroups of MRSA strains, one of which could be treated with an available antibiotic combination. The researchers hope to develop similar antibiotic susceptibility tests for other bacterial species, such as Pseudomonas aeruginosa. [UC San Diego, eBioMedicine]
An antimicrobial developed from lactoferrin, a protein found in breast milk, may be useful in fighting antibiotic-resistant bacteria. UK researchers at University College London and National Physical Laboratory identified and isolated a “miniscule fragment” of the protein that gives it antimicrobial properties, which helps protect infants from disease. Using the isolated fragment, they engineered virus-like antimicrobial nanoparticles that can be precisely delivered to a bacterial site and “elicit rapid and localized membrane-disrupting responses,” halting the spread of bacteria. [The Guardian, Chemical Science]
Low-cost prevention measures applied to relief workers might have avoided the fall 2010 cholera epidemic in Haiti. If relief workers had been screened for cholera, given antibiotic prophylaxis at departure, given prophylaxis one week before departure or vaccinated against the disease, the model predicted that the risk of cholera infections could have been reduced by 82 percent, 50 percent, 91 percent and 61 percent, respectively. The research, published in PLOS Medicine, also found that combining vaccination and one week of pre-departure prophylaxis reduced the probability of cases by 98 percent. They concluded that though all of the strategies studied were effective, antibiotic prophylaxis was the lowest cost approach. [PLOS Medicine, Yale School of Public Health]
CDDEP is hiring a Communications Intern for the Washington, D.C. office. For more information and to apply, visit cddep.org/jobs.
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