May 22, 2015
A weekly roundup of news on drug resistance and other topics in global health.
Challenges facing new antibiotic discovery and development are explored in an article in the journal Science. CDDEP Director Ramanan Laxminarayan comments in the article that smaller pharmaceutical companies have the capacity and should themselves bring drugs to the market. He contends that big pharma companies “are not the drivers of innovation” for antibiotic development. [Science (subscription required)]
The US House of Representatives Energy and Commerce Committee has unanimously approved a bipartisan bill to catalyze medical innovation. The bill, known as the 21st Century Cures Act, authorizes annual increases of $1.5 billion to the NIH budget for 3 years and sets aside a mandatory $10 billion funding over 5 years for a new NIH Innovation Fund, with at least $500 million providing annual matching funds for research on areas including infectious diseases and antibiotics. The bill also calls for reforms to the NIH and FDA. This is just the first step for the bill, which will not become law unless passed by the full House of Representatives and the Senate and signed by the President. [Science]
Simple, inexpensive rapid diagnostics could provide the “technological leap” necessary for India to effectively combat antibiotic resistance. An article published in LiveMint and Der Tagesspiegel focused on the current state of diagnostic use for antibiotic prescriptions in India Though some larger hospitals have the laboratories necessary to diagnose bacterial infections, “when 80% of the country does not have microbiology or culture facilities, counting on diagnostics for writing the right prescription may sound fanciful.” The article cited CDDEP research to highlight the depth of the problem: A CDDEP study published in The Lancet in 2014 found antibiotic use in India increased 62% percent between 2000 and 2010, compared with an average 36% increase in the rest of the world. [LiveMint]
Foodborne illnesses cost the United States $15.5 billion annually, according to a USDA report released this week. The report details the overall economic burden of illnesses caused by foodborne pathogens and includes a detailed breakdown of the 15 most common pathogens. Just five pathogens are responsible for 90 percent of the burden: Salmonella, Listeria monocytogenes, Campylobacter and Norovirus. [USDA]
Researchers have re-engineered an old antibiotic to create new and more potent versions that show early effectiveness in treating drug-resistant respiratory tract and sexually transmitted bacterial infections. Their work, published in the journal Science Translational Medicine, describes altering the chemical structure of spectinomycin, a safe but weak drug first introduced in the 1960s, to enable it to “enter a broad range of bacteria, bind to the ribosome and block protein synthesis.” [Science Translational Medicine, Scicasts]
A new rule proposed by the FDA would require antibiotic manufacturers to report livestock antibiotic sales by type of animal. Under current regulations, drug companies must report total antibiotic sales, but health advocates say that a more detailed picture of which animals are receiving antibiotics could help focus policy solutions aimed at reducing antibiotic resistance. [The New York Times]
A routinely administered vaccine may reduce the risk for the most common type of childhood cancer. The Haemophilus influenzae type B (HiB) vaccine has previously been linked to reduced likelihood of acute lymphoblastic leukemia (ALL), and scientists at the University of California, San Francisco have now determined the likely mechanism. In a paper in Nature Immunology, they demonstrate that infection with the HiB bacterium can activate two enzymes that cause blood cell mutations linked to the cancer; HiB vaccination reduces the risk of ALL by 20 percent. [Nature Immunology, The New York Times]
A gel filled with “toxin-absorbing nanosponges” may help treat methicillin-resistant Staphylococcus aureus (MRSA) skin infections. The treatment, developed by materials scientists at the University of San Diego, combines two different technologies—nanosponges and hydrogels—to target toxins produced by the bacteria. The nanosponges are designed to mimic red blood cells and attract toxins so they can be removed from the bloodstream, while the hydrogel functions to keep the nanosponges in place and bind them to the infection site. The study showed that the technique “minimized the growth of skin lesions on mice infected with MRSA” without the use of antibiotics. [Advanced Materials, EurekAlert]
Cholera cases in Haiti have quadrupled to almost a 1,000 per week, up from around 1,000 per month. The WHO estimates that 2015 could see up to 28,000 cholera cases as the epidemic has now lost the focus of the international community. According to Pedro Medrano Rojas, Senior Coordinator for Cholera Response in Haiti for the United Nations, “The lack of resources has already led to the closure of 91 of the 250 treatment centres in the country and has caused the departure of many international partners.” Since the 2010 earthquake, 735,000 cholera cases and more than 9,000 deaths have occurred. [UN News Centre]
Antibiotics may be a viable alternative to surgery for treatment of appendicitis, according to a paper that summarized five studies on antibiotic use for appendicitis published this week in the New England Journal of Medicine. The study found that 70 percent of patients receiving antibiotics for the infection did not ultimately require surgery, and that those that did were no more likely to have complications than those who had surgery immediately. [New England Journal of Medicine, The New York Times]
Incidence of multidrug-resistant Shigella in the United States has risen significantly in the past year. The rise in incidence was detailed in a Scientific American investigation that reported 275 CDC-confirmed cases of ciprofloxacin-resistant Shigella in the country since May 2014. The number of confirmed cases is likely far lower than total incidence, however, as shigellosis is routinely underreported and difficult to identify. The paper includes an infographic showing changes in Shigella incidence over the last year in each U.S. state, as well as the number of ciprofloxacin-resistant cases by state. [Scientific American]
Large-scale diabetes testing in India could produce numerous false positives and may not be an efficient allocation of health care resources. A study published in PLOS Medicine used a microsimulation and data from 58 studies to determine the health system implications of four types of large-scale screening for diabetes—three using surveys and the fourth with glucose testing. The researchers found that out of 567 million Indians eligible for such screening, the methods would produce positive results for 150-300 million people, but only 26-37 million of those would actually meet the criteria for a true diabetes diagnosis. They concluded that because of the relatively high cost of testing (US$5.28-$17.06 depending on testing type) and high chance of false positives, “[r]esource allocators should consider the health system burden of screening and confirmatory testing when instituting large-scale community-based screening for diabetes.” [PLOS Medicine]
Two promising developments to combat malaria were reported this week. At the World Health Assembly, countries have adopted a goal of reducing the number of malaria cases by 90% in the next 15 years at an estimated cost of $100 million. According to Dr. Pedro Alonso, head of WHO’s Global Malaria Program, the returns would far outweigh the costs. He calls the goal “ambitious but achievable,” bringing us “very close to eradication.” Meanwhile, using satellite data and remote sensing approaches, researchers at the Australian National University are working on a new surveillance system for malaria and other parasitic diseases. Though unlikely to replace traditional surveillance systems, their approach will provide additional information from areas that are difficult to monitor. [AFP, Voice of America]
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