November 25, 2019
Vaccines should be used as a tool to slow the spread of antimicrobial resistance. A Lancet report has highlighted the role of vaccines in slowing the spread antimicrobial resistance (AMR). Vaccines can reduce the spread of AMR by targeting resistance genes, preventing infections, reducing the use of antimicrobials, and decreasing the prevalence of viral infections. While using vaccines as a tool against AMR has received some recent attention, encouraging companies and governments to invest in vaccine development remains a challenge. CDDEP director Ramanan Laxminarayan emphasizes that more data is needed to identify which specific vaccines have the largest potential to reduce resistance. [The Lancet]
New antibiotic approved for complicated UTIs. The US Food and Drug Administration (FDA) approved a new antibiotic for the treatment of complicated urinary tract infections (UTIs) that are resistant to common treatment options. Fetroja demonstrated safety and efficacy compared to alternative antibiotics in a trial of nearly 450 patients with complicated UTIs, and the new drug represents an advancement in antibiotic development for resistant infections. [FDA]
New York becomes first state to disclose the names of hospitals and nursing homes with C. auris cases. The New York Times released a list of all the hospitals and nursing homes in New York state that have identified Candida auris colonizations and infections within the past three years. New York is the first state to disclose this information with the aim of providing transparency and encouraging increased prevention and control measures for the deadly fungus. Manhattan, Brooklyn, and Queens had the highest number of facilities with reported C. auris cases, although the number of colonized/infected patients in each facility was not reported. [NYTimes]
Researchers identify deadly strain of Klebsiella in Brazilian teaching hospital. Researchers conducted a retrospective cohort study of 165 adults with Klebsiella pneumoniae Carbapenemase-producing K. pneumoniae (KPC-KP) blood stream infections in a Brazilian teaching hospital between 2014 and 2016. The 30-day mortality rate of all cases was 60 percent, and 66 percent of infections were caused by the CC258 strain. The deadly ST16 strain, which was isolated from 12 percent of cases, had a 95 percent mortality rate and was linked to a significantly higher odds of a fatal outcome (OR=21.4). [Clinical Infectious Diseases]
Ebola vaccine prequalification will facilitate licensure in high-risk countries. The World Health Organization (WHO) has prequalified the Ervebo Ebola vaccine, which has already protected over 250,000 people in the current Democratic Republic of Congo (DRC) outbreak. This milestone indicates that the vaccine has met the WHO standards on vaccine safety, efficacy, and quality, and will facilitate vaccine licensure in high-risk countries. The European Commission also granted full licensure to the vaccine. Next month, the Gavi Vaccine Alliance board will meet to discuss a long-term Ebola vaccine program and global stockpile. [Gavi, CIDRAP]
Dengue vaccine candidate shows success in phase 3 trial. A tetravalent dengue vaccine candidate (TAK-003) demonstrated efficacy in a phase 3 trial among healthy children and adolescents in dengue-endemic regions across Asia and Latin America. The overall vaccine efficacy among children who received two vaccine injections compared to placebo was 80.2 percent, and efficacy against dengue-related hospitalizations was 95.4 percent. [NEJM]
Surgical antibiotic prophylaxis often prescribed inappropriately in Australia. A team of researchers analyzed data from Surgical National Antimicrobial Prescribing Survey audits in Australian hospitals between 2016 and 2018 and identified high rates of inappropriate surgical antibiotic prophylaxis. The appropriateness of procedural antibiotic prophylaxis ranged from 33.7 percent for dental surgery to 68.9 percent for neurosurgery. The appropriateness of post-surgery prescriptions ranged from 21.5 percent for breast surgery to 59.7 percent for eye procedures. Incorrect timing and duration were identified as the most common reasons for inappropriate prescriptions. [JAMA Network Open]
Trends of antimicrobial use and resistance have plateaued across Europe. According to an analysis using data from the European Surveillance of Antimicrobial Consumption Network and the European Antimicrobial Resistance Surveillance Network, trends of antimicrobial use and resistance in Escherichia coli and Klebsiella pneumoniae have dropped or remained stable across Europe in the past six years. Following years of increasing antimicrobial use and resistance trends, the study identified a plateau in resistance to third-generation cephalosporinsand carbapenems,as well as a decline in carbapenem consumption between 2013 and 2018. While results suggest that public health efforts to improve antibiotic use are working, the authors note that most trends are slowing, and not decreasing. [Eurosurveillance]
Climate change may have severe impacts on disease transmission. A group of researchers from institutions across the globe released the 2019 report of The Lancet Countdown, which assesses the health impacts of climate change. Last year was one of the hottest years on record globally, and the world today is over four degrees warmer than the average pre-industrial temperature. The report notes a link between warming temperatures and global suitability for pathogens, as well as rising infectious disease rates. Authors hope to raise awareness among policymakers and the public about the harmful health impacts of climate change. [The Lancet]
Antimicrobial consumption in livestock is highest in China, according to 2013 estimates. [CDDEP]
