Weekly Digest: Web-based handwashing program reduces infections; U.S. foodborne pathogen antibiotic resistance remains steady

“Once resistance emerges, [it] can spread among bacteria very quickly in India because of poor sanitation in the community and poor implementation of infection control practices in hospital.” Business Today India published an interview with CDDEP Director Ramanan Laxminarayan this week on the problem of antibiotic resistance in India and potential solutions. Citing CDDEP research, Laxminarayan noted that India is consuming antibiotics at an alarming rate, including last-resort drugs like carbapenems. Antibiotic stewardship programs in hospitals, enforcement of restrictions on over-the-counter antibiotic sales and public awareness campaigns on appropriate antibiotic use are key elements of a national strategic plan to address the issue. [Business Today India, The Lancet]

An internet-based handwashing program may help reduce the spread of infections during winter flu season, according to research published in The Lancet. In a randomized trial that included more than16,000 participants, those the intervention group—who had access to an automated web-based program once weekly for four weeks that tracked handwashing behavior, provided feedback, reinforced helpful attitudes and addressed false beliefs—had a 14 percent lower risk of general infection and a 20 percent lower risk of catching flu than those in the control group. [The Lancet, BBC]

Antimicrobial resistance among foodborne pathogens in the United States is stable for most species, but increasing in at least two Salmonella subtypes. According to the FDA’s annual National Antimicrobial Resistance Monitoring System (NARMS) report, about 80 percent of human Salmonella isolates were not resistant to any antibiotics tested in 2012-3, similar to levels over the past 10 years. However, multi-drug resistance in the common Salmonella serotype l 4,[5],12:i:- increased from 18 percent in 2011 to 46 in 2013. Resistance levels in some bacteria in retail chicken meat are declining.  [CIDRAP, FDA]

French Guiana abandoned chloroquine as a malaria treatment 20 years ago because of widespread antimalarial resistance—now the parasite has evolved to become chloroquine-susceptible again. In 1995, more than 90 percent of Plasmodium falciparum parasites in the country were resistant to chloroquine; in 2012, it was less than 30 percent. Research reported in the Proceedings of the National Academy of Sciences found the cause of renewed susceptibility was a single mutation in the pfcrt allele of Plasmodium falciparum that emerged in 2002 and became prevalent over the course of a decade. The genetic change also impaired the strain’s susceptibility to piperaquine, another malaria drug—suggesting that piperaquine pressure may have driven the prevalence of P. falciparum isolates with the mutation. [Medical Xpress, PNAS]

Patients infected with methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia who report a penicillin allergy would benefit from further allergy testing before treatment instead of treatment with vancomycin. Researchers at Massachusetts General Hospital evaluated three options for treating these patients: 1) vancomycin with no allergy testing, 2) medical history-guided allergy testing before treatment decision and 3) skin test-guided allergy testing before treatment decision. Patients treated with vancomycin had the lowest cure rate, the highest recurrence rate, the highest frequency of allergic reactions and the highest rate of adverse drug effects. The authors suggest further research to distinguish between preferences for medical history-guided or skin test-guided allergy testing. [Clinical Infectious Diseases]

Children who have had malaria have a significantly higher risk of developing Burkitt’s lymphoma, a type of blood cancer, and now researchers may know why. Researchers at Rockefeller University found that an enzyme produced to create malaria-fighting antibodies in mice also causes collateral damage to DNA in the cells that produce them—a change that is linked to development of the blood cancer. [Cell, Rockefeller University]

A group of zoologists may have identified a new strategy for bacterial control that subverts resistance by interrupting bacterial collaboration. When treated with gallium nitrate, bacteria bind to the gallium ions instead of iron—a nutrient necessary for bacterial survival. Gallium nitrate is already approved by the FDA, and the researchers found it to be effective at suppressing growth of Pseudomonas aeruginosa without the development of drug resistance. The research was presented at a recent evolutionary biology conference in Zurich. [The Economist]

A device that fits in a suitcase may be able to detect counterfeit drugs in as little as 15 minutes. The product, PharmaChk, was developed by a Boston University biomedical engineer and tests for the concentration of active ingredient present in a drug sample. The researchers anticipate that PharmaChk will cost less than the GPHF-Minilab, a similar device currently on the market that takes a few hours to get results. [NPR]