News Scan for Sep 22, 2020

News brief

Massachusetts reports fifth EEE case of the year

Health officials in Massachusetts recently reported the state's fifth eastern equine encephalitis (EEE) case of the year, involving a woman in her 60s who was exposed in Plymouth County, where a similar was detected earlier this month in an area known to be at higher risk.

The Massachusetts Department of Public Health (MDPH) said most of the state's cases since 2000 have occurred before the middle of September, and though mosquito populations are dropping, the risk of contracting EEE remains until after the first hard frost. Wisconsin and Indiana have also reported sporadic cases this year.

The US Centers for Disease Control and Prevention (CDC) says the infections are rare but can be fatal and that the nation averages about 11 EEE cases a year, but 38 were reported in 2019, with Massachusetts the hardest-hit state. Transmission is most common in and around freshwater hardwood swamps in Atlantic and Gulf Coast states and in the Great Lakes region.
Sep 17 MDPH press release
CDC background information

WHO advisors urge flu vaccination to prioritize health workers, seniors

Vaccine advisors to the World Health Organization (WHO) yesterday released new interim guidance for flu vaccination during the COVID-19 pandemic, which slightly changes the order of the priority risk groups to put health workers at the top of the list, followed by older adults.

The WHO Strategic Advisory Group of Experts (SAGE) said flu transmission might have been altered by COVID-19 measures and limited travel due to travel restrictions, but noted the steps vary by country and flu transmission could rise and circulate alongside SARS-CoV-2 as steps are relaxed.

It emphasized that the interim recommendations should be considered alongside its 2012 guidance, knowing that demand for flu vaccine this year might be higher. Modifications this year were made to optimize control of flu during the COVID-19 pandemic and should not interfere with targeting existing risk groups based on national policies.

The expert's interim guidance also covers program considerations for those planning flu vaccine campaigns, research considerations, and knowledge gaps.
Sep 21 WHO SAGE interim flu vaccination recommendations

Stewardship / Resistance Scan for Sep 22, 2020

News brief

CARB-X to fund development of drug for E coli urinary infections

CARB-X announced today that it will award drug maker GlaxoSmithKline (GSK) up to $7.51 million to develop a drug to treat and prevent urinary tract infections (UTIs) caused by Escherichia coli.

The award will help fund development of GSK3882347, an orally bioavailable small molecule drug that targets and binds itself to a protein (FimH) found on the surface of E coli, preventing the bacteria from binding to the bladder wall and causing an infection. GSK recently began a phase 1 study to explore the drug's safety, tolerability, and pharmacokinetics.

"GSK's project is in the early stages of development, and if successful, could potentially treat and prevent recurrent UTIs caused by E. coli and stop harmful bacteria from spreading in the body," CARB-X Research and Development Director Erin Duffy, PhD, said in a press release.

Since launching in 2016, CARB-X (the Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator) has awarded $250 million to accelerate the preclinical development of 68 antibacterial products.
Sep 22 CARB-X press release

Study finds Japanese stewardship guidelines did not lessen antibiotic use

National guidelines to promote the appropriate use of antibiotics in Japan had no effect on trends in antibiotic use for patients with acute respiratory tract infection (ARTI) and gastroenteritis, Japanese researchers reported today in Infection Control and Hospital Epidemiology.

Using data from a national claims database from June 2016 to June 2018, researchers from the University of Tokyo examined antibiotic use for ARTI or gastroenteritis among outpatients 6 years and older. To determine whether guidelines issued by the Japanese government in 2017 on clinical management of ARTI and gastroenteritis had any impact on antibiotic prescribing for those conditions, they conducted an interrupted time series analysis to calculate the season-adjusted changes in the rate of antibiotic prescriptions in the year before and the year after the guidelines were issued.

Previous studies had found that more than 70% of oral antibiotics prescribed in Japan in 2012 and 2013 were for those two conditions, often unnecessarily.

A total of 13,177,735 patients with ARTI and 300,565 patients with gastroenteritis were evaluated in the 2-year study period. Among patients with ARTI, there was a significant downward trend in antibiotic use during the 2-year study period (−0.06% per week; 95% confidence interval [CI], −0.07% to −0.04%), but there was no significant change in trends of antibiotic use between the pre-issue period and post-issue period (trend difference, −0.01% per week; 95% CI, −0.10% to 0.07%).

Similarly, for patients with gastroenteritis, there was no significant change in the trends of antibiotic use between the pre-issue period and post-issue period (trend difference, −0.02% per week; 95% CI, −0.04% to 0.01%). Similar associations were observed in analyses for broad-spectrum antibiotic use.

"Our findings indicate that the issue of national guidelines may not be an immediately effective intervention to change the prescribing behaviors of general practitioners, and they suggest the importance of further multifaceted strategies to promote optimal antimicrobial use," the authors of the study wrote. They suggest that financial incentives, prescribing restrictions, and clinician and patient education are strategies that should be explored.
Sep 22 Infect Control Hosp Epidemiol abstract