Saudi Arabia reports possible hospital MERS outbreak in Buraydah
The Saudi Arabian Ministry of Health (MOH) has reported a possible hospital outbreak of MERS-CoV in Buraydah, the site of several recently diagnosed cases of the respiratory disease.
On Jan 6 a 73-year-old Saudi woman in Buraydah was listed in critical condition after testing positive for Middle East respiratory syndrome coronavirus (MERS-CoV). He infection is listed as secondary and health-acquired. Since Jan 2, five women in Buraydah have been diagnosed as having MERS, and two of them have died.
On Jan 7, the MOH said that a 57-year-old expatriate man in Al Hofuf had MERS-CoV, and on Jan 8 the agency said that both he and a 52-year-old Saudi man in Najran died from MERS complications. The MOH said the man from Al Hofuf, had a non-primary infection, meaning he likely contracted the disease from somewhere else.
The new cases raise Saudi Arabia's MERS-CoV total to 1,600, including 638 deaths. Ten people are still in treatment or monitoring.
Jan 6 MOH report
Jan 7 MOH report
Jan 8 MOH report
Analysis indicates tedizolid is an alternative option for MRSA skin infections
A meta-analysis of 15 clinical trials has found that tedizolid could be an alternative option for the treatment of serious skins infections caused by methicillin-resistant Staphylococcus aureus (MRSA), researchers recently reported in BMC Infectious Diseases.
For the review, researchers combed 10 databases to find studies that estimated the relative effectiveness of tedizolid, an oxazolidinone-class antibiotic, and established monotherapy comparators (including vancomycin, daptomycin, linezolid, and ceftaroline) for treating acute bacterial and skin structure infections caused by MRSA. Vancomycin has historically been the standard treatment for MRSA, but concerns about slow bactericidal activity and the emergence of resistance have called its efficacy into question.
Outcomes of interest included clinical response at end of therapy (EOT), post-therapy evaluation (PTE), and treatment of discontinuations resulting from adverse events (AEs).
Among the 15 trials that met the inclusion criteria, fixed-effect models showed that tedizolid had higher odds for clinical response at EOT (OR, 1.7) and at PTE (OR, 1.6) than vancomycin, but there was no evidence of a difference between tedizolid and the other comparator drugs in odds of clinical response for EOT or PTE. In addition, there was no evidence of a difference between any of the treatments for discontinuation because of AEs.
"These findings suggest that tedizolid provides an alternative option for the management of serious skin infections caused by suspected or documented MRSA," the authors write. They note, however, that the study is subject to the limitations inherent in all network meta-analyses (including quality of included studies, publication bias, and limited data), and the results should be interpreted accordingly.
Jan 7 BMC Infect Dis study
Study: Low doses of aminoglycosides for MDR-TB can reduce hearing loss
A study today from Dutch researchers indicates that lower doses of aminoglycosides for the treatment of multidrug-resistant tuberculosis (MDR-TB) can reduce one of the drugs' more significant side effects while still remaining effective.
In a study published in Antimicrobial Agents and Chemotherapy, investigators from the University of Gronningen retrospectively evaluated 80 patients treated for MDR-TB from 2000 to 2012. The patients received doses of 6.5 mg/kg/day of amikacin and kanamycin, the aminoglycosides that form the cornerstone of MDR-TB treatment. While World Health Organization guidelines recommend 15 mg/kg/day, hearing loss and nephrotoxicity have been observed in 8% of 37% of patients receiving those drugs for any period.
The purpose of the study was to evaluate a strategy that used lower doses of aminoglycosides based on the susceptibility of the infection to the drugs and the concentration of the drugs in patients' blood.
Overall, the investigators found that lower doses of the drugs resulted in less hearing loss for the patients, with only 9 of the 70 patients (12.9%) who were available for audiometry tests showing hearing loss at high decibels. And of the 52 patients with available clinical data, 35 (67.3%) had successful outcomes, with none of the patients having a documented treatment failure or relapse.
These results, the authors write, suggest that "the efficacy at this lower dosage is maintained with limited toxicity" and provide enough evidence for a prospective randomized trial.
"After more than 30 years of medical practice prescribing aminoglycosides in a dose of 15 mg/kg, we believe that a formal study is warranted between standard of care, and an individualized approach based on drug susceptibility and drug concentrations," they write.
Jan 9 Antimicrob Agents Chemother abstract
