Flu research network details emergency response plan
An influenza research network established by the National Institutes of Health (NIH) in 2007 to help answer key questions during outbreaks now has a response plan to help it prepare for new challenges. A team led by the Centers for Infectious Disease Research and Development (CIDRAP), which publishes CIDRAP News, detailed the plan yesterday in Influenza and Other Respiratory Viruses.
The Centers of Excellence for Influenza Research and Surveillance (CEIRS) is a network of five multidisciplinary research centers, with several international partners, funded by the NIH. During the 2009 H1N1 pandemic, for example, the network tackled key knowledge gaps that helped inform the outbreak response.
To address organizational improvements, experts have suggested that the network address three main issues: having a mechanism to define the current technical response capabilities of each CEIRS center, establishing a more standardized research approach during emergencies, and defining more clearly the role of the National Institute of Allergy and Infectious Diseases CEIRS project officer during an emergency response.
To address the issues, the centers worked to develop the CEIRS Influenza Response Plan, and the new report describes the steps that went into the work. It also outlines and ranks CEIRS research priorities in an emergency situation and provides an operational strategy for executing them.
Apr 19 Influenza Other Respir Viruses report
Study: Hygiene in homes, daily life may reduce antimicrobial resistance
Improved hygiene in homes and communities can reduce antimicrobial resistance (AMR) by preventing infections and decreasing antibiotic prescribing, according to a position paper commissioned by the Global Hygiene Council in the American Journal of Infection Control.
The authors said that such hygiene measures, combined with provision of clean water and proper sanitation, could reduce the circulation of resistant bacteria, regardless of a country's socioeconomic status.
AMR action plans typically address infection prevention and control only in healthcare settings, but the authors say that the greatest risk of disease transmission occurs in settings such as homes, workplaces, schools, daycares, and on public transportation. This is particularly important in light of increasing numbers of immunocompromised people receiving care at home.
The authors recommend "targeted hygiene" measures such as hand washing and surface disinfection before, during, and after high-risk activities such as food handling, using the toilet, changing diapers, coughing, sneezing, washing clothing, and caring for an infected family member.
To prevent microbicide-related AMR, however, the use of disinfectants needs to be appropriate, with attention to recommended concentrations and contact times.
"The authors call upon national and international policy makers, health agencies and healthcare professionals to further recognize the importance of targeted hygiene in the home and everyday life settings for preventing and controlling infection, in a unified quest to tackle AMR," the authors wrote.
In a related study in the same journal, researchers also highlight the importance of hand washing, but in the setting of reducing hospital-acquired Clostridioides difficile transmissions.
About 2,000 people die of infections with resistant bacteria every day worldwide, or about 730,000 a year, the authors of the position paper wrote.
Apr 17 Am J Infect Control paper and related study
Study supports antibiotics after umbilical clamping in C-sections
A large prospective study by researchers in Switzerland suggests that it is safe to give prophylactic antibiotics to mothers after umbilical cord clamping in Caesarian section, as opposed to before. The results of the study appear in an abstract published by the European Congress of Clinical Microbiology and Infectious Diseases (ECCMID).
The study looked at data on mothers who were given surgical antibiotic prophylaxis (SAP) either within 60 minutes before incision or after clamping at 178 hospitals from 2009 to 2018. Antibiotics included cefuroxime, cefazolin, amoxicillin/clavulanate, or ceftriaxone. Using generalized linear multilevel models that adjusted for patient characteristics, procedural variables, and healthcare system factors, the researchers assessed the association between SAP administration relative to incision and clamping and the surgical site infection (SSI) rate.
Among the 55,901 patients who met the study criteria, SAP was administered before incision in 26,405 patients (47.2%) and after clamping in 29,496 patients (52.8%). Overall, 846 SSIs were documented, of which 379 occurred before incision and 449 after clamping. The adjusted odds ratio (OR) for SAP administration after clamping was not significantly associated with an increased SSI rate (OR, 1.14; 95% confidence interval [CI], 0.96 to 1.36; P = 0.144) when compared to before incision. Supplementary and subgroup analyses supported these main results.
The World Health Organization currently recommends SAP in Caesarian section before incision to reduce the risk of SSIs, but the authors of the study say these findings, and the latest research on the potentially detrimental effects of early-life antibiotic exposure, are reasons to re-evaluate that guidance.
ECCMID was cancelled this year because of the COVID-19 pandemic, but studies scheduled to be presented have been published in a book of abstracts.
Apr 17 ECCMID abstract
