News Scan for Jun 19, 2018

News brief

Salmonella outbreak linked to precut melon sickens 10 more, 70 total

Ten more illnesses have been reported in a multistate Salmonella outbreak linked to precut melon, pushing the total to 70, and two more states have reported cases, the US Centers for Disease Control and Prevention (CDC) said today in an update.

The CDC first announced the outbreak involving Salmonella Adelaide linked to precut melon and fruit medley products from Caito Foods on Jun 8, the same day the company recalled its products.

Kentucky and Tennessee are the two latest states to report patients connected to the outbreak, lifting the total number of affected states to seven. The others are Illinois, Indiana, Michigan, Missouri, and Ohio. So far, 34 patients have been hospitalized, and no deaths have been reported. The most recent illness onset was Jun 3.

Affected products were sold in 22 states at many different stores under many different labels, and the CDC said that the Food and Drug Administration (FDA) has now posted a list of stores and states. "More stores and states may be added as FDA receives more information," the CDC added.
Jun 19 CDC outbreak update
FDA list of stores and states

Report: Boy contracts cowpox after feeding calves

A Welsh teenager contracted cowpox after feeding calves, the BBC reported. This is the first human case of cowpox reported in Wales in at least 10 years, according to the report.

The doctor who diagnosed the boy as having cowpox explained the case during the recent European Society for Pediatric Dermatology annual meeting.

The boy, age 15, lives on the Wrexham-Cheshire border, and developed lesions on his hands after feeding calves about 3 months ago. The unsightly lesions were painless but itchy, and he has recovered.

According to Public Health Wales, the disease is very rare, but usually benign. Cowpox is not transmitted from person to person.

Cowpox fluid was used in immunization programs across Europe in the 18th and 19th centuries as a proto-smallpox vaccine, after Edward Jenner noticed that milk maids were less susceptible to smallpox after having contracted cowpox.
Jun 16 BBC story

Stewardship / Resistance Scan for Jun 19, 2018

News brief

Study shows how antibiotic regimen affects resistance in urinary E coli

A retrospective multicenter study showed a dose-response relationship between antimicrobial use and resistance in uropathogens in older adults, Belgian researchers reported yesterday in Antimicrobial Resistance and Infection Control.

In the study, microbiological results for individual patient samples, retrieved from 15 voluntary participating clinical laboratories in 2005, were linked with individual antimicrobial consumption and sociodemographic data. The purpose of the research was to study the influence of different variables of antimicrobial prescribing on the occurrence of resistance in Escherichia coli isolated from urine samples in Belgian adults over the age of 65.

The final data used in the study contained information on resistance status for 7,397 E coli isolates obtained from 5,650 patients. The results demonstrated that resistance in E coli was higher when more antibiotics (more than nine prescriptions) had been prescribed before isolation of the sample, especially in women (significant interaction P = 0.0016).

In addition, the effect of route administration interacted with the number of preceding prescriptions, provided that the number of preceding prescriptions is not extremely high. With up to nine prescriptions, when other variables held constant, the probability of resistance decreased by increase in the proportion of preceding parenteral antibiotic prescriptions (significant interaction P = 0.0067).

The authors say the findings on route of administration and antimicrobial resistance, which has previously received little attention, should be further explored.
Jun 18 Antimicrob Resist Infect Control study

Pizza Hut to stop serving chicken raised with medically important antibiotics

The nation's second-largest pizza chain today announced that it would stop serving chicken raised with medically important antibiotics by 2022.

In a statement on its website, Pizza Hut said that the commitment comprises all chicken sold by the company, including chicken wings. Pizza Hut, which stopped using chicken raised with antibiotics important to human medicine in its pizza last year, is the first national pizza chain to commit to an antibiotic policy for chicken wings.

Matt Wellington, antibiotics program director for U.S. PIRG, praised the decision. "Pizza Hut's announcement is another step toward preserving life-saving medicines for what they're meant for, treating illness," Wellington said in a press release.

The move means that all of the Yum! Brands restaurant chains, which also include KFC and Taco Bell, have now pledged to reduce the use of medically important antibiotics in their chicken supply.
Jun 19 Pizza Hut statement
Jun 19 U.S. PIRG statement

Triclosan found to induce multidrug resistance in E coli

A team of scientists from the University of Queensland has found that an environmentally relevant concentration of the antimicrobial chemical triclosan induces heritable multidrug resistance in E coli.

In a study published recently in the journal Environment International, researchers from Queensland's Advanced Water Management Centre exposed wild-type E coli to varying amounts of triclosan, ranging from a sub-minimum inhibitory concentration (0.02 and 0.2 milligrams per liter (mg/L), which are environmentally relevant concentrations) to a near-lethal concentration of 2 mg/L. After 30 days of exposure, they measured resistance to eight types of antibiotics.

The tests revealed that after 30 days, exposure to 0.2 mg/L of triclosan induced resistance to several antibiotics. Further investigation found that the oxidative stress induced by triclosan caused mutations in several key genes—fabL, frdD, marR, acrR, and soxR. These mutations led to resistance by up-regulating genes encoding beta-lactamases and multidrug efflux pumps—two important resistance mechanisms—and down-regulating genes related to membrane permeability.

Study author Jianhua Guo, PhD, said the findings suggest the environmental impact of triclosan—a chemical commonly found in consumer products such as soap and toothpaste—should be investigated.

"This discovery provides strong evidence that the triclosan found in personal care products that we use daily is accelerating the spread of antibiotic resistance," Guo said in a University of Queensland press release.

In September 2016, The US Food and Drug Administration banned the use of triclosan and other antimicrobial ingredients in over-the-counter soaps, saying they were no more effective at killing germs than plain soap and water.
Jun 11 Environ Int abstract
Jun 19 University of Queensland news release