Top Infectious Disease News of the Week—September 8, 2019

#5: Successful Antimicrobial Stewardship Takes Team Approach

As antimicrobial resistance and the risk of so-called “superbugs” have become major issues in the health care industry, some organizations have raced to develop internal processes to mitigate resistance, usually under the banner of an “antimicrobial stewardship program.”

That’s good news, insofar as it suggests hospitals are working hard to actively reduce the risks inherent to treatment at hospitals. In a new article published in Clinical Microbiology and Infection, an international team of infectious disease specialists lay out the bad news: most of these programs are being developed without clear guidance on which processes, guidelines, and structures are most effective at achieving the goals of antimicrobial stewardship.

The paper aims to change that, laying out an evidence-based “how-to” guide to help health care organizations optimize their antimicrobial stewardship programs (ASPs) based on the latest scientific evidence.

Read the full article.

#4: FMT Decreases Antimicrobial Resistance in Study of Children with C diff

Fecal microbiota transplantation (FMT) in children with Clostridioides difficileinfection (C diff) reduced antimicrobial resistance genes and potential pathogens, a new study found.

The study, published in Open Forum Infectious Diseases, included 9 patients younger than 21 years with recurrent C diff identified at Inova Fairfax Hospital and the Johns Hopkins Medical Institute. Stool samples were collected and analyzed before and after FMT for up to 24 weeks. Healthy adult donors were screened for potential pathogens.

C diff symptoms resolved within 3 days of FMT for all patients, with no recurrences reported during the follow-up time. While antimicrobial resistance (AMR) genes existed in all samples, they dropped substantially, and those decreases were sustained throughout the study. Multidrug resistance genes also fell.

Read the full article.

#3: Doxycycline Prophylaxis an Effective Option for Bacterial STIs

As uptake of pre-exposure prophylaxis (PrEP) to prevent HIV infection increases, so too does the rate of some sexually transmitted infections (STIs), especially among gay, bisexual, and other men who have sex with men (MSM), recent studies show. Because of this alarming trend, investigators are exploring prophylactic options for bacterial STIs, including syphilis and chlamydia.

A group of international academic and government investigators conducted a review, published in Clinical Infectious Diseases, to examine the current research, knowledge gaps, and challenges surrounding doxycycline prophylaxis to prevent bacterial STIs.

“The US is experiencing its worst [sexually transmitted infection] epidemic in more than a generation. Syphilis is at its highest level in more than 25 years. Cases of congenital syphilis and deaths in newborns due to syphilis are rising,” Jeffrey Klausner, MD, professor of medicine in the Division of Infectious Diseases and the Program in Global Health at UCLA’s Fielding School of Public Health, and an author on the study, told Contagion^®. “We urgently need new strategies to control sexually transmitted diseases like syphilis.”

Read the full article.

#2: Contagion® Connect Episode 2: 'The Most Expensive Drug Is the One That Doesn't Work'

Welcome to Contagion^® Connect. This new podcast will bring you expert perspectives on trending infectious disease topics.

In this episode, we take a dual look at the recently announced changes to antibiotic reimbursements from the Centers for Medicare and Medicaid Services. First, we’ll speak to Dr. Susan Davis, an infectious disease pharmacist, about the impact from a clinician standpoint. Then we'll talk to Larry Edwards, CEO of Tetraphase Pharmaceuticals, for an industry perspective.

Listen to the podcast here.

#1: Novel Drug Combination Noninferior for Treatment of cUTI

CSE, a novel combination of ceftriaxone, sulbactam and disodium ethylenediaminetetraacetic acid (EDTA) could be an alternative to meropenem for treatment of complicated urinary tract infections (cUTI), including acute pyelonephritis (AP), a recent study found.

The double-blind, randomized, noninferiority study, published in Open Forum Infectious Diseases, found that CSE was effective and well-tolerated for treating multidrug-resistant gram-negative pathogens. It included 230 patients at 17 sites in India who received either intravenous CSE every 12 hours, or intravenous meropenem every 8 hours, for 5 to 14 days.

“In the present era where antimicrobial resistance is increasing at an unprecedented rate and new antibiotic development isn’t nearly enough to keep pace with it, fixed-dose combinations have an extremely important role to play,” corresponding author Mohd Amin Mir, MS, MSc, PGDPM, director of clinical research at Venus Medicine Research Centre in India, told Contagion^®.

Read the full article.