Top 5 Contagion® News Articles for the Week of March 19, 2017

This week’s Top 5 articles focused on multiple infectious diseases, such as human papilloma virus (HPV), a sexually transmitted disease for which a new 2-dose regimen has recently been found to be just as effective as the typical 3-dose regimen for some populations. In addition, researchers have found that obesity and heart failure can have a negative impact on the effectiveness of antibiotic regimens for some skin and soft tissue infections. Along the same vein as skin and soft tissue infections, we published an article on the pervasiveness of Staphylococcus aureus skin infections in professional sports. Finally, a new report on the potential for the 2016-2017 flu season to last until May for parts of the United States and an article on the importance of disinfectants in the era of the “superbug” round out our top two articles for the week.

#5: Updated HPV Vaccine Recommendations Include 2 Doses for Some, 3 for Others

Sexually transmitted diseases continue to be an issue around the world and so methods to treat and prevent these infections are important. Since adherence to treatments and prevention methods can prove difficult, new research that provides evidence for the effectiveness of easier or more efficient methods of treatment and prevention is particularly exciting.

Human papillomavirus (HPV) is one sexually transmitted disease that has been linked with the development of cancers in some people. Therefore, the development of an HPV vaccine in 2006 provided much-needed hope against a potentially deadly disease. The vaccine was initially developed as a 3-dose regimen for pre-teen female patients, but recent research has found the vaccine to be effective for female patients in more age ranges, as well as male patients.

This week we published coverage on research that shows that “girls and boys who start the HPV vaccine series between the ages of 9 and 14 [and who are not immunocompromised] need only two doses,” as opposed to the typical 3-dose regimen of the past. Indeed, the authors of the study state that, “Through 10 years of follow-up from clinical trials, no evidence of waning protection after a 3-dose series of HPV vaccine has been found. Because antibody kinetics are similar with 2-dose and 3-dose series, duration of protection is also expected to be long-lasting after a 2-dose series.”

The new, easier-to-adhere to 2-dose regimen may help increase disappointing vaccination rates for HPV.

"Although the vaccine has been available for nearly a decade, HPV vaccine uptake has been slow, with estimated national three-dose coverage of adolescent females about 40% and adolescent males about 22%," said Kelly Jamison, MPH, a research scientist and analyst at the Bureau of Sexually Transmitted Disease Control of the New York City Department of Health and Mental Hygiene, and colleagues in their presentation on the research.

To learn more about the 2-dose vs 3-dose HPV vaccine, click here.

#4: Obesity and Heart Failure Increase Odds of Treatment Failure in SSTI Patients

Obesity has been linked with a number of complications when coupled with other health conditions and treatment, and researchers have now uncovered one more. According to the results of a new study, “outpatients with uncomplicated skin and soft tissue infections (SSTIs) who have heart failure and obesity are at increased risk of failing oral antibiotic therapy.”

Incidence of SSTIs in the outpatient setting in the United States has been steadily increasing. In fact, in 1997, incidence was 8.6 million, and in 2005, the number of cases almost doubled at 14.2 million. In addition, rates of hospitalizations for poorly managed infections have also continued to rise.

Treatment for these infections in the outpatient setting is typically a course of oral antibiotics. The failure rate for these treatments can range from 10% to 21%. The risk factors that contribute to failure have been up to now unknown. Therefore, researchers from Veterans Affairs Western New York Healthcare System sought to learn the factors that contribute to these failure rates, at least in the Western New York Healthcare System.

The researchers found that patients who had failed antibiotic treatment within 30 days, “had a greater mean BMI than those who experienced successful treatment (34.2 kg/m2 vs31.32 kg/m2; P = 0.0098); they also had an increased prevalence of heart failure (15.9% vs 7.1%; P = 0.027).”

In an interview with Contagion®, Kari A. Mergenhagen, PharmD, BCPS AQ-ID, Veterans Affairs Western New York Healthcare System, Buffalo, New York, the study’s senior said, “Some possible solutions might include increased doses of oral antibiotics, use of intravenous antibiotic therapy, or closer follow up with health care professionals.”

Read more about the effect obesity and heart failure have on SSTI treatment here.

#3: Staph Infections Pervasive in Professional Sports

Given the exertion on the body and release of bodily fluids present when competing in professional sports, it is no wonder that Staphylococcus aureus (staph) infections can run rampant among players. One recent example is that of “Ultimate Fighter” James Krause, who, as a result of cut on his leg, suffered a staph infection that required nearly two weeks in the hospital and three surgeries to clean out. Fellow mixed martial arts (MMA) fighters Kenny Florian and Jason Miller have also suffered severe staph infection and indeed, participants on the television show “The Ultimate Fighter” have suffered several “undisclosed” staph infections.

Staph infections are not only rampant in the world of MMA. Professional football players, such as Tom Brady and Peyton Manning have both contracted staph infections.

“Gymnasiums, locker rooms, and other high-traffic areas where large volumes of bodily fluids like sweat and blood may be left behind by numerous people are prime growing grounds for S. aureus. Bacteria may spread via direct contact with an infected individual, through the use of contaminated objects like free weights, or by otherwise bringing infected fluids from the carrier into the body.” In fact, Jeanine Thomas, founder and president of methicillin-resistant Staphylococcus aureus (MRSA) Survivors Network told Contagion®, “Staph is the cockroach of bacteria. We keep throwing antibiotics and treatments at it, and it just keeps finding a way to spread and survive.” And, infected individuals can spread the infection without even knowing they themselves are infected.

The Centers for Disease Control and Prevention site locker rooms and gymnasiums as notorious breeding grounds for staph infections and it is for this reason that good personal hygiene, hand washing, and equipment and environmental cleaning actions are strongly encouraged.

More on staph infections in professional sports is available here.

#2: Health Officials Predict Flu Season Could Last Until May

Although flu season is typically synonymous with winter, health officials are claiming that this year’s flu season could last well into May.

Flu activity is on the decline in most parts of the United States; however, southern and south eastern portions of the country are still experiencing high flu activity. “According to the Centers for Disease Control and Prevention’s (CDC) new weekly flu report, the states that are currently experiencing high influenza-like illness activity include: Alabama, Arkansas, Georgia, Kansas, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Mississippi, Missouri, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, and Wyoming.”

Although most of the illness experienced this flu season were reportedly due to infection with the influenza A (H3N2) strain of the virus, the CDC is reporting that the rise in recent infections is due to the influenza B strain. This year’s influenza vaccine was found to have a 73% effectiveness rate against circulating influenza B viruses. There is no data available as to whether or not those who are newly infected with the influenza B strain received the vaccine or not.

Two states that are experiencing high incidence of infection are Georgia and Texas. In many schools in Georgia, the increase in infections has impacted some schools to the point that up to 10% of the student population has been home sick with the flu. To stave off further spread of infection, officials are encouraging parents to keep their children home if they are sick. In Texas, cases of serious influenza infections are high, with upwards of 15 flu-related deaths reported since October 2, 2016.

To learn more about the latest on the flu season in the United States, click here.

#1: Disinfectants and the Rise of the Resistant Bug

With the discovery of 35 cases of the resistant fungal infection, Candida auris, in the United States, clinicians and public health officials have become increasingly concerned about environmental cleaning and disinfection. Particularly because C. auris is environmentally hardy, and transmissible between people. Indeed, healthcare practitioners know all-too-well the problems that can arise from such a resilient pathogen as they have been struggling to battle another hard to manage pathogen, Clostridium difficile, for years.

In fact, perhaps “triggered by the rise of C. auris, the Centers for Disease Control and Prevention (CDC) recently released new recommendations for the use of hospital-grade disinfectants effective against C. diff.”

C. diff is notorious for persisting in the environment, and therefore, special cleaning agents are required to be used for disinfection. Products that should be used must be EPA-registered against C. diff., and such items can be hard to find for use in cleaning tools such as stethoscopes or computers on wheels that go in and out of exam rooms. It is because of this that germicidal wipes with these EPA designations can be particularly helpful for clinicians. The announcement that Clorox's Healthcare Bleach Wipe as effective against 58 organisms with a three-minute wet time is particularly exciting at a time when organisms such as C. diff and C. auris are becoming more rampant. Indeed, “as new organisms are identified and existing ones become resistant to antimicrobials, the availability of strong disinfecting products has become even more pivotal.”

To read more on disinfectants in the era of the “superbug,” click here.