Top 5 Infectious Disease News Stories Week of January 11-18

Looking at the Slow Adoption of AUC-Based Monitoring for Vancomycin

Abdulwhab Shremo, PharmD, discusses the complexities of AUC-based vancomycin dosing, highlighting why its adoption has been slow despite the 2020 guidelines from the Infectious Diseases Society of America. While progress is being made, he points out that implementing AUC monitoring requires significant coordination, such as obtaining two levels within the correct interval, which contrasts with the simpler, but less ideal, single-trough method many hospitals still use. He emphasizes that transitioning to AUC-based dosing is a major shift, and institutions need time to adapt.

Widespread Beta-Lactamase Resistance Genes Pose Growing Threat Across One Health Domains in the US

A comprehensive review of research highlights the widespread distribution of beta-lactamase resistance genes, such as blaCTX-M-15 and blaCMY-2, across human, animal, and environmental sources in the U.S., underscoring the role of antimicrobial resistance (AMR) in public health. The study, which analyzed 335 articles, found significant variation in the prevalence of these genes, with human samples exhibiting the highest rates. The findings emphasize the need for integrated AMR surveillance across the One Health continuum, particularly to address the spread of resistant strains like E. coli sequence type ST131, which is linked to the critical third-generation cephalosporin resistance. The study advocates for targeted surveillance efforts to manage and mitigate the risks associated with these resistance genes in both human and animal health.

New Combo Drug Shows Strong Results For Worm Infections in Children

A recent Phase 2/3 trial published in The Lancet Infectious Diseases tested a fixed-dose combination (FDC) of albendazole and ivermectin for treating soil-transmitted helminths (STHs) like Trichuris trichiura, hookworm, and Strongyloides stercoralis in children from Ethiopia, Kenya, and Mozambique. The study found that the FDC significantly outperformed albendazole alone, with cure rates for T trichiura reaching 97.2% for the three-day regimen, compared to just 35.9% with albendazole monotherapy. The FDC also showed improved efficacy for hookworm infections. This combination therapy offers a simpler, more effective treatment option, especially for T trichiura, which has been notoriously difficult to treat with albendazole alone. The FDC simplifies logistics by eliminating the need for individual dosing, making it a practical solution for large-scale deworming efforts. These findings support global efforts to eliminate STH by 2030, aligning with the WHO’s roadmap for controlling these infections.

Black Women and HIV: Breaking Down Barriers, Having Conversations in the Communities

In 2024, the CDC reported a significant disparity in HIV diagnoses, with Black women, who represent only 13% of the US female population, accounting for 50% of HIV cases among women. Barriers to HIV prevention and care for Black women include access issues, economic challenges, and cultural factors, highlighting the need for targeted intervention. In response, ViiV Healthcare has adopted a community-focused approach, such as sponsoring discussions at nontraditional spaces like the Beautycon conference to address sexual health. A key initiative, the Risk to Reasons program, aims to shift the narrative from "risk" to "reasons" for prevention, with a focus on empowering Black women by understanding their motivations. This program represents ViiV's first multimillion-dollar philanthropic investment dedicated to addressing the specific needs of Black women in the fight against HIV.

The "Skip Phenomenon" in Blood Infections

The "skip phenomenon" (SP) in Staphylococcus lugdunensis infective endocarditis (IE) refers to a clinical pattern where blood cultures intermittently test negative before eventually testing positive again, indicating recurrent bacteremia despite ongoing antibiotic treatment. A study highlighted by Patrick D Crowley, DO, found that one-third of patients with S lugdunensis IE experience this phenomenon, which is linked to longer durations of bacteremia, extended hospital stays, and a higher 1-year mortality rate. Crowley emphasizes the importance of recognizing SP, particularly in patients with S. lugdunensis or Staphylococcus aureus bacteremia, and suggests delaying central line placement until two consecutive negative cultures are obtained. Early intervention, including imaging for potential hidden infections, and specialist involvement are key to improving outcomes for these patients. Further research is needed to fully understand the factors contributing to the increased mortality associated with SP.