Top Infectious Disease News of the Week—April 29, 2018

#5: Mosquito-Borne Diseases Pose Growing Threat to United States

A recent historical analysis highlights the need for experts to be ready to respond to outbreaks of emerging mosquito-borne diseases in the United States.

The article emphasizes the potential threat for the introduction of new mosquito-borne pathogens from tropical regions, discusses the impact of globalization on disease emergence, and highlights the importance of keeping track of public health issues in developing countries.

Max J. Moreno-Madriñán, PhD, from Indiana University—Purdue University Indianapolis, Indianapolis, Indiana, and Michael Turell, PhD, from VectorID LLC, Frederick, Maryland, published their article online in the May 2018 issue of Emerging Infectious Diseases, the Centers for Disease Control and Prevention’s (CDC) monthly peer-reviewed public health journal.

Read more about the growing threat of mosquito-borne diseases.

#4: Vector-Borne Disease Cases Have Tripled in the United States Since 2004

A new Vital Signs Report published by the Centers for Disease Control and Prevention (CDC) has found that vector-borne disease cases have tripled in the United States, with upwards of 640,000 cases reported between 2004 and 2016, underscoring the need for stronger prevention and control efforts.

The report, published in the most recent Morbidity and Mortality Weekly Report(MMWR), assessed data trends pertaining to all diseases that are nationally notifiable and transmitted via the bite of an infected mosquito, tick, or flea.

Authors of the report stressed that out of 16 reportable vector-borne diseases, only 1 of them—yellow fever—has a vaccine that individuals can use to protect themselves against infection, which is particularly troublesome as the burden of these diseases continues to grow.

Read more about vector-borne diseases in the United States.

#3: The Ugly Reality of Privacy Curtains

Privacy curtains, two words that make most infection preventionists shudder. Although hospitals are trying to move toward single-patient rooms to meet the demands of patient satisfaction, the truth is that such design models are expensive and challenging for older facilities. As a result, most facilities are still using privacy curtains to circumvent the design issues and create shared patient rooms, increase privacy in the emergency department and urgent care, and more.

The reason these curtains induce headaches in infection prevention and control programs is that they are required to be touched to be moved and unlike counters or medical devices, require laundering to be cleaned. Frequently touched with dirty hands before and after interacting with patients and/or the environment, these curtains—like any object, but especially a fabric one—are ripe for microbial contamination. However, aside from a visibly soiled curtain that would be off-putting to patients, what’s the incentive for hospitals to clean them?

Read more about the problem with privacy curtains.

#2: FDA Advisory Committee Votes Unanimously in Support of TPOXX

The US Food and Drug Administration (FDA)’s Antimicrobial Drugs Advisory Committee has voted unanimously that the benefits of TPOXX, a small molecule antiviral treatment for smallpox, outweigh its risks.

In February, the FDA granted priority review to the application. TPOXX, also known as tecovirimat and ST-246, is a patented oral drug that is easy to store, transport, and administer. “There could be several potential uses for an effective antiviral drug to treat orthopoxvirus infections: to reduce mortality and morbidity in those infected with smallpox (or another orthopoxvirus) virus, to protect the non-immune who risk developing smallpox following virus exposure, and as an adjunct to the smallpox vaccine in order to reduce the frequency of serious adverse events due to the live virus used for vaccination,” according to SIGA Technologies.

Read more about TPOXX.

#1: FDA Advisory Committee Votes Unanimously in Favor of Plazomicin for Adults with cUTIs

The US Food and Drug Administration (FDA)’s Drug Advisory Committee voted unanimously in favor of Achaogen's plazomicin for the treatment of adults with complicated urinary tract infections (cUTIs).

The vote was 15-0; no members of the panel abstained. However, when it came to deciding if substantial evidence was provided for the safety and effectiveness of plazomicin for the treatment of bloodstream infections in patients with limited or no treatment options, the majority (11) of the committee voted against it, while 4 members voted yes.

“We are encouraged by the Committee's unanimous vote in favor of plazomicin for complicated urinary tract infections (cUTI). The discussion underscored the real-world challenges that healthcare providers face every day given limited or inadequate treatment options for certain pathogens,” Achaogen's Chief Executive Officer Blake Wise said in a recent statement.

“Regarding bloodstream infections, the Limited-Population Antibacterial Drug pathway, or LPAD, is a novel approach that enables the FDA to consider the benefits and risks for the sickest patients who have few or no available treatment options, and to approve antibiotics like plazomicin that we believe, have the potential to address these limited patient populations," he added.

Plazomicin, is a new aminoglycoside antibacterial for the treatment of serious bacterial infections due to multidrug-resistant Enterobacteriaceae, including carbapenem-resistant Enterobacteriaceae (CRE); it was designed to address current and future unmet needs when it comes to these hard-to-treat resistant infections.

On January 2, 2018, Achaogen announced that the FDA had accepted their New Drug Application (NDA) for priority review. The NDA was supported by data collected from 2 phase 3 clinical trials: Evaluating Plazomicin in cUTI (EPIC) and Combating Antibiotic-Resistant Enterobacteriaceae (CARE).

The EPIC trial evaluated the efficacy and safety of plazomicin compared with meropenem for the treatment of adult patients with cUTI or acute pyelonephritis (AP). A total of 609 patients were enrolled in the trial and positive top-line data were reported. Plazomicin met the objective of non-inferiority compared with meropenem for the FDA-specified primary efficacy endpoints; it also achieved superiority for the EMA-specified primary efficacy endpoints.

Read more about plazomicin.