Top Infectious Disease News of the Week—August 26, 2018

#5: Going Against the Norm: Testing A New Skin Disinfectant

Decolonizing a patient’s skin is critical for reducing microbial burden during hospitalization, especially before surgery to reduce the risk of surgical site infections, as well as other health care-associated infections (HAIs). Topical antiseptics are commonly used to clean and decolonize patients who may be going into surgery or those who are unable to clean themselves and who are at risk for infection (ie, patients in intensive care units). The use of these antiseptics come with added caveats, though, and so, there is a continued push for finding new methods for decolonizing patients’ skin.

The gold standard topical antiseptic is chlorhexidine gluconate because it can quickly and effectively rid the skin of microbes; however, there is also a risk for skin irritation and allergies when using the antiseptic, which can result in skin breakdown and pain for the patient. Moreover, chlorhexidine gluconate should not be used on patients with compromised skin. With concern for microbial resistance continuing to grow, scientists are searching for new agents that can be used for disinfection and decolonization on all groups of patients.

Read more about the skin disinfectant.

#4: Use of Oritavancin as Outpatient Treatment for ABSSTIs Generates Potential Cost Savings at Community Hospital

The results of a study published in the July 2018 issue of Hospital Pharmacy provide additional evidence in support of the use of oritavancin as a cost-saving outpatient treatment for acute bacterial skin and skin structure infections (ABSSTIs) in patients who would otherwise be admitted to the hospital for therapy.

ABSSTIs are the leading cause of infection-related hospital admissions in the United States, in part, because treatment for these infections often requires 5 to 14 days of intravenous (IV) antibiotics. In addition to the cost of the treatment, these admissions incur room, lab, and other hospital-associated costs. Furthermore, many patients who are admitted for ABSSTIs do not have existing comorbidities, systemic signs of infection, or evident symptoms of infection other than the site of the infection itself. As such, the development of an effective treatment that could be administered to these patients over less time, and in the outpatient setting, is desirable.

Read more about oritavancin as outpatient treatment for ABSSTIs.

#3: Infectious Diseases on the Rise Amid the Opioid Epidemic

In a recent Association of Health Care Journalists (AHCJ) webcast, 2 public health experts discussed the recent rapid increase in the incidence of infectious diseases that has been linked with injection drug use (IDU).

Jonathan Mermin, MD, MPH, Director, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), US Centers for Disease Control and Prevention, Atlanta, Georgia, shared a national perspective on this problem.

More than 600,000 Americans have died from opioid overdose since 2000, he said. Of particular concern, he added, is the interconnectedness between drug overdoses and reports of new cases of hepatitis C virus (HCV) infection.

The United States has seen a steady rise in the incidence of HCV cases since 2010, including doubling of the number of reports of pregnant women infected with the virus; this surge in HCV incidence is linked to IDU with sharing of needles, Dr. Mermin explained.

Read more about infectious diseases and the opioid epidemic.

#2: FDA Approves Eravacycline for Complicated Intra-Abdominal Infections

The US Food and Drug Administration (FDA) has approved Tetraphase Pharmaceuticals, Inc’s eravacycline, (XERAVA) for the treatment of complicated intra-abdominal infection (cIAI) in adults 18 years and older.

Eravacycline is a tetracycline-class antibacterial injection that has demonstrated potent activity against multidrug-resistant pathogens. In clinical trials, eravacycline was well tolerated and produced favorable results in curing patients with cIAI and demonstrated non-inferiority to ertapenem and meropenem.

The drug does not have a dose adjustment requirement when given to patients with renal impairment and the drug may be given to patients with penicillin allergies, according to a statement issued by Tetraphase.

Read more about eravacycline for complicated intra-abdominal infections.>!--page-->

#1: 2018-2019 Flu Vaccine Recommendations from ACIP

New recommendations from the US Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) reveal that health care providers have the intranasally-administered live attenuated influenza vaccine (LAIV) among their arsenal of available vaccines for the 2018-2019 flu season.

The reintroduction of intranasal LAIV vaccine is based on data on its effectiveness from previous seasons, including data from 5 US observational studies and a systematic review and meta-analysis of US and non-US studies. Although previous LAIV vaccines were found to have poor effectiveness against influenza A(H1N1)pdm09-like viruses, they proved effective against influenza B viruses, which tend to be responsible for the marked uptick in infections during the second half of the flu season. Furthermore, manufacturer data suggest that the new H1N1pdm09-like virus included in the 2018-2019 vaccines “has improved replicative fitness over previous H1N1pdm09-like viruses included in LAIV,” according to CDC’s Morbidity and Mortality Weekly Report (MMWR).

The types of available vaccines for the 2018-2019 flu season include the LAIV and recombinant influenza vaccine (RIV) as quadrivalent vaccines, and inactivated influenza vaccines (IIVs) as both a high-dose IIV trivalent and adjuvanted IIV trivalent.

As Contagion^® reported in March, the influenza strains to be included in the trivalent vaccines include:

• Influenza A/Michigan/45/2015 (H1N1)pdm09-like virus
• Influenza A/Singapore/INFIMH-16-0019/2016 (H3N2)-like virus Replaces A/Hong Kong/4801/2014 (H3N2)-like virus from the 2017-2018 northern hemisphere influenza vaccine
• Influenza B/Colorado/06/2017-like virus (B/Victoria/2/87 lineage) Replaces B/Brisbane/60/2008-like virus from the 2017-2018 northern hemisphere influenza vaccine

Read more about the 2018-2019 flu recommendations.