Source: https://www.cidrap.umn.edu/news-pers...an-sep-15-2021

News Scan for Sep 15, 2021
Multidrug-resistant bacteria in Switzerland; Global flu snapshot
Filed Under:
Antimicrobial Stewardship; Influenza, General


NDM-producing Enterobacterales levels rising in Switzerland

Researchers in Switzerland have identified an increase in New Delhi metallo-beta-lactamase (NDM)–producing Enterobacterales, according to a report published today in Emerging Infectious Diseases.
Of the 532 carbapenemase-producing Enterobacterales (CPE) samples obtained from Swiss hospitals and clinics in 2019 and 2020, 141 were confirmed to be NDM-positive—accounting for more than 25% of all CPE submitted to the Swiss National Reference Center for Emerging Antibiotic Resistance (NARA). NDM enzymes are capable of conferring resistance to nearly all beta-lactam antibiotics, including carbapenems, and treatment options for infections caused by NDM-producing Enterobacterales are limited, as they frequently harbor additional resistance genes.
Most of the NDM-positive isolates were either Klebsiella pneumoniae (59 of 141) or Escherichia coli (52 of 141), and more than 50% were obtained from screening swab samples. Among the 108 isolates that were sequenced, NDM-1 was the most prevalent, occurring in 56 isolates, mostly K pneumoniae (34 of 56). NDM-5 was the next most common, occurring in 40 of 49 E coli isolates, and other variants included NDM-4 and NDM-7. Fourteen of the isolates co-produced a second carbapenemase, predominantly an OXA-48-like enzyme, and almost one third of the isolates produced a 16S rRNSA methylase conferring high-level resistance to aminoglycosides.
Further molecular analysis found that the E coli and K pneumoniae isolates harbored multiple plasmids and belonged to sequence types and clonal complexes that have been identified in hospital outbreaks in other parts of the world. The authors of the study suggest these successful lineages are likely responsible for the observed increase in NDM-producing Enterobacterales.
"This 2-year study gives a snapshot of the epidemiology of NDM producers in Switzerland and illustrates how the use of [whole-genome sequencing] is both an essential and informative tool for surveillance and for monitoring emerging resistance," the study authors write. "Our findings underpin the importance of the surveillance of NDM-producing bacteria and particularly the monitoring of successful clonal lineages and plasmids."
Sep 15 Emerg Infect Dis study

Global flu stays low, though H3N2 rising in South Asia

In a global flu update that covers the last half of August, the World Health Organization (WHO) this week said overall activity remained very low in both hemispheres, though levels continue to increase in India and Nepal. The agency included its usual caveat that flu activity and detection are likely affected by COVID-19 measures and the pandemic's impacts on surveillance.
Flu circulation in India and Nepal is dominated by H3N2. Elsewhere, locations in the Americas, including the Caribbean, Central America, and Mexico, reported sporadic influenza B cases, and parts of Africa continue to report sporadic flu cases.
Of the few respiratory specimens that were positive for flu during the end of August, 62.2% were influenza A, and of the subtyped influenza A viruses, 93.3% were H3N2. Of characterized influenza B viruses, all but two belonged to the Victoria lineage.
Sep 13 WHO global flu update