Shiloh
Editor, Senior Moderator
Source: http://www.cidrap.umn.edu/news-perspective/2016/05/drug-resistance-scan-may-12-2016
Drug Resistance Scan for May 12, 2016
Shorter MDR-TB regimen; Antibiotic resistance action plan; Colorado scope infections
Filed Under:
Antimicrobial Resistance; Tuberculosis; Healthcare-Associated Infections
[h=3]WHO recommends shorter treatment regimen for some MDR-TB patients[/h] Following the development of a rapid diagnostic test for multidrug-resistant tuberculosis (MDR-TB) strains, the World Health Organization (WHO) today recommended a shorter treatment regimen for patients with uncomplicated MDR-TB infections.
The shorter regimen costs less than $1,000 per patient and comprises 9 to 12 months of second-line antibiotics, a marked decrease in treatment time compared with the current MDR-TB schedule that takes 18 to 24 months. Toxicity of second-line fluoroquinolones and injectable antibiotics taken over a long period prompt many people to discontinue treatment, and the WHO estimates that less than 20% of the 480,000 MDR-TB patients worldwide are treated properly.
The shortened schedule is recommended only for patients with MDR-TB that is not resistant to second-line antibiotics. Its implementation is facilitated by MTBDRsl, a new DNA-based diagnostic test that identifies resistant strain mutations in 24 to 48 hours, whereas standard resistance testing can take more that 3 months. Rapid testing is crucial, because people infected with MDR-TB resistant to second-line drugs can develop extensively drug-resistant tuberculosis (XDR-TB) infections on the shortened regimen.
The new treatment recommendations are based on studies involving 1,200 patients with uncomplicated MDR-TB in ten countries. The shortened antibiotic schedule has been implemented in 12 sub-Saharan and West African countries, along with Bangladesh and Uzbekistan.
Faster diagnosis of resistant strains and shorter treatment time to promote patient adherence will help WHO member states reach the global goal of reducing tuberculosis incidence by 80% by 2030, the agency said.
May 12 WHO press release
[h=3]International leaders advise immediate action on antibiotic resistance[/h] International policy leaders and scientists from more than 30 countries have called for immediate global action to remedy medical and agricultural contributions to antibiotic resistance, according to a report released today from the Wellcome Trust.
The report from an Apr 26-27 summit led by the Wellcome Trust describes three evidence-based actions that nations can take immediately to address improper antibiotic use at the human-animal interface. In many countries, agricultural use of antibiotics to encourage animal growth or prevent disease exceeds medical use, and a "One Health" response to combating resistance is essential, the report said.
The report first calls on national governments to reduce agricultural antibiotic use by improving animal husbandry practices, offering insurance policies to offset farmers' income loss as they reduce antimicrobial use, and implementing better cleaning and disinfection processes on farms to limit consumers' exposure to drug-resistant bacteria in animal food products.
Second, the report encourages government leaders to improve surveillance on antibiotic use and resistance in human and animal populations, educate people about when antibiotics are ill-advised, and label drugs in a way that emphasizes their protected status.
Summit attendees also said that basic public health measures, including access to clean water, improved sanitation, and hospital infection control, are integral to reducing antibiotic use worldwide. They called for immediate limits on Internet antibiotic purchases and financial incentives for antibiotic sales. All countries should implement the recommendations in a scalable way, considering their available resources, the report said.
May 12 Wellcome Trust report
[h=3]University of Colorado Hospital confirms endoscope-related outbreak[/h] The University of Colorado Hospital has confirmed that nine patients developed infections, three of whom died, after undergoing procedures with a contaminated duodenoscope, according to a May 9 story in the Denver Post.
Olympus Medical System Corp., the scope's manufacturer, reported six of the hospital's infections and two deaths due to Escherichia coli contamination in a Jan 22 report to the US Food and Drug Administration (FDA), and the company reported an additional two infections linked to the hospital on Feb 29. The University of Colorado Hospital recently confirmed nine cases and three deaths, all linked to the same endoscope, following outside inquiries, the story said.
The duodenoscope, which was recalled after a US Senate investigation in January, was used for 791 endoscopic retrograde cholangiopancreatography procedures (ERCPs) at the hospital. The Olympus scopes are difficult to disinfect and have been linked to at least 250 infections nationwide, though cases often go unreported by hospitals, the story said.
Also, reports have noted infections with multidrug-resistant bacteria in patients who have undergone ERCPs with reprocessed duodenoscopes, even when manufacturer instructions are properly followed, the story noted. And last year at least two patients at the University of California at Los Angeles died of drug-resistant bacterial infections after an ERCP.
Independent laboratory analysis after the recall found that the scope used by the University of Colorado Hospital contained fluid contaminated with bacteria in its suction chamber, internal staining, gaps in adhesive, and buckling throughout the insertion tube, the story said.
Hospital spokesperson Dan Weaver said that all infected patients were extremely ill at the time of the procedure, and the effect of infection on the three deaths is unknown, the story reported. The FDA said that the benefits of ERCP for patients with pancreatic and biliary duct tumors outweigh the risks of infection.
May 9 Denver Post story
Mar 28 CIDRAP news item about the outbreak
Drug Resistance Scan for May 12, 2016
Shorter MDR-TB regimen; Antibiotic resistance action plan; Colorado scope infections
Filed Under:
Antimicrobial Resistance; Tuberculosis; Healthcare-Associated Infections
[h=3]WHO recommends shorter treatment regimen for some MDR-TB patients[/h] Following the development of a rapid diagnostic test for multidrug-resistant tuberculosis (MDR-TB) strains, the World Health Organization (WHO) today recommended a shorter treatment regimen for patients with uncomplicated MDR-TB infections.
The shorter regimen costs less than $1,000 per patient and comprises 9 to 12 months of second-line antibiotics, a marked decrease in treatment time compared with the current MDR-TB schedule that takes 18 to 24 months. Toxicity of second-line fluoroquinolones and injectable antibiotics taken over a long period prompt many people to discontinue treatment, and the WHO estimates that less than 20% of the 480,000 MDR-TB patients worldwide are treated properly.
The shortened schedule is recommended only for patients with MDR-TB that is not resistant to second-line antibiotics. Its implementation is facilitated by MTBDRsl, a new DNA-based diagnostic test that identifies resistant strain mutations in 24 to 48 hours, whereas standard resistance testing can take more that 3 months. Rapid testing is crucial, because people infected with MDR-TB resistant to second-line drugs can develop extensively drug-resistant tuberculosis (XDR-TB) infections on the shortened regimen.
The new treatment recommendations are based on studies involving 1,200 patients with uncomplicated MDR-TB in ten countries. The shortened antibiotic schedule has been implemented in 12 sub-Saharan and West African countries, along with Bangladesh and Uzbekistan.
Faster diagnosis of resistant strains and shorter treatment time to promote patient adherence will help WHO member states reach the global goal of reducing tuberculosis incidence by 80% by 2030, the agency said.
May 12 WHO press release
[h=3]International leaders advise immediate action on antibiotic resistance[/h] International policy leaders and scientists from more than 30 countries have called for immediate global action to remedy medical and agricultural contributions to antibiotic resistance, according to a report released today from the Wellcome Trust.
The report from an Apr 26-27 summit led by the Wellcome Trust describes three evidence-based actions that nations can take immediately to address improper antibiotic use at the human-animal interface. In many countries, agricultural use of antibiotics to encourage animal growth or prevent disease exceeds medical use, and a "One Health" response to combating resistance is essential, the report said.
The report first calls on national governments to reduce agricultural antibiotic use by improving animal husbandry practices, offering insurance policies to offset farmers' income loss as they reduce antimicrobial use, and implementing better cleaning and disinfection processes on farms to limit consumers' exposure to drug-resistant bacteria in animal food products.
Second, the report encourages government leaders to improve surveillance on antibiotic use and resistance in human and animal populations, educate people about when antibiotics are ill-advised, and label drugs in a way that emphasizes their protected status.
Summit attendees also said that basic public health measures, including access to clean water, improved sanitation, and hospital infection control, are integral to reducing antibiotic use worldwide. They called for immediate limits on Internet antibiotic purchases and financial incentives for antibiotic sales. All countries should implement the recommendations in a scalable way, considering their available resources, the report said.
May 12 Wellcome Trust report
[h=3]University of Colorado Hospital confirms endoscope-related outbreak[/h] The University of Colorado Hospital has confirmed that nine patients developed infections, three of whom died, after undergoing procedures with a contaminated duodenoscope, according to a May 9 story in the Denver Post.
Olympus Medical System Corp., the scope's manufacturer, reported six of the hospital's infections and two deaths due to Escherichia coli contamination in a Jan 22 report to the US Food and Drug Administration (FDA), and the company reported an additional two infections linked to the hospital on Feb 29. The University of Colorado Hospital recently confirmed nine cases and three deaths, all linked to the same endoscope, following outside inquiries, the story said.
The duodenoscope, which was recalled after a US Senate investigation in January, was used for 791 endoscopic retrograde cholangiopancreatography procedures (ERCPs) at the hospital. The Olympus scopes are difficult to disinfect and have been linked to at least 250 infections nationwide, though cases often go unreported by hospitals, the story said.
Also, reports have noted infections with multidrug-resistant bacteria in patients who have undergone ERCPs with reprocessed duodenoscopes, even when manufacturer instructions are properly followed, the story noted. And last year at least two patients at the University of California at Los Angeles died of drug-resistant bacterial infections after an ERCP.
Independent laboratory analysis after the recall found that the scope used by the University of Colorado Hospital contained fluid contaminated with bacteria in its suction chamber, internal staining, gaps in adhesive, and buckling throughout the insertion tube, the story said.
Hospital spokesperson Dan Weaver said that all infected patients were extremely ill at the time of the procedure, and the effect of infection on the three deaths is unknown, the story reported. The FDA said that the benefits of ERCP for patients with pancreatic and biliary duct tumors outweigh the risks of infection.
May 9 Denver Post story
Mar 28 CIDRAP news item about the outbreak