https://www.cidrap.umn.edu/news-briefs
Clinicians describe challenge of treating multidrug-resistant war wounds from Ukraine
News brief
2 minutes ago.
Chris Dall, MA
Topics
Antimicrobial Stewardship
In a slide presentation at this week's European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) in Copenhagen, Denmark, a team of surgeons and infectious disease clinicians highlighted the complexity and multidrug-resistant, polymicrobial nature of some of the war wounds they are seeing in Ukraine.
The presentation focused on 14 patients with highly complex musculoskeletal infections from gunshot and bomb wounds who were treated at the Center for Musculoskeletal Surgery at the Charite-University Hospital in Berlin from March to December 2022. Of the 14, 13 were colonized with multidrug-resistant gram-negative organisms, including Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, and Escherichia coli, as well coagulase-negative staphylococci, enterococci, and fungal organisms.
Of 25 gram-negative isolates analyzed, 72% were resistant to carbapenems and newer cephalosporins (ceftazidime-avibactam and ceftozolane-tazobactam), 39% were resistant to cefiderocol, 20% to colistin, and 96% to ciprofloxacin.
"We are dealing with a completely new pathogen spectrum than what we would expect to see in Germany," lead author Maria Virginia Dos Santos, MBBS, said in an ECCMID press release. "In these horrific war injuries, we are seeing high incidence of multi-resistant gram-negative pathogens, and all our cases have been polymicrobial infections."
We are dealing with a completely new pathogen spectrum.
Dos Santos said suboptimal surgical and antibiotic treatment in the often unsterile and low-resource conditions of a war zone likely contributed to the complexity of the wounds.
All of the patients required empiric treatment with a combination of antibiotics, along with removal of dead bone and soft tissue, soft-tissue reconstruction, and reconstructive surgery. Two of the patients have been discharged and returned to Ukraine, eight have no signs of infection and are undergoing rehabilitation, two are still undergoing treatment, and two have developed new acute infections.
In two reports published in Eurosurveillance in December 2022, researchers at hospitals in Germany and the Netherlands reported an uptick in multidrug-resistant organisms linked to patients who had fled or were evacuated from hospitals in Ukraine.
Report: Medical oxygen suppliers should do more to address shortages in poor countries
News brief
5 minutes ago.
Mary Van Beusekom, MS
Topics
Resilient Drug Supply
The world's largest gas producers should seize the opportunity to reduce long-term inequities in access to medical liquid oxygen in low- and middle-income countries (LMICs), according to a report today from the Access to Medicine Foundation.
The Netherlands-based foundation said that, amid the COVID-19 pandemic, Air Liquide, Air Products, Linde, Messer, Nippon Sanso Holdings Corp., and SOL Group showed they can mitigate shortages through efforts such as shifting more production capacity from industrial to medical oxygen and transporting oxygen tankers and trailers on chartered aircraft.
But about half of healthcare facilities in poor countries still don't have reliable access to oxygen, leading to preventable deaths. "This is despite the fact that medical oxygen is included in the World Health Organization's Model List of Essential Medicines, meaning it is a product that should be available in every country’s health system," the report said.
"Medical gases are a small part of these companies' business, yet society needs them to ensure this vital lifeline is available both during emergencies and to meet the daily medical oxygen needs of all health systems," Access to Medicine Chief Executive Officer Jayasree Iyer, MD, PhD, said in the report.
Six priority actions
Air Liquide is the only firm with a clear strategy for ensuring access to oxygen in LMICs, the report said. The others haven't identified specific targets but have reported expanding oxygen to more regions and buying equipment to boost oxygen production.
The report identifies six priority actions:
Marburg virus confirmed in another Equatorial Guinea health worker
News brief
15 minutes ago.
Lisa Schnirring
Topics
Marburg
One more Marburg virus case has been confirmed in Equatorial Guinea's outbreak, involving a healthcare worker from Bata who was under monitoring after exposure to a previous patient, the head of the World Health Organization (WHO) said today.
At a media briefing, Tedros Adhanom Ghebreyesus, PhD, the WHO's director-general, said the new case was detected on the day of illness onset and that the patient was given antiviral treatment according to government protocols, with support from the WHO.
The new case raises the outbreak total to 16 confirmed cases, of which 11 were fatal. Also, 23 probable cases have been reported, all fatal. Also, the new case puts the number of infections in healthcare workers at five.
Equatorial Guinea is battling its first Marburg virus outbreak, with cases reported across four provinces, with multiple cases reported from Bata, the country's largest city and home to a port and an international airport. A close cousin of Ebola, Marburg virus spreads among people through the body fluids of infected patients.
Wisconsin confirms first CWD detection in Winnebago County
News brief
18 minutes ago.
Stephanie Soucheray, MA
Topics
Chronic Wasting Disease
The Wisconsin Department of Natural Resources (DNR) has confirmed chronic wasting disease (CWD) in a deer in Winnebago County, the first time the fatal prion disease has been detected in that county.
The wild deer—a 3-year-old doe —tested positive in the town of Nepeuskun, which is within 10 miles of the Waushara County, Green Lake County, and Fond du Lac County borders. This detection renews a 3-year baiting and feeding ban in the county, as well as renews a 2-year baiting and feeding ban in Waushara County, Green Lake County, and Fond du Lac County.
"Baiting or feeding deer encourages them to congregate unnaturally around a shared food source where infected deer can spread CWD through direct contact with healthy deer or by leaving behind infectious prions in their saliva, blood, feces and urine," the DNR said in a statement on the detection.
CWD has been detected in cervids in North America, Canada, South Korea, and Scandinavia. The Wisconsin DNR first began testing animals in 1999, with the first positive detected in 2002.
Clinicians describe challenge of treating multidrug-resistant war wounds from Ukraine
News brief
2 minutes ago.
Chris Dall, MA
Topics
Antimicrobial Stewardship
In a slide presentation at this week's European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) in Copenhagen, Denmark, a team of surgeons and infectious disease clinicians highlighted the complexity and multidrug-resistant, polymicrobial nature of some of the war wounds they are seeing in Ukraine.
The presentation focused on 14 patients with highly complex musculoskeletal infections from gunshot and bomb wounds who were treated at the Center for Musculoskeletal Surgery at the Charite-University Hospital in Berlin from March to December 2022. Of the 14, 13 were colonized with multidrug-resistant gram-negative organisms, including Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, and Escherichia coli, as well coagulase-negative staphylococci, enterococci, and fungal organisms.
Of 25 gram-negative isolates analyzed, 72% were resistant to carbapenems and newer cephalosporins (ceftazidime-avibactam and ceftozolane-tazobactam), 39% were resistant to cefiderocol, 20% to colistin, and 96% to ciprofloxacin.
"We are dealing with a completely new pathogen spectrum than what we would expect to see in Germany," lead author Maria Virginia Dos Santos, MBBS, said in an ECCMID press release. "In these horrific war injuries, we are seeing high incidence of multi-resistant gram-negative pathogens, and all our cases have been polymicrobial infections."
We are dealing with a completely new pathogen spectrum.
Dos Santos said suboptimal surgical and antibiotic treatment in the often unsterile and low-resource conditions of a war zone likely contributed to the complexity of the wounds.
All of the patients required empiric treatment with a combination of antibiotics, along with removal of dead bone and soft tissue, soft-tissue reconstruction, and reconstructive surgery. Two of the patients have been discharged and returned to Ukraine, eight have no signs of infection and are undergoing rehabilitation, two are still undergoing treatment, and two have developed new acute infections.
In two reports published in Eurosurveillance in December 2022, researchers at hospitals in Germany and the Netherlands reported an uptick in multidrug-resistant organisms linked to patients who had fled or were evacuated from hospitals in Ukraine.
Report: Medical oxygen suppliers should do more to address shortages in poor countries
News brief
5 minutes ago.
Mary Van Beusekom, MS
Topics
Resilient Drug Supply
The world's largest gas producers should seize the opportunity to reduce long-term inequities in access to medical liquid oxygen in low- and middle-income countries (LMICs), according to a report today from the Access to Medicine Foundation.
The Netherlands-based foundation said that, amid the COVID-19 pandemic, Air Liquide, Air Products, Linde, Messer, Nippon Sanso Holdings Corp., and SOL Group showed they can mitigate shortages through efforts such as shifting more production capacity from industrial to medical oxygen and transporting oxygen tankers and trailers on chartered aircraft.
But about half of healthcare facilities in poor countries still don't have reliable access to oxygen, leading to preventable deaths. "This is despite the fact that medical oxygen is included in the World Health Organization's Model List of Essential Medicines, meaning it is a product that should be available in every country’s health system," the report said.
"Medical gases are a small part of these companies' business, yet society needs them to ensure this vital lifeline is available both during emergencies and to meet the daily medical oxygen needs of all health systems," Access to Medicine Chief Executive Officer Jayasree Iyer, MD, PhD, said in the report.
Six priority actions
Air Liquide is the only firm with a clear strategy for ensuring access to oxygen in LMICs, the report said. The others haven't identified specific targets but have reported expanding oxygen to more regions and buying equipment to boost oxygen production.
The report identifies six priority actions:
- Prioritize, measure, and report progress on medical liquid oxygen
- Improve affordability for populations and health systems
- Provide a sustainable supply of oxygen
- Foster long-term partnerships to close access gaps
- Support health systems and staff to operate, maintain, and administer medical oxygen systems
- Plan for emergencies
Marburg virus confirmed in another Equatorial Guinea health worker
News brief
15 minutes ago.
Lisa Schnirring
Topics
Marburg
One more Marburg virus case has been confirmed in Equatorial Guinea's outbreak, involving a healthcare worker from Bata who was under monitoring after exposure to a previous patient, the head of the World Health Organization (WHO) said today.
At a media briefing, Tedros Adhanom Ghebreyesus, PhD, the WHO's director-general, said the new case was detected on the day of illness onset and that the patient was given antiviral treatment according to government protocols, with support from the WHO.
The new case raises the outbreak total to 16 confirmed cases, of which 11 were fatal. Also, 23 probable cases have been reported, all fatal. Also, the new case puts the number of infections in healthcare workers at five.
Equatorial Guinea is battling its first Marburg virus outbreak, with cases reported across four provinces, with multiple cases reported from Bata, the country's largest city and home to a port and an international airport. A close cousin of Ebola, Marburg virus spreads among people through the body fluids of infected patients.
Wisconsin confirms first CWD detection in Winnebago County
News brief
18 minutes ago.
Stephanie Soucheray, MA
Topics
Chronic Wasting Disease
The Wisconsin Department of Natural Resources (DNR) has confirmed chronic wasting disease (CWD) in a deer in Winnebago County, the first time the fatal prion disease has been detected in that county.
The wild deer—a 3-year-old doe —tested positive in the town of Nepeuskun, which is within 10 miles of the Waushara County, Green Lake County, and Fond du Lac County borders. This detection renews a 3-year baiting and feeding ban in the county, as well as renews a 2-year baiting and feeding ban in Waushara County, Green Lake County, and Fond du Lac County.
"Baiting or feeding deer encourages them to congregate unnaturally around a shared food source where infected deer can spread CWD through direct contact with healthy deer or by leaving behind infectious prions in their saliva, blood, feces and urine," the DNR said in a statement on the detection.
CWD has been detected in cervids in North America, Canada, South Korea, and Scandinavia. The Wisconsin DNR first began testing animals in 1999, with the first positive detected in 2002.