NEWS SCAN: Resistant Klebsiella strain, egg-linked cases top 1,600, online flu advice, bioterror drug funds, H5N1 strategy

Sep 21, 2010

CDC reports unique strain of antibiotic-resistant Klebsiella
The US Centers for Disease Control and Prevention (CDC) reported today that a certain antibiotic-resistant strain of Klebsiella pneumoniae has been identified for the first time in the United States. The patient, a US citizen who became sick with diarrhea during a Mediterranean cruise and was hospitalized in Greece before returning stateside for further treatment, had a "carbapenem-resistant Klebsiella pneumoniae strain that produced a Verona integron-encoded metallo-beta-lactamase (VIM) carbapenemase not reported previously among Enterobacteriaceae in the United States," according to the report. Carbapenem is a class of antibiotics that are often the last line of defense against Klebsiella. The novel strain has been reported in Greece and is resistant to all antimicrobials usually used to treat Klebsiella infection. In spite of this, the patient recovered enough to be discharged from her US hospital after 26 days. Screening of 22 potentially exposed patients from the hospital did not reveal further isolates of the novel strain. The VIM strain—and other Klebsiella strains that produce K pneumoniae carbapenemase (KPC)—is an example of carbapenem-resistant Enterobacteriaceae, or CRE. Other CRE include pathogens that carry the recently reported resistance enzyme NDM-1 (New Delhi metallo-beta-lactamase-1), which has been found in Escherichia coli as well as K pneumoniae. The CDC said in today's report that KPC is "the most common mechanism of carbapenem resistance among Enterobacteriaceae" in the country. It added, "Cases of CRE are a significant, emerging public health problem regardless of the mechanism of carbapenem resistance." The agency recommends vigilance at all healthcare facilities.
Sep 21 MMWR report
CDC guidance for CRE infections
Aug 20 CIDRAP News article on NDM-1

CDC: Egg-linked Salmonella cases top 1,600
The CDC yesterday posted an update on the Salmonella Enteritidis (SE) outbreak investigation linked to a national egg recall, which notes that as many as 1,608 reported cases of SE are probably connected to the outbreak, 89 more than the previous total reported on Sep 9.The CDC said Food and Drug Administration (FDA) officials have completed their on-site investigations of both farms that produced the recalled eggs and are evaluating the data, including sampling results. Many sample results are undergoing subtyping. The FDA has found 17 positive environmental samples, 10 more than noted in its previous update.
Sep 20 CDC Salmonella outbreak update

Study finds shortcomings in online flu advice
Italian researchers who explored how well 2009 H1N1 flu prevention information on the Web meshed with World Health Organization (WHO) recommendations found that good and complete information wasn't always available or accessible. They began with frequently used flu-related "Google Trends" search strings in three search engines on Aug 13, 2009, on servers in four English-speaking countries: Australia, Canada, the United Kingdom, and the United States. Then for each search result (from 147 Web sites) they analyzed information gained in up to four clicks into the Web site, starting from the search engine's page, comparing it with a 21-item checklist they developed from the WHO flu prevention recommendations. Results showed the prevention methods varied by country and type of Web site, with public health agency sites having more comprehensive information and news providers providing inadequate advice. Most sites mentioned hand washing and respiratory etiquette measures consistent with WHO recommendations, but other measures were less frequently mentioned. They concluded that health providers are still a main source of information about flu prevention and can play a key role in guiding patients to reliable online sources.
Sep 20 BMC Public Health abstract

DoD funds $30 million effort to probe oceans for anti-bioterror drugs
The US Department of Defense (DoD) is funding efforts to tap the oceans' biodiversity to develop novel antibiotics against bioterror threats such as plague and tularemia. The DoD's Defense Threat Reduction Agency awarded San Diego–based Trius Therapeutics up to $29.5 million to collaborate with the Scripps Institution of Oceanography at the University of California, San Diego (UCSD). According to a UCSD press release, Trius will use its proprietary Focused Antisense Screening Technology to identify potential antibacterial compounds from marine natural product libraries discovered by Scripps professor of oceanography William Fenical. Trius will then apply its drug-design capabilities to develop antibacterial compounds against potential bioterror pathogens such as Yersinia pestis, Francisella tularensis, and Burkholderia pseudomallei, the causative agents of plague, tularemia, and melioidosis. Trius believes that these compounds may also protect against hospital-acquired drug-resistant pathogens. "The oceans are a huge resource where biodiversity is greatest on our planet," Fenical said in the release. "The biomedical potential comes from plants, animals, and microbes that have unique genetic compositions."
Sep 20 UCSD press release

Vietnam sets H5N1 management goals
Vietnamese health and agriculture officials met with international organizations in Hanoi yesterday to form a plan for battling the H5N1 avian influenza virus over the next 5 years, Voice of Vietnam reported today. Veterinary service activities are still falling short, and poultry infections are still being transmitted to humans, Vietnam's agriculture ministry reported at the meeting. Its minister Diep Kinh Tan said that the country and international organizations have spent $201.7 million over the past 5 years to train medical workers and expand laboratory capacity. However, he said the country still faces challenges in managing the spread of the H5N1 virus. Vietnam is one of the handful of countries where the disease is endemic in poultry. Conference delegates also said Vietnam needs to stabilize vaccine prices and control cross-border virus transmission.

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