NEWS SCAN: Antibacterial drug task force, drug-resistant strep, Salmonella in Europe, H1N1 hospitalizations

Sep 24, 2012

FDA forms task force to foster antibacterial development
The US Food and Drug Administration (FDA) announced today it has formed an internal task force to support development of new antibacterial drugs in the face of increasing resistance to current drugs. The Antibacterial Drug Development Task Force will explore novel scientific approaches (such as innovative clinical trial designs) to bolster drug development; identify issues surrounding antibacterial drugs, including the lack of a robust pipeline of new drugs; evaluate FDA guidance on drug development to see if changes are needed; and work with thought leaders to explore innovative approaches to drug development. The task force was mandated by the Food and Drug Administration Safety and Innovation Act signed into law this summer, the FDA said in a news release. "Our hope is that this effort will result in important new breakthroughs in the field of antibacterial drug development and help in the fight against antibiotic resistance," said task force chair Rachel Sherman, MD, of the FDA's Center for Drug Evaluation and Research (CDER). The task force comprises 19 CDER scientists and clinicians.
Sep 24 FDA news release

Notable fall seen in strep susceptibility to antimicrobials
Significant increases in Streptococcus pneumoniae resistance to several antimicrobials, especially the older beta-lactams, have occurred since the introduction of pneumococcal conjugate vaccines, according to an update of SENTRY Antimicrobial Surveillance Program results reported in Diagnostic Microbiology and Infectious Disease. The longitudinal survey spanned 1998 through 2011 and included 18,911 isolates, the majority from lower respirator tract infections, obtained at medical centers across the United States. Susceptibility of S pneumoniae strains from 1998 to 2011 fell from 97.1% to 81.1% for amoxicillin/clavulanate, from 96.8% to 85.2% for high-dose penicillin, and from 97.0% to 88.3% for ceftriaxone. High levels of potency were demonstrated for the fluoroquinolone levofloxacin (99.8% in 1999, 98.8% in 2011) and the new cephalosporin ceftaroline (99.1% to 100.0% from 2009 to 2011, depending on breakpoint criteria) as well as daptomycin, linezolid, tigecycline, and vancomycin (100.0% in 2011). The authors conclude that fluroquinolones and ceftaroline should assume a greater therapeutic role in suspected pneumococcal infections.
Sep 23 Diagn Microbiol Infect Dis abstract

Turkey meat likely source of European Salmonella outbreak
Turkey meat is the likely source of an antibiotic-resistant Salmonella Stanley outbreak in Europe that has involved 167 confirmed and 254 probable cases since Aug 1, the European Centre for Disease Prevention and Control (ECDC) said in a recent report. Cases caused by the outbreak strain have been reported in Austria, the Czech Republic, Germany, Hungary, the Slovak Republic, and the United Kingdom, the agency said. "The epidemiological and microbiological information gathered through the public health, food and veterinary investigations strongly suggest that the turkey production chain is the source of the outbreak," but beef, pork, and chicken may also be contributing to it, the ECDC said. Investigators in six countries found Salmonella strains from turkeys and turkey meat that had indistinguishable DNA fingerprints, resistance to nalidixic acid, and decreased susceptibility to ciprofloxacin, the agency said. Isolates with similar DNA patterns also were detected in some cases from broiler chicken flocks and meat from cattle and pigs. More cases will probably be reported, because control measures to remove the source of infection and potential food vehicles have not yet been implemented. No country has reported unusually severe illnesses in the outbreak, but officials said they need more information from trace-back and trace-forward investigations to assess the risk associated with it.
Sep 20 ECDC report

Big rise in flu hospitalizations for some age-groups during pandemic
During the 2009 pandemic, rates of hospitalization for laboratory-confirmed influenza increased over mean rates for previous flu seasons by factors of 5 or more in several age-groups, a study published in the Journal of Infectious Disease found. The researchers analyzed data from the Emerging Infections Programs (EIP) network covering the period Apr 15, 2009, through Apr 30, 2010, during which EIP conducted surveillance among 22.1 million people in 10 US states. Children aged 5 to 17 showed a 5-fold increase in hospitalization during the pandemic over previous flu seasons, adults 18 to 49 years showed a 6-fold increase, and adults 50 to 64 showed a 5-fold increase. Adults aged 75 or older showed a substantially lower rate of hospitalization during the pandemic. The authors found that school-aged children constituted a significantly larger proportion of hospitalizations during the first wave of the pandemic than the second wave, indicating early spread among this group. Also in children, a larger proportion of those hospitalized had underlying medical conditions compared with previous flu seasons, and a larger proportion of both children and adults with underlying conditions died.
Sep 21 J Infect Dis abstract

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