News Scan for Apr 05, 2017

H5N1 in Africa, H5N8 in France
Staph aureus bacteremia

H5N1 outbreaks continue in Africa; more H5N8 reported from France

Cameroon and Nigeria reported more highly pathogenic H5N1 avian flu outbreaks on poultry farms, and France reported four more H5N8 outbreaks from its hard-hit southwest, according to the latest notifications from the World Organization for Animal Health (OIE).

In Cameroon, H5N1 struck another location in Ouest province, not far from where two other outbreaks were recently reported. The event began on Mar 7 at a commercial facility housing 12-week-old chickens. The virus killed 21,407 of 25,413 susceptible birds, and authorities culled the remaining ones.

Meanwhile, neighboring Nigeria reported two more H5N1 outbreaks in Bauchi state, located in the central part of the country. One began on Mar 31 at a farm housing 16-week-old cockerels, killing 155 of 410 birds. The other outbreak started on Apr 1 at a farm housing 36-week-old layers, killing 600 of 6,800 birds.

Cameroon and Nigeria are among a handful of African nations that have reported a resurgence of H5N1 since 2015.

Elsewhere, France reported four more highly pathogenic H5N8 outbreaks, all in Landes department. The start dates range from Feb 15 to Feb 18, and it's unclear how many poultry were affected. Some of the detections came during tests before depopulation or before moving birds outside the surveillance zone for slaughtering. One of the outbreaks occurred at a facility housing Guinea fowl.
Apr 4 OIE report on H5N1 in Cameroon
Apr 4 OIE report on H5N1 in Nigeria
Apr 4 OIE report on H5N8 in France


Automated intervention aids treatment of Staph aureus bacteremia

An automated, pharmacist-driven intervention significantly improved adherence to quality of care standards in patients with Staphylococcus aureus bacteremia (SAB), according to a small study yesterday in Clinical Infectious Diseases.

In the retrospective, single-center experimental study conducted at The Ohio State University Wexler Medical Center, researchers set out to investigate the impact on SAB patients of an automated patient scoring tool integrated into the electronic medical record. When the tool detects S aureus DNA in the blood, it triggers an alert in the medical record that prompts hospital pharmacists to make standardized recommendations (based on the hospital's evidence-based practice guidelines) to promote adherence to SAB quality-of-care measures and encourage ID consultation.

The primary outcome of the study, which compared a 3-month pre-intervention period with a 3-month intervention period, was overall compliance with adherence to four individual quality-of-care components (infectious disease [ID] consult, repeat blood cultures, echocardiogram, and initiation of SAB-targeted antimicrobial treatment). Secondary outcomes were also analyzed.

Overall, 84 patients were included in the study (45 in the pre-intervention and 39 in the intervention group). As a whole, all four quality-of-care components were more frequently adhered to in the intervention group, with the incidence of ID consult increasing by 20% in the intervention group. In addition, all 39 patients in the intervention group had SAB-targeted antimicrobial therapy initiated, compared with 84.4% in the pre-intervention group. There were no significant differences in the number of patients from the two groups who received echocardiograms and repeat blood cultures.

In addition, there were no differences between the two groups in duration of bacteremia, length of stay, infection-related length of stay, or readmission. All-cause mortality, however, was six times higher in the pre-intervention group.

The authors of the study say the findings suggest the intervention could become an integral part of SAB treatment and an element of expanded hospital antibiotic stewardship programs.
Apr 4 Clin Infect Dis abstract

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