News Scan for Sep 18, 2019

News brief

Study rules out association between flu vaccination and miscarriage

A study over three flu seasons found no association between flu vaccination and miscarriage, according to findings published yesterday in Vaccine.

The investigation was a follow-up to a 2017 study by the same research group over two flu seasons involving few cases that unexpectedly found an association between receiving repeated doses of seasonal flu vaccine and miscarriage. At the time, the team said the effect might be unique to the seasons immediately following the 2009 pandemic and that they would do a follow-up study to examine more recent flu seasons.

For the new study, the team, using a case-control design, looked at data from three flu seasons in the Vaccine Safety Datalink (VSD), a collaboration funded by the US Centers for Disease Control and Prevention (CDC) that uses electronic health records to study vaccine safety. The seasons were 2012-13, 2013-14, and 2014-15. The researchers matched cases (women who had miscarried) and controls (women with live births) for several factors, including flu vaccination status in the previous flu season. Of 1,908 cases found in the VSD, 1,236 were included in the main analysis.

Of 627 matched pairs who were vaccinated against flu in the previous season, the group found no association between vaccination during a 28-day risk window and miscarriage. Adjusted odds ratio was 0.9 (95% confidence interval, 0.6 to 1.5). Also, the team found no association among women who didn't receive the flu vaccine the previous year, for whom the adjusted odds ratio ranged from 0.6 to 0. No association was found between miscarriage and flu vaccination in other risk windows or when vaccine was analyzed in relation to conception date.

The authors said the findings add support to current recommendations that women should be vaccinated against flu anytime during pregnancy, including the first trimester.
Sep 17 Vaccine abstract
Sep 13, 2017, CIDRAP News story "Study signals association between flu vaccine, miscarriage"

 

Report: Universal health coverage may be hindered by antibiotic resistance

Failure to manage rising antimicrobial resistance (AMR) could hinder the advancement of universal health coverage, and must be addressed if universal health coverage is to be achieved, according to a new policy brief from advocacy group ReAct.

Based on insights from experts from 33 countries who attended a July conference organized by ReAct and the South Centre, the report argues that AMR poses a major threat to the financing of universal health coverage because it will lead to resistant infections that require more expensive antibiotics and longer hospitalization, as well as increased medical risks and costs from surgery, chemotherapy, and organ transplants. This will make healthcare more expensive for both the individual and for society and undermine the essence and goals of universal health coverage.

"Sustainable financing of universal health coverage needs to consider the current and long-term risks of antimicrobial resistance: the choice is to pay now, or pay much more later," the authors of the report write.

They add that, for a universal health strategy to be successful, it has to address AMR by placing more emphasis on infection prevention and control, investing more in training and education for health professionals, strengthening monitoring and surveillance of resistant pathogens, and ensuring that antibiotics are accessible but not used irrationally. The report also calls for more political leadership and a financing strategy that rewards better performance in managing AMR.

The report concludes, "The expansion of primary health care, access to essential medicines and diagnostics, access to clean water and sanitation, prevention of infections, increased vaccination coverage and other measures are important components of antimicrobial resistance programs that improve quality of care. This illustrates that antimicrobial resistance and universal health coverage go hand-in-hand." 

The report comes ahead of the United Nations high-level meeting on universal health coverage, which will be held on Sep 23 during the UN General Assembly in New York.
Sep 17 ReAct policy brief

 

Report highlights prevalence of MRSA bacteremia in Australia

Roughly one in five Staphylococcus aureus bacteremia (SAB) isolates collected from Australian hospitals in 2017 were methicillin-resistant, according to a new report from the Australian Group on Antimicrobial Resistance.

Of the 2,515 isolates collected from 36 institutions participating in the Australian Staphylococcus aureus Sepsis Outcome Programme (ASSOP) in 2017, 19% were methicillin-resistant S aureus (MRSA). Among the MRSA isolates, resistance to non-beta-lactams was common, with approximately 42% of MRSA isolates also showing resistance to erythromycin and ciprofloxacin and 14% showing resistance to co-trimoxazole, tetracycline, and gentamicin. In addition, 31.3% of MRSA isolates were multidrug-resistant. Resistance to non-beta-lactam antimicrobials was largely attributed to two healthcare-associated MRSA clones: ST22-IV and ST239-III.

The 30-day mortality associated with methicillin-resistant SAB was 18.9%, compared with 14% for methicillin-susceptible SAB.

The report notes that while the percentage of methicillin-resistant SAB has decreased significantly in Europe (from 23.9% in 2009 to 16.9% in 2017) and in other parts of the world, it has remained stable in Australia (19.1% in 2013 to 19.0% in 2017), possibly because of a significant rise in community-associated MRSA cases.

"ASSOP 2017 has demonstrated antimicrobial resistance in SAB in Australia continues to be a significant problem and continues to be associated with a high mortality. This may be due, in part, to the high prevalence of methicillin-resistant SAB in Australia, which is significantly higher than most EU/EEA countries," the report concludes. "Consequently MRSA must remain a public health priority and continuous surveillance of SAB and its outcomes and the implementation of comprehensive MRSA strategies targeting hospitals and long-term care facilities are essential."
Sep 16 ASSOP 2017 report

 

NIH to fund monoclonal antibody treatment for resistant pathogens

Biotechnology company Inovio Pharmaceuticals announced yesterday that it has received a $4.6 million grant from the National Institutes of Health (NIH) to develop a treatment for multidrug-resistant infections that's based on its DNA-encoded monoclonal antibodies (dMAb) program.

According to a company press release, Inovio, in collaboration with The Wistar Institute, has demonstrated that the dMAb technology can effectively treat multidrug-resistant infections in animal models. The platform uses synthetic gene sequences that instruct a patient's cells to produce an encoded monoclonal antibody that specifically targets the bacterial pathogen. The NIH grant will support additional pre-clinical studies.

"Antimicrobial resistance represents an expanding global public health concern and a tremendous market opportunity for Inovio," said company president and chief scientific officer Laurent Humeau, PhD. "Our ultimate goal is to create a paradigm shift approach to monoclonal antibody technology that results in a pipeline of high impact dMAb products, which can be developed with corporate partnerships, external funding, and collaborations. This grant from the NIH will further this goal."

Inovio is also developing a dMAb product to treat and prevent Zika infection.
Sep 17 Inovio press release

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