News Scan for Sep 24, 2019

CDC biosafety center designation
;
CARB-X diagnostic graduate
;
Outpatient antibiotic prescribing
;
Hospital Candida auris outbreak

PAHO/WHO taps CDC as biosafety and biosecurity collaborating center

The US Centers for Disease Control and Prevention (CDC) announced yesterday that the Pan American Health Organization (PAHO)/World Health Organization (WHO) have designated the CDC's Center for Global Health as a PAHO/WHO Collaborating Center for Biosafety and Biosecurity.

Effective for 4 years, the designation is the first awarded to a CDC/WHO collaborating center that taps the CDC's wide biosafety and biosecurity expertise to help countries safely handle and contain diseases such as Ebola, flu, and polio.

The CDC said it has decades of experience helping countries build biosafety and biosecurity capacity, such as a 2012 project to help Thailand establish a certification training program for operating biological safety cabinets. In 2017, an assessment from the WHO and CDC paves the way for certification of yellow fever regional reference lab at the Uganda Virus Research Institute.

Kevin Karem, PhD, associate director for lab science at the CDC's Center for Global Health, said in a CDC statement that global labs provide data that drive public health actions and support solutions to global health programs. "In a world that is increasingly interconnected, our ability to prevent, identify, contain and respond to biological threats—whether intentional or naturally occurring—is imperative to protect health and save lives," he added.

In its role as a collaborating center, the CDC will provide leadership in the development of recommendations and guidance on lab biosafety and biological management, support PAHO/WHO in the use of cutting-edge training and technological innovations, and continue work on improving global biosafety and biosecurity.
Sep 23 CDC press release

 

CARB-X touts success of rapid diagnostic test

CARB-X announced today that a test designed to rapidly detect antibiotic resistance genes in whole-blood samples has become to first diagnostic to "graduate" from the CARB-X portfolio.

CARB-X (the Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator) awarded T2 Biosystems of Lexington, Mass., $2 million in 2017 to develop the T2Resistance Panel, which can detect 13 resistance genes in gram-positive and gram-negative pathogens directly from a whole-blood specimen within 3-to-5 hours. The test was granted Breakthrough Device designation by the Food and Drug Administration earlier this year, and is expected to soon be available for research use only in the United States and commercial use in Europe.

"We are incredibly grateful to CARB-X for the funding and support they provided to our team in the development of the T2 Resistance Panel over the past year and a half," T2 Biosystems chairman and CEO John McDonough said in a CARB-X press release. "Rapid identification of the genes and species associated with antibiotic resistance can help enable the reduction of unnecessary antibiotic use, which is the primary cause of resistance."

"The T2Resistance Panel will provide healthcare professionals with a new rapid test, a first of its kind, to provide timely and accurate detection of drug-resistant infections and inform treatment decisions to ensure patients are given the most appropriate care," said CARB-X executive director Kevin Outterson, JD.

The test is one of four diagnostics in the CARB-X portfolio.
Sep 24 CARB-X press release

 

Study highlights improper first-line antibiotic prescribing for outpatients

A comparison of antibiotics prescribed for pharyngitis, sinusitis, and acute otitis media in a variety of outpatient settings found that only 50% of patients received recommended first-line antibiotics—when the figure should be closer to 80%.

A research team led by CDC scientists published its findings yesterday in Antimicrobial Agents and Chemotherapy.

The researchers based their analysis on the 2014 MarketScan Commercial Database, focusing on antibiotics selected for the three conditions at retail clinics, emergency departments, urgent cares, and offices. Previous studies have profiled antibiotic prescribing patterns for the conditions at emergency departments (EDs) and offices, but evidence was lacking on antibiotic selection at retail health and urgent care centers, which make up a growing percentage of US outpatient visits.

The study included records of pediatric patients and adults up to age 65. First-line therapy was defined as amoxicillin or penicillin for pharyngitis and amoxicillin or amoxicillin-clavulanate for sinusitis and pediatric ear infection.

Overall, of antibiotic visits for the three conditions, 50% of patients received first-line therapy, but the percentage varied by setting, with first-line therapy at 70% for retail clinics, 57% for EDs, 49% in urgent care centers, and 50% in offices. First-line therapy was higher for children (62%) than adults (41%). Percentages also varied by condition, and macrolides were the most common non-first-line therapy.

When the group looked at common respiratory conditions, 50% of patients received first-line antibiotics, with retail clinics highest at 70%.

The researchers concluded that all settings can improve antibiotic selection, given that first-line therapy should be used in at least 80% of visits for the three conditions.
Sep 23 Antimicrob Agents Chemother abstract

 

Report puts cost of 34-case Candida auris outbreak at over $1 million

A 34-case outbreak of Candida auris infections at a London hospital in 2016 and 2017 spotlights how devastating the multidrug-resistant fungus can be, in both clinical impact and hospital costs, according to a study yesterday in the Journal of Infection.

Investigators with King's College Hospital identified 14 confirmed or probable infected patients from July 2016 through February 2017, as well as 20 colonized patients. Eight of the patients had C auris bloodstream infections.

The researchers determined that infection was significantly associated with prolonged hospital stay, hemodialysis, and recent antifungal therapy. Isolates from patients demonstrated variable susceptibility to amphotericin and the triazoles, and isolates clustered with the South Asian strains of the fungus. Four patients died within 30 days of infection or colonization, including two who had infections.

They cite the lack of early identification and isolation of the index case-patient as the likely initiating factor in the outbreak.

The authors estimated that the total cost of the outbreak was £1 ($1.25 million), not including the lost opportunity cost of cancelled operations, extra consumables in the operating rooms, screening costs before a formal test was introduced in the lab, and other miscellaneous costs. In addition, the researchers reported a substantial cost associated with isolation and precautions taken for patients who were awaiting confirmation of C auris during the initial part of the outbreak but were ultimately negative.

The authors write, "In conclusion, controlling an outbreak of C. auris requires a multipronged approach which can be expensive over the short term. Implementation of hospital wide communication, detection by screening, mandatory isolation and aggressive disinfection at an early stage may help reduce transmission and morbid complications of the disease."
Sep 23 J Infect abstract

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