Drug Resistance Scan for May 13, 2014

News brief

Transatlantic task force tackles antibiotic resistance

The US Department of Health and Human Services (HHS) and the European Commission (EC) today released the first progress report of the Transatlantic Taskforce on Antimicrobial Resistance (TATFAR) and extended the US/EC partnership 2 additional years, HHS announced in a news release.

TATFAR was created in 2009 following a US–European Union (EU) presidential summit with the goal of improving cooperation in three areas: (1) appropriate therapeutic use of antimicrobial drugs in medical and veterinary settings, (2) prevention of healthcare- and community-associated drug-resistant infections, and (3) strategies for improving the pipeline of new antimicrobial drugs.

TATFAR adopted 17 recommendations for collaboration, which have been implemented through increased communication, regular meetings, joint workshops, and the exchange of information, approaches, and best practices, HHS said. Successes in 2011 through 2013 include adoption of procedures for timely international communication, publication of a report on developing new diagnostic tests, and presentations to the scientific community to increase awareness about funding opportunities.

US and EU agencies will focus on 1 new and 15 existing recommendations in the coming years, the report said.

"The partnership offers a unique perspective to tackle antimicrobial resistance worldwide," said Jimmy Kolker, HHS assistant secretary for global affairs. "We hope that the positive outcomes of this partnership will serve as a global model as we continue to work on this critical issue."
May 13 HHS press release
May 13 full HHS/EC report

UK study finds same MRSA strains in humans, pets

The same strains of methicillin-resistant Staphylococcus aureus (MRSA) circulate in both humans and pets without undergoing host adaptation, according to a study today in mBio, published by the American Society for Microbiology (ASM).

UK researchers sequenced the genomes of 46 MRSA samples from cats and dogs collected from 2003 to 2007 from two large veterinary hospitals and several smaller veterinary practices in the United Kingdom. The samples were found to be similar to human MRSA strains.

"Phylogenomic analyses showed that all companion animal isolates were interspersed throughout the epidemic MRSA-15 (EMRSA-15) pandemic clade and clustered with human isolates from the United Kingdom, with human isolates basal to those from companion animals, suggesting a human source for isolates infecting companion animals," they wrote.

EMRSA-15 is a common MRSA family of strains that were first detected in the United Kingdom in the 1990s.

"Our study demonstrates that humans and companion animals readily exchange and share MRSA bacteria from the same population," said senior author Mark Holmes, VetMB, PhD, of the University of Cambridge, in an ASM news release. The study "provides evidence that antibiotic usage in animal medicine is shaping the population of a major human pathogen," he added.

Holmes says pet owners should not be concerned about the study's findings. "MRSA infection in cats and dogs is still extremely rare," he said. "There is very little risk of owners getting ill from their pets." He added that healthy pets are not likely to pick up MRSA from their owners but said the study serves as "a reminder that constant vigilance and high levels of hygiene are just as important when treating cats and dogs as with humans."
May 13 mBio study
May 13 ASM news release

News Scan for May 13, 2014

News brief

Ohio measles outbreak hits 73 cases as US totals pile up

A measles outbreak in Ohio has reached 73 cases—the largest state outbreak since 1996—and has helped spur US cases to some of their highest levels in recent years, according to data from the Ohio Department of Health (ODH) and the US Centers for Disease Control and Prevention (CDC).

The Ohio outbreak began in March and involves patients from 1 to 52 years old, with about even numbers male and female, according to an ODH update today. Five patients have required hospitalization. Forty-five of the cases have been in Knox County, while Ashland County has recorded the second-highest total, at 14.

All of the patients are Amish, according to a USA Today story published today. The outbreak began after Amish missionaries returned from the Philippines, which is experiencing a large, ongoing measles outbreak.

On May 9 the CDC listed 187 measles cases from 15 US outbreaks since Jan 1, closing in on the total of 189 for all of last year. The number for this year, however, is already outdated, because the ODH said its most recent case had a disease onset of May 11.

In 1996, Utah reported a 119-case measles outbreak. Since 2000, when local measles cases were considered eradicated in the United States, the country has had from 37 cases in 2004 to 220 in 2011, the CDC said. The agency said last month that the country's pace of new measles cases through Apr 18 was its fastest since 1996.
Most recent ODH case numbers
May 13 USA Today story
May 9 CDC update

Serology study in rural Cambodia finds no evidence of H5N1 infection

Scientists who studied 800 rural adults in an H5N1-endemic region in Cambodia for 2 years found detectable antibody titers in 21 (3%) people against five avian flu strains but not H5N1, according to a study yesterday in PLoS One.

US and Cambodian researchers took serum samples from adults living in rural Kampong Cham province 12 months and 24 months after they were enrolled in the study in 2008 and contacted them weekly during that period to identify influenza-like illness (ILI).

One enrollee was hospitalized with H5N1 avian flu and withdrew from the study. Among the other volunteers, 197 ILI cases (22.1%) were confirmed by polymerase chain reaction as influenza A infections, but none were caused by avian flu viruses.

During the 2-year study, 21 participants (3.0%) had detectable antibody titers (1:10 or greater) against the studied viruses: 1 against H4N6, 3 against H6N1, 9 against H9N2, 6 against H11N9, and 2 against H12N5. The authors noted that serologic evidence for subclinical infections was sparse, with only one enrollee showing a fourfold rise in microneutralization titer against H12N5.

The authors conclude, "Despite conducting this closely monitored cohort study in a region enzootic for H5N1 HPAI [highly pathogenic avian influenza], we were unable to detect subclinical avian influenza infections, suggesting either that these infections are rare or that our assays are insensitive at detecting them."
May 12 PLoS One study

CDC warns of unpasteurized dairy product hazards

The CDC sent a letter late last week to state and territorial public health officials warning about the risks of consuming unpasteurized dairy products and providing resources.

In the May 9 letter, Robert Tauxe, MD, MPH, deputy director of the CDC's Division of Foodborne, Waterborne, and Environmental Diseases, encouraged officials to forward the letter "to those involved with raw milk issues" in states and territories.

"Pathogens such as Escherichia coli O157, Campylobacter jejuni, and Salmonella can contaminate milk during the milking process," Tauxe said in the letter. "Adherence to good hygienic practices during milking can reduce, but not eliminate, the risk of milk contamination. Pasteurization is the only way to ensure that fluid milk products do not contain harmful bacteria."

He noted that the CDC recorded 81 outbreaks from 2007 through 2012 associated with unpasteurized dairy products, with the pace of the outbreaks quickening in more recent years. Those outbreaks resulted in 979 illnesses and 73 hospitalizations, and 81% occurred in states in which the sale of raw milk was legal.

Tauxe pointed officials to the CDC's updated raw milk Web site.
May 9 CDC letter