Experts develop research agenda for pediatric infections, stewardship
A group of clinicians and researchers with expertise in pediatric healthcare-associated infections (HAIs) and antimicrobial stewardship has developed a list of high-priority research topics for improving health outcomes in children.
Published last week in Infection Control and Hospital Epidemiology, the list of recommendations was developed through a multistep, 7-month process that included literature review, interactive teleconferences, web-based surveys, and two in-person meetings. At the end of the process, experts from the Centers for Disease Control and Prevention and academic children's hospitals across the country came up with six HAI topics and six antimicrobial stewardship topics as high-priority targets for future research.
The authors of the paper say the research agenda is necessary because HAI rates in children are similar to those in adults, but pediatric HAIs differ significantly from those experienced by adults, and HAI prevention strategies developed and tested in adult settings cannot be easily implemented in pediatric settings. In addition, while general principles of antimicrobial stewardship are shared across patient populations and settings, there are important differences between adult and pediatric patients that need further investigation.
The six high-priority HAI topics included judicious testing for Clostridioides difficile infection, chlorhexidine bathing, measuring and preventing hospital bloodstream infection rates, surgical-site infection prevention, and surveillance and prevention of multidrug-resistant gram-negative rod infections.
The six antimicrobial stewardship topics included beta-lactam allergy de-labeling, judicious use of perioperative antibiotics, intravenous-to-oral conversion of antimicrobial therapy, developing a patient-level "harm index" for antibiotic exposure, and benchmarking and/or peer comparison of antibiotic use in common pediatric inpatient conditions.
Nov 26 Infect Control Hosp Epidemiol abstract
High-path avian flu outbreaks expand in Europe, other regions
More countries reported additional highly pathogenic H5N8 and H5N5 avian flu outbreaks in poultry, and numerous more—even outside of Europe—reported more detections of both strains in wild birds, according to the latest notifications from the World Organization for Animal Health (OIE).
Regarding poultry outbreaks, South Korea reported an event at a duck farm in North Jeolla province that began on Nov 26, the country's first such outbreak since March 2018. One sick bird was found, and officials culled 19,000 ducks at the facility, as well as 392,000 other ducks and chickens at other farms as a preventive step. An investigation into the source is still under way.
Elsewhere, Poland reported an H5N8 outbreak at a poultry farm in Wielkopolska province,
Meanwhile, H5N5 struck a Belgian broiler farm in West Flanders province, the first involving the strain since 2017. It started on Nov 18, killing 600 of 151,600 birds.
In wild bird developments, several countries reported more H5N8 detections, mainly in waterfowl. For example, Norway reported H5N8 in a wild goose found sick on Nov 22 in Rogaland province, the country's first such detection. And Iran reported H5N8 in wild geese found dead near Meyghan Lake in Markazi province, the country's first detection of the strain since 2018.
Other countries reporting wild bird outbreaks include Germany with both H5N5 and H5N8, Belgium with H5N8, Italy with H5, Sweden with H5N8, the Netherlands with H5N5, and Slovenia with H5N8.
Nov 30 OIE report on H5N8 in South Korea
Nov 26 OIE report on H5N8 in Poland
Nov 27 OIE report on H5N5 in Belgium
Nov 30 OIE report on H5N8 in Norwegian wild birds
Nov 23 OIE report on H5N8 in Iranian wild birds
In low-pathogenic avian flu developments, South Africa reported eight more H7 outbreaks at commercial ostrich farms. The events occurred from Sep 10 to Oct 7.
Nov 23 OIE report on low path H7 in South Africa