Stewardship / Resistance Scan for Jul 25, 2017

News brief

CARB-X awards $17.6 million to fund new antibiotic development

CARB-X, the international public-private initiative to stimulate new antimicrobial development, today announced the winners of its second round of funding.

The seven projects to receive funding from CARB-X (the Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator) include five potential new class antibiotics for gram-negative bacteria, a potential new treatment for drug-resistant gonorrhea, and a new molecule targeting a superbug that causes infections in cystic fibrosis patients. The companies will share $17.6 million to speed pre-clinical development of their products. The money will also fund a phase 1 clinical trial of a new oral broad-spectrum antibiotic.

Two of the companies are based in the United States. The others are in the United Kingdom, Ireland, France, and India.

"We are looking to support the best potential new treatments and diagnostics across the world," CARB-X Executive Director Kevin Outterson, JD, said in a press release. "We are especially pleased that today's awards mean we are now supporting scientists in six countries."

CARB-X is funded by the Biomedical Advanced Research and Development Authority (BARDA) and the Wellcome Trust, a global charitable foundation based in London, with additional support from the National Institute of Allergy and Infectious Diseases (NIAID). It's the world's largest public-private partnership devoted to preclinical antibacterial research and development.

In its first round of funding, announced Mar 30, CARB-X awarded $24 million to 11 biotech companies. The initiative has pledged to commit $450 million over 5 years to spur new antibiotic research and development.
Jul 25 CARB-X press release


Global study notes higher improper prescribing with antibacterials

An analysis published late last week involving prescribing data from 53 countries found higher rates of improper antibacterial prescribing compared with antifungal prescribing.

Writing in the Journal of Antimicrobial Chemotherapy, Belgian scientists reported data on 48,565 prescriptions (43,513 [90%] for antibacterials and 2,062 [4%] for antifungals for systemic use) given to 34,731 patients in early 2015. The reasons for prescribing (77.7% vs 71.8%) and stop/review dates (38.3% vs 31.9%) were found more often in notes for antibacterials than for antifungals.

The team found that antibacterials were prescribed according to local guidance only 57.0% of the time, compared with 71.0% for antifungals.

The authors conclude, "All of the quality indicators in this study can be used to improve the quality of antimicrobial prescribing. For example, the proportion of the oral mode of administration can be increased among antibacterials with excellent bioavailability since oral therapy is easy to give and cheaper than intravenous therapy. . . . Another example is issuing antimicrobials by the pharmacist only if the reason for the prescription is documented in the patient's notes."
Jul 21 J Antimicrob Chemother study

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News Scan for Jul 25, 2017

News brief

Sanofi: Yellow fever vaccine depleted until middle of 2018

The supply of Sanofi Pasteur's yellow fever vaccine YF-Vax is depleted in the United States until the middle of next year, the company said in a press release yesterday. Sanofi said the vaccine would be available again once Sanofi moves production to new "state of the art" facilities.

In the meantime, Sanofi said that Stamaril, the company's yellow fever vaccine manufactured in France, will be made available to Americans through the Food & Drug Administration's Expanded Access Investigational New Drug Application. Stamaril is considered investigational in the United States and not licensed for use.

According to the Centers for Disease Control and Prevention's (CDC's) travelers' health Web site, Americans may still be able to find YF-Vax at their local clinic. The CDC provides a map of YF-Vax and Stamaril supplies across the United States.
Jul 24 Sanofi press release
CDC Travelers' Health


Study places risk of contracting Lyme from tick bite at 2.6%

A modeling study yesterday from a team of Dutch scientists predicts that the overall risk of contracting Lyme disease from a deer tick bite is 2.6%, and the risk increases with tick engorgement, tick attachment time, and detection of Borrelia burgdorferi DNA in ticks.

To calculate the risk, the scientists compiled outcomes from three large prospective European studies on tick bites. The studies included 50 cases of Lyme borreliosis among 3,525 reports of tick bites. Substantially engorged ticks carried a 5.5% risk of transmitting harmful bacteria, contrasted with a 1.4% risk associated with low-engorgement ticks. If patients estimated that the tick was attached for less than 12 hours, there was a 2% risk of illness, as opposed to a 5.2% risk when the tick was attached for 4 days or longer.

According to the study, ticks that tested positive for Borrelia DNA posed a five times higher hazard than Borrelia-negative ticks.

"Further research is needed to explore how such risk assessment could be implemented for clinical decision making by physicians, since it would involve rapid testing of ticks for infection with Borrelia and estimation of tick attachment duration," the authors concluded.
Jul 24 PLoS One study


Peptide treatment for preventing Zika spread promising in mouse study

A research team from China today reported promising findings for a synthetic peptide that that inhibited Zika infection in pregnant mice, which might be useful for preventing birth defects in offspring. They published details of their experiments in Nature Communications.

The peptide they tested, called Z2, was made from the stem region of the Zika virus envelope protein. The researchers noted that peptide drugs are receiving more attention, because they're thought be safer and less expensive to develop than small-molecule or antibody-based antiviral treatments.

First, the team determined that Z2 could inactivate Zika virus, based on in vitro studies in three different cell lines. In the second part of their study they experimentally infected pregnant mice, then administered Z2 or phosphate-buffered saline. Investigators monitored the penetration of the treatment in maternal organs in the developing fetuses, while also assessing the safety of Z2.

The researchers found that Z2 can penetrate the placental barrier and enter fetal tissues and blocked the vertical transmission of Zika virus. Based on monitoring of weight and observations, they saw no adverse events in mothers or pups.

They concluded that the drug could be considered for preclinical development.
Jul 25 Nat Commun abstract


H5N1 avian flu strikes Myanmar poultry farm

Myanmar's livestock ministry has reported a highly pathogenic H5N1 avian flu outbreak, its first since April 2016, according to a notification today from the World Organization for Animal Health (OIE).

The event began on Jul 16 when farmers noticed clinical signs, including sudden deaths, in a commercial layer flock in Tanintharyi region in far southern Myanmar. The virus killed 3,194 of 5,000 susceptible birds, and the remaining birds were culled.

An investigation didn't identify a source of the outbreak, but officials said contributing factors included a lack of biosecurity on the farm and that the farm holder had an illegal processing area at the front of the farm.
Jul 25 OIE report on H5N1 in Myanmar


H3N2 dominant strain as flu levels rise in Southern Hemisphere

Most countries in the Southern Hemisphere reported increasing or peak levels of flu in recent weeks, according to the latest global flu update from the World Health Organization (WHO).

Though influenza A (H3N2) is the dominant strain, influenza B is co-circulating in many countries reporting high flu activity. Oceania, Australia, and New Zealand reported flu activity following seasonal patterns, and increasing trends of influenza-like illnesses (ILI). In temperate South America, flu has peaked, and in Southern Africa, seasonal activity was increasing, with H1N1 circulating alongside H3N2.

H1N1 also predominated in Southern Asia and the Philippines. Flu activity in Southeast Asia was increasing this past week, with South China reporting increased ILI activity and respiratory illnesses. All influenza subtypes are circulating in Southeast Asia.
Jul 24 WHO update

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