Tainted eye drops tied to 81 cases of highly resistant Pseudomonas, 4 deaths

News brief
Eye drops
© ICEH, Community Eye Health / Flickr cc

The US Centers for Disease Control and Prevention (CDC) has confirmed a fourth death and more vision loss in an outbreak of infections caused by a unique strain of extensively drug-resistant Pseudomonas aeruginosa involving at least 81 people in 18 states.

"The infections are caused by a strain of carbapenem-resistant P. aeruginosa that produces the Verona integron-encoded metallo-β-lactamase (VIM) and the Guiana-Extended Spectrum-β-Lactamase (GES)," the CDC said in an update late last week. "Isolates are P. aeruginosa sequence type (ST) 1203 and harbor blaVIM-80 and blaGES-9, a combination not previously identified in the United States."

In addition to the deaths, which is one more than the CDC reported in its March 25 update, people experiencing vision loss from their infection now total 14, up from 8 cases.

The CDC and the Food and Drug Administration recommend that clinicians and patients stop using and discard EzriCare Artificial Tears and two additional products made by Delsam Pharma of Mamaroneck, New York: Artificial Tears and Artificial Ointment. The manufacturer has recalled these products.

Resistant to many antibiotics

Testing at public health labs showed that outbreak isolates are not susceptible to a wide range of antibiotics: cefepime, ceftazidime, piperacillin-tazobactam, aztreonam, carbapenems, ceftazidime-avibactam, ceftolozane-tazobactam, fluoroquinolones, polymyxins, amikacin, gentamicin, and tobramycin. A subset of five isolates was susceptible to cefiderocol.

Specimens were collected from May 2022 to April 2023.

The CDC said, "Bacteriophage (phage) with activity against the outbreak strain have been identified at University of California at San Diego’s Center for Innovative Phage Applications and Therapeutics (IPATH) and at the Yale Center for Phage Biology and Therapy." The agency said clinicians should contact IPATH if they wish to explore phage therapy.

Patients with COVID-19 at time of heart attack have more clotting

News brief

Man having heart attackAn international COVID-19 registry shows an increased rate of clotting in heart attack patients with COVID-19, according to data recently presented at the Society for Cardiovascular Angiography & Interventions (SCAI) 2023 Scientific Sessions.

Clots were seen in multiple arteries in close to 30% of patients with COVID-19 at the time of an ST-elevated myocardial infarction, or STEMI, but in less than 5% of patients with STEMI who did not have COVID-19 at the time their heart attack.

A STEMI is one of the most severe types of heart attacks seen in cardiac patients, as it is caused by the sudden, complete blockage of a coronary artery. Previous research has shown the pre-COVID-19 mortality in STEMI patients was below 5%, but climbs to 20% to 25% in patients who have COVID-19 at the time of their heart attack.

Study involved 234 patients

The findings were based on angiography reports from 234 patients from 17 sites—12 in the United States and 5 in Canada. Researchers assessed a number of cardiac feature in the blinded analysis. The study intervention was the effect of percutaneous coronary intervention, a non-surgical procedure that opens blocked arteries.

"These new insights point to the need for clinicians to be meticulous with blood thinning strategies, early interventions, and patient follow-up," said Payam Dehghani, MD, FRCPC, FACC, FSCAI, co-director of the Prairie Vascular Research Inc and an associate professor at the University of Saskatchewan, in a society press release.

These new insights point to the need for clinicians to be meticulous with blood thinning strategies, early interventions, and patient follow-up.

The researchers said further investigation is needed to understand the relationship between COVID-19 and heart attacks. "COVID-19 is a pro-inflammatory, clot forming disease and we now see its effect in the coronary arteries," Dehghani said.

HERA donates $8.6 million for fight against antimicrobial resistance

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The European Commission's (EC's) Health Emergency Preparedness and Response Authority (HERA) will give €8 million (about $8.6 million US) to the Global Antibiotic Research & Development Partnership (GARDP) and the World Health Organization (WHO) to tackle the growing threat of antimicrobial resistance (AMR) over the next 3 years.

GARDP announced the collaboration late last week after the three organizations held their first steering committee meeting in Geneva. The partnership will work to ensure sustainable access to treatments for resistant infections, promote responsible antibiotic use, improve affordability, and prioritize research into new antibiotics.

Under the EU4Health programme, the three organizations will work to boost capacities at the national, regional, and global levels to increase preparedness for and response to health emergencies, the release said.

GARDP will study neonatal sepsis, gonorrhea

As part of this work, GARDP will use its €5 million ($5.4 million) allotment for late-stage clinical development, regulatory actions, and improved access to antibiotics for serious bacterial, sexually transmitted, and children's infections.

In the news release, GARDP Executive Director Manica Balasegaram, MBBS, called AMR "one of the top ten global health threats facing the planet. The HERA funding will allow GARDP to carry out the first-ever clinical trial evaluating new combination treatments for neonatal sepsis, and advance the development of a new treatment for gonorrhoea and another new treatment for serious bacterial infections in adults and children."

The HERA funding will allow GARDP to carry out the first-ever clinical trial evaluating new combination treatments for neonatal sepsis.

GARDP is a not-for-profit foundation that develops new treatments for the most pressing drug-resistant infections. The WHO and the Drugs for Neglected Diseases Initiative founded GARDP in 2018.

The WHO will use its €2 million ($2.2 million) allocation to support research and development, and the remaining €1 million ($1.1 million) will go to the WHO-GARDP's SECURE project to accelerate access to essential antibiotics.

Pierre Delsaux, MA, who heads HERA, said the partnership will allow the collaborators "to progress the development of new medical countermeasures for tackling antimicrobial resistance, one of the three priority cross-border health threats identified by HERA." HERA was established in September 2021 as an EC directorate-general in response to the COVID-19 pandemic.

Atypical BSE ('mad cow' disease) reported in US cow

News brief
Beef cattle

The US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) announced an atypical bovine spongiform encephalopathy (BSE) case in a beef cow that was at least 5 years old at a slaughter plant in South Carolina, marking the seventh BSE case since 2003.

The cow was testing during surveillance for animals that are deemed unsuitable for slaughter, APHIS said in a statement. Tests at the National Veterinary Services Laboratories in Ames, Iowa, were positive for atypical L-type BSE. The cow was sourced from a herd in Tennessee, and APHIS and its state animal health partners continue their investigation.

The animal didn't go through the slaughtering process, posing no threat to the food supply or human health.

Atypical BSE can occur in older cows and can arise spontaneously, APHIS said. Unlike the classical form of BSE ("mad cow" disease), atypical BSE hasn't been linked to contaminated feed or ingesting contaminated materials.

Scientists don't fully understand what causes prions to change from normal to abnormal and are exploring if genetic or environmental factors may play a role, according to APHIS, which said the finding doesn't change the nation's negligible risk status and shouldn't affect the beef trade.

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