Study bolsters evidence of heightened heart attack risk after flu

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People who are sick with flu are six times more likely to experience a heart attack the week after they test positive compared to the year before or the year after, researchers from the Netherlands will report at the European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) meeting in Copenhagen between Apr 15 and Apr 18.

Canadian researchers had reported the connection before, but the new study factors in death records, which include out-of-hospital heart attacks.

In the new study, researchers examined test results from 16 labs across the Netherlands, along with death and hospital records. Of 26,221 flu cases confirmed between 2008 and 2019, 401 people had at least one heart attack within one year of flu diagnosis. There were 419 heart attacks all together.

Of the 419 heart attacks, 25 occurred in the first 7 days after flu diagnosis, 217 in the year before and 177 in the year after, not counting the week after testing positive. Roughly one third died from any cause within a year of their flu diagnosis. The team calculated that people are 6.16 times more likely to have a heart attack in the week after flu diagnosis, similar to the 6.05 times greater risk that the Canadian group found, but at a level that translates to a weaker association of 2.42 times greater risk.
Flu infection can increase blood coagulation that, along with inflammation prompted by the immune response, could contribute to arterial plaque ruptures that lead to a heart attack, the researchers said.

Annemarijn de Boer, PhD, one of the study coauthors who is with the Julius Center for Life Sciences and Primary Care in Utrecht, said in an ECCMID press release that showing a more robust connection from a different population has important public health implications. "Our results endorse strategies to prevent influenza infection, including vaccination."


Study highlights successful use of combination antibiotic in outpatients with complicated infections

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A multicenter US study found that the combination antibiotic ceftolozane/tazobactam was successfully used to treat a variety of complicated, multidrug-resistant infections in outpatient settings, researchers reported yesterday in Open Forum Infectious Diseases.

Ceftolozane/tazobactam (C/T) was the first cephalosporin/beta-lactamase inhibitor combination approved by the US Food and Drug Administration and has generally been used to treat adults with complicated infections—such as intra-abdominal infection (IAI), urinary tract infection (UTI), and hospital-acquired/ventilator-associated pneumonia (HABP/VABP)—in acute care settings. Little real-world data on outpatient use is available. To evaluate use of the drug as outpatient parenteral antimicrobial therapy (OPAT), researchers evaluated outcomes among patients treated at 33 office infusion centers from 2015 through 2020.

Among the 126 patients identified (median age, 59; 59% male; 39% immunocompromised), bone and joint infection (BJI) was the most common infection (27%), followed by UTI (23%), respiratory tract infection (RTI, 18%), IAI (16%), complicated skin and soft tissue infection (cSSTI, 13%), and bacteremia (3%). Pseudomonas aeruginosa (63%) was the most common gram-negative pathogen identified, followed by Escherichia coli (13%) and Klebsiella spp (7%). Of the P aeruginosa isolates, 66% were multidrug-resistant and 45% were carbapenem-resistant. Extended-spectrum beta-lactamase producers were identified in 44% of all Enterobacterales isolates.

Overall clinical success was achieved in 84.7% of patients, with successful outcomes observed in 72.7% of BJI patients, 96.6% of UTI patients, 95.4% of RTI patients, 80% of IAI patients, 82.4% of cSSTI patients, and 66.7% of bacteremia patients. Non-successful outcomes were due to persistent infections (9.7%) and drug discontinuations (5.6%).

"We believe these real-world findings support the use of C/T in the outpatient setting for serious Gram-negative infections," the study authors concluded.

Americas region dengue surge gains more steam

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A spike in dengue activity in the Americas in 2022 has continued into 2023, with the situation burdening health systems in some countries, the Pan American Health Organization (PAHO) said yesterday in an update.

Other mosquito borne diseases are also in the rise, including chikungunya, but dengue currently makes up 75% of all arbovirus cases, the group said.

In the first 10 weeks of 2023, countries in the region reported 393,185 dengue infections, up from 390,733 during the same period in 2022. The four countries with the highest incidences are Bolivia, Nicaragua, Belize, and Brazil. Bolivia's increase is 23 times higher than for the same time span in 2022.

Colombia, Peru, and Brazil have reported the highest numbers of severe cases. So far this year, the region has reported 114 deaths from dengue.

PAHO urged countries to strengthen their health services and reinforce vector control efforts at both the community and individual levels.

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