WHO describes MERS cluster in Saudi Arabia

News brief

Yesterday the World Health Organization (WHO) confirmed three cases of MERS-CoV (Middle East respiratory syndrome coronavirus) infection in Saudi Arabia linked to a Riyadh hospital, one of them fatal. 

Also, in Taif, a 32-year-old man has died from MERS-CoV. That man had contact with camels, and his case is not considered part of the outbreak. 

Two patients shared a hospital room

In the Riyadh outbreak, the patients are men ages 56 to 60 years with underlying health conditions. They did not have camel contact and were not healthcare workers. The three cases were reported from April 10 and 17.

"The three cases are epidemiologically linked to exposures in a health-care facility in Riyadh, although investigations are ongoing to verify this and understand the route of transmission," the WHO said. 

The index case-patient, who died from his infection, shared a hospital room with the second patient identified. The third patient was a man who was treated at the same hospital as the first two patients but in a separate ward. As of April 21, the second and third case-patients remained in intensive care units.

Since the first report of MERS-CoV in Saudi Arabia in 2012, there have been 2,204 human cases and 860 deaths globally, with the vast majority in Saudi Arabia.

WHO issues guidance to prevent catheter-related bloodstream infections

News brief

The World Health Organization (WHO) today published guidelines aimed at preventing bloodstream infections from peripheral intravenous catheters (PIVCs).

Nurse inserting catheter
dimarik / iStock

Noting that up to 70% of all hospitals inpatients require the use of a catheter inserted into a peripheral vein or artery, the WHO says that poor practices in the insertion, maintenance, and removal of PIVCs carry the high risk of introducing bacteria into the bloodstream, which can result in life-threatening conditions such as sepsis and difficult-to-treat complications in major organs—particularly when the infections are caused by antibiotic-resistant bacteria.

The burden of these infections is significant. The WHO estimates that, from 2000 through 2018, the average mortality among patients with healthcare-associated sepsis was 24.4% and more than double that—52.3%—among intensive care unit patients.

Preventable infections

But the agency believes that catheter-associated bloodstream infections are among the most preventable healthcare-associated infections if proper procedures are followed by clinicians. The evidence-based guidelines include 14 good practice statements and 23 recommendations that focus on education and training of healthcare workers, techniques of asepsis and hand hygiene, catheter selection, and proper PIVC insertion, maintenance, access, and removal.

"Infections associated with health care delivery represent a preventable tragedy and a serious threat to the quality and safety of health care," Bruce Aylward, WHO assistant director-general for universal healthcare, said in a WHO press release. "Implementing clean care and infection prevention and control recommendations is critical to saving lives and alleviating a great deal of avoidable suffering experienced by people around the world."  

Subsequent guidelines will address other type of intravascular catheters.

More poultry associations join international effort to cut antimicrobial use in poultry

News brief
Young broiler chickens
Bob Nichols / USDA

Seven more groups involved in poultry production have signed on to an international effort to reduce the use of antimicrobials on poultry farms.

The organizations, which include poultry associations from several European countries and fast-food giant Yum! Brands, announced yesterday that they'll adopt principles developed by the Transformational Strategies for Farm Risk Output Mitigation (TRANSFORM) project to ensure the proper use of antimicrobials on poultry farms. Funded by the US Agency for International Development, the project is led by a consortium that includes Cargill, Heifer International, and the International Poultry Council (IPC) and uses antimicrobial stewardship principles developed by the IPC.

The principles encourage adopters to commit to taking action in four key areas: (1) taking a risk-based approach around each instance of antimicrobial use, (2) adopting farm management practices that improve animal health and reduce the need for antimicrobials, (3) using antimicrobials only in compliance with national authorizations, and (4) using medically important antibiotics only under a supervising veterinarian's diagnosis and oversight.

Sending a message about stewardship

A total of 26 organizations have now signed on to TRANSFORM, representing more than 40% of global poultry meat production. Launched in 2021, the project has provided training to more than 80,000 farmers in India and Kenya.

"By proactively supporting science-based antimicrobial use principles, the private sector is sending a clear message that antimicrobial stewardship is good business," IPC President Ricardo Santin said in a Cargill press release. "We hope others are inspired to make the same commitments to stewardship, adopting science-based practices that both improve animal health and deliver benefits to their bottom line."  

Cochrane: Zinc may help shorten common cold, but more evidence needed

News brief

Taking zinc could shorten the duration of the common cold by 2 days, according to a Cochrane review today. The evidence is not conclusive, however, and potential benefits must be balanced against side effects including bowel problems, nausea and unpleasant taste, the reviewers note.

woman coughing
Drazen Zigic / iStock

For the past 40 years zinc has been marketed as a way to both lessen the severity and shorten the duration of colds. It has been proposed that the mineral inhibits viral replication in the upper respiratory tract. 

The new review analyzed results from 34 studies (15 prevention, 19 treatment) involving 8,526 participants. Using zinc was associated with little or no reduction in the risk of developing a cold, the mean annual number of colds, or symptom severity. 

The authors found there may be a reduction in the mean duration (MD) of the cold in days (MD, 2.37; 95% confidence interval [CI], 4.21 to 0.53). Overall, the authors said it was lowcertainty evidence.

Non-serious side effects can occur with zinc

Having no serious side effects from zinc was considered moderate-certainty evidence, but there is likely an increased risk of nonserious adverse events when zinc was used for cold treatment (risk ratio, 1.34; 95% CI, 1.15 to 1.55). 

"Ultimately, it's up to the individual to decide whether the risk of potential unpleasant side-effects is worth the benefit of potentially shortening their illness by a few days," said first author of the review Daryl Nault, MS, of Maryland University of Integrative Health, in a press release from Cochrane. 

Ultimately, it's up to the individual to decide whether the risk of potential unpleasant side-effects is worth the benefit of potentially shortening their illness by a few days.

The authors noted that studies varied significantly with dose of zinc administered, type of zinc administered, and route of administration (nasal spray or lozenge). 

"Future studies should adopt standardized methods for administering and reporting treatments and defining and reporting outcomes," said senior author Susan Wieland, MD, of the University of Maryland School of Medicine, in the press release.


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