News Scan for Aug 19, 2016

MCR-1 in UTI in Switzerland
HPV vaccine acceptance
UN cholera lawsuit immunity

Swiss researchers report MCR-1 in E coli from a urinary tract infection

Researchers in Switzerland yesterday reported they detected the MCR-1 resistance gene in a single Escherichia coli isolate collected from samples of human urinary tract infections. The research appeared in the International Journal of Infectious Diseases.

The study was the first prospective analysis of the prevalence of both MCR-1 and MCR-2 genes—which can transfer resistance to the last-resort antibiotic colistin to different types of bacteria—in human clinical samples, the authors said.

The researchers screened 2,049 enterobacterial isolates from two Swiss laboratories first for colistin resistance, then for the presence of MCR-1 and MCR-2. While 6 of the isolates (2 E coli, 2 Klebsiella pneumoniae, 1 Hafnia alvei, and 1 Salmonella isolate) were found to be colistin resistant, none of them tested positive for MCR-like genes. A single E coli strain that was susceptible to colistin, however, tested positive for MCR-1.

The researchers said the low prevalence rate of plasmid-mediated colistin resistance in the human clinical samples, despite the fact that colistin is used widely in Switzerland to treat infected animals, suggests that a high transfer of MCR-like genes from humans to animals has not yet occurred and might be possible to prevent. But the fact that MCR-1 was found in a colistin-susceptible E coli isolate indicates the gene might spread silently. To combat this, they urged large and regular screening of animal isolates.

The MCR-1 gene was first identified in E coli samples from food, animals, and patients in China in November 2015. Since then it has been detected in more than 30 countries. MCR-1–positive E coli has been previously found in Swiss hospital patients and in Swiss food.

MCR-2 was first detected in E coli isolates from Belgian pigs last month.
Aug 18 Int J Infect Dis abstract
Jul 7 CIDRAP News story on MCR-1 in Belgian pigs

Survey: Only 1 in 5 parents support mandatory school HPV vaccination

Only about one in five parents support mandatory human papillomavirus (HPV) vaccination as a requirement of school attendance, a study today in Cancer Epidemiology, Biomarkers & Prevention found.

US researchers polled 1,501 parents of 11- to 17-year-old children on the Web from November 2014 through January 2015. They found that only 21% of parents agreed that laws requiring HPV vaccination for school attendance are a "good idea," while 54% disagreed. If school-entry requirements included opt-out provisions, the results flip-flopped: Agreement increased to 57% for that scenario, while 21% disagreed.

Parents more often agreed with requirements without opt-out provisions if they were Hispanic, believed HPV vaccine was as important or was more important than other adolescent vaccines, or believed HPV vaccine was effective in preventing cervical cancer. Respondents agreed less often if they lived in the Midwest or believed that drug company profits were behind HPV vaccine efforts.

The authors conclude, "Opt-out provisions greatly increase parent support of school-entry requirements for HPV vaccination but may make them ineffective."
Aug 19 Cancer Epidemiol Biomarkers Prev abstract

UN maintains immunity in cholera lawsuits

A US federal appeals court has affirmed United Nations (UN) immunity from a damage claim filed by Haitian cholera victims, the Associated Press (AP) reported today. The claim involved 5,000 people who blamed the UN for a cholera outbreak that swept through the country months after its January 2010 earthquake.

The ruling came just days after UN officials took some ownership for the epidemic, which researchers say began when UN peacekeepers from Nepal dumped human waste into the Artibonite River in October of 2010, causing the worst cholera epidemic in recent history. Cholera is now endemic in Haiti, and more than 9,300 Haitians have died and 800,000 have become ill from the disease. 

Until this week, UN officials had denied any responsibility for the outbreak as it claimed legal immunity under a 1946 convention, according to the AP.

The AP reported that advocates for the cholera victims have 90 days to make an appeal to the U.S. Supreme Court.
Aug 19 AP story

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