Stewardship / Resistance Scan for Jan 12, 2017

Antibiotic resistance investment
Candida auris biofilms

New Web site details CDC investments in fight against antibiotic resistance

The Centers for Disease Control and Prevention (CDC) has released a new online tool that will enable users to find out how the agency is financially supporting efforts to combat antibiotic resistance across the country.

The CDC AR Investment Map is an interactive site where you can click on individual states to find out how much money the CDC is providing in fiscal year 2016 to state health departments to help tackle antibiotic resistance. The site also includes a detailed breakdown of the funding for each state by activity, including investments in public health laboratories to help identify antibiotic-resistant threats more quickly, in healthcare-associated infection control programs to prevent the spread of drug-resistant bugs, and in efforts to improve antibiotic use.

Overall, Congress appropriated $160 million to the CDC in 2016 to fight antibiotic resistance. The agency says the investments detailed on the new Web site will work toward meeting national goals to prevent drug-resistant infections as outlined in the National Action Plan for Combating Antibiotic-Resistant Bacteria.
CDC Antibiotic Resistance Investment Map


Study describes drug-resistant Candida auris biofilms

A study today in Emerging Infectious Diseases reports that Candida auris, a drug-resistant yeast that's been associated globally with life-threatening invasive diseases, has the capacity to form antifungal-resistant biofilms.

In the study, researchers grew biofilms from strains of C auris and compared them with biofilms grown from C albicans and C glabrata, two other types of yeast that can also cause invasive infections. Biofilms are complex communities of bacteria that form on any surface exposed to bacteria and water and can tolerate higher doses of antibiotics than their planktonic counterparts. Biofilm formation, the authors write, "is a key driver of C albicans pathogenicity and is associated with patient death."

The researchers found that C auris formed biofilms that were significantly reduced compared with C albicans but much greater than the biofilms formed by C glabrata. And when they tested the C auris biofilms and planktonic cells against a selection of antifungal agents, they found that the biofilms could resist some of the agents that were active against planktonic cells. The researchers were particularly interested to find that the antifungal caspofungin, which is normally highly effective against Candida biofilms, was inactive against C auris biofilms.

"These features contribute not only to C auris virulence but also to its survival in hospital environments, increasing its ability to cause outbreaks," the authors write.

The disinfectant chlorhexidine, however, was effective, exhibiting the greatest activity against C auris biofilms and planktonic cells. As a result, the authors conclude that while it is unlikely that the spread of C auris can be controlled by antifungal stewardship approaches alone, chlorhexidine "can be advocated for topical control of C auris at standard concentrations for skin and wound cleaning and disinfection."

C auris was first identified in the ear of a Japanese patient in 2009 and has caused hospital outbreaks across Asia and South America. In November, the CDC said 13 cases have been identified in the United States.
Jan 12 Emerg Infect Dis dispatch

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