News Scan for Mar 23, 2018

Contact precautions and resistance
Antimicrobial use on farms
Polio in Afghanistan
HPV vaccine uptake

Study finds contact precautions did not reduce drug-resistant infections

A 9-year single-center study by Columbia University scientists published yesterday in Infection Control & Hospital Epidemiology found that decreases in multidrug-resistant organisms (MDROs) were likely not due to implementing universal contact precautions (UCPs).

The researchers analyzed data from a clinical research database from 2006 through 2014 and compared monthly MDRO rates before and after UCP implementation. They compared three intensive care units that implemented UCP with three that did not.

They determined that MDRO rates overall decreased over time, but they found no significant decrease in the trend during the UCP period compared with the baseline period for any of the three UCP units. They also found no significant difference between UCP units (6.6% decrease in MDRO rates per year) and non-UCP units (6.0% decrease per year).

The authors concluded, "The results of this 9-year study suggest that decreases in MDROs, including multidrug-resistant gram-negative bacilli, were more likely due to hospital-wide improvements in infection prevention during this period and that UCP had no detectable additional impact."
Mar 22 Infect Control Hosp Epidemiol study


Group publishes guidance for monitoring farm-level antimicrobial use

The veterinary antimicrobial stewardship network AACTING this week released experience-based guidelines detailing best practices on setting up systems for antimicrobial use (AMU) data collection, analysis, benchmarking, and reporting at the farm level.

AACTING, which is a "network on quantification of veterinary antimicrobial usage at herd level and analysis, communication and benchmarking to improve responsible usage," said in the guidance, "At the national level, data on the sales of veterinary antimicrobial products have been shown to be important for guiding and supporting general policy making decisions."

The authors add, "Monitoring antimicrobial use at farm or prescriber level, however, is much more targeted than at the national level, as it offers the ability to pinpoint 'non-prudent' or excessive AMU and can help guide farm-specific preventive or corrective actions. The information arising from farm-level AMU monitoring is critical for driving antimicrobial stewardship, i.e. the establishment and implementation of measures aimed at combatting AMR by promoting responsible AMU practices."

The guidelines not only provide support for designing or fine-tuning farm-level AMU monitoring systems, they can help sync farm-level data within and among countries, the report says.
Mar 21 AACTING guidelines
AACTING website


Two new cases of wild polio virus recorded in Afghanistan

Afghanistan confirmed the detection of two new cases of wild poliovirus type 1 (WPV1), according to the latest update from the Global Polio Eradication Initiative (GPEI). The cases were first mentioned last week in an advanced notification.

One case was reported in Kundar province, with an onset of paralysis on Feb 14. The second case was reported in Kandahar province, with onset of paralysis on Feb 19. The new cases raise the number of WPV1 cases in Afghanistan in 2018 to five.

The Democratic Republic of the Congo (DRC) also reported the detection of a new case of circulating vaccine-derived poliovirus type 2 (cVDPV2). According to GPEI, the case was reported in Mulongo district, Haut Lomami province, with onset of paralysis on Jan 31. This is the third case of cVDPV2 reported in the DRC this year.

The DRC, supported by the GPEI, is using monovalent oral polio vaccine type 2 to immunize children in districts where cVDPV2 has recently been detected.
Mar 20 GPEI report


US HPV vaccination rates rise, especially among boys

A new study measuring uptake of the human papillomavirus (HPV) vaccine among 9- to 26-year-old Americans showed vaccination rates increasing among boys and men from 7.8% to 27.4% over a 6-year period.

The study was published today in the Journal of Infectious Diseases and included annual vaccination data gathered from the National Health and Nutrition Examination Survey from 2011 through 2016.

In 2011, the US Advisory Committee on Immunization Practices (ACIP) recommended that all boys over the age of 9 be vaccinated against HPV, a sexually transmitted virus that can cause cervical cancer. ACIP recommended the vaccine for girls and young women in 2006.

While the rate of overall vaccination increased among girls and women from 37.7% to 45.7% during the study period, all vaccination gains were made among women ages 18 to 26, with the increases in those age 22 to 26 reaching statistical significance. Rates among girls ages 9 to 17 did not increase.

All age-groups of boys and young men saw a significant increase in vaccination rates, but rates for both sexes were well below national goals.

"HPV vaccine coverage among males and females in the general U.S. population clearly  remains well below national targets, including the Healthy People 2020 goal to achieve >80% up-to-date coverage among 13-15 year olds," the authors concluded.
Mar 23 J Infect Dis

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