Stewardship / Resistance Scan for Jul 31, 2018

MDR infection and mortality risk
CARB-X funds C diff drug

Study: Long-term risk of infection, death in patients harboring MDR bacteria

Harboring multidrug-resistant gram-negative bacteria (MDRGNB) significantly increases patients' long-term risk for subsequent MDRGNB infection and mortality after hospital discharge, Taiwanese researchers report today in Antimicrobial Resistance and Infection Control.

In an observational study, researchers at National Taiwan University Hospital recruited 817 patients who had been hospitalized in 2009 and discharged after receiving active microbiological surveillance cultures for MDRGNB infection or colonization. MDRGNB was defined as a gram-negative pathogen resistant to at least three antimicrobial classes. The researchers then recorded subsequent MDRGNB infection and mortality within 12 months after index hospitalization and determined the frequency and risk factors for subsequent infection and mortality associated with previous MDRGNB status.

Of the 817 patients, 125 were identified in the index hospitalization as MDRGNB culture-positive (MDRGNB-CP) and 629 were classified as MDRGNB culture-negative (MDRGNB-CN). In total, 129 patients had at least one subsequent MDRGNB infection during the follow-up period (60 MDRGNB-CP patients and 69 MDRGNB-CN patients), and 148 patients died (53 MDRGNB-CP and 95 MDRGNB-CN). Escherichia coli and Acinetobacter baumannii were the most prevalent MDR species identified during index hospitalization and in subsequent infections, while patients colonized with Proteus mirabilis and Pseudomonas aeruginosa had the highest hazard risk for developing subsequent infection.

After controlling for other confounders, positive MDRGNB culture during index hospitalization was found to be an independent predictor for subsequent MDRGNB infection (hazard ratio [HR], 5.35], all-cause mortality (HR, 2.42), and subsequent MDRGNB infection-associated mortality (HR, 4.88).

The researchers say their findings highlight the urgent need for effective approaches to prevent the spread of MDRGNB in hospitals and mitigate MDRGNB colonization burden after hospitalization.  
Jul 31 Antimicrob Resist Infect Control study


CARB-X to fund novel antibiotic alternative for C difficile infection

CARB-X today announced funding for a novel therapeutic to fight Clostridium difficile infection (CDI).

The award of $0.68 million to SciBac of San Francisco, CA, will support early-stage development of SCB-102, the company's oral antibiotic alternative for the prevention and treatment of recurrent CDI. The drug, which consists of three hybrid molecules, specifically targets and kills C difficile bacteria, stops its colonization of the colon, neutralizes its toxins, and prevents spore formation.

"SciBac has essentially created a new class of drugs," Jeanette Mucha, CEO of SciBac, said in a CARB-X press release. "Our patented platform technology allows us to mate different species of microbes. This means we can harness the microbiome to both treat and prevent antibiotic resistant disease, with targeted modes of action."

According to the US Centers for Disease Control and Prevention, CDI causes an estimated 15,000 deaths each year in the United States. One in five patients experiences a recurrence of the infection.

The company could receive an additional $3.08 million if certain project milestones are met.

CARB-X (the Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator) is currently funding 35 research and development projects targeting the most serious drug-resistant bacteria, and has announced awards totaling $90.1 million since it was established in 2016
Jul 31 CARB-X press release

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