News Scan for Dec 04, 2020

XDR Klebsiella strains in Italy
Polio in 3 countries
More avian flu outbreaks

Extensively drug-resistant Klebsiella pneumoniae strains detected in Italy

Two extensively drug-resistant strains of Klebsiella pneumoniae identified in two patients at an Italian hospital in May appear to be a dangerous variant of a strain that caused an outbreak in Tuscany in 2018 and 2019, Italian scientists reported yesterday in Eurosurveillance.

The strains of K pneumoniae carrying the blaNDM gene were isolated from two critically ill patients at University Hospital Pisa and were resistant to all tested antibiotics, including colistin, fosfomycin, and tigecycline.

Genomic analysis indicated that both strains belonged to the ST147 sequence type, which is the same sequence type as the NDM-1-producing K pneumoniae clone that caused a large outbreak in Tuscany in 2018-2019 and infected or colonized more than 300 patients at the same hospital. The outbreak clone was resistant to all beta-lactam antibiotics but susceptible to colistin, fosfomycin, and tigecycline.

A comparison of the ST147 K pneumoniae isolates from the two patients with isolates from the earlier outbreak showed the sequences formed a cluster, but the 2020 isolates harbored an NDM-9 gene containing additional resistance mutations. The authors of the report say the new variant likely emerged from a subgroup of highly related strains from the 2018-2019 outbreak and will be more challenging for clinicians to treat because of its resistance to additional antibiotic classes.

"The persistence of K. pneumoniae ST147 isolation suggests that this clone can be considered as endemic in the Pisa University Hospital and there is risk of spread to other hospitals in Tuscany and elsewhere," the authors wrote. "Several actions, such as systematic screening of hospitalised patients, contact precautions, and cohorting of colonised/infected patients are ongoing to contain the spread of this clone."
Dec 3 Euro Surveill rapid communication


Three countries add to their polio totals

Three countries—Pakistan, the Democratic Republic of the Congo (DRC), and Mali—reported more polio cases over the past week, the Global Polio Eradication Initiative (GPEI) said in its latest weekly update.

Pakistan reported one more wild poliovirus type 1 (WPV1) case, which involves a patient from Balochistan province, lifting its total for the year to 82. Earlier this week, assailants in the Khyber Pakhtunkhwa province city of Bannu killed a police officer who was guarding a polio immunization team, Press Trust of India (PTI) reported.

In Africa, the DRC and Mali both reported more circulating vaccine-derived poliovirus type 2 (cVDPV2) cases. The DRC reported five new cases from three different provinces, putting its 2020 total at 68. And the GPEI said two more were reported from Mali. Though the details aren't clear, it said the country has reported 26 cases this year so far.

In another African development, the GPEI said one of the continent's biggest polio immunization campaigns just wrapped up in Chad, where 3.3 million in 91 districts were vaccinated.
Dec 3 GPEI weekly update
Dec 3 PTI report


Six countries report more high path avian flu in poultry and wild birds

In the latest highly pathogenic avian flu developments, Germany, Poland, and the United Kingdom reported more outbreaks in poultry and China, France, and Belgium reported H5N8 detections in wild birds, according to the latest notifications from the World Organization for Animal Health (OIE).

Germany reported one more H5N8 outbreak, this time at a layer farm in Mecklenburg-Vorpommern state, which has recently reported other similar events. The latest outbreak began on Nov 30, killing 50 of 28,500 susceptible birds. Also, Poland reported an outbreak involving the same strain at a turkey broiler farm in Mazowieckie province that began on Dec 1, killing 1,703 of 117,108 susceptible birds.

Elsewhere in Europe, the United Kingdom reported two more H5N8 outbreaks, one at a turkey-fattening farm in Hambleton, North Yorkshire, and another in poultry and captive birds at a location near Melton Mowbray in Leicestershire. In response to the recent rise in outbreak activity, the UK's Department for Environment, Food, and Rural Affairs (DEFRA) ordered new measures that take effect Dec 14, including a requirement that all bird keepers keep their animals indoors and follow strict biosecurity measures.

Three other countries reported more highly pathogenic avian influenza, mostly H5N8 in wild birds. Belgium reported H5N8 in four outbreaks in waterfowl in West Flanders and East Flanders provinces, France reported H5 in a wild goose found dead in Morbihan department in Brittany, and China reported H5N8 in mute swans at a nature park in Shanxi province.
Dec 3 OIE report on H5N8 in Germany
Dec 3 OIE report on H5N8 in Poland
Dec 3 DEFRA statement
Dec 3 OIE report on H5N8 in the UK
Dec 4 OIE report on H5N8 in Belgian wild birds
Dec 2 OIE report on H5 in French wild birds
Nov 30 OIE report on H5N8 in Chinese waterfowl

In low-pathogenic developments, South Africa reported another H7 outbreak at a commercial ostrich farm in Western Cape province. The outbreak began on Nov 2 and sickened 44 of 208 birds at the facility.
Dec 3 OIE report on low-path H7 in South Africa

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