News Scan for Dec 30, 2020

COVID-19 hospital infections
Yellow fever in Senegal

Hospital-acquired infections complicate COVID-19 recovery

An Italian study in the Journal of Antimicrobial Chemotherapy yesterday found that 21.9% of hospitalized COVID-19 patients acquired bacterial or fungal superinfections—infection by a secondary pathogen—that complicated the course of their recovery.

Researchers studied clinical data and outcomes for 315 COVID-19 patients admitted to the University Hospital of Pisa from Mar 4 to Apr 30 and found documented superinfections—bacterial or fungal infections occurring 48 hours or more after hospital admission—in 69 patients (21.9%).

Common superinfection pathogens included Enterobacterales bacteria (44.9%), non-fermenting gram-negative bacilli (15.6%), Gram-positive bacteria (15.6%), and fungi (5.5%).

Patients who required invasive mechanical ventilation were more likely to acquire a superinfection during their hospital stay (odds ratio [OR], 5.6; 95% confidence interval [CI], 2.4 to 13.1; P < 0.001). Patients previously treated with broad-spectrum antibiotics or immune system suppressing medications were also at higher risk of superinfection (OR, 2.85 and 5.09, respectively).

The researchers found that hospital stays for patients with superinfections were significantly longer than for patients without superinfections (30 days vs 11 days; P < 0.001), but mortality rates were similar (18.8% vs 23.2%; P = 0.445).

"The widespread use of antibiotics in the COVID-19 pandemic may exacerbate antimicrobial resistance and may ultimately lead to increased morbidity as an unintended consequence of this already tragic pandemic," the study authors caution.
Dec 29 J Antimicrob Chemother study


Seven more yellow fever cases in Senegal

From October through December, 7 confirmed cases of yellow fever were identified in eastern Senegal across the Tambacounda region (4), Kedougou region (2), and Matam region (1), according to the World Health Organization (WHO). Prior to the third confirmed case in November, the Strategic Tool for Assessing Risks (STAR) called the yellow fever risk "low," which means a large outbreak is unlikely although small outbreaks may occur.

In Tambacounda, officials reported confirmed yellow fever cases Oct 29, Oct 31, Nov 12, and Nov 16 in three males and one female ranging from 8 years old to 40 years old. Two deaths occurred, one being the 8-year-old boy and the other a 23-year-old man.

The Kedougou and Matam cases were identified in December, as were two presumptive cases in Kedougou. The Matam patient was a 90-year-old male; no patient information was available for the Kedougou cases.

While the yellow fever vaccine can give lifelong immunity, the WHO notes that the affected communities are in remote rural areas where vaccine coverage can be difficult and where primates and standing water can help propagate the mosquito-borne disease. Additionally, the COVID-19 pandemic may have caused disruptions to routine immunization programs.

This outbreak news follows Senegal's first case of yellow fever in 2020, reported at the end of August. Prior to that, the country had no confirmed cases since early 2018. The WHO does not think travel or trade restrictions to Senegal are necessary at this time.
Dec 29 WHO disease outbreak news

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