CARB-X to fund development of electronic antibiotic susceptibility test
CARB-X announced today that it is awarding up to $2.5 million to Avails Medical of Menlo Park, California, to develop an electronic antibiotic susceptibility test (eAST).
The Avails eAST has 96 integrated electronic biosensors in a disposable lid that would fit onto widely available susceptibility testing panels and rapidly detect bacterial growth when immersed in positive blood culture samples. Company officials say the aim of the technology is to provide phenotypic results that can guide antibiotic therapy decisions within 4 hours. Current susceptibility testing methods take days to identify the most effective antibiotic treatments.
"Speed is a critical component of effectively diagnosing and treating serious antibiotic-resistant bacterial infections, including bloodstream infections," Erin Duffy, PhD, chief of research and development at CARB-X (the Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator), said in a CARB-X press release. "Every hour of delay in effective treatment increases the risk of complications and septic shock."
Avails Medical could receive up to $14.7 million in additional CARB-X funding if the project, which is currently in the feasibility development phase, successfully progresses to later phases.
Since its launch in 2016, CARB-X has awarded more than $278.5 million for projects focused exclusively on drug-resistant bacteria. There are currently 51 active projects in the CARB-X portfolio.
Feb 1 CARB-X press release
UK study: Flu vaccine linked to fewer amoxicillin prescriptions in seniors
Influenza vaccination was associated with reduced amoxicillin prescribing in a large cohort of UK seniors, according to a study published late last week in PLOS One.
To estimate the effects of the flu vaccine on amoxicillin prescribing in UK adults age 65 and over, researchers analyzed electronic health record data on 88,158 who turned 65 and received the vaccine in the year 2000 but had not received the vaccine the 2 previous years. They then matched the vaccinated patients 1:1 with unvaccinated patients based on a propensity score model.
The time to prescription of amoxicillin, which is frequently prescribed for respiratory illness and may serve as a proxy for flu diagnosis, in the year before and the year after vaccination was analyzed using the Prior Event Rate Ratio (PERR) Pairwise method to address bias from measured and unmeasured confounders.
Compared to the unvaccinated patients, those from the vaccinated group were more likely to be prescribed amoxicillin in the year prior to vaccination (hazard ratio [HR], 1.90; 95% confidence interval [CI], 1.83 to 1.98) and the year following vaccination (HR, 1.64; 95% CI, 1.58 to 1.71). But after adjusting for prior differences in the two groups using the PERR Pairwise method, the vaccinated group had a 14% lower risk of receiving amoxicillin (HR, 0.86; 95% CI, 0.81 to 0.92) after vaccination.
Subgroup analysis showed similar results for vaccinated adults 65 to 75 (HR, 0.87; 95% CI, 0.82 to 0.93) and those age 75 and over (HR, 0.84; 95% CI, 0.76 to 0.94).
"Antibiotic resistance is a growing healthcare problem, the consequences of which include longer healthcare stays and more expensive healthcare costs," the study authors wrote. "Our findings suggest that improving uptake of influenza vaccination in older patients can contribute to strategies to reduce antibiotic resistance."
Jan 29 PLOS One study
Review finds high mortality from ICU infections in lower-income countries
A review of literature on intensive care unit (ICU)-acquired infections suggests mortality is much higher in ICUs in low- and middle-income countries (LMICs) compared with higher-income countries, as is the level of antibiotic resistance, Dutch and Indonesian researchers reported late last week in Antimicrobial Resistance and Infection Control.
The scoping review of 51 articles on ICU-acquired infections in LMICs from 2005 to 2018 found average point-prevalence rate of 22.4 infected patients per 100 present, which is comparable to the 19.5% rate recorded in Western European countries in 2011 and 2012. But the overall ICU mortality in LMICs was 33.6% (varying from 14% to 70% across studies), compared with a 15.3% ICU mortality rate found in a European Union study conducted from 2008 through 2012 and a 18.2% ICU mortality rate found in a 2009 study of ICUs in 75 countries.
The reviewers also found that multidrug-resistant gram-negative species were the most prevalent group of pathogens in ICUs in LMICs, with Acinetobacter baumannii (24%), Pseudomonas aeruginosa (16%), and Klebsiella pneumoniae (15%) causing more than 50% of infections. By comparison, these three pathogens caused less than 25% of ICU infections in Western Europe in the same period.
The authors note that the findings are limited by the relatively few high-quality studies, most of them conducted in only a handful of countries.
"Many gaps in knowledge remain since most LMICs have not produced high quality reports," they wrote. "However, from the reported evidence it is clear that the rate of ICU-acquired infections is likely to be somewhat higher in LMICs compared to high income countries and that the ICU mortality rate is much higher."
Jan 29 Antimicrob Resist Infect Control study