News Scan for Jul 01, 2021

Prevalence of resistant S aureus
US melioidosis cases
H3N2 flu vaccine
H5N1 avian flu in Togo

Global prevalence of vanco-resistant Staph has more than tripled: study

The global prevalence of vancomycin-resistant Staphylococcus aureus (VRSA) has more than tripled in the past two decades, according to a systematic review and meta-analysis yesterday in Antimicrobial Resistance & Infection Control.

The review of 62 published studies on VRSA prevalence rates, conducted by a team of Chinese and Iranian researchers, found that prevalence increased from 2% of 466 isolates before 2006 to 6% of 6,692 isolates from 2006 through 2014 and 7% of 5,798 isolates from 2015 through 2020.  Prevalence was highest in Africa (16%) and Asia (5%), followed by North America (4%), South America (3%), and Europe (1%). The frequencies of VRSA isolates from clinical, non-clinical, and mixed samples were 6%, 7%, and 14%, respectively.

Analysis of the genetic backgrounds of VRSA strains found that 71% and 26% were positive for vanA and vanB resistance genes, respectively, and 4% contained the vanC1 gene.

The first case of VRSA, which tends to be multidrug-resistant, was reported in 2002. The study authors suggest the increased prevalence and detection of VRSA could be attributed to more frequent use of vancomycin for treatment of methicillin-resistant S aureus infections, better diagnostics, and a change in vancomycin resistance breakpoints since 2006.

"This study clarifies that the rigorous monitoring of definite antibiotic policy, regular surveillance/control of nosocomial-associated infections and intensive surveillance of vancomycin-resistance are required for preventing emergence and further spreading of VRSA," they wrote.
Jun 30 Antimicrob Resist Infect Control study


CDC issues alert about 3 US melioidosis cases

The US Centers for Disease Control and Prevention (CDC) yesterday warned health providers about three melioidosis cases involving patients in three states that appear to be linked, though investigators are still looking for the source.

In a Health Advisory Network (HAN) notice, the CDC said the patients affected by the rare infections don't have a foreign travel history. They are from Kansas, Texas, and Missouri. Two are adults, and one is a child.

The first illness was identified in March, and the patient—who had underlying risk factors—died. Two others were identified in May, and one is still hospitalized, while the other was discharged to a rehabilitation facility.

Genetic analysis of the Burkholderia pseudomallei samples from the patients suggests a common source, such as an imported product or an animal, but so far the source hasn't been identified.

B pseudomallei is a tier 1 select agent and is most common in tropical and subtropical regions. Most US cases occurred in people who visited areas in which the disease, which can affect animals and people, is endemic. The CDC said the cases stand out because none of the patients had traveled recently outside the United States.

Symptoms can be nonspecific, ranging from fever to joint pain, and people with underlying conditions are at higher risk for contracting the disease. Human-to-human infections are rare, with lab workers thought to be at higher risk. The CDC urged health providers to consider melioidosis patients with similar symptoms, even if they don't have a travel history.
Jun 30 CDC HAN notice


FluGen testing new flu vaccine against H3N2 in older adults

FluGen today announced $11.4 million in US Defense Department funding to support a phase 1b study of its live, single-replication intranasal monovalent flu vaccine that targets H3N2, one of the two circulating strains of influenza A.

The trial will compare how the intranasal vaccine, M2SR, compares to a licensed quadrivalent vaccine that is considered the current standard of care for adults aged 65 and above. This age-group is considered most at-risk for serious complications from seasonal flu infections.

"The current standard of care has not been shown to be widely effective in protecting this population from virus drift, particularly against H3N2," said FluGen President Paul Radspinner in a press release. "We believe M2SR has the potential to be a more effective vaccine option in older adults, as it induces a broad antibody response, including mucosal, humoral, and cellular immunity, even in the presence of pre-existing immunity to the flu."

Three hundred adults will be included in the trial, which is set to begin in the second quarter of 2022, timed for the flu season. The trial design will allow researchers to measure immune responses generated by M2SR and the standard of care vaccine in older adults. In particular, researchers will be looking at the efficacy of the vaccine against drifted influenza strains among study subjects who receive either vaccine alone, both vaccines administered simultaneously, or both given sequentially.
Jul 1 FluGen press release


H5N1 avian flu strikes 2 poultry farms in Niger

Togo reported two highly pathogenic H5N1 avian flu outbreaks in poultry, its first since 2019, according to a recent notification from the World Organization for Animal Health (OIE).

The outbreaks began on Jun 1 and Jun 16 at two layer farms in Maritime region in the far south. Taken together, the virus killed 752 of 2,000 susceptible birds. The surviving poultry were culled to curb the spread of the virus.

A few other African countries have reported H5N1 outbreaks in poultry over the past few months, including South Africa, Mali, and Niger.
Jun 29 OIE report on H5N1 in Togo

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