News Scan for Aug 16, 2022

News brief

Healthcare workers wearing respirators 40% less likely to contract COVID

A study of more than 2,900 healthcare workers (HCWs) shows that those who wore a respirator were more than 40% less likely to be infected with COVID-19 than those wearing a surgical mask.

In the study, published yesterday in JAMA Network Open, researchers evaluated SARS-CoV-2 infection rates and cumulative COVID-19 patient exposures among 2,919 HCWs at seven healthcare networks in Switzerland from September 2020 to September 2021, before the Omicron variant became widespread.

At the end of the study, the team asked participants whether they had worn FFP2 respirators (similar to N95 respirators in the United States) or surgical masks during contact with COVID-19 patients other than during aerosol-generating procedures. To quantify cumulative patient exposures, the researchers multiplied the self-reported number of contacts with COVID-19 patients by average contact duration.

Of the 2,919 HCWs, 749 (26%) tested positive for COVID-19. Among participants with patient exposure, test positivity was 21% for those wearing a respirator, compared with 35% in those using surgical masks or a mix of masks (odds ratio [OR], 0.49).

Risk factors for COVID-19 infection included an infected household member (OR, 7.79) and exposure to patients (OR, 1.20 per category of cumulative contact), while respirator use (OR, 0.56) and vaccination (OR, 0.55) were protective.

"SARS-CoV-2 positivity in HCWs was associated with cumulative COVID-19 patient exposure," the researchers wrote. "The odds of being SARS-CoV-2–positive were reduced by more than 40% in individuals using respirators irrespective of cumulative exposure, even after adjusting for multiple work- and nonwork-related covariables."

The authors said that the data suggest a dose-response relationship between exposure to COVID-19 patients and the risk of infection. "Consequent use of respirators and SARS-CoV-2 vaccination might substantially decrease the work-related risk for HCWs exposed to patients with COVID-19," they wrote. "Whether these results are applicable to newer viral variants, which are more contagious and less neutralized by most vaccines, remains to be seen."
Aug 15 JAMA Netw Open research letter


Omicron subvariant BA.5 now makes up 89% of US COVID-19 infections

The highly transmissible Omicron subvariant BA.5 now causes almost 90% of US COVID-19 cases, and First Lady Jill Biden has tested positive for the disease but has mild symptoms.

The Centers for Disease Control and Prevention's (CDC's) Nowcast variant tracker estimates that BA.5 now accounts for 88.8% of new US COVID-19 cases, while BA.4 accounts for 5.3% and BA.4.6 accounts for 5.1% of new cases. Four weeks ago BA.5 made up 74.0% of COVID-19 cases, and 2 weeks ago it accounted for 84.5%.

Jill Biden's COVID-19 symptoms so far remain mild, the White House announced today, according to the Associated Press (AP). President Joe Biden continues to test negative after recovering from COVID.

The 71-year-old first lady began experiencing symptoms late last night after testing positive earlier in the day, the White House said in a statement. Both Jill Biden President Biden have received four doses of the Pfizer COVID vaccine. She has been prescribed Paxlovid and will isolate at the Biden vacation home for at least 5 days. Her close contacts have been notified.

The 7-day average of new daily US COVID-19 cases is 99,832, with 489 daily deaths, according to the New York Times tracker. The HHS Protect Public Data Hub shows that 41,170 inpatient beds and 4,428 ICU beds are in use for COVID-19 across the country. Almost 87,000 child COVID-19 cases were reported for the week ending Aug 11, down from more than 96,000 the previous week, according to the American Academy of Pediatrics.

In other US news, the School District of Philadelphia has mandated that students and staff wear masks for the first 10 days of the school year and pre-kindergartners wear masks all school year, Fox News reports.
CDC Nowcast variant tracker
Aug 16 AP story
Aug 16
White House statement

Stewardship / Resistance Scan for Aug 16, 2022

News brief

BD, Accelerate announce collaboration on rapid ID, susceptibility tests

Becton, Dickinson and Company (BD) and Accelerate Diagnostics yesterday announced a commercial collaboration agreement to bring rapid identification and antibiotic susceptibility tests to more clinicians and patients worldwide.

Under the agreement, BD will market and sell through its global sales network the Food and Drug Administration–approved Accelerate Pheno system, which delivers rapid pathogen identification and antibiotic susceptibility test results from blood cultures 1 to 2 days faster than traditional laboratory methods. The agreement also covers the Accelerate Arc module.

The companies say the two testing systems will help clinicians determine faster whether a patient needs an antibiotic, and if so, which one they need. 

"When a patient is very sick, every minute matters," Brooke Story, MBA, president of Integrated Diagnostic Solutions for BD, said in a press release. "Through our collaboration with Accelerate Diagnostics, we can help clinicians more quickly, efficiently and effectively treat patients, which may lead to a reduction in health care costs and help slow the spread of antimicrobial resistance."
Aug 15 Accelerate Diagnostics press release


Survey reveals low antibiotic knowledge, improper antibiotic use in China

The overall level of antibiotic knowledge in China is low, and inappropriate use of antibiotics is high, according to the results of a survey published last week in BMC Infectious Diseases.

The online survey, conducted from July through September 2018, was used to collect data from respondents in China on antibiotic use and related knowledge. While non-prescription antibiotic sales are illegal in China, the practice is common, and inappropriate antibiotic use has long been widespread. The survey focused on three aspects of inappropriate antibiotic use: self-medication with antibiotics (SMA), self-storage with antibiotics (SSA), and non-adherence to antibiotic treatment (NAAT). Logistic regression was used to determine factors associated with these inappropriate behaviors.

Of the 15,526 respondents, more than 55% could not correctly identify whether antibiotics were used to treat bacterial or viral infections, and 57.6% could not distinguish antibiotics from anti-inflammatory agents. Overall, 26.0%, 46.6% and 27.4% of the participants had high, medium, and low levels of antibiotic knowledge, respectively.

Regarding inappropriate use, 37.1% reported SMA, 67.9% reported SSA, and 53.3% reported NAAT in the past 6 months. A breakdown of the four types of non-adherence behaviors showed that 48.3%, 15.2%, 25.5%, and 78.0% of respondents said that they had missed antibiotics, increased antibiotic dosage, decreased antibiotic dosage, and discontinued antibiotics once symptoms disappeared, respectively.

After adjusting for other variables, multivariate logistic regression analyses showed that respondents aged 30 to 44 years (adjusted odds ratio [aOR], 1.36; 95% confidence interval [CI], 1.26 to 1.47), with higher levels of education (aOR, 1.16; 95% CI, 1.05 to 1.29), poor status of self-perceived health (aOR, 1.57; 95% CI, 1.38 to 1.80), and medium (aOR, 1.08; 95% CI, 1.02 to 1.15) or low (aOR, 1.40; 95% CI, 1.28 to 1.54) levels of antibiotic knowledge were more likely to report SMA, SSA, and NAAT.

The study authors say the results indicate an urgent need for a national action plan and effective public health strategies to address the widespread inappropriate use of antibiotics in China.
Aug 13 BMC Infect Dis study

This week's top reads