News Scan for Oct 07, 2021

News brief

Estimate: 1 in 500 US children, 65% of them minorities, orphaned by COVID

More than 140,000 US children lost a parent or other caregiver from COVID-19 during the pandemic, representing one caregiver loss for every four coronavirus deaths, suggests a modeling study today in Pediatrics.

Led by US Centers for Disease Control and Prevention (CDC) and Imperial College London researchers, the study estimated deaths directly or indirectly attributed to the pandemic, the latter of which included those linked to lockdowns and reduced access to or quality of healthcare and treatment of chronic diseases.

From Apr 1, 2020, through Jun 30, 2021, 142,637 Americans younger than 18 years, or 1 in 500, lost a parent, custodial grandparent, or grandparent caregiver—which represents even more of a blow to children of single parents.

Children of minority race made up 65% of those losses. Relative to White children, those who were American Indian/Alaska Native had 4.5 times higher odds of losing a parent, while Black children were 2.4 times more likely, and Hispanic children were 1.8 times more likely.

National Institute of Drug Abuse Director Nora Volkow, MD, who was not a study author, said these racial disparities need prompt attention. "We must address the many underlying inequities and health disparities that put people of color at greater risk of getting COVID-19 and dying from COVID-19, which puts children of color at a greater risk of losing a parent or caregiver and related adverse effects on their development," she said in a CDC news release.

The authors noted that parental loss has been tied to lower educational attainment, developmental problems, reduced self-esteem, engagement in risky sexual behavior, and higher rates of substance abuse, poverty, housing insecurity, suicide, violence, sexual abuse, and exploitation.

In the release, lead author Susan Hills, PhD, called COVID-19–related orphanhood a hidden global pandemic that requires the provision of resources and services. “All of us—especially our children—will feel the serious immediate and long-term impact of this problem for generations to come," she said.

"Addressing the loss that these children have experienced—and continue to experience—must be one of our top priorities, and it must be woven into all aspects of our emergency response, both now and in the post-pandemic future."
Oct 7 Pediatrics study
Oct 7 CDC
news release


Beta-lactam antibiotics first may improve bloodstream infection survival

Administration of a beta-lactam antibiotic before vancomycin in patients with bloodstream infections (BSIs) may reduce early mortality, according to a study published this week in Clinical Infectious Diseases.

In the multicenter observational study, researchers from Johns Hopkins University School of Medicine and Children's Hospital of Philadelphia looked at data on patients 13 years and older who were treated for BSIs from July 2016 through June 2020 and received a beta-lactam before vancomycin.

While the choice and timing of antibiotic administration for BSIs has been thoroughly studied, little attention has been paid to the sequence of antibiotic administration. The study authors hypothesized that, when the causative pathogen is not immediately known, administering a broad-spectrum beta-lactam antibiotic first might improve survival.

The primary outcome of the study was mortality within 7 days from the time of blood culture collection. The secondary outcome was mortality within 48 hours of blood culture collection.

Of 3,376 eligible patients, 2,685 (79.5%) received a beta-lactam and 691 (20.5%) received vancomycin as their initial antibiotic. In an inverse probability of treatment weighting (IPTW) analysis, conducted to ensure that patients who received a beta-lactam first and those who received vancomycin first were similar on all patient variables, administration of a beta-lactam agent prior to vancomycin reduced 7-day mortality by 52% (adjusted odds ratio [aOR], 0.48; 95% confidence interval [CI], 0.33 to 0.69).

Similar results were observed when evaluating 48-hour mortality (aOR, 0.45; 95% CI: 0.24 to 0.83). Administration of vancomycin prior to a beta-lactam was not associated with improved survival in the subgroup of 524 patients who had methicillin-resistant Staphylococcus aureus BSI (aOR, 0.93; 95% CI, 0.33 to 2.63).

The study authors say that with an estimated 13,245 BSIs per year, prioritizing beta-lactam administration has the potential to save 737 lives per year, "underscoring the significant impact of a relatively simple practice change."
Oct 4 Clin Infect Dis abstract


CDC: Salmonella outbreak tied to salads infected 31 people in 4 states

The CDC says its investigation into a Salmonella Typhimurium outbreak that was linked to packaged salads from BrightFarms has come to an end; it confirmed 31 cases in 4 states—Wisconsin, Illinois, Minnesota, and Pennsylvania—20 more than in its most recent update.

Four people were hospitalized during this outbreak, and no deaths were reported. Illness-onset dates range from Jun 10 to Aug 18. Illinois had the most illnesses, with 18, followed by Wisconsin (10), Pennsylvania (2), and Michigan (1).

The CDC first began tracking the outbreak on Jul 14, when 4 cases were identified in two states. On Jul 22, the CDC identified a total of 11 people infected with the bacterium, and on Jul 15, Jul 21, and Jul 28, BrightFarms recalled several packaged salad greens linked to the outbreak.

The Food and Drug Administration identified a BrightFarms greenhouse farm in Rochelle, Illinois, as the likely source of packaged salad greens bought by sick people, the CDC said.

Investigation interviews showed a clear link to prepackaged salads. "Of the 27 people interviewed, 26 (96%) reported eating leafy greens," the CDC said. "Among those 26 people, 22 (85%) reported eating prepackaged salads."
Oct 6 CDC

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