Three more Ebola cases reported in the DRC
Three more Ebola cases, one of them fatal, were reported in the Democratic Republic of the Congo's (DRC's) latest resurgence near Beni in North Kivu province, according to a World Health Organization (WHO) DRC office tweet today. The case total is now five including three deaths, said the World Health Organization (WHO) African regional office today on Twitter.
As of Oct 17, health officials have identified 369 contacts and are monitoring 308 of them. The latest cases were in the Butsili health area, which is in Beni Health Zone, one of the epicenters of the large 2018-20 outbreak.
Officials have said preliminary genetic testing suggests that the outbreak is linked to the earlier large outbreak, an event that was centered in North Kivu province. In risk assessments of the latest cluster, the WHO said sporadic cases in the wake of major outbreaks are expected as survivors can carry the virus in immune-protected parts of the body for longer than 6 months. Also, animal species in the DRC can harbor the virus.
The first confirmed case in the latest resurgence is a young boy who died following the deaths of three of his neighbors, who had been sick with Ebola-like symptoms. Earlier this year, a similar flare-up in a different part of North Kivu province resulted in 12 cases, 6 of them fatal.
Oct 18 WHO African regional office tweet
Oct 18 WHO DRC office tweet
Resistant ICU infections linked to longer hospital stays, excess costs
Antibiotic-resistant infections acquired in the intensive care unit (ICU) were associated with significant increases in excess hospital days and healthcare costs in three southern European countries, according to a study published today in Infection Control & Hospital Epidemiology.
Using data from the European Surveillance System, researchers studied a cohort of adult patients who developed ICU-acquired infections related to an invasive procedure at hospitals in Spain, Portugal, and Italy from 2008 through 2016. They used regression, matching, and time-to-event methods to analyze the association between antibiotic-resistant infections and excessive length of stay (LOS), controlling for several confounding factors and time-dependent biases. They also calculated the associated economic burden of excess resource utilization for each country.
In total, 13,441 patients were included in the analysis. Of these patients, 4,106 (30.5%) were infected with antibiotic-resistant organisms and matched 1:1 to patients with susceptible infections. The median age of all patients was 62 years. In the fully adjusted estimates, the association between resistance status and excess LOS was 2.76 days in the linear model (95% confidence interval [CI], 1.98 to 3.54), 2.60 days in the matched model (95% CI, 1.66 to 3.55), and the hazard ratio was 1.15 in the Cox regression model (95% CI, 1.1 to 1.19).
These estimates, alongside the prevalence of resistance, translated into direct hospitalization attributable costs per ICU-acquired infection of 5,224€ (US $6,066) for Spain, 4,461€ (US $5,180) for Portugal, and 4,320€ (US $5,016) for Italy.
"These results contribute significantly to the antimicrobial resistance literature that explores the consequences of resistance on health and economic outcomes," the study authors write.
Oct 18 Infect Control Hosp Epidemiol abstract
Elbow bumps may transfer MRSA just as much as fist bumps
In another study today in the same journal, researchers from the Cleveland VA Medical Center reported that both a fist bump and an elbow bump are associated with frequent transfer of methicillin-resistant Staphylococcus aureus (MRSA).
Elbow bumps have been increasingly used as greetings over fist bumps and handshakes with the idea that they lessen the potential for pathogenic microorganism transfer. To test this hypothesis, the researchers enrolled 40 patients in isolation for MRSA colonization and paired them with a research staff member wearing sterile gloves and a piece of cotton cloth over their elbows. Each MRSA-colonized patient performed one greeting with a staff member using their right fist or elbow, and one greeting using their left fist or elbow, with the order of the greetings alternating among consecutive participants. The researchers then analyzed the fists and elbows of the MRSA-colonized patients, along with the gloves and elbow cloth from the staff members, for the presence of MRSA.
The results showed no significant difference in the frequency of MRSA transfer for the fist bump compared with the elbow bump (10 of 40 [25%] vs 6 of 40 [15%]). Even so, MRSA was recovered more frequently from the fist versus the elbow of the MRSA-colonized patients (16 of 40 [40%] vs 9 of 40 [22.5%]). Also, significantly more MRSA colonies were recovered from fists compared with elbows, and more MRSA colonies were transferred via fists.
The study authors note that the findings of the study suggest that noncontact greetings should be encouraged instead. "In addition to promoting noncontact greetings, there is a need to improve patient hand hygiene and to identify other strategies to reduce transfer of pathogens by hands and clothing," they write.
Oct 18 Infect Control Hosp Epidemiol abstract
H5N6 avian flu hospitalizes farmer in China
China reported another human H5N6 avian flu infection, marking its 24th of the year, according to a statement from Hong Kong's Centre for Health Protection (CHP).
The patient is a 60-year-old woman from the city of Changde in Hunan province, located in southern China. She worked as a farmer and was exposed to dead poultry before her symptoms began on Oct 3. The woman was hospitalized on Oct 13, where she is listed in critical condition.
Since 2014, China has reported 48 H5N6 cases, which are often severe or fatal. H5N6 is known to circulate in poultry, mainly in some Asian nations. So far, China and Laos are the only ones to report human cases.
Oct 18 CHP statement