Stewardship / Resistance Scan for Mar 30, 2022

News brief

GARDP announces new North American branch

The Global Antibiotic Research and Development Partnership (GARDP), based in Geneva, Switzerland, this week announced the formation of a new sister organization in the United States.

GARDP and GARDP North America will work together on a common portfolio of projects that aim to accelerate the development and delivery of treatments for antibiotic-resistant infections caused by the priority pathogens identified by the World Health Organization and the Centers for Disease Control and Prevention, according to a GARDP news release.

Created by the WHO and the Drugs for Neglected Diseases Initiative, GARDP works with partners in government, the private sector, academia, and civil society to develop and ensure sustainable access to new antibiotics. Likewise, GARDP North America will champion new drug development and global access and promote policies aimed at incentivizing antibiotic development, while focusing on strengthening ties with current and future partners in the United States.

"It will tap into the U.S.'s strong tradition of partnerships between the public, non-profit, and private sectors to realize global and public health objectives," GARDP says.
Mar 28 GARDP North America news release

Study finds high levels of resistance in US urine isolates

A study of Enterobacterales urine isolates from more than 650 US healthcare facilities found high levels of antimicrobial resistance (AMR), with clear geographic variations, US researchers reported yesterday in the International Journal of Infectious Diseases.

For the retrospective study, researchers examined more than 1.3 million non-duplicate, non-contaminant Enterobacterales urine isolates collected from ambulatory and hospitalized adult patients at 321 inpatient and 338 ambulatory care facilities from 2018 through 2020. They evaluated the percentage of non-susceptible isolates overall, by geographic region, and by inpatient and ambulatory populations.

Nationwide, high rates of resistance to antibiotics used for urinary tract infections (UTIs) were observed, including beta-lactams (60.8% and 55.8% for inpatient and ambulatory settings, respectively), fluoroquinolones (27.5% and 21.6%), trimethoprim/sulfamethoxazole (25.4% and 22.4%), and nitrofurantoin (27% and 21.6%). Isolates with an extended-spectrum beta-lactamase (ESBL)-producing phenotype (13.2% and 8.6%) and multidrug resistance (23.4% and 17.7% for ≥2 drugs; 9.9% and 6.4% for ≥3 drugs) were also common.

Statistically significant differences by geographic region were observed for all AMR classes in both inpatient and ambulatory settings, with the highest rates generally observed in the East South Central region.

The study authors note that while there were clear geographic variations, all regions showed AMR levels high enough to negate the use of common empiric UTI therapies according to Infectious Diseases Society of America recommended thresholds (>20% for trimethoprim/sulfamethoxazole and >10% for nitrofurantoin).

"The elevated levels of resistance to commonly used empiric UTI therapies highlight the need for new oral antibiotics effective against resistant uropathogens," they wrote. "Until such therapies are available, appropriate UTI management may require judicial use of pathogen diagnostic tests and antimicrobial susceptibility panels along with antimicrobial stewardship programs designed to reduce resistance in uropathogens."
Mar 29 Int J Infect Dis study

News Scan for Mar 30, 2022

News brief

Most COVID pneumonia survivors had lung anomalies at 1 year: study

Among 91 COVID-19 pneumonia survivors in Austria, 54% had lung abnormalities on computed tomography (CT) imaging 1 year after symptom onset, suggests an observational study yesterday in Radiology.

A team led by University of Innsbruck researchers evaluated the chest CTs of the 91 patients 2, 3, 6, and 12 months after COVID-19 symptom onset. It was a secondary analysis of a prospective, observational, multicenter study conducted from Apr 29 to Aug 12, 2020. Average patient age was 59 years, and 38% were women.

CT abnormalities were seen in 54% of participants, including 34% with patterns of subtle subpleural reticulation (interlacing lines resembling a net) or ground-glass opacities (hazy areas), or both. Twenty percent had extensive ground-glass opacities, reticulations, bronchial dilation, and/or microsystic (abnormally small red blood cells) changes.

Multivariable analysis showed that age older than 60 years (odds ratio [OR], 5.8), severe COVID-19 illness (OR, 29.0), and male sex (OR, 8.9) were tied to CT abnormalities at 1 year. Lower qualitative CT severity score was seen during subsequent CTs. Over the study period, 44% of patients experienced complete resolution of their CT abnormalities, while 63% saw no further improvement beyond 6 months.

"Our results emphasize early and longitudinal monitoring of COVID-19 participants," the study authors wrote. "Unfortunately, there is still an urgent need for further studies focusing on histological and clinical correlations within the first three months after COVID-19 to identify participants at risk for developing CT abnormalities and who would benefit from early tailored therapeutic concepts."
Mar 29 Radiology study

Data spotlight loss of taste may linger 9 months after COVID-19

A new research letter in the International Journal of Infectious Diseases from French scientists shows that, 9 months after COVID-19 diagnosis, 30% of patients have an impaired sense of taste, but complete loss of taste is uncommon.

The observational, retrospective study was conducted at the Nord Franche-Comte Hospital and included COVID-19 inpatients and outpatients from Mar 1 to May 31, 2020. A total of 214 patients were involved, and the mean age was 48.8 years.

Of the patients seen at the hospital, 65.9% had loss of taste, and 34.1% had a reduced ability to taste during their initial illness. One hundred ninety-two patients with impaired taste (89.7%) had olfactory dysfunction (impaired ability to smell) as well.

Three months after diagnosis, 86.9% of patients had recovered their sense of taste, but after 9.5 months, 29.9% of patients still reported taste dysfunction. Patients who had persistent taste dysfunction reported a longer period of taste loss during their initial illness (median duration, 24 days), compared to patients who had their taste return (14 days during initial illness.)

Only two (3.1%) patients reported total loss of taste 9.5 months after infection.

The authors said a long duration of loss of taste during the initial illness is likely associated with persistent taste dysfunction.
Mar 29 Int J Infect Dis study