A weekly roundup of news on drug resistance and other topics in global health.

Study highlights the fatal outcomes of colistin resistant infections in India and the urgent need for new antibiotics. CDDEP Resident Scholar Sumanth Gandra, MD, and colleagues publish the outcomes of colistin resistant infections in India in the American Journal of Infection Control. The study conducted over 5 years, evaluated clinical outcomes of 75 patients with colistin- and carbapenem-resistant bloodstream infections at a tertiary care center in India. In-hospital mortality rate was found to be as high as nearly 70 percent. The researchers highlight an urgent need for new antibiotics to treat these infections and implementation of effective infection control measures to check the spread of these drug resistant organisms.  [AJIC]

Potential preventive therapy for neonatal sepsis. Researchers at the university of Nebraska may have found a simple, inexpensive solution for preventing sepsis in babies, a global health priority called out at the 70th World Health Assembly this year. In a large, randomized clinical trial in rural India, an oral synbiotic (combination of an prebiotic and probiotic) given to more than 4,500 newborns was found to reduce neonatal sepsis and death by 40 percent. The trial demonstrated that boosting gut immunity is effective in protecting infants in the first few months of life. The findings are exciting, especially for low- and middle-income countries, where sepsis in babies claims most of the million annual deaths worldwide, with no efficient means of prevention currently available. [Nature]

MDR- and XDR-TB treatments not promising, according to study. Global experts have been warning about the emergence of multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB). Now, a small study from China, reports that patients with MDR- and XDR-TB have low rates of treatment success. Researchers assessed 481 records of TB patients (2 percent XDR-TB and 98 percent MDR-TB cases) in the Hunan province of China, between 2011 and 2014. The treatment was successful in 57 percent of all patients, 58 percent for MDR-TB patients and only in 30 percent for XDR-TB patients. Patients resistant to fluoroquinolones, were found to have poorer treatment outcomes, and those who started treatment in 2014 showed 3 times better response as compared to those in 2011. This improvement indicates advancements in care, diagnostic services, treatment and follow-up. The study appeared in BMC Infectious Diseases[BMC Infectious DiseasesCIDRAP]

WHO: Polio continues to be a global emergency. In the fourteenth meeting of the International Health Regulations (IHR) held this month, the World Health Organization (WHO) emergency committee decided to continue the status of “public health emergency of international concern (PHEIC),” for polio. While steady progress has been noted in the three polio endemic countries of Pakistan, Afghanistan, and Nigeria, concerns have been raised about detection of positive environmental samples in Pakistan and unimmunized pockets in both Afghanistan and Nigeria. Reports of vaccine-derived poliovirus cases in the Democratic Republic of Congo (DRC) and Syria also fell in line with the status quo. [WHO]

Antivirals are effective to treat and prevent flu. Public health experts have long debated the use of antivirals as a treatment option or as prophylaxis for influenza. Now, a study by European Center for Disease Prevention and Control (ECDC) has reaffirmed the effectiveness of neuraminidase inhibitors to treat and prevent flu. Three large systematic reviews assessing efficacy, effectiveness and safety of oral oseltamivir and inhaled zanamivir were considered to recommend them for treatment of severe influenza patients and those at high risk of complications, including prophylactic use for the most vulnerable and their families. [ECDC]

CDDEP Blog: Should you finish the course of antibiotics? Yes—(until further notice). CDDEP Resident Scholar Sumanth Gandra, MD, reviews the recent provocative analysis in The BMJ, which questioned the dictum to “complete the course,” of antibiotics to prevent drug resistance. The analysis sparked controversy among health professionals and sowed confusion in the public, with many media reports implying that patients themselves should decide when to stop their antibiotics. Gandra writes, “It is true that there is no evidence to indicate that stopping antibiotics early will lead drug resistant infections. However, it is important to remember that the primary reason for giving antibiotics is to cure infection, not to prevent drug resistance. While we may need to change prescribing habits, the only way that can be done responsibly is to systematically assess regimen lengths for common infections in clinical trials.” [CDDEP]