August 28, 2015
A roundup of news on drug resistance and other topics in global health.
Two groups of researchers working independently may have solved a key problem necessary for the development of a universal flu vaccine. Conventional flu vaccines are tailored each year to the strains predicted to prevail, based on global surveillance. The Holy Grail has long been a vaccine that will protect against any strain. Two research groups have now successfully targeted a part of the hemagglutinin protein that is constant across strains. Previous attempts to base a vaccine on this protein were foiled by its instability, and the breakthroughs were in stabilizing the molecule. In trials, both vaccines afforded various degrees of protection to distantly related flu strains in mice (who were fully protected), ferrets and monkeys. [Nature Medicine, Science, Science News]
The U.S. FDA issued warnings to three duodenoscope makers whose devices have been linked to carbapenem-resistant Enterobacteriaceae (CRE) outbreaks. The warnings were issued to Olympus Medical Systems, Fujifilm and the Pentax division of Hoya. The FDA faulted Olympus and Pentax for failing to report infections within 30 days. Pentax and Fujifilm were also reprimanded for ineffective cleaning and sterilization recommendations. All three companies were given 15 days to respond with remediation plans. [BMJ]
Cell phone data may be an accurate predictor of infectious disease transmission. Researchers at the Harvard School of Public Health and Princeton University used call data from 15 million anonymous mobile phone users in Kenya to track locations of rubella cases over the course of a year. They discovered that the cell data predicted rubella occurrences more accurately than seasonal weather patterns or school term dates, both of which had been studied previously as potential tools for tracking outbreaks. [PNAS, Harvard]
Long-distance travelers—such as students on study abroad programs—are likely helping to spread antibiotic resistance, even without exposure to antibiotics. Research reported in Antimicrobial Agents and Chemotherapy found significant increases in the presence of resistance genes for sulfonamides, trimethoprim and beta-lactam antibiotics in Swedish exchange students after they had studied in India or Central Africa. None of the students included had received antibiotics for six months prior to travel or during their time abroad. [American Society for Microbiology News, Antimicrobial Agents and Chemotherapy]
Rapid diagnostic tests (RDTs) for malaria are rarely used for febrile patients in Nigeria—even when healthcare providers are specifically trained in their use, according to research published in PLOS ONE. Study authors conducted a stratified cluster-randomized trial in 42 communities in Nigeria’s Enugu state, with three intervention groups: 1) RDTs with provider training, 2) RDTs with provider training plus a school-based community intervention and 3) a control group that received RDTs with basic instruction. RDT use was low in all groups (34, 48, and 37 percent, respectively), with no significant differences among them. [PLOS ONE]
“People are not petri plates, and we need to revisit the way antibiotics are developed, tested, and prescribed.” Researchers at the University of California Santa Barbara identified a heretofore unknown antibiotic resistance mechanism by testing antibiotics against Salmonella and Yersinia bacteria in an environment that mimicked an intracellular environment, rather than the usual agar plates. The mechanism explains a proportion of antibiotic treatment failures and more importantly, suggests better susceptibility tests for infected patients and ultimately, could play a role in new antibiotic development. [EBioMedicine, UCSB]
In a cholera outbreak where vaccine supply is limited, more cases can be prevented and more lives saved by giving a larger number of people one dose of vaccine than by giving the recommended two doses to fewer people. This finding comes from a mathematical modeling study in PLOS Medicine. The authors cited complex logistics of vaccine refrigeration and difficulty tracking individuals over the two-week interval between doses—particularly after disasters like the Haiti earthquake—as contributing to the result. [Johns Hopkins School of Public Health, PLOS Medicine]
An extract made from European Chestnut leaves cleared MRSA skin infections in mice with no signs of resistance after two weeks of treatment. The compound selectively disarms Staphylococcus aureus colonies—including MRSA—by interfering with the bacteria’s ability to communicate with one another, known as quorum sensing. In turn, this stops production of various toxins that injure tissues. Because the extract targets only S. aureus and no other bacteria, it is less likely to disturb the skin microbiome than conventional antibiotics. [PLOS ONE, Emory University]
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