APUA Highlights: February 2015
APUA Headquarters in Action
Results of CRP POC Summit accepted for publication
Last May, APUA Headquarters in Boston convened a “CRP Point of Care Summit” which brought together key stakeholders and opinion leaders in the use of C - reactive protein (CRP) as a diagnostic aid. Our goal was to facilitate a meaningful and coordinated discussion covering the clinical utility and barriers to utilization, cost effectiveness, changes in patient outcomes and the impact into Antimicrobial Stewardship when a POC CRP test is deployed.
We are pleased to announce that a paper covering the results of this meeting entitled “Improving Outpatient Antibiotic Prescribing for Respiratory Tract Infections: Results of New Algorithms Used in European Trials” has been accepted for publication in the journal Infection Control & Hospital Epidemiology. (Publication date to be determined)
This meeting was supported by an unrestricted educational grant from Alere Inc. and we thank them for their continued support of our mission to preserve the power of antibiotics and contain escalating antibiotic resistance throughout the world.
APUA in support of President Obama’s FY 2016 budget increase to combat antibiotic resistance
In September 2014 President Obama signed an Executive Order launching Federal efforts to combat the rise in antibiotic-resistant bacteria. In addition, the President’s Council of Advisors on Science and Technology released a report with recommendation for addressing the antibiotic-resistance crisis.
The President’s FY 2016 Budget builds on these recent efforts by nearly doubling the amount of Federal funding for combating and preventing antibiotic resistance to more than $1.2 billion.
APUA has written President Obama thanking and commending him for his continued commitment to antibiotic stewardship. Additionally, we have joined with other organizations representing healthcare providers, patients, scientists, veterinarians, industry and public health in writing and lobbying the members of the Congressional Committee on Appropriations to support and approve this proposed budget.
APUA supports proposed PATH Act
A bill entitled the “Promise for Antibiotics and Therapeutics for Health (PATH) Act” has been introduced in the US Congress. This legislation would establish a new limited population antibacterial drug approval pathway for antibiotics to treat serious or life-threatening infections for which there exists an unmet medical need. APUA supports the PATH Act and, along with others, has written the bill’s sponsors thanking them for their leadership on this critical issue.
The Italian Chapter remains active and organized a March 6 National Meeting on ‘New diagnostic tools for critical patients’. Rapid diagnostics represent a key factor in preventing clinicians from inappropriate use of antimicrobials, and have been a major focus of health legislation in Europe over the last few years.
APUA-Croatia contributes to the joint efforts of many professional societies of the Croatian Medical Association, the Croatian Academy of Medical Sciences and the Croatian Ministry of Health in promoting public campaigns for rational use of antibiotics. On 18 November 2014, the European Antibiotic Awareness Day (EAAD) Symposium was organized in Zagreb with over 300 medical doctors and pharmacists attending the meeting. In addition to EAAD leaflets and posters that are distributed every year, a picture book was also designed for use in pediatric offices and kindergartens.
APUA-Croatia is one of the organizers of the 8th Croatian Symposium on Antibiotic Resistance to be held in Zagreb, 13 – 14 March 2015. These symposia take place every three years and give an overview of resistance trends in Croatia and worldwide and discuss best clinical practice in antibiotic use. These symposia are well attended by professionals of different specialties, especially clinical microbiologists and infectious disease doctors. This year’s focus will be on carbapenemase producing enterobacteriaceae as these multidrug resistant organisms are still not endemic in Croatian hospitals but are starting to occur with increasing incidence.
Due to the well-functioning laboratory network for antibiotic resistance surveillance established in 1996 at the Croatian Academy of Medical Sciences, Croatia has a good record of antibiotic resistance rates in different parts of the country. However, action based on these data is still suboptimal. The Croatian Interdisciplinary Coordination Mechanism (ISKRA) coordinates different activities targeting containment of resistance, from surveillance to guidelines development and education. An important part of these activities includes promoting antibiotic stewardship programs. The consulting role of antibiotic stewardship teams is not yet fully recognized in Croatia and the exchange of experience in this field with the international APUA family is very much welcomed.
A domestic symposium on the antibiotic resistance of Staphylococcus aureus will be held on April 15th, 2015 under the auspices of APUA-Korea. Topics include antibiotic resistance such as the increase of vancomycin MIC and VISA (vancomycin-intermediate Staphylococcus aureus), hVISA (heterogeneous vancomycin-intermediate Staphylococcus aureus), Staphylococcus aureus vaccine, rapid diagnosis and molecular imaging of MRSA infections. Chapter leader of APUA-S. Korea, Dr. Yang Soo Kim, will also host the ‘International Symposium on Staphylococci and Staphylococcal Infections (ISSSI)’ in August 2016 in Seoul, Korea. Globally, more than five-hundred people participate and discuss the issues about Staphylococci and Staphylococcal Infections. Antibiotic resistance is one of the major issues of ISSSI.
Dr. Kim published an article in the Journal of Antimicrobial Chemotherapy reporting that of 268 MRSA isolates from Asan Medical Center, a 2700-bed tertiary-care hospital, an alarmingly high 101 (37.7%) were identified as hVISA. He also published an article on the community-associated MRSA strain ST72-SCCmecIV causing bloodstream infections in the same journal. Of the 352 typed MRSA isolates, 342 isolates (97.2%) belonged to three Panton-Valentine leucocidin-negative strains: ST5-SCCmecII (70.2%), ST72-SCCmecIV (22.4%) and ST239-SCCmecIII (4.6%). CA-MRSA accounted for 18% of community-acquired SAB and was significantly associated with bone and joint infection. He has been publishing many articles about S. aureus infections.
It has been mandatory since 2012 for large hospitals in Korea to report six multidrug-resistant pathogens: MRSA, VISA VRE, carbapenem-resistant Enterobacteriaceae, carbapenem-resistant Pseudomonas aeruginosa and carbapenem-resistant Acinetobacter causing bloodstream infections to the Center for Disease Control of Korea. Antibiotic prophylaxis for surgery has been one of the major evaluation items for healthcare accreditation by Ministry of Health and Welfare of Korea, for several years. Due to these combined efforts, the prevalence rate of multidrug-resistant organisms is decreasing in ICUs in large hospitals in Korea.
APUA-Ecuador president, Dr. Ana Paulina Celi, is the elected president of the Pan American Association of Infectious Diseases, and the President of the XVII Pan American Congress on Infectious Diseases that will be held in Quito, Ecuador, on May 15th-19th.
The program features six scheduled symposia, four conferences each on bacterial resistance, rational use of antibiotics, and stewardship. There will be high level speakers such as Yehuda Carmeli, Patrice Nordman, Laurence Poiriel, Connie Price, Silvia Muñoz Price, Steve Gordon, Rafael Canton, Jordi Vila, Giussepe Cornaglia, Mary Virginia Villegas and other Latin American speakers in these subjects. The event will have 106 speakers and approximately 1,000 attendees.
This year the 13th Congress of Bulgarian Microbiologists will be held between 15 and 18 April 2015 at the National Palace of Culture in Sofia, and many representatives of the APUA-Bulgaria Chapter will participate. Participants will present on a variety of topics including:
- Infections in general pathology and pediatrics
- Antimicrobial resistance (antibiotics, antiprotozoal, antihelminth, antiviral, and antimycotic drugs)
- Respiratory tract infections
- Food and water-borne infections
- Sexually transmitted infections and skin mycoses
- Vaccine-preventable infections
- Infections associated with medical service and infections in immune deficiencies
- Applied microbiology
Another important event will be the celebration of the 70th Anniversary of the Medical University - Plovdiv, Plovdiv, 20 - 22 May 2015.
News and Publications of Note
President Obama’s State of the Union address heralds good news for antimicrobial resistance fight
In his State of Union address to the nation, President Barack Obama, brought attention to the growing global problem of antimicrobial resistance. The White House said it would nearly double the current funding towards researching new medicines and pursuing therapies based on individual genetic makeup of patients; an initiative called “precision medicine”. The US Centers for Disease Control and Prevention estimates that every year 2 million people become infected, leading to about 23,000 deaths from bacteria and other microbes.
The Obama administration has been lauded for its response to reports from the CDC, WHO, and the PCAST Report on Combating Antimicrobial Resistance which all highlighted the seriousness of the issue and its global ramifications.
Researchers search for antibiotics in the Arctic Circle
As antibiotic resistance increases and more antibiotics are losing effectiveness, researchers are looking in unusual places for new antibiotics – places like the waters of the Artic. For larger pharmaceutical companies, it is not cost-effective to develop antibiotics because the drugs are usually taken for a short time before resistance becomes an issue. Consequently smaller companies and projects have assumed the task of developing the next generation of antibiotics by looking in novel geographic locations. Researchers hope that the extreme environment of the Arctic is an indication that organisms that live there are capable of overcoming extreme pathogens. Early results are promising, but there is still a long road ahead for the development of the new generation of antibiotics. The article can be found here.
New antibiotic discovered in the dirt
A team of scientists from Northeastern University in Boston and NovoBiotic Pharmaceuticals have discovered a potential new family of antibiotics in soil-dwelling bacteria. Early tests in mice suggest that the new compound, named teixobactin, is effective in fighting a variety of bacteria including staphylococcus and drug-resistant TB. Efforts to generate teixobactin-resistant mutant bacteria failed, thus proving that teixobactin has low susceptibility to resistance. The novel compound was discovered in soil samples from Maine using a method known as the iChip, which allows bacteria that are unculturable in the lab to be grown in their natural habitat. The methodology opens up new possibilities for exploring new environments for novel compounds produced by previously unculturable organisms. The report can be accessed here.
Superbugs estimated to cost millions of deaths per year
A British government project called the Review of Antimicrobial Resistance was commissioned in 2014 by the Prime Minister, David Cameron, to investigate the future global impact of antibiotic resistance. Preliminary reports estimate that by 2050, a staggering 10 million people per year will die and at least $100 trillion in gross national product will be lost if resistance grows and/or new drugs aren’t developed. This exceeds the estimated number of annual deaths due to cancer and TB combined and does not include secondary costs associated with resistance. Furthermore, the greatest burden would be incurred by Asia and Africa where antibiotic resistance is rapidly growing. In spite of this sobering report, it was reiterated that, if action is taken now, these outcomes do not have to become a reality. Read the full article here.
Global Antibiotic Resistance Partnership launches maiden issue of GARPNet News
The Global Antibiotic Resistance Partnership, an ongoing project of the Center for Disease Dynamics, Economics and Policy (CDDEP), has published the first GARPNet News, a bi-monthly update for and by members of the global GARP network. Antibiotic resistance news and policy updates in Kenya, India, and South Africa were highlights of the first edition.
Kenya’s second annual Antibiotic Resistance Awareness Week which coincided with CDC’s Get Smart Week (held from November 17 – 23, 2014) focused on the growing problem of antibiotic resistance in the country. The Nairobi-centered events drew media attention and brought together stakeholders from the Ministry of Health, hospital administration, and health care workers.
GARP-India held a 2-day workshop in late November 2014, chaired by CDDEP Director, Professor Ramanan Laxminarayan. The workshop focused on antimicrobial stewardship in India, and the creation of a public-private partnership between Haffkine Institute and bioMerieux India for future collaboration.
On October 16, 2014 at its Antimicrobial Resistance Summit, GARP-South Africa, working with the Ministry of Health and other partners, released its Antimicrobial Resistance National Framework 2014-2024. The document aims to strengthen ongoing efforts, optimize surveillance and early detection of resistance, improve infection prevention, and promote stewardship in both animal and human health.
CDC reports decrease in healthcare-associated infections
In January, the CDC released the National and State Healthcare-Related Infections Progress Report (HAI Progress Report). The CDC tracks infections, responds to outbreaks, provides expertise, and leads in research with the aim of ultimately eliminating HAIs. The report includes data from acute-care hospitals based on six types of HAIs, namely: central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), surgical site infections (SSI), hospital-onset Clostridium difficile infections (C.difficile), and hospital-onset methicillin-resistant Staphylococcus aureus (MRSA) bacteremia (bloodstream infections).
At the national level, the report cites a 46% decrease in CLABSI between 2008 and 2013, a 19% decrease in SSI (related to specific procedures tracked in the report from 2008 to 2013), an 8% decrease in hospital-onset MRSA bacteremia between 2011 and 2013, and a 10% decrease in hospital-onset C.difficile between 2011 and 2013. State-specific data and the full report are accessible here.
New SHEA Guidance for proper attire in healthcare settings
Infection Control Today recently published some guidelines for issues regarding healthcare personnel attire. The publication highlights how, in recent years, there has been growing awareness of the transmittance of microbes in healthcare settings. One method that has been hypothesized for this phenomenon is through doctors’ coats, scrubs, and other articles of clothing. As much as clothing in the healthcare setting is mainly dictated by tradition and individual facilities, the report offers some recommendations on how to both preserve tradition and improve patient safety. Some of the key points made include: enforcing a “bare below the elbow (BBE)” policy, providing multiple coats for doctors to change in and out of while attending to patients, and providing laundry services at little or no cost at the health facility. Read the full document here.
Scientists find evidence of antibiotic resistance in the Thames River
Scientists at the University of Warwick and University of Exeter in England have discovered that large amounts of antibiotic-resistant bacteria live close to water treatment facilities. These bacteria are suspected of contributing to growing antibiotic resistance in rivers and streams which pollute the environment. They believe that these bacteria could be responsible for up to half of the increase in resistance that has been observed in recent times. The study, which uses samples from the Thames River, shows that the amount of resistant bacteria varies depending on the type of water treatment facility. It also shows that other factors such as rainfall and land cover affect the prevalence of antibiotic resistance. Further, their investigation has revealed linkages between metallic compounds and antibiotic resistance – which sheds light on antibiotic resistance mechanisms not previously known. The study is further proof of the global issue of growing antibiotic resistance and the many ways that human activities affect the environment around us. Read the report here.
Powerful antibiotic found in garlic
Researchers at the University of Edinburgh’s Centre for Infectious Diseases have foundthat a chemical found in garlic may be effective in treating lung infections in people with cystic fibrosis. In people with cystic fibrosis, the bacteria Burkholderia cepacia complex (Bcc) causes serious and sometimes life-threatening lung infections; it is also highly resistant to antibiotics. The chemical, called allicin, is naturally produced in garlic to defend the plant against plant pathogens in soil and water. It has been found that allicin inhibits the growth of bacteria and kills plant pathogens at higher doses by chemically modifying key enzymes and halting vital biological processes. The researchers have stated that more studies are needed to determine the exact mechanism by which allicin attacks Bcc; once this is known, it can be incorporated into current treatments.
Upcoming Events and Opportunities
February 26 – 28: ASA 16th Annual Meeting, Brisbane, Australia
The Australian Society for Antimicrobials will be hosting its 16th Annual Meeting titled “Antimicrobials 2015”. Participants will enjoy presentations from experts from around the world including Sara Cosgrove of Johns Hopkins University, Jan Kluytmans of Erasmus Medical University, Sally Roberts of Auckland City Hospital, Gunnar Kahlmeter of Central Hospital, Sweden, and Benjamin Howden of Melbourne University. The program’s symposia cover many different aspects on antimicrobials and sessions include “Alternative Perspectives on Antimicrobial Use”, “Carbapenemases”, “What to Report and How to Treat”, “Enterococci" and "SMART Platforms”. In addition, there will be two pharmacy symposia on Saturday afternoon titled “The Bugs and Treatment” and "Antimicrobial Stewardship". Six proffered papers and two poster sessions are also planned for the meeting.
To promote discussion and interaction between delegates and the invited speakers the meeting’s registration includes lunches, morning and afternoon teas and admission to the Howard Florey Reception and the Industry Reception.
March 13-14: 8th Croatian Symposium on Antibiotic Resistance, Zagreb, Croatia
APUA-Croatia is one of the sponsors of this Symposium which was inaugurated in 1994. Croatia has a long history in antibiotic resistance surveillance which led to the creation of the Croatian Committee for Antibiotic Resistance Surveillance in the 1990s. The Symposium is a collaboration between the Ministry of Health of Croatia and international participants as a time to share ideas and experiences. The main topic of the Symposium will be rational use of antibiotics and the preservation of their efficacy.
March 18-21, 2015: ASID Annual Scientific Meeting, Auckland, New Zealand
The Australasian Society for Infectious Diseases will be holding their Annual Scientific Meeting in Auckland and is the premium meeting for adult and pediatric infectious disease and clinical microbiology specialists. The themes for this year’s meeting include staphylococcal and streptococcal infections, respiratory infections, infectious disease diagnostics, and food-borne infections.
Participants will enjoy keynote lectures, symposia, and educational workshops as they interact with infectious disease experts from New Zealand, Australia and other parts of the world.
March 19-20, 2015: Interregional Association for Clinical Microbiology and Antimicrobial Therapy (IACMAC), South Conference, Rostov-on-Don, Russia
IACMAC is a non-profit organization devoted to the promotion of research and education in the fields of clinical microbiology and antimicrobial chemotherapy. It was founded in 1997 and now IACMAC includes over 2300 members from 36 regions of Russia.
IACMAC is affiliated to the International Society of Chemotherapy (ISC) since 1997, Federation of the European Societies for Chemotherapy and for Infection (FESCI) since 1997, and The Federation of European Microbiological Societies (FEMS) since 2001, and works in collaboration with WHO, the Alliance for the Prudent Use of Antibiotics (APUA), the European Society for Clinical Microbiology and Infectious Diseases (ESCMID), the American Society for Microbiology (ASM), and the European Commission.
IACMAC holds scientific conferences, supports postgraduate education and teaching, and collaborates on research projects and professional matters.
March 26-28th, 2015: 6th Annual Consortium of Universities for Global Health (CUGH) Conference, Boston, MA, USA
The 6th conference hosted by Boston University and the Consortium of Universities for Global Health is entitled “Mobilizing Research for Global Health”. This year’s conference boasts a long list of experts in field from prestigious institutions including Boston University, MIT, Harvard University, WHO, London School of Hygiene & Tropical Medicine, and the Bill and Melinda Gates Foundation to name a few. Themes include Ebola, technology in genetics, vaccines for the 21st century, disaster preparedness and response and much more.
Participants of the conference include students, researchers, educators, administrators, NGOs, and representatives from the public and private sectors. They will enjoy workshops, poster presentations, award presentations, and networking in the historical city of Boston. More information about the conference can be found here.
April 25-28, 2015: 25th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID), Copenhagen, Denmark
The 25th ECCMID will provide an excellent forum for delegates to attend, update their knowledge and learn about the latest innovations in the field. Specialists in the field are invited to take part in this important annual congress which expects up to 10,000 delegates.
At this year’s event, which will take place in Copenhagen, there will be many educational sessions and workshops, symposia, e-Poster sessions, a keynote lecture, and an opportunity for participants to meet experts in the field. More information about the Congress can be found on the website.
May 15-19: XVII Pan American Congress on Infectious Diseases, Quito, Ecuador
The Panamerican Association of Infectology (API) will bring infectious disease experts from five continents to its 2015 Congress which will be held in Quito. The Congress will feature speakers, keynote lectures, symposia, oral and poster presentations, and workshops. Participants will also have an opportunity to socialize and explore the locale during the 5-day Congress. It promises to be an event of great learning, engagement, sharing, and networking for all delegates and sponsors.
May 30-June 2, 2015: 115th General Meeting of the American Society for Microbiology (ASM), New Orleans, LA, USA
ASM’s General Meetings are a time for infectious disease experts, microbiologists, and industry leaders to come together to connect, learn, and be inspired by the best. The 115th General Meeting will focus on the central role of microbes in the biosphere by exploring innovations in the field of microbiology. Topics for the event will be centered on three main themes of: basic science, clinical microbiology, and career development. With plenary sessions in the mornings and symposia in the afternoons, there will plenty of opportunities for participants to engage with one another and guest speakers. Complete program details can be accessed here.