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APUA and CDC Campaign to Raise Awareness about C. difficile

This month, APUA was chosen to be a professional partner in the monthly CDC campaign "Vital Signs." The March campaign for Vital Signs was focused on C. difficile infections, the only type of healthcare-associated infection to have increased in incidence over the last decade while other HAIs have declined. APUA publicized the campaign on the APUA website and through social media, helping to disseminate the CDC's Morbidity and Mortality Weekly Report (MMWR) on C. difficile, the CDC consumer fact sheet, and many other resources for healthcare practitioners, administrators, and policymakers. In addition, we provided examples of past APUA research studies and Congressional testimonies on the subject. The Boston Globe documented APUA's collaborative efforts with the CDC on this campaign, citing Dr. Stuart Levy's expert opinion.
 

APUA Represented at Congressional Hearing

On March 8, Dr. Stuart Levy represented APUA at the Congressional hearing “The Science Is Clear: Inappropriate Use of Antibiotics in Animal Agriculture Threatens Public Health,” sponsored by the Center for a Livable Future (CLF) and the Center for Science in the Public Interest (CSPI). Representative Louise Slaughter (D-NY) opened the house session, and Robert Lawrence, M.D. (CLF Director) and Caroline Smith DeWaal, J.D. (CSPI) provided introductory remarks. Expert panelists included James Johnson, M.D. (University of Minnesota School of Medicine), Stuart Levy, M.D. (Tufts University School of Medicine), Lance Price, Ph.D. (Translational Genomics Research Institute), and Tara Smith, Ph.D. (University of Iowa College of Public Health).  As panelists spoke, two main points emerged: inappropriate use of antibiotics in livestock promotes the growth of antimicrobial-resistant bacteria, and these bacteria pose an immense risk to society and human health. More information and each panelist’s slides can be found on the CLF blog. APUA also distributed a fact sheet entitled "The Need to Improve Antibiotic Use in Food Animals." 
 

APUA-Nepal: Report from the Field

APUA-Nepal published the 8th issue of their Clinical Newsletter this year, featuring a comparative study of the antibiotic sensitivity patterns of common isolates in Koshi Zonal Hospital. Isolate sensitivity was compared between April-June 2010 and May-July 2011. One key finding demonstrated that E.coli, K. pneumoniae, and S. aureus showed significantly increased resistance to cotrimoxazole, an important antibiotic for treating respiratory, urinary, and gastrointestinal infections, septicemias, and infection prevention during organ transplants, especially in patients immunocompromised due to HIV or other immune disorders. 
 

IDSA Proposes New Approach for Drug Approval

On March 8, the Infectious Diseases Society of America (IDSA) submitted a proposal for a new drug approval approach as part of the legislation to reauthorize the FDA Prescription Drug User Fee Act (PDUFA) within the context of the Generating Antibiotic Incentives Now (GAIN) Act. The Special Population Limited Medical Use (SPLMU) mechanismwould enable pharmaceutical companies to conduct clinical trials on specified SPLMU medications in less time, in fewer subjects than required at present, and at much less expense. These measures could be invaluable in speeding treatment delivery to patient populations who have no other alternatives. Find out more about the SPLMU mechanismhere. 
 

CDC and ASTHO Share HAI Toolkit for Policymakers

The Association of State and Territorial Health Officials (ASTHO) and the Centers for Disease Control and Prevention (CDC) have created a toolkit and companion report to provide guidance to policy makers on promising ways to use legal and policy interventions as tools in implementing a comprehensive state-level HAI prevention program. The toolkit includes an inventory of state HAI legislation and examples of legal and policy interventions, while the companion report summarizes the outcomes of stakeholder meetings and other consultations regarding the early impact of HAI policies in states. More information is available on the CDC website.
 

WHO Launches Open-Access Book on Antimicrobial Resistance

The Patient Safety Programme of WHO made its new book “The Evolving Threat of Antimicrobial Resistance – Options for Action” freely available online on March 8. The book calls attention to the “limited lifespan of antibiotics” and the “crisis [that] has been building up over decades, so that today common and life-threatening infections are becoming difficult or even impossible to treat.” WHO comprehensively addresses the ever-increasing health and economic burden by urging stronger worldwide actions across a broad spectrum of policymaking, including improved surveillance, reducing antibiotic use in animal husbandry, ensuring infection prevention and control in healthcare facilities, and making political commitments to support innovation. 
 

Danish EU Presidency Holds Conference on Antimicrobial Resistance

The Danish EU Presidency reemphasized antimicrobial resistance as one of its top health priorities in the conference "Common EU Measures for Combating Antimicrobial Resistance," attended by the Director of the ECDC and the Director General of WHO. The conference was held to exchange best practices and foster discussion about solutions such as improved data collection and surveillance, stopping the overuse of antibiotics, and reducing the use of critically important antibiotics. In particular, the conference drew attention to the alarming upward trend in antibiotic-resistant hospital infections. Director Marc Sprenger of the ECDC also addressed the links between antibiotic use in hospitals, in communities, and in animals, concluding “The problems of high antibiotic consumption levels in both humans and animals, and of AMR, cannot be solved in isolation. Animals and humans are one health.”
 

"Forgotten Antibiotics: An Inventory"

"Forgotten Antibiotics: An Inventory in Europe, the United States, Canada, and Australia" by Pulcini et al. (published in the January 2012 issue of Clinical Infectious Diseases) surveyed all systemic antibiotics approved in those regions and identified the ones that were no longer commonly used. The authors then assessed the known or potential value of these antibiotics against common resistant infections using specified criteria, and identified 33 antibiotics as being "of value." Out of 38 countries, very few of those antibiotics were available in most countries, and more than half of them were only available in fewer than half of the countries. The study discussed the implications of these findings in high-income countries, and brought up the possibility that drugs abandoned as unprofitable by manufacturers could still be effective and affordable for middle and low-income countries. 
 

"ESBLs: A Threat to Human and Animal Health?"

A joint working group of the Advisory Committee on Antimicrobial Resistance and Healthcare Associated Infection (ARHAI) and the Defra Antimicrobial Resistance Coordination (DARC) Group was established in the United Kingdom to address concerns about resistant enzymes called extended-spectrum beta (β)-lactamases (ESBLs) in bacteria. Their report "ESBLs: A Threat to Human and Animal Health?" stresses the crucial importance of characterizing ESBL-type bacteria to analyze the transfer pathways by which they spread resistance. Anticipated benefits of rigorous characterization include improved options for surveillance, control, and therapy against ESBL-bacteria in humans and in animals, and better measures of outcomes and research gaps. 
 

"Amoxicillin for Acute Rhinosinusitis"

"Amoxicillin for Acute Rhinosinusitis" by Garbutt et al. (published in the March 2012 issue of the Journal of the American Medical Association) suggests that for sinus infections, antibiotics may not be the best method of treatment. In a study of 166 adults with sinus infections, those who were given the amoxicillin did not report symptom improvement any faster than those who received a placebo. People in both groups experienced about the same amount of relief after three days. 
 

Global Health Magazine on Vaccines

The 13th issue of Global Health Magazine, entitled "Save Money and People: Invest in Vaccines," examines the enormous health benefit for adopting comprehensive vaccine action plans, the innovative finance tools to promote vaccine program delivery, and the success stories of country-specific vaccination initiatives. All of these factors are part of the "Decade of Vaccines," a commitment of global health leaders and the Bill and Melinda Gates Foundation to extend the benefits of vaccines to all people.