Category: Infection

One of the most common bacterial illnesses in the world could soon become harder to treat, biologists warn after the findings of their latest study. Researchers at the Santa Fe Institute, in New Mexico, found that the bacteria Escherichia coli — known as E. coli — is remarkably adept at evolving to survive exposure to antibiotics. This could pose a major problem for doctors and patients hoping to fight E. coli infections in the future. “In essence, this study suggests that bacteria like E. coli may be more adept at evolving resistance to antibiotics than we initially thought, and this has broader implications for understanding how various systems in evolutionary biology, chemistry, and other fields adapt and evolve,” Andreas Wagner, Ph.D., a Swiss researcher who contributed to the study, said in a statement. For their research, published Friday in the journal Science, they wanted to test the concept of a “rugged fitness landscape” in evolutionary biology. Basically, researchers wanted to determine whether organisms such as E. coli that have not optimally evolved over the years could ever reach their biological “peak” — or its strongest and most optimal form for replicating. Using CRISPR technology, they intentionally created the inefficient, or “rugged”, fitness landscape among bacteria. Out of the 260,000 mutations they intentionally introduced, 75% of the bacteria evolved in the lab environment gained traits that would increase their resistance to antibiotics. The findings suggest that the bacteria has better evolutionary fitness than previously believed—a worrying prospect. E. coli is responsible for nearly 50 million infections in the U.S. each year, according to the Food and Drug Administration (FDA). It is responsible for 3,000 deaths in America every year, mostly children under the age of 5 and seniors aged 65 and older. It usually causes infections after a person consumes contaminated food, including raw beef or milk. Global health experts fear that many bacteria that cause infections in humans could evolve to resist the antibiotics used to treat them in hospitals around the world. The World Health Organization describes antibiotic resistance as one of the world’s top public health threats. A majority of E. coli infections, however, can be combated with limited medical intervention. Symptoms of infection usually include cramps, vomiting and diarrhea. However, in severe cases a patient may be prescribed antibiotics to deal with the illness.

Seaman Joseph A. Boomhower / US Navy A new study based on British birth outcomes shows placental presence of Streptococcus agalactiae (known as group B Streptococcus, or GBS) is linked to double or triple the risk of neonatal intensive care unit (NICU) admission, roughly 10 times greater than previous estimates. Group B strep is a common bacterium found in the genital tract of roughly 20% of pregnant women. Previous research has identified GBS in the placenta of around 5% of women before labor. US women receiving prenatal care are routinely screened for the bacterium, and antibiotics are recommended for use in labor to avoid passing on the pathogen to the infant, but widespread screening is not as common in the United Kingdom. Findings may change UK screening guidelines In the study, published today in Nature Microbiology, researchers looked at the presence of GBS and admission to the NICU, using data from a previous study of 436 infants born at term, and a second cohort of 925 pregnancies. The researchers found that 1 in 200 babies were admitted with sepsis associated with GBS, much higher than expected. Of 436 infants born at term, 7 out of 30 (23.3%) with placental GBS DNA and 34 of 406 (8.4%) without placental GBS DNA were admitted to the NICU (odds ratio, 3.3; 95% confidence interval, 1.3 to 7.8.) Significantly more newborns are admitted to the neonatal unit as a result of GBS-related sepsis than was previously thought. “In the UK, we’ve traditionally not screened mothers for GBS, but our findings—that significantly more newborns are admitted to the neonatal unit as a result of GBS-related sepsis than was previously thought—profoundly changes the risk/benefit balance of universal screening,” said author Francesca Gaccioli, MD, from the University of Cambridge, in a university press release on the study. The authors of the study then analyzed umbilical cord serum in infants who suffered sepsis and positive placental GBS DNA, and found levels of four pro-inflammatory cytokines were signifianctly raised, suggesting the GBS caused a cytokine storm. “We conclude that GBS causes about ten times the number of cases of neonatal morbidity than is currently recognized and that this morbidity is associated with bacterial invasion of the placenta and extreme activation of the fetal innate immune system before birth,” the authors concluded.

WENATCHEE — With reports of a mysterious canine respiratory disease sweeping across parts of the United States, veterinarian Collin Bonnett of Cascade Veterinary Clinics wants to let locals know what to look out for. “This seems to be a complex, what’s called canine infectious respiratory disease. Kennel cough for example is one version of this. Sneezing, sometimes ocular discharge, squinting. Things like that,” says Bonnett. Cases of the new disease have been confirmed nationwide and are slowly gaining proximity to Washington. In August, the Oregon Department of Agriculture began receiving word of an unknown respiratory disease infecting dogs. A recent press release from the Oregon Veterinary Medical Association says that there have now been over 200 cases reported to the ODA. Dogs allegedly begin experiencing respiratory issues similar to kennel cough, but do not respond to standard antibiotic treatment. This develops into a form of chronic pneumonia-like symptoms that can result in poor outcomes in just 24 to 36 hours. As of two weeks ago, no cases of this new disease have been reported to the Washington State Department of Agriculture. However, pet owners should still be on the lookout. “Generally, these dogs are lethargic and off of their food. They don’t want to perform; go for a normal walk or run that they would do, but certainly the coughing, sneezing, hacking thing would be the principle, clinical signs owners should be looking for,” says Bonnett. WSDA is urging pet owners to take proper precautions by keeping pet vaccinations up to date and avoiding areas with other dogs. “If a dog is displaying any clinical signs of coughing, sneezing or inappetence, those kinds of things, it would be responsible for them to not take them to boarding facilities, playgrounds, dog parks, family visits and things like that,” says Bonnett. Bonnet also stressed that if pets do start displaying respiratory symptoms that they are seen by a veterinarian and isolated from other pets. Veterinarians who encounter a potential case of this new respiratory disease should contact Washington State RVC Coordinator Minden Buswell with the WSDA.

Cases of the COVID-19 variant Omicron BA.2.86, also known as Pirola, have tripled in two weeks, comprising between 5% and 15% of all infections, according to the Centers for Disease Control and Prevention (CDC). The COVID-19 variant Omicron BA.2.86 — as well as its offshoots, including JN.1 — has been reclassified as a “variant of interest” by the World Health Organization (WHO). Despite its prevalence, BA.2.86 “does not appear to be driving increases in infections or hospitalizations in the United States,” the CDC stated in its report. OVER HALF THE PEOPLE WHO GET COVID HAVE LINGERING SYMPTOMS AFTER 3 YEARS, NEW STUDY FINDS Both the CDC and WHO agree that “the public health risk posed by this variant is low compared with other circulating variants.” The updated COVID-19 vaccines that were approved by the FDA in September are believed to “increase protection against BA.2.86, as they do for other variants,” the CDC noted. Cases of the COVID-19 variant Omicron BA.2.86, also known as Pirola, have tripled in two weeks, comprising between 5% and 15% of all infections, according to the CDC. (iStock) “To date, existing vaccines have been very effective in protecting people, particularly those who have been boosted multiple times through a vaccine or natural infection, not only from symptomatic infection, but importantly from severe disease, hospitalization and death,” said Richard Reithinger, PhD, a distinguished research fellow in the Global Health Division at International Development Group in Washington, D.C., in a statement to Fox News Digital. COVID IS NOT A CONCERN FOR AMERICANS HEADING INTO CHRISTMAS, OTHER HOLIDAYS, SAYS SURVEY: ‘JUST ANOTHER VIRUS’ The CDC said it is not clear whether BA.2.86 causes different symptoms — but noted that most variants produce similar effects. “The types of symptoms and how severe they are usually depend more on a person’s immunity than which variant causes the infection,” the statement said. Despite its prevalence, BA.2.86 (also known as Pirola) “does not appear to be driving increases in infections or hospitalizations in the United States,” the CDC stated in its report. (iStock) The variant is also expected to respond to the current tests and treatments. Reithinger noted that while the pandemic is officially over, COVID-19 is not a thing of the past. “A concern of the new BA.2.86 variant was that because it has 35 mutations in the spike protein, it would be able to evade the immune response more readily than other variants that emerged in the last couple of months,” he told Fox News Digital. “Early clinical data does not seem to indicate this being the case.” CLICK HERE TO SIGN UP FOR OUR HEALTH NEWSLETTER The increase in BA.2.86 cases is due to the U.S. entering the “COVID-19 season” and also a sufficient number of people having developed non-BA.2.86 immunity, according to the doctor. Outside of vaccines, Reithinger recommends that high-risk groups adopt risk-mitigating behaviors, including wearing masks, frequently washing hands and avoiding crowded environments. The updated COVID-19 vaccines that were approved by the FDA in September are believed to “increase protection against BA.2.86, as they do for other variants,” the CDC noted. (iStock) “People — particularly those with greater risk of infection and severe disease — should continue to be sensitized and vigilant about COVID-19 and the disease it may cause,” he told Fox News Digital. “People who are at greater risk of infection and severe disease should consult with their physicians about whether they should be administered one of the currently available boosters,” he added. CLICK HERE TO GET THE FOX NEWS APP Those at highest risk include people older than 60 years, the immunocompromised, those with comorbidities such as asthma and diabetes, and people working in high-risk-of-exposure employment, such as the service industry, Reithinger noted. For more Health articles, visit www.foxnews/health. Melissa Rudy is health editor and a member of the lifestyle team at Fox News Digital.

A recent spike in respiratory illnesses in China and a request from the World Health Organization (WHO) for more information may give some people an uneasy sense of deja vu. Almost four years ago, undiagnosed clusters of respiratory illness were one of the earliest signs of what would become an unprecedented global pandemic that shuttered economies and devastated health systems. Fast forward to last week, the WHO said it was aware of media reports of cases of undiagnosed pneumonia in children’s hospitals in Beijing and other areas of the country. It cited a warning from ProMed, a global outbreak surveillance system, that included some haunting similarities to one of the first notices it ever sent about SARS-COV-2. “Undiagnosed pneumonia — China: (Beijing, Lainong) children, reported epidemic, request for information,” ProMED said on November 22. Loading… Vision on state run news inside China has shown hundreds of people seated in the waiting room of a hospital in Nanjing, in China’s eastern Jiangsu province, with IV drips hanging from the ceiling. In another story, director of the outpatient department of Beijing Children’s Hospital Li Yuchuan is quoted as saying the internal medicine department was receiving 7,000 patients a day, far beyond hospital capacity. After monitoring media reports, the WHO requested more information to identify “whether these were separate events, or part of the known general increase in respiratory illnesses in the community”. WHO’s query and the public nature of the request was “a little unusual”, but “not surprising”, according to Christine Jenkins, a professor of medicine at the University of New South Wales. “When infections like these, such as [when the] first SARS occurred and subsequently when [SARS-CoV-2] occurred in China, initially it was exceptionally difficult to get information,” she said. “I think the WHO is taking a much more proactive approach to surveillance.” China had 24 hours to respond. Health authorities from the Chinese Center for Disease Control and Prevention (CDC) and the Beijing Children’s Hospital provided WHO with data indicating there “has been no detection of any unusual or novel pathogens or unusual clinical presentations”. A mysterious respiratory illness does not appear to be spreading around China, but a combination of pathogens, the lifting of restrictions and the onset of winter may all be fuelling a surge in sickness. Scientists say the situation warrants close monitoring and are “alert, but not alarmed”. China says multiple pathogens are circulating A post by the Beijing Friendship Hospital service earlier this month said the number of children attending the hospital was rising, reaching up to 1,800 daily outpatient and emergency patients across two districts. WHO said it had been advised by Chinese authorities that “the rise in respiratory illness has not resulted in patient loads exceeding hospital capacities”. As part of its response to the WHO, Chinese officials provided data, which included laboratory results from infected children, that indicated the clusters were due to multiple known pathogens. These included the flu, adenovirus, RSV and mycoplasma pneumoniae, a common bacterium that usually causes mild illness. Outpatient consultations and hospital admissions for children with mycoplasma pneumoniae had increased in China since May, according to the data provided to WHO. Known viruses such as RSV and the flu had begun circulating in October. Mycoplasma pneumonia and RSV are both known to affect children more than adults, which may explain the spike in younger patients. An explanation on the clusters provided to China’s government-run news outlet, The Global Times by Zhang Wenhong — a Shanghai infectious diseases doctor who is sometimes referred to as China’s Anthony Fauci — indicated the rise in infections was due to a reduction in public safety measures post-COVID-19. “Zhang explained the reason for prevalent respiratory illness infection is because various protective measures such as wearing masks and staying at home in the past years have greatly reduced the incidence of diseases,” the paper reported. Chinese officials say they did not detect any “unusual or novel diseases” in the country, the World Health Organization said.(AP: Ng Han Guan) The article went on to detail how the low incidence of diseases has “led to a decrease in the body’s pre-existing antibodies”. “The doctor noted that this winter, the incidence of respiratory infectious diseases will increase, but China still has the right tools to combat the rise in cases,” it said. Zhang also said the country had “sufficient technical expertise [and] public health resources” to deal with the current outbreak. In an effort to keep track of spreading cases, China’s National Health Commission spokesperson Mi Feng has called on local authorities to expand the number of relevant clinics and extend opening hours. Since mid-October, Chinese authorities have stressed the need to strengthen the capacity of the health system to manage patients, according to WHO, in addition to enhancing disease surveillance in health care facilities and community settings. “WHO is closely monitoring the situation and is in close contact with national authorities in China,” WHO said. Health experts are ‘alert but not alarmed’ Since the global pandemic sparked an increase in public health messaging designed to keep people safe, citizens around the world are on higher alert to the spread of viruses and illnesses. Increased hospital admissions and requests for more information can be alarming, but are an important part of keeping people alert and informed. “There’s just a huge potential increased risk if there is a serious pathogen that we don’t understand and don’t know how to treat,” Professor Jenkins said. “So I think transparency, openness, rapid communication and very rapid scientific response and medical response is what’s required.” China has pointed to the lifting of restrictions as one factor behind the rise in infections, a post-pandemic experience replicated in other countries around the world last year once governments began unwinding public health measures. Last winter, China was still pursuing a COVID-zero strategy and implementing strict lockdowns when cases were identified.(Reuters via China Daily) In one Australian study, scientists noted how non-pharmaceutical interventions and travel restrictions for controlling COVID-19 had “impacted the circulation of

Leaves are down, temperatures are cooler, and that means it’s prime time for pruning oak trees, which can be infected by the oak wilt fungus if they’re pruned during the high-risk period of April 15 to July 15. “Beetles that can carry the disease from tree to tree are not very active now, and the trees are not vulnerable to […] Sorry! An active online subscription is required to access this content. Please login below or Subscribe today!

(WXYZ) — State officials with the Michigan Department of Agriculture and Rural Development (MDARD) and the Michigan State University Veterinary Diagnostic Laboratory (MSU VDL) are warning pet owners to be on the lookout for signs of illness in their dogs as an atypical canine infectious respiratory illness has affected dogs in at least a dozen states. At this point, no cases of the illness have been reported in Michigan. However, officials warn there are a number of infectious respiratory diseases in dogs, many of which can be prevented or minimized through either routine vaccination or timely veterinary care. “While the exact cause of this illness remains unknown, taking some basic steps to prevent a dog’s exposure to harmful germs can go a long way to protecting their overall health,” said State Veterinarian Nora Wineland, DVM, MS, DACVPM, in a news release. “If owners notice respiratory symptoms (such as coughing, sneezing, or nasal discharge) in their dogs, it is important to reach out to their veterinarian early on in their animal’s illness so diagnostic testing can be completed and an appropriate course of treatment can begin.” Officials say that, in general, the mystery illness is contagious, spreading among dogs that have had contact with other dogs. Signs of the disease include coughing, sneezing, nasal and/or eye discharge, fever, loss of appetite, and lethargy. Coughing may persist for weeks to months, and severe forms of the disease can progress to life-threatening pneumonia. However, they also warn that the only way to distinguish between the multiple causes of infectious respiratory disease in dogs is through early diagnostic testing. For a case to be considered suspect for the mystery illness, diagnostic testing is required to rule out other common causes. The state is recommending the following measures for dog owners to keep their pets safe: Work with their veterinarian to ensure their dog is up to date on routine vaccinations. Make sure their dog is fully vaccinated before interacting with other dogs. Avoid food and water bowls shared by multiple unknown dogs. Contact their veterinarian if their dog is exhibiting any signs of illness and keep their dog at home and away from other dogs. Keep their dog away from dogs that are sick or whose vaccination status is unknown. They are also encouraging animal shelter and kennel staff to follow intake and vaccination protocols when bringing in new dogs and continue to follow required isolation protocols and recommended cleaning/disinfection procedures for surfaces and equipment.If dogs exhibit signs of respiratory illness, it is best to keep them at home and away from other dogs and contact your veterinarian. For more information regarding this atypical canine infectious respiratory illness, contact your veterinarian or visit the American Veterinary Medical Association’s website.

The PAWS medical staff are following a highly infectious, upper respiratory illness that is affecting dogs here in Maine closely. Symptoms are similar to kennel cough and the cause is still to be determined. It seems to be spreading rapidly and has popped up across the country. Most exposures happen in settings like doggy day care, in a kennel environment, and other places where dogs congregate together (dog parks, hiking trails etc.) but there have been cases with no known exposure. Common signs to watch for are coughing and sneezing, nasal or eye discharge, lethargy and decreased appetite. It is causing lasting respiratory disease and pneumonia in severe cases. We recommend keeping your pets up to date on all vaccines which will help keep their immune systems strong. Also, protecting any older pets and puppies, as well as any dogs that may have a weakened immune system. There unfortunately is not a lot known about the virus, but in general most respiratory diseases are spread through direct contact and from exposure to droplets from coughing or sneezing. These droplets can contaminate in-animate objects, such as food and water bowls, as well as toys and even our hands. Maintaining good hand sanitation is important as well as keeping the environment as clean as possible. Going into the holiday season we know there is the necessity of boarding our pets but if able to avoid this if you are unsure about the health status about the health status of other dogs in the environment. Since PAWS is an animal shelter and having dogs in close quarters with each other there is a definite risk present. We are doing everything possible to take precautions and keep our canine companions healthy. We will keep everyone updated as we learn more. Respectfully, Kathy Moretti, LVT – Director of Clinical Operations PAWS Medical Team Dr. Simonson, Dr. James, Dr. Salvaggio, and Dr. Pierce

One of the more interesting emerging developments in medicine is the connection between rapid diagnostics and de-escalating antibiotics to enable optimal outcomes with quicker resolutions. A group from the University of Pittsburgh Medical Center studied this clinical care scenario. Specifically, they conducted a retrospective, observational study comparing patients with Streptococcus spp bacteremia over two 6-month periods. The investigators utilized a pre-rapid diagnostic testing (RDT), and post-RDT time periods. In the former, patients were prospectively followed by the antimicrobial stewardship program (ASP) and they provided recommendations based on gram-stain and organism identification results. During the latter, blood cultures were tested by GenMark ePlex BCID-GP that identifies S agalactiae, S anginosis group, S pneumoniae, S pyogenes and Streptococcus spp within 90 minutes which were reported directly to the ASP for recommendations on 3 actions: antibiotic discontinuation, de-escalation, or additional diagnostic testing. What they found was that using rapid PCR testing had a positive effect on the timing of a broad-spectrum antibiotic course. “With those results, we were able to narrow therapy sooner than we would with traditional identification methods,” said study investigator Tyler Tate, MD, fellow, University of Pittsburgh Medical Center. “Our primary outcome was time to antibiotic de-escalation. In our pre intervention group, in which blood cultures were identified with traditional methods, our median time to de-escalation was approximately 8 hours. And in the post-intervention group, our median time to antibiotic de-escalation was approximately 42 hours with an average reduction of approximately 46 hours time spent on broad spectrum therapy.” Contagion spoke with Tate recently at IDWeek and he offered further insights on the study and how this form of testing can help with stewardship. Reference Tate T, Viehman A, Shields R. Rapid Diagnostic Testing is Associated with Decreased Broad Spectrum Antibiotic Use in Streptococcal Blood Stream Infections. Presented at: IDWeek 2023. October 11-14, 2023; Boston, MA. Abstract 94.

A recent report published in the American Journal of Infection Control (AJIC) suggests that creating a dedicated team of nurses to assist with central line insertions can significantly reduce the risk of patients developing bloodstream infections. The report, authored by infection preventionists at UNC Health, shows that implementing a dedicated team led to a 47% reduction in the proportion of central line-associated bloodstream infections (CLABSIs) occurring within 7 days of line placement among patients included in the program. To examine the report’s results, Infection Control Today® (ICT®) spoke with Shelley Summerlin-Long, MPH, MSW, BSN, RN, senior quality improvement leader, infection prevention, UNC Medical Center, Chapel Hill, North Carolina. The team was launched in 2019 with 4.5 fulltime employees to cover 24-hour, 7-day-a-week clinical coverage. The team’s “key finding was during the team’s first 3 years [from] 2019 to 2022, we found that CLABSIs that were occurring during those first 6 days after central line insertions decreased by 47% in the areas within that team’s scope,” Summerlin said. “They play an important role during the insertion process,” Summerlin continued. “They are there to [provide] support. The evidence-based guidelines for CLABSI prevention recommend having a second person, a trained health care provider in the room during central line insertions who is empowered to stop the procedure, if there are any breaches in aseptic technique and who is there to document on the checklist, and in general, support the provider who is inserting the central lines. Our central venous access device (CVAD) Liaison team is there to help set up the room to document on the checklist, again, to observe the aseptic technique, help the provider if there are any issues that come up, and then go get additional supplies if needed. And they’re experts in this and able to guide that the provider and especially helpful for our learners, our residents.”