The annual meeting of the Infectious Diseases Society of America took place Oct. 21 to 24 in Vancouver, Canada, and attracted over 4,700 participants from 82 countries. The conference focused on advances in the prevention and management of infectious diseases. Presentations highlighted advances in the development of antibiotics and prevention of antibiotic resistance; HIV management; and emerging, foodborne, and pediatric infections.
In one study, Helio S. Sader, M.D., of JMI Laboratories in North Liberty, Iowa, and colleagues found that the combination of a novel anti-methicillin-resistant Staphylococcus aureus cephalosporin, ceftaroline, and a new β-lactamase inhibitor, NXL104, prevented enterobacteriaceae species from producing large amounts of AmpC β-lactamase and resistance to third generation cephalosporins.
"The combination approach could be used against gram-negative and gram- positive infections. There are some infections caused by resistant bacteria that it does not cover but it does add to the armamentarium for the vast majority of other resistant strains. This approach could be used as a single drug combination that would replace the use of two or three drugs used to treat organisms, and [would] likely be cost-effective over the longer term because it could prevent the use of multiple drugs to treat one infection," said study co-author Ronald Jones, M.D., of JMI. "Combining a new cephalosporin with [a] β-lactamase inhibitor, like ceftaroline plus NXL104, demonstrates an exciting antibiotic development strategy that can further address physicians' need for effective therapies."
Investigators at the U.S. Centers for Disease Control and Prevention in Atlanta estimated the potential impact of 13-valent pneumococcal conjugate vaccine on invasive pneumococcal disease (IPD) over a 10-year period in children younger than 5 years of age. The investigators estimate a substantial reduction but not elimination of IPD in U.S. children by 2020.
"There was a lot of talk about vaccines coming out this year, including 13-valent vaccines for pneumococcal disease to minimize the disease in children under the age of 5. This is very exciting, as the vaccine could potentially be used in adults as well, [which is] especially promising for the elderly population," Jones said.
Recent studies have shown that Vibrio cholerae strains have shown diminished susceptibility to ciprofloxacin. Therefore, in a double-blind, controlled study, Wasif A. Khan, of the International Centre for Diarrhoeal Diseases Research in Dhaka, Bangladesh, and colleagues randomized 246 patients (with evidence of infection shown on dark-field microscopy) to azithromycin or ciprofloxacin.
"We have found that single-dose azithromycin is more effective than six-dose ciprofloxacin therapy for the treatment of cholera," Khan said. "The data revealed that azithromycin was highly clinically successful in 63 percent of those who received azithromycin and 44 percent of patients who received ciprofloxacin, as well as bacteriologically successful in 68 percent of patients who received azithromycin and 45 percent who received ciprofloxacin."
Kahn concluded that the most common antibiotic used for cholera, ciprofloxacin, is no longer effective for treatment, as Vibrio cholerae O1 strains have shown diminished susceptibility. However, a single dose of azithromycin is effective for the treatment of cholera.
In another study, Richard T. Lester, M.D., of the University of British Columbia in Vancouver, Canada, and colleagues evaluated the use of cell phone short-message service (SMS) to improve outcomes of HIV patients undergoing treatment with antiretroviral therapy.
"We evaluated HIV-infected patients starting antiretroviral therapy at three HIV clinics in Kenya to compare weekly SMS to standard of care. We found that this approach was popular among patients and they were glad that someone cared and kept them on track with treatment administration," Lester said.
The investigators assessed adherence by self-reports over the previous month and suppression of HIV-1 viral RNA load at one year and found improvement in these outcomes with SMS support as compared to standard care.
"There is a major cost benefit associated with this type of approach, as better adherence to medications would lead to [fewer] medical emergencies and crises and help delay the need to use more expensive HIV drug regimens," Lester said. "Mobile, wireless communications are an evolving and permanent part of our health system's future globally. It's important that we now have evidence that patient-focused interventions using cell phones can improve patient outcomes, including in resource-limited settings."
Huabiao Chen, Ph.D., of the Massachusetts General Hospital in Boston, and colleagues evaluated the susceptibility of CD4 T cells from elite controllers to HIV-1 infection to understand the underlying mechanism for why these patients do not get sick from HIV infection.
"We found that this reduced susceptibility to HIV-1 infection is associated with higher expression levels of the protein p21. The selective upregulation of p21 may represent a natural barrier against HIV-1 reverse transcription and mRNA transcription in CD4 T cells from elite controllers. An intrinsic resistance of CD4 T cells to HIV-1 might significantly contribute to the ability of elite controllers to maintain undetectable viral replication," said study co-author Mathias Lichterfeld, M.D., of the Massachusetts General Hospital.
IDSA: Klebsiella Pneumoniae Carbapenemase Incidence Up
MONDAY, Oct. 25 (HealthDay News) -- The incidence of Klebsiella pneumoniae carbapenemase (KPC) is on the rise in a major metropolitan city, according to the results of a survey presented at the annual meeting of the Infectious Diseases Society of America, held from Oct. 21 to 24 in Vancouver, Canada.
IDSA: Novel Adenovirus Identified in Titi Monkey Group
MONDAY, Oct. 25 (HealthDay News) -- A novel adenovirus appears to be the cause of an outbreak of pneumonia and hepatitis in a group of Titi monkeys, and the virus also may have been transmitted to a human, according to a study presented at the annual meeting of the Infectious Diseases Society of America, held from Oct. 21 to 24 in Vancouver, Canada.
IDSA: Brazilian MRSA Strain Found in United States
MONDAY, Oct. 25 (HealthDay News) -- The Brazilian epidemic clonal complex of methicillin-resistant Staphylococcus aureus (MRSA), associated with increased drug resistance, significant mortality, and risk for invasive disease, has been identified in the United States, according to data presented during a session focusing on antibiotics and antibiotic resistance at the annual meeting of the Infectious Diseases Society of America, held from Oct. 21 to 24 in Vancouver, Canada.
IDSA: H1N1 Vaccine Safe, Well Tolerated in Pregnant Women
FRIDAY, Oct. 22 (HealthDay News) -- The 2009 H1N1 influenza vaccine appears to be safe in pregnant women, with vaccine uptake among pregnant women higher than in previous seasons, according to two studies presented during an influenza press conference at the annual meeting of the Infectious Diseases Society of America, held from Oct. 21 to 24 in Vancouver, Canada.
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