Highlights from ASM Microbe 2016 include PrEP use and racial disparities, new bacteria causing Lyme Disease, and more!
Below are highlights from the inaugural meeting that combined the American Society for Microbiology’s general meeting and the Interscience Conference on Antimicrobial Agents and Chemotherapy.
Improving MRSA Care
Previous research has shown that screening patients for MRSA on admission to the ICU can help reduce transmission rates when compared with no screening. However, studies have also shown that most patients with MRSA are treated outside the ICU. In 2005, a hospital system began using polymerase chain reaction tests to screen all incoming patients for MRSA. Patients who screened positive for MRSA were identified as colonized in their medical records, placed in gown and glove isolation, and decolonized. The rate of MRSA in the hospital decreased from 8.9 cases per 10,000 patient-days prior to universal screening to 3.9 cases per 10,000 patients at 18 months after initiating universal screening. After comparing the use of decolonization with no decolonization, the authors observed no differences in MRSA rates. After using an electronic protocol to identify patients at high risk for MRSA carriage, the hospital system was able to capture 90% of carriers while only testing 50% of admissions.
Bacteria on Gloves & Plastic Surfaces
Clinical investigations have yet to define the number and types of common bacteria that can be transmitted from contaminated examination gloves to hospital surfaces. For a study, researchers inoculated examination gloves with bacteria that are commonly found in healthcare-associated infections, including multidrug-resistant strains of Escherichia coli, Klebsiella pneumonia, A baumannii, and Pseudomonas aeruginosa. Contaminated gloves were touched to a sterilized polypropylene surface immediately after inoculation, at 30 seconds, and at 3 minutes. Transmission to the surface immediately after inoculation occurred in 5% to 10% of all bacteria. However, only A baumannii—including drug-sensitive and multidrug-resistant strains—remained detectable after 3 minutes.
New Bacteria Causing Lyme Disease
In North America, Borrelia burgdorferi has been the only bacterium known to cause Lyme disease. However, Mayo Clinic researchers—who tested blood and synovial fluid samples earlier in 2016 from patients infected with Lyme disease—discovered six infections that did not trace back to B. burgdorferi. Patients with these infections experienced confusion, nausea, and vomiting along with rash, fever, and other typical Lyme symptoms. While the previously unknown and newly named Borrelia mayonii seems to cause unusually high concentrations of bacteria in the blood, the six patients recovered after receiving the standard antibiotics used to treat Lyme disease. The research team noted that B. mayonii is currently found only in the Upper Midwest of the United States.
PrEP Use & Racial Disparities
Current rates of pre-exposure prophylaxis (PrEP) use in the United States are lacking. To address this research gap, patient-level data were collected from 82% of U.S. retail pharmacies that dispensed PrEP between January 2012 and September 2015 for a study. Results showed that nearly 50,000 patients started PrEP during the study period. A 523% increase was observed between the third quarters of 2013 and 2015. Among PrEP users in 2015, 74% were Caucasian, 12% were Hispanic, 10% were African American, and 4% were Asian. The proportion of African Americans had decreased from 12% in 2012. The proportion of women using PrEP also decreased, dropping from 49% in 2012 to just 11% in the third quarter of 2015. African-American women were more than four times less likely to have started PrEP than Caucasian women.
Fluoroquinolone Use & CDI
Prior studies suggest that up to 80% of fluoroquinolone use is inappropriate and this commonly prescribed antibiotic is a high-risk agent for causing Clostridium difficile infection (CDI). Researchers conducted a study to determine the impact on CDI rates of a respiratory fluoroquinolone restriction program across a hospital system. The program included education and implementation of criteria for fluoroquinolone use. Following implementation of the program, the hospital system experienced a 94% overall reduction in respiratory fluoroquinolone days of therapy per 1,000 patient days and a 35% reduction in hospital-acquired CDI cases per 1,000 patient days.
NEWS FROM ASM MICROBE 2016
MORE FROM ASM MICROBE 2016