Shiloh
Editor, Senior Moderator
Source: http://www.cidrap.umn.edu/news-perspective/2018/03/stewardship-resistance-scan-mar-29-2018
Stewardship / Resistance Scan for Mar 29, 2018
Candida auris in Europe; Experimental C diff drug
Filed Under:
Antimicrobial Stewardship; Fungal Infection; Clostridium difficile
[h=3]Candida auris cases in Europe on the rise, with 620 since 2013[/h] From 2013 through 2017 European officials recorded 620 cases of Candida auris, mostly from four large outbreaks, and 110 of them (17.7%) involved bloodstream infections, according to a report today in Eurosurveillance.
Almost all the cases were in Spain (388) and the United Kingdom (221). More than 75% (466) cases were reported as colonizations, with no apparent illness. In addition to the 110 bloodstream infections, officials documented 40 other infections, while 4 cases were of unknown status. In addition, the incidence rose in recent years, with 23 cases reported in 2015, 290 in 2016, and 303 in 2017.
The authors of the report write, "The increasing number of sporadic cases, mostly invasive infections, compared with the ECDC rapid risk assessment in 2016 confirms that introduction of C. auris into hospitals in Europe is occurring repeatedly, each time with the potential risk for further transmission and healthcare-associated outbreaks. The reason why some cases of C. auris have caused large outbreaks while other cases were sporadic with no apparent further transmission remains unclear."
The study also noted gaps in European surveillance. The experts report that preparedness and response steps for C auris have been taken in only 20 of the 30 European Union nations. The most common measures were dissemination of laboratory alerts (18 countries), offers for reference identification and antifungal susceptibility testing to hospitals (13), and clinical alerts (10).
Mar 29 Eurosurveillance report
[h=3]Experimental drug shown effective against recurrent C difficile[/h] A phase 2 trial shows that one dose? but not two ? of an experimental drug to prevent recurrent Clostridium difficile infection was more effective than a placebo, according to researchers who published their study today in Clinical Infectious Diseases.
The investigators included in the study 127 C difficile patients from 21 centers in the United States and Canada. Of those, 41 received two doses of the drug, called RBX2660; 44 received two doses of a placebo; and 42 received one dose or RBX2660 and one dose of the placebo.
Efficacy for the one-dose group was 67%, compared with 61% in the two-dose group and 45% in the placebo-only group, but the difference reached statistical significance only for the one-dose group.
Of the 54 patients whose treatment did not succeed in the first (blinded) phase, 5 elected to receive one additional dose of RBX2660 and 49 agreed to two additional doses. For this non-blinded (open-label) portion of the study, treatment success rates were 80% (4/5) and 78% (38/49), respectively. That brought the overall success rate for participants who received at least one dose of RBX2660 in the blinded or open-label phases to 89%.
The authors conclude, "These data provide important insights for a larger Phase 3 trial and continued clinical development of RBX2660."
Mar 29 Clin Infect Dis study
Stewardship / Resistance Scan for Mar 29, 2018
Candida auris in Europe; Experimental C diff drug
Filed Under:
Antimicrobial Stewardship; Fungal Infection; Clostridium difficile
[h=3]Candida auris cases in Europe on the rise, with 620 since 2013[/h] From 2013 through 2017 European officials recorded 620 cases of Candida auris, mostly from four large outbreaks, and 110 of them (17.7%) involved bloodstream infections, according to a report today in Eurosurveillance.
Almost all the cases were in Spain (388) and the United Kingdom (221). More than 75% (466) cases were reported as colonizations, with no apparent illness. In addition to the 110 bloodstream infections, officials documented 40 other infections, while 4 cases were of unknown status. In addition, the incidence rose in recent years, with 23 cases reported in 2015, 290 in 2016, and 303 in 2017.
The authors of the report write, "The increasing number of sporadic cases, mostly invasive infections, compared with the ECDC rapid risk assessment in 2016 confirms that introduction of C. auris into hospitals in Europe is occurring repeatedly, each time with the potential risk for further transmission and healthcare-associated outbreaks. The reason why some cases of C. auris have caused large outbreaks while other cases were sporadic with no apparent further transmission remains unclear."
The study also noted gaps in European surveillance. The experts report that preparedness and response steps for C auris have been taken in only 20 of the 30 European Union nations. The most common measures were dissemination of laboratory alerts (18 countries), offers for reference identification and antifungal susceptibility testing to hospitals (13), and clinical alerts (10).
Mar 29 Eurosurveillance report
[h=3]Experimental drug shown effective against recurrent C difficile[/h] A phase 2 trial shows that one dose? but not two ? of an experimental drug to prevent recurrent Clostridium difficile infection was more effective than a placebo, according to researchers who published their study today in Clinical Infectious Diseases.
The investigators included in the study 127 C difficile patients from 21 centers in the United States and Canada. Of those, 41 received two doses of the drug, called RBX2660; 44 received two doses of a placebo; and 42 received one dose or RBX2660 and one dose of the placebo.
Efficacy for the one-dose group was 67%, compared with 61% in the two-dose group and 45% in the placebo-only group, but the difference reached statistical significance only for the one-dose group.
Of the 54 patients whose treatment did not succeed in the first (blinded) phase, 5 elected to receive one additional dose of RBX2660 and 49 agreed to two additional doses. For this non-blinded (open-label) portion of the study, treatment success rates were 80% (4/5) and 78% (38/49), respectively. That brought the overall success rate for participants who received at least one dose of RBX2660 in the blinded or open-label phases to 89%.
The authors conclude, "These data provide important insights for a larger Phase 3 trial and continued clinical development of RBX2660."
Mar 29 Clin Infect Dis study