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HHS FUNDS AI-ENHANCED ANTIBIOTIC DISCOVERY PROJECT

News brief
September 30, 2024
Chris Dall, MA
Topics
Antimicrobial Stewardship

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The US Department of Health and Human Services (HHS) last week announced funding
for a project that will use artificial intelligence (AI) to accelerate the
discovery and development of new antibiotics.

To speed up the lengthy and laborious process of screening and testing molecular
compounds for antibacterial activity, the Transforming Antibiotic R&D with
Generative AI to stop Emerging Threats (TARGET) project will use generative AI
to broaden the pool of candidate molecules for screening and deep learning to
assess each candidate's effectiveness as an antibiotic. The aim of the project,
which is being funded through the Advanced Research Projects Agency for Health
(ARPA-H), is to identify 15 promising leads for new antibiotics.

"The rise of antibiotic resistance threatens to turn once-treatable infections
into life-threatening ones, but with AI, we can accelerate the discovery of new
antibiotics to address this threat like never before," ARPA-H Director Renee
Wegrzyn, PhD, said in a press release. "With TARGET, ARPA-H is bringing together
experts across antibiotic discovery, AI, and clinical testing to ensure we can
refill the global pipeline of antibiotics and stop people from becoming
seriously ill due to treatable infections."

The project will be led by Phare Bio, in collaboration with the Collins Lab at
the Massachusetts Institute of Technology and Harvard University's Wyss
Institute, with a budget of up to $27 million.


UNITAID CALLS FOR MORE RAPID GONORRHEA DIAGNOSTIC TESTS

News brief
September 30, 2024
Chris Dall, MA
Topics
Antimicrobial Stewardship
Gonorrhea
CDC / Alissa Eckert

Global health organization Unitaid last week called for a "concerted global
effort" to introduce accurate and affordable diagnostic tests in low-resource
countries to address the rising number of gonorrhea infections and antimicrobial
resistance (AMR).

In a report released ahead of the United Nations High-Level Meeting on AMR,
Unitaid highlights the diagnostic access gaps that results in both
undertreatment and overtreatment of gonorrhea infections in low- and
middle-income countries (LMICs) with a high burden of gonorrhea. Because of the
lack of affordable, rapid point-of-care (POC) diagnostic tests in these
settings, treatment decisions are based on observed signs and reported symptoms.
Yet more than half of gonorrhea cases are asymptomatic, resulting in a high
number of untreated, missed infections. Conversely, lack of gonorrhea-specific
diagnostics means patients with symptoms often receive several treatments.


TESTS ARE IN DEVELOPMENT, BUT MAY REMAIN INACCESSIBLE

The report provides an overview of the 75 POC and near-POC tests currently in
development that have the potential to turn test results around in less than 30
minutes and improve antibiotic selection, including three that have already been
cleared by the US Food and Drug Administration. It also lays out the barriers in
LMICs that are preventing these tests from reaching those who need them, such as
affordability, limited resources and healthcare infrastructure, and
prioritization of higher mortality diseases by policymakers.

"Despite the need and the promise of new technologies, significant market
challenges impede test accessibility in LMICs," the report states. "There is a
high risk that products will become readily available in well-resourced settings
and remain largely inaccessible in LMICs."

To address these barriers, the report highlights opportunities for intervention,
including market-shaping strategies, product development support, and
integrating gonorrhea and other sexually transmitted infection testing into
reproductive, maternal, and HIV healthcare services. 

“Early work to implement testing will provide valuable evidence and experience
to build demand and guide countries on feasible and cost-effective ways to
introduce gonorrhea testing and improve health outcomes, particularly for
vulnerable populations," Kelsey Barrett, Unitaid’s Technical Manager for
Maternal and Child Health, said in a press release.


FIDAXOMICIN UNDERUSED FOR C DIFF INFECTIONS, STUDY FINDS

News brief
September 30, 2024
Chris Dall, MA
Topics
Antimicrobial Stewardship
Clostridium difficile
CDC / Jennifer Oosthuizen

The use of fidaxomicin for Clostridioides difficile infection (CDI) has
increased significantly since 2021 but it remains underutilized,
researchers reported today in Clinical Infectious Diseases.

Using the PINC AI Healthcare database, researchers from Washington University
School of Medicine and Merck examined records on adults who received CDI
treatment before and after 2021, when updated guidelines from the Infectious
Diseases Society of America (IDSA) recommended fidaxomicin as the only
first-line agent for CDI, with vancomycin as an alternative option. Prior to
2021 vancomycin and metronidazole had been the recommended first-line agents for
CDI, which is the most common healthcare-associated infection in adults and
affects an estimated 460,000 US patients each year. Evidence on how CDI
treatment patterns have changed since the 2021 guidelines has been limited.


FIDAXOMICIN USE MORE THAN DOUBLES

A total of 45,049 patients from 779 US hospitals were included in the study,
with 29,520 in the pre-period (January 2020 to June 2021) and 15,529 in the
post-period (October 2021 to September 2022). From the pre-period to the
post-period, fidaxomicin use increased from 5.9% to 13.7%, while vancomycin used
declined from 87.9% to 82.9% and metronidazole from 21.6% to 17.2%. Among census
regions, increases in fidaxomicin use were smallest in the northeast, and
greatest in the south.

In a secondary analysis that compared clinical and cost outcomes among patients
treated exclusively with fidaxomicin versus vancomycin, fidaxomicin was
associated with lower CDI recurrence (6.1% vs 10.2%) and higher sustained
clinical response (91.7% vs 87.9%), while 90-day post-discharge costs were
similar. The study authors note that these findings are consistent with prior
research.

"While fidaxomicin use for CDI increased (and more than doubled) since the
publication of the updated IDSA guidelines, it remained low relative to
vancomycin and metronidazole use," the study authors wrote. "These novel
findings imply that a substantial number of patients could have received the
benefits of fidaxomicin if more hospitals had followed the ISDA 2021
guidelines."


QUICK TAKES: LOCAL DENGUE IN CALIFORNIA, MORE H5N1 IN COWS AND POULTRY,
MINNESOTA RABIES FATALITY

News brief
September 30, 2024
Lisa Schnirring
Topics
Dengue
Avian Influenza (Bird Flu)
Rabies
 * The Los Angeles Department of Public Health said it is investigating a fourth
   local dengue case, which involves a resident of Panorama City. It noted that
   the case isn't related to a local dengue cluster in Baldwin Park. Panorama
   City is about 40 miles west of Baldwin Park. Local dengue cases are extremely
   rare in Los Angeles County, and health officials urged area residents to take
   precautions such as wearing mosquito repellent and removing mosquito-breeding
   sites. 
 * The US Department of Agriculture (USDA) Animal and Plant Health Inspection
   Service (APHIS) has confirmed three more H5N1 avian flu outbreaks in dairy
   herds, two in California and one in Idaho. The latest outbreaks push the
   national total to 242 across 14 states. Also, APHIS confirmed one more H5N1
   outbreak in poultry, this time at a farm in Idaho’s Lincoln County that has
   700 birds.
 * The Minnesota Department of Health (MDH) announced that it is investigating a
   fatal rabies case involving a person older than 65 years who was exposed to a
   bat in July in the western part of the state. The latest case is Minnesota’s
   fourth since 2000. The patient's diagnosis was confirmed on September 20
   based on testing at the Centers for Disease Control and Prevention (CDC). The
   MDH said it is working with the patient's family and healthcare facilities
   where the patient was treated to assess if any others were potentially
   exposed and may need treatment.

ALL BRIEFS


IN CASE YOU MISSED IT

Previous Next
Officials probe fifth local dengue case in LA County
California reports likely H5N1 infection in dairy worker
APHIS gives $12 million to states, tribes for fight against chronic wasting
disease
German health officials probe symptoms in contact of Rwandan Marburg patient
US markers show more COVID decline, with RSV rise in the southeast
Ghana reports first mpox case of the year
Doxy-PEP linked to increased proportion of tetracycline resistance genes in the
gut
Study: Prolonged antibiotics common in COVID patients with and without sepsis
Officials probe fifth local dengue case in LA County
California reports likely H5N1 infection in dairy worker
APHIS gives $12 million to states, tribes for fight against chronic wasting
disease
German health officials probe symptoms in contact of Rwandan Marburg patient
US markers show more COVID decline, with RSV rise in the southeast
Ghana reports first mpox case of the year
Doxy-PEP linked to increased proportion of tetracycline resistance genes in the
gut
Study: Prolonged antibiotics common in COVID patients with and without sepsis
Officials probe fifth local dengue case in LA County
California reports likely H5N1 infection in dairy worker
APHIS gives $12 million to states, tribes for fight against chronic wasting
disease
German health officials probe symptoms in contact of Rwandan Marburg patient


THIS WEEK'S TOP READS


 1.  MISSOURI INVESTIGATES MORE POSSIBLE HUMAN-TO-HUMAN H5N1 AVIAN FLU SPREAD
     
     At least one household member and six healthcare workers who encountered
     the index case-patient are being investigated after showing symptoms of
     viral infection.
     
     Stephanie Soucheray
     September 27, 2024
     


 2.  STUDY: COVID-19 VACCINATION PROTECTS AGAINST SERIOUS CARDIOVASCULAR DISEASE
     
     There was a 17% higher risk of extrasystoles, or extra heart beats, after
     dose one.
     
     Stephanie Soucheray
     October 1, 2024
     


 3.  WHO: CASES AT BORDER AND CAPITAL AMONG MARBURG CONCERNS IN RWANDA
     
     Rwanda's health ministry today reported two more cases, along with one more
     death, lifting the total to 29 cases, 10 of them fatal.
     
     Lisa Schnirring
     October 1, 2024
     


 4.  GERMAN HEALTH OFFICIALS PROBE SYMPTOMS IN CONTACT OF RWANDAN MARBURG
     PATIENT
     
     The man and his traveling companion, who reportedly had flulike symptoms,
     were taken to University Hospital Eppendorf in Hamburg. 
     
     Lisa Schnirring
     October 2, 2024
     


 5.  VAGUE SYMPTOMS, OVERLAP WITH OTHER ILLNESSES COMPLICATE LONG-COVID
     DIAGNOSIS
     
     In one study, over half of long-COVID patients also were diagnosed as
     having myalgic encephalomyelitis/chronic fatigue syndrome.
     
     Mary Van Beusekom
     September 30, 2024
     


 6.  RWANDA CONFIRMS MORE MARBURG CASES, PLANS VACCINE TRIAL
     
     Like past Marburg outbreaks, health workers have been heavily impacted,
     accounting for 29 of the 36 cases.
     
     Lisa Schnirring
     October 3, 2024
     


 7.  RWANDA REPORTS FIRST MARBURG VIRUS OUTBREAK
     
     Control measures include limiting attendance at funerals of people who died
     from Marburg infections. 
     
     Lisa Schnirring
     September 30, 2024
     


 8.  H5N1 INFECTS SECOND FARM WORKER IN CALIFORNIA AS FEDS BOLSTER VACCINE
     SUPPLY
     
     Along with updates on recent human infections, federal officials detailed
     new awards for H5 vaccines, which will double the doses slated for the
     national stockpile.
     
     Lisa Schnirring
     October 4, 2024
     


 9.  CALIFORNIA REPORTS LIKELY H5N1 INFECTION IN DAIRY WORKER
     
     The patient experienced conjunctivitis after contact with infected dairy
     cattle in the state's Central Valley.
     
     Lisa Schnirring
     October 3, 2024
     


 10. QUICK TAKES: LOCAL DENGUE IN CALIFORNIA, MORE H5N1 IN COWS AND POULTRY,
     MINNESOTA RABIES FATALITY
     
     The latest local dengue case in Los Angeles county isn't related to the
     cluster reported earlier this month.
     
     Lisa Schnirring
     September 30, 2024
     


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