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Emergence of SARS-CoV-2 B.1.1.7 Lineage

• A more highly transmissible variant of SARS-CoV-2, B.1.1.7, has been detected in start highlight12end highlight U.S. states.
• Modeling data indicate that B.1.1.7 has the potential to increase the U.S. pandemic trajectory in the coming months.
• The increased transmissibility of the B.1.1.7 variant warrants universal and increased compliance with mitigation strategies, including distancing and masking.
• Higher vaccination coverage might need to be achieved to protect the public.

Source: CDC

Candida auris Outbreak in a COVID-19 Specialty Care Unit — Florida

• In July 2020, the Florida Department of Health was alerted to three Candida auris bloodstream infections and one urinary tract infection in four patients with coronavirus disease 2019 (COVID-19).
• auris is a multidrug-resistant yeast that can cause invasive infection.
• Its ability to colonize patients asymptomatically and persist on surfaces has contributed to previous C. auris outbreaks in health care settings.

Source: CDC

Exclusion of bacterial co-infection in COVID-19 using baseline inflammatory markers and their response to antibiotics

• COVID-19 is infrequently complicated by bacterial co-infection, but antibiotic prescriptions are common.
• In this study they used community-acquired pneumonia (CAP) as a benchmark to define the processes that occur in bacterial pulmonary infections, testing the hypothesis that baseline inflammatory markers and their response to antibiotic therapy could distinguish bacterial co-infection from COVID-19.
• They propose that in COVID-19, absence of both elevated baseline WCC and antibiotic-related decrease in CRP can exclude bacterial co-infection and facilitate antibiotic stewardship efforts.

Source: Oxford Academic

 Antibiotic use towards the end of life: development of good practice recommendations

• The objective of this study is the development of evidence-based good practice recommendations for clinicians considering the use of antibiotics in patients towards the end of life.
• Good practice recommendations were agreed with focus on three areas: making shared decisions about future care; agreeing clear goals and limits of therapy; reviewing all antibiotic prescribing decisions regularly.
• These will be disseminated widely to support optimal care for patients towards the end of life.
• A patient version of the recommendations has also been produced to support implementation.

Source: BMJ Supportive Care

Effect of tocilizumab on clinical outcomes at 15 days in patients with severe or critical coronavirus disease 2019: randomised controlled trial

• This study aims to determine whether tocilizumab improves clinical outcomes for patients with severe or critical coronavirus disease 2019 (covid-19).
• In patients with severe or critical covid-19, tocilizumab plus standard care was not superior to standard care alone in improving clinical outcomes at 15 days, and it might increase mortality

Source: The BMJ

Revisiting the UK’s strategy for delaying the second dose of the Pfizer covid-19 vaccine

• There is ongoing debate about the UK government’s decision to delay the second dose of the Pfizer/BioNTech vaccine until 12 weeks after the first dose.
• The UK’s strategy to delay the second dose of both the Oxford/AstraZeneca and Pfizer/BioNTech vaccines is so that more people can be vaccinated with their first dose rather than giving a smaller number of people both doses.
• The hope is that this will save more lives.
• There are also supply and delivery pressures with the vaccine rollout, although this has not been disclosed as a reason for the dosing delay.

Source: The BMJ

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