1- Monday Infectious Disease News – 13th September

1 – Use of dalbavancin in infective endocarditis: a case series

• Infective endocarditis, typically caused by Gram-positive organisms such as viridans group streptococci and Staphylococcus aureus, is associated with high mortality and morbidity and requires aggressive, prolonged antimicrobial treatment and sometimes surgery.
• Dalbavancin, a lipoglycopeptide active against Gram-positive pathogens, has a long half-life, which allows IV treatment as one dose or two doses with a prolonged interval, offering personalized treatment for complex psychosocial situations or facilitating early discharge.
• This retrospective case series reports use of dalbavancin in a small cohort of patients with infective endocarditis treated at Lancashire Cardiac Centre, Blackpool Teaching Hospitals Foundation Trust, UK.
• Dalbavancin is an alternative treatment option at hospital discharge when conventional antibiotics may not be suitable due to complex psychosocial issues or early discharge is required.

Source: Oxford Academic

2 – Early antimicrobial stewardship team intervention on appropriateness of antimicrobial therapy in suspected sepsis: a randomized controlled trial

• There has been concern that the imperative to administer rapid antimicrobials in septic patients may result in inappropriate antimicrobial use.
• This study aimed to determine the impact of early antimicrobial stewardship (AMS) team intervention in patients with Medical Emergency Team (MET) calls for suspected sepsis.
• AMS team intervention resulted in significant improvement in appropriateness of antimicrobial therapy following MET calls due to suspected sepsis.
• Targeted AMS review should be implemented to support early antimicrobial de-escalation and optimization in patients with suspected sepsis.

Source: Oxford Academic

3 – Evaluation of procalcitonin-guided antimicrobial stewardship in patients admitted to hospital with COVID-19 pneumonia

• Procalcitonin is a biomarker that may be able to identify patients with COVID-19 pneumonia who do not require antimicrobials for bacterial respiratory tract co-infections.
• This study aims to evaluate the safety and effectiveness of a procalcitonin-guided algorithm in rationalizing empirical antimicrobial prescriptions in non-critically ill patients with COVID-19 pneumonia.
• A procalcitonin-guided algorithm may allow for the safe reduction of antimicrobial usage in hospitalized non-critically ill patients with COVID-19 pneumonia.

Source: Oxford Academic

4- Efficacy of a novel antimicrobial hydrogel for eradication of Staphylococcus epidermidis, Staphylococcus aureus and Cutibacterium acnes from preformed biofilm and treatment performance in an in vivo MRSA wound model

• Bacterial biofilm formation is a complicating factor in the antimicrobial treatment of bacterial infections.
• In this study, we assessed the impact of a novel hydrogel with the active antimicrobial compound JBC 1847 on eradication of preformed biofilms of Staphylococcus epidermidis, Cutibacterium acnes and MRSA in vitro, and evaluated the in vivo efficacy of MRSA wound treatment.
• The novel hydrogel shows promising results as a candidate for future wound treatment, likely to be highly effective even in the case of biofilm-complicating infected wounds.

Source: Oxford Academic

5 – Evaluation of Rapid Polymyxin Pseudomonas test in clinical Pseudomonas aeruginosa isolates with various degrees of multidrug resistance

• Pseudomonas aeruginosa is of great concern among MDR bacteria and rapid and reliable in vitro antibiotic susceptibility testing methods are extremely necessary.
• Colistin is, in many cases, among the limited useful alternatives for these isolates.
• Unfortunately, only a few reliable in vitro methods are validated for testing susceptibility to colistin. Although EUCAST and CLSI recommend broth microdilution (BMD) as the standard method for antibiotic susceptibility testing, this method is not routinely performed in microbiology laboratories.
• However, some commercial products based upon BMD have tested well and offer consistent results.
• This study aims to evaluate the performance of the colorimetric Rapid Polymyxin Pseudomonas Test (RPPT)
• The RPPT was able to accurately detect both colistin-susceptible and -resistant isolates within 4 h, offering a rapid alternative for a prompt decision about the inclusion of this antibiotic in a patient’s treatment.

Source: Oxford Academic

6 – Cross-reactive CD4+ T cells enhance SARS-CoV-2 immune responses upon infection and vaccination

• The functional relevance of pre-existing cross-immunity to SARS-CoV-2 is a subject of intense debate.
• Here, they show that human endemic coronavirus (HCoV)-reactive and SARS-CoV-2-cross-reactive CD4+ T cells are ubiquitous but decrease with age.
• They identified a universal immunodominant coronavirus-specific spike peptide (S816-830) and demonstrate that pre-existing spike- and S816-830-reactive T cells were recruited into immune responses to SARS-CoV-2 infection and their frequency correlated with anti-SARS-CoV-2-S1-IgG antibodies.
• Spike-cross-reactive T cells were also activated after primary BNT162b2 COVID-19 mRNA vaccination displaying kinetics similar to secondary immune responses.
• The results highlight the functional contribution of pre-existing spike-cross-reactive T cells in SARS-CoV-2 infection and vaccination.
• Cross-reactive immunity may account for the unexpectedly rapid induction of immunity following primary SARS-CoV-2 immunization and the high rate of asymptomatic/mild COVID-19 disease courses.

Source: Science.org

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