PEERA HEMARAJATA, M.D., PH.D., D(ABMM)

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Lit Review Mar #2

March 25, 2018

Disclaimer: this compilation of synopses have been collected from multiple sources, including Mark Crislip's Puscast, Journal Watch Infectious Diseases, Medscape Infectious Diseases, CDC MMWR, AMA Morning Rounds, ProMED Mail, Journal of Clinical Microbiology, Antimicrobial Agents and Chemotherapy, Clinical Infectious Diseases, and more. I chose these articles based on their relevance to clinical microbiology and would be of interest to my fellows, and some other pieces that I found amusing to read. All credit goes to these original contributors. I'm just a messenger :).

 

Leading Photo by slon_dot_pics from Pexels

 

Tuberculosis — United States, 2017

https://www.cdc.gov/mmwr/volumes/67/wr/mm6711a2.htm?s_cid=mm6711a2_e

  • World TB Day: 3/24/18!

  • 9,093 new cases in the US in 2017

  • Incidence rate decreased 2%/year, total cases decreased from 1.8%

    • Rate is too slow: we need 3.9% to achieve TB elimination in 2100

  • Of course CA reported the most cases among all states, but HI beat us on the incidence rate (5.2 vs 8.1%)

 

Preliminary Incidence and Trends of Infections with Pathogens Transmitted Commonly Through Food — Foodborne Diseases Active Surveillance Network, 10 U.S. Sites, 2006–2017

https://www.cdc.gov/mmwr/volumes/67/wr/mm6711a3.htm?s_cid=mm6711a3_e

  • FoodNet: tracks lab confirmed infection caused by 9 pathogens

    • Campylobacter, Cryptosporidium, Cyclospora, Listeria, Salmonella, Shiga toxin-producing Escherichia coli (STEC) O157 and non-O157, Shigella, Vibrio, Yersinia

  • Side note: NARMS – FDA and USDA, tracks resistance in 5 organisms

    • Campylobacter, , Shiga toxin-producing Escherichia coli O157, Shigella, Salmonella (both typhoidal and non-typhoidal, Vibrio except cholera

  • CIDT becoming more popular: seeing increase in case number in some pathogens that could be missed in culture: Yersinia, Vibrio, non-O157 STEC

  • Cases of Salmonella detected by CIDT increased a lot, and seems like most cases were positive in reflex culture

    • Overall case number did not decrease: although some serotypes associated with poultry or beef decreased (due to new USDA measures), other serotypes replaced them

  • Overall STEC increased, but probably due to non-O157 (which should increase as more labs use CIDT), O157 was hypothesized to decrease due to reduced incidence of HUS in children (since most HUS cases are caused by O157)

 

Fatal Yellow Fever in Travelers to Brazil, 2018

https://www.cdc.gov/mmwr/volumes/67/wr/mm6711e1.htm?s_cid=mm6711e1_e

  • 10 cases of YF in travelers to Brazil reported to ProMED (Program for Monitoring Emerging Diseases – an internet based outbreak reporting system) since Jan 2018

  • None had been vaccinated

  • 4 deaths

  • Vaccine: all eligible persons aged ≥9 months traveling to many areas in Brazil, including São Paulo and Rio de Janeiro (especially Ilha Grande), at least 10 days before traveling

Notes from the Field: False-Negative Hepatitis B Surface Antigen Test Results in a Hemodialysis Patient — Nebraska, 2017

https://www.cdc.gov/mmwr/volumes/67/wr/mm6710a6.htm?s_cid=mm6710a6_e

  • 2010: dialysis patient with unknown immunity, got HBV vaccines before starting dialysis, tested negative for HBsAg and positive for anti-HBs

  • 2016: admitted for other stuff, positive for HBsAg

    •  All this time had not been under protocol for HBV positive patient in dialysis center

  • Confirmed by VL

  • Found sG145R mutation in S gene

    • Some older generations of FDA-approved kits did not detect this mutant

    • Anti-HBs not effective

 

Notes from the Field: Assessing Rabies Risk After a Mass Bat Exposure at a Research Facility in a National Park — Wyoming, 2017

https://www.cdc.gov/mmwr/volumes/67/wr/mm6710a7.htm?s_cid=mm6710a7_e

  • August 2017: 20 local public health nurses exposed to bats and bat excrements while staying overnight at a national park research facility

  • Huge effort in identifying people who had been in the facility over the summer

  • Notes: rabies can spread via bites, scratches, mucous membrane contact with saliva, most US cases associated with bats - 75% of become ill within 3 months

Multistate Outbreak of Salmonella Infections Linked to Kratom

https://www.cdc.gov/salmonella/kratom-02-18/index.html

  • Kratom: plant consumed for its stimulant effects and as an opioid substitute

    • Native to Thailand, Malaysia, Indonesia, and Papua New Guinea

  • Outbreak in 35 states involving 87 people (as of 3/15/18), 27 hospitalized, no death

  • Most patients consumed powder form that they purchased from retail locations and online

  • Epi data suggested kratom product as likely to be involved, but no common brands or suppliers

    • Where were these grown????

  • WGS and PFGE on patient isolates confirmed outbreak caused by Salmonella I 4,[5],12:b:- , Salmonella Javiana, Salmonella Okatie, Salmonella Thompson, some of these were found on in both kratom product and ill people

Behaviors, movements, and transmission of droplet-mediated respiratory diseases during transcontinental airline flights

http://www.pnas.org/content/early/2018/03/13/1711611115

  • Study sponsored by Boeing

  • Study team of 10 flew on 20 transcontinental flights (about 6 hours) and recorded behavior of passengers to calculate contact time between passengers and crew

    • One passenger coughed moderately during flight

  • Built a model of infection: an infected passenger in different locations in coach, and an infected crew member

    • Used transmission rate in plane from a 1977 report of transmission of flu-like il