HIV Incidence: Effect of Universal Testing and Treatment

MedicalResearch.com Interview with:

Prof-Richard-Hayes.jpg

Prof. Hayes

Dr. Richard J. Hayes, DSc, FMedSci
Professor of Epidemiology and International Health
London School of Hygiene and Tropical Medicine

MedicalResearch.com: What is the background for this study?

Response: HIV incidence rates remain at very high levels in many parts of southern Africa. Universal testing and treatment (i.e., ensuring that everyone in a community tests for HIV and that everyone diagnosed with HIV is started on treatment as soon as possible) has been proposed as a strategy to achieve steep reductions in HIV incidence in generalized epidemics. Prior trials have shown inconsistent results as to whether this strategy could be effective.

HPTN 071 (PopART) was carried out in 21 urban communities in Zambia and South Africa, with individual communities randomly assigned into one of three arms: A, B or C. The 14 communities in Arms A and B received annual rounds of home-based HIV testing by community health workers who supported linkage to care, antiretroviral therapy (ART) adherence and other HIV services. The seven communities in Arm C received the local standard of care. We looked to see if the HIV incidence in the communities receiving universal testing and treatment would be lower (over time) compared to the incidence in the standard of care communities.

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Barriers to PReP Therapy for HIV Prevention

MedicalResearch.com Interview with:

Rogério Meireles Pinto, LCSW, Ph.D. Professor and Associate Dean for Research University of Michigan School of Social Work 

Dr. Pinto

Rogério Meireles Pinto, LCSW, Ph.D.
Professor and Associate Dean for Research
University of Michigan School of Social Work

MedicalResearch.com: What is the background for this study?

Response: In order to decrease the rate of HIV infection, interventions to scale up PrEP will need to address identified barriers at multiple ecological levels. In the past decade, interventions proposed to address PrEP implementation barriers were limited to one ecological level or another (e.g., individual or community). The failure to consider interventions targeting multiple ecological levels simultaneously may help explain why PrEP implementation is lagging. This failure is also due to methodological limitations of PrEP implementation studies.This high-quality paper presents a thorough and theoretically grounded review of original research on HIV Pre-Exposure Prophylaxis (PrEP) implementation in the U.S.

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Woke Retroviruses May Trigger Multiple Sclerosis and ALS

MedicalResearch.com Interview with:

Prof. Dr. Patrick Küry Dept. of Neurology Heinrich-Heine-University Düsseldorf Germany

Prof. Küry

Prof. Dr. Patrick Küry
Dept. of Neurology Heinrich-Heine-University
Düsseldorf Germany

MedicalResearch.com: What is the background for this study? How do these viruses in our DNA differ from others such as the herpes family of viruses?

Response: The background of our current two published studies is elucidating the role of endogenous retroviruses such as the HERV-W in contributing to neurological disease initiation and progression. Our new paper in PNAS (Kremer et al., PNAS 2019) describes a novel axon damage scenario for Multiple Sclerosis (MS) in which a “toxic” protein called ENV from HERV-W instructs so called microglial cells in the human brain to attack and damage myelinated axons.

Our second review article (Gruchot et al., Front Genet 2019) summarizes currently known effects on endogenous retroviruses exerted towards neural cells, that means cells other than the infiltrating immune cells. There is currently a shift of attention and research in the MS field in that resident neural cells such as oligodendrocytes, precursor cells, stem cells and microglial cells and their reactions are intensively investigated.

HERVs are evolutionary acquired retroviruses (RNA viruses able to integrate into host DNA via reverse transcription from RNA to DNA) that were collected during evolution by our ancestors. Some of them remained in our genome (8% of our genome is HERV related) and in most cases appear to be non-functional, mutated or genetically silenced. A few of them, as for example HERV-W in MS or HERV-K in ALS, can apparently be activated, woken up so to say, and one of the mechanisms leading to activation might be an infection by Herpesviruses. Note that herpesviruses such as for example the Epstein Bar Virus (EBV) are long known suspected triggers of MS, however, a direct correlation could never be demonstrated. HERVs such as HERV-W might therefore constitute the missing link.

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Longer Antibiotic Treatment for Pneumonia Isn’t Always Better

MedicalResearch.com Interview with:

Valerie M. Vaughn, MD MSc Assistant Professor of Medicine and Research Scientist, Division of Hospital Medicine The Patient Safety Enhancement Program and Center for Clinical Management Research Michigan Medicine and the Ann Arbor VA Medical Center

Dr. Vaughn

Valerie M. Vaughn, MD MSc
Assistant Professor of Medicine and Research Scientist, Division of Hospital Medicine
The Patient Safety Enhancement Program and Center for Clinical Management Research
Michigan Medicine and the Ann Arbor VA Medical Center 

MedicalResearch.com: What is the background for this study?

Response: Pneumonia is one of the top causes for hospitalization and one of the main reasons for antibiotic use in US hospitals. In the past decade, studies have suggested that patients can be safely treated with short course antibiotic therapy instead of the prolonged courses we used to prescribe.

Our study looked at prescribing practices in 43 hospitals across the state of Michigan to see if we were appropriately prescribing short course therapy, and if so, how that affected patients. Continue reading

Synthetic Cannabidiol Explored As Potential Topical Antibiotic

MedicalResearch.com Interview with:

Dr Mark Blaskovich PhD Institute for Molecular Bioscience's Centre for Superbug Solutions The University of Queensland In collaboration with Botanix Pharmaceuticals Ltd

Dr. Blaskovich

Dr Mark Blaskovich PhD
Institute for Molecular Bioscience’s Centre for Superbug Solutions
The University of Queensland
In collaboration with Botanix Pharmaceuticals Ltd 

MedicalResearch.com: What is the background for this study?  

Response: Botanix is a company that has been developing topical formulations of CBD for treatment of skin diseases such as atopic dermatitis and acne, based on its reported anti-inflammatory properties. However, these diseases are also associated with bacterial infection, so they were interested in looking at potential antimicrobial activity, as there are some previous literature reports suggesting it is active. They contacted us to do some more in-depth investigations.

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Don’t Swallow Pool Water! Diarrhea-Causing Crypto Lurks in Summer Swimming Pools

MedicalResearch.com Interview with:

Radhika Gharpure MPH DVM Epidemic Intelligence Service Officer CDC

Dr. Gharpure

Radhika Gharpure MPH DVM
Epidemic Intelligence Service Officer
CDC

MedicalResearch.com: What is the background for this report? Would you tell us about cryptosporidiosis infections?  Where is is found? How is it transmitted?

Response: The data from our most recent report looked at outbreaks caused by Cryptosporidium (Crypto) in the United States during 2009 – 2017. Outbreaks have increased an average of 13% each year. Crypto, a parasite, is spread through the poop of infected humans or animals. People can get sick after they swallow the parasite in contaminated water or food or after contact with infected people or animals.

Crypto is the leading cause of disease outbreaks in the United States linked to water, specifically outbreaks linked to pools or water playgrounds.

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How Well Did California’s Interventions to Improve Vaccination Rates Work?

MedicalResearch.com Interview with:
Ms. Cassandra Pingali

Ms. Pingali worked on this paper while a a graduate student at Emory University, and completed it post-graduation.
She is currently an ORISE fellow at Centers for Disease Control and Prevention
Immunization Services Division

MedicalResearch.com: What is the background for this study?

Response: Despite high overall immunization coverage in the United States, we are currently experiencing the largest measles outbreak since measles was declared eliminated in 2000. In 2014, California grappled with a very large measles outbreak known as the “Disneyland” outbreak. Later investigation revealed that most of the affected children were unvaccinated against measles despite the availability of a safe and effective vaccine.

In order to prevent future outbreaks, California officials wanted to improve their declining childhood vaccination coverage. California passed two laws and implemented an educational program for school staff to increase vaccination rates in the state. We felt it was important to take a systematic look at these interventions and examine if public health initiatives such as these are working to improve vaccination rates.

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Does the HPV Vaccine Come With a Moral Hazard?

MedicalResearch.com Interview with:
“Syringe and Vaccine” by NIAID is licensed under CC BY 2.0
Ali Moghtaderi PhD MBA
Assistant Research Professor and
Avi Dor PhD
Professor of Health Policy and Economics
Milken Institute School of Public Health
George Washington University

MedicalResearch.com: What is the background for this study?

Response: In this study, we investigate the effect of Human Papillomavirus (HPV) vaccination on participation in Pap test, which is one of the most effective cancer screening interventions. Cervical cancers are causally linked to HPV infections. The Pap test is a diagnostic procedure for early detection of cervical cancer. HPV vaccination provides partial protection against cervical cancer, and the Pap test is strongly recommended for women 21 to 65 years of age even after vaccination. If vaccination leads to a reduction in testing participation, it could contribute to greater incidence and severity of cervical cancer. Note that we focus on relatively older women (age 22 or older) who were not vaccinated at younger ages.  Continue reading

Measles Vaccine in Early Childhood Associated with Long Term Health and Cognitive Benefits

MedicalResearch.com Interview with:

Arindam Nandi  PhD Center for Disease Dynamics, Economics & Policy

Dr. Nandi

Arindam Nandi  PhD
Center for Disease Dynamics, Economics & Policy 

MedicalResearch.com: What is the background for this study?  

Response: The motivation for this study comes from a small but growing body of evidence on the potential long-term benefits of vaccines. The recent resurgence of measles outbreaks in several countries which had previously eliminated the virus makes our study additionally relevant. There have been over 1,000 measles cases reported across 28 states in the US so far in 2019, which is the largest number of cases the country has seen in almost 3 decades. Similarly high number of cases have been reported in several European countries in recent years. This study reiterates the importance of vaccination and proves the long-term benefits of the measles vaccine in low- and middle-income countries, which account for a large proportion of global measles cases.

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Study Finds Ajoene Disrupts Biofilm in Chronic Wounds, and Enhances Antibiotic Effectiveness

MedicalResearch.com Interview with:

David Houston Senior Scientist and wound project Neem Biotech

Dr. Houston

David Houston PhD
Senior Scientist and wound project
Neem Biotech

MedicalResearch.com: What is the background for this study?  

Response: Biofilms are complex bacterial communities formed during the natural infection process as a protection mechanism and controlled by bacterial quorum sensing. These biofilm communities allow infections to spread by producing toxins that inhibit the body’s immune system, generating exopolysaccharide and changes in metabolic state that reduce the efficacy of antibiotics and activating virulence factors, which ultimately drive the spread of infection. Stopping the spread of infection by inhibition of quorum sensing has potential to manage a wide range of infections, including in wounds.

In chronically-infected wounds, the prevention of biofilm formation, disruption of mature biofilms, reduction of virulence factors and thereby the spread of infection remains clinically elusive. Quorum sensing (QS) pathways regulate microbial motility, virulence factor production and the formation and maturation of biofilms. Inhibiting QS therefore presents a potential mode of therapeutic intervention for infections.

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Antibody Points Way Toward Norovirus Vaccine

MedicalResearch.com Interview with:

CDC Image Based on electron microscopic (EM) imagery, this three-dimensional (3D) illustration provides a graphical representation of a single norovirus virion, set against a white background. Though subtle, the different colors represent different regions of the organism’s outer protein shell, or capsid. Illustrator: Alissa Eckert, MS

CDC Image
Based on electron microscopic (EM) imagery, this three-dimensional (3D) illustration provides a graphical representation of a single norovirus virion, set against a white background. Though subtle, the different colors represent different regions of the organism’s outer protein shell, or capsid. Illustrator: Alissa Eckert, MS

Lisa Lindesmith, MS
Research specialist
Ralph S. Baric, PhD
Professor, Departments of Epidemiology, Microbiology and Immunology
Lineberger Comprehensive Cancer Center
Gillings School of Global Public Health
University of North Carolina

MedicalResearch.com: What is the background for this study? Would you briefly explain the types of outbreaks caused by Norovirus infections?

Response: Noroviruses cause about 20% of endemic and 50% of food-borne acute gastroenteritis, infecting all age groups, globally.  While may different strains of norovirus cause outbreaks primarily in community settings, since the mid-1990’s the GII.4 strains of norovirus have caused waves of pandemic disease every 2-7 years.  These pandemics are associated with emergence of a GII.4 strain that has changed key viral domains rendering the virus less susceptible to recognition by and protection from a person’s immune system.  For a vaccine to be efficacious against pandemic GII.4 strains, it must be able to train the immune system to focus on the part of the GII.4 virus that does not change over time.

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A Painless Heat Patch May Help Resolve Warts

MedicalResearch.com Interview with:

Richard J. Antaya, MD, FAAD, FAAP Professor, Dermatology and Pediatrics Yale University School of Medicine

Dr. Antaya

Richard J. Antaya, MD, FAAD, FAAP
Professor, Dermatology and Pediatrics
Yale University School of Medicine 

MedicalResearch.com: What is the background for this study?

Response: Localized hyperthermia has been reported to hasten the resolution of warts and treat both benign and malignant neoplasms. Numerous clinical studies employing various methods to increase the cutaneous surface temperature, including: infrared radiation, radiofrequency, Nd:YAG laser, moxibustion, warm water immersion, ultrasound, and exothermic heat patches, have all yielded positive results.

We published a proof-of-concept, open-label trial, representing the largest experience to date employing chemical reaction induced exothermic heat patches for the treatment of warts. Localized hyperthermia from all sources currently has a low level of evidence and strength of recommendation because of the lack of well-designed, sufficiently powered studies.  Continue reading

USPSTF Statement on PReP: Preexposure Prophylaxis for the Prevention of HIV Infection

MedicalResearch.com Interview with:

John W. Epling, Jr., M.D., M.S.Ed Professor of Family and Community Medicine Virginia Tech Carilion School of Medicine Roanoke, VA USPSTF Task Force Member

Dr. Epling

John W. Epling, Jr., M.D., M.S.Ed
Professor of Family and Community Medicine
Virginia Tech Carilion School of Medicine
Roanoke, VA
USPSTF Task Force Member
Medical Director of Employee Health and Wellness
Carilion Clinic
Dr. Epling maintains an active clinical primary care practice 

MedicalResearch.com: What is the background for this study?

Response: HIV continues to be a significant public health issue, with about 40,000 people diagnosed each year. The U.S. Preventive Services Task Force reviewed the most recent evidence on how primary care clinicians can best help prevent HIV and its devastating health consequences. We looked at the research on two different topics: screening for HIV, and pre-exposure prophylaxis—a medication that prevents HIV, commonly known as PrEP. 

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Most Patients with Cellulitis May Not Need IV Antibiotics

MedicalResearch.com Interview with:

Example of cellulitis erysipelas from DermnetNZ.org

Example of cellulitis erysipelas from DermnetNZ.org

Richard Brindle DM FRCP
Honorary Reader, University of Bristol, UK 

MedicalResearch.com: What is the background for this study?

Response: This review is an update of the 2010 Cochrane Review of Interventions for cellulitis and erysipelas (DOI: 10.1002/14651858.CD004299) but focusing on antibiotics.  It provides a valuable resource for clinicians in summarizing current best evidence and highlighting gaps in the research. This review will inform the production of evidence-based guidelines covering antibiotic choice, route of administration, duration of treatment and the role of combinations of antibiotics. Continue reading

Metagenomic Sequencing Enhanced Diagnosis of Meningitis and Encephalitis Infections

MedicalResearch.com Interview with:

Dr. Charles Chiu, M.D./Ph.D. Professor, Laboratory Medicine and Medicine / Infectious Diseases Director, UCSF-Abbott Viral Diagnostics and Discovery Center Associate Director, UCSF Clinical Microbiology Laboratory UCSF School of Medicine

Dr. Chiu

Dr. Charles Chiu, M.D./Ph.D.
Professor, Laboratory Medicine and Medicine / Infectious Diseases
Director, UCSF-Abbott Viral Diagnostics and Discovery Center
Associate Director, UCSF Clinical Microbiology Laboratory
UCSF School of Medicine

MedicalResearch.com: What is the background for this study? Would you describe what is meant by metagenomic sequencing?

Response: Metagenomic next-generation sequencing (mNGS) is the use of technology to generate millions of sequence reads to diagnose infection sin patients by characterizing the full range of potential pathogens (bacteria, viruses, fungi, and parasites) in a single sample. Although shown to be a promising diagnostic tool for  infectious diseases in case reports and limited case series (Chiu and Miller Nature Reviews Genetics 20, 341-355 (2019)), to date the “real-life” utility of this approach for patient care has hitherto not been demonstrated.  This study is the first prospective, multi-center study of clinical mNGS testing for the diagnosis of neurological infections in acutely ill hospitalized patients presenting with meningitis and/or encephalitis.

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Mandates Improve With Influenza Vaccination Rates of Hospital Personnel

Megan C. Lindley, MPHDeputy Associate Director for ScienceImmunization Services DivisionCDC

Megan C. Lindley

MedicalResearch.com Interview with:
Megan C. Lindley, MPH

Deputy Associate Director for Science
Immunization Services Division
CDC

MedicalResearch.com: What is the background for this study?

Response: Despite longstanding recommendations from the Advisory Committee on Immunization Practices, healthcare personnel influenza vaccination coverage remains below the Healthy People 2020 target of 90%. Healthcare employers use a variety of strategies to promote influenza vaccination among healthcare personnel, including facility-level mandates for vaccination. Several U.S. states have also enacted laws related to healthcare personnel influenza vaccination, but the effect of these laws on vaccination uptake is unclear.

Our study used influenza vaccination coverage data reported by over 4,000 U.S. hospitals to examine three kinds of laws:
(1) Assessment laws, which require hospitals to assess healthcare personnel influenza vaccination status;
(2) Offer laws, which require hospitals to offer the influenza vaccine to healthcare personnel; and
(3) Ensure laws, which require hospitals to require healthcare personnel to demonstrate proof of influenza vaccination. Continue reading

Few Teen Moms Protect Themselves with Condoms and Long Acting Contraceptives

MedicalResearch.com Interview with:
Lee Warner, PhD

Chief of the Women’s Health and Fertility Branch
Division of Reproductive Health
CDC

MedicalResearch.com: What is the background for this study?

Response: Previous research has found lower prevalence of condom use combined with the most effective reversible contraceptive methods among teens, but this is the first study to our knowledge to confirm the finding among sexually active teen mothers in the postpartum period.

Our new paper finds that only 3 in 10 postpartum teen mothers report using condoms combined with a more effective contraceptive method (either long-acting reversible contraception or LARC or a non-LARC hormonal method). Dual use was 50 percent lower among LARC users compared with users of non-LARC hormonal methods.

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T2Bacteria Panel Can Detect Blood Stream Infections in Hours, not Days

MedicalResearch.com Interview with:

Minh-Hong Nguyen, MDInfectious DiseasesProfessor of MedicineDirector, Transplant Infectious DiseasesDirector, Antimicrobial Management ProgramDepartment of Medicine University of Pittsburgh School of Medicine

Dr, Minh-Hong Nguyen

Minh-Hong Nguyen, MD
Infectious Diseases
Professor of Medicine
Director, Transplant Infectious Diseases
Director, Antimicrobial Management Program
Department of Medicine
University of Pittsburgh School of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Blood cultures, the gold standard for diagnosing blood stream infections, are insensitive and limited by prolonged time to results. Early institution of appropriate antibiotics is a crucial determinant of improved outcomes in patients with sepsis and blood stream infections (BSI). For these reasons, development of rapid non-culture diagnostic tests for blood stream infections is a top priority.

The T2Bacteria panel is the first direct from blood, non-culture test cleared by FDA for diagnosis of blood stream infections .  It detects within 4-6 hours the 5 most common ESKAPE bacteria that are frequent causes of hospital infection, and which are often multi-drug resistant.  This study shows that the T2Bacteria panel rapidly and accurately diagnosed and identified ESKAPE bacterial BSIs, and identified probable and possible BSIs that were missed by blood cultures (in particular among patients who were already receiving antibiotics).

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HPV6 Serology Associated with Bladder Cancer

MedicalResearch.com Interview with:

Lael S. Reinstatler, MD, MPH.PGY 4 Urology ResidencyDartmouth Hitchcock

Dr. Reinstatler


Lael S
Reinstatler, MD, MPH.
PGY 4 Urology Residency
Dartmouth Hitchcock

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Human Papillomavirus is an oncogenic virus associated with other genitourinary cancers including penile cancer.

HPV is detectable in urine and in urethral swabs and it interacts with stratified squamous epithelium which lines the majority of the genitourinary tract. Prior research has identified HPV in bladder tumors but detection methods are inconsistent.

In this study, we looked for an association with HPV serology (indicating prior HPV systemic exposure) and bladder cancer.

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Novel Lantibiotic Against C. diff Infections May Improve Lipid Profile

MedicalResearch.com Interview with:

Rajesh Kumar NV, Ph.D.Affiliation during the study:Senior Manager, Human Therapeutics Division,Intrexon Corporation, Germantown, MD, USA

Dr. Rajesh Kumar NV

Rajesh Kumar NV, Ph.D.
Affiliation during the study:
Senior Manager, Human Therapeutics Division,
Intrexon Corporation, Germantown, MD, USA
Current affiliation:
Translational Research Program Manager, Oncology Drug Discovery,
Department of Radiation Oncology and Molecular Radiation Sciences,
Johns Hopkins University School of Medicine
Baltimore, MD,  


MedicalResearch.com: What is the background for this study?

Response: Clostridium difficile is a bacterium that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon. Clostridium difficile infection is the most frequent form of colitis in hospitals and nursing homes and affects millions of patients in the United States and abroad. Clostridium difficile associated disease (CDAD) is a global public health challenge where even mild to moderate infections at times can quickly progress to a fatal disease if not treated promptly.

OG253 is a novel lantibiotic in development for the treatment of CDAD. Lantibiotics are antimicrobial peptides whose chemical structure includes a bridge maintained by the non-canonical amino acid lanthionine. The primary objective of our study was to evaluate the repeated dose toxicokinetics and any possible side effects of OG253 as enteric-coated capsules following daily oral administrations of three different doses (6.75, 27 and 108 mg/day) for a single day or seven consecutive days in both genders of rats.

An enteric-coated capsule of OG253 was formulated in an attempt to circumvent the proteolytic degradation of OG253 in the upper digestive tract and specifically deliver this lantibiotic to the distal portion of the small intestine. Continue reading

Bat Borne Nipah Virus Transmitted by Human Secretions

MedicalResearch.com Interview with:

Birgit Nikolay PhDMATHEMATICAL MODELLING OF INFECTIOUS DISEASESInstitut Pasteur

Dr. Nikolay

Birgit Nikolay PhD
MATHEMATICAL MODELLING OF INFECTIOUS DISEASES
Institut Pasteur 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Nipah virus was identified by the World Health Organization as an emerging infectious disease that may cause major epidemics if the pathogen evolves to become more transmissible, leading the organization to prioritize it for research to prevent future health emergencies. In the absence of efficient treatments or vaccines, the only way to control Nipah virus outbreaks is through targeted interventions that limit opportunities of spread. Designing such interventions is challenging in a context where transmission mechanisms remain poorly understood. The study provides important insights to better understand these mechanisms.

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Genetically Fast-Changing Superbugs at Hospitals Require More Stringent Cleaning Methods

Genetically Fast-Changing Superbugs at Hospitals Require More Stringent Cleaning MethodsThe number of deaths caused by resistant bacteria is expected to reach 10 million by 2025, according to the Centers of Disease Control and Prevention. A highly resistant bacteria found in hospitals – Klebsiella pneumoniae – is now a big global threat, according to a recent (April, 2019) study published by researchers from University College London. Researchers have issued a warning that more stringent cleaning of infectious wards and new air disinfection protocols are key to battling the bug. This is because this bacteria possesses the ability to change genetically at an alarming rate, adapting and essentially nullifying the effect of all current antibiotics.

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West Nile Virus: Lag Time in Reporting Precludes Accurate Public Health Decisions

MedicalResearch.com Interview with:

Nicholas B. DeFelice, PhDDepartment of Environmental Medicine & Public HealthIcahn School of Medicine at Mount SinaiNew York, New York

Dr. DeFelice

Nicholas B. DeFelice, PhD
Department of Environmental Medicine & Public Health
Icahn School of Medicine at Mount Sinai
New York, New York

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Effective allocation of public health resources during an outbreak is complicated and often reactive. Thus, it is important that we develop quantitative tools that can accurately and rapidly forecast the progression of an outbreak and provide decision support. Recently, several advancements have been made in the realm of infectious disease forecasting: it is a field that is growing in exciting directions. However, for these forecasting tools to work in real time, we must understand how the forecasting apparatus and observational network work in real time to ensure they are sufficient to support accurate operational predictions.

We previously showed that accurate and reliable forecasts of West Nile virus outbreaks can be made using surveillance data and a mathematical model representing the interactions between birds, mosquitoes and risk of human spillover. This model system was able to retrospectively forecast mosquito infection rates prior to the week of peak mosquito infection, and to forecast accurately the seasonal total number of human West Nile virus cases prior to when the majority of cases were reported.

For this study, we were interested in the data flow process and the question of whether appropriate infrastructure is in place to support real time forecasting. If this forecast system were made operational in real time, public health officials would have an evidence-based decision-support tool to help

1) actively target control of infected mosquito populations (i.e., larviciding and adulticiding),

2) alert the public to future periods of elevated West Nile virus spillover transmission risk, and

3) identify when to intensify blood donor screening. Continue reading

How Long Does Protection from DTaP Vaccination Last?

MedicalResearch.com Interview with:

Dr. Matthieu Domenech de Cellès PhDBiostatistics, Biomathematics, Pharmacoepidemiology, and Infectious Diseases Unit, Institut Pasteur, Inserm U1181, University of Versailles St-Quentin-en-Yvelines,Versailles, France

Dr. Domenech de Cellès

Dr. Matthieu Domenech de Cellès PhD
Biostatistics, Biomathematics, Pharmacoepidemiology, and
Infectious Diseases Unit, Institut Pasteur, Inserm U1181,
University of Versailles St-Quentin-en-Yvelines,
Versailles, France

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Most high-income countries now use acellular pertussis vaccines (called DTaP, which are sub-unit vaccines based on purified antigens of the bacterium Bordetella pertussis) to protect children against pertussis. Although clinical trials demonstrated the short-term effectiveness of DTaP vaccines, there was a growing concern that the duration of protection they conferred was not very long. Those concerns were mostly based on the results of a number of epidemiological studies, which showed that the relative risk of contracting pertussis increased substantially over time, typically by 20–40% every year since last vaccination.

Although such increases seem high, it was not immediately obvious how to interpret them—the more so because pertussis epidemiology is complex.

In our study, we developed mathematical models of pertussis epidemiology to try to understand what the results of recent epidemiological studies really meant about the effectiveness and the duration of protection of DTaP vaccines. The most interesting—and perhaps counterintuitive—finding of our study was that those results are fully consistent with highly effective DTaP vaccines, which confer long-term protection. This is a consequence of the fact that pertussis is highly contagious and that the immunity conferred by DTaP, though very high, is not perfect.    Continue reading

Early Childhood Infections Associated With Eating Disorders In Adolescence

MedicalResearch.com Interview with:

Lauren Breithaupt, PhDDepartment of PsychologyGeorge Mason UniversityFairfax, Virginia

Dr. Breithaupt

Lauren Breithaupt, PhD
Department of Psychology
George Mason University
Fairfax, Virginia 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Our study provides novel insight into the relationship between the immune system and eating disorders characterized by chronic restriction (e.g., anorexia nervosa) and binge eating and/or purging (e.g., binge eating disorder, bulimia nervosa). These findings also add to the growing body of literature linking the immune systems broadly and mental disorders.

We found that infections in early childhood were associated with an increased risk of anorexia nervosa, bulimia nervosa, and other eating disorders such as binge eating disorder in adolescence. These relationships appear to be both time and dose-dependent, meaning that the onset of eating disorder diagnosis is greatest in the first three months following the infection, and the more infections, the greater the risk.    Continue reading

Travelers Can Bring Home Drug-Resistant Bacteria as Souvenirs from Low and Middle Income Countries

MedicalResearch.com Interview with:

Lynn Meurs, PhDEPIET fellow at Robert Koch InstituteEuropean Centre for Disease Prevention and ControlGermany

Dr. Meurs

Lynn Meurs, PhD
EPIET fellow at Robert Koch Institute
European Centre for Disease Prevention and Control
Germany

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: It is unknown how Enterobacteriaceae (ESBL) -producing bacteria are spread, but several studies have shown that intercontinental travellers often return home with these drug-resistant bacteria.

The aim of our study was to investigate into more detail what causes colonisation with these bacteria in people travelling to low and/or middle-income countries  (LMICs) in the tropics and subtropics. We found that out of the travellers that were ESBL-negative before travelling, 23% of returned with ESBL-producing bacteria. In line with previous studies, we found that travelling to Eastern, Southern, and Western Asia is associated with ESBL colonisation.

Unexpectedly, we furthermore found that staying in a hotel as well as in private accommodation as compared to other types of commercial accommodation such as hostels, camping or guesthouses, was associated with the colonisation with these drug-resistant bacteria. Continue reading

MSM: Microbes Associated with Sexual Behavior Can Alter Immune System to Increase HIV Risk

MedicalResearch.com Interview with:

Brent E. Palmer, PhDAssociate Professor of MedicineDirector, ClinImmune and ACI/ID Flow Cytometry FacilityDivision of Allergy and Clinical ImmunologyAurora, Colorado 80045

Brent Palmer

Brent E. Palmer, PhD
Associate Professor of Medicine
Director, ClinImmune and ACI/ID Flow Cytometry Facility
Division of Allergy and Clinical Immunology
University of Colorado Anschutz Medical College
Aurora, Colorado 80045 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Previous studies showed that in western populations, men who have sex with men (MSM) have a distinct gut microbiome composition when compared with men who have sex with women (MSW).

We wanted to understand how these microbiome differences in MSM could impact their immune system. To test this, we transferred feces from healthy MSW and MSM to gnotobiotic (germ-free) mice and examined the immune system in the mice post-transplant. In mice that received transfers from MSM, there were higher frequencies of activated T cells in gut tissues, which are the primary targets of HIV.

This result suggested that gut microbes associated with MSM sexual behavior may actually contribute to HIV transmission by driving activation of HIV target cells. In fact, when we stimulated human gut derived cells with gut microbes isolated from MSM and MSW, cells that were stimulated with microbes from MSM were infected at a higher rate.

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ASPECT-NP: Randomized, Double-Blind, Phase III Trial Comparing Efficacy & Safety of Ceftolozane/Tazobactam vs Meropenem in Ventilated Nosocomial Pneumonia

MedicalResearch.com Interview with:

Dr. Elizabeth Rhee MD Director, Infectious Disease Clinical Research at Merck

Dr. Rhee

Elizabeth Rhee, MD
Executive Director, Infectious Disease Clinical Research
Merck Research Laboratories

MedicalResearch.com: What is the background for this study? Would you briefly explain the condition of ventilated nosocomial pneumonias?

Dr. Rhee: Nosocomial pneumonia (NP) is a lung infection that occurs during a hospital stay. NP is often serious, and is associated with high mortality. It is one of the most common health-care associated infections in both the U.S. and Europe, accounting for over 20% of such cases. Gram-negative bacteria, mainly Pseudomonas aeruginosa (PSA) and Enterobacteriaceae, are frequent causes of nosocomial pneumonia. Limited options currently exist for the management of NP caused by Gram-negative pathogens. This is concerning because rates of resistance to Gram-negative bacteria are growing, and they are becoming increasingly difficult to treat.

Forms of nosocomial pneumonia include hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP), and ventilated HAP. High rates of death (ranging from 20% to more than 50%) are especially associated with ventilated HAP. Pseudomonas aeruginosa, a Gram-negative bacterium, is the most common cause of HAP/VAP in both the U.S. and Europe. Patients with NP are often critically ill, requiring ventilator support and time in intensive care, and it was important to look at this population as we explore new options for the treatment of NP.

Ceftolozane/tazobactam (C/T) is an antipseudomonal cephalosporin/beta-lactamase inhibitor combination with broad in vitro activity against Gram-negative pathogens, including multi-drug resistant (MDR) P. aeruginosa and many extended-spectrum beta-lactamase (ESBL) producers. It is FDA approved for complicated intra-abdominal and urinary tract infections in adults at 1.5g (1g ceftolozane/0.5g tazobactam) q8h. C/T is currently being studied at an investigational new dose of 3g (2g/1g) q8h, for the treatment of ventilated nosocomial pneumonia, in the ASPECT-NP Phase 3 trial.

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Lack of HPV Vaccination in Young Minority Men Is Not a Matter of Access

MedicalResearch.com Interview with:
Perry N Halkitis, PhD, MS, MPH
Dean and Professor
Department of Urban-Global Public Health
Rutgers Public Health 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: The rate of human papillomavirus (HPV) infection is high among young minority gay, bisexual, and other men who have sex with men despite the availability of a vaccine that can prevent the infection, a Rutgers School of Public Health study found.

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Massive Reduction in Cervical Cancer Among Vaccinated Young Women

MedicalResearch.com Interview with:

Dr. Tim PalmerHonorary Senior LecturerDepartment of PathologyUniversity of EdinburghEdinburgh, UK

Dr. Palmer

Dr. Tim Palmer
Honorary Senior Lecturer
Department of Pathology
University of Edinburgh
Edinburgh, UK 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: High risk HPV infection is the obligate cause of between 70 and 90% of cervical cancers, depending upon the country. The development of vaccines against the commonest hr-HPV types has the potential to reduce the burden of cervical cancer, especially in low and middle income countries that cannot afford screening programmes. Cervical cancer affects predominantly women in their 30s and is a major public health issue even in countries with well-established screening programmes. Scotland has had a successful immunisation programme since 2008, and women immunised at age 12 to13 have been screened since 2015. We can therefore demonstrate the effect of hr-HPV immunisation on the pre-invasive stages of cervical cancer.

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