First Influenza-Associated Pediatric Deaths Reported This Flu Season

The Centers for Disease Control and Prevention (CDC) has reported the first pediatric influenza deaths of the new flu season.

The two deaths were documented in CDC's "Weekly U.S. Influenza Surveillance Report."

The deaths occurred the week ending October 12. CDC notes that one death was associated with an influenza A virus for which no subtyping was performed and one death was associated with an influenza B/Victoria virus.

The latest CDC FluView report, for the week ending October 19, indicated that while seasonal influenza activity in the United States increased slightly, it remains low. About 1.7% of visits to a healthcare provider were for influenza-like illness. While such illness is higher than the previous week, it remains below the national baseline of 2.4%. Louisiana and Puerto Rico are experiencing high influenza-like illness activity. While a majority of the country is reporting sporadic or local flu activity, the viruses are widespread in Maryland and regional in Louisiana.

We may now be in influenza season, but it's not too late to get your flu shot. The CDC recommends that everyone six months of age and older should get an influenza vaccine every season with rare exception.

Concerning when to get vaccinated, CDC states the following:

"Because the timing of the onset, peak and end of flu seasons varies from year to year and cannot be predicted, it is difficult to say when is the best time to be vaccinated for any one season. In trying to balance the need to get many people vaccinated before flu activity begins with concerns about potential waning of vaccine-induced immunity during the flu season, CDC and the Advisory Committee on Immunization Practices (ACIP) recommend that vaccination be offered by the end of October.

"Children six months through eight years of age who need two doses should receive their first dose as soon as possible after the vaccine becomes available to allow the second dose (which must be administered at least four weeks later) to be received by the end of October.

"For people who need only one dose for the season, vaccinating early – for example, in July or August –may lead to reduced protection against flu later in the season, particularly among older adults. While vaccination should optimally occur before the onset of flu activity in the community, providers should continue to offer and encourage vaccination as long as flu viruses are circulating and unexpired vaccine is available. To avoid missed opportunities for vaccination, vaccination can be offered during routine health care visits and hospitalizations."

CDC, ACIP and the Healthcare Infection Control Practices Advisory Committee (HICPAC) recommend that all U.S. healthcare workers get vaccinated annually against influenza.

To find a flu clinic near you, click here.

Spread of Antibiotic-Resistant E. Coli Superbugs Linked to Toilet Hygiene

New research published in The Lancet Infectious Diseases indicates that poor toilet hygiene is more likely to spread antibiotic-resistant E. coli than food.

As a news release on the research notes, E. coli has become considerably more antibiotic resistant in recent years in humans and animals. Particularly noteworthy are those strains of the bacteria with extended spectrum beta-lactamases (ESBL), which are enzymes that destroy many important penicillin and cephalosporin antibiotics.

Researchers set out to determine whether antibiotic-resistant E. coli that cause bloodstream infections are passed from person to person or acquired via the food chain. The scientists pursued this research by sequencing the genomes of resistant E. coli from multiple sources across the United Kingdom. These included human bloodstream infections, human feces, human sewerage, animal slurry, and variety of meat, fruit and salad.

The central conclusion: There was little crossover of ESBL-E. coli from animals to humans.

Lead author Prof. David Livermore, from the University of East Anglia's Norwich Medical School, said, in the release: "… the likeliest route of transmission for ESBL-E. coli is directly from human to human, with fecal particles from one person reaching the mouth of another. … We need to carry on cooking chicken well and never to alternately handle raw meat and salad. There are plenty of important food-poisoning bacteria, including other strains of E. coli, that do go down the food chain. But here — in the case of ESBL-E. coli — it's much more important to wash your hands after going to the toilet. … And it's particularly important to have good hygiene in care homes, as the most of the severe E. coli infections occur among the elderly."

The research — titled "Extended-spectrum β-lactamase-producing Escherichia coli in human-derived and foodchain-derived samples from England, Wales, and Scotland: an epidemiological surveillance and typing study" — was published in The Lancet Infectious Diseases on Oct. 22, 2019.

Antibiotic for Complicated UTIs Receives Approval From FDA Panel

A new antibiotic for complicated urinary tract infection (cUTI) has received approval from the U.S. Food and Drug Administration's (FDA) Antimicrobial Drugs Advisory Committee, according to a news release.

The investigational antibiotic cefiderocol is made by Shionogi & Co. of Japan. The FDA panel recommended — by a vote of 14-2 — approval of the antibiotic for the treatment of cUTI, including pyelonephritis, in patients with limited or no alternative treatment options.

As the release notes, the Advisory Committee provides the FDA with independent advice and recommendations. The FDA is not bound by the committee's guidance but takes its recommendation into consideration when reviewing investigational medicines.

Cefiderocol was designated as a qualified infectious disease product (QIDP) by the FDA. Under this designation, cefiderocol was previously granted "fast-track" status for FDA approval for its potential as a new antibiotic to treat serious or life-threatening conditions and address unmet medical needs.

While the FDA panel provided its recommendation, there were caveats, reports MedPage Today. These included suggestions for the inclusion of a boxed warning discussing potential mortality risk, with mention of a special risk among patients with hospital-acquired bacterial pneumonia or ventilator-associated bacterial pneumonia, and the conducting of additional research and studies.

If cefiderocol receives FDA approval, it will be marketed under the brand name FETROJA.