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Highlights from the 22nd ECCMID
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Highlights from the 22nd ECCMID For more on the 22nd ECCMID see http://www.congrex.ch/ eccmid2012/
The 22nd annual European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) was held on March 31 to April 3, 2012, in London, UK. More than 10 000 infectious diseases experts gathered in the ExCel Exhibition Centre, London. Special emphasis was given to emerging infections, including influenza, antibiotic resistance, infection control, and sexually transmitted infections. Emilio Bouza (Gregorio Maranon Hospital in Madrid, Spain) received this year’s award for excellence in clinical microbiology and infectious diseases in recognition of his work on catheter-related infections.
A forgotten STI Trichomonas vaginalis, a pathogenic flagellate protozoan able to infect the urogenital tract in both men and women, was the focus of a thoughtprovoking symposium. The genome sequence is now available: 160 megabases encode 60 000 proteins. Infection with T vaginalis causes genital discharge, and is associated with an increased risk of HIV, poor reproductive outcomes, premature birth, and low birth weight. WHO estimate that T vaginalis is the most common sexually transmitted infection (STI), with 248·5 million cases worldwide in 2005 compared with 101·5 million for Chlamydia tracomatis and 88 million for Neisseria
gonorrhoeae. Figures from the UK Health Protection Agency (HPA) show that in 2009 there were 429 cases of T vaginalis in men and 5225 in women, 96% were from England, most of which were from London. Despite the high burden of infections, there has been a lack of interest in this infection. Catherine Ison (HPA Centre for Infectious Diseases, London, UK) reported that typical treatment for T vaginalis is metronidazole given as a 2 g single dose or 250 mg dose three times a day for 7 days; alternatively, a related compound, tinidazole, can be used as a 2 g single dose. Although rare, clinical resistance and persistent infection do occur, but the mechanism is poorly understood. Alternative treatments for patients allergic to the 5-nitroimidazoles compounds include parmomycin sulfate, furazolidone, and povidone-iodine. Charlotte A Gaydos (Division of Infectious diseases, John Hopkins University, Baltimore, MD, USA) pointed out how the prevalence of the infection is not well characterised. Results obtained with the APTIMA Trichomonas assay—the first nucleic acid amplification tests approved by the US Food and Drug Administration—have shown a high prevalence in black people (20·2%) and women age 40 years or older (11·8%). John White (Department of Sexual Health and HIV, Guy’s and St Thomas’ NHS Foundation Trust, London, UK) reported that a transcription-mediated amplification assay for T vaginalis, improved clinical detection by 34·5% compared with standard wet-mount microscopy.
Paul Campbell/Getty Images
European MRSA incidence
ECCMID was held in the London Docklands, UK
370
In an oral session (abstr 1608), M A Borg, E Scicluna, and U Frank on behalf of the European Union (EU) Implement Project Group reported on meticillin-resistant Staphylococcus aureus (MRSA) distribution. The EU-
funded IMPLEMENT project between March and October, 2011, surveyed infection prevention and control practices, and a total of 223 replies were received from hospitals in 29 countries. The prevalence of MRSA was 5% or less in 105 hospitals, 5–20% in 47 hospitals, and 20% or higher in 71 hospitals. MRSA was rarest in hospitals that did daily surveillance and analysed the cause of infections. Hospitals that regularly assessed the competence of their personnel’s ability to draw blood through catheters had lower MRSA prevalences.
Hepatitis C treatment Thomas F Baumert (University of Strasbourg, Strasbourg, France) reported a novel antiviral approach to prevent primary infection by targeting the hepatitis C virus host entry factors with receptor-specific monoclonal antibodies or small molecules. This approach might also restrain virus spread in patients with chronic infection. Viral entry into target cells is a multistep process involving several host factors. By use of a functional genome-wide RNAi screen, a network of receptor tyrosine kinases (RTKs) used by the virus as entry factors was identified. Such kinases act on postbinding steps by disrupting CD81-claudin-1 co-receptor associations and membrane fusion. The targeting of host entry factors by receptorspecific monoclonal antibodies or inhibition of RTKs by protein kinase inhibitors could block entry and infection of all hepatitis C virus. Tarik Asselah (INSERM, Clichy, France) reported that following approval of boceprevir and telaprevir for the treatment of hepatitis C in 2011, second generation direct acting antivirals seem to be showing efficacy in phase 3 (TMC435 and BI201335) and phase 2 (PSI-7977) trials.
Raffaella Bosurgi www.thelancet.com/infection Vol 12 May 2012
Highlights from the 22nd ECCMID For more on the 22nd ECCMID see http://www.congrex.ch/ eccmid2012/
The 22nd annual European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) was held on March 31 to April 3, 2012, in London, UK. More than 10 000 infectious diseases experts gathered in the ExCel Exhibition Centre, London. Special emphasis was given to emerging infections, including influenza, antibiotic resistance, infection control, and sexually transmitted infections. Emilio Bouza (Gregorio Maranon Hospital in Madrid, Spain) received this year’s award for excellence in clinical microbiology and infectious diseases in recognition of his work on catheter-related infections.
A forgotten STI Trichomonas vaginalis, a pathogenic flagellate protozoan able to infect the urogenital tract in both men and women, was the focus of a thoughtprovoking symposium. The genome sequence is now available: 160 megabases encode 60 000 proteins. Infection with T vaginalis causes genital discharge, and is associated with an increased risk of HIV, poor reproductive outcomes, premature birth, and low birth weight. WHO estimate that T vaginalis is the most common sexually transmitted infection (STI), with 248·5 million cases worldwide in 2005 compared with 101·5 million for Chlamydia tracomatis and 88 million for Neisseria
gonorrhoeae. Figures from the UK Health Protection Agency (HPA) show that in 2009 there were 429 cases of T vaginalis in men and 5225 in women, 96% were from England, most of which were from London. Despite the high burden of infections, there has been a lack of interest in this infection. Catherine Ison (HPA Centre for Infectious Diseases, London, UK) reported that typical treatment for T vaginalis is metronidazole given as a 2 g single dose or 250 mg dose three times a day for 7 days; alternatively, a related compound, tinidazole, can be used as a 2 g single dose. Although rare, clinical resistance and persistent infection do occur, but the mechanism is poorly understood. Alternative treatments for patients allergic to the 5-nitroimidazoles compounds include parmomycin sulfate, furazolidone, and povidone-iodine. Charlotte A Gaydos (Division of Infectious diseases, John Hopkins University, Baltimore, MD, USA) pointed out how the prevalence of the infection is not well characterised. Results obtained with the APTIMA Trichomonas assay—the first nucleic acid amplification tests approved by the US Food and Drug Administration—have shown a high prevalence in black people (20·2%) and women age 40 years or older (11·8%). John White (Department of Sexual Health and HIV, Guy’s and St Thomas’ NHS Foundation Trust, London, UK) reported that a transcription-mediated amplification assay for T vaginalis, improved clinical detection by 34·5% compared with standard wet-mount microscopy.
Paul Campbell/Getty Images
European MRSA incidence
ECCMID was held in the London Docklands, UK
370
In an oral session (abstr 1608), M A Borg, E Scicluna, and U Frank on behalf of the European Union (EU) Implement Project Group reported on meticillin-resistant Staphylococcus aureus (MRSA) distribution. The EU-
funded IMPLEMENT project between March and October, 2011, surveyed infection prevention and control practices, and a total of 223 replies were received from hospitals in 29 countries. The prevalence of MRSA was 5% or less in 105 hospitals, 5–20% in 47 hospitals, and 20% or higher in 71 hospitals. MRSA was rarest in hospitals that did daily surveillance and analysed the cause of infections. Hospitals that regularly assessed the competence of their personnel’s ability to draw blood through catheters had lower MRSA prevalences.
Hepatitis C treatment Thomas F Baumert (University of Strasbourg, Strasbourg, France) reported a novel antiviral approach to prevent primary infection by targeting the hepatitis C virus host entry factors with receptor-specific monoclonal antibodies or small molecules. This approach might also restrain virus spread in patients with chronic infection. Viral entry into target cells is a multistep process involving several host factors. By use of a functional genome-wide RNAi screen, a network of receptor tyrosine kinases (RTKs) used by the virus as entry factors was identified. Such kinases act on postbinding steps by disrupting CD81-claudin-1 co-receptor associations and membrane fusion. The targeting of host entry factors by receptorspecific monoclonal antibodies or inhibition of RTKs by protein kinase inhibitors could block entry and infection of all hepatitis C virus. Tarik Asselah (INSERM, Clichy, France) reported that following approval of boceprevir and telaprevir for the treatment of hepatitis C in 2011, second generation direct acting antivirals seem to be showing efficacy in phase 3 (TMC435 and BI201335) and phase 2 (PSI-7977) trials.
Raffaella Bosurgi www.thelancet.com/infection Vol 12 May 2012