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Highlights from the 52nd ICAAC
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Highlights from the 52nd ICAAC
Influenza A H3N2 from pigs Lyn Finelli (Centers for Disease Control and Prevention, Atlanta, GA, USA; session 1733) described the US epidemic of influenza A H3N2 with apparent animal origin. In 2011, 12 cases of human infection with an H3N2 variant with the M gene from the 2009 pandemic influenza A H1N1 virus were reported. The virus has been circulating in pigs in the USA since 2010. Finelli said 302 human cases have been reported from ten states since July, 2012 (at time of going to press the number of cases had risen to 306). Infection causes a mild illness with symptoms similar to those of seasonal influenza, although 16 patients have been admitted to hospital and there has been one death. Children are most likely to be infected, with the mean age of patients being 8 years. Only limited person-to-person transmission has been reported. Prolonged exposure to pigs, usually in the setting of agricultural fairs, is the main risk factor for infection. Finelli stated that the infected pigs are usually raised at home by children, who show them at local fairs. Infection has not been associated with the commercial pig industry. Finelli expects the epidemic to decline as the fair season comes to an end.
Community-associated ESBL producers Several posters reported community-associated Enterobacteriaceae producing extendedspectrum β-lactamase (ESBL) enzymes, a resistance type typically identified in health-care settings. Among fecal samples collected during a community survey from 1713 healthy adults (mean age 52 years, 60·5% women) living in the Amsterdam area, Elien Reuland (VU University Medical Center, Amsterdam, Netherlands; poster C2-104) and colleagues found ESBL-producing Enterobacteriaceae in 145 (8·5%) samples, of which 91% were Escherichia coli. Genes encoding CTX-M-1 were found in 21 isolates and those encoding CTX-M-15 in 54. CTX-M-1 is an enzyme associated with E coli in poultry in the Netherlands, and CTX-M-15 is common in human gut E coli in countries with high levels of ESBL resistance in clinical isolates. Reuland and colleagues note that in the Netherlands, “the prudent use of antimicrobials in humans contrast[s] with a very high use in food-producing animals”. Yohei Doi (University of Pittsburgh Medical Center, Pittsburgh, PA, USA; poster C2-112) and colleagues found that among 291 patients infected or colonised with ESBL-producing E coli from five hospitals across the USA over 1 year, 107 (36·8%) cases met the definition of being community associated. Community-associated ESBL-producing Enterobacteriaceae were also described in posters from the UK (12 of 556 [2·2%] isolates, of which 483 were community associated; C2-102), Guinea-Bissau (133 [32·6%] ESBL carrier children among 408 visiting an emergency ward; C2-107), Romania (12 of 30 [23%] E coli isolates; C2-110), and Spain (4% of 208 E coli isolates; C2-111).
www.thelancet.com/infection Vol 12 November 2012
Patrick Smith/Visuals Unlimited, Inc/Science Photo Library
This year’s Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC; Sept 9–12) returned to one of its regular homes in San Francisco, CA, USA. Reflecting its origin as the clinical meeting of the American Society for Microbiology, ICAAC’s focus is on infectious diseases in industrialised countries. Nevertheless, ICAAC covered a broad and eclectic range of infectious diseases subjects, although the lack of a late-breaker session on the hot topic of the Yosemite hantavirus cases was disappointing. Some highlights of the meeting are reported below.
Golden Gate Bridge, San Francisco, CA
Norovirus vaccine A randomised, double-blind, placebocontrolled trial of a bivalent, intramuscular norovirus virus-like particle (VLP) vaccine was reported by John Treanor (University of Rochester, Rochester, NY, USA; session G-1048) and colleagues. 73 participants aged 18–85 years were randomly assigned to receive two doses, 4 weeks apart, of vaccine or saline. Study endpoints were antibody geometric mean titres (GMTs) to the GI.1 and GII.4 VLPs. No participants reported vaccinerelated serious adverse events. After vaccination, GMTs against GI.1 VLP increased 118-fold in participants aged 18–49 years, 83-fold in those aged 50–64, and 24-fold in those aged 65–85; corresponding GMTs against GII.4 VLP increased 49-fold, 25-fold, and nine-fold, respectively. The second dose of vaccine did not boost antibody titres. By day 393, antibody titre in those aged 18–49 years continued to be raised 19-fold to GI.1 and 3.4-fold to GII.4 compared with baseline. Whether phase 2 trials of the vaccine will take place is unclear. The company developing the vaccine, LigoCyte Pharmaceuticals, has announced that it was being acquired by Takeda Pharmaceuticals.
For more on the 52nd ICAAC see http://www.icaac.org/
John McConnell 833
Highlights from the 52nd ICAAC
Influenza A H3N2 from pigs Lyn Finelli (Centers for Disease Control and Prevention, Atlanta, GA, USA; session 1733) described the US epidemic of influenza A H3N2 with apparent animal origin. In 2011, 12 cases of human infection with an H3N2 variant with the M gene from the 2009 pandemic influenza A H1N1 virus were reported. The virus has been circulating in pigs in the USA since 2010. Finelli said 302 human cases have been reported from ten states since July, 2012 (at time of going to press the number of cases had risen to 306). Infection causes a mild illness with symptoms similar to those of seasonal influenza, although 16 patients have been admitted to hospital and there has been one death. Children are most likely to be infected, with the mean age of patients being 8 years. Only limited person-to-person transmission has been reported. Prolonged exposure to pigs, usually in the setting of agricultural fairs, is the main risk factor for infection. Finelli stated that the infected pigs are usually raised at home by children, who show them at local fairs. Infection has not been associated with the commercial pig industry. Finelli expects the epidemic to decline as the fair season comes to an end.
Community-associated ESBL producers Several posters reported community-associated Enterobacteriaceae producing extendedspectrum β-lactamase (ESBL) enzymes, a resistance type typically identified in health-care settings. Among fecal samples collected during a community survey from 1713 healthy adults (mean age 52 years, 60·5% women) living in the Amsterdam area, Elien Reuland (VU University Medical Center, Amsterdam, Netherlands; poster C2-104) and colleagues found ESBL-producing Enterobacteriaceae in 145 (8·5%) samples, of which 91% were Escherichia coli. Genes encoding CTX-M-1 were found in 21 isolates and those encoding CTX-M-15 in 54. CTX-M-1 is an enzyme associated with E coli in poultry in the Netherlands, and CTX-M-15 is common in human gut E coli in countries with high levels of ESBL resistance in clinical isolates. Reuland and colleagues note that in the Netherlands, “the prudent use of antimicrobials in humans contrast[s] with a very high use in food-producing animals”. Yohei Doi (University of Pittsburgh Medical Center, Pittsburgh, PA, USA; poster C2-112) and colleagues found that among 291 patients infected or colonised with ESBL-producing E coli from five hospitals across the USA over 1 year, 107 (36·8%) cases met the definition of being community associated. Community-associated ESBL-producing Enterobacteriaceae were also described in posters from the UK (12 of 556 [2·2%] isolates, of which 483 were community associated; C2-102), Guinea-Bissau (133 [32·6%] ESBL carrier children among 408 visiting an emergency ward; C2-107), Romania (12 of 30 [23%] E coli isolates; C2-110), and Spain (4% of 208 E coli isolates; C2-111).
www.thelancet.com/infection Vol 12 November 2012
Patrick Smith/Visuals Unlimited, Inc/Science Photo Library
This year’s Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC; Sept 9–12) returned to one of its regular homes in San Francisco, CA, USA. Reflecting its origin as the clinical meeting of the American Society for Microbiology, ICAAC’s focus is on infectious diseases in industrialised countries. Nevertheless, ICAAC covered a broad and eclectic range of infectious diseases subjects, although the lack of a late-breaker session on the hot topic of the Yosemite hantavirus cases was disappointing. Some highlights of the meeting are reported below.
Golden Gate Bridge, San Francisco, CA
Norovirus vaccine A randomised, double-blind, placebocontrolled trial of a bivalent, intramuscular norovirus virus-like particle (VLP) vaccine was reported by John Treanor (University of Rochester, Rochester, NY, USA; session G-1048) and colleagues. 73 participants aged 18–85 years were randomly assigned to receive two doses, 4 weeks apart, of vaccine or saline. Study endpoints were antibody geometric mean titres (GMTs) to the GI.1 and GII.4 VLPs. No participants reported vaccinerelated serious adverse events. After vaccination, GMTs against GI.1 VLP increased 118-fold in participants aged 18–49 years, 83-fold in those aged 50–64, and 24-fold in those aged 65–85; corresponding GMTs against GII.4 VLP increased 49-fold, 25-fold, and nine-fold, respectively. The second dose of vaccine did not boost antibody titres. By day 393, antibody titre in those aged 18–49 years continued to be raised 19-fold to GI.1 and 3.4-fold to GII.4 compared with baseline. Whether phase 2 trials of the vaccine will take place is unclear. The company developing the vaccine, LigoCyte Pharmaceuticals, has announced that it was being acquired by Takeda Pharmaceuticals.
For more on the 52nd ICAAC see http://www.icaac.org/
John McConnell 833