January 2019
Emerging Infectious Diseases Journal
Highlights: Emerging Infectious Diseases, Vol. 25, No. 1, January 2019
Important Note: Not all articles that EID publishes represent work done at CDC or by CDC staff. In your stories, please clarify whether a study was conducted by CDC (“a CDC study”) or by another institution (“a study published by CDC in the EID journal”). Opinions expressed by authors contributing to EID do not necessarily reflect the opinions of CDC or the institutions with which the authors are affiliated. EID requests that, when possible, you include a live link to the actual journal article in your stories. Once the embargo lifts, this month’s articles will be found in the Ahead of Print section of the EID website at https://wwwnc.cdc.gov/eid/ahead-of-print.
The articles of interest summarized below will appear in the January 2019 issue of Emerging Infectious Diseases, CDC’s monthly peer-reviewed public health journal. This issue will feature Emerging Viruses. December 12, 2018, at 12 p.m. EDT.
1. Identification of Lonepinella sp. in Koala Bite Wound Infections, Holly Angela Sinclair et al.
Lonepinella koalarum is a species of bacteria known to inhabit the gums of koalas. It is the only species of the genus Lonepinella, a member of the family Pasteurellaceae. Researchers in Australia analyzed what initially appeared to be 3 recent cases of L. koalarum infection in humans who had sustained bites from koalas. All 3 patients had pus-filled skin and soft tissue lesions, requiring wound cleaning and debridement (surgical removal of infected tissue). In each case, the infecting bacteria were susceptible to the antimicrobial drugs commonly prescribed for such infections (amoxicillin and clavulanic acid, third-generation cephalosporins, and ciprofloxacin). However, 2 isolates were nonsusceptible to benzylpenicillin, underscoring the need for clinicians to isolate bacteria and determine antimicrobial susceptibilities when managing these infections. Also, because the observed characteristics of bacteria within the Pasteurellaceae family are often unreliable at assigning isolates to a genus and species, and because identification with commercial kits is not always possible, the researchers note that genetic sequence analysis might be required. By using a combination of genetic analyses, they identified what might be novel Lonepinella-like organisms causing some of the infections.
Contact: Holly Sinclair, Pathology Queensland, Department of Microbiology, Royal Brisbane and Women’s Hospital Complex, Herston, QLD, Australia, 4029; email: holly.sinclair@health.qld.gov.au. Phone: +61421508950
2. Prescription of Antibacterial Drugs for HIV-Exposed, Uninfected Infants, Malawi, 2004–2010, Alexander C. Ewing et al.
Resistance to antibacterial drugs has resulted in longer illnesses, more deaths, and increased treatment costs around the world. Because infants are more susceptible than adults to infectious diseases, antibacterial drug administration to infants is correspondingly higher. In sub-Saharan Africa, a growing population at high risk for infectious diseases is HIV-exposed, uninfected infants. Researchers studied the magnitude and factors associated with antibacterial use among HIV-exposed, uninfected infants enrolled in a large randomized controlled trial conducted in Malawi during 2004–2010 that assessed maternal and infant antiretroviral therapy (ART) for preventing mother-to-child transmission of HIV during breastfeeding. Antibacterial drugs were prescribed to 80% of HIV-exposed, uninfected infants, and most (67%) of these prescriptions were for respiratory infections. Most commonly prescribed were penicillins (43%) and sulfonamides (23%). Male infants and infants whose mothers had higher HIV viral loads had greater hazards of receiving antibacterial drugs. By contrast, factors associated with lower hazards of receiving a prescription for antibacterial drugs were receipt of cotrimoxazole preventive therapy, receipt of maternal or infant ART, and older infant age. With the expansion of lifelong ART coverage in Malawi and other areas of high HIV prevalence and the increasing availability of effective vaccines, HIV-exposed, uninfected infants in Malawi might experience fewer infectious diseases and a resulting decrease in prescription of antibacterial drugs.
Contact: CDC Media Relations, 404-639-3286 or media@cdc.gov.
3. Zoonotic Source Attribution of Salmonella enterica Serotype Typhimurium Using Genomic Surveillance Data, United States, Shaokang Zhang et al.
Each year, »9.4 million episodes of foodborne illness occur in the United States. According to CDC, »95% of those infections are sporadic, nonoutbreak cases for which specific food exposures and contamination sources remain difficult to determine. Salmonella enterica is one of the most common foodborne pathogens worldwide, causing >1 million human cases and an economic burden of $3.7 billion annually in the United States alone, and S. enterica serotype Typhimurium is one of the most common causes of human salmonellosis in many countries, including the United States. Increasingly, routine surveillance and monitoring of foodborne pathogens using whole-genome sequencing (WGS) is creating opportunities to study foodborne illness epidemiology beyond routine outbreak investigations and case–control studies. To this end, a group of researchers developed a machine-learning program that examined WGS data from a large collection of Salmonella Typhimurium isolates from 3 major US laboratory surveillance and monitoring programs. Those researchers successfully screened for 50 key genetic indicators throughout Salmonella Typhimurium genomes to help determine what kind of livestock animal was the source of a particular outbreak strain of Salmonella Typhimurium. By using these data, they were able to identify retrospectively the livestock animal source in 7 of 8 major zoonotic Salmonella Typhimurium outbreaks that occurred in the United States during 1998–2013. Their approach demonstrates a potential new tool to help identify root sources of foodborne Salmonella Typhimurium outbreaks that are frequently linked to chicken, pork, and beef.
Contact: Xiangyu Deng, University of Georgia, Center for Food Safety; email: xdeng@uga.edu.
