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Background

Mycoplasma pneumoniae respiratory infections are transmitted by aerosol and droplets in close contact.

Aim

We investigated global M. pneumoniae incidence after implementation of non-pharmaceutical interventions (NPIs) against COVID-19 in March 2020.

Methods

We surveyed M. pneumoniae detections from laboratories and surveillance systems (national or regional) across the world from 1 April 2020 to 31 March 2021 and compared them with cases from corresponding months between 2017 and 2020. Macrolide-resistant M. pneumoniae (MRMp) data were collected from 1 April 2017 to 31 March 2021.

Results

Thirty-seven sites from 21 countries in Europe, Asia, America and Oceania submitted valid datasets (631,104 tests). Among the 30,617 M. pneumoniae detections, 62.39% were based on direct test methods (predominantly PCR), 34.24% on a combination of PCR and serology (no distinction between methods) and 3.37% on serology alone (only IgM considered). In all countries, M. pneumoniae incidence by direct test methods declined significantly after implementation of NPIs with a mean of 1.69% (SD ± 3.30) compared with 8.61% (SD ± 10.62) in previous years (p < 0.01). Detection rates decreased with direct but not with indirect test methods (serology) (–93.51% vs + 18.08%; p < 0.01). Direct detections remained low worldwide throughout April 2020 to March 2021 despite widely differing lockdown or school closure periods. Seven sites (Europe, Asia and America) reported MRMp detections in one of 22 investigated cases in April 2020 to March 2021 and 176 of 762 (23.10%) in previous years (p = 0.04).

Conclusions

This comprehensive collection of M. pneumoniae detections worldwide shows correlation between COVID-19 NPIs and significantly reduced detection numbers.…

Pneumonia -- United States…

Background

Respiratory syncytial virus (RSV) is the predominant cause of clinical pneumonia among infants and young children, often peaking during the winter months in temperate regions.

Aim

To describe RSV seasonality in 13 European countries and examine its association with meteorological factors.

Methods

We included weekly RSV seasonality data from 13 European countries between week 40 2010 and week 39 2019. Using local weighted regression method, we modelled weekly RSV activity with meteorological factors using data from the 2010/11 to the 2017/18 season. We predicted the weekly RSV activity of the 2018/19 season across 41 European countries and validated our prediction using empirical data.

Results

All countries had annual wintertime RSV seasons with a longitudinal gradient in RSV onset (Pearson’s correlation coefficient, r = 0.71, 95% CI: 0.60 to 0.80). The RSV season started 3.8 weeks later (95% CI: −0.5 to 8.0) in countries in the eastern vs western parts of Europe, and the duration ranged from 8–18 weeks across seasons and countries. Lower temperature and higher relative humidity were associated with higher RSV activity, with a 14-day lag time. Through external validation, the prediction error in RSV season onset was −2.4 ± 3.2 weeks. Similar longitudinal gradients in RSV onset were predicted by our model for the 2018/19 season (r = 0.45, 95% CI: 0.16 to 0.66).

Conclusion

Meteorological factors, such as temperature and relative humidity, could be used for early warning of RSV season onset. Our findings may inform healthcare services planning and optimisation of RSV immunisation strategies in Europe.…

Use of Gram stains to select antibiotics for ventilator-associated pneumonia offers similar clinical outcomes as guideline-based broad-spectrum treatment, study reports. …

Also on the top 10 list are healthcare workers' mental health, vaccine errors, non-ventilator-associated pneumonia, emergency use authorization, and telemetry monitoring. …

Treatment of uncomplicated pediatric community-acquired pneumonia with a short, 5-day course of antibiotics results in a superior clinical response compared to the standard 10-day course. …

Background

Intensive care units (ICU) constitute a high-risk setting for antimicrobial resistance (AMR).

Aim

We aimed to describe secular AMR trends including meticillin-resistant Staphylococcus aureus (MRSA), glycopeptide-resistant enterococci (GRE), extended-spectrum cephalosporin-resistant Escherichia coli (ESCR-EC) and Klebsiella pneumoniae (ESCR-KP), carbapenem-resistant Enterobacterales (CRE) and Pseudomonas aeruginosa (CRPA) from Swiss ICU. We assessed time trends of antibiotic consumption and identified factors associated with CRE and CRPA.

Methods

We analysed patient isolate and antibiotic consumption data of Swiss ICU sent to the Swiss Centre for Antibiotic Resistance (2009–2018). Time trends were assessed using linear logistic regression; a mixed-effects logistic regression was used to identify factors associated with CRE and CRPA.

Results

Among 52 ICU, MRSA decreased from 14% to 6% (p = 0.005; n = 6,465); GRE increased from 1% to 3% (p = 0.011; n = 4,776). ESCR-EC and ESCR-KP increased from 7% to 15% (p < 0.001, n = 10,648) and 5% to 11% (p = 0.002; n = 4,052), respectively. CRE, mostly Enterobacter spp., increased from 1% to 5% (p = 0.008; n = 17,987); CRPA remained stable at 27% (p = 0.759; n = 4,185). Antibiotic consumption in 58 ICU increased from 2009 to 2013 (82.5 to 97.4 defined daily doses (DDD)/100 bed-days) and declined until 2018 (78.3 DDD/100 bed-days). Total institutional antibiotic consumption was associated with detection of CRE in multivariable analysis (odds ratio per DDD: 1.01; 95% confidence interval: 1.0–1.02; p = 0.004).

Discussion

In Swiss ICU, antibiotic-resistant Enterobacterales have been steadily increasing over the last decade. The emergence of CRE, associated with institutional antibiotic consumption, is of particular concern and calls for reinforced surveillance and antibiotic stewardship in this setting.

For mild to moderate pediatric community-acquired pneumonia (CAP), treatment can be reduced to 3 days with low-dose twice-a-day amoxicillin. …

Researchers found that a "breath print" identified patients with COVID-19 pneumonia with 88% accuracy upon admission to an ICU. Other researchers are developing breath tests as well. …

This report describes two instances of fatal anthrax pneumonia in welders.

The vaccine, which received FDA approval in July, protects against 15 strains of Streptococcus pneumoniae. …

Background

Vibrio spp. are aquatic bacteria that prefer warm seawater with moderate salinity. In humans, they can cause gastroenteritis, wound infections, and ear infections. During the summers of 2018 and 2019, unprecedented high sea surface temperatures were recorded in the German Baltic Sea.

Aim

We aimed to describe the clinical course and microbiological characteristics of Vibrio infections in Germany in 2018 and 2019.

Methods

We performed an observational retrospective multi-centre cohort study of patients diagnosed with domestically-acquired Vibrio infections in Germany in 2018 and 2019. Demographic, clinical, and microbiological data were assessed, and isolates were subjected to whole genome sequencing and antimicrobial susceptibility testing.

Results

Of the 63 patients with Vibrio infections, most contracted the virus between June and September, primarily in the Baltic Sea: 44 (70%) were male and the median age was 65 years (range: 2–93 years). Thirty-eight patients presented with wound infections, 16 with ear infections, six with gastroenteritis, two with pneumonia (after seawater aspiration) and one with primary septicaemia. The majority of infections were attributed to V. cholerae (non–O1/non-O139) (n = 30; 48%) or V. vulnificus (n = 22; 38%). Phylogenetic analyses of 12 available isolates showed clusters of three identical strains of V. vulnificus, which caused wound infections, suggesting that some clonal lines can spread across the Baltic Sea.

Conclusions

During the summers of 2018 and 2019, severe heatwaves facilitated increased numbers of Vibrio infections in Germany. Since climate change is likely to favour the proliferation of these bacteria, a further increase in Vibrio-associated diseases is expected.

Equine Herpes Virus -- United StatesHerpesvirus is highly contagious among horses and can cause a variety of ailments in equids, including rhinopneumonitis (a respiratory disease usually found in young horses), abortion in broodmares, and equine herpesvirus myeloencephalitis (EHM, the neurologic form).

In many horses, the 1st or only sign of EHV-1 infection is fever, which can go undetected. In addition to fever, other common signs of EHV-1 infection in young horses include cough, decreased appetite, depression, and a nasal…

Plague -- United StatesThe Wyoming Department of Health (WDH) announced today, [Wed 15 Sep 2021], the detection of a rare but serious case of pneumonic plague in a northern Fremont County resident. Plague is a bacterial infection that can be deadly to humans and other mammals, including pets, if not treated promptly with antibacterials. This disease can be transmitted to humans from sick animals or by fleas coming from infected animals; in this case, the person had contact with sick pet cats.

Plague can also be…

Plague -- MadagascarAccording to the European Centre for Disease Prevention and Control (ECDC) report issued on 10 Sep 2021, 30 cases of pneumonic plague have been reported in the Republic of Madagascar. Pneumonic plague, one of several forms of plague, is endemic in Madagascar. The WHO previously confirmed that 7 cases have been fatal, all of them in the municipality of Miandrandra. Madagascar's last major plague outbreak was in 2017, which resulted in 209 deaths; these were classified as pneumonic…