Top Infectious Disease News of the Week—October 27, 2019

#5: Complicated UTIs—A Common and Costly Problem: Public Health Watch

Complicated urinary tract infections (cUTIs) are an expensive proposition—which is particularly frightening given how common they are.

Research suggests cUTIs affect more than 100 million people globally per year. In the United States, some 70%—80% have been linked with the use of indwelling catheters, accounting for 1 million cases annually alone.

Now, thanks to a new analysis published on October 21^st in Open Forum Infectious Diseases, we have a better sense of how much it costs to treat these pesky bugs, which requires hospitalization in as many as 30% of cases. And, perhaps not surprisingly, the expense equation is likely exacerbated by infections caused by antimicrobial-resistant bacteria.

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#4: Tracing ESBL E coli in the UK: Human Hygiene Contributes More to Infection Than Food Chain

Extended-spectrum β-lactamase-producing Escherichia coli (ESBL-E coli) strains demonstrate antibiotic resistance due to ESBL enzymes targeting many penicillin and cephalosporin antibiotics. This makes preventing ESBL-E coli infections from occurring in the first place a target for efforts to preserve antibiotic efficacy.

It was not previously known whether ESBL-E coli was acquired via the food chain or passed from person to person. Now, a new report in The Lancet Infectious Diseases suggests that poor post-toilet hygiene and infection prevention measures are more likely to spread ESBL-E coli than food products.

Investigators in the United Kingdom (UK), where ESBL-E coli is responsible for more than 5000 cases of bacteremias annually, used selective media to detect ESBL-E coli in routinely submitted samples of human feces between August 1, 2013, and December 15, 2014. The team also collected samples from sewage, farm slurry, and retail foodstuffs in East Anglia, London, northwest England, Scotland, and Wales. The recovered isolates were sequenced and compared with 293 bloodstream and 83 veterinary surveillance ESBL-E coli isolates from the same regions.

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#3: AI Could Present a New Paradigm in Epidemiology

When it comes to infectious diseases, prevention, surveillance, and rapid-response efforts can go a long way toward slowing or stalling outbreaks. But as artificial intelligence and machine learning become increasingly important parts of the global health care system, a new strategy is emerging in the fight against infectious diseases.

More and more scientists are developing ways to use artificial intelligence (AI) to predict the spread of infectious diseases before they happen. Though the process is extremely complicated, successful implementation of predictive modeling could represent a major leap forward in the fight to rid the world of some of the most insidious infectious diseases.

And while there’s still a long way to go, public health officials and epidemiologists are already beginning to see some of the benefits.

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#2: Gepotidacin Phase 3 Clinical Program Launches

GlaxoSmithKline (GSK) has launched a phase 3 clinical program for gepotidacin, a potential first-in-class antibiotic.

The candidate belongs to a new chemical class called triazaacenaphthylene bacterial topoisomerase inhibitors and will be investigated for treating uncomplicated urinary tract infections (UTIs) and urogenital gonorrhea. In the past 20 years, neither of the 2 infections have been addressed by new oral antibiotics.

According to a statement issued by GSK, gepotidacin works by interacting with 2 key bacterial enzymes that are responsible for bacterial replication—DNA gyrase and topoisomerase IV (type 2 topoisomerases). The dual targeting mechanism of action, which is reported to be distinct from all currently approved antibiotics, confers activity against pathogens that are resistant to currently available antibiotics, including fluoroquinolones.

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#1: NIH and Bill & Melinda Gates Foundation to Collaborate on Gene-Based HIV Cure

Advances in genetics research have led to the development of effective gene-based treatments for conditions including blindness and certain types of leukemia. Now, the National Institutes of Health (NIH) and the Bill & Melinda Gates Foundation have announced that $200 million will be invested over the next 4 years towards developing gene-based cures for both HIV and sickle cell disease.

Each organization will invest $100 million with the intention of making effective and affordable cures globally available, including in low-resource settings.

“This collaboration is an ambitious step forward, harnessing the most cutting-edge scientific tools and NIH’s sizable global HIV research infrastructure to one day deliver a cure and end the global HIV pandemic,” said Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, part of the NIH, in a press release. “We are taking into account those with the greatest need at the foundation of this effort, to ensure that, if realized, this exceptional public health achievement will be made accessible to all.”

The collaboration will focus on 2 primary areas of coordination. The first area is to identify potential candidate cures for both diseases for pre-clinical and clinical evaluation, which will be co-funded by the 2 groups. The second area of collaboration is to define long-term opportunities to work with African partners in advancing viable options to late-phase clinical trials, for which funding will be determined based on progress.

According to the NIH, the projects will require “new delivery systems that can get prospective therapies to the right places in the body and optimize treatments to target the cells involved in the respective diseases efficiently and specifically.”

Particularly for HIV, this will require a system that targets the reservoir of proviral DNA that continues to exist in a small number of cells, even in patients with a history of effective antiviral therapy. One potential approach is to locate the reservoir of infected cells that harbor integrated HIV genomes after treatment and target DNA sequences with gene-editing technology.

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