Anti infective

Joint Interscience Conference of Antimicrobial Agents and Chemotherapy (ICAAC) and International Congress of Chemotherapy and Infection (ICC) meeting, September 2015: congress highlights

A focus on the diagnosis, prevention and treatment of infectious diseases: symposium highlights from the 2015 joint Interscience Conference of Antimicrobial Agents and Chemotherapy (ICAAC) and International Congress of Chemotherapy and Infection (ICC) meeting. 1

The American Society for Microbiology and the International Society of Chemotherapy joined forces to host this joint meeting from 17–21 September 2015 in San Diego, California, with the aim of providing the principal meeting in 2015 for clinical microbiologists, infectious disease physicians, researchers and pharmacists to improve the control of infections worldwide. 1
 

The effectiveness of pneumococcal vaccines

In this symposium, supported jointly by the American Society for Microbiology and the Bill & Melinda Gates Foundation, leading experts discussed a wide range of issues relating to pneumococcal disease – a major cause of morbidity and mortality globally that is preventable by vaccination. 2

Richard Adegbola discussed the impact of introducing pneumococcal conjugate vaccine (PCV) in industrialised countries on nasopharyngeal carriage, leading to indirect (herd) protection. 3 PCVs are now being introduced in more and more low- and lower–middle-income countries (LLMICs), which have a higher overall nasopharyngeal Streptococcus pneumoniae carriage rate than industrialised countries. 3The impact of PCV vaccination programmes on carriage of respiratory bacteria in LLMICs is yet to be investigated. 3

Anne von Gottberg presented recent surveillance data on the effect of vaccination using PCV-7, and subsequently PCV-13, on invasive pneumococcal infection in South Africa. 4The researchers found a large reduction in vaccine-serotype disease, not only among children but also among adults, suggesting that the introduction of PCV had an indirect benefit as well as a substantial direct benefit. 4

Diagnosing infectious diseases

This symposium reviewed the panel tests that are available for infectious diseases and are now being used in some laboratories clinically. 5However, further information is required on the scope of testing for enteric, bacterial respiratory and other infectious diseases, and the potential impact that panel tests may have on clinical care. 5

As an example, Marc Couturier discussed gastrointestinal pathogen panels, highlighting that few studies have assessed the potential advantages of these new methods over more traditional pathogen-detection methods. 6Evolving issues of gastrointestinal pathogen panel tests include defining which patients require the assays, the impact on the investigation of outbreaks and the cost of conducting these tests in large patient populations. 6

Antimicrobial stewardship

An increase in interest and initiatives in antimicrobial stewardship has been observed in low- to middle-income countries, presumably due to the growing recognition of the need to contain microbial resistance, in particular in low-resource settings where the availability of second- and third-line antimicrobials may be scarce. 7

In this symposium dedicated to antimicrobial stewardship in low- to middle-income countries, Hosam Zowawi discussed how social media platforms could potentially be used as mass education platforms, raising awareness of appropriate antibiotic use not only in the general public but also in medical communities. 8The access to reliable networking infrastructure and communication in low- to middle-income countries is increasing, and social media campaigns could be less costly than public media campaigns. 8

Antimicrobial resistance

Antimicrobial resistance is a worldwide, multifactorial public health problem with no simple solutions.9 Surveillance often does not result in infection control and global networking is required to gather comprehensive data. 9Potential solutions for tackling antimicrobial resistance are complex, and include surveillance, increased knowledge of the non-human setting as a reservoir for resistance genes, improving the use of rapid diagnostic tests and infection control outside of hospital settings. 9

Lorena López-Cerero highlighted the key issues in the surveillance and control of antimicrobial resistance in non-human settings.10 She warned of the increasing prevalence of multidrug-resistant gram-negative bacteria that can cause infections in humans in some countries. 10 Control strategies include the regulation of antimicrobial waste dumping and improvements in the use of antimicrobials in farms and agriculture. 10

Additionally, Neil Woodford’s presentation focussed on rapid diagnostic tests. 11Rapid diagnostics may enable early switching from empirical therapy to targeted therapy, or even eliminate the need for empirical therapy. 11New generations of rapid diagnostic tests that can inform prescribers not only of evidence for bacterial infection and the potential resistance of a pathogen, but also if a pathogen is susceptible to a particular drug, would help overcome antimicrobial resistance and facilitate improved antibiotic stewardship. 11

Reference list

1. ICAAC/ICC 2015. [Online]. Accessed 25 September 2015.
   
2. Pneumococcal conjugate vaccine effectiveness in developed and developing countries. [Session] ICAAC/ICC 2015.
   
3. Adegbola RA. Pneumococcal carriage in low & lower-middle income countries. ICAAC/ICC 2015.
   
4. von Gottberg A. Impact of PCV on invasive pneumococcal disease in South Africa. ICAAC/ICC 2015.
   
5. Panel tests for infectious diseases diagnosis: how much is enough? [Session] ICAAC/ICC 2015.
   
6. Couturier MR. Gastrointestinal pathogen panels. ICAAC/ICC 2015.
   
7. Key issues in antimicrobial stewardship in low-to-middle income countries. [Session] ICAAC/ICC 2015.
   
8. Zowawi HM. Antimicrobial stewardship in the outpatient setting: educating the patients and the role of the media. ICAAC/ICC 2015.
   
9. Antimicrobial resistance: from surveillance to action. [Session] ICAAC/ICC 2015.
   
10. López-Cerero L. Surveillance and control of resistance in non-human settings: priorities and challenges. ICAAC/ICC 2015.
    
11. Woodford N. Rapid diagnostic tests for the control of resistant microorganisms: from development to application. ICAAC/ICC 2015.