Communicable

The last episode of the year carries a special end-of-year message from the CMI Comms editors and replays the very first episode of Communicable aired on 10 May 2024, in which editors Angela Huttner, Marc Bonten, and Erin McCreary discuss late-breaker clinical trials presented at ESCMID Global 2024 in Barcelona, providing insights into the trials’ designs, results, and implications. The DOTS trial compared two doses of long-acting dalbavancin to standard of care in patients with complicated S. aureus bacteraemia. GAME-CHANGER compared cefiderocol to standard of care for Gram-negative infections. PediCAP compared oral step-down therapy with amoxicillin with or without clavulanic acid at shorter durations to the current WHO-recommended standard of five days of intravenous antibiotic therapy in children with severe pneumonia. Additional results from the MULTICAP and CLEEN trials, the CAMERA-2 follow-on in vitro analysis, and the Burkina Faso Escherichia coli transmission study are also discussed. This episode was peer-reviewed by Dr. Yousra Kherabi (Clinical Trials Research Section, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA; Infectious and Tropical Diseases Department, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris; and Université Paris Cité, Inserm, IAME, Paris, France).

The topic of climate change can engender a ‘doom and gloom’ narrative, as many climate and health consequences are already manifesting. Our host, Dr. Navaneeth Narayanan is joined by two ID physicians passionate about climate change and sustainable clinical practice, Dr. Shreya Doshi (Washington DC, US) and Dr. Laura Jung (Leipzig, Germany). Together they discuss new trends in infectious diseases observed in clinical practice as a direct consequence of climate change, including how tropical diseases are not so tropical anymore. They also outline ways individual clinicians and hospitals can be more sustainable and offer additional resources for the listeners (see below).  This episode was edited by Kathryn Hostettler and peer reviewed by Dr. Loora Grünvald of the University of Tartu, Estonia.  LiteratureMora C et al. Nat Clim Chang (2022). doi: 10.1038/s41558-022-01426-1Doshi S et al. J Pediatric Infect Dis Soc (2023). doi: 10.1093/jpids/piae029Hofmeister RJ et al. OFID (2024). doi: 10.1093/ofid/ofae368 Judson SD et al. OFID (2024). doi: 10.1093/ofid/ofae691Jung L et al. Lancet Planet Health (2023). 10.1016/S2542-5196(22)00253-4UN General Assembly High-Level Meeting on antimicrobial resistance 2024 https://www.who.int/news-room/events/detail/2024/09/26/default-calendar/un-general-assembly-high-level-meeting-on-antimicrobial-resistance-2024  Additional resourcesLancet countdown on health and climate change  https://www.thelancet.com/countdown-health-climateMedicine for a changing planet https://www.medicineforachangingplanet.org/Rx for climate https://www.rxforclimate.org/

Wastewater surveillance is a powerful epidemiological tool that “mirrors our life,” and has gained wide attention in recent years due to its application during the COVID-19 pandemic. The hosts this week, Drs. Navaneeth Narayanan and Emily McDonald, are joined by two wastewater surveillance experts, Dr. Nasreen Hassoun-Kheir of Geneva University Hospitals, a WHO Collaborating Centre on antimicrobial resistance (AMR), as well as Professor David Graham of Newcastle University, United Kingdom, to discuss how this surveillance method—as well as a multidisciplinary approach—are central to understanding community health, infection control and pandemic preparedness. This episode was edited by Kathryn Hostettler and peer reviewed by Dr. James Donnelly of the Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.LiteratureUN Environment Programme (UNEP), Bracing for superbugs (2023) https://www.unep.org/resources/superbugs/environmental-action  Hassoun-Kheir N, et al. EMBRACE-WATERS statement (2021). doi:10.1016/j.onehlt.2021.100339 Hassoun-Kheir N, et al. Systematic review (2020). doi: 10.1016/j.scitotenv.2020.140804 Trask JD, et al. (1942). https://pmc.ncbi.nlm.nih.gov/articles/PMC2135222/Chapters (00:00) - Introduction (03:03) - Icebreaker question (08:33) - What is wastewater surveillance (WWS)? (12:47) - How does WWS relate to infection surveillance? (16:57) - WWS & pandemic preparedness (21:09) - Is the data accessible to the public? (25:10) - WWS uses in healthcare settings & mass health: what it can and cannot answer (43:00) - What's next for WWS: experts' picks (48:33) - Take-home messages

Substandard and falsified (SF) antimicrobials are a neglected global health problem and have been implicated as drivers of antimicrobial resistance (AMR). Substandard medicines are authorized medical products that fail to meet either their quality standards or their specifications, whereas falsified medicines are those that deliberately and fraudulently misrepresent their identity, composition or source. Host Angela Huttner is joined by Pernette Bourdillon Esteve, Technical Officer for the World Health Organization’s Substandard/falsified Medical Products group, and Ben Cooper, epidemiologist at Oxford University and head of its Drug-Resistant Infection and Disease Dynamics (DRIaDD), to explore the effects of SF antimicrobials on people and AMR.This episode was edited by Kathryn Hostettler and peer-reviewed by Dr. Arjana Zerja of Mother Teresa University Hospital in Tirana, Albania. Literature Cavany S et al.  Nat Commun 14, 6153 (2023). doi: 10.1038/s41467-023-41542-w WHO Global Surveillance and Monitoring System for substandard and falsified medical products (2017). https://www.who.int/publications/i/item/9789241513425