Highlighting the breakthroughs in the realm of infection prevention, the focus of this article lies on recent studies involving Mandimycin for hardy fungal infections, varying hospital Antimicrobial Resistance (AMR) trends, a six-month HIV treatment, global dilemmas around hepatitis testing, and the beginning of a Lassa fever vaccine trial.
Discovered by Dr. Zhuo Shang, Ph.D., Mandimycin, an innovative polyene antifungal antibiotic provides a glimmer of hope to combat the burgeoning issue of multidrug-resistant fungal pathogens, including Candida auris. Straying from the conventional mode of action of antifungals, which target ergosterol in fungal membranes, Mandimycin distinctively disrupts the membrane by binding to phospholipids, instigating ion leakage, and eventually, cell death. This inventive mechanism diminishes the chance of resistance development, which remains a significant hurdle for prevalent treatments.
Early studies indicate that Mandimycin effectively battles resistant pathogens, including Candida auris, while maintaining a reduced renal toxicity profile compared to existing counterparts. Yet it requires further probing to evaluate its safety and clinical potential, with a considerable focus on off-target toxicity due to its interaction with phospholipids across all cell membranes. An extensive 10-year CDC study divulged that hospital-onset Antimicrobial Resistance (AMR) generally dipped from 2012 to 2019, only to witness a surge during the 2020-2021 COVID-19 pandemic spell.
Resistance rates for pathogens like MRSA, VRE, CRE, CRAsp, and MDR P. aeruginosa either remained stable or diminished through the decade. However, infections attributed to extended-spectrum cephalosporin-resistant E. coli and Klebsiella spp. showed an upward trend, precisely in sterile and nonsterile body sites. The pandemic resulted in heightened hospital-onset resistant cases due to factors such as escalated patient severity, prolonged stays, and relaxed infection control practices.
The study underscored noticeable regional, species, and demographic disparities, with older adults and males demonstrating higher infection instances. The study underscores the necessity for flexible, continually-evolving infection prevention initiatives, especially during periods of substantial healthcare system pressure.
The recent CROI 2025 conference showcased findings from a Phase II study assessing the effectiveness and safety of a long-acting regimen (LTZ), consisting of lenacapavir (LEN), teropavimab (TAB), and zinlirvimab (ZAB), administered every six months (Q6M). This was compared against daily oral antiretroviral therapy (SBR) in treating virologically suppressed individuals with HIV-1. After 26 weeks, both groups saw 96% of participants maintaining virologic suppression (HIV-1 RNA <50 copies/mL). The LTZ regimen, delivered through subcutaneous LEN and intravenous TAB and ZAB, depicted comparable efficacy to daily oral ART, with mild injection site reactions being the most frequently reported side effect. This study propels LTZ’s potential as a long-acting, Q6M HIV treatment, welcoming a convenient and simplified treatment regime for patients struggling with daily regimens. It necessitates further research to determine the durability of virologic suppression and the long-term safety of this regimen.
A global survey across Africa, Asia, and Latin America accentuated widespread misconceptions and fear about hepatitis B (HBV) and C (HCV), discouraging individuals from pursuing testing and treatment. The survey also unveiled geographical disparities, with a higher reluctance to seek testing in countries like Morocco and South Africa. Despite the presence of preventable and treatable therapies, the underdiagnosis of hepatitis persists as a grave issue, predominantly in low- and middle-income countries, where only a small percentage get diagnosed or receive antiviral treatment.
The World Health Organization states that chronic hepatitis B and C result in 1.3 million deaths per year. The report highlights the imperative need for ramping up education, broadening testing access, and implementing workplace policies that champion preventive care.
The University of Maryland School of Medicine recently started enrollment for a clinical study to test LASSARAB’s safety and immune response, an experimental vaccine against Lassa fever. The study aims to conclude if the vaccine can protect against both rabies and Lassa fever, using 55 healthy adults aged 18-50 as subjects. Earlier trials in nonhuman primates demonstrated full protection post two doses.
Source: https://www.contagionlive.com/view/top-5-infectious-disease-new-stories-week-of-march-15-march-22