An Interactive Tool to See Antibacterial Resistance Over Time

Do you need to know the percentage of Salmonella Typhi resistant to nalidixic acid in California in 2001? A resource now exists that can give you that answer.

The Centers for Disease Control (CDC) has released a tool called National Antimicrobial Resistance Monitoring System (NARMS) Now: Human Data, and it allows users to access antimicrobial resistance data based on year and geographical region. The interactive site tracks resistance for four bacteria that cause foodborne illness: Salmonella, Shigella, Campylobacter, and E. coli O157.

CDC Press Release–Passenger Notification

CDC and Frontier Airlines Announce Passenger Notification Underway

On the morning of Oct. 14, the second healthcare worker reported to the hospital with a low-grade fever and was isolated. The Centers for Disease Control and Prevention confirms that the second healthcare worker who tested positive last night for Ebola traveled by air Oct. 13, the day before she reported symptoms.

Because of the proximity in time between the evening flight and first report of illness the following morning, CDC is reaching out to passengers who flew on Frontier Airlines flight 1143 Cleveland to Dallas/Fort Worth Oct. 13.

CDC is asking all 132 passengers on Frontier Airlines flight 1143 Cleveland to Dallas/Fort Worth on October 13 (the flight route was Cleveland to Dallas Fort Worth and landed at 8:16 p.m. CT) to call 1 800-CDC INFO (1 800 232-4636). After 1 p.m. ET, public health professionals will begin interviewing passengers about the flight, answering their questions, and arranging follow up. Individuals who are determined to be at any potential risk will be actively monitored.

The healthcare worker exhibited no signs or symptoms of illness while on flight 1143, according to the crew. Frontier is working closely with CDC to identify and notify passengers who may have traveled on flight 1143 on Oct. 13.  Passengers who may have traveled on flight 1143 should contact CDC at 1 800-CDC INFO (1 800 232-4636).

 

Frontier Airlines Statement

 “At approximately 1:00 a.m. MT on October 15, Frontier was notified by the CDC that a customer traveling on Frontier Airlines flight 1143 Cleveland to Dallas/Fort Worth on Oct. 13 has since tested positive for the Ebola virus. The flight landed in Dallas/Fort Worth at 8:16 p.m. local and remained overnight at the airport having completed its flying for the day at which point the aircraft received a thorough cleaning per our normal procedures which is consistent with CDC guidelines prior to returning to service the next day. It was also cleaned again in Cleveland last night. Previously the customer had traveled from Dallas Fort Worth to Cleveland on Frontier flight 1142 on October 10.

Customer exhibited no symptoms or sign of illness while on flight 1143, according to the crew. Frontier responded immediately upon notification from the CDC by removing the aircraft from service and is working closely with CDC to identify and contact customers who may traveled on flight 1143.

Customers who may have traveled on either flight should contact CDC at 1 800 CDC-INFO.

The safety and security of our customers and employees is our primary concern. Frontier will continue to work closely with CDC and other governmental agencies to ensure proper protocols and procedures are being followed.”

Confirmed Case of Ebola Diagnosed in the United States

CNN is reporting that a patient in Dallas, Texas is the first person diagnosed with Ebola Virus in the United States.

According to the CDC, the patient traveled to the United States from Liberia on 9/19-9/20. The patient exhibited symptoms on 9/24, sought care on 9/26, and was admitted to the hospital on 9/28. Today, the CDC received and tested samples from the patient and confirmed the presence of the Ebola Virus by PCR methodologies.

The CDC and the Dallas County Health and Human Services will conduct contact interviews to determine if the patient may have had contact with anyone while infectious. If any contacts are identified, they will be quarantined and monitored for 21 days (the longest known incubation period for the virus).

CDC director Tom Frieden, MD, MPH says, “I have no doubt in my mind that we will stop it here.”

Be that as it may, it doesn’t hurt to be prepared. Lab professionals and pathologists should be familiar with the CDC’s Ebola information page.

CDC Update on the Ebola Outbreak

Yesterday Dr. Tom Frieden, Director of the Centers for Disease Control in Atlanta, briefed the media about the current Ebola outbreak in Africa and called for an immediate global response to the outbreak. “There’s nothing mysterious about what we need to do,” says Frieden. “The only real question is whether we’ll do it fast enough.”

Read the full transcript on the CDC website.

Read Maryn McKenna’s astute summary on the Superbug blog.

CDC Recommendations for Laboratory Detection of STDs

Several months ago the CDC updated their recommendations for laboratory detection of Chlamydia trachomatis and Neisseria gonorrhoeae.

A summary:

Chlamydia trachomatis

  • Swabs must have a plastic or wire shaft and a rayon, Dacron, or cytobrush tip.
  • Swabs must be inserted 2-3 cm into the male urethral or 1-3 cm into the endocervical canal followed by 2-3 rotations
  • Specimens should be sent to the laboratory 1) within 24 hours of collection, 2) in sucrose phosphate glutamate buffer or M4 media, and 3) at less than or equal to 4 degrees C

Neisseria gonorrhoeae

  • Gram stain of male urethral specimen that contains PMS and intracellular Gram-negative diplococcic is considered diagnostic
  • A negative Gram stain result does NOT rule out infection
  • Swabs must have a plastic or wire shaft and a rayon, Dacron, or cytobrush tip.
  • Swabs must be inserted 2-3 cm into the male urethral or 1-3 cm into the endocervical canal followed by 2-3 rotations
  • For specimen transport, culture transport systems are preferred over swab transport systems
  • Specimens should be plated and incubated in an increased CO2 environment as soon as possible
  • Culture media should include selective (such as Thayer-Martin or Martin-Lewis) and nonselective (such as chocolate) agar
  • Oxidase-positive, Gram-negative diplococcic that grow on selective media can be presumptively identified as N. gonorrhoeae

Nucleic acid amplification tests (NAATs) are superior when compared to other culture and nonculture diagnostic methods for both organisms. However, it’s important that lab professionals understand the limitations of these tests.

Microbiologists should take the time to read the report here.

 

Swails

Kelly Swails, MT(ASCP), is a laboratory professional, recovering microbiologist, and web editor for Lab Medicine.

Ebola Information for Laboratory Professionals

While it’s unlikely you will ever encounter a case of Ebola, it’s best to be prepared. The CDC has a health advisory page full of information, including specimen requirements for Ebola testing. The laboratory’s first step is to contact their state health department.