Federation of Infection Societies Conference 2024, Liverpool

Listen here:

https://idiotspodcasting.buzzsprout.com/1782416/episodes/16237971-95-fis-2024-part-1-amr-bacteria

https://idiotspodcasting.buzzsprout.com/1782416/episodes/16277864-96-fis-2024-part-2-viruses

https://idiotspodcasting.buzzsprout.com/1782416/episodes/16277940-97-fis-2024-part-3-fungi-ntm-quinolones-and-others

AMR

AMR 2024-2029 Action Plan

• Epidemiology
  • 2021: 1.14m deaths
  • By 2050: 39m dead of AMR infection
  • BSI: 21% are AMR
• Prescribing (from ESPAUR):
  • 80% primary care
  • 2ry: increasing Px, particularly ED/Other Specialty Services
  • Overall increase of 2.4%
• AMR action plan outcomes:

• 5 human health targets:
  • Prevent increase in a specific set of Drug-R infections
  • prevent increase in GN BSI (from 2019 baseline)
  • Increase knowledge of AMR by 10%
  • Reduce total use ABx in humans by 5% (cf. 2019)
  • 70% Abx use is Access.

Aztreonam-Avibactam (Pfizer)

• Epid: Colocation over time of serine + MBL carbapenemases.

  • NDM now dominant CPE beta-lactamase

  • Associated with longer ICU stay, LoS, highter mortality

    

• Aztreonam-Avibactam active against all except:

  • Pseudomonas aeruginosa:
    • 30-80% Susc. - has other Res Mechs (despite Pseudo AmpC inactivation, efflux pumps might take over)
    • MBL Pseudomonas: <10% will be Azt-Avi Susc. (MBL rides along other Res Mechs)
  • ABC (Acinetobacter baumanii calcoaceticus complex):
    • Avibactam doesn’t work on intrinsic Oxacillinases (OXA23, OXA51)
    • Aztreo has no activity against ABC!

• EUCAST BP:

  • Steno: None yet
  • Entero: 4/4