collateral damage
Antimicrobial resistance growing with war in Ukraine
Antimicrobial-resistance is a global health scourge, one made worse by the spread of bacteria impervious to multiple antibiotics among patients wounded in the Ukrainian war. Rates of antimicrobial resistance were already high in Ukraine, but a survey of three Ukrainian hospitals published yesterday by the CDC found many patients had war-wound infections that were difficult or impossible to treat because they were caused by resistant bacteria. These results mirror what's happened in other conflicts, including Iraq.
Gaps in infection prevention and control as well as lab capacity may be causing delays in identifying these dangerous germs, potentially leading to spread in Ukraine and beyond its borders. An example of the problem: Among 353 patients on surveyed hospital wards, 50 had health care–associated infections. "The spread of antimicrobial resistance in Ukraine is an urgent crisis that must be addressed, even during an ongoing war," the researchers say.
covid-19
Study attempts to ease long Covid symptoms through the gut microbiome
A study published in Lancet Infectious Diseases yesterday on a live microbial dietary supplement's effects on long Covid was praised in a commentary as "a foundational step." But caveats should be foregrounded: People's reports of a treatment's effects on their symptoms may not be reliable, and results from one ethnic group may not apply to others.
Previous research has shown people with long Covid have less diverse microbiomes, so the study randomized half of participants with at least one long Covid symptom to take an oral combination of prebiotics and probiotics daily for six months. The other half took a placebo.
At the trial's end, more people in the treatment group said their fatigue, memory loss, difficulty concentrating, GI upset, and general unwellness had eased compared with people in the placebo group, which also generally felt improvement. The authors speculate that lower systemic inflammation thanks to higher gut microbial diversity might be at play, while urging more study of the gut microbiome in long Covid.
health equity
Clinical trials for gynecologic cancers are weak on diversity, study says
"Nothing about us without us" has been a rallying cry for generations. The expression came to mind in light of this study published yesterday in JAMA Oncology on the dearth of underrepresented populations in clinical trials. Among more than half a million women with endometrial, ovarian, or cervical cancer, the odds of clinical trial enrollment were lower among Asian, Black, and Hispanic women compared to white women. The overrepresentation of white women when measured against the U.S. population persisted for all three gynecologic cancers, while underrepresentation was true for Asian and Hispanic women. Black women were adequately represented for endometrial and cervical cancers but underrepresented for ovarian cancer.
Overall, women who received a diagnosis for one of the three cancers between 2016 and 2019 were roughly 10 times more likely to be enrolled in clinical trials compared with those who received a diagnosis between 2004 and 2006. Still, "[r]acial and ethnic disparities in clinical trial enrollment are unjust and hinder development of new cancer treatments," the researchers write.
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