Research Roundup: Covid; MRSA; Community-Acquired Pneumonia; Alzheimer’s; Decompensated Cirrhosis

CIDRAP: Study: SARS-CoV-2 Was Evolutionarily Poised To Jump From Bats To Humans
SARS-CoV-2 has undergone few adaptations since it jumped from bats to humans, sparking the COVID-19 pandemic, a study published late last week in PLOS Biology shows.UK, US, and Belgian researchers sequenced 133,741 human SARS-CoV-2 genomes from December 2019 to October 2020 and 69 coronavirus genomes from horseshoe bats to identify novel adaptations to the human host. Lead author Oscar MacLean, PhD, of the University of Glasgow, said in a PLOS news release that the findings don't mean that there have been no changes, only that they have not been evolutionarily significant. (3/15)

CIDRAP: Central Line-Associated Bloodstream Infections Rise During Pandemic
A new study from researchers with the US Centers for Disease Control and Prevention shows a significant increase in central line–associated bloodstream infections (CLABSIs) in US acute care hospitals during the early months of the COVID-19 pandemic. Published yesterday in Infection Control & Hospital Epidemiology, the study analyzed 13,136 inpatient units from 2,986 acute care hospitals and found that the standardized infection ratio (SIR) for CLABSI's in April, May, and June of 2020 climbed by 28% compared with the same months in 2019, from 0.68 to 0.87. Critical care units saw the greatest percentage increase (39%) in SIR, from 0.75 in 2019 to 1.04 in 2020, and ward locations experienced the second highest increase (13%). Critical care locations had the highest number of CLABSIs in the second quarter of 2020, with 1,911. (3/16)

American Academy Of Pediatrics: Factors Associated With Severe SARS-CoV-2 Infection 
Initial reports on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in children suggested that very young age and comorbidities may increase risk of severe evolution, but these findings remained to be confirmed. We aimed to analyze the clinical spectrum of hospitalized pediatric SARS-CoV-2 infection and predictors of severe disease evolution. (Ouldali et al, 3/1)

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CIDRAP: VA Study Links Contact Precautions With Reduced MRSA Transmission
Department of Veterans Affairs (VA) hospitals that conducted contact precautions for patients with methicillin-resistant Staphylococcus aureus (MRSA) had a nearly 50% reduction in MRSA transmission, researchers reported this week in JAMA Network Open. In the study, researchers from the VA Salt Lake City Health Care System and the University of Utah School of Medicine applied mathematical models to data from patients admitted to VA acute care hospitals from January 2008 through December 2017 to determine whether contact precautions for MRSA carriers had any impact on patient-to-patient transmission. Contact precautions, which involve the use of gloves and gowns by healthcare staff when interacting with MRSA carriers and their environment, are one element of the MRSA Prevention Initiative introduced by the VA in 2007, but their effectiveness has been questioned. Other elements include surveillance and hand hygiene. (3/15)

CIDRAP: Randomized Trial Supports Shorter Antibiotic Course For Kids' Pneumonia
The results of a randomized clinical trial suggest a shorter course of antibiotics in children who have community-acquired pneumonia (CAP) is as effective as a longer course, Canadian researchers reported this week in JAMA Pediatrics. The noninferiority trial, involving children at two Canadian hospitals who had CAP that did not require hospitalization, found that clinical cure rates were similar in children treated with 5 days of amoxicillin versus those treated with 10 days. (Dall, 3/12)

New England Journal of Medicine: Donanemab In Early Alzheimer’s Disease 
A hallmark of Alzheimer’s disease is the accumulation of amyloid-β (Aβ) peptide. Donanemab, an antibody that targets a modified form of deposited Aβ, is being investigated for the treatment of early Alzheimer’s disease. (Mintun et al, 3/13)

JAMA Network: Deficits In Advance Care Planning For Patients With Decompensated Cirrhosis At Liver Transplant Centers
How is advance care planning experienced by patients with decompensated cirrhosis and clinicians at liver transplant centers? In this qualitative study of 46 transplant center clinicians and 42 patients with decompensated cirrhosis, semistructured interviews found that despite patient interest in discussing end-of-life issues, few such conversations occurred between patients and clinicians. Conversations focused on the need for liver transplant rather than on end-of-life decision-making, with which surrogate decision makers often struggled. (Patel et al, 3/15)