2010 Annual Conference on Antimicrobial Resistance - National

88 Pages·2010·3.35 MB·English

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Table of Contents
Conference Objectives ....................................................................................................................................2
Acknowledgments ...........................................................................................................................................4
Conference Committee Members ..................................................................................................................4
NFID Staff .......................................................................................................................................................5
Invited Presenters ...........................................................................................................................................6
Accreditation and Continuing Education ......................................................................................................7
Disclosures ......................................................................................................................................................7
General Information .....................................................................................................................................11
American with Disabilities Act ...........................................................................................................11
Conference Information Desk ............................................................................................................11
Conference Location ..........................................................................................................................11
Messages .............................................................................................................................................11
No Smoking Policy .............................................................................................................................11
Poster Session ....................................................................................................................................11
Meet the Experts Breakfast Session ...................................................................................................11
Program and Abstracts .......................................................................................................................12
Registration Fees and Hours .............................................................................................................12
Verification of Attendance ..................................................................................................................12
Affiliated Events and Other Meetings ..........................................................................................................13
Hotel Floor Plan ...........................................................................................................................................14
Program At-A-Glance ...................................................................................................................................15
Program Agenda ...........................................................................................................................................16
Note-taking Outlines ....................................................................................................................................25
Poster Session Program ...............................................................................................................................52
Meet the Experts Biographies ......................................................................................................................55
Abstracts .......................................................................................................................................................58
Abstracts of Invited Presentations .....................................................................................................58
Abstracts of Submitted Oral Presentations .......................................................................................67
Abstracts of Submitted Poster Presentations ....................................................................................74
Author Index .................................................................................................................................................86
2010 Conference on Antimicrobial Resistance
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Conference Objectives
Overall Conference Objectives
At the conclusion of this conference, participants should be able to meet the following objectives:
• Discuss the science, prevention and control of antimicrobial resistance
• Define issues and potential solutions to the problem of antimicrobial resistance
Symposium Objectives:
Keynote Address
• Review and discuss the current situation of antimicrobial resistance worldwide and ways in which its evolution can be
contained so that you can participate in the global effort of containing the evolution of antimicrobial resistance; imple-
ment more prudent use of anti-infective drugs in day to day management of patients; improve the quality of life of
patients by using anti-infective drugs only when necessary, and in the long term preventing the need for second and third
line anti-infectives that may be associated with higher cost and greater side-effects
Symposium 1: The Economic and Public Policy Aspects of Antibiotic Resistance and
Antibiotic Development
• Review components of the economic burden of antibiotic resistance; describe the challenges involved in deriving an esti-
mate of the cost of resistance in the United States, with examples of several approaches to the costing of resistance; dis-
cuss the results of two different costing studies; from the two studies, discuss an estimate of the overall cost of resistant
infections in US hospitals; and review the economic and social/psychological costs of resistance to patients themselves,
particularly the uninsured, with reference to MRSA infection
• Review economic and behavioral factors that influence the development of new antimicrobial agents or other products
that could delay the emergence and spread of resistance, and conservation of antibiotic effectiveness
• Discuss the policy issues regarding the production and conservation of antimicrobial effectiveness

Symposium 2: Susceptibility Issues
• Review the most threatening types of antibiotic resistances occurring and increasing in the USA and around the world;
recognize the patterns of resistance and provide in vitro susceptibility monitoring services (reference-quality in vitro tests)
to guide interventions to minimize greater expansion in the practice environment; implement accurate, practical in vitro
methods in clinical microbiology facilities to focus optimal treatment and prevention of on-going epidemic occurrences of
difficult to treat, multidrug-resistant pathogens (CLSI or EUCAST methods and interpretations)
• Describe the role of PK-PD data, bacterial population distribution, and clinical response data on setting susceptibility break-
points for antimicrobial agents; list the reasons why knowing just the resistance mechanisms may not predict clinical out-
come in vivo; identify regulatory, manufacturing, and clinical hurdles for implementation of new susceptibility breakpoints
• Discuss the overlap of resistance reservoirs in food producing animals with human clinical settings via contamination of food and
water and how these resistance phenotypes and genotypes add to the burden of antimicrobial resistance in human medicine
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Symposium 3: Implications of Rapid Diagnostic Testing
• Describe the strengths and limitations of latent class statistical methods for evaluation of test accuracy (sensitivity and
specificity) for chronic infectious diseases
• U nderstand the challenges facing diagnosis of 2009 H1N1 influenza cases early in the pandemic; review updates on emerg-
ing antiviral resistance; and know the benefits and limitations of available diagnostic tests for public health surveillance and
clinical management
Symposium 4: Antiviral Drug Resistance
• Describe resistant profiles of currently approved drugs against HBV; review management strategies to prevent and treat
resistance; discuss future problems of HCV drug resistance
• Review drug resistance monitoring methods and surveillance data for FDA-approved anti-influenza antiviral drugs in order
to facilitate the understanding of influenza drug susceptibility and treatment options available in clinical settings; implement
CDC recommendations and interim guidance on the use of antivirals for the treatment of patients with influenza infections
based on trends detected through influenza resistance surveillance and to improve the likelihood of successful treatment; en-
courage the proper use of antivirals as treatment option to reduce morbidity and mortality from complications that may arise
from influenza infection
• Describe the clinical consequences of antiviral resistance in pandemic and seasonal H1N1 viruses; determine effective anti-
viral options for prevention and treatment of oseltamivir-resistant influenza infections
Symposium 5: Methicillin-resistant Staphylococcus aureus (MRSA)
• Discuss MRSA epidemiology in context of livestock production and its implications for occupational and public health as
well as food safety
• Describe the components necessary to implement an active surveillance program for MRSA in a tertiary-care healthcare
institution; review the outcome measures by which the success or failure of active surveillance programs for MRSA may be
judged; identify factors that might contribute to reduced efficacy of active surveillance programs for MRSA; recognize op-
portunities for ongoing improvement of established infection control programs to control MRSA
• Review the typical and unusual clinical manifestations of CA-MRSA infections in children to identify infections that may
be caused by this organism; describe the importance of the USA300 MRSA clone as a cause of healthcare associated infec-
tions; review the diagnostic approaches for suspected CA-MRSA infections in children so that the appropriate laboratory and
imaging studies can be utilized; list the most appropriate antibiotics for empiric treatment of suspected MRSA infections in
children as well as indications for surgical intervention
Symposium 6: Stewardship and Policy
• Describe the multiple applications of antimicrobials in veterinary species and how the veterinary profession is ad-
dressing stewardship of these uses; interpret and assess accuracy of literature and press which applies to veterinary
stewardship of antimicrobials
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Acknowledgments (as of January 20, 2010)
This conference is supported, in part, through
unrestricted educational grants from:
Astellas Pharma US, Inc.
BD Diagnostics
Cubist Pharmaceuticals, Inc.
Forest Research Institute, Inc.
GangaGen Inc.
Pfizer Inc.
Schering-Plough Corporation
3M Healthcare
NFID recognizes the following individuals for their
support and contributions in planning this event
Lisa Becton, DVM Stuart H. Cohen, MD Neil Fishman, MD
Conference Organizing and Scientific Conference Organizing and Scientific Conference Organizing Committee
Program Committees Program Committees Society for Healthcare
American Veterinary Medical Infectious Diseases Society of America Epidimiology of America
Association University of California, Davis Medical University of Pennsylvania
National Pork Board Center School of Medicine
Harris, MO Sacramento, CA Philadelphia, PA
Taja L. Blackburn, PhD Kathryn M. Edwards, MD Gayle K. Gilmore, RN, MA, MIS, CIC
Conference Organizing and Scientific NFID CME Committee Conference Organizing and Scientific
Program Committees Vanderbilt University Medical Center Program Committees
US Environmental Protection Agency Nashville, TN Association for Professionals in
Washington, DC Infection Control and Epidemiology
George M. Eliopoulos, MD Duluth, MN
John S. Bradley, MD Scientific Program Committee
Conference Organizing and Scientific Beth Israel Deaconess Medical Center Debra A. Goff, PharmD
Program Committees Boston, MA NFID CME Committee
American Academy of Pediatrics The Ohio State University
Children’s Hospital, San Diego Paula J. Fedorka-Cray, PhD Medical Center
San Diego, CA Scientific Program Committee Columbus, OH
US Department of Agriculture
Mitchell L. Cohen, MD, USPHS Athens, GA George C. Hill, PhD
Conference Organizing and Scientific NFID CME Committee
Program Committees Thomas M. File, Jr., MD Vanderbilt University School
Centers for Disease Control and NFID CME Committee of Medicine
Prevention Summa Health System Nashville, TN
Atlanta, GA Akron, OH
Marguerite Jackson, PhD, RN, FAAN
John F. Fisher, MD NFID CME Committee
NFID CME Committee University of California, San Diego
Medical College of Georgia School of Medicine
Augusta, GA San Diego, CA
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Jane M. Knisely, PhD Vincent H. Tam, PharmD
Conference Organizing Committee Conference Organizing and Scientific Program Committees
National Institute for Allergies and Infectious Diseases/NIH Society of Infectious Diseases Pharmacists
Bethesda, MD University of Houston College of Pharmacy
Houston, TX
Stuart B. Levy, MD
Conference Organizing Committee Alan D. Tice, MD
Alliance for the Prudent Use of Antibiotics NFID CME Committee
Tufts University School of Medicine John A. Burns School of Medicine
Boston, MA University of Hawaii
Honolulu, HI
Sasha Madison, MPH, CIC
NFID CME Committee Mary E. Torrence, DVM, PhD
Stanford Hospital and Clinics Conference Organizing and Scientific Program Committees
Stanford, CA US Department of Agriculture
Beltsville, MD
Donna Mazyck, RN, MS
NFID CME Committee J. Todd Weber, MD
Maryland State Department of Education Conference Co-Chair, Conference Organizing and
Baltimore, MD Scientific Program Committees
Centers for Disease Control and Prevention
Renee P. McLeod, PhD, APRN, BC Stockholm, Sweden
NFID CME Committee
Bradman University School of Nursing & Richard K. Zimmerman, MD, MPH
Health Professionals NFID CME Committee
San Diego, CA University of Pittsburgh
Pittsburgh, PA
George A. Pankey, MD
NFID CME and Scientific Program Committees NFID Staff, Bethesda, MD
Ochsner Clinic Foundation
New Orleans, LA
KerryAnn Bolton
Education Coordinator
Georges Peter, MD
NFID CME Committee
Sharon Cooper-Kerr
Warren Alpert Medical School of Brown University
Director, Events Planning
Brookline, MA
Lauren Ero
John H. Powers, III, MD, FACP, FIDSA
Director, Continuing Medical Education
Conference Organizing Committee
George Washington University School of Medicine
Charlotte Lazrus
Washington, DC
Executive Assistant
Susan J. Rehm, MD
Len Novick
Conference Co-Chair, Conference Organizing, Scientific
Executive Director
Program, and NFID CME Committees
National Foundation for Infectious Diseases
Bethesda, MD
Mary E. Singer, MD
Conference Organizing and Scientific Program Committees
US Food and Drug Administration
Silver Spring, MD
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Invited Presenters*
Michael Apley, DVM, PhD, DACVCP Ronald N. Jones, MD
Director, PharmCATS Bioanalytical Laboratory CEO/President
Kansas State University JMI Laboratories
Manhattan, KS North Liberty, IA
Peter Davies, PhD, BVSc Sheldon L. Kaplan, MD
Professor, Veterinary Population Medicine Professor & Vice Chairman for Clinical Affairs
University of Minnesota Head, Pediatric Infectious Disease Section
St. Paul, MN Baylor College of Medicine
Chief, Infectious Disease Service
Michael N. Dudley, PharmD, FIDSA Head, Department of Medicine
Senior Vice President, Research and Development & Texas Children’s Hospital
Chief Scientific Officer Houston, TX
Mpex Pharmaceuticals, Inc.
San Diego, CA Ebbing Lautenbach, MD, MPH, MSCE
Associate Professor of Medicine and Epidemiology
Neil Fishman, MD Associate Director, Clinical Epidemiology Unit
Associate Professor of Medicine Director of Research, Department of Healthcare Epidemiology
University of Pennsylvania School of Medicine and Infection Control
Philadelphia, PA University of Pennsylvania School of Medicine
Philadelphia, PA
Susan D. Foster, PhD
Director of Public Policy and Education Ramanan Laxminarayan, PhD, MPH
Alliance for the Prudent Use of Antibiotics Senior Fellow
Boston, MA Resources for the Future
Washington, DC
Ian Gardner, MPVM, BVSc, PhD
Professor of Epidemiology M. Kevin Outterson, JD, LLM
University of California Associate Professor
Davis, California Boston University School of Law
Boston, MA
Larisa V. Gubareva, MD, PhD
Team Leader, Molecular Epidemiology Robert C. Owens, Jr., PharmD
Centers for Disease Control & Prevention Co-Director
Atlanta, Georgia Maine Medical Center
Portland, ME
Frederick G. Hayden, MD
Stuart S. Richardson Professor of Clinical Virology and Professor George Sakoulas, MD
of Medicine and Pathology Assistant Professor
University of Virginia Health Systems University of California, San Diego School of Medicine
Charlottesville, VA Sharp Memorial Hospital
San Deigo, CA
David L. Heymann, MD
Chair Usha Stiefel, MD
Health Protection Agency Assistant Professor
London, UK Case Western Reserve University School of Medicine
Chief, Infectious Diseases Section
Daniel B. Jernigan, MD, MPH Louis Stokes Cleveland Department of Veterans Affairs Medical
Deputy Director, Influenza Division Center
Centers for Disease Control & Prevention Cleveland, OH
Atlanta, Georgia
Heiner Wedemeyer, MD, PhD
John A. Jernigan, MD, MS Research Group Leader
Deputy Chief, Prevention and Response Branch Hannover Medical School
Division of Healthcare Quality Promotion Hannover, Germany
Centers for Disease Control and Prevention
Atlanta, Georgia David G. White, Ph.D.
Director, Office of Research
US Food and Drug Administration
*Speakers and presentations subject to change Laurel, MD
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Accreditation and Continuing Education
Continuing Medical Education
The National Foundation for Infectious Diseases (NFID) is accredited by the Accreditation Council for Continuing Medical
Education (ACCME) to provide Continuing Medical Education (CME) for physicians. NFID takes responsibility for the content,
quality, and scientific integrity of this CME activity.
NFID designates this educational activity for a maximum of 17 AMA PRA Category 1 creditsTM . Physicians should only claim
credit commensurate with the extent of their participation in the activity.
Continuing Nursing Education
NFID is an approved provider of continuing nursing education by the Maryland Nurses Association, an accredited approver
by the American Nurses Credentialing Center’s Commission on Accreditation. This educational activity has been approved for
17 contact hours. To earn contact hours, each participant must attend the entire conference, sign in daily, and complete the
conference evaluation form.
Designated Continuing Education Activities
Sessions designated with a symbol have been approved for credit. No other sessions are eligible for credit hours.
CME and Nursing Certificates
In order to ensure that you receive the credits to which you are entitled, please complete and return the Continuing Education
and Evaluation form to conference staff at the Conference Information Desk, or mail to:
NFID, Office of CME
4733 Bethesda Avenue, Suite 750
Bethesda, MD 20814
FOR NURSES ONLY: you must also sign in daily and attend the entire conference to receive credit for attendance.
Disclosures
As a sponsor accredited by the ACCME, NFID must ensure balance, independence, objectivity, and scientific rigor in its
educational activities. All individuals in a position to influence the content of this activity have disclosed: (1) any relevant
financial interest or other relationship with the manufacturer(s) of any commercials product(s) and/or provider(s) of
commercial services discussed in an educational presentation and/or with any commercial supporters of the activity; (2) any
intention to discuss off-label uses of regulatedsubstances or devices. Disclosure information is reviewed in advance to manage
and resolve any conflict of interest that may affect the balance and scientific integrity of an educational presentation.
The intent of this disclosure is not to prevent a speaker or program planner with a relevant financial or other relationship from
making a presentation or assisting in conference organization. The intent is to provide listeners with information on which they
can make their own judgments. It remains for the audience to determine whether the speaker’s interests or relationships have
influenced the presentation.
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Individuals in a Position to Control the Content:
• Michael Apley (Faculty) received grants for clinical • Kathryn M. Edwards (NFID CME Committee)received
research from Elanco Animal Health; and served as an grants for clinical research from sanofi pasteur, CSL,
advisor, consultant or speaker for Elanco Animal Health Wyeth and Novartis.
and Pfizer Animal Health.
• George M. Eliopoulous (Conference Scientific Program
• Lisa Becton (Conference Organizing and Scientific Committee) served as an advisor or consultant
Program Committees) has no relevant financial for Cubist, Arpida, Theravance, Achaogen, LEAD
relationships. Therapuetics, and Bayer Schering. He received grants
or contracts for clinical research from Theravance,
• Taja L. Blackburn (Conference Organizing and
Pfizer and Novexel.
Scientific Program Committees) has no relevant
financial relationships. • Lauren Ero (NFID Director, Continuing Medical
Education) has no relevant financial relationships.
• KerryAnn Bolton (NFID Education Coordinator) has
no relevant financial relationships. • Paula J. Fedorka-Cray (Conference Scientific Program
Committee) served as an advisor or consultant for and
• John S. Bradley (Conference Organizing and Scientific
received grants for research from Intervet/Schering.
Program Committees) served as an advisor or consultant
for Johns & Johnson, Pfizer, Bayer, and Cubist. He • Thomas M. File, Jr. (NFID CME Committee) served
received grants for clinical research from Johnson & as an advisor, consultant or speaker for Advanced Life
Johnson, Cubist and Pfizer. Sciences, Astellas/Theravance, Cerexa/Forest, Ortho-
McNeil, Protez, Merck, Nabriva, Pfizer, Schering
• Cindy R. Cisar (Presenter) has no relevant financial
Plough, Targanta and Wyeth; received grants for
relationships.
clinical research from Cerexa, Ortho-McNeil, Protez,
• Mitchell L. Cohen (Conference Organizing and
Pfizer, Boehringer Ingelheim, Gilead and Tibotec.
Scientific Program Committees) has no relevant
• John F. Fisher (NFID CME Committee) served as an
financial relationships.
advisor, consultant or speaker for Pfizer, Wyeth and
• Stuart H. Cohen (Conference Organizing and Scientific
Astellas.
Program Committees) served as a speaker or member
• Neil Fishman (Conference Organizing Committee and
of a speakers’ bureau for Cubist, Pfizer, Merck, and
Faculty) has no relevant financial relationships.
Astellas.
• Susan D. Foster (Faculty) has no relevant financial
• Sharon Cooper-Kerr (NFID Director, Events) has no
relationships.
relevant financial relationships.
• Ian Gardner (Faculty) has no relevant financial
• Peter Davies (Faculty) has no relevant financial
relationships.
relationships.
• Gayle K. Gilmore (Conference Organizing andScientific
• David M. Donovan (Presenter) has no relevant financial
Program Committees) has no relevant financial
relationships.
relationships.
• Michael N. Dudley (Faculty) is employed by and has
stocks, stock options, and/or bond holdings from Mypex
Pharmaceuticals.
SCIENCE - PREVENTION - CONTROL
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• Debra A. Goff (NFID CME Committee) served as an • Emil Lesho (Presenter) has no relevant financial
advisor, consultant or speaker for Merck, Cubist and relationships.
Schering; received a grant for clinical research from
• Stuart B. Levy (Conference Organizing Committee)
Cepheid.
served as an advisor or consultant for, owns stock, stock
• Mary Joy N. Gordoncillo (Presenter) has no relevant options or bonds from and holds a patent for and/or
financial relationships. royalties from Paratek Pharmaceuticals.
• Larisa V. Gubareva (Faculty) has no relevant financial • Sasha Madison (NFID CME Committee and Content
relationships. Reviewer) has no relevant financial relationships.
• Elizabeth Hamilton (Presenter) has no relevant • Donna Mazyck (NFID CME Committee) has no relevant
financial relationships. financial relationships.
• Frederick G. Hayden (Faculty) served as an advisor or • Renee P. McLeod (NFID CME Committee) served as an
consultant for Roche, GlaxoSmithKline, Biocryst, 3-V advisor, consultant or speaker for GlaxoSmithKline.
Biosciences, NexBio, MedImmune and Merck.
• Yoko Miyasaki (Presenter) has no relevant financial
• Michael J. Hearn (Presenter) has no relevant financial relationships.
relationships.
• Len Novick (NFID Executive Director) owns stock,
• David L. Heymann (Faculty) owns stock, stock options stock options or bonds from Viropharma, Pfizer,
or bonds from GlaxoSmithKline. Novavax and Cubist.
• George C. Hill (NFID CME Committee) has no relevant • M. Kevin Outterson (Faculty) has no relevant financial
financial relationships. relationships.
• Marguerite Jackson (NFID CME Committee) owns • Jeannette Ouyang-Latimer (Presenter) has no relevant
stock, stock options or bonds from Cellestis, Inc. financial relationships.
• Daniel B. Jernigan (Faculty) has no relevant financial • Robert C. Owens (Faculty) has no relevant financial
relationships. relationships.
• Ronald N. Jones (Faculty) owns stock, stock options or • George A. Pankey (NFID CME and Conference
bonds from GlaxoSmithKline, Merck and Novartis. Scientific Program Committees) has no relevant
financial relationships.
• Sheldon L. Kaplan (Faculty) received grants for clinical
research from Pfizer and Cubist. • Georges Peter (Chair NFID CME Committee) served
as an advisor, consultant or speaker for Merck, Noravax,
• Jane M. Knisely (Conference Organizing Committee) has
Novartis and Wyeth; owns stock, stock options or bonds
no relevant financial relationships.
from Bristol Myers Squibb.
• Munawwar A. Khan (Presenter) has no relevant
financial relationships.
• Ramanan Laxminarayan (Faculty) has no relevant
financial relationships.
2010 Conference on Antimicrobial Resistance
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• John H. Powers, III (Conference Organizing • J. Todd Weber (Conference Co-Chair, Conference
Committee) served as an advisor or consultant for Organizing and Scientific Program Committees) has
Acureon, Advanced Life Sciences, Astellas, Astra- no relevant financial relationships.
Zeneca, Basilea, Centegen, Cerexa, ConCERT, Cubist,
• Heiner Wedemeyer (Faculty) served as an advisor or
Destiny, Forest, Gilead, Great Lakes, Johnson &
consultant for, served as a speaker or member of a
Johnson, LEO, Merck, Methylgene, Mpes, Octoplus,
speakers’ bureau for, and received grants for clinical
Pharming, Takeda, Theravance, and Wyeth.
research from Roche, BMS, Gilead, Schering-Plough,
• Susan J. Rehm (NFID Medical Director, Conference and Novartis. He also served as an advisor or consultant
Co-Chair, Conference Organizing, Scientific Program for Abbott.
and NFID CME Committees) served as an advisor,
• David G. White (Faculty) has no relevant financial
consultant or speaker for Pfizer; served as a speaker or a
relationships.
member of a speakers’ bureau for Cubist, Roche and Wyeth;
• Richard K. Zimmerman (NFID CME Committee)
and received grants for clinical research from Cubist.
received grants for clinical research from MedImmune
• George Sakoulas (Faculty) served as an advisor or
and Merck; and served as an advisor, consultant or
consultant for Cubist, Pfizer, Ortho-McNeil, and
speaker for Merck.
Astellas; served as a speaker or member of a speakers’
bureau for Cubist, Pfizer, and Astellas.
• Mary E. Singer (Conference Organizing and Scientific
Program Committees) has no relevant financial
relationships.
• Gary E. Stein (Presenter) received grants for clinical
research from Schering Plough.
• Usha Stiefel (Faculty) has no relevant financial
relationships.
• Vincent H. Tam (Conference Organizing and Scientific
Program Committees) served as a speaker or member
of a speakers’ bureau for Merck; and received grants for
clinical research from Astra-Zeneca, Merck, Schering-
Plough, and Achaogen.
• Alan D. Tice (NFID CME Committee) served as an
advisor, consultant or speaker for Cubist and Merck;
received grants for clinical research from Human
Genome Sciences, Roche and 3 Rivers.
• Mary E. Torrence (Conference Organizing and
Scientific Program Committees) has no relevant
financial relationships.