Infectious Disease: JAMA Theme Issue

This week's JAMA is a special ID Theme Issue with a publication coinciding with IDWeek 2014. For the infection prevention inclined there is a Viewpoint by Dan Morgan (along with Dan Diekema and Keith Kaye) that asks us to consider contact precautions as secondary/adjunctive measures for MRSA and VRE but suggests that their use is prudent for MDR-GNR. I guess the BUGG study has me convinced that contact isolation works for MRSA, so I'll have to disagree with my esteemed colleagues. There are two important trials of candidate vaccines for avian influenza and an excellent editorial by John Treanor bringing us up to date on pandemic influenza options. There is also a cluster-randomized trial of SDD and SOD from the Netherlands by Marc Bonten's group with an editorial by Kollef and Micek. I'm sure we'll expound on this study more in the future. Besides the CDC's hospital antibiotic use study that I posted on earlier, there is a CDC outbreak investigation describing a 39-patient NDM-E. coli (CRE) outbreak associated with duodenoscopes. In the accompanying editorial, Rutala and Weber ask "whether current US endoscope reprocessing guidelines are adequate to ensure a patient-safe gastrointestinal endoscope."

I would be remiss if I didn't point you to the Editorial by the ID-Issue Editor, Preeti Malani. She did a wonderful job pulling this issue together and in her editorial outlines the many broad threats to human health that we still face from infectious diseases. In particular she highlights the "worldwide, major disparities (that) cause many individuals to lack access to clean water, safe food, and fundamental elements of infection prevention, such as hand hygiene and basic sanitation." She also worked closely with Cassio Lynm, the medical illustrator who created the cover image (above). Clouds ominously bring forth climate change as the sea harbors new pathogens and threatens those sequestered safely on shore. And the one barrier we have against the multitude of threats? Contact (and droplet) precautions. I couldn't agree more.