B. Breedlove

E. Tkadlec et al.

K. Fullerton

Outbreaks of influenza B occurred worldwide from November 2017 to April 2018. In April 2018, laboratory-confirmed cases of influenza were reported in more than 107 countries or regions.1 During that period, World Health Organization (WHO) Global Influenza Surveillance and Response System laboratories tested more than 97,000 specimens. About 10,000 specimens were positive for influenza viruses, of which about 44% were influenza B virus.1 The clinical spectrum of influenza B infection varies from self-limited illness to respiratory failure and death.

Carbapenems are broad-spectrum antimicrobials that have activity against chromosomal cephalosporinases and extended-spectrum β-lactamases. However, the emergence of carbapenem-hydrolyzing β-lactamases has threatened the clinical efficacy of this class of drugs, and resulted in the nightmare of extreme drug resistance in gram-negative organisms aptly termed carbapenem-resistant Enterobacteriaceae (CRE).1 Carbapenemase-producing organisms usually arise when previously carbapenemase-negative strains acquire carbapenemase genes from other bacteria; therefore use of cephalosporins and/or carbapenems can drive this gene acquisition, and thus is an important risk factor in the development of colonization and infection.

We recently read with interest the systematic review and meta-analysis by Flynn et al,1 which aimed to “compare the effectiveness of connector decontamination with 70% alcohol wipes, alcoholic chlorhexidine gluconate wipes, or alcohol impregnated caps to prevent catheter-associated bloodstream infection (CABSI).” The article concludes that “alcohol impregnated caps and alcoholic chlorhexidine gluconate wipes were associated with significantly less CABSI than 70% alcohol wipes,” and that these results require confirmation in randomly assigned controlled trials.