Researchers developing new tool to distinguish between viral, bacterial infections


Antibiotics are lifesaving drugs, but overuse is leading to antibiotic resistance, one of the world’s most pressing health threats. Scientists identified 11 genetic markers in blood that accurately distinguished between viral and bacterial infections 80 to 90 percent of the time. The finding is important because physicians don’t have a good way to confirm bacterial infections like pneumonia and more-often-than-not default to an antibiotic. The goal of the research is to develop a tool, such as a blood test, that physicians can use to rule out a bacterial infection with enough certainty that they are comfortable, and their patients are comfortable, foregoing an antibiotic. Credit: University of Rochester Medical Center

Antibiotics are lifesaving drugs, but overuse is leading to one of the world’s most pressing health threats: antibiotic resistance. Researchers at the University of Rochester Medical Center are developing a tool to help physicians prescribe antibiotics to patients who really need them, and avoid giving them to individuals who don’t.

Scientists from the University’s National Institutes of Health-funded Respiratory Pathogens Research Center identified 11  in blood that accurately distinguished between viral and bacterial infections (antibiotics help us fight bacterial infections, but aren’t effective and shouldn’t be used to treat viruses). The finding, published today in the journal Scientific Reports, is important because physicians don’t have a good way to confirm bacterial infections like pneumonia and more-often-than-not default to an antibiotic.

“It’s extremely difficult to interpret what’s causing a , especially in very ill patients who come to the hospital with a high fever, cough, shortness of breath and other concerning symptoms,” said Ann R. Falsey, M.D., lead study author, professor and interim chief of the Infectious Diseases Division at UR Medicine’s Strong Memorial Hospital. “My goal is to develop a tool that physicians can use to rule out a  with enough certainty that they are comfortable, and their patients are comfortable, foregoing an antibiotic.”

Falsey’s project caught the attention of the federal government; she’s one of 10 semifinalists in the Antimicrobial Resistance Diagnostic Challenge, a competition sponsored by NIH and the Biomedical Advanced Research and Development Authority to help combat the development and spread of . Selected from among 74 submissions, Falsey received $50,000 to continue her research and develop a prototype diagnostic test, such as a blood test, using the genetic markers her team identified.

A group of 94 adults hospitalized with lower respiratory tract infections were recruited to participate in Falsey’s study. The team gathered clinical data, took blood from each patient, and conducted a battery of microbiologic tests to determine which individuals had a bacterial  (41 patients) and which had a non-bacterial or viral infection (53 patients). Thomas J. Mariani, Ph.D., professor of Pediatrics and Biomedical Genetics at URMC, used complex genetic and statistical analysis to pinpoint markers in the blood that correctly classified the patients with bacterial infections 80 to 90 percent of the time.

“Our genes react differently to a virus than they do to bacteria,” said Mariani, a member of the Respiratory Pathogens Research Center (RPRC). “Rather than trying to detect the specific organism that’s making an individual sick, we’re using genetic data to help us determine what’s affecting the patient and when an antibiotic is appropriate or not.”

Falsey, co-director of the RPRC, and Mariani say that the main limitation of their study is the small sample size and that the genetic classifiers selected from the study population may not prove to be universal to all .

A patent application has been filed for their method of diagnosing bacterial infection. Edward Walsh, M.D., professor of Infectious Diseases, and Derick Peterson, Ph.D., professor of Biostatics and Computational Biology at URMC, also contributed to the research.

According to the Centers for Disease Control and Prevention, antibiotic resistant bacteria cause at least 2 million infections and 23,000 deaths each year in the United States. The use of  is the single most important factor leading to  around the world.

Finger prick test wins EUR 1 million to fight antibiotic resistance


The test can quickly tell if an infection is viral or bacterial. Image credit: European Union

A finger prick test that can show almost instantly whether an infection is bacterial or viral has won EUR 1 million from the EU as part of the first-ever Horizon Prize.

It’s important as antibiotics are only effective against bacterial infections yet often the symptoms of bacterial and viral infections are very similar.

The unnecessary use of antibiotics is leading to the emergence of drug-resistant bacteria known as superbugs which cause around 25 000 deaths in Europe each year, according to EU data.

At a special ceremony in Leuven, Belgium, the Minicare HNL test was awarded the first-ever Horizon Prize, a funding mechanism that allows small firms and inventors to access research funding by offering solutions to a pre-defined problem.

The EUR 1 million prize will be used to get the finger prick test ready to be commercialised, and the developers hope it will mean doctors prescribe fewer antibiotics.

‘There is a misuse and abuse of antibiotics today and that’s because doctors don’t have the tools to distinguish between viral and bacterial infections,’ said Professor Per Venge, the founder of P & M Venge AB, a Swedish medical research company which is behind the Minicare HNL test along with Philips Diagnostics in the Netherlands.

The winning product is a small handheld device that can check a drop of blood for the presence of human neutrophil lipocalin (HNL).

‘There is a misuse and abuse of antibiotics today and that’s because doctors don’t have the tools to distinguish between viral and bacterial infections.’

Prof. Per Venge, Minicare HNL

‘HNL is a protein that blood cells release when they have a bacterial infection, but they won’t if there is a viral infection,’ said Prof. Venge. ‘That means it is possible to measure elevated levels of HNL as a sign of bacterial infection.’

The device is being designed for general practices as well as emergency departments. Since antibiotics don’t work on viruses this would allow doctors to safely avoid prescribing them.

Speaking at the awards ceremony, Marie-Paule Kieny, assistant director-general at the World Health Organization, said: ‘Compelling evidence shows that (antimicrobial) resistance is driven by the total volume of antibiotics used.’

Biggest risk

The biggest risk is in complex medical treatments such as hip replacements, organ transplants, cancer chemotherapy and the care of premature babies, as the patients are dependent on antibiotics to keep infection at bay.

Jeroen Nieuwenhuis, a senior director at Philips, said it would be years rather than decades before the device would be available in doctors’ offices.

‘We now have a proof of concept which is very encouraging, but before we can get to a test that can be used in a practice there is still a lot of development to be done so we have to validate it on many more patients.’

The other two finalists were ImmunoPoC, a business working on a finger prick test that can differentiate between bacterial and viral infections within 15 minutes. The other, PulmoCheck, is developing a device that reacts to body fluids from a bacterial infection within two to six minutes.

Carlos Moedas, the European Commissioner for Research, Innovation and Science, presented the award and spoke of the growing risk of drug-resistant bacteria: ‘Most bacterial diseases used to be extremely deadly. Now, in just a few days, you can get cured – and we take that for granted.

‘All three finalists that came here tonight are working to revolutionise diagnosis,’ he said. ‘To break the doubt that leads to out-of-control antibiotic use.’

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Scientists just announced our best shot at ending antibiotic resistance to date


A molecule that reverses antibiotic resistance.

Scientists have developed a molecule that reverses antibiotic resistance in multiple strains of bacteria at once, making it one of the most promising advances we’ve had to date in the fight against superbugs.

The announcement couldn’t come at a better time – in the past week, researchers have reported that a US woman was killed by a superbug resistant to every available antibiotic, and that antibiotic resistance is now spreading faster and more stealthily than they’d expected. In the war against superbugs, we’re currently losing.

 Even public health officials, known for their ‘keep calm and carry on’ approach to emerging health threats, are quietly freaking out. A report in 2014 predicted that superbugs will kill 300 million people by 2050, and the United Nations has declared the issue a “fundamental threat“.

The problem is that bacterial infections we’ve easily been able to deal with in the past, such as pneumonia, E. coli, and gonorrhoea, are rapidly evolving the ability to survive our antibiotics. Unless we come up with some new drug options soon, we’re going to very quickly run out of ways to protect ourselves.

“We’ve lost the ability to use many of our mainstream antibiotics,” said lead researcher Bruce Geller from Oregon State University.

“Everything’s resistant to them now. That’s left us to try to develop new drugs to stay one step ahead of the bacteria, but the more we look the more we don’t find anything new,” he added.

“So that’s left us with making modifications to existing antibiotics, but as soon as you make a chemical change, the bugs mutate and now they’re resistant to the new, chemically modified antibiotic.”

One of the ways that bacteria spread antibiotic resistance is through a gene that produces an enzyme known as New Delhi Metallo-beta-lactamase (NDM-1).

 NDM-1 is so worrying, because it makes bacteria resistant to a class of penicillins called carbapenems – better known as our ‘last resort’ drugs. Thanks to NDM-1, that last resort is quickly failing.

“The significance of NDM-1 is that it is destroys carbapenems, so doctors have had to pull out an antibiotic, colistin, that hadn’t been used in decades because it’s toxic to the kidneys,” said Geller.

“That is literally the last antibiotic that can be used on an NDM-1-expressing organism, and we now have bacteria that are completely resistant to all known antibiotics.”

To try to fight this, Geller and his colleagues have created a molecule that attacks NDM-1, and reverses antibiotic resistance in many different strains of bacteria – meaning it could give us the chance to use antibiotics again which are currently useless.

The molecule is a type of PPMO, which stands for peptide-conjugated phosphorodiamidate morpholino oligomer, and it disables NDM-1.

Previously, researchers had tried to use naturally-occurring PPMOs against superbugs, but they only worked on one particular strain of bacteria. This new molecule is different.

“We’re targeting a resistance mechanism that’s shared by a whole bunch of pathogens,” said Geller.

“It’s the same gene in different types of bacteria, so you only have to have one PPMO that’s effective for all of them, which is different than other PPMOs that are genus specific.”

The team tested the new PPMO out on three different genera of bacteria in a petri dish – all of which expressed NDM-1 and were resistant to carbapenems.

They used the new molecule alongside a type of carbapenem called meropenem, and showed that it quickly restored the antibiotics’ ability to kill the bacteria.

They then used a combination of the new PPMO and meropenem on mice who were infected with antibiotic-resistant E. coli, and showed it could effectively treat the infection and improve survival rates for the mice.

This suggests that, in future, the PPMO could be used alongside existing antibiotics to make bacteria susceptible to them once again.

“A PPMO can restore susceptibility to antibiotics that have already been approved, so we can get a PPMO approved and then go back and use these antibiotics that had become useless,” said Geller.

To be clear, showing that this strategy works in the lab and in mice isn’t evidence enough that it will work in humans just yet, but the team says it could be ready for clinical trials in the next three years.

Until then, we’ll have to wait and see. But it’s the first bit of good news we’ve had about superbugs in a long time, so we’ll be watching the progress closely.

UN Classifies Antibiotic Resistance as a Crisis, Putting It on Par With Ebola and HIV


IN BRIEF

Antibiotic resistance, the ability of bacteria to evolve to combat treatment, has been declared a crisis by the United Nations. The classification will hopefully lead to the funding and research needed to combat, or even fully eradicate, the problem, which is currently responsible for more than 23,000 deaths per year in the U.S. alone.

SUPER DRUG, SUPER BUG

Since Alexander Fleming’s discovery of penicillin in 1928, antibiotics have come to revolutionize medicine in the 20th century. By systematically killing off microbes that cause infections, antibiotics made it easy to cure bacterial infections from wounds as well as highly communicable diseases such as pneumonia, gonorrhea, and syphilis. Along with vaccines, antibiotics have considerably improved the life expectancy of people all over the world.

Here’s the rub: like humans, microbes can adapt.

When exposed to antibiotics frequently enough, bacteria can evolve to combat the treatments. Also known as antibiotic resistance, this phenomenon results in bacteria that is more resistant (if not fully immune) to the drugs that could treat them before. A report from Quartz showed that the U.S. Centers for Disease Control and Prevention (CDC) has estimated that 23,000 people die each year as a direct consequence of antibiotic resistance, and that’s just in the U.S.

The issue is so serious that the United Nations has now elevated the problem of antibiotic resistance to crisis level.

https://embed.ted.com/talks/ramanan_laxminarayan_the_coming_crisis_in_antibiotics

TAKING COLLECTIVE ACTION

The new categorization puts antibiotic resistance on par with Ebola and HIV as a threat to humanity, and while the declaration alone won’t be enough to completely eradicate the problem of antibiotic resistance, it marks a global commitment to combating the issue and saving lives. With 193 member states of the UN General Assembly signing the document, the world is clearly in agreement that action needs to be taken.

As more companies in those countries, particularly those in the pharmaceutical and food industries, adopt policies aimed to reduce the overuse of antibiotics and more research is conducted on the topic, we should see a decrease in the number of deaths related to antibiotic resistance. Perhaps the next ruling the UN makes on the issue will be one in the other direction, from crisis level to problem of the past.

Antibiotic Resistance Breakthrough: New Treatment Prevents Bacterial Skin Infections


English scientists may have hit upon a novel way of fighting off antibiotic-resistant superbugs: Turning our skin into the equivalent of a Slip ‘N Slide.

Researchers at the University of Sheffield have developed an experimental treatment designed to protect skin wounds from being infected by various multidrug-resistant strains of Staphylococcus aureus. Rather than attacking the germs, however, the treatment instead makes it harder for them to attach to our skin cells in the first place. In experiments with cultured skin cells and a 3D tissue-engineered model of injured skin, the treatment reduced the bacteria’s stickiness to cells by 50 to 60 percent when compared to a control. Importantly, the treatment didn’t appear to interfere with the skin cells’ natural healing process, meaning it may be perfectly harmless to real people. The results of their trial were published recently in PLOS-One.

“This development is a huge breakthrough in the fight against antibiotic-resistance,” said senior author Dr. Pete Monk of the University’s Department of Infection, Immunity and Cardiovascular Science in a statement.

Staphylococcus aureus

English scientists have developed an experimental treatment that makes it harder for antimicrobial-resistant bacteria to stick to skin cells and cause skin infections. Above, in magenta, are methicillin-resistant Staphylococcus aureus, or MRSA.National Institute of Allergy and Infectious Diseases (NIAID)

The treatment is derived from a class of proteins that already play a vital role within our human bodies called tetraspanins. Tetraspanins are located in the cell membrane and, among many other responsibilities, help cells stick to surfaces or other cells. They do so by joining together with other parts of the cell, including other tetraspanins, and forming structures called tetraspanin-enriched microdomains. Unfortunately, certain bacteria, viruses, and protozoans can also manipulate these structures to stick themselves to cells and gain entry within, including HIV.

To come up with their treatment, the researchers tested out specific compounds, or peptides, from one of these structures previously shown in the lab to short-circuit the stickiness of many bacterial species. One peptide in particular, Peptide 800, proved especially effective in making skin cells non-sticky. And because these peptides don’t harm or kill bacteria, it’s less likely that they will encourage further drug resistance.

Skin infections are already a big worry within hospitals, a premier hotspot of superbugs, and the researchers are hopeful their treatment can be an especially important tool in preventing open wounds caused by surgery and bed sores from becoming infected.

“We hope that this new therapy can be used to help relieve the burden of skin infections on both patients and health services while also providing a new insight into how we might defeat the threat of antimicrobial drug resistance,” said Monk. “The therapy could be administered to patients using a gel or cream and could work well as a dressing. We’re hoping it can reach clinical trials stage in the next three to five years.”

Though the potential of tetraspanin-related therapies is obviously exciting, it’s still in the very early stages. Among one of the stumbling blocks, as mentioned earlier, is that the therapy only partially reduced bacteria’s sticking power. That suggests there might be other ways these bacteria manage to stick to us, and it’s likely the treatment may not work as effectively when applied to different types of cells (keratinocytes, which the peptides were most effective on, make up our outer skin). Given their ability to work against different species of bacteria and their low toxicity, though, the authors believe the sky’s the limit for these nifty little peptides.

Antibiotic Resistance — What Promotes It, and How Can We Beat It?


The featured Catalyst documentary, “Antibiotic Resistance,” offers a 30-minute-long review of some of the many factors contributing to this man-made scourge.

Story at-a-glance

  • Prior to antibiotics, half of the world’s population died from infections. This is the reality we now face yet again, unless we somehow manage to get antibiotic resistance under control
  • Bacteria are incredibly adaptable, capable of sharing genetic material through proximity alone. If they’re close enough, gene packages can rapidly transfer between different bacteria
  • Bacteriophages, a type of virus, are a natural predator of bacteria, capable of killing bacteria that antibiotics cannot. Phage therapy is now being explored as a potential alternative to conventional antibiotics

Today, people are so used to the idea that an antibiotic can cure just about any infection; few can even consider the possibility that someday this remedy may no longer be an option.

Indeed, antibiotics have increased the human lifespan by about a decade, and certain conditions simply could not be treated without them. Take organ transplants for example. Without antibiotics, such procedures become tremendously risky, with a low rate of success.

According to Catalyst, about half of all emergency room admissions are also related to bacterial infections, and they too would have a poor rate of recovery without antibiotics.

Even minor surgeries become risky propositions without these infection-busting drugs. Ditto for everyday infections resulting from cuts, scrapes or bites.

In many ways, modern medicine as we know it is built around a foundation of antibiotics, and that foundation is now severely threatened by the emergence of microbes that are resistant to even our harshest, last-resort antibiotics.

Prior to antibiotics, half of the world’s population died from infections, and many died during early childhood. This is the reality we now face yet again, unless we somehow manage to get antibiotic resistance under control.

Animals and Humans Are Part of a Bacterial Ecosystem

In recent years, researchers have discovered that bacteria and other microorganisms are far from mere adversaries to be carpet-bombed into oblivion. Instead, microorganisms are part and parcel of us — we exist as part of a bacterial ecosystem and, in fact, many of our biological processes rely on them.

Even pathogenic bacteria that can cause severe disease only really become a threat to health when they’re allowed to crowd out other, more beneficial bacteria that naturally help keep the pathogens in check. Even certain viruses play an important and supportive role in human health.

Part of the drug resistance problem we’re now facing as a result of decades’ worth ofantibiotic misuse is the fact that bacteria are incredibly adaptable. Unless they’re completely wiped out, the surviving stragglers pass on their resistance to other bacteria.

Another piece of the puzzle is bacteria’s ability to share genetic material outside of the procreative process. Scientists recently discovered a bacterial gene (called mcr-1) that can spread among different bacteria with remarkable ease, conferring resistance to the strongest antibiotics in our medical arsenal.

This is a scenario that many have feared might happen, and now there’s no escaping its reality. Less than a year after the mcr-1 gene was first discovered in pigs and people in China,1,2,3 it has now been identified in the U.S., both in pork samples and a patient being treated for E.coli infection.4,5

How Bacteria Share Genetic Material

All that’s required for bacteria to share genetic material, delivered in little packages called plasmids, is proximity. If they’re close enough, the plasmid can rapidly transfer between the various bacteria bumping against each other.

As explained in the film, if humans had this kind of gene-sharing ability, you’d be able to change the color of your eyes from blue to brown simply by standing next to a brown-eyed person. For bacteria, this ability means they can spread drug resistance to other bacteria at “astonishing speeds.”

Unfortunately, scientists drastically underestimated the speed at which resistance can spread, and now we’re faced with a far shorter deadline, in terms of “the end of antibiotics” in medicine, than previously expected.

To give you an idea of just how quickly resistance is now spreading, consider this: a brand new antibiotic was introduced in 2010. The very next year, resistant bacteria were detected.

Antibiotics Are Overused in Human Medicine

Overuse of antibiotics in human medicine is one contributing factor to rising drug resistance among bacteria. In Australia, antibiotics are prescribed at a rate of more than one prescription for every man, woman and child each year. The situation is similar in many other developed nations.

According to Dr. Arjun Srinivasan, associate director of the U.S. Centers for Disease Control and Prevention (CDC), as much as half of all antibiotics used in American clinics and hospitals “are either unneeded or patients are getting the wrong drugs to treat their infections.”6

Lack of education is part of the problem. More than 40 percent of Americans and an astonishing 65 percent of Australians still believe antibiotics can treat viral infections.7Many patients also insist on taking an antibiotic “just in case” — a strategy that is highly inadvisable.

Antibiotics have both short- and long-term effects on the composition and health of the microbes in your gut, and your microbiome plays a crucial role in your overall immune function and general health. You really don’t want to decimate yourmicrobiome with an antibiotic unless absolutely necessary.

Children treated with antibiotics also raise their risk of developing health problems in adulthood, including making them more susceptible to infectious diseases, allergies, obesity and autoimmune disorders as they grow older.8,9

Doctors are not without blame though. Forty-five percent of British doctors admit prescribing antibiotics even when they know it won’t do any good.10

Antibiotic Use in Food Production Must Be Curbed

According to the CDC,11 there are 12 antibiotic-resistant pathogens that pose a “serious” threat to public health, and one-third of them are found in food. The four drug-resistant pathogens in question are:

  • Campylobacter
  • Salmonella
  • E. coli
  • Shigella

While livestock sometimes need antibiotics to cure an infection, concentrated animal feeding operations (CAFOs) routinely use antibiotics to speed up growth and counteract poor hygiene and crowded living conditions.

In the U.S., an estimated 80 percent of antibiotics sold end up in livestock. In Australia, approximately 70 percent of all antibiotics are used in agriculture.

As noted in the film, industrialized factory farming owes its success to the routine use of antibiotics. However, we’re now paying an unexpectedly heavy price for this convenient way of raising cheap food, as agricultural use of antibiotics is feeding and speeding up the spread of drug-resistant bacteria that kill an estimated 23,000 Americans each year.

Antibiotic Resistance Spreads Via Multiple Routes

Drug-resistant bacteria also accumulate in CAFO manure that is then spread on fields and enters waterways, allowing the drug-resistant bacteria to spread far and wide and ultimately back up the food chain to your dinner plate. You can see how easily antibiotic resistance spreads, via the food you eat and community contact, in the CDC’s infographic below.

Phage Therapy Explored as an Alternative to Antibiotics

A type of virus called a bacteriophage, or simply “phage,” is a natural predator of bacteria, capable of killing bacteria that antibiotics cannot. In fact for every bacteria in your intestine there are about 10 phages. Wherever bacteria reside, you will also find phages, because phages depend on bacteria for their survival. Evidence suggests that phages partner with animals and humans to stave off bacterial infections and control the composition of friendly microbes in your body.

So-called phage therapy is now being explored as a potential alternative to conventional antibiotics. As noted in the film, if a patient can be safely infected with the right phage, it could be a therapy to beat antibiotic resistance.

Phages specialize in breaking open and killing certain kinds of bacteria, hijacking them in order to replicate. Most phages have hollow heads, which store their DNA and RNA, and tunnel tails designed for binding to the surface of their bacterial targets. Once a phage has attached itself to a bacterium, the viral DNA is injected through the tail into the host cell.

Progeny are rapidly produced inside the host, until these little phages burst from the host cell, killing it in the process. These phages then go on to infect and kill more target bacteria until all bacteria have been consumed. What makes phages unique is that they cannot affect any cell other than bacteria, so they offer great hope as a targeted therapy against bacterial infections.

Another experimental type of treatment involves removing the drug-resistant gene package (the plasmid) from the bacteria, using a genetically engineered bacterium. Animal studies show that mice infected with drug-resistant bacteria that are given this treatment end up responding to the conventional antibiotics again. Scientists believe this kind of tool may allow them to develop treatments against bacterial infections that won’t promote resistance in the process.

How You Can Help Stop the Spread of Antibiotic-Resistant Disease

In light of the growing problem of antibiotic-resistant disease, it would be wise to employ techniques and strategies that will not only reduce your own risk of falling victim, but also help curtail the spread of antibiotic resistance in general. While the problem of antibiotic resistance really needs to be stemmed through public policy on a nationwide level, the more people who get involved on a personal level, the better. Such strategies include:

Using antibiotics only when absolutely necessary

For example, antibiotics are typically unnecessary for most ear infections, and they do NOT work on viruses. They only work on bacterial infections, and even then, they’re best reserved for more serious infections.

Taking an antibiotic unnecessarily will kill off your beneficial gut bacteria for no reason at all, which could actually make it more difficult for you to recover from your illness. If you do take a course of antibiotics, be sure to reseed your gut with healthy bacteria, either by eating fermented foods or taking a high-quality probiotic.

As an all-around preventive measure, make sure your vitamin D level is optimized year-round, especially during pregnancy, along with vitamin K2. A number of other natural compounds can also help boost your immune system function to help rid you of an infection, including vitamin C, oil of oregano, garlic, Echinacea and tea tree oil.

High-quality colloidal silver may be a valuable addition to your medicine cabinet to treat cuts and scrapes in lieu of antibacterial creams. Colloidal silver has been regarded as an effective natural antibiotic for centuries, and research shows it can even be helpful against some antibiotic-resistant pathogens.12,13,14

Manuka honey can also be used for topical applications. Clinical trials have found that Manuka honey can effectively eradicate more than 250 clinical strains of bacteria, including some resistant varieties, such as MRSA.

Avoiding antibacterial household products

This includes items such as antibacterial soaps, hand sanitizers and wipes, as these too promote antibiotic resistance.

Properly washing your hands with warm water and plain soap, to prevent the spreading of bacteria

Be particularly mindful of washing your hands and kitchen surfaces after handling raw meats, as about half of all meat sold in grocery stores around the U.S. is likely to be contaminated with potentially dangerous bacteria.

Purchasing organic, antibiotic-free meats and other foods

Reducing the spread of antibiotic-resistant bacteria is a significant reason for making sure you’re only eating grass-fed, organically raised meats and animal products. Besides growing and raising your own, buying your food from responsible, high-quality, and sustainable sources is your best bet, and I strongly encourage you to support the small family farms in your area.

Ecologists find another cause of antibiotic resistance


UGA ecologist finds another cause of antibiotic resistance
Tinker Creek is a pristine black water stream on the Savannah River Site. The bacteria in this stream are susceptible to antibiotics. Credit: Linda Lee/University of Georgia

While the rapid emergence of antibiotic-resistant bacteria has prompted the medical community, non-profit organizations, public health officials and the national media to educate the public to the dangers of misusing and overusing antibiotics, the University of Georgia’s J. Vaun McArthur is concerned that there’s more to the problem than the misuse of common medications.

McArthur, a senior research ecologist with the Savannah River Ecology Laboratory and Odum School of Ecology, believes environmental contaminants may be partly to blame for the rise in bacterial resistance, and he tested this hypothesis in streams on the U.S. Department of Energy’s Savannah River Site.

The 310-square mile site near Aiken, South Carolina, east of the Savannah River, was closed to the public in the early 1950s to produce materials used in nuclear weapons. This production led to legacy waste, or contamination, in limited areas of the site. This waste impacted some of the streams in the industrial areas.

“The site was constructed and closed to the public before were used in medical practices and agriculture,” McArthur said. “The streams have not had inputs from wastewater, so we know the observed patterns are from something other than antibiotics.”

McArthur tested five antibiotics on 427 strains of E. coli bacteria in the streams. His research team collected samples from 11 locations in nine streams, which included sediment as well as water samples. The level of metal contamination among these locations varied from little to high.

The results, published in the journal Environmental Microbiology, revealed high levels of in eight of the 11 water samples. The highest levels were found at the northern location of Upper Three Runs Creek, where the stream system enters the site, and on two tributaries located in the industrial area, U4 and U8. The level of antibiotic resistance was high in both water and sediment samples from these streams.

UGA ecologist finds another cause of antibiotic resistance
Bacteria from the U8 tributary on the Savannah River Site are resistant to antibiotics. Credit: Linda Lee/University of Georgia

McArthur said Upper Three Runs Creek flows through residential, agricultural and industrial areas before it enters the SRS, so the bacteria in this stream have been exposed to antibiotics. In contrast, U4 and U8 are completely contained within the site and have no known input from antibiotics. However, they have a long history of inputs from the legacy waste.

McArthur conducted a second screening using 23 antibiotics on U4, U8 and U10, a nearby stream with little to no industrial impact.

“More than 95 percent of the bacteria samples from these streams were resistant to 10 or more of the 23 antibiotics,” McArthur said. These included front-line antibiotics—gatifloxacin and ciprofloxacin, which are used to treat basic bacterial infections from pink eye to urinary tract and sinus infections.

The contaminated streams U4 and U8 had the highest level of antibiotic resistance.

“These streams have no source of antibiotic input, thus the only explanation for the high level of antibiotic resistance is the environmental contaminants in these streams—the metals, including cadmium and mercury,” McArthur said.

McArthur said the three tributaries of Upper Three Runs Creek, U4, U8 and U10 vary in the level of contamination respectively, from highly impacted and impacted to not as impacted.

It is possible that antibiotic-exposed wildlife may have dumped waste into these streams, MacArthur said, but only streams with a history of industrial input had . Bacteria in the six streams in the pristine areas of the site were susceptible to the antibiotics.

McArthur said it is concerning that these antibiotic-resistant drain into the Savannah River, a large body of water bordering Georgia and South Carolina. The Savannah River shares at least two major characteristics with many large bodies of water in the U.S. It is in close proximity to residential communities, and it receives industrially contaminated water—prone to antibiotic resistance.

“The findings of this study may very well explain why resistant bacteria are so widely distributed,” McArthur said.

WHO multi-country survey reveals widespread public misunderstanding about antibiotic resistance


As WHO ramps up its fight against antibiotic resistance, a new multi-country survey shows people are confused about this major threat to public health and do not understand how to prevent it from growing.

Antibiotic resistance happens when bacteria change and become resistant to the antibiotics used to treat the infections they cause. Over-use and misuse of antibiotics increase the development of resistant bacteria, and this survey points out some of the practices, gaps in understanding and misconceptions which contribute to this phenomenon.

Almost two thirds (64%) of some 10 000 people who were surveyed across 12 countries say they know antibiotic resistance is an issue that could affect them and their families, but how it affects them and what they can do to address it are not well understood. For example, 64% of respondents believe antibiotics can be used to treat colds and flu, despite the fact that antibiotics have no impact on viruses. Close to one third (32%) of people surveyed believe they should stop taking antibiotics when they feel better, rather than completing the prescribed course of treatment.

“The rise of antibiotic resistance is a global health crisis, and governments now recognize it as one of the greatest challenges for public health today. It is reaching dangerously high levels in all parts of the world,” says Dr Margaret Chan, WHO Director-General, in launching the survey findings today. “Antibiotic resistance is compromising our ability to treat infectious diseases and undermining many advances in medicine.”

The survey findings coincide with the launch of a new WHO campaign ‘Antibiotics: Handle with care’—a global initiative to improve understanding of the problem and change the way antibiotics are used.

“The findings of this survey point to the urgent need to improve understanding around antibiotic resistance,” says Dr Keiji Fukuda, Special Representative of the Director-General for Antimicrobial Resistance. “This campaign is just one of the ways we are working with governments, health authorities and other partners to reduce antibiotic resistance. One of the biggest health challenges of the 21st century will require global behaviour change by individuals and societies.”

The multi-country survey included 14 questions on the use of antibiotics, knowledge of antibiotics and of antibiotic resistance, and used a mix of online and face-to-face interviews. It was conducted in 12 countries: Barbados, China, Egypt, India, Indonesia, Mexico, Nigeria, Russian Federation, Serbia, South Africa, Sudan and Viet Nam. While not claiming to be exhaustive, this and other surveys will help WHO and partners to determine the key gaps in public understanding of the problem and misconceptions about how to use antibiotics to be addressed through the campaign.

Some common misconceptions revealed by the survey include:

  • Three quarters (76%) of respondents think that antibiotic resistance happens when the body becomes resistant to antibiotics. In fact bacteria—not humans or animals—become resistant to antibiotics and their spread causes hard-to-treat infections.
  • Two thirds (66%) of respondents believe that individuals are not at risk of a drug-resistant infection if they personally take their antibiotics as prescribed. Nearly half (44%) of people surveyed think antibiotic resistance is only a problem for people who take antibiotics regularly. In fact, anyone, of any age, in any country can get an antibiotic-resistant infection.
  • More than half (57%) of respondents feel there is not much they can do to stop antibiotic resistance, while nearly two thirds (64%) believe medical experts will solve the problem before it becomes too serious.

Another key finding of the survey was that almost three quarters (73%) of respondents say farmers should give fewer antibiotics to food-producing animals.

To address this growing problem, a global action plan to tackle antimicrobial resistance was endorsed at the World Health Assembly in May 2015. One of the plan’s 5 objectives is to improve awareness and understanding of antibiotic resistance through effective communication, education and training.

Key findings of the survey by country

Barbados (507 face-to-face interviews)

Only 35% of respondents say they have taken antibiotics within the past 6 months—the lowest proportion of any country included in the survey; of those who have taken antibiotics, 91% say they were prescribed or provided by a doctor or nurse.

Fewer than half of respondents (43%) have heard of the term ‘antibiotic resistance’; and fewer than half (46%)—less than any other country in the survey—believe that many infections are becoming increasingly resistant to treatment by antibiotics.

Only 27% of respondents agree with the statements ‘Antibiotic resistance is one of the biggest problems the world faces’ and that ‘Experts will solve the problem’—the lowest proportion of all participating countries for both questions.

China (1,002 online interviews)

57% of respondents report taking antibiotics within the past 6 months; 74% say they were prescribed or provided by a doctor or nurse; 5% say they purchased them on the internet.

More than half (53%) of respondents wrongly believe that they should stop taking antibiotics when they feel better, rather than taking the full course as directed.

61% of respondents think, incorrectly, that colds and flu can be treated by antibiotics.

Two thirds (67%) of respondents are familiar with the term ‘antibiotic resistance’ and three quarters (75%) say it is ‘one of the biggest problems in the world’.

83% of respondents say that farmers should give fewer antibiotics to animals—the highest proportion of any country in the survey.

Egypt (511 face-to-face interviews)

More than three quarters (76%) of respondents say they have taken antibiotics within the past 6 months, and 72% say they were prescribed or provided by a doctor or nurse.

55% of respondents incorrectly think that they should stop taking antibiotics when they feel better, rather than taking the full course; and more than three quarters (76%) wrongly believe that antibiotics can be used to treat colds and flu.

Less than one quarter (22%) of respondents have heard of the term ‘antibiotic resistance’—the lowest proportion of any country included in the survey.

India (1,023 online interviews)

More than three quarters (76%) of respondents report having taken antibiotics within the past 6 months; 90% say they were prescribed or provided by a doctor or nurse.

Three quarters (75%) of respondents think, incorrectly, that colds and flu can be treated with antibiotics; and only 58% know that they should stop taking antibiotics only when they finish the course as directed.

While 75% agree that antibiotic resistance is one of the biggest problems in the world, 72% of respondents believe experts will solve the problem before it becomes too serious.

Indonesia (1,027 online interviews)

Two thirds (66%) of respondents report having taken antibiotics in the past 6 months; 83% of respondents say they were prescribed or provided by a doctor or nurse.

More than three quarters (76%) of respondents know that they should only stop taking antibiotics when they have taken all of them as directed, but 63% incorrectly think they can be used to treat colds and flu.

84% of respondents are familiar with the term ‘antibiotic resistance’ and two thirds (67%) believe that many infections are becoming increasingly resistant to treatment by antibiotics.

Mexico (1,001 online interviews)

Three quarters (75%) of respondents report having taken antibiotics within the past 6 months; 92% say they were prescribed by a doctor or nurse; and 97% say they got them from a pharmacy or medical store.

The majority of respondents (83%) accurately identify that bladder/urinary tract infections (UTIs) can be treated with antibiotics, but 61% wrongly believe that colds and flu can be treated with antibiotics.

89% of respondents in Mexico say they have heard of the term ‘antibiotic resistance’ and 84% believe many infections are becoming increasingly resistant to treatment by antibiotics—a higher proportion than any other country included in the survey on both questions.

Nigeria (664 face-to-face interviews)

Almost three quarters (73%) of respondents report taking antibiotics within the past 6 months; 75% of respondents state they were prescribed or provided by a doctor or nurse; 5% say they bought them from a stall or hawker.

More respondents in Nigeria than any other country included in the survey correctly identify that antibiotics do not work for colds and flu (47%), however 44% of respondents think they do.

Only 38% of respondents have heard of the term ‘antibiotic resistance’—the second lowest proportion of all the countries surveyed.

Russian Federation (1,007 online interviews)

A little more than half of respondents (56%) report having taken antibiotics within the past 6 months; the same proportion (56%) say their most recent course of antibiotics was prescribed or provided by a doctor or nurse—the lowest proportion of any country included in the survey.

Two thirds (67%) of respondents incorrectly think colds and flu can be treated with antibiotics, and more than one quarter (26%) think they should stop taking antibiotics when they feel better rather than taking the full course as directed.

Awareness of the term ‘antibiotic resistance’ was high among respondents at 82%.

71% think antibiotics are widely used in agriculture in their country and 81% say that farmers should give fewer antibiotics to animals.

Serbia (510 face-to-face interviews)

Fewer than half (48%) of respondents say they have taken antibiotics within the past 6 months; 81% say they were prescribed or provided by a doctor or nurse.

The majority of respondents (83%) accurately identify that bladder infections/UTIs can be treated with antibiotics, but more than two thirds (68%) wrongly believe that colds and flu can be treated with antibiotics.

Only 60% of respondents in Serbia have heard of the term ‘antibiotic resistance’ and only one third (33%) think it is one of the biggest problems the world faces.

81% of respondents say that farmers should give fewer antibiotics to animals.

South Africa (1,002 online interviews)

65% of respondents say they have taken antibiotics within the past 6 months; a higher proportion of people than any other country included in the survey (93%) say their last course of antibiotics was prescribed or provided by a doctor or nurse, and 95% say they had advice from a medical professional on how to take them.

87% of respondents know they should only stop taking antibiotics when they finish the course of treatment—a higher proportion than any other country included in the survey.

The same proportion (87%) of respondents—and again more than any other country in the survey—recognize that the statement ‘It’s OK to use antibiotics that were given to a friend of family member, as long as they were used to treat the same illness’ is false. It is a practice which can encourage the development of resistance.

Sudan (518 face-to-face interviews)

More than three quarters (76%) of respondents report having taken antibiotics within the past 6 months; 91% say they were prescribed or provided by a doctor or nurse.

62% of respondents incorrectly think they should stop taking antibiotics when they feel better—more than any other country included in the survey—and 80% think antibiotics can be used to treat colds and flu. Both of these statements are incorrect. These are practices which encourage the development of antibiotic resistance.

94% of respondents agree that people should use antibiotics only when prescribed, and 79% believe that antibiotic resistance is one of the biggest problems the world faces—the highest percentages on both questions of any of the countries where the survey was undertaken.

Viet Nam (1,000 online interviews)

71% of respondents state they have taken antibiotics within the past 6 months; three quarters (75%) report they were prescribed or provided by a doctor or nurse.

86% of respondents think that the body becomes resistant to antibiotics (whereas in fact it is bacteria)—a higher proportion than any other country included in the survey.

83% think that many infections are becoming increasingly resistant to antibiotics.

70% of respondents think that antibiotics are widely used in agriculture in their country and almost three quarters (74%) agree that ‘antibiotic resistance is one of the biggest problems the world faces’.

Notes to editors

About the survey

The multi-country survey was limited to 2 countries per WHO Region, 12 countries overall. Data cannot be considered to be representative of each Region, nor of the global situation. Fieldwork was carried out by research agency 2CV between 14 September and 16 October 2015. A total of 9772 respondents completed the 14 question survey either online or during a face-to-face street interview. Document with key findings:

About the ‘Antibiotics: Handle with care’ campaign

WHO is launching a global campaign, ‘Antibiotics: Handle with care’, during the first World Antibiotic Awareness Week, 16-22 November 2015. The aim of the campaign is to raise awareness and encourage best practices among the public, policymakers, health and agriculture professionals to avoid the further emergence and spread of antibiotic resistance. For more information and to download campaign materials:

Novel Programs and Discoveries Aim to Combat Antibiotic Resistance


In the wake of increasing antimicrobial resistance threats, this article discusses some recent government initiatives and efforts by scientists, physicians, and public health officials to combat drug-resistant bacteria.

With increasing concerns over the continued development of bacterial resistance to antibiotic drugs, researchers and public health officials are conducting and supporting new initiatives to develop novel antibiotics and to discover the mechanisms involved with resistance in bacteria that cause urinary tract infections, pneumonia, bloodstream infections, and others.

http://jama.jamanetwork.com/Mobile/article.aspx?articleid=2301348&utm_source=FBPAGE&utm_medium=social_jn&utm_term=203770487&utm_content=content_engagement|article_engagement&utm_campaign=article_alert&linkId=15304598

PROGRAMMING DNA TO REVERSE ANTIBIOTIC RESISTANCE IN BACTERIA


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At its annual assembly in Geneva last week, the World Health Organization approved a radical and far-reaching plan to slow the rapid, extensive spread of antibiotic resistance around the world. The plan hopes to curb the rise caused by an unchecked use of antibiotics and lack of new antibiotics on the market.

New Tel Aviv University research published in PNAS introduces a promising new tool: a two-pronged system to combat this dangerous situation. It nukes antibiotic resistance in selected bacteria, and renders other bacteria more sensitive to antibiotics. The research, led by Prof. Udi Qimron of the Department of Clinical Microbiology and Immunology at TAU’s Sackler Faculty of Medicine, is based on bacterial viruses called phages, which transfer “edited” DNA into resistant bacteria to kill off resistant strains and make others more sensitive to antibiotics.

According to the researchers, the system, if ultimately applied to pathogens on hospital surfaces or medical personnel’s hands, could turn the tide on untreatable, often lethal bacterial infections. “Since there are only a few pathogens in hospitals that cause most of the antibiotic-resistance infections, we wish to specifically design appropriate sensitization treatments for each one of them,” Prof. Qimron says. “We will have to choose suitable combinations of DNA-delivering phages that would deliver the DNA into pathogens, and the suitable combination of ‘killing’ phages that could select the re-sensitized pathogens.”

Reprogramming the system

“Antibiotic-resistant pathogens constitute an increasing threat because antibiotics are designed to select resistant pathogens over sensitive ones,” Prof. Qimron says. “The injected DNA does two things: It eliminates the genes that cause resistance to antibiotics, and it confers protection against lethal phages.

“We managed to devise a way to restore antibiotic sensitivity to drug-resistant bacteria, and also prevent the transfer of genes that create that resistance among bacteria,” he continues.

Earlier research by Prof. Qimron revealed that bacteria could be sensitized to certain antibiotics — and that specific chemical agents could “choose” those bacteria more susceptible to antibiotics. His strategy harnesses the CRISPR-Cas system — a bacterial DNA-reprogramming system Prof. Qimron pioneered — as a tool to expand on established principles.

According to the researchers, “selective pressure” exerted by antibiotics renders most bacteria resistant to them — hence the epidemic of lethal resistant infections in hospitals. No counter-selection pressure for sensitization of antibiotics is currently available. Prof. Qimron’s strategy actually combats this pressure — selecting for the population of pathogens exhibiting antibiotic sensitivity.

“We believe that this strategy, in addition to disinfection, could significantly render infections once again treatable by antibiotics,” said Prof. Qimron.

Prof. Qimron and his team are now poised to apply the CRISPR/phage system onpseudomonas aeruginosa — one of the world’s most prevalent antibiotic-resistant pathogens involved in hospital-acquired infections — and to test whether bacterial sensitization works in a more complex microbial environment: the mouse cage.