tag:blogger.com,1999:blog-6297038928525377502.comments2021-04-11T03:58:24.173-04:00"Superbugs and Drugs"®Genevra Pittmanhttp://www.blogger.com/profile/09186313642544757475noreply@blogger.comBlogger16125tag:blogger.com,1999:blog-6297038928525377502.post-29866670542415995812012-11-20T01:26:15.841-05:002012-11-20T01:26:15.841-05:00Subsequently, after spending many hours on the int...Subsequently, after spending many hours on the internet at last We've uncovered an individual that definitely does know what they are discussing many thanks a great deal wonderful postAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-6297038928525377502.post-7011128436229134022011-06-03T14:32:17.628-04:002011-06-03T14:32:17.628-04:00F.D.A. Approves Drug to Treat Hospital Scourge
ht...F.D.A. Approves Drug to Treat Hospital Scourge<br /><br />http://www.nytimes.com/2011/05/28/health/28drug.html?scp=3&sq=Optimer&st=cseAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-6297038928525377502.post-53694930416615224342011-03-22T16:02:11.728-04:002011-03-22T16:02:11.728-04:00One of the major epidemiological questions related...One of the major epidemiological questions related to the situation of multi-resistant Salmonella concord isolates in internationally adopted Ethiopian children is the following: is it a global evolving problem or is it only of a local interest? As Beyene and co-workers results indicated, the treatment of Salmonella non-typhi infections in pediatric patients from Ethiopia seems to be an important problem because of the reduced susceptibility of these germs to beta-lactams and to other antimicrobials. Is it a problem outside of the endemic area(s)? Yes, it is, but to a very limited extent, due to the secondary cases already documented in the adoption families. I think that the small number of identified cases since the first communicated cases in Western Europe (i.e. more than seven years) could ensure us that those secondary cases are really rare. Could this problem be a global threat? Probably not, at least for now. Indeed there are some risks related to the capacity of Salmonella species to transfer genetic region encoding for antimicrobial resistance to other gram-negatives, including Escherichia coli, a much more frequent pathogen in northern countries where it is the largely dominant etiology of urinary tract infections. Such multi-resistance of E. coli (including ESBL presence and resistance to quinolones) in general population could be a tremendous problem for the treatment of upper urinary tract infections, which consists generally of beta-lactams and/or quinolones, exactly the antibiotics that could be compromised by horizontal transfer of resistance genes from Salmonella concord to Escherichia coli. The contribution of this phenomenon to changes in the Escherichia coli resistance is difficult to differentiate from other determinants, especially antimicrobial consumption. However, we didn’t have any data about an increase of the multi-resistance in E coli in the areas where S concord cases were reported and we can assume that such transfer is difficult. An explanation could be provided by the results of molecular studies indicating that the ESBL encoding gene CTX-M15 is chromosomally located in Salmonella concord and only the sequence qnrA encoding for a protein of resistance to quinolones is located on genetic transferable units. But even if this transfer happens, it is only in the gut of the index patient. For a horizontal transfer of multi-resistant Escherichia coli a gap in the personal hygiene is needed. Hand hygiene and food hygiene are essential for the control of water and food-borne diseases and generally for the control of a majority of infections. <br /><br />Gabriel-Adrian Popescu, <br />Associate Professor of Infectious Diseases, <br />“Carol Davila” School of Medicine, Bucharest, RomaniaGabriel Adrian Popescu, MD, PhDnoreply@blogger.comtag:blogger.com,1999:blog-6297038928525377502.post-76182025351149292452011-03-15T11:19:44.282-04:002011-03-15T11:19:44.282-04:00The high rate of isolation of S. Concord in Ethiop...The high rate of isolation of S. Concord in Ethiopia in the previous and present studies is unusual when compared to that of other countries. In the current study, a higher proportion of children under five years of age presenting with No Typhoid Salmonella infection developed bacteraemia, this finding may be attributed to lower immune status in the younger children. Dissemination of NTS might also be enhanced by intestinal inflammation resulting from chronic diarrhoeal disease, parasitic infection, or suboptimal nutrition.<br /><br />A worrying aspect of the S. Concord isolates from Ethiopian adoptees is the levels of antibiotic resistance, however, as there is now a concern over the global spread of antibiotic-resistant S. Concord, this emphasises the need for local as well as national surveillance for emerging resistance. <br /><br />S. Concord in Ethiopia needs further study to clarify the animal or food source associated with its epidemiology. Epidemiological investigations of salmonellosis in developing countries such as Ethiopia are difficult to conduct because of the limited scope of strain typing available for the studies and a lack of coordinated surveillance systems. <br /><br />It is essential for global control that countries such as Ethiopia are able to document the occurrence and trends of Salmonella serovars to detect local, regional, national, and even international outbreaks .The strain isolated was highly invasive, highly antibiotic-resistant, and represents a threat to heath care globally.<br />This will enable early warning about potentially virulent strains and should facilitate the elimination of the source by suggesting preventive actions.Dr. Miguel Angel Peredo López Velardenoreply@blogger.comtag:blogger.com,1999:blog-6297038928525377502.post-61404243962190119562011-03-10T05:02:17.263-05:002011-03-10T05:02:17.263-05:00"Eyes of the South African hippopotamus"..."Eyes of the South African hippopotamus"<br />I share with you the multi-resistance and the diversity of beta-lactamase mediated resistance in Salmonella spp. isolated in a single tertiary hospital in Durban South Africa. This study was conducted by Dr U Govinden for her Phd for which I served as supervisor:<br />"Extended spectrum β-lactamases (ESBLs) were characterized in Salmonella spp. isolates from a pediatric ward of a hospital in Durban. Forty one Salmonella spp. were subjected to serotyping, antibiotic susceptibility testing, E-Tests for ESBL detection, iso-electric focusing, polymerase chain reaction for detection of genes and sequencing. Isolates were screened for the presence of blaTEM, blaSHV, blaCTX-M, blaOXA , blaCMY, blaDHA and blaACC genes. The most common serotype was Salmonella Typhimurium. Isolates were multi-drug resistant with 100% susceptibility only to meropenem and ciprofloxacin. Tazobactam was the most effective inhibitor. Forty-one percent of the isolates were resistant to ceftriaxone, thus limiting therapeutic options for Salmonella infections.TEM-1 was the most predominant β-lactamase found in 51% of isolates while SHV-12 found in 39 % was the most common ESBL. TEM-63 was evident in 29 %, TEM-116 in 10 % and TEM-131 was found in one isolate. The high ceftazidime MICs of isolates expressing only TEM-63 were indicative of R164S substitution which widens the binding cavity to accommodate the bulky side chains of oxyimino-aminothiazolyl cephalosporins. The identification of TEM-131 which differs from TEM-63 by 1 amino acid reiterates the evolutionary potential of the TEM-type β-lactamase. Other ESBLs identified included SHV-2, CTX-M-3, CTX-M-15 and CTX-M-37. CMY-2 and the OXA-1 β-lactamase were also detected. This is the first report of TEM-116, CTX-M-3, -15 and -37 in Salmonella spp. in South Africa. All isolates with nalidixic acid MICs > 48 µg/ml had the mutation D87N, or D87G in the QRDR of the gyrA gene. This study showed that Salmonella spp. may be multi-drug resistant with the propensity to harbour β-lactamases in unique combinations. The diversity of ESBLs and the co-expression of quinolone resistance suggests that their incidence in salmonellae needs to be monitored."Professor Sabiha Essackhttp://hs.ukzn.ac.za/officeofthedean.aspxnoreply@blogger.comtag:blogger.com,1999:blog-6297038928525377502.post-71938638384275369202011-03-07T10:04:21.277-05:002011-03-07T10:04:21.277-05:001. What are the possible reasons for this microorg...1. What are the possible reasons for this microorganism not being isolated for 25 years?<br />2. What are the possible mechanisms for this organism being more virulent and multi-drug resistant?<br />3. What could be possible explanation of narrow geographical distribution of this micro organism; even in Kenya it is uncommon?<br />4. What are the differences in biochemical and antigenic properties of S. Concord from other sero types?<br />5. Sharing method of identification of S. Concord will be appreciated.<br />6. Is there any evidence of S.enterica typhoid vaccine effectiveness to protect from S. Concord?<br /> We agree to develop surveillance mechanism locally and globally.Dr. B.M. Pokharel (Microbiologist) and Dr.K.K.Kafle (Clinical Pharmacologist) from APUA’s Nepal Chapternoreply@blogger.comtag:blogger.com,1999:blog-6297038928525377502.post-46264427964920332312011-03-04T09:52:17.324-05:002011-03-04T09:52:17.324-05:00Getenet Beyene, Satheesh Nair, Daniel Asrat, Yohan...Getenet Beyene, Satheesh Nair, Daniel Asrat, Yohannes Mengistu, Howard Engers, John Wain<br />J. Infect Dev Ctries 2011; 5(1): 023-033<br /> <br /><br />The article by Getenet Beyene et al published in the January 2011 issue of the Journal of Infections in Developing countries focuses on multidrug resistant Salmonella Concord infection in children from Ethiopia. There have been a number of reports documenting isolation of S. Concord from Ethiopian adoptees. Questions have been asked about the role of orphanages in sustaining these strains through poor hygienic practices and overuse of antibiotics. This recent publication clearly demonstrates however that multidrug resistant S. Concord in Ethiopia affects a larger population much beyond the small group of adoptees and orphanages.<br /> <br /><br />Nontyphoidal salmonellae (NTS) in Africa are increasingly seen to cause severe disease manifestations including septicaemia. Published reports have highlighted the fact that S. Concord in Ethiopian population is associated not only with multidrug resistance, but also with invasiveness. These observations raise questions about factors contributing to such invasiveness, bacterial related, host related or both? Increase in bacteraemia due to NTS group C is reported to coincide with increase in HIV prevalence in Thailand (Kiratisin P, 2008 Trans R Soc Trop Med Hyg 102, 384-388 ). HIV prevalence of 3.5% in Ethiopia however does not explain invasive S. Concord disease in 30.6% of patients. Beyene et al have hypothesised about role of intestinal inflammation due to other agents, nutritional factors as well as possible changes in bacterial virulence as contributory factors.<br /><br />In Asia NTS burden is much lower than in Africa with Salmonella Typhi and Paratyphi being far more prevalent (Khan MI, 2010 Trop Med Int Health 15(8), 960-963). S. Concord has been shown to predominate in Ethiopia, but S. Enteridis and S. Typhimurium are reported to be the more frequent isolates in other parts of Africa. More over in both Africa and Asia distribution of NTS has been shown to change over time. The literature begs the question as to whether there is a global distribution pattern of Salmonellae in particular of NTS, and what triggers the change. As observed by Dr. Okeke in her commentary, there is a need for local surveillance worldwide. The capacity of laboratories in endemic regions to speciate NTS is limited by a lack of resources and funding. For effective and long term surveillance strengthening such laboratories remains a priority.<br /><br />Data generated through surveillance would be helpful in developing measures to break the transmission chain. In terms of prevention while vaccines are an option, the ultimate solution for NTS as well as for other enteric pathogens rests with the urgent need to improve community infrastructure, provision of safe drinking water and sewage disposal in endemic regions.<br /><br />Drug resistance is a recognised concern in NTS globally. Beyene et al report 86.5% ESBL positivity and 70% multidrug resistance within the study S. Concord isolates (n:81). Resistance in NTS while extremely important is a reflection of a far greater problem; that of increasing antimicrobial resistance in pathogens across board. The theme of World Health day this year “antimicrobial resistance” is a reflection of the magnitude of global concern. Beyene et al call for improvement in health systems, a call, that underpins efforts at controlling antimicrobial resistance, not just for S. Concord, but for all pathogens. This is indeed a critical point as without improvement of health systems it will be hard to control the complex issue of antimicrobial resistance across the world.Rumina Hasan from Aga Khan University in Karachi, Pakistannoreply@blogger.comtag:blogger.com,1999:blog-6297038928525377502.post-81317361290771098832011-02-18T09:47:11.210-05:002011-02-18T09:47:11.210-05:00APUA is eager to collaborate on this initiative an...APUA is eager to collaborate on this initiative and applauds Dr. Gould’s antimicrobial stewardship efforts and activities.APUAhttps://www.blogger.com/profile/11084383928444078635noreply@blogger.comtag:blogger.com,1999:blog-6297038928525377502.post-7969333736858378792011-01-24T13:41:09.877-05:002011-01-24T13:41:09.877-05:00The capital of Ugands's main sewer plant off o...The capital of Ugands's main sewer plant off of Old Port Bell and Spring Roads may still send its effluent to Murchison Bay, very near to the fresh water intake for the city. Murchison Bay is a highly confined portion of Lake Victoria and the circulation, hence flushing may be poor to almost non existent. With respect to the spread of antibiotic resistance, it would be prudent for the students at Makerere to run disc-diffusion tests on the local water and to run tests for inclusion of antibiotic resistant genes (ARGs) in the potable supply.<br /><br /> To facilitate such testing, I would suggest that they contact Dr Amy Pruden and Virginia Tech for protocols on running tests on ARGs.<br /><br /> The Wastewater Research Division, Municipal Environmental Research Laboratory, U.S. Environmental Protection Agency, Cincinnati, Ohio, notes that: "Several researchers have pointed out that wastewater, treated or untreated, is a primary contributor of bacteria to the aquatic ecosystem (12, 16, 17, 20, 27, 29). Studies have been conducted which demonstrate that significant numbers of multiple drug-resistant coliforms occur<br /> in rivers (17), bays (9), bathing beaches (28),<br /> and coastal canals (13). Waters contaminated by<br /> bacteria capable of transferring drug resistance<br /> are of great concern since there is the potential for transfer of antibiotic resistance to a pathogenic species."<br /><br /> Available information shows that conventional<br /> wastewater purification methods are not adequate for removal of antibiotic-resistant bacteria. The ARGs are not amenable to typical chlorine levels and many filters used by wastewater systems fail to remove ARGs.<br /><br /> With respect to the use of UV, the EPA study noted-----"It is interesting to note that although there was no significant increase observed in the percentage of streptomycin-resistant total coliforms surviving UV irradiation, the ability of this population to transfer antibiotic resistance increased."<br /><br /> "For certain antibiotic combinations, selection<br /> of antibiotic-resistant total coliforms by UV<br /> treatment is shown in Table 6 for strains isolated on media containing chloramphenicol. Before UV treatment, the strains exhibiting the Sm Te Cm Am and the Sm Te Cm Km Am resistance patterns made up a total of 40% of all isolates.<br /> After UV treatment, 70% of all isolates from<br /> media containing chloramphenicol exhibited one<br /> or the other of these resistance patterns." Reference: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC241834/pdf/aem00183-0119.pdf<br /><br /> For nations with foreign exchange issues and the need to import expensive pharmaceuticals, it behooves the leaders of those nations to take extra precautions to reduce internal issues that might exacerbate the rising levels of antibiotic resistance.<br /><br /> Dr. Edo McGowan<br /><br /> January 24, 2011 1:38 PMAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-6297038928525377502.post-60353336235506001962011-01-24T12:12:47.483-05:002011-01-24T12:12:47.483-05:00The information that sewer plants are major genera...The information that sewer plants are major generators of resistant organisms has been around for at least four decades. Statistics show that about 60% of the generated sewage sludge in this nation goes on US farms. <br /><br />Our research here in Santa Barbara has been mainly with recycled (reclaimed) water. As good sources of drinkable water dry up or are contaminated, there is a large push to substitute reclaimed water. This makes good sense only if that water is safe---which we and others are showing it is not. <br /><br />Reclaimed water is a major source of dispersed antibiotic resistance. It becomes critical when this water is used to irrigate crops that are consumed raw. Peer-reviewed papers document that reclaimed water carries pathogens that are not detected by the simple standard tests and also contains pharmaceuticals and contaminants of emerging concern. These pollutants can be and are taken into the edible portions of these crops along with antibiotic resistant microbes. Thus no amount of washing at the kitchen sink has effect.<br /><br />We have tested this water from two separate sewer plants in the vicinity of Santa Barbara. If we use the state-approved multi-tube MPN test and test the water where the industry typically tests (at the point of release into the delivery pipes), we typically get non-detect. But if we go to the end of the pipe at the point of use (POU) we often find bacterial counts that wildly exceed the allowed counts. In some cases, our results at the ends of the pipe are so high they are off the charts. This is water being used, at least in Santa Barbara, for crops consumed raw from community gardens. <br /><br />If we test the reclaimed water at these same points, i.e., point of release to the delivery pipes and again at the end of the pipe, i.e., POU, using SensiDisc diffusion on Muller Hinton, we are finding multi-drug resistant organisms. In some cases these organisms are resistant to 11 of the 12 challenge antibiotics in our Kirby Bauer. This is going out the pipes and sprinklers, becoming aerosolized and drifting into adjoining homes. It certainly is available to those playing on lawns irrigated with this water such as the school playing fields and golf courses.<br /><br />Then, in many sewer plants, there is the use of UV. Meckes noted that in cases, the bacteria that were resistant and coming out of sewer plants saw enhanced resistance when exposed to UV. Additionally, Amy Pruden (personal communication) notes that the DNA from UV-killed bacteria is not altered. Thus, there is no assurance that non-pathogens will not pick up this genetic information, thence becoming resistant and pathogenic. <br />It is critical to understand that there are sources of released antibiotic resistant microbes that the regulators are well aware of but essentially refuse to effectively deal with. Until there is enough political pressure applied to this subject, it will remain an undisclosed source to confound the treatment of resistant infections and at the same time see our diminishing tools yet faster depleted.<br /><br />Dr Edo McGowan<br /><br />CaliforniaAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-6297038928525377502.post-85665903289848306482010-12-21T08:22:15.469-05:002010-12-21T08:22:15.469-05:00One problem with the antibiotic industry is that i...One problem with the antibiotic industry is that it is overun with biologists who find new and better ways to study the problem and incidence of resistance, but doesn't answer the problem. We need new drugs, we have known for some time it is a problem. <br /><br /><br /><br />I would encourage the NSF and the NIH to increase the funding to the chemical sciences at all the levels, so that the next generations of scientists able to emerge and generate the next waves of compounds happens. <br /><br />Look at the graduate schools. There are 10 to 1 biology grad students to chemistry, and logically 10 to 1 in industry. <br /><br />This imbalance is the core problem in developing newer agents. <br /><br />Too many biologists and not enough chemists!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-6297038928525377502.post-14919994291735349842010-11-23T17:15:30.171-05:002010-11-23T17:15:30.171-05:00How to meet the existing need for information?
Cl...How to meet the existing need for information?<br /><br />Cliodna, thank you for sharing the general results of the British surveys. “… most of the general public agree that overuse of antibiotics increases resistance […] Respondents also know the principles of prudent antibiotic use […] However, despite many public campaigns the use of antibiotics hasn't changed”… <br /><br />Where is the disconnect?<br /><br />Considering the high importance of antibiotics and health issues in everyday life, it is not surprising that a majority of the population is aware of antibiotic resistance. The current and, obviously, partial understanding of antibiotic resistance by the general population turns the dissemination of information into a difficult task. Just like closed-end questions, any additional information given has the side effect of activating passive knowledge. Personal prejudices and experiences which are often negative thereby occupy the foreground of debate about antibiotics and antibiotic resistance. As long as no additional information is given, an objective understanding of the issue prevails. However, when information is given that is not sufficiently objective, predominantly confused reactions are evoked.<br /><br />A great advantage for the communication of information is the high credibility of scientists as communicators. Scientists are often judged as most credible, even more credible than physicians. Once more, a need for information can be identified that goes beyond personal concern: the population desires accurate information on what kind of infection they have and how to treat it. Therefore, my support goes to the emphasis of campaigns on the type of microorganism causing the infection, thus the need for accurate diagnosis, and the use of antibiotics for only bacteria.Mirella Zulueta, M.D., Ph.D., Director of Translational Research at APUAhttp://www.apua.orgnoreply@blogger.comtag:blogger.com,1999:blog-6297038928525377502.post-64508108969877564282010-11-21T18:14:35.386-05:002010-11-21T18:14:35.386-05:00CDC is to be congratulated on energized and well-d...CDC is to be congratulated on energized and well-designed efforts to address appropriate use of antibiotics in the community as well as in healthcare facilities. As we still cope with challenges from MRSA, we are becoming more aware of CRE emergence in healthcare facilities in the Commonwealth. This, and the continued increases in antimicrobial resistance observed in pneumococci, gonococci and M. tuberculosis, bring to the fore the need for a broad mobilization of public and healthcare partners in renewed efforts to address both the causes and consequences of antimicrobial resistance.Alfred DeMaria, M.D., Massachusetts Department of Public Healthhttp://www.mass.gov/dphnoreply@blogger.comtag:blogger.com,1999:blog-6297038928525377502.post-56558290568308058292010-11-17T14:49:58.484-05:002010-11-17T14:49:58.484-05:00Thanks, Jean. To add to this, European Centre for...Thanks, Jean. To add to this, European Centre for Disease Prevention and Control (ECDC) reported <a href="http://economictimes.indiatimes.com/news/news-by-industry/healthcare/biotech/healthcare/Super-superbug-NDM-1-spreads-in-Europe/articleshow/6942854.cms" rel="nofollow">today</a> that NDM-1 has now been detected in 13 European countries and is being referred to as a "super super bug".APUAhttps://www.blogger.com/profile/08697038324333876545noreply@blogger.comtag:blogger.com,1999:blog-6297038928525377502.post-10288074162135120412010-03-12T11:41:20.017-05:002010-03-12T11:41:20.017-05:00Interesting question. Anabolic steroids are used i...Interesting question. Anabolic steroids are used in about 80% of American feedlot cattle, according to some estimates. They are used to promote weight gain and muscle development, but some studies have shown that these hormones impact human health when we are exposed to hormone residues on our meat, or from water that has been contaminated by manure. I don't know how this affects hunger and weight, but it has been linked to early-onset puberty in girls, and breast and prostate cancer. An article from the Sierra Club's magazine a few years ago addressed steroid use in farm animals and the general problems with cheap, mass-produced food: http://www.sierraclub.org/sierra/200611/cheapfood.aspGenevra Pittmanhttps://www.blogger.com/profile/09186313642544757475noreply@blogger.comtag:blogger.com,1999:blog-6297038928525377502.post-35399782488035744722010-03-12T09:48:55.385-05:002010-03-12T09:48:55.385-05:00next, i want to know about steroids given to anima...next, i want to know about steroids given to animals. as in, how much artificial steroid does the average american consume each year that wasn't there in 1960 or thereabouts? exactly what are they feeding the poor beasts and why? how much of this substance is metabolized and how much reaches us unchanged? is this why the world is getting fat? why are we so hungry?roxannehttps://www.blogger.com/profile/01128220639115937918noreply@blogger.com