A new strain of methicillin-resistant Staphylococcus aureus (MRSA), once found only in pigs, now accounts for more than 20 percent of all human MRSA infections in the Netherlands.
The heavy use of antibiotics in industrialized livestock operations can account for resistant bacteria, such as MRSA. The new strain of MRSA, known as NT-MRSA, has so far primarily affected pig farmers and cattle farmers, and regions of the Netherlands with high densities of pig and cattle farms. The new strain has a high hospitalization rate, and can make people severely ill.
The Union of Concerned Scientists has estimated that 70 percent of all the antibiotics used in the United States are used as livestock feed additives. The United States does not systematically test pigs, cattle, and other food animals for MRSA. Almost 100,000 annual MRSA infections in the United States, of which almost a fifth are fatal.
Source:Organic Consumers Association December 6, 2007
Sunday, December 30, 2007
Infection rates at hospitals continue to grow
John Colson
Aspen, CO Colorado|Aspen Times
December 30, 2007
ROARING FORK VALLEY — Colorado and local public health officials say they don’t know the extent of reportedly increasing infection rates inside rural hospitals around the state, other than to concede that the rates are generally, if slowly, rising.
Laws are being passed in other states to require public data collection about hospital-acquired infections, in particular new strains of antibiotic-resistant bacterial infections.
Critics of existing health care policies nationwide are demanding that the new rules and techniques be adopted throughout the country to combat what they say is a particularly virulent and dangerous disease, known as MRSA.
In Colorado, however, data collection regarding MRSA (formally named Methicillin-Resistant Staphylococcus Aureus) is required only in Denver County. And Colorado is not one of the states that has adopted stringent new guidelines aimed at curbing the spread of MRSA in hospitals, nursing homes and other health care facilities.
“It is a persistent pathogen and it is out of control in most of the [U.S.] health care system,” declared Dr. Barry Farr, professor emeritus at the University of Virginia, and one of several nationally respected physicians tracking the MRSA phenomenon.
New infection control guidelines in several states in the U.S., as well as in European countries and other regions of the world, are requiring that hospitals screen all “at risk patients” and follow stringent measures to fight the spread of bacteria and disease.
The main enemy in this war is MRSA, although there are other bacteria and germs of concern. Together they amount to what some observers believe is a serious and worsening health care crisis in this country.
Dubbed a “superbug” by some, MRSA is the antibiotic resistant form of Staphylococcus Aureus, or S. Aureus, a type of staph infection that researchers believe has been around as long as humans have walked the earth.
It was not until the latter half of the 20th century that staph bacteria began developing resistance to treatment by antibiotics, particularly methicillin, which was commonly used to treat staph infections in hospitals.
The bacteria lives harmlessly on a person’s skin, and in nasal passages. Most infections result in skin problems ranging from pimples to boils. But the more serious complications from MRSA infections — most commonly in hospitals — are happening much more often, experts say.
And it is in hospitals around the country that the MRSA incidence is reaching what some experts say alarming, if not crisis proportions, causing serious diseases that can result in lengthy hospital stays, the amputation of limbs and even death.
An Illinois woman, Jeanine Thomas, founder of the MRSA Survivors Network and advocate for state and national legislation to combat the disease, writes on her Web site that she contracted an MRSA infection during ankle surgery in 2000. The infection went into her bone marrow, leading to seven surgeries to save her leg from amputation. She said she has spent 17 months out of the past five years in a sick-bed dealing with secondary infections, and still has health concerns.
Thomas, working with others, convinced the Illinois state legislature to pass laws requiring mandatory screening of “at-risk” patients for MRSA before they enter a hospital. “At-risk” means patients coming from nursing homes, or those headed to the intensive care unit, among other definitions.
Highly critical of health care officials who downplay the dangers of MRSA and similar pathogens, she said, “They always like to look like they’re doing something, but they’re doing nothing [in many areas]. We are where we are because of their inaction.”
In 1980, MRSA reportedly accounted for only 2 percent of all S. Aureus hospital-acquired infections reported in 300 hospitals that were part of a CDC study. More recently, MRSA is estimated to account for more than 60 percent of S. Aureus infections, according to an article in the February, 2006 edition of the magazine, “Infection Control Today.”
Across the U.S., advocates are calling for tighter monitoring of the resistant strains and much closer observance of what are known as “active detection and isolation” techniques aimed at cutting the incidence of MRSA-type infections.
Farr was a medical internist at UVA in the early 1980s, he said, when the university hospital detected rising MRSA rates and instituted “active detection and isolation” methods to keep the disease in check.
The measures include rigorous enforcement of rules on hand washing, the meticulous cleaning of equipment and hospital rooms, the use of gowns and disposable aprons to prevent doctors and nurses from spreading germs on clothing, and the testing of incoming patients to identify and isolate those carrying the bacterium.
Farr told an interviewer in 2004 that studies show that health care workers only wash their hands between patients about 40 percent of the time.
The measures have been formalized into guidelines published in 2003 by the Society for Healthcare Epidemiology of America (SHEA), authored largely by William R. Jarvis, MD, of Emory University School of Medicine, president of Jason and Jarvis Associates, and a former official of the Center for Disease Prevention and Control [CDC].
The measures worked, Farr said, and have been adopted in other selected parts of the country, including the states of Illinois, New Jersey and Pennsylvania. But unless all states, meaning all hospitals, nursing homes, VA facilities, and other health care centers begin following the same methods, MRSA infection rates will continue to grow, he believes.
As an example, Farr said, medical officials in Western Australia recently adopted the “active detection and isolation” methodology in response to rising MRSA infection rates, and the rates declined. But other parts of Australia did not follow suit, “so they spectacularly failed” to curb the disease, he said, and MRSA spread back into Western Australia.
He said some European nations, including the Netherlands and Denmark, have made it a national priority to follow the “active detection and isolation” guidelines.
Locally, hospital and community health officials say there is no requirement by the Colorado Department of Public Health and Environment to enumerate or report MRSA infections. The result, these officials say, is that there is no data on how many patients who are carriers of the bacteria, or “colonized,” as medical professional term it, are admitted to hospitals.
Hospital officials in Aspen and Glenwood Springs recently have said their best option for controlling what they admit is a growing problem is to educate the public on different personal hygiene techniques, such as washing hands frequently and avoiding the use of towels, washcloths or sports equipment that has been used by someone else.
Within the halls of local hospitals, where patients are known to contract “hospital-acquired MRSA,” the standard procedures involve isolating the patient from others, and instituting sterile-room rules requiring that everyone, both hospital staff and visitors, don gowns and gloves before entering the patient’s room to avoid picking up and carrying the bacteria into other parts of the facility.
But according to Farr and others, such measures are typically viewed as a last resort and only come into play when hospital staff learns through general testing that a patient suffers from a MRSA infection. And that, he maintains, may well be too late both for that patient and to stop the possible spread of infection.
Roughly 94,000 Americans contracted life-threatening MRSA infections, and more than 18,600 of those died in the U.S. in 2005, roughly 2,600 more than died of AIDS or HIV that year, according to the CDC. The CDC estimates that perhaps 1 percent of the U.S. population is “colonized” by MRSA bacteria and capable of spreading it to others.
At least 1 percent of Americans are carrying the bacteria on their skin, but few of them get sick, Gershman said.
Aspen, CO Colorado|Aspen Times
December 30, 2007
ROARING FORK VALLEY — Colorado and local public health officials say they don’t know the extent of reportedly increasing infection rates inside rural hospitals around the state, other than to concede that the rates are generally, if slowly, rising.
Laws are being passed in other states to require public data collection about hospital-acquired infections, in particular new strains of antibiotic-resistant bacterial infections.
Critics of existing health care policies nationwide are demanding that the new rules and techniques be adopted throughout the country to combat what they say is a particularly virulent and dangerous disease, known as MRSA.
In Colorado, however, data collection regarding MRSA (formally named Methicillin-Resistant Staphylococcus Aureus) is required only in Denver County. And Colorado is not one of the states that has adopted stringent new guidelines aimed at curbing the spread of MRSA in hospitals, nursing homes and other health care facilities.
“It is a persistent pathogen and it is out of control in most of the [U.S.] health care system,” declared Dr. Barry Farr, professor emeritus at the University of Virginia, and one of several nationally respected physicians tracking the MRSA phenomenon.
New infection control guidelines in several states in the U.S., as well as in European countries and other regions of the world, are requiring that hospitals screen all “at risk patients” and follow stringent measures to fight the spread of bacteria and disease.
The main enemy in this war is MRSA, although there are other bacteria and germs of concern. Together they amount to what some observers believe is a serious and worsening health care crisis in this country.
Dubbed a “superbug” by some, MRSA is the antibiotic resistant form of Staphylococcus Aureus, or S. Aureus, a type of staph infection that researchers believe has been around as long as humans have walked the earth.
It was not until the latter half of the 20th century that staph bacteria began developing resistance to treatment by antibiotics, particularly methicillin, which was commonly used to treat staph infections in hospitals.
The bacteria lives harmlessly on a person’s skin, and in nasal passages. Most infections result in skin problems ranging from pimples to boils. But the more serious complications from MRSA infections — most commonly in hospitals — are happening much more often, experts say.
And it is in hospitals around the country that the MRSA incidence is reaching what some experts say alarming, if not crisis proportions, causing serious diseases that can result in lengthy hospital stays, the amputation of limbs and even death.
An Illinois woman, Jeanine Thomas, founder of the MRSA Survivors Network and advocate for state and national legislation to combat the disease, writes on her Web site that she contracted an MRSA infection during ankle surgery in 2000. The infection went into her bone marrow, leading to seven surgeries to save her leg from amputation. She said she has spent 17 months out of the past five years in a sick-bed dealing with secondary infections, and still has health concerns.
Thomas, working with others, convinced the Illinois state legislature to pass laws requiring mandatory screening of “at-risk” patients for MRSA before they enter a hospital. “At-risk” means patients coming from nursing homes, or those headed to the intensive care unit, among other definitions.
Highly critical of health care officials who downplay the dangers of MRSA and similar pathogens, she said, “They always like to look like they’re doing something, but they’re doing nothing [in many areas]. We are where we are because of their inaction.”
In 1980, MRSA reportedly accounted for only 2 percent of all S. Aureus hospital-acquired infections reported in 300 hospitals that were part of a CDC study. More recently, MRSA is estimated to account for more than 60 percent of S. Aureus infections, according to an article in the February, 2006 edition of the magazine, “Infection Control Today.”
Across the U.S., advocates are calling for tighter monitoring of the resistant strains and much closer observance of what are known as “active detection and isolation” techniques aimed at cutting the incidence of MRSA-type infections.
Farr was a medical internist at UVA in the early 1980s, he said, when the university hospital detected rising MRSA rates and instituted “active detection and isolation” methods to keep the disease in check.
The measures include rigorous enforcement of rules on hand washing, the meticulous cleaning of equipment and hospital rooms, the use of gowns and disposable aprons to prevent doctors and nurses from spreading germs on clothing, and the testing of incoming patients to identify and isolate those carrying the bacterium.
Farr told an interviewer in 2004 that studies show that health care workers only wash their hands between patients about 40 percent of the time.
The measures have been formalized into guidelines published in 2003 by the Society for Healthcare Epidemiology of America (SHEA), authored largely by William R. Jarvis, MD, of Emory University School of Medicine, president of Jason and Jarvis Associates, and a former official of the Center for Disease Prevention and Control [CDC].
The measures worked, Farr said, and have been adopted in other selected parts of the country, including the states of Illinois, New Jersey and Pennsylvania. But unless all states, meaning all hospitals, nursing homes, VA facilities, and other health care centers begin following the same methods, MRSA infection rates will continue to grow, he believes.
As an example, Farr said, medical officials in Western Australia recently adopted the “active detection and isolation” methodology in response to rising MRSA infection rates, and the rates declined. But other parts of Australia did not follow suit, “so they spectacularly failed” to curb the disease, he said, and MRSA spread back into Western Australia.
He said some European nations, including the Netherlands and Denmark, have made it a national priority to follow the “active detection and isolation” guidelines.
Locally, hospital and community health officials say there is no requirement by the Colorado Department of Public Health and Environment to enumerate or report MRSA infections. The result, these officials say, is that there is no data on how many patients who are carriers of the bacteria, or “colonized,” as medical professional term it, are admitted to hospitals.
Hospital officials in Aspen and Glenwood Springs recently have said their best option for controlling what they admit is a growing problem is to educate the public on different personal hygiene techniques, such as washing hands frequently and avoiding the use of towels, washcloths or sports equipment that has been used by someone else.
Within the halls of local hospitals, where patients are known to contract “hospital-acquired MRSA,” the standard procedures involve isolating the patient from others, and instituting sterile-room rules requiring that everyone, both hospital staff and visitors, don gowns and gloves before entering the patient’s room to avoid picking up and carrying the bacteria into other parts of the facility.
But according to Farr and others, such measures are typically viewed as a last resort and only come into play when hospital staff learns through general testing that a patient suffers from a MRSA infection. And that, he maintains, may well be too late both for that patient and to stop the possible spread of infection.
Roughly 94,000 Americans contracted life-threatening MRSA infections, and more than 18,600 of those died in the U.S. in 2005, roughly 2,600 more than died of AIDS or HIV that year, according to the CDC. The CDC estimates that perhaps 1 percent of the U.S. population is “colonized” by MRSA bacteria and capable of spreading it to others.
At least 1 percent of Americans are carrying the bacteria on their skin, but few of them get sick, Gershman said.
Saturday, December 29, 2007
SV hospital seeing rise in community acquired MRSA cases
By Dana Cole
Herald/Review
Published on Friday, December 28, 2007
Hand washing is extremely important now more than ever. SIERRA VISTA — Know as Methicillin-resistant Staphylococcus aureus, or MRSA, this staph infection is extremely resistant to most antibiotics.
It has become one of the country’s most common causes of skin infection and is considered a rapidly emerging public health problem.
At one time MRSA was known as the “Hospital Superbug.”
“That’s because it was found in hospitals, nursing homes and other health care facilities,” said Ann Kuhl, infection control coordinator for Sierra Vista Regional Health Center. “But in recent years, we have seen a community acquired form of MRSA. In fact, the number of community acquired cases has jumped exponentially in the past five years.”
More than half of all MRSA cases seen at the Sierra Vista hospital are the community acquired form and have nothing to do with the hospital, Kuhl said.
“The two types look and act differently, so it’s easy for us to track,” she added. “The community acquired MRSA manifests as a skin infection and often starts out as a small red lesion that grows quickly and is generally localized.”
While hospital-associated MRSA was first identified in 1968, the community acquired form is fairly new, Kuhl said.
There are steps that can be taken to reduce the incidence of community acquired MRSA infections.
“Good hygiene is key,” Kuhl stated. “Wash your hands regularly, with soap. All open cuts or sores need to be kept clean.”
The smallest scrapes, paper cuts, animal scratches, as well as open skin lesions, are an invitation for MRSA infections. “Staph, in general, if you give it a way to enter into the body, can become a big problem,” Kuhl warns. “We just can’t emphasize thorough and frequent hand washing enough. Hand sanitizers are very effective.”
Taking basic contact precautions and keeping home environments clean also are imperative for good infection control. Clusters of community acquired MRSA skin infections have been documented in athletes participating in contact sports, military recruits, IV drug users and prisoners. Other risk factors include close skin-to-skin contact, exposure to contaminated items and surfaces and crowded living conditions.
The bacteria Staphylococcus aureus is present in many people and typically causes no problems. It’s estimated that about a third of the population carry it in the nose, throat and on the skin. But if it gets inside the body, such as under the skin, it can cause serious, potentially fatal infections. If staph infects the lungs, it can cause pneumonia.
“Staphylococcus aureus becomes a health problem when it’s resistant to commonly used antibiotics,” Kuhl said. “Staphylococcus aureus that is resistant to Methicillin is MRSA.”
More than 50 percent of the staph isolates seen by SVRHC are resistant to the usual antibiotics that are used to treat them, Kuhl said.
While most healthy people will never become seriously ill from this bacteria, it can be a health threat for young children, the elderly and people with weakened immune systems. Despite documented risk factors, Kuhl warns there are no patterns when it comes to community acquired MRSA, which further emphasizes the need for everyone to take extra precautions.
The hospital is planning a three-month-long MRSA prevention campaign, an educational program that all 800 hospital employees will be required to attend.
“We’re using this program as a reminder for our staff, emphasizing the importance of good hand hygiene and why we need to take extra precautions,” Kuhl said. “When a patient comes in with MRSA, it’s our policy to take special precautions when working with that person.”
Herald/Review
Published on Friday, December 28, 2007
Hand washing is extremely important now more than ever. SIERRA VISTA — Know as Methicillin-resistant Staphylococcus aureus, or MRSA, this staph infection is extremely resistant to most antibiotics.
It has become one of the country’s most common causes of skin infection and is considered a rapidly emerging public health problem.
At one time MRSA was known as the “Hospital Superbug.”
“That’s because it was found in hospitals, nursing homes and other health care facilities,” said Ann Kuhl, infection control coordinator for Sierra Vista Regional Health Center. “But in recent years, we have seen a community acquired form of MRSA. In fact, the number of community acquired cases has jumped exponentially in the past five years.”
More than half of all MRSA cases seen at the Sierra Vista hospital are the community acquired form and have nothing to do with the hospital, Kuhl said.
“The two types look and act differently, so it’s easy for us to track,” she added. “The community acquired MRSA manifests as a skin infection and often starts out as a small red lesion that grows quickly and is generally localized.”
While hospital-associated MRSA was first identified in 1968, the community acquired form is fairly new, Kuhl said.
There are steps that can be taken to reduce the incidence of community acquired MRSA infections.
“Good hygiene is key,” Kuhl stated. “Wash your hands regularly, with soap. All open cuts or sores need to be kept clean.”
The smallest scrapes, paper cuts, animal scratches, as well as open skin lesions, are an invitation for MRSA infections. “Staph, in general, if you give it a way to enter into the body, can become a big problem,” Kuhl warns. “We just can’t emphasize thorough and frequent hand washing enough. Hand sanitizers are very effective.”
Taking basic contact precautions and keeping home environments clean also are imperative for good infection control. Clusters of community acquired MRSA skin infections have been documented in athletes participating in contact sports, military recruits, IV drug users and prisoners. Other risk factors include close skin-to-skin contact, exposure to contaminated items and surfaces and crowded living conditions.
The bacteria Staphylococcus aureus is present in many people and typically causes no problems. It’s estimated that about a third of the population carry it in the nose, throat and on the skin. But if it gets inside the body, such as under the skin, it can cause serious, potentially fatal infections. If staph infects the lungs, it can cause pneumonia.
“Staphylococcus aureus becomes a health problem when it’s resistant to commonly used antibiotics,” Kuhl said. “Staphylococcus aureus that is resistant to Methicillin is MRSA.”
More than 50 percent of the staph isolates seen by SVRHC are resistant to the usual antibiotics that are used to treat them, Kuhl said.
While most healthy people will never become seriously ill from this bacteria, it can be a health threat for young children, the elderly and people with weakened immune systems. Despite documented risk factors, Kuhl warns there are no patterns when it comes to community acquired MRSA, which further emphasizes the need for everyone to take extra precautions.
The hospital is planning a three-month-long MRSA prevention campaign, an educational program that all 800 hospital employees will be required to attend.
“We’re using this program as a reminder for our staff, emphasizing the importance of good hand hygiene and why we need to take extra precautions,” Kuhl said. “When a patient comes in with MRSA, it’s our policy to take special precautions when working with that person.”
Friday, December 14, 2007
CDC and other health groups ask public to consider dangers of antiobiotic resistance
While viruses cause colds and the flu, taking antibiotics for a virus may do more harm than good.
That’s why the Centers for Disease Control and Prevention, along with other health advocates, are asking that during this cold and flu season people consider the dangers of antibiotic resistance. A course of antibiotics won’t fight the virus, make the patient feel better, yield a quicker recovery or keep others from getting sick.
In fact, antibiotic resistance, which is associated with the recent news reports of methicillin-resistant Staphylococcus aureus, or MRSA, is among the growing public health concerns in the world.
Antibiotic resistance occurs when bacteria change or adapt to treatments. That reduces or eliminates the effectiveness of drugs designed to cure or prevent infections. Public health officials have been increasingly outspoken about how widespread inappropriate use of antibiotics has fueled an increase in antibiotic-
resistant bacteria.
Here are tips from the CDC:
Do not demand antibiotics when a healthcare provider says they are not needed. They will not help treat your infection.
Do not take an antibiotic for a viral infection like a cold, a cough, flu or acute bronchitis.
When you are prescribed an antibiotic, do not skip doses or stop taking the medicine early.
Do not take antibiotics prescribed for someone else. Taking the wrong medicine may allow bacteria to multiply.
Prevent the spread of infections through frequent hand washing.
Talk with your healthcare provider about antibiotic resistance.
That’s why the Centers for Disease Control and Prevention, along with other health advocates, are asking that during this cold and flu season people consider the dangers of antibiotic resistance. A course of antibiotics won’t fight the virus, make the patient feel better, yield a quicker recovery or keep others from getting sick.
In fact, antibiotic resistance, which is associated with the recent news reports of methicillin-resistant Staphylococcus aureus, or MRSA, is among the growing public health concerns in the world.
Antibiotic resistance occurs when bacteria change or adapt to treatments. That reduces or eliminates the effectiveness of drugs designed to cure or prevent infections. Public health officials have been increasingly outspoken about how widespread inappropriate use of antibiotics has fueled an increase in antibiotic-
resistant bacteria.
Here are tips from the CDC:
Do not demand antibiotics when a healthcare provider says they are not needed. They will not help treat your infection.
Do not take an antibiotic for a viral infection like a cold, a cough, flu or acute bronchitis.
When you are prescribed an antibiotic, do not skip doses or stop taking the medicine early.
Do not take antibiotics prescribed for someone else. Taking the wrong medicine may allow bacteria to multiply.
Prevent the spread of infections through frequent hand washing.
Talk with your healthcare provider about antibiotic resistance.
Manure Management Reduces Levels Of Antibiotics And Antibiotic Resistance Genes
ScienceDaily (Dec. 3, 2007) — Antibiotic resistance is a growing human health concern. Researchers around the globe have found antibiotics and other pharmaceuticals to be present in surface waters and sediments, municipal wastewater, animal manure lagoons, and underlying groundwater. Researchers at Colorado State University (CSU) describe a study to find out if animal waste contributes to the spread of antibiotics and antibiotic resistance genes (ARG), and if they can be reduced by appropriate manure management practices.
In the study researchers investigated the effects of manure management on the levels of antibiotics and ARG in manures. The study was conducted at two scales. In the pilot-scale experiment, horse manure was spiked with the antibiotics chlortetracycline, tylosin, and monensin and compared to horse manure that was not spiked with antibiotics to determine the response of ARG in unacclimated manures. In the large-scale experiment, dairy manure and beef feedlot manure, which were already acclimated to antibiotics, were monitored over time.
The manures were subjected to high-intensity management (HIM-amending with leaves and alfalfa, watering, and turning) and low-intensity management (LIM-no amending, watering, and turning) for six months. During this time, the levels of antibiotics were monitored using high-performance liquid chromatography (HPLC) and tandem mass spectrometry (MS/MS). In addition, two types of ARG that confer resistance to tetracycline, tet(W) and tet(O), were monitored using quantitative polymerase chain reaction (Q-PCR).
In the pilot study, chlortetracycline, tylosin, and monensin all dissipated more rapidly in the HIM-manure than in the LIM-manure. In the large-scale study, feedlot manure initially had higher concentrations of the several tetracycline antibiotics than the dairy manure. After four months of treatment, tet(W) and tet(O) decreased significantly in dairy manure, but two more months of treatment were necessary for similar reductions of ARG in the feedlot manures.
The results showed that HIM was more effective than LIM at increasing the rate of antibiotic dissipation, but it was not a significant factor in reducing the levels of ARG. The length of treatment time was the main factor in reducing the levels of both antibiotics and ARG. For manures with initially high levels of antibiotics, treatment times of at least six months may be necessary for a significant reduction in levels of antibiotics and ARG. The results also provided evidence that ARG may be present for extended time periods even after antibiotics have fully dissipated.
Scientists at Colorado State University are continuing research in this area by examining full-scale local on-farm waste management practices. Together this research will lead to a better understanding of possible ARG mitigation strategies so that best management practices can be developed to reduce the effects that animal waste may have on the spread of ARG.
This research was published in the November-December issue of Journal of Environmental Quality. Funding was provided by the USDA Agricultural Experiment Station at CSU and the National Science Foundation (NSF).
Adapted from materials provided by American Society of Agronomy.
In the study researchers investigated the effects of manure management on the levels of antibiotics and ARG in manures. The study was conducted at two scales. In the pilot-scale experiment, horse manure was spiked with the antibiotics chlortetracycline, tylosin, and monensin and compared to horse manure that was not spiked with antibiotics to determine the response of ARG in unacclimated manures. In the large-scale experiment, dairy manure and beef feedlot manure, which were already acclimated to antibiotics, were monitored over time.
The manures were subjected to high-intensity management (HIM-amending with leaves and alfalfa, watering, and turning) and low-intensity management (LIM-no amending, watering, and turning) for six months. During this time, the levels of antibiotics were monitored using high-performance liquid chromatography (HPLC) and tandem mass spectrometry (MS/MS). In addition, two types of ARG that confer resistance to tetracycline, tet(W) and tet(O), were monitored using quantitative polymerase chain reaction (Q-PCR).
In the pilot study, chlortetracycline, tylosin, and monensin all dissipated more rapidly in the HIM-manure than in the LIM-manure. In the large-scale study, feedlot manure initially had higher concentrations of the several tetracycline antibiotics than the dairy manure. After four months of treatment, tet(W) and tet(O) decreased significantly in dairy manure, but two more months of treatment were necessary for similar reductions of ARG in the feedlot manures.
The results showed that HIM was more effective than LIM at increasing the rate of antibiotic dissipation, but it was not a significant factor in reducing the levels of ARG. The length of treatment time was the main factor in reducing the levels of both antibiotics and ARG. For manures with initially high levels of antibiotics, treatment times of at least six months may be necessary for a significant reduction in levels of antibiotics and ARG. The results also provided evidence that ARG may be present for extended time periods even after antibiotics have fully dissipated.
Scientists at Colorado State University are continuing research in this area by examining full-scale local on-farm waste management practices. Together this research will lead to a better understanding of possible ARG mitigation strategies so that best management practices can be developed to reduce the effects that animal waste may have on the spread of ARG.
This research was published in the November-December issue of Journal of Environmental Quality. Funding was provided by the USDA Agricultural Experiment Station at CSU and the National Science Foundation (NSF).
Adapted from materials provided by American Society of Agronomy.
Teacher Dies from Staph Infection
ROCKVILLE, Md. -- A Rockville teacher died Sunday evening due to complications from a virulent form of staph infection.
Merry King, 48, was a special education teacher at Herbert Hoover Middle School.
School officials said the 48-year-old had been absent from Hoover since Nov. 30 and hospitalized since early last week.
King's daughter, Charlotte Oliver, told school officials her mother had been in a coma and died five days later of complications from a methicillin-resistant Staphylococcus aureus, or MRSA, infection.
"We're not really certain when or how she picked it up," Oliver said. "She may have had it for a while. By the time she checked into the hospital it was so acute that there wasn't a lot they could do."
"Ms. King was a beloved staff member and students in her class will be deeply affected by her death," said Hoover Middle School Principal Billie-Jean Bensen, in a letter sent home with students.
Bensen said there is no indication King's illness was related to her work at the school and there is no reason to believe anyone there has an increased risk of contracting MRSA.
The classroom in which King worked was sanitized with bleach, News4's Megan McGrath reported. Common areas at the school are scheduled to be sanitized Tuesday night. Officials said they do not believe there is a threat to students, staff or faculty at the school.
As King's family copes with the loss, they are also disinfecting the teacher's home.
Students learned of her death on Monday and said they were very upset by it.
Officials said there were grief counselors on hand at the school.
In a letter sent home to parents, the school's principal expressed condolences and at the same time moved to reassure parents that their children are safe.
As parents dropped their children off at school Tuesday, many said they were not worried about their children contracting the disease.
The Montgomery school system has had 43 cases in 31 schools this school year, primarily among student athletes, said Kate Harrison, a spokeswoman for the Montgomery County school system. There are currently only four active cases among county students. Harrison said King's case was believed to be the first since August involving a teacher.
Dozens of cases of the infection have been reported in the Washington region, but exact figures are not available because doctors are not required to report MRSA to state health authorities.
An estimated 90,000 people in the United States fall ill each year from MRSA. It is not clear how many die from the infection; one estimate put it at more than 18,000, which would be slightly higher than U.S. deaths from AIDS.
Merry King, 48, was a special education teacher at Herbert Hoover Middle School.
School officials said the 48-year-old had been absent from Hoover since Nov. 30 and hospitalized since early last week.
King's daughter, Charlotte Oliver, told school officials her mother had been in a coma and died five days later of complications from a methicillin-resistant Staphylococcus aureus, or MRSA, infection.
"We're not really certain when or how she picked it up," Oliver said. "She may have had it for a while. By the time she checked into the hospital it was so acute that there wasn't a lot they could do."
"Ms. King was a beloved staff member and students in her class will be deeply affected by her death," said Hoover Middle School Principal Billie-Jean Bensen, in a letter sent home with students.
Bensen said there is no indication King's illness was related to her work at the school and there is no reason to believe anyone there has an increased risk of contracting MRSA.
The classroom in which King worked was sanitized with bleach, News4's Megan McGrath reported. Common areas at the school are scheduled to be sanitized Tuesday night. Officials said they do not believe there is a threat to students, staff or faculty at the school.
As King's family copes with the loss, they are also disinfecting the teacher's home.
Students learned of her death on Monday and said they were very upset by it.
Officials said there were grief counselors on hand at the school.
In a letter sent home to parents, the school's principal expressed condolences and at the same time moved to reassure parents that their children are safe.
As parents dropped their children off at school Tuesday, many said they were not worried about their children contracting the disease.
The Montgomery school system has had 43 cases in 31 schools this school year, primarily among student athletes, said Kate Harrison, a spokeswoman for the Montgomery County school system. There are currently only four active cases among county students. Harrison said King's case was believed to be the first since August involving a teacher.
Dozens of cases of the infection have been reported in the Washington region, but exact figures are not available because doctors are not required to report MRSA to state health authorities.
An estimated 90,000 people in the United States fall ill each year from MRSA. It is not clear how many die from the infection; one estimate put it at more than 18,000, which would be slightly higher than U.S. deaths from AIDS.
Montgomery Village Student Diagnosed With MRSA
MONTGOMERY VILLAGE, Md. -- A student at Montgomery Village Middle School has been diagnosed with MRSA, an antibiotic-resistant strain of staph infection.
The student is the first at the school to be diagnosed with methicillin-resistant Staphylococcus aureus, school officials said.It's the 43rd case in the Montgomery County school system this year.
School officials said the student is being treated and is attending class, News4's Jane Watrel reported.
Principal Edgar E. Malker and school nurse Maureen Reges released a statement urging families of students at the school to practice good hygiene and check skin regularly for lesions.
Merry King, a middle school special education teacher in Potomac, died earlier this week from MRSA.
The Montgomery school system has had 43 cases in 31 schools this school year, primarily among student athletes, said Kate Harrison, a spokeswoman for the Montgomery County school system.
Health officials said MRSA is not found only in schools, but also in places like rec centers and health clubs.
Dozens of cases of the infection have been reported in the Washington region, but exact figures are not available because doctors are not required to report MRSA to state health authorities.
Health officials said basic hygiene can prevent the spread of the disease. Washing hands and clothes and not sharing personal articles are the best safeguards, they said.
An estimated 90,000 people in the United States fall ill each year from MRSA. It is not clear how many die from the infection; one estimate put it at more than 18,000, which would be slightly higher than U.S. deaths from AIDS.
The student is the first at the school to be diagnosed with methicillin-resistant Staphylococcus aureus, school officials said.It's the 43rd case in the Montgomery County school system this year.
School officials said the student is being treated and is attending class, News4's Jane Watrel reported.
Principal Edgar E. Malker and school nurse Maureen Reges released a statement urging families of students at the school to practice good hygiene and check skin regularly for lesions.
Merry King, a middle school special education teacher in Potomac, died earlier this week from MRSA.
The Montgomery school system has had 43 cases in 31 schools this school year, primarily among student athletes, said Kate Harrison, a spokeswoman for the Montgomery County school system.
Health officials said MRSA is not found only in schools, but also in places like rec centers and health clubs.
Dozens of cases of the infection have been reported in the Washington region, but exact figures are not available because doctors are not required to report MRSA to state health authorities.
Health officials said basic hygiene can prevent the spread of the disease. Washing hands and clothes and not sharing personal articles are the best safeguards, they said.
An estimated 90,000 people in the United States fall ill each year from MRSA. It is not clear how many die from the infection; one estimate put it at more than 18,000, which would be slightly higher than U.S. deaths from AIDS.
Lyme Arthritis Study Sheds Light On Antibiotic Resistance And Persistent Joint Inflammation
Lyme disease in the U.S. is caused by a form of bacteria, the spirochete Borrelia burgdorferi, infecting humans by tick bites. It typically begins with a bull's-eye skin rash, accompanied by fever, muscle aches, or other flu-like symptoms. If diagnosed early, Lyme can be treated successfully within a month with either oral or intravenous antibiotics. Nearly 60 percent of patients who do not receive antibiotic therapy early in the illness develop intermittent or persistent arthritis, particularly affecting the knees. Moreover, a small percentage of Lyme patients who do receive antibiotic therapy suffer from persistent arthritis for months or even several years after 2-3 months of oral and intravenous antibiotic therapy. This confounding condition has been termed antibiotic-refractory, or slowly resolving, Lyme arthritis.
To gain insights into the survival of spirochetes following antibiotic therapy, researchers at the Center for Immunology and Inflammatory Diseases at Massachusetts General Hospital, Harvard Medical School, and the National Center for Infectious Diseases at the Centers for Disease Control and Prevention teamed up to study antibody responses to Borrelia burgdorferi in patients with antibiotic-refractory or antibiotic-responsive Lyme arthritis. Presented in the December 2007 issue of Arthritis & Rheumatism , their findings indicate that joint inflammation persists in patients with antibiotic-refractory Lyme arthritis after the disease-spreading spirochetes have been killed.
To compare antibody responses and determine their effect on Lyme arthritis, the team tested at least 3 blood serum samples each from 41 patients with antibiotic-refractory arthritis, 23 patients with antibiotic-responsive arthritis, and 10 non-antibiotic-treated controls - arthritis patients who had contracted Lyme disease during the late 1970s before the cause of the disease was known. Samples were obtained during the period of arthritis and sometimes after several months of remission for all patient groups. The patients with antibiotic-refractory and antibiotic-responsive arthritis had a similar age range, sex distribution, and duration of arthritis prior to antibiotic therapy.
All samples were tested for IgG reactivity with Borrelia burgdorferi bacteria and 4 outer surface lipoproteins of the spirochete. Among non-antibiotic-treated patients, antibody titers to Borrelia burgdorferi remained high throughout a prolonged period of persistent arthritis, 2 to 5 years. In contrast, in patients with antibiotic-responsive arthritis, the level of antibody titers to Borrelia burgdorferi and most outer-surface proteins remained steady or decreased within the first 3 months of starting antibiotic therapy. Consistent with this finding, these patients usually experienced relief from joint swelling during a 1-month course of oral antibiotics. In patients afflicted with antibiotic-refractory arthritis, the level of antibody titers to Borrelia burgdorferi and most outer-surface antigens increased slightly during the first 1 to 3 months of treatment. These patients suffered from persistent joint swelling for a median duration of 10 months, despite 2 to 3 months of oral or intravenous antibiotics. However, by 4 to 6 months after starting antibiotic therapy, antibody titers declined to similar levels in both antibiotic-treated groups, regardless of their differences in arthritis symptoms.
"In Lyme disease, there is a great need for a test that could be used in clinical practice as a marker for spirochetal eradication," observes Dr. Allen C. Steere, the senior author of the study. Yet, as he acknowledges, ridding the body of the Borrelia burgdorferi bacteria and its surface antigens does not always bring relief from arthritis. "Increasing antibody titers in patients usually suggested the presence of live spirochetes, whereas declining titers suggested that they had been killed," he notes. "Thus, patients with Lyme arthritis who have a sustained, gradual decline in antibody reactivity probably have the nearly complete or total eradication of spirochetes from the joint as a result of antibiotic therapy, even if joint inflammation persists after the period of infection."
----------------------------
Article adapted by Medical News Today from original press release.
----------------------------
Article: "Antibody Responses to Borrelia burgdorferi in Patients With Antiobiotic-Refractory, Antibiotic-Responsive, or Non-Antibiotic-Treated Lyme Disease," Priya Kannian, Gail McHugh, Barbara J.B. Johnson, Rendi M. Bacon, Lisa J. Glickstein, and Allen C. Steere, Arthritis & Rheumatism, December 2007.
Source: Amy Molnar
Wiley-Blackwell
To gain insights into the survival of spirochetes following antibiotic therapy, researchers at the Center for Immunology and Inflammatory Diseases at Massachusetts General Hospital, Harvard Medical School, and the National Center for Infectious Diseases at the Centers for Disease Control and Prevention teamed up to study antibody responses to Borrelia burgdorferi in patients with antibiotic-refractory or antibiotic-responsive Lyme arthritis. Presented in the December 2007 issue of Arthritis & Rheumatism , their findings indicate that joint inflammation persists in patients with antibiotic-refractory Lyme arthritis after the disease-spreading spirochetes have been killed.
To compare antibody responses and determine their effect on Lyme arthritis, the team tested at least 3 blood serum samples each from 41 patients with antibiotic-refractory arthritis, 23 patients with antibiotic-responsive arthritis, and 10 non-antibiotic-treated controls - arthritis patients who had contracted Lyme disease during the late 1970s before the cause of the disease was known. Samples were obtained during the period of arthritis and sometimes after several months of remission for all patient groups. The patients with antibiotic-refractory and antibiotic-responsive arthritis had a similar age range, sex distribution, and duration of arthritis prior to antibiotic therapy.
All samples were tested for IgG reactivity with Borrelia burgdorferi bacteria and 4 outer surface lipoproteins of the spirochete. Among non-antibiotic-treated patients, antibody titers to Borrelia burgdorferi remained high throughout a prolonged period of persistent arthritis, 2 to 5 years. In contrast, in patients with antibiotic-responsive arthritis, the level of antibody titers to Borrelia burgdorferi and most outer-surface proteins remained steady or decreased within the first 3 months of starting antibiotic therapy. Consistent with this finding, these patients usually experienced relief from joint swelling during a 1-month course of oral antibiotics. In patients afflicted with antibiotic-refractory arthritis, the level of antibody titers to Borrelia burgdorferi and most outer-surface antigens increased slightly during the first 1 to 3 months of treatment. These patients suffered from persistent joint swelling for a median duration of 10 months, despite 2 to 3 months of oral or intravenous antibiotics. However, by 4 to 6 months after starting antibiotic therapy, antibody titers declined to similar levels in both antibiotic-treated groups, regardless of their differences in arthritis symptoms.
"In Lyme disease, there is a great need for a test that could be used in clinical practice as a marker for spirochetal eradication," observes Dr. Allen C. Steere, the senior author of the study. Yet, as he acknowledges, ridding the body of the Borrelia burgdorferi bacteria and its surface antigens does not always bring relief from arthritis. "Increasing antibody titers in patients usually suggested the presence of live spirochetes, whereas declining titers suggested that they had been killed," he notes. "Thus, patients with Lyme arthritis who have a sustained, gradual decline in antibody reactivity probably have the nearly complete or total eradication of spirochetes from the joint as a result of antibiotic therapy, even if joint inflammation persists after the period of infection."
----------------------------
Article adapted by Medical News Today from original press release.
----------------------------
Article: "Antibody Responses to Borrelia burgdorferi in Patients With Antiobiotic-Refractory, Antibiotic-Responsive, or Non-Antibiotic-Treated Lyme Disease," Priya Kannian, Gail McHugh, Barbara J.B. Johnson, Rendi M. Bacon, Lisa J. Glickstein, and Allen C. Steere, Arthritis & Rheumatism, December 2007.
Source: Amy Molnar
Wiley-Blackwell
Thursday, December 13, 2007
Be vigilant against staph
WITH ABOUT 19,000 people dying nationwide each year from antibiotic-resistant staph infections, it's important to be vigilant in personal hygiene, public health surveillance and aggressive countermeasures at a level consistent with the fight against AIDS infections.
Indeed, more people die in the United States each year from staph infections than from AIDS.
Local officials confronted the deadly bacteria recently in Spanish Fort, when a high school football player developed an infection. To their credit, school officials called in a professional cleaning crew to disinfect school buildings.
Fortunately, the Spanish Fort student recovered, but others who have contracted staph weren't so lucky. A Valley, Ala., woman died in October of complications from MRSA (methicillin-resistant Staphylococcus aureus) infection, becoming the first MRSA victim in Alabama.
It's estimated that 90,000 people have MRSA in the United States at any one time, though most of the cases occur in hospitals where health care professionals take aggressive measures against any infection.
Staph bacteria, though, are often present on the skin and in nasal passages. The "super bug" drug-resistant bacteria live among easily treatable bacteria and can enter a person's bloodstream through a minor scrape or cut, or through the skin pores.
Moreover, the dangerous bacteria can live on towels and other items that have come in contact with skin, jumping onto new hosts who come in contact with them, spreading and leading to an outbreak (defined as three or more cases).
Ironically, these super bugs occur because of the medical community's aggressive use of antibiotics against normal bacteria. Because of this widespread use, some bacteria become resistant to drugs.
But staph infections can be prevented, which is where personal hygiene comes in. Health officials suggest frequent washing of hands, showering after exercise, avoiding using someone else's towel, razor or other personal items that come in contact with skin, and cleansing of exercise equipment in public gyms.
Public health officials, too, can do more by requiring more aggressive reporting of individual cases, especially those that develop outside hospitals. With public awareness, personal hygiene and public health watchfulness, outbreaks of MRSA from community sources can become a health problem of the past.
© 2007 Press-Register. All rights reserved.
Indeed, more people die in the United States each year from staph infections than from AIDS.
Local officials confronted the deadly bacteria recently in Spanish Fort, when a high school football player developed an infection. To their credit, school officials called in a professional cleaning crew to disinfect school buildings.
Fortunately, the Spanish Fort student recovered, but others who have contracted staph weren't so lucky. A Valley, Ala., woman died in October of complications from MRSA (methicillin-resistant Staphylococcus aureus) infection, becoming the first MRSA victim in Alabama.
It's estimated that 90,000 people have MRSA in the United States at any one time, though most of the cases occur in hospitals where health care professionals take aggressive measures against any infection.
Staph bacteria, though, are often present on the skin and in nasal passages. The "super bug" drug-resistant bacteria live among easily treatable bacteria and can enter a person's bloodstream through a minor scrape or cut, or through the skin pores.
Moreover, the dangerous bacteria can live on towels and other items that have come in contact with skin, jumping onto new hosts who come in contact with them, spreading and leading to an outbreak (defined as three or more cases).
Ironically, these super bugs occur because of the medical community's aggressive use of antibiotics against normal bacteria. Because of this widespread use, some bacteria become resistant to drugs.
But staph infections can be prevented, which is where personal hygiene comes in. Health officials suggest frequent washing of hands, showering after exercise, avoiding using someone else's towel, razor or other personal items that come in contact with skin, and cleansing of exercise equipment in public gyms.
Public health officials, too, can do more by requiring more aggressive reporting of individual cases, especially those that develop outside hospitals. With public awareness, personal hygiene and public health watchfulness, outbreaks of MRSA from community sources can become a health problem of the past.
© 2007 Press-Register. All rights reserved.
MRSA case in Mattawan HS
MATTAWAN (NEWSCHANNEL 3) - A student at Mattawan High School has been diagnosed with MRSA.
Methicillin-resistant Staphylococcus aureus or MRSA is one of the "superbugs" that have evolved resistance to some commonly used antibiotics.
The Superintendent has told Newschannel 3 that the school has not been closed and the Health Department does not consider it a serious case.
The Superintendent also says that the school district is following cleaning and disinfecting procedures outlined by the Health Department.
The condition of the student with the infection is not known.
Methicillin-resistant Staphylococcus aureus or MRSA is one of the "superbugs" that have evolved resistance to some commonly used antibiotics.
The Superintendent has told Newschannel 3 that the school has not been closed and the Health Department does not consider it a serious case.
The Superintendent also says that the school district is following cleaning and disinfecting procedures outlined by the Health Department.
The condition of the student with the infection is not known.
Deodoriser may help beat superbugs in hospitals
By Simon Bristow
A MACHINE used to rid hospitals of bad smells could help beat so-called superbugs.
Wigan-based firm Scent Technologies has discovered that its ST-PRO deodorising machine not only issues a pleasant aroma, but proves highly effective in killing airborne bacteria associated with MRSA and Clostridium difficile.
The discovery was made almost by chance at a hospital in Whiston, St Helens, three years ago. And following seven months of clinical trials in the burns unit at Wythenshawe Hospital, Manchester, the product is to be developed and produced by Hull company Bonus Electrical.
Prof Valerie Edwards-Jones, a microbiologist at Manchester Metropolitan University, said: "We found in the burns unit that it reduced airborne counts by 90 per cent. What surprised us was in the control room, where we didn't have any vapours, the counts were down there."
He said the results were "very encouraging."
The machine, which has also been trialled at Airedale Hospital, works by releasing an invisible vapour containing essential oils into the air.
Scent Technologies director Roy Jackson said the machine could also be used in offices and adapted for use in aircraft.
A MACHINE used to rid hospitals of bad smells could help beat so-called superbugs.
Wigan-based firm Scent Technologies has discovered that its ST-PRO deodorising machine not only issues a pleasant aroma, but proves highly effective in killing airborne bacteria associated with MRSA and Clostridium difficile.
The discovery was made almost by chance at a hospital in Whiston, St Helens, three years ago. And following seven months of clinical trials in the burns unit at Wythenshawe Hospital, Manchester, the product is to be developed and produced by Hull company Bonus Electrical.
Prof Valerie Edwards-Jones, a microbiologist at Manchester Metropolitan University, said: "We found in the burns unit that it reduced airborne counts by 90 per cent. What surprised us was in the control room, where we didn't have any vapours, the counts were down there."
He said the results were "very encouraging."
The machine, which has also been trialled at Airedale Hospital, works by releasing an invisible vapour containing essential oils into the air.
Scent Technologies director Roy Jackson said the machine could also be used in offices and adapted for use in aircraft.
Glaxo boosts pipeline with two new biotech deals
By Ben Hirschler
LONDON (Reuters) - GlaxoSmithKline , Europe's biggest drugmaker, continued its recent rapid pace of deal-making on Monday by signing two new early-stage biotech alliances in cancer and anti-infective medicine.
The deals with privately owned U.S. cancer specialist OncoMed Pharmaceuticals and Belgium's Galapagos NV involve limited upfront investment. But Glaxo could make multibillion-dollar milestone payments if the products succeed.
Glaxo, like many large drugmakers, is hungry to find promising new drugs from outside its own laboratories and has stepped up its external collaboration efforts in the past year.
Further deals could be forthcoming as the year-end approaches, some analysts say.
Under the alliance with OncoMed, worth up to $1.4 billion (684 million pounds) or more, Glaxo has secured access to the Californian company's novel antibodies that target cancer stem cells.
Cancer stem cells are believed to play a key role in the establishment, metastasis -- or spread -- and recurrence of cancer.
The collaboration gives Glaxo an option to license four product candidates from OncoMed's library of monoclonal antibodies and increases its growing presence in oncology, the two companies said in a joint statement.
OncoMed will receive an undisclosed initial cash payment as well as an equity investment. In addition, it is eligible to earn milestone payments up to $1.4 billion from Glaxo, if certain clinical projects are commercially successful.
OncoMed will also get double-digit percentage royalties on eventual product sales, while Glaxo will have an option to invest in a future OncoMed initial public offering.
GALAPAGOS ALLIANCE
Separately, Glaxo has struck an alliance with Galapagos to discover and develop new anti-infective medicines against up to six targets based on Galapagos's natural product drug-delivery platform.
Galapagos will receive up to 3.5 million euros (2.51 million pounds) in technology access fees and up to 215 million euros ($315.1 million) in total payments for each marketed product.
Galapagos will be responsible for the discovery and development of natural product small molecule drug candidates through to "proof of concept" in clinical trials, at which point GSK will have exclusive option to license each compound for further development and commercialisation on a worldwide basis.
Shares in Galapgos were 3.4 percent higher by 2:34 p.m., while Glaxo was 0.8 percent lower in a slightly weaker European pharmaceuticals sector <.SXDP>.
The move reflects Glaxo's decision to place more emphasis on developing new antibiotics and anti-virals, after announcing in February it was setting up a new drug-discovery unit devoted to infectious diseases.
Other recent Glaxo licensing deals include an October agreement with Synta Pharmaceuticals Corp for rights to its experimental skin cancer drug, which could eventually earn the U.S. firm more than $1 billion, and a potential $1.5 billion brain drug deal with Targacept Inc in July.
In November, Glaxo agreed to buy privately held heart drug specialist Reliant Pharmaceuticals for $1.65 billion.
(Editing by Louise Ireland)
(c) Reuters 2007. All rights reserved.
LONDON (Reuters) - GlaxoSmithKline , Europe's biggest drugmaker, continued its recent rapid pace of deal-making on Monday by signing two new early-stage biotech alliances in cancer and anti-infective medicine.
The deals with privately owned U.S. cancer specialist OncoMed Pharmaceuticals and Belgium's Galapagos NV involve limited upfront investment. But Glaxo could make multibillion-dollar milestone payments if the products succeed.
Glaxo, like many large drugmakers, is hungry to find promising new drugs from outside its own laboratories and has stepped up its external collaboration efforts in the past year.
Further deals could be forthcoming as the year-end approaches, some analysts say.
Under the alliance with OncoMed, worth up to $1.4 billion (684 million pounds) or more, Glaxo has secured access to the Californian company's novel antibodies that target cancer stem cells.
Cancer stem cells are believed to play a key role in the establishment, metastasis -- or spread -- and recurrence of cancer.
The collaboration gives Glaxo an option to license four product candidates from OncoMed's library of monoclonal antibodies and increases its growing presence in oncology, the two companies said in a joint statement.
OncoMed will receive an undisclosed initial cash payment as well as an equity investment. In addition, it is eligible to earn milestone payments up to $1.4 billion from Glaxo, if certain clinical projects are commercially successful.
OncoMed will also get double-digit percentage royalties on eventual product sales, while Glaxo will have an option to invest in a future OncoMed initial public offering.
GALAPAGOS ALLIANCE
Separately, Glaxo has struck an alliance with Galapagos to discover and develop new anti-infective medicines against up to six targets based on Galapagos's natural product drug-delivery platform.
Galapagos will receive up to 3.5 million euros (2.51 million pounds) in technology access fees and up to 215 million euros ($315.1 million) in total payments for each marketed product.
Galapagos will be responsible for the discovery and development of natural product small molecule drug candidates through to "proof of concept" in clinical trials, at which point GSK will have exclusive option to license each compound for further development and commercialisation on a worldwide basis.
Shares in Galapgos were 3.4 percent higher by 2:34 p.m., while Glaxo was 0.8 percent lower in a slightly weaker European pharmaceuticals sector <.SXDP>.
The move reflects Glaxo's decision to place more emphasis on developing new antibiotics and anti-virals, after announcing in February it was setting up a new drug-discovery unit devoted to infectious diseases.
Other recent Glaxo licensing deals include an October agreement with Synta Pharmaceuticals Corp for rights to its experimental skin cancer drug, which could eventually earn the U.S. firm more than $1 billion, and a potential $1.5 billion brain drug deal with Targacept Inc in July.
In November, Glaxo agreed to buy privately held heart drug specialist Reliant Pharmaceuticals for $1.65 billion.
(Editing by Louise Ireland)
(c) Reuters 2007. All rights reserved.
TROOPS BRING BUG TO CANADA
Hospitals Warned; Drug-resistant bacterium coming from Afghanistan
Tom Blackwell, National Post
Published: Thursday, December 13, 2007
Federal authorities are warning hospitals across the country to beware a highly drug-resistant bacterium that wounded troops are bringing back from Afghanistan -- and which could inadvertently be spread to civilian patients.
The threat posed by the resistant strain of acinetobacter underlines the health care system's general lack of readiness for such emerging infections as they arrive in the country, said a senior Public Health Agency of Canada official.
Several soldiers being treated in civilian hospitals here have already developed pneumonia from the drug-resistant strain of the bacterium, which scientists say likely originated in the Canadian-led trauma centre at Kandahar Air Field.
Hospitals are being advised by the agency to screen injured soldiers for the bug, and take infection-control precautions if they test positive.
No transmission to nonmilitary patients has yet been detected, and the bug is not seen as much of a danger to healthy people outside of hospital. The fear, however, is that the resistant strain could genetically combine with more easily treatable versions of the bacterium that are more common in Canadian intensive-care units, said Shirley Paton of the public health agency.
"We're seeing a new organism being introduced into the Canadian swamp of organisms, this one being highly resistant," she said. "If we get someone with this highly resistant strain, are the two bugs going to get together into one? ... We're quite concerned that this will start spreading and become the acinetobacter of choice in the ICUs. We're really worried about that kind of transmission."
Outbreaks that may have originated in soldiers coming from Iraq or Afghanistan have already occurred in U.S. and British hospitals.
It is "critical" that hospital infection-control officers here are aware of the issue and respond appropriately, says a recent article in the Canadian Journal of Infection Control by agency officials and outside experts.
"Ultimately, there is the risk that you end up with a brand of organism that is invulnerable to antibiotics. There is little treatment available," said Dr. Andrew Simor of Toronto's Sunnybrook Health Sciences Centre, one of the country's leading infectious-disease experts. "We have to take that seriously."
The public health agency is planning a meeting for February or March involving the Department of National Defence, provincial public health departments and major hospitals to discuss the acinetobacter problem, and newly emerged pathogens generally, Ms. Paton said.
"How do we respond to something that is just arriving? Can we track it, can we stop it? Can we hold it?" she asked. "I don't think we have the processes in place yet to really respond in a nice, efficient, everybody-knows-what-they're-doing kind of manner."
Drug-resistant microbes, sometimes called superbugs, have become an increasing cause for anxiety in Canadian hospitals, with the most common of them, Methicillin-resistant staphylococcus aureus (MRSA) being blamed for thousands of deaths a year.
Often found in soil, acinetobacter is a danger to the old and seriously ill, particularly those on breathing machines, causing wound and blood infections and pneumonia. It was detected in many American casualties of the Vietnam war, then arose again in 2003 when U.S. and British
doctors started finding it in soldiers returning injured from Iraq and Afghanistan. At least four U.S. troops have died from the infection since then.
Canadian soldiers started testing positive for the bug after their mission in southern Afghanistan began last year. The most seriously wounded are sent to civilian hospitals here for further treatment.
At least 10 with acinetobacter have shown up in ICUs, Ms. Paton said. There have been an unknown number of other "walking wounded" troops with the bug, who have not been admitted to hospitals but might have visited family physicians or military doctors, she said.
A paper published in the journal BMC Infectious Diseases in August documents the cases of four Canadian soldiers, injured by roadside bombs and other means, who ended up on ventilators in 2006. All developed a pneumonia caused by acinetobacter that was resistant even to the carbapenem class of antibiotics, virtually the last line of defence against the microbe.
Although the paper does not mention the outcomes of their cases, Dr. Simor, a co-author of the paper, said he is unaware of any deaths from acinetobacter infection of Canadian combatants.
An investigation by the Defence Department found an identical strain of the bacteria in a ventilator used at the Canadian-managed trauma hospital on Kandahar Air Field, a NATO base, suggesting that is where it originated. Measures have since been taken to try to clear the field hospital of acinetobacter, Dr. Simor said.
Meanwhile, the Forces' health services department has advised families of some returning soldiers to avoid unprotected contact with the soldier until he or she has been screened for acinetobacter, according to an article by three military doctors in a recent issue of Wound Care Canada.
Tom Blackwell, National Post
Published: Thursday, December 13, 2007
Federal authorities are warning hospitals across the country to beware a highly drug-resistant bacterium that wounded troops are bringing back from Afghanistan -- and which could inadvertently be spread to civilian patients.
The threat posed by the resistant strain of acinetobacter underlines the health care system's general lack of readiness for such emerging infections as they arrive in the country, said a senior Public Health Agency of Canada official.
Several soldiers being treated in civilian hospitals here have already developed pneumonia from the drug-resistant strain of the bacterium, which scientists say likely originated in the Canadian-led trauma centre at Kandahar Air Field.
Hospitals are being advised by the agency to screen injured soldiers for the bug, and take infection-control precautions if they test positive.
No transmission to nonmilitary patients has yet been detected, and the bug is not seen as much of a danger to healthy people outside of hospital. The fear, however, is that the resistant strain could genetically combine with more easily treatable versions of the bacterium that are more common in Canadian intensive-care units, said Shirley Paton of the public health agency.
"We're seeing a new organism being introduced into the Canadian swamp of organisms, this one being highly resistant," she said. "If we get someone with this highly resistant strain, are the two bugs going to get together into one? ... We're quite concerned that this will start spreading and become the acinetobacter of choice in the ICUs. We're really worried about that kind of transmission."
Outbreaks that may have originated in soldiers coming from Iraq or Afghanistan have already occurred in U.S. and British hospitals.
It is "critical" that hospital infection-control officers here are aware of the issue and respond appropriately, says a recent article in the Canadian Journal of Infection Control by agency officials and outside experts.
"Ultimately, there is the risk that you end up with a brand of organism that is invulnerable to antibiotics. There is little treatment available," said Dr. Andrew Simor of Toronto's Sunnybrook Health Sciences Centre, one of the country's leading infectious-disease experts. "We have to take that seriously."
The public health agency is planning a meeting for February or March involving the Department of National Defence, provincial public health departments and major hospitals to discuss the acinetobacter problem, and newly emerged pathogens generally, Ms. Paton said.
"How do we respond to something that is just arriving? Can we track it, can we stop it? Can we hold it?" she asked. "I don't think we have the processes in place yet to really respond in a nice, efficient, everybody-knows-what-they're-doing kind of manner."
Drug-resistant microbes, sometimes called superbugs, have become an increasing cause for anxiety in Canadian hospitals, with the most common of them, Methicillin-resistant staphylococcus aureus (MRSA) being blamed for thousands of deaths a year.
Often found in soil, acinetobacter is a danger to the old and seriously ill, particularly those on breathing machines, causing wound and blood infections and pneumonia. It was detected in many American casualties of the Vietnam war, then arose again in 2003 when U.S. and British
doctors started finding it in soldiers returning injured from Iraq and Afghanistan. At least four U.S. troops have died from the infection since then.
Canadian soldiers started testing positive for the bug after their mission in southern Afghanistan began last year. The most seriously wounded are sent to civilian hospitals here for further treatment.
At least 10 with acinetobacter have shown up in ICUs, Ms. Paton said. There have been an unknown number of other "walking wounded" troops with the bug, who have not been admitted to hospitals but might have visited family physicians or military doctors, she said.
A paper published in the journal BMC Infectious Diseases in August documents the cases of four Canadian soldiers, injured by roadside bombs and other means, who ended up on ventilators in 2006. All developed a pneumonia caused by acinetobacter that was resistant even to the carbapenem class of antibiotics, virtually the last line of defence against the microbe.
Although the paper does not mention the outcomes of their cases, Dr. Simor, a co-author of the paper, said he is unaware of any deaths from acinetobacter infection of Canadian combatants.
An investigation by the Defence Department found an identical strain of the bacteria in a ventilator used at the Canadian-managed trauma hospital on Kandahar Air Field, a NATO base, suggesting that is where it originated. Measures have since been taken to try to clear the field hospital of acinetobacter, Dr. Simor said.
Meanwhile, the Forces' health services department has advised families of some returning soldiers to avoid unprotected contact with the soldier until he or she has been screened for acinetobacter, according to an article by three military doctors in a recent issue of Wound Care Canada.
Hospital 'dealing with' super bug
SERVICES at a major Brisbane hospital with an outbreak of a "super bug" will not be disrupted despite two wards being closed, its clinical chief says.
The Royal Brisbane and Women's Hospital clinical chief executive officer, Professor Keith McNeil, said staff were working to eradicate vancomycin resistant enterococcus (VRE), which is resistant to antibiotics.
On Friday, the hospital closed two 30-bed wards to new admissions when 21 patients tested positive to the bug, caused by an enterococcus bacteria which normally lives safely in the bowel.
The medical wards are being disinfected and patients are being screened as they leave.
Prof McNeil said staff had been put on extra shifts to carry out the "labour-intensive" cleaning, but said hospital was not under unusual strain.
"Bed pressures are ever present every day," he said.
"We run a balance between the number of people that are coming in and the number of people who (we) are able to discharge, so we have to put in strategies to try and maintain that throughput of patients.
"At this point in time we are not having any difficulties."
Most patients who tested positive to the bug were not sick, Prof McNeil said.
However, people with low immunity - including those with chronic disease, organ transplant recipients, diabetics and elderly people - can suffer severe infection, which is difficult to treat because of the bug's resistance.
Prof McNeil said some patients receiving dialysis had tested positive but had not come down with "overwhelming illness" as yet.
He said dealing with super bugs was now part of the day-to-day management of all hospitals.
"That's part of being a big teaching hospital," he said.
"We're not unique in this - this happens all around Australia and all around the developed world."
The Royal Brisbane and Women's Hospital clinical chief executive officer, Professor Keith McNeil, said staff were working to eradicate vancomycin resistant enterococcus (VRE), which is resistant to antibiotics.
On Friday, the hospital closed two 30-bed wards to new admissions when 21 patients tested positive to the bug, caused by an enterococcus bacteria which normally lives safely in the bowel.
The medical wards are being disinfected and patients are being screened as they leave.
Prof McNeil said staff had been put on extra shifts to carry out the "labour-intensive" cleaning, but said hospital was not under unusual strain.
"Bed pressures are ever present every day," he said.
"We run a balance between the number of people that are coming in and the number of people who (we) are able to discharge, so we have to put in strategies to try and maintain that throughput of patients.
"At this point in time we are not having any difficulties."
Most patients who tested positive to the bug were not sick, Prof McNeil said.
However, people with low immunity - including those with chronic disease, organ transplant recipients, diabetics and elderly people - can suffer severe infection, which is difficult to treat because of the bug's resistance.
Prof McNeil said some patients receiving dialysis had tested positive but had not come down with "overwhelming illness" as yet.
He said dealing with super bugs was now part of the day-to-day management of all hospitals.
"That's part of being a big teaching hospital," he said.
"We're not unique in this - this happens all around Australia and all around the developed world."
Key move in the war on superbugs
Michelle Fiddler,
Liverpool Echo
The Royal Liverpool and Broadgreen University Hospitals NHS trust will become one of the first in the country to use equipment with timing devices to warn staff when keyboards need cleaning.
Research into killer hospital bugs such as MRSA has found they can be spread by staff using dirty computer equipment.
The new keyboards will be used for all computers in ward areas.
Diane Wake, director of infection prevention and control, said: “The keyboards will be an additional safety measure to ensure a clean and secure, health care environment.
“These innovative products will be a great help to staff in our hospitals in the battle against infections.
“We are committed to doing everything we can no matter how small, innovative or unique it may be.”
The keyboards are completely flat, making them easier to clean, and they have hidden sensors so a red light flashes when surfaces have not been cleaned thoroughly enough.
Ms Wake said: “Good, but basic, routine clinical practices will secure victory against infections. Doing simple things well, and doing them all the time, is the guaranteed recipe for success.
“With the increasing computerisation of the NHS, the keyboards will ensure that bugs are less likely to spread when doctors and nurses move between computers and patients.
“Plus, the keyboards will be a steady reminder to keep things as clean as can be.”
The keyboards were thought up at University College London Hospitals. Research by microbiologists suggests that bacteria levels on keyboards fall by 70% if they are cleaned every 12 hours.
Keyboard covers last for two to three months. They can be a haven for bacteria as they are often difficult to clean.
michellefiddler@liverpool echo.co.uk
Liverpool Echo
The Royal Liverpool and Broadgreen University Hospitals NHS trust will become one of the first in the country to use equipment with timing devices to warn staff when keyboards need cleaning.
Research into killer hospital bugs such as MRSA has found they can be spread by staff using dirty computer equipment.
The new keyboards will be used for all computers in ward areas.
Diane Wake, director of infection prevention and control, said: “The keyboards will be an additional safety measure to ensure a clean and secure, health care environment.
“These innovative products will be a great help to staff in our hospitals in the battle against infections.
“We are committed to doing everything we can no matter how small, innovative or unique it may be.”
The keyboards are completely flat, making them easier to clean, and they have hidden sensors so a red light flashes when surfaces have not been cleaned thoroughly enough.
Ms Wake said: “Good, but basic, routine clinical practices will secure victory against infections. Doing simple things well, and doing them all the time, is the guaranteed recipe for success.
“With the increasing computerisation of the NHS, the keyboards will ensure that bugs are less likely to spread when doctors and nurses move between computers and patients.
“Plus, the keyboards will be a steady reminder to keep things as clean as can be.”
The keyboards were thought up at University College London Hospitals. Research by microbiologists suggests that bacteria levels on keyboards fall by 70% if they are cleaned every 12 hours.
Keyboard covers last for two to three months. They can be a haven for bacteria as they are often difficult to clean.
michellefiddler@liverpool echo.co.uk
Tuesday, November 27, 2007
"Superbug" — what you need to know about MRSA
By Carol M. Ostrom
Seattle Times health reporter
The head of the federal Centers for Disease Control and Prevention calls MRSA the "cockroach of bacteria." It's omnipresent, tough and adaptable.
This fall, methicillin-resistant Staphylococcus aureus suddenly went from a festering public-health issue to the top of the national news on word that it's worse than previously thought.
Many people — and many media outlets — started seeing it as a much bigger menace than a simple roach.
It became "the superbug," and the tales of its incredible power have featured people fighting for their lives after getting what they thought was a simple little "spider bite."
But what is MRSA, anyway? How afraid should you really be?
Last month, a report in the Journal of the American Medical Association estimated that in 2005, some 94,000 people were infected by the most serious form of MRSA infections, and one in five died.
Since then, public-health officials have been singing out of both sides of their mouths.
On one hand, they want to reassure people: Like many germs, MRSA is common. Many of us carry it around on our skin and in our noses, and it lives on surfaces from athletic gear to fabric. Outside the hospital, it's not hard to avoid, but if you get it, you'll likely just get a treatable skin infection.
On the other hand, the public-health gurus want to sound an alarm. They warn that MRSA is a symptom of a larger danger: the great number of germs worldwide becoming increasingly resistant to antibiotics.
"The prospect that effective antibiotics may not be available to treat seriously ill patients in the near future is real," says Dr. Jeff Duchin, communicable-diseases chief for Public Health — Seattle & King County.
So what do you really need to know and do?
Q: What is MRSA?
A: Germs, also known as bacteria, have been around forever. Staphylococcus aureus, also called "staph," was first identified in 1880 by a Scottish surgeon poking around in pus oozing from hospital patients. After antibiotics were discovered in 1928, staph was largely beaten back. But S. aureus evolved to survive the oldest type of antibiotics, called the penicillin-methicillin class. Methicillin-resistant Staphylococcus aureus (MRSA) was first identified in 1968.
Q: Why is it such a big deal all of a sudden?
A: Actually, the problem isn't new. Although most people don't get serious infections, staph has always been a "bad bug," says Duchin.
MRSA is even badder. Researchers are discovering that MRSA is surprisingly widespread and becoming tougher. It's a classic lesson in Darwinian evolution: As the weaker germs are killed by antibiotics, the strongest, most resistant ones survive and multiply, particularly when antibiotics are used improperly.
In 2000, a new strain of MRSA "took off like wildfire," according to Dr. Yuan-Po Tu, a MRSA tracker at the Everett Clinic. Before, most MRSA infections were caused by a strain mostly contracted in hospitals. This new, "community acquired" strain can be even more virulent, potentially causing severe illnesses even in healthy people.
Q: What does MRSA do?
A: Most of the time, community-acquired MRSA (sometimes shortened to CA-MRSA) causes skin and soft-tissue infections that can be treated with other readily available antibiotics. But if not properly treated, the bug can work its way into the body and is tough to get out.
The vast majority of serious, "invasive" MRSA infections and deaths occur in hospitalized patients who are suffering from other serious diseases, have lowered immunity or have recently undergone surgery.
Q: How is it spread?
A: MRSA likes to travel. Not by air, but by hand, towel, clothes, bedding and gym equipment.
Unlike the flu virus, MRSA isn't caught by breathing it in — there has to be actual skin-to-germ contact. The CDC says high-risk groups include children, athletes, military recruits, prisoners and other population groups who live in crowded or impoverished living conditions.
Q: So MRSA is inevitable?
A: No, because there are easy ways of avoiding it. Alcohol-based hand cleaner works. So does good, old-fashioned hand-washing.
And so does a bit of courage.
According to Duchin, not all health-care providers are religious about washing their hands according to guidelines. In the hospital, that means before and after seeing you. So you need to ask them: "Did you wash your hands?"
Don't be afraid of insulting them. "There are only two acceptable answers: 'Thank you for reminding me,' and 'I just did it, but thank you for asking,' " says Marcia Patrick, infection-control director for MultiCare Health System in King and Pierce counties.
Q: What else can I do?
A: Besides frequent hand-cleaning, the best defenses are avoiding skin-to-skin contact with other people's skin infections and learning how to care for wounds, Duchin says. And get a flu shot, he says, because MRSA-caused pneumonia can follow the flu.
The CDC also recommends:
• Showering immediately after exercise.
• Avoiding sharing items such as towels and razors.
• Using a barrier such as a towel or clothing between your skin and shared exercise equipment.
• Ensuring that surfaces are cleaned regularly at the public places you often go.
Any surfaces known to be contaminated by any type of staph, including MRSA, should be disinfected, but generally "extraordinary disinfection measures" or closures of schools or workplaces aren't necessary, Duchin says.
Q: Should I worry about cuts and scrapes?
A: Not any more than you already should: Keep them clean and covered. Watch for what Duchin calls the cardinal signs of infection: redness, warmth, swelling and pain, or a fever. If you have a bump or boil, surrounded by a lot of redness, don't assume it's a "spider bite." It probably isn't. Think MRSA, and make sure your doctor does, too.
Q: What about my kids?
A: "All kids are getting scratches and scrapes all the time, and the vast majority aren't getting infected" when kept clean and covered, Duchin says. "The world is full of bugs; that's why we have immune systems and vaccines."
But consider asking your day-care center, school or gym to install alcohol-gel dispensers and posters on what they are for, suggests medical writer Naida Grunden, who has written about a Pennsylvania hospital's successful efforts to reduce MRSA.
Q: If I'm going into the hospital, should I get a MRSA test?
A: There are different views on whether this simple test — a nose swab, basically — is worthwhile. Grunden says yes. "Could save your life," she says. But neither Duchin nor the CDC recommends that step because the germs are so common and it's not clear why some people get sick and others don't.
Q: OK, I'm careful. Can I quit worrying?
A: "It's important to understand the real threat posed by antibiotic-resistant bacteria, but it's not necessary to panic," says Duchin.
Even so, don't be lulled into a false sense of security, he warns, or MRSA and other germs could soon outstrip our ability to kill them.
Seattle Times health reporter
The head of the federal Centers for Disease Control and Prevention calls MRSA the "cockroach of bacteria." It's omnipresent, tough and adaptable.
This fall, methicillin-resistant Staphylococcus aureus suddenly went from a festering public-health issue to the top of the national news on word that it's worse than previously thought.
Many people — and many media outlets — started seeing it as a much bigger menace than a simple roach.
It became "the superbug," and the tales of its incredible power have featured people fighting for their lives after getting what they thought was a simple little "spider bite."
But what is MRSA, anyway? How afraid should you really be?
Last month, a report in the Journal of the American Medical Association estimated that in 2005, some 94,000 people were infected by the most serious form of MRSA infections, and one in five died.
Since then, public-health officials have been singing out of both sides of their mouths.
On one hand, they want to reassure people: Like many germs, MRSA is common. Many of us carry it around on our skin and in our noses, and it lives on surfaces from athletic gear to fabric. Outside the hospital, it's not hard to avoid, but if you get it, you'll likely just get a treatable skin infection.
On the other hand, the public-health gurus want to sound an alarm. They warn that MRSA is a symptom of a larger danger: the great number of germs worldwide becoming increasingly resistant to antibiotics.
"The prospect that effective antibiotics may not be available to treat seriously ill patients in the near future is real," says Dr. Jeff Duchin, communicable-diseases chief for Public Health — Seattle & King County.
So what do you really need to know and do?
Q: What is MRSA?
A: Germs, also known as bacteria, have been around forever. Staphylococcus aureus, also called "staph," was first identified in 1880 by a Scottish surgeon poking around in pus oozing from hospital patients. After antibiotics were discovered in 1928, staph was largely beaten back. But S. aureus evolved to survive the oldest type of antibiotics, called the penicillin-methicillin class. Methicillin-resistant Staphylococcus aureus (MRSA) was first identified in 1968.
Q: Why is it such a big deal all of a sudden?
A: Actually, the problem isn't new. Although most people don't get serious infections, staph has always been a "bad bug," says Duchin.
MRSA is even badder. Researchers are discovering that MRSA is surprisingly widespread and becoming tougher. It's a classic lesson in Darwinian evolution: As the weaker germs are killed by antibiotics, the strongest, most resistant ones survive and multiply, particularly when antibiotics are used improperly.
In 2000, a new strain of MRSA "took off like wildfire," according to Dr. Yuan-Po Tu, a MRSA tracker at the Everett Clinic. Before, most MRSA infections were caused by a strain mostly contracted in hospitals. This new, "community acquired" strain can be even more virulent, potentially causing severe illnesses even in healthy people.
Q: What does MRSA do?
A: Most of the time, community-acquired MRSA (sometimes shortened to CA-MRSA) causes skin and soft-tissue infections that can be treated with other readily available antibiotics. But if not properly treated, the bug can work its way into the body and is tough to get out.
The vast majority of serious, "invasive" MRSA infections and deaths occur in hospitalized patients who are suffering from other serious diseases, have lowered immunity or have recently undergone surgery.
Q: How is it spread?
A: MRSA likes to travel. Not by air, but by hand, towel, clothes, bedding and gym equipment.
Unlike the flu virus, MRSA isn't caught by breathing it in — there has to be actual skin-to-germ contact. The CDC says high-risk groups include children, athletes, military recruits, prisoners and other population groups who live in crowded or impoverished living conditions.
Q: So MRSA is inevitable?
A: No, because there are easy ways of avoiding it. Alcohol-based hand cleaner works. So does good, old-fashioned hand-washing.
And so does a bit of courage.
According to Duchin, not all health-care providers are religious about washing their hands according to guidelines. In the hospital, that means before and after seeing you. So you need to ask them: "Did you wash your hands?"
Don't be afraid of insulting them. "There are only two acceptable answers: 'Thank you for reminding me,' and 'I just did it, but thank you for asking,' " says Marcia Patrick, infection-control director for MultiCare Health System in King and Pierce counties.
Q: What else can I do?
A: Besides frequent hand-cleaning, the best defenses are avoiding skin-to-skin contact with other people's skin infections and learning how to care for wounds, Duchin says. And get a flu shot, he says, because MRSA-caused pneumonia can follow the flu.
The CDC also recommends:
• Showering immediately after exercise.
• Avoiding sharing items such as towels and razors.
• Using a barrier such as a towel or clothing between your skin and shared exercise equipment.
• Ensuring that surfaces are cleaned regularly at the public places you often go.
Any surfaces known to be contaminated by any type of staph, including MRSA, should be disinfected, but generally "extraordinary disinfection measures" or closures of schools or workplaces aren't necessary, Duchin says.
Q: Should I worry about cuts and scrapes?
A: Not any more than you already should: Keep them clean and covered. Watch for what Duchin calls the cardinal signs of infection: redness, warmth, swelling and pain, or a fever. If you have a bump or boil, surrounded by a lot of redness, don't assume it's a "spider bite." It probably isn't. Think MRSA, and make sure your doctor does, too.
Q: What about my kids?
A: "All kids are getting scratches and scrapes all the time, and the vast majority aren't getting infected" when kept clean and covered, Duchin says. "The world is full of bugs; that's why we have immune systems and vaccines."
But consider asking your day-care center, school or gym to install alcohol-gel dispensers and posters on what they are for, suggests medical writer Naida Grunden, who has written about a Pennsylvania hospital's successful efforts to reduce MRSA.
Q: If I'm going into the hospital, should I get a MRSA test?
A: There are different views on whether this simple test — a nose swab, basically — is worthwhile. Grunden says yes. "Could save your life," she says. But neither Duchin nor the CDC recommends that step because the germs are so common and it's not clear why some people get sick and others don't.
Q: OK, I'm careful. Can I quit worrying?
A: "It's important to understand the real threat posed by antibiotic-resistant bacteria, but it's not necessary to panic," says Duchin.
Even so, don't be lulled into a false sense of security, he warns, or MRSA and other germs could soon outstrip our ability to kill them.
MRSA in the NEWS
Estimates based on a US-wide extrapolation of data collected from a number of hospital sites and recently published by the Center of Disease Control (CDC) in JAMA (Klevens, R.M., et al., Invasive Methicillin Resistant Staphylococcus aureus Infections in the United States. JAMA, 2007. 298(15): p. 1763-1771) put the number of annual MRSA associated fatalities at more than 18,000. This makes MRSA infections a burden comparable to the one caused by AIDS.
The involvement of the CDC gave the report a semi-official character and massive media attention in the US. The increased public concern bears the danger of scientifically unfounded hyperactivity and even panic reactions. Besides the widely publicized school closures there have been reports of discrimination against suspected MRSA patients by employers, co-workers, and even family members.
Outside the US and the UK the issue is less prominent. However, media prominence does not correlate with the severity of the problem. In a report by the DGKH (German society for hospital hygiene) “Krank im Krankenhaus” PDF published in cooperation with Alliance Health Insurance, the number of MRSA associated fatalities was estimated at up to 50'000 (in a sample population of about 450 million).
This corresponds to a significantly higher prevalence compared to the 18'000 for the US (a population of about 300 million). Although the report was mentioned in a number of news articles there was no obvious effect on public opinion or politics.
However, there is reason to believe that the serious concerns surrounding MRSA will eventually be contained. There are number of promising treatments on the way. More importantly since MRSA is a problem of hygiene rather than therapy on a larger scale, hospitals are rapidly changing their practices. Much has been learned and continues to be learned form virtually MRSA free zones such as the Netherlands. In addition low-cost, reliable, and efficient methods for mass screening such as BCM® MRSA ELF® are made available.
One should not forget that the human costs resulting from other hygiene related microbial pandemics are much greater. One example is Shigella spp. which according to WHO estimates kills 1.6 million people every year. As in the case of MRSA such tragedy could be almost entirely prevented if proper practice and low-cost robust methods of screening were implemented.
The involvement of the CDC gave the report a semi-official character and massive media attention in the US. The increased public concern bears the danger of scientifically unfounded hyperactivity and even panic reactions. Besides the widely publicized school closures there have been reports of discrimination against suspected MRSA patients by employers, co-workers, and even family members.
Outside the US and the UK the issue is less prominent. However, media prominence does not correlate with the severity of the problem. In a report by the DGKH (German society for hospital hygiene) “Krank im Krankenhaus” PDF published in cooperation with Alliance Health Insurance, the number of MRSA associated fatalities was estimated at up to 50'000 (in a sample population of about 450 million).
This corresponds to a significantly higher prevalence compared to the 18'000 for the US (a population of about 300 million). Although the report was mentioned in a number of news articles there was no obvious effect on public opinion or politics.
However, there is reason to believe that the serious concerns surrounding MRSA will eventually be contained. There are number of promising treatments on the way. More importantly since MRSA is a problem of hygiene rather than therapy on a larger scale, hospitals are rapidly changing their practices. Much has been learned and continues to be learned form virtually MRSA free zones such as the Netherlands. In addition low-cost, reliable, and efficient methods for mass screening such as BCM® MRSA ELF® are made available.
One should not forget that the human costs resulting from other hygiene related microbial pandemics are much greater. One example is Shigella spp. which according to WHO estimates kills 1.6 million people every year. As in the case of MRSA such tragedy could be almost entirely prevented if proper practice and low-cost robust methods of screening were implemented.
Thursday, July 5, 2007
New Technlogy to Prevent Disease Transmission in Dental Water
Genesis Dental Technologies, LLC Launches New Web Site Featuring the AquaSept(TM) Independent Water Delivery System to Prevent Disease Transmission in Dental Water
NEWS RELEASE
ELMWOOD, Wis., June 25 /PRNewswire/ -- Researchers, microbiologists, dental professionals and organizations have known for decades about potential risks and concerns of disease transmission caused by dental water containing high levels of bacteria and biofilm. As health professionals became more aware of diseases such as HIV/AIDS, tuberculosis/respiratory infections, hepatitis, bacterial endocarditis, legionnaires disease and pseudomonas-related diseases in immune-compromised patients, more CDC recommendations were issued and are now referred to as standard precautions. Still with all these precautions and the ability to measure the bacterial levels, lethal drug-resistant strains continue to spread around the country and are frequently reported in national news. A few months ago a hepatitis B transmission between two patients in one dental office was reported (The Journal of Infectious Diseases 2007; 195:1311- 1314). The route of transmission is still under investigation.
In order to reduce patient risk of disease transmission due to shared dental water, the CDC issued guidelines in December 2003 (see http://www.aquasept.com/, go to The Library, Links and Downloads page and review pages 28, 29, 30, and 46 of the PDF version of the CDC Guidelines). These guidelines specify the use of sterile irrigation fluids during any invasive procedure where tissue penetration is likely to occur. To comply with CDC Guideline, the dental professional can install an AquaSept(TM) Independent Water Delivery System. This system provides for the sterile delivery of irrigation fluids through a sterilized container, sterilized fluid delivery line and the sterilized dental handpiece. This allows the dental professional to provide each patient with separate, sterile dental water and practice the best possible dental water infection control standards for the benefit of the patient and all associates in the dental office.
There is a potential time bomb lurking in current dental office water systems. The current design of all built-in water systems is the bi-directional flow of fluid. While the largest portion of fluid is expelled out the end of the handpiece, friction causes a "passive retraction" of microscopic particles from the patient's mouth, through the dental instrument, up the water line and into the water reservoir. (See the "Biofilm" section of http://www.aquasept.com/). The continued use of the same water line and water reservoir among a group of patients results in cross contamination of the dental water among patients. The AquaSept(TM) Independent Water Delivery System prevents and protects patients from such cross contamination.
To quote a prominent dental professional with years of private practice and dental university experience: "In the 21st Century, the danger of infectious disease is heightened because of 1) the emergence of more dangerous microbes that defy medical treatment and can lead to a fatality, 2) a rise in patients who are immuno-compromised due to other conditions, and are therefore much more susceptible to disease with fatal consequences and 3) a rise in antibiotic-resistant strains." Robert Hasel, D.D.S.
Genesis Dental Technologies, LLC is a division of Genesis Industries, Inc. founded in June 1985 and is located in Elmwood, WI, about an hour east of the St. Paul/Minneapolis metro area.
For information on the AquaSept(TM) Independent Water Delivery System, please contact Genesis Dental Technologies, LLC at 715-639-2042, 1-800-523-8185 or email info@aquasept.com. For additional information visit http://www.aquasept.com/. Genesis Dental Technologies, LLC
CONTACT: John Dykstra, Sales and Marketing of Genesis Dental
Technologies, +1-715-639-2042, fax, +1-715-639-9205, johnd@aquasept.com
Web site: http://www.aquasept.com/
NEWS RELEASE
ELMWOOD, Wis., June 25 /PRNewswire/ -- Researchers, microbiologists, dental professionals and organizations have known for decades about potential risks and concerns of disease transmission caused by dental water containing high levels of bacteria and biofilm. As health professionals became more aware of diseases such as HIV/AIDS, tuberculosis/respiratory infections, hepatitis, bacterial endocarditis, legionnaires disease and pseudomonas-related diseases in immune-compromised patients, more CDC recommendations were issued and are now referred to as standard precautions. Still with all these precautions and the ability to measure the bacterial levels, lethal drug-resistant strains continue to spread around the country and are frequently reported in national news. A few months ago a hepatitis B transmission between two patients in one dental office was reported (The Journal of Infectious Diseases 2007; 195:1311- 1314). The route of transmission is still under investigation.
In order to reduce patient risk of disease transmission due to shared dental water, the CDC issued guidelines in December 2003 (see http://www.aquasept.com/, go to The Library, Links and Downloads page and review pages 28, 29, 30, and 46 of the PDF version of the CDC Guidelines). These guidelines specify the use of sterile irrigation fluids during any invasive procedure where tissue penetration is likely to occur. To comply with CDC Guideline, the dental professional can install an AquaSept(TM) Independent Water Delivery System. This system provides for the sterile delivery of irrigation fluids through a sterilized container, sterilized fluid delivery line and the sterilized dental handpiece. This allows the dental professional to provide each patient with separate, sterile dental water and practice the best possible dental water infection control standards for the benefit of the patient and all associates in the dental office.
There is a potential time bomb lurking in current dental office water systems. The current design of all built-in water systems is the bi-directional flow of fluid. While the largest portion of fluid is expelled out the end of the handpiece, friction causes a "passive retraction" of microscopic particles from the patient's mouth, through the dental instrument, up the water line and into the water reservoir. (See the "Biofilm" section of http://www.aquasept.com/). The continued use of the same water line and water reservoir among a group of patients results in cross contamination of the dental water among patients. The AquaSept(TM) Independent Water Delivery System prevents and protects patients from such cross contamination.
To quote a prominent dental professional with years of private practice and dental university experience: "In the 21st Century, the danger of infectious disease is heightened because of 1) the emergence of more dangerous microbes that defy medical treatment and can lead to a fatality, 2) a rise in patients who are immuno-compromised due to other conditions, and are therefore much more susceptible to disease with fatal consequences and 3) a rise in antibiotic-resistant strains." Robert Hasel, D.D.S.
Genesis Dental Technologies, LLC is a division of Genesis Industries, Inc. founded in June 1985 and is located in Elmwood, WI, about an hour east of the St. Paul/Minneapolis metro area.
For information on the AquaSept(TM) Independent Water Delivery System, please contact Genesis Dental Technologies, LLC at 715-639-2042, 1-800-523-8185 or email info@aquasept.com. For additional information visit http://www.aquasept.com/. Genesis Dental Technologies, LLC
CONTACT: John Dykstra, Sales and Marketing of Genesis Dental
Technologies, +1-715-639-2042, fax, +1-715-639-9205, johnd@aquasept.com
Web site: http://www.aquasept.com/
Anacor's boron-based drug stops the rot
25/06/2007 - An unusual drug that contains a crucial boron atom can effectively treat fungal infections, and could also prove invaluable in the effort to counter antibacterial drug resistance.
Scientists from the young US pharma firm Anacor developed AN2690, the first in a new class of antibiotics that contain a crucial boron atom. Together with a team from the European Molecular Biology Laboratory (EMBL) outstation in Grenoble, France, the researchers have now discovered exactly how the drug works.
"We have discovered a new compound that has the potential to treat common chronic nail infections caused by fungi [onychomycosis]," said Dickon Alley, a researcher at Anacor Pharmaceuticals.
"Now that we know how AN2690 works, the same approach could be adapted to target other aminoacyl-tRNA synthetases with editing sites and also other pathogenic microbes," said Stephen Cusack, Head of EMBL.
"We are now working towards finding related antibacterial compounds that could help counter the problem of antibiotic resistance."
Alley explained that the compound kills fungi by blocking their ability to make proteins. It does this by blocking an enzyme called leucyl-tRNA synthetase, which is involved in translation, one of the last steps in the process of turning a gene's DNA code into a protein.
The process begins when the cell makes an RNA version of the gene's code, called messenger RNA (mRNA). Ribosomes, the cell's protein synthesis machinery, then translate the mRNA into protein by stitching together the amino acids in the order specified by the message. This requires the help of molecules called transfer RNAs (tRNAs), which link the mRNA to the correct amino acid.
Leucyl-tRNA synthetase is one of a group of enzymes called aminoacyl-tRNA synthetases that attach the correct amino acid to each tRNA. Some of these enzymes have two main functional parts, or active sites: a site that links the amino acid to the tRNA, and a separate editing site that proofreads this process and removes wrongly added amino acids.
To find out how exactly AN2690 blocks leucyl-tRNA synthetase Stephen Cusack, Head of EMBL Grenoble, and his team generated crystals of the enzyme bound to tRNA in the presence of AN2690.
They then used X-rays to examine the structure of the complex. Cusack and his colleagues found that AN2690 sticks in the editing site of the enzyme where it makes a very strong bond to the end of the tRNA, trapping it on the enzyme.
This stops the enzyme working and thus blocks protein synthesis, killing the fungal cell. The mechanism crucially depends on a boron atom that is part of AN2690, which is needed to link the compound to the tRNA.
According to Anacor, it is the first time that scientists have described such a mechanism, suggesting boron containing compounds as a promising new class of drug candidates. The drug itself is currently in Phase II trials.
The pharma industry in general is watching this approach keenly. In February, Schering-Plough paid over $575m ($40m upfront) to gain the exclusive global rights to AN2690 from Anacor. Historically, several other pharma companies have also shown an interest in aminoacyl-tRNA synthetase inhibitors.
Curiously, as far back as 1999, AstraZeneca (then plain Zeneca), had a patent issued for an assay to identify potential drugs aimed at this target. However, whether this technology bared any fruit is unclear.
In June 2006, AZ announced that its "genomic approach to anti-bacterials is yielding its first candidates". The company was referring to AZD1279, a bactericidal antibiotic from a new chemical class, which has showed good in vitro activity against resistant organisms including Streptococcus pneumoniae. AZ said at the time that the drug would enter Phase I clinical trials for respiratory infections in 2006.
The target for this drug was never disclosed however, and a spokesperson for AZ told DrugResearcher.com that the drug has now been scrapped, although she couldn't say why this decision had been taken.
Cubist Pharmaceuticals is, or at least was, interested in this target as well, having penned an academic article called 'Aminoacyl tRNA synthetases as targets for new anti-infectives' in a 1999 edition of the Federation of American Societies for Experimental Biology journal. However, again, there is no mention of this target on their website and the company was unable to confirm whether this target was still being investigated.
Why Anacor's drug seems to be enjoying success where others have failed is not known. However, it is good news for onychomycosis sufferers, the patients AN2690 aims to treat initially. It affects approximately 7 to 10 per cent of the US population, including 48 percent of those over age 70. More than 90 percent of those cases are caused by two specific fungi: Trichophyton rubrum and Trichophyton mentagrophytes. However, current treatments are limited, according to Anacor.
Existing topical treatments only succeed in 12 per cent of cases, despite sales accounting for $300m (€223m). Whereas systemic treatments are more effective (in around half of all cases), they have known toxicity. Novartis' Lamisil (terbinafine) generated sales of $978m in 2006 but the same drug has, in rare cases caused liver failure. These have resulted in the need for a transplant and even death, although the relationship between the liver problems and the drug is "uncertain", according to the drug's approved label, as the patients' involved had serious pre-existing liver conditions.
Scientists from the young US pharma firm Anacor developed AN2690, the first in a new class of antibiotics that contain a crucial boron atom. Together with a team from the European Molecular Biology Laboratory (EMBL) outstation in Grenoble, France, the researchers have now discovered exactly how the drug works.
"We have discovered a new compound that has the potential to treat common chronic nail infections caused by fungi [onychomycosis]," said Dickon Alley, a researcher at Anacor Pharmaceuticals.
"Now that we know how AN2690 works, the same approach could be adapted to target other aminoacyl-tRNA synthetases with editing sites and also other pathogenic microbes," said Stephen Cusack, Head of EMBL.
"We are now working towards finding related antibacterial compounds that could help counter the problem of antibiotic resistance."
Alley explained that the compound kills fungi by blocking their ability to make proteins. It does this by blocking an enzyme called leucyl-tRNA synthetase, which is involved in translation, one of the last steps in the process of turning a gene's DNA code into a protein.
The process begins when the cell makes an RNA version of the gene's code, called messenger RNA (mRNA). Ribosomes, the cell's protein synthesis machinery, then translate the mRNA into protein by stitching together the amino acids in the order specified by the message. This requires the help of molecules called transfer RNAs (tRNAs), which link the mRNA to the correct amino acid.
Leucyl-tRNA synthetase is one of a group of enzymes called aminoacyl-tRNA synthetases that attach the correct amino acid to each tRNA. Some of these enzymes have two main functional parts, or active sites: a site that links the amino acid to the tRNA, and a separate editing site that proofreads this process and removes wrongly added amino acids.
To find out how exactly AN2690 blocks leucyl-tRNA synthetase Stephen Cusack, Head of EMBL Grenoble, and his team generated crystals of the enzyme bound to tRNA in the presence of AN2690.
They then used X-rays to examine the structure of the complex. Cusack and his colleagues found that AN2690 sticks in the editing site of the enzyme where it makes a very strong bond to the end of the tRNA, trapping it on the enzyme.
This stops the enzyme working and thus blocks protein synthesis, killing the fungal cell. The mechanism crucially depends on a boron atom that is part of AN2690, which is needed to link the compound to the tRNA.
According to Anacor, it is the first time that scientists have described such a mechanism, suggesting boron containing compounds as a promising new class of drug candidates. The drug itself is currently in Phase II trials.
The pharma industry in general is watching this approach keenly. In February, Schering-Plough paid over $575m ($40m upfront) to gain the exclusive global rights to AN2690 from Anacor. Historically, several other pharma companies have also shown an interest in aminoacyl-tRNA synthetase inhibitors.
Curiously, as far back as 1999, AstraZeneca (then plain Zeneca), had a patent issued for an assay to identify potential drugs aimed at this target. However, whether this technology bared any fruit is unclear.
In June 2006, AZ announced that its "genomic approach to anti-bacterials is yielding its first candidates". The company was referring to AZD1279, a bactericidal antibiotic from a new chemical class, which has showed good in vitro activity against resistant organisms including Streptococcus pneumoniae. AZ said at the time that the drug would enter Phase I clinical trials for respiratory infections in 2006.
The target for this drug was never disclosed however, and a spokesperson for AZ told DrugResearcher.com that the drug has now been scrapped, although she couldn't say why this decision had been taken.
Cubist Pharmaceuticals is, or at least was, interested in this target as well, having penned an academic article called 'Aminoacyl tRNA synthetases as targets for new anti-infectives' in a 1999 edition of the Federation of American Societies for Experimental Biology journal. However, again, there is no mention of this target on their website and the company was unable to confirm whether this target was still being investigated.
Why Anacor's drug seems to be enjoying success where others have failed is not known. However, it is good news for onychomycosis sufferers, the patients AN2690 aims to treat initially. It affects approximately 7 to 10 per cent of the US population, including 48 percent of those over age 70. More than 90 percent of those cases are caused by two specific fungi: Trichophyton rubrum and Trichophyton mentagrophytes. However, current treatments are limited, according to Anacor.
Existing topical treatments only succeed in 12 per cent of cases, despite sales accounting for $300m (€223m). Whereas systemic treatments are more effective (in around half of all cases), they have known toxicity. Novartis' Lamisil (terbinafine) generated sales of $978m in 2006 but the same drug has, in rare cases caused liver failure. These have resulted in the need for a transplant and even death, although the relationship between the liver problems and the drug is "uncertain", according to the drug's approved label, as the patients' involved had serious pre-existing liver conditions.
MRSA test call for farm animals
All farm animals should be tested for a form of the superbug MRSA, an organic group has urged the government.
The Soil Association says the bug is widespread in the Netherlands, Belgium and Germany, from where some of the meat eaten in the UK is imported.
In the Netherlands, 39% of pigs tested positive for the bug which can be passed to humans.
And 13% of calves also tested positive for the bug, which is different to the strain found in hospitals.
Poultry meat
The studies found that 50% of farmers were also positive, some of whom have been resistant to antibiotics.
The Soil Association blamed the use of antibiotics in farming for the problem.
No MRSA has been found in British farm animals but poultry meat and pork is imported from infected countries.
The Food Standards Agency says people will not catch the bug from meat if it is prepared hygienically and cooked properly.
Source:- BBC News
The Soil Association says the bug is widespread in the Netherlands, Belgium and Germany, from where some of the meat eaten in the UK is imported.
In the Netherlands, 39% of pigs tested positive for the bug which can be passed to humans.
And 13% of calves also tested positive for the bug, which is different to the strain found in hospitals.
Poultry meat
The studies found that 50% of farmers were also positive, some of whom have been resistant to antibiotics.
The Soil Association blamed the use of antibiotics in farming for the problem.
No MRSA has been found in British farm animals but poultry meat and pork is imported from infected countries.
The Food Standards Agency says people will not catch the bug from meat if it is prepared hygienically and cooked properly.
Source:- BBC News
Sunday, July 1, 2007
Bird flu cases in southern Germany show highly pathogenic H5N1 variant
25 Jun 2007 bbj.hu
At least some of the cases of bird flu discovered this weekend near the southern city of Nuremberg involve a highly pathogenic variety of the H5N1 strain, Germany's Ministry of Food, Agriculture and Consumer Protection said Sunday.
All seven of the birds — five swans, one duck and one goose found dead on Friday and Saturday — had the H5N1 strain, and further tests were still ongoing to determine if they were infected with the highly pathogenic variety. The country's top veterinary laboratory, the Friedrich Loeffler Institute, confirmed that three wild birds - two swans and a goose - found in two lakes near Nuremberg had tested positive for the worst strain of the H5N1 virus – Reuters reports.
It is the first bird flu discovered in Germany this year, and the first report of wild birds infected this year within the European Union. The H5N1 strain has, however, been found in poultry farms in three other EU countries this year: Hungary, Britain and the Czech Republic, the European Commission said.
Thirteen EU nations were hit by bird flu last year — Austria, Denmark, Poland, Italy, Greece, Britain, Germany, the Czech Republic, Slovakia, Slovenia, Sweden, Hungary and France. Bird flu is believed to spread along bird migration routes. The H5N1 strain has decimated poultry stocks since 2003 and killed at least 191 people worldwide, most of them directly infected by sick birds in Asia. Experts fear, however, that the virus could mutate into a form easily transmitted between people. (iht.com)
At least some of the cases of bird flu discovered this weekend near the southern city of Nuremberg involve a highly pathogenic variety of the H5N1 strain, Germany's Ministry of Food, Agriculture and Consumer Protection said Sunday.
All seven of the birds — five swans, one duck and one goose found dead on Friday and Saturday — had the H5N1 strain, and further tests were still ongoing to determine if they were infected with the highly pathogenic variety. The country's top veterinary laboratory, the Friedrich Loeffler Institute, confirmed that three wild birds - two swans and a goose - found in two lakes near Nuremberg had tested positive for the worst strain of the H5N1 virus – Reuters reports.
It is the first bird flu discovered in Germany this year, and the first report of wild birds infected this year within the European Union. The H5N1 strain has, however, been found in poultry farms in three other EU countries this year: Hungary, Britain and the Czech Republic, the European Commission said.
Thirteen EU nations were hit by bird flu last year — Austria, Denmark, Poland, Italy, Greece, Britain, Germany, the Czech Republic, Slovakia, Slovenia, Sweden, Hungary and France. Bird flu is believed to spread along bird migration routes. The H5N1 strain has decimated poultry stocks since 2003 and killed at least 191 people worldwide, most of them directly infected by sick birds in Asia. Experts fear, however, that the virus could mutate into a form easily transmitted between people. (iht.com)
Friday, June 22, 2007
Microbes beating medicine
21 Jun 2007
Deaths from previously treatable infections will become more common unless there is investment in the science needed to tackle antibiotic resistance Europe's leading scientists have warned in a report published today (21 June 2007).
The report(1), produced by European Academies Science Advisory Council (EASAC), of which the Royal Society is a member, highlights the ever growing problem of antibiotic resistance in pathogens such as MRSA, Clostridium difficile, E-coli and infectious diseases such as tuberculosis, pneumonia and meningitis.
Scientists from across Europe are calling for the EU and Member States to provide greater support for the development of simple and cheap means of identifying specific infections as early as possible and greater support for drug companies who are seeking to develop new treatments. The report also urges greater awareness and monitoring of the problem, more prudent use of antibiotics, more effective containment of the spread of resistance and greater cooperation and coordination across Europe.
Hospital acquired infections are believed to account for 175,000 deaths in Europe each year, many of which are attributable to antibiotic resistance.
Professor Volker ter Meulen, President of the Leopoldina Academy of Sciences, Germany and Chair the report's working group, said: "The problem of antibiotic resistance is growing. Our concern is that the European policy makers are not doing enough to stimulate the development of new antibacterial drugs and encourage the sharing of information between Member States. This is vital to identify patterns and tackle resistance.
"For example, research and development for new antibiotic drugs is not an attractive option for drug companies in comparison with treatments for long-term chronic illnesses which offer a better return on investment. Drug companies will need to be incentivised to continue valuable antibiotic R&D."
Antibiotic resistance is not just a problem for hospitals and patients but for everyone. Business will be hit, with employees off sick. There is also the danger that antibiotic resistant pathogens could enter the food chain via livestock.
Professor Richard Moxon, based at the University of Oxford and a member of the working group, said: "It is crucially important to rebuild European academic capability in microbiology and clinical infectious disease infrastructure. But antibiotic resistance is not just a medical issue. Social habits may lead to increased cases of resistance such as the over-prescribing of general antibiotics instead of ones designed to treat specific pathogens. In some EU states antibiotics can even be bought without prescriptions.
"All factors that could lead to antibiotic resistance or be affected by it need to be considered. EU institutions and Government departments in Member States responsible for public health, environment, industry and scientific research have to work together to take action to tackle this problem."
In monitoring the trend of drug resistance across Europe, the observation and recording of resistance is extremely valuable. The European Commission is responsible for coordinating this surveillance, and gathers information from Member States to plot the spread of infections. However the report found that data collected is of a variable standard making comparisons between countries difficult.
"Knowing where the problems are most common is extremely valuable to predict possible impacts on the economy, to bring about changes in healthcare practice and inform research funders throughout Europe on where research funding should be focused," added Professor ter Meulen
Deaths from previously treatable infections will become more common unless there is investment in the science needed to tackle antibiotic resistance Europe's leading scientists have warned in a report published today (21 June 2007).
The report(1), produced by European Academies Science Advisory Council (EASAC), of which the Royal Society is a member, highlights the ever growing problem of antibiotic resistance in pathogens such as MRSA, Clostridium difficile, E-coli and infectious diseases such as tuberculosis, pneumonia and meningitis.
Scientists from across Europe are calling for the EU and Member States to provide greater support for the development of simple and cheap means of identifying specific infections as early as possible and greater support for drug companies who are seeking to develop new treatments. The report also urges greater awareness and monitoring of the problem, more prudent use of antibiotics, more effective containment of the spread of resistance and greater cooperation and coordination across Europe.
Hospital acquired infections are believed to account for 175,000 deaths in Europe each year, many of which are attributable to antibiotic resistance.
Professor Volker ter Meulen, President of the Leopoldina Academy of Sciences, Germany and Chair the report's working group, said: "The problem of antibiotic resistance is growing. Our concern is that the European policy makers are not doing enough to stimulate the development of new antibacterial drugs and encourage the sharing of information between Member States. This is vital to identify patterns and tackle resistance.
"For example, research and development for new antibiotic drugs is not an attractive option for drug companies in comparison with treatments for long-term chronic illnesses which offer a better return on investment. Drug companies will need to be incentivised to continue valuable antibiotic R&D."
Antibiotic resistance is not just a problem for hospitals and patients but for everyone. Business will be hit, with employees off sick. There is also the danger that antibiotic resistant pathogens could enter the food chain via livestock.
Professor Richard Moxon, based at the University of Oxford and a member of the working group, said: "It is crucially important to rebuild European academic capability in microbiology and clinical infectious disease infrastructure. But antibiotic resistance is not just a medical issue. Social habits may lead to increased cases of resistance such as the over-prescribing of general antibiotics instead of ones designed to treat specific pathogens. In some EU states antibiotics can even be bought without prescriptions.
"All factors that could lead to antibiotic resistance or be affected by it need to be considered. EU institutions and Government departments in Member States responsible for public health, environment, industry and scientific research have to work together to take action to tackle this problem."
In monitoring the trend of drug resistance across Europe, the observation and recording of resistance is extremely valuable. The European Commission is responsible for coordinating this surveillance, and gathers information from Member States to plot the spread of infections. However the report found that data collected is of a variable standard making comparisons between countries difficult.
"Knowing where the problems are most common is extremely valuable to predict possible impacts on the economy, to bring about changes in healthcare practice and inform research funders throughout Europe on where research funding should be focused," added Professor ter Meulen
Tuesday, June 19, 2007
Kane Biotech Announces a Positive Independent Research Publication on Its DispersinB Technology
NEWS RELEASE
Jun 18, 2007 09:44 ET
WINNIPEG, MANITOBA--(Marketwire - June 18, 2007) - Kane Biotech Inc. (TSX VENTURE:KNE), a biotechnology company engaged in the development of products that prevent and disperse microbial biofilms, is pleased to announce an independent research publication on the Company's DispersinB technology, a patent pending anti-biofilm technology. The paper appeared in the recent edition of online scientific journal 'Antimicrobial Agents and Chemotherapy' published by American Society for Microbiology.
The research findings reported in the publication, entitled "Synergistic activity of dispersin B and cefamandole nafate in the inhibition of staphylococcal growth on polyurethanes" co-authored by Dr. Gianfranco Donelli from the Department of Health, Istituto Superiore di Santa, Rome, Italy, and Dr. Jeff Kaplan from the Department of Oral Microbiology, the University of Medicine and Dentistry of New Jersey (UMDNJ), demonstrates that DispersinB is not cytotoxic and that DispersinB treatment makes bacteria growing in biofilms more susceptible to an antibiotic such as cefamandole nafate.
"This research not only provides evidence that the DispersinB enzyme is non-toxic but also demonstrates that when DispersinB is combined with an antibiotic it enhances the activity of the antibiotic against biofilm-embedded bacteria such as Staphylococcus epidermidis" stated Dr. Kaplan, also the inventor of the technology. "These findings confirm that DispersinB-antibiotic combinations provide highly effective tools for preventing bacterial colonization of medical devices, including catheters."
"This study provides solid evidence that our technology is very effective in the fight against biofilms that attach to medical devices and also demonstrates that naturally occurring DispersinB is not cytotoxic." said Gord Froehlich, President and CEO of Kane Biotech. "Our database of scientific evidence continues to grow as we prepare this technology for commercialization."
DispersinB is a novel enzyme capable of both inhibiting and dispersing bacterial biofilms. Kane Biotech has a worldwide exclusive license to all human, animal and industrial applications of DispersinB from the UMDNJ. Kane Biotech is presently using dispersinB alone, and in combination with other antimicrobial agents to develop a proprietary medical device coating.
About Dr. Jeffrey Kaplan
Jeffrey Kaplan received a Bachelor of Science degree in Biology from the University of Illinois at Chicago in 1980 and a Ph.D. in Molecular Biology from the same institution in 1985. He received postdoctoral training in the Department of Microbiology at the Albert Einstein College of Medicine, Bronx, N.Y., and in the Department of Microbiology at Columbia University, College of Physicians and Surgeons, New York, N.Y. Dr. Kaplan worked for 10 years in the Oncology Department at Wyeth Pharmaceuticals, Pearl River, N.Y., before joining the Department of Oral Biology at New Jersey Dental School in 1999.
Dr. Kaplan's lab is studying the detachment and dispersal of bacterial cells from biofilms with an emphasis on the gram-negative periodontal pathogen Aggregatibacter actinomycetemcomitans. His research is funded by the several grant agencies, including the National Institute of Health (NIH), USA. His discovery of DispersinB supported by the NIH grant was listed in the "NIH Annual Performance Report of 2004" as one of the thirteen achievements of the year.
About Kane Biotech Inc.
Kane Biotech is a biotechnology company engaged in the development of products to prevent and disperse microbial biofilms. Biofilms develop when bacteria, and other microorganisms, form a protective matrix that acts as a shield against attack. When in a biofilm, bacteria become highly resistant to antibiotics, biocides, disinfectants, high temperatures and host immune responses. This resiliency contributes to human health problems such as recurrent urinary tract infections, medical device associated infections and tooth decay.
Kane Biotech Inc. uses a patent protected technology based on molecular mechanisms of biofilm formation and methods for finding compounds that inhibit or disrupt biofilms. The Company has evidence that this technology has a great potential to significantly improve the ability to prevent and/or destroy biofilms in several medical and industrial applications.
Caution Regarding Forward-Looking Information
Certain statements contained in this press release constitute forward-looking information within the meaning of applicable Canadian provincial securities legislation (collectively, "forward-looking statements"). These forward-looking statements relate to, among other things, our objectives, goals, targets, strategies, intentions, plans, beliefs, estimates and outlook, including, without limitation, our anticipated future operating results, and can, in some cases, be identified by the use of words such as "believe," "anticipate," "expect," "intend," "plan," "will," "may" and other similar expressions. In addition, any statements that refer to expectations, projections or other characterizations of future events or circumstances are forward-looking statements.
These statements reflect management's current beliefs and are based on information currently available to management. Certain material factors or assumptions are applied in making forward-looking statements, and actual results may differ materially from those expressed or implied in such statements. Important factors that could cause actual results to differ materially from these expectations include, among other things: Kane's early stage of development, lack of product revenues and history of operating losses, uncertainties related to clinical trials and product development, rapid technological change, uncertainties related to forecasts, competition, potential product liability, additional financing requirements and access to capital, unproven markets, supply of raw materials, income tax matters, management of growth, partnerships for development and commercialization of technology, effects of insurers' willingness to pay for products, system failures, dependence on key personnel, foreign currency risk, risks related to regulatory matters and risks related to intellectual property and other risks detailed from time to time in Kane's filings with Canadian securities regulatory authorities, as well as Kane's ability to anticipate and manage the risks associated with the foregoing. Kane cautions that the foregoing list of important factors that may affect future results is not exhaustive. When relying on Kane's forward-looking statements to make decisions with respect to Kane, investors and others should carefully consider the foregoing factors and other uncertainties and potential events.
These risks and uncertainties should be considered carefully and prospective investors should not place undue reliance on the forward-looking statements. Although the forward-looking statements contained in this press release are based upon what management believes to be reasonable assumptions, Kane cannot provide assurance that actual results will be consistent with these forward-looking statements. Kane undertakes no obligation to update or revise any forward-looking statement.
The TSX Venture Exchange does not accept responsibility for the adequacy or accuracy of this release.
For more information, please contact
Kane Biotech Inc.
Justin Gagnon
Investor Relations Professional
(204) 478-5602
(204) 453-1314 (FAX)
Email: jgagnon@kanebiotech.com
Website: www.kanebiotech.com
Jun 18, 2007 09:44 ET
WINNIPEG, MANITOBA--(Marketwire - June 18, 2007) - Kane Biotech Inc. (TSX VENTURE:KNE), a biotechnology company engaged in the development of products that prevent and disperse microbial biofilms, is pleased to announce an independent research publication on the Company's DispersinB technology, a patent pending anti-biofilm technology. The paper appeared in the recent edition of online scientific journal 'Antimicrobial Agents and Chemotherapy' published by American Society for Microbiology.
The research findings reported in the publication, entitled "Synergistic activity of dispersin B and cefamandole nafate in the inhibition of staphylococcal growth on polyurethanes" co-authored by Dr. Gianfranco Donelli from the Department of Health, Istituto Superiore di Santa, Rome, Italy, and Dr. Jeff Kaplan from the Department of Oral Microbiology, the University of Medicine and Dentistry of New Jersey (UMDNJ), demonstrates that DispersinB is not cytotoxic and that DispersinB treatment makes bacteria growing in biofilms more susceptible to an antibiotic such as cefamandole nafate.
"This research not only provides evidence that the DispersinB enzyme is non-toxic but also demonstrates that when DispersinB is combined with an antibiotic it enhances the activity of the antibiotic against biofilm-embedded bacteria such as Staphylococcus epidermidis" stated Dr. Kaplan, also the inventor of the technology. "These findings confirm that DispersinB-antibiotic combinations provide highly effective tools for preventing bacterial colonization of medical devices, including catheters."
"This study provides solid evidence that our technology is very effective in the fight against biofilms that attach to medical devices and also demonstrates that naturally occurring DispersinB is not cytotoxic." said Gord Froehlich, President and CEO of Kane Biotech. "Our database of scientific evidence continues to grow as we prepare this technology for commercialization."
DispersinB is a novel enzyme capable of both inhibiting and dispersing bacterial biofilms. Kane Biotech has a worldwide exclusive license to all human, animal and industrial applications of DispersinB from the UMDNJ. Kane Biotech is presently using dispersinB alone, and in combination with other antimicrobial agents to develop a proprietary medical device coating.
About Dr. Jeffrey Kaplan
Jeffrey Kaplan received a Bachelor of Science degree in Biology from the University of Illinois at Chicago in 1980 and a Ph.D. in Molecular Biology from the same institution in 1985. He received postdoctoral training in the Department of Microbiology at the Albert Einstein College of Medicine, Bronx, N.Y., and in the Department of Microbiology at Columbia University, College of Physicians and Surgeons, New York, N.Y. Dr. Kaplan worked for 10 years in the Oncology Department at Wyeth Pharmaceuticals, Pearl River, N.Y., before joining the Department of Oral Biology at New Jersey Dental School in 1999.
Dr. Kaplan's lab is studying the detachment and dispersal of bacterial cells from biofilms with an emphasis on the gram-negative periodontal pathogen Aggregatibacter actinomycetemcomitans. His research is funded by the several grant agencies, including the National Institute of Health (NIH), USA. His discovery of DispersinB supported by the NIH grant was listed in the "NIH Annual Performance Report of 2004" as one of the thirteen achievements of the year.
About Kane Biotech Inc.
Kane Biotech is a biotechnology company engaged in the development of products to prevent and disperse microbial biofilms. Biofilms develop when bacteria, and other microorganisms, form a protective matrix that acts as a shield against attack. When in a biofilm, bacteria become highly resistant to antibiotics, biocides, disinfectants, high temperatures and host immune responses. This resiliency contributes to human health problems such as recurrent urinary tract infections, medical device associated infections and tooth decay.
Kane Biotech Inc. uses a patent protected technology based on molecular mechanisms of biofilm formation and methods for finding compounds that inhibit or disrupt biofilms. The Company has evidence that this technology has a great potential to significantly improve the ability to prevent and/or destroy biofilms in several medical and industrial applications.
Caution Regarding Forward-Looking Information
Certain statements contained in this press release constitute forward-looking information within the meaning of applicable Canadian provincial securities legislation (collectively, "forward-looking statements"). These forward-looking statements relate to, among other things, our objectives, goals, targets, strategies, intentions, plans, beliefs, estimates and outlook, including, without limitation, our anticipated future operating results, and can, in some cases, be identified by the use of words such as "believe," "anticipate," "expect," "intend," "plan," "will," "may" and other similar expressions. In addition, any statements that refer to expectations, projections or other characterizations of future events or circumstances are forward-looking statements.
These statements reflect management's current beliefs and are based on information currently available to management. Certain material factors or assumptions are applied in making forward-looking statements, and actual results may differ materially from those expressed or implied in such statements. Important factors that could cause actual results to differ materially from these expectations include, among other things: Kane's early stage of development, lack of product revenues and history of operating losses, uncertainties related to clinical trials and product development, rapid technological change, uncertainties related to forecasts, competition, potential product liability, additional financing requirements and access to capital, unproven markets, supply of raw materials, income tax matters, management of growth, partnerships for development and commercialization of technology, effects of insurers' willingness to pay for products, system failures, dependence on key personnel, foreign currency risk, risks related to regulatory matters and risks related to intellectual property and other risks detailed from time to time in Kane's filings with Canadian securities regulatory authorities, as well as Kane's ability to anticipate and manage the risks associated with the foregoing. Kane cautions that the foregoing list of important factors that may affect future results is not exhaustive. When relying on Kane's forward-looking statements to make decisions with respect to Kane, investors and others should carefully consider the foregoing factors and other uncertainties and potential events.
These risks and uncertainties should be considered carefully and prospective investors should not place undue reliance on the forward-looking statements. Although the forward-looking statements contained in this press release are based upon what management believes to be reasonable assumptions, Kane cannot provide assurance that actual results will be consistent with these forward-looking statements. Kane undertakes no obligation to update or revise any forward-looking statement.
The TSX Venture Exchange does not accept responsibility for the adequacy or accuracy of this release.
For more information, please contact
Kane Biotech Inc.
Justin Gagnon
Investor Relations Professional
(204) 478-5602
(204) 453-1314 (FAX)
Email: jgagnon@kanebiotech.com
Website: www.kanebiotech.com
Monday, June 18, 2007
Antibiotics in failing health
By Karen Augé
Denver Post Staff Writer
The Denver Post
The last time a new tuberculosis drug was developed, Richard Nixon was in the White House and Dr. Michael Iseman was a young resident in a New York City hospital.
That drug, Rifampin, "was the biggest thing to hit TB in 30 years," said Iseman, now a doctor at National Jewish Medical and Research Center in Denver.
Since then, Iseman has become a recognized authority on TB and Rifampin has remained the centerpiece of TB treatment.
Now, however, a growing number of tuberculosis strains are not fazed by the drug - as in the highly publicized case of Andrew Speaker, who is being treated at National Jewish.
Tuberculosis isn't the only infection increasingly impervious to the antibiotics in medicine's arsenal.
In the past decade, federal agencies - such as the Centers for Disease Control and Prevention, the National Institutes of Health, and the Food and Drug Administration - have warned that antibiotic overuse has led to evolving drug-resistant bacteria.
At the same time, the agencies say, there is a dearth of research dollars for new antibiotics - creating a looming medical crisis.
"Infections that were once easily curable with antibiotics are becoming difficult, even impossible, to treat," the Infectious Disease Society of America warned in its report "Bad Bugs, No Drugs."
"The problem is dollars, not chemistry," said Christopher Spivey, a spokesman for the Boston-based Alliance for the Prudent Use of Antibiotics.
Antibiotics not as profitable
Antibiotic development requires huge investments of money, $400 million to $800 million, according to a study in the journal Clinical Infectious Diseases.
To provide as much income as drug companies get from the sale of one drug to a person who, for example, takes a weight-loss pill daily, a company would have to sell antibiotics to 200 to 500 people with an illness like pneumonia, Spivey said.
There are currently under development 50 drugs each for obesity, pain and Type II diabetes, according to PhRMA, a group representing the nation's leading drugmakers.
There are just nine new drugs in the works for tuberculosis and eight for malaria.
For staph infections and drug- resistant staph infections, PhRMA lists 23 drugs under development.
This isn't a new trend. FDA approval of new anti-bacterial drugs has dropped 56 percent in 20 years, according to a 2004 study by Brad Spellberg, a professor of medicine at the University of California, Los Angeles.
Work on new TB drugs has languished in part because of the widespread, mistaken belief that the disease was no longer a problem in this country, said Mel Spigelman, director of research and development for the Global Alliance for TB Drug Development.
Iseman said that on the world market drugmakers are discouraged from developing antibiotics.
"There is a tendency - in global use - for knock-offs," Iseman said. "Companies simply choose not to honor patent protections and it's done under the seemingly noble rubric of, 'we have patients dying of - whatever disease - in our country and we can't afford your drug, so we're going to make our own.' "
In its report, the infectious-disease society recommended incentives, such as tax breaks, for antibiotic research and development.
Difficult to draw attention
Still, drug companies don't get much public sympathy these days, which could make it politically tough for members of Congress to grant those tax breaks, Iseman said.
Antibiotic development "won't get on the radar until there is a really good killing plague," Spivey said.
In that respect, Speaker may have unintentionally done a favor for TB drug research by drawing attention to the disease, Spivey said.
Since 2000, interest in TB has picked up, said the TB Alliance's Spigelman.
While only a handful of new TB drugs are in the pipeline, even that is progress, Spigelman said.
"In 2000, we had zero," he said.
This year, the National Institutes of Health will spend $158 million on TB- drug research. The Bill and Melinda Gates Foundation has pledged $900 million over the next decade.
Four drug companies - Bayer, Novartis, AstraZeneca International and GlaxoSmithKline - now have units working on infectious diseases, including TB.
Bacteria, however, reproduce every 10 minutes or so, while it takes humans about 20 years to develop means to battle new strains, Iseman said.
"They have the ability to adapt to our drugs," he said. "So if you're in Vegas, you bet on the bugs."
Staff writer Karen Augé can be reached at 303-954-1733 or kauge@denverpost.com.
--------------------------------------------------------------------------------
A history of antibiotics and drug resistance
1920s-'50s: Scientists harness the power of living organisms to fight bacteria, ushering in the era of antibiotics.
1928: Scottish bacteriologist Alexander Fleming, above, accidentally discovers that a mold juice he names penicillin can kill staphylococcus bacteria.
1940: Oxford University pathologist Howard Florey isolates pure penicillin and demonstrates how it can cure a wide range of pathogens, including strep infections, gonorrhea and syphilis.
1943: Penicillin becomes the first antibiotic to be put in widespread use.
1944: Russian-born microbiologist Selman Waksman, working in the United States with soil microbiologist Albert Schatz, discovers streptomycin, a powerful antibiotic that proves effective against tuberculosis.
1958: American molecular geneticist Joshua Lederberg wins the Nobel Prize in medicine for demonstrating the way bacteria interact and exchange genetic material - a key concept behind drug resistance.
1967: The first penicillin-resistant pneumonococcal bacteria are reported in Papua New Guinea.
1968: Drug-resistant Shigella diarrhea kills 12,500 people in Guatemala.
1970-72: Penicillin-resistant gonorrhea spreads around the world, transmitted in part by U.S. servicemen, who contract the disease from prostitutes in Southeast Asia.
1976: Several weeks after attending an American Legion convention in Philadelphia, 34 people die from a mysterious form of pneumonia that thwarts available treatments and comes to be known as Legionnaires' disease.
1980s-'90s: The public-health effects of drug-resistant bacteria become clear, prompting new concerns about infectious diseases.
1986: The U.S. Food and Drug Administration, the Centers for Disease Control and Prevention, and the Department of Agriculture establish a national anti-
microbial-resistance monitoring system to track food-borne microbes.
1988-95: Studies in Finland, the Netherlands and other European countries find increased drug resistance in farm animals. Many of the livestock are fed antibiotics as growth-promoters.
1990: Puppeteer Jim Henson, creator of the Muppets, dies of toxic-shock syndrome induced by an aggressive strain of streptococcus that acts too quickly for antibiotics to work.
1992: An influx of immigrants sparks a tuberculosis epidemic in New York and other cities, forcing local officials to remobilize dormant TB prevention efforts. The federal government is spending just $55,000 a year monitoring drug resistance.
1995: A form of staph infection that is resistant to methicillin results in almost a half-billion dollars in direct medical costs and claims 1,409 lives in New York City hospitals.
1996: Japanese bacterial geneticists detect the world's first staph infection capable of resisting the powerful antibiotic vancomycin.
1997: Health officials report the percentage of antibiotic-resistant cases has surged from 2 percent in 1991 to 43 percent in 1997.
1998: The Institute of Medicine contends that overuse of antibiotics has brought about widespread drug resistance, estimating that as many as half of the prescriptions for the drugs given each year to outpatients are unnecessary. The U.S. Centers for Disease Control and Prevention spends more than $11 million a year monitoring drug resistance.
2000: The Food and Drug Administration approves one of the newest major new antibiotics, Bayer's ciprofloxacin hydrochloride, known as Cipro. Cipro makes news the following year as a treatment for a spate of unsolved anthrax poisonings.
Denver Post Staff Writer
The Denver Post
The last time a new tuberculosis drug was developed, Richard Nixon was in the White House and Dr. Michael Iseman was a young resident in a New York City hospital.
That drug, Rifampin, "was the biggest thing to hit TB in 30 years," said Iseman, now a doctor at National Jewish Medical and Research Center in Denver.
Since then, Iseman has become a recognized authority on TB and Rifampin has remained the centerpiece of TB treatment.
Now, however, a growing number of tuberculosis strains are not fazed by the drug - as in the highly publicized case of Andrew Speaker, who is being treated at National Jewish.
Tuberculosis isn't the only infection increasingly impervious to the antibiotics in medicine's arsenal.
In the past decade, federal agencies - such as the Centers for Disease Control and Prevention, the National Institutes of Health, and the Food and Drug Administration - have warned that antibiotic overuse has led to evolving drug-resistant bacteria.
At the same time, the agencies say, there is a dearth of research dollars for new antibiotics - creating a looming medical crisis.
"Infections that were once easily curable with antibiotics are becoming difficult, even impossible, to treat," the Infectious Disease Society of America warned in its report "Bad Bugs, No Drugs."
"The problem is dollars, not chemistry," said Christopher Spivey, a spokesman for the Boston-based Alliance for the Prudent Use of Antibiotics.
Antibiotics not as profitable
Antibiotic development requires huge investments of money, $400 million to $800 million, according to a study in the journal Clinical Infectious Diseases.
To provide as much income as drug companies get from the sale of one drug to a person who, for example, takes a weight-loss pill daily, a company would have to sell antibiotics to 200 to 500 people with an illness like pneumonia, Spivey said.
There are currently under development 50 drugs each for obesity, pain and Type II diabetes, according to PhRMA, a group representing the nation's leading drugmakers.
There are just nine new drugs in the works for tuberculosis and eight for malaria.
For staph infections and drug- resistant staph infections, PhRMA lists 23 drugs under development.
This isn't a new trend. FDA approval of new anti-bacterial drugs has dropped 56 percent in 20 years, according to a 2004 study by Brad Spellberg, a professor of medicine at the University of California, Los Angeles.
Work on new TB drugs has languished in part because of the widespread, mistaken belief that the disease was no longer a problem in this country, said Mel Spigelman, director of research and development for the Global Alliance for TB Drug Development.
Iseman said that on the world market drugmakers are discouraged from developing antibiotics.
"There is a tendency - in global use - for knock-offs," Iseman said. "Companies simply choose not to honor patent protections and it's done under the seemingly noble rubric of, 'we have patients dying of - whatever disease - in our country and we can't afford your drug, so we're going to make our own.' "
In its report, the infectious-disease society recommended incentives, such as tax breaks, for antibiotic research and development.
Difficult to draw attention
Still, drug companies don't get much public sympathy these days, which could make it politically tough for members of Congress to grant those tax breaks, Iseman said.
Antibiotic development "won't get on the radar until there is a really good killing plague," Spivey said.
In that respect, Speaker may have unintentionally done a favor for TB drug research by drawing attention to the disease, Spivey said.
Since 2000, interest in TB has picked up, said the TB Alliance's Spigelman.
While only a handful of new TB drugs are in the pipeline, even that is progress, Spigelman said.
"In 2000, we had zero," he said.
This year, the National Institutes of Health will spend $158 million on TB- drug research. The Bill and Melinda Gates Foundation has pledged $900 million over the next decade.
Four drug companies - Bayer, Novartis, AstraZeneca International and GlaxoSmithKline - now have units working on infectious diseases, including TB.
Bacteria, however, reproduce every 10 minutes or so, while it takes humans about 20 years to develop means to battle new strains, Iseman said.
"They have the ability to adapt to our drugs," he said. "So if you're in Vegas, you bet on the bugs."
Staff writer Karen Augé can be reached at 303-954-1733 or kauge@denverpost.com.
--------------------------------------------------------------------------------
A history of antibiotics and drug resistance
1920s-'50s: Scientists harness the power of living organisms to fight bacteria, ushering in the era of antibiotics.
1928: Scottish bacteriologist Alexander Fleming, above, accidentally discovers that a mold juice he names penicillin can kill staphylococcus bacteria.
1940: Oxford University pathologist Howard Florey isolates pure penicillin and demonstrates how it can cure a wide range of pathogens, including strep infections, gonorrhea and syphilis.
1943: Penicillin becomes the first antibiotic to be put in widespread use.
1944: Russian-born microbiologist Selman Waksman, working in the United States with soil microbiologist Albert Schatz, discovers streptomycin, a powerful antibiotic that proves effective against tuberculosis.
1958: American molecular geneticist Joshua Lederberg wins the Nobel Prize in medicine for demonstrating the way bacteria interact and exchange genetic material - a key concept behind drug resistance.
1967: The first penicillin-resistant pneumonococcal bacteria are reported in Papua New Guinea.
1968: Drug-resistant Shigella diarrhea kills 12,500 people in Guatemala.
1970-72: Penicillin-resistant gonorrhea spreads around the world, transmitted in part by U.S. servicemen, who contract the disease from prostitutes in Southeast Asia.
1976: Several weeks after attending an American Legion convention in Philadelphia, 34 people die from a mysterious form of pneumonia that thwarts available treatments and comes to be known as Legionnaires' disease.
1980s-'90s: The public-health effects of drug-resistant bacteria become clear, prompting new concerns about infectious diseases.
1986: The U.S. Food and Drug Administration, the Centers for Disease Control and Prevention, and the Department of Agriculture establish a national anti-
microbial-resistance monitoring system to track food-borne microbes.
1988-95: Studies in Finland, the Netherlands and other European countries find increased drug resistance in farm animals. Many of the livestock are fed antibiotics as growth-promoters.
1990: Puppeteer Jim Henson, creator of the Muppets, dies of toxic-shock syndrome induced by an aggressive strain of streptococcus that acts too quickly for antibiotics to work.
1992: An influx of immigrants sparks a tuberculosis epidemic in New York and other cities, forcing local officials to remobilize dormant TB prevention efforts. The federal government is spending just $55,000 a year monitoring drug resistance.
1995: A form of staph infection that is resistant to methicillin results in almost a half-billion dollars in direct medical costs and claims 1,409 lives in New York City hospitals.
1996: Japanese bacterial geneticists detect the world's first staph infection capable of resisting the powerful antibiotic vancomycin.
1997: Health officials report the percentage of antibiotic-resistant cases has surged from 2 percent in 1991 to 43 percent in 1997.
1998: The Institute of Medicine contends that overuse of antibiotics has brought about widespread drug resistance, estimating that as many as half of the prescriptions for the drugs given each year to outpatients are unnecessary. The U.S. Centers for Disease Control and Prevention spends more than $11 million a year monitoring drug resistance.
2000: The Food and Drug Administration approves one of the newest major new antibiotics, Bayer's ciprofloxacin hydrochloride, known as Cipro. Cipro makes news the following year as a treatment for a spate of unsolved anthrax poisonings.
Malta has third highest rate of antibiotic resistant infections in Europe
by Juan Ameen
A recently published European report has found that Malta has the third highest percentage of potentially deadly antibiotic-resistant hospital-acquired infections out of a list of 29 countries.
The report, which was compiled by the European Centre for Disease Prevention, found that Malta had an MRSA rate of around 55 per cent in 2005.
The study pointed out that, at present, the most important disease threat is from microorganisms that have become resistant to antibiotics. However, it went on to say that these are becoming a bigger problem outside hospitals because the microorganisms are also circulating within the community.
Romania had the highest rate of MRSA with almost 72 per cent, followed by Cyprus with around 65 per cent.
Malta came next with around 55 per cent, a slight reduction over last year’s figure of 57 per cent.
It estimated that around three million people in the EU catch a healthcare-associated infection that is fatal in around 50,000 cases.
It attributed the problem to the over-use or inappropriate use of antibiotic and anti-viral drugs, the spread of drug-resistant microbes, especially in hospitals, clinics and care centres, and a shortage of new antibiotic drugs.
“A key factor for the development of antimicrobial resistance is the amount of antibiotics used,” it said.
The study noted that detailed data on the use of antibiotics and its consumption patterns are difficult to obtain but pointed out that it is “difficult to understand why the amount of antibiotics consumed per inhabitant varies three-fold between member states.”
A recently published European report has found that Malta has the third highest percentage of potentially deadly antibiotic-resistant hospital-acquired infections out of a list of 29 countries.
The report, which was compiled by the European Centre for Disease Prevention, found that Malta had an MRSA rate of around 55 per cent in 2005.
The study pointed out that, at present, the most important disease threat is from microorganisms that have become resistant to antibiotics. However, it went on to say that these are becoming a bigger problem outside hospitals because the microorganisms are also circulating within the community.
Romania had the highest rate of MRSA with almost 72 per cent, followed by Cyprus with around 65 per cent.
Malta came next with around 55 per cent, a slight reduction over last year’s figure of 57 per cent.
It estimated that around three million people in the EU catch a healthcare-associated infection that is fatal in around 50,000 cases.
It attributed the problem to the over-use or inappropriate use of antibiotic and anti-viral drugs, the spread of drug-resistant microbes, especially in hospitals, clinics and care centres, and a shortage of new antibiotic drugs.
“A key factor for the development of antimicrobial resistance is the amount of antibiotics used,” it said.
The study noted that detailed data on the use of antibiotics and its consumption patterns are difficult to obtain but pointed out that it is “difficult to understand why the amount of antibiotics consumed per inhabitant varies three-fold between member states.”
Saturday, June 16, 2007
Study Finds Pomegranate Effective In Fighting Bacteria, Viruses
A Pace University Study has found that pure pomegranate juice and pomegranate liquid extract are effective in fighting viruses and bacteria. According to their findings, 100% Pomegranate juice and POMx liquid extract could significantly reduce microbes found in the mouth that commonly cause cavities, staph infections and food poisoning
If the answer to improved health through protection against common germs and pathogens was as simple as drinking pomegranate juice, it seems everyone would be a lot healthier.
Recent preliminary research by Milton Schiffenbauer, Ph.D., a biology professor at Pace University in New York, indicates it just might be that simple. The research revealed that 100% pomegranate juice and POMx liquid extract (pomegranate polyphenol extract), made from the Wonderful variety of pomegranate grown in California, have antiviral and antibiotic effects. His findings will be introduced May 22 at the American Society for Microbiology's annual meeting in Toronto in a presentation entitled: "The Inactivation of Virus and Destruction of Bacteria by Pomegranate Juice."
In this exploratory study, Schiffenbauer tested 100% pomegranate juice and POMx liquid extract and the effect each had on a bacterial virus T1 and several bacteria over various periods of time, in various conditions and with the addition of other ingredients. The titer of T1 virus,(a model system) which infects E.coli B decreased up to 100% within 10 minutes of the addition of 100% pomegranate juice or POMx liquid extract. The research was funded by Pace University and POM Wonderful LLC and was conducted using POM Wonderful pomegranate products.
Both were also found to be effective in the destruction of bacteria S. mutans, known to cause cavities, S. aureus, the most common cause of staph infections, and B. cereus, a common cause of food poisoning. Schiffenbauer's findings also indicate that 100% pomegranate juice and POMx liquid extract inhibit the spread of Methicillin-resistant Staphylococcus aureus (MRSA), having widespread implications in the treatment of these potentially pathogenic microorganisms.
The addition of the POM products to various oral agents, including toothpaste and mouthwash, gave these agents an antimicrobial effect.
This work comes on the heels of earlier studies conducted by Schiffenbauer that found that white tea and green tea extracts also have antimicrobial effects. According to Schiffenbauer, pomegranate has gotten even better results than the teas.
Source: postchronicle.com
If the answer to improved health through protection against common germs and pathogens was as simple as drinking pomegranate juice, it seems everyone would be a lot healthier.
Recent preliminary research by Milton Schiffenbauer, Ph.D., a biology professor at Pace University in New York, indicates it just might be that simple. The research revealed that 100% pomegranate juice and POMx liquid extract (pomegranate polyphenol extract), made from the Wonderful variety of pomegranate grown in California, have antiviral and antibiotic effects. His findings will be introduced May 22 at the American Society for Microbiology's annual meeting in Toronto in a presentation entitled: "The Inactivation of Virus and Destruction of Bacteria by Pomegranate Juice."
In this exploratory study, Schiffenbauer tested 100% pomegranate juice and POMx liquid extract and the effect each had on a bacterial virus T1 and several bacteria over various periods of time, in various conditions and with the addition of other ingredients. The titer of T1 virus,(a model system) which infects E.coli B decreased up to 100% within 10 minutes of the addition of 100% pomegranate juice or POMx liquid extract. The research was funded by Pace University and POM Wonderful LLC and was conducted using POM Wonderful pomegranate products.
Both were also found to be effective in the destruction of bacteria S. mutans, known to cause cavities, S. aureus, the most common cause of staph infections, and B. cereus, a common cause of food poisoning. Schiffenbauer's findings also indicate that 100% pomegranate juice and POMx liquid extract inhibit the spread of Methicillin-resistant Staphylococcus aureus (MRSA), having widespread implications in the treatment of these potentially pathogenic microorganisms.
The addition of the POM products to various oral agents, including toothpaste and mouthwash, gave these agents an antimicrobial effect.
This work comes on the heels of earlier studies conducted by Schiffenbauer that found that white tea and green tea extracts also have antimicrobial effects. According to Schiffenbauer, pomegranate has gotten even better results than the teas.
Source: postchronicle.com
Friday, June 15, 2007
USA: Milliken launches new antimicrobial-charged fabric technology
LAS VEGAS: The one of largest privately-held textile and chemical manufacturers in the world, Milliken® & Company has announced a new antimicrobial-charged fabric technology called BioSmart™ that harnesses the sanitising power of EPA-registered chlorine bleach and helps to reduce the spread of infection-causing bacteria and viruses, including emerging antibiotic-resistant microbes, said Travis Greer, senior technologist for Milliken’s Apparel and Specialty Fabrics division in a release.
The product made with BioSmart are key to effective infection prevention strategies and programs in the workplace, in community settings and at home and extends the capabilities of EPA-registered chlorine base sanitisers – proven hygienic agents that do not promote resistant microbes, to maintain an effective antimicrobial barrier against contamination.
The technology can be applied to synthetics, cotton and poly/cotton fabrics and are ideal for industries where bacterial contamination is a concern, including food processing and services, healthcare, public safety, hospitality, sports apparel, activewear and military.
BioSmart fabrics are non-irritating to the skin and have passed the ISO skin irritation and skin sensitivity tests an it is both durable and effective for the life of most garments as the fabric technology literally recharges after every washing, thus providing a longer shelf life and optimising value for manufacturers, laundries and consumers alike.
In addition, BioSmart fabrics are odorless, dry quickly and wick moisture and is currently available in butcher coats and other garments for the food safety and processing industries through G&K Services.
BioSmart is a patent-pending textile technology that binds chlorine molecules to the surface of fabrics.
Founded in 1865, Milliken & Company is a privately held textile and chemical company that employs approximately 10,000 associates worldwide and operates nearly 50 manufacturing facilities in the US and eight countries.
The product made with BioSmart are key to effective infection prevention strategies and programs in the workplace, in community settings and at home and extends the capabilities of EPA-registered chlorine base sanitisers – proven hygienic agents that do not promote resistant microbes, to maintain an effective antimicrobial barrier against contamination.
The technology can be applied to synthetics, cotton and poly/cotton fabrics and are ideal for industries where bacterial contamination is a concern, including food processing and services, healthcare, public safety, hospitality, sports apparel, activewear and military.
BioSmart fabrics are non-irritating to the skin and have passed the ISO skin irritation and skin sensitivity tests an it is both durable and effective for the life of most garments as the fabric technology literally recharges after every washing, thus providing a longer shelf life and optimising value for manufacturers, laundries and consumers alike.
In addition, BioSmart fabrics are odorless, dry quickly and wick moisture and is currently available in butcher coats and other garments for the food safety and processing industries through G&K Services.
BioSmart is a patent-pending textile technology that binds chlorine molecules to the surface of fabrics.
Founded in 1865, Milliken & Company is a privately held textile and chemical company that employs approximately 10,000 associates worldwide and operates nearly 50 manufacturing facilities in the US and eight countries.
Thursday, June 14, 2007
Too many antibiotics? Use could lead to resistant bacteria
By Matt Whetstone, Cadillac News
Philosophies about antibiotics are changing.
While antibiotics are great to treat disease, there is a drawback. In a nation where people have become increasingly reliant on antibiotics, bacteria have become increasingly resistant to the drugs.
In the medical community, beginning to change the way things are done truly begins by changing attitudes.
Oftentimes, patients enter a doctor’s office insistent on receiving antibiotics.
In a study performed using patients with strep throat, two groups were given antibiotics while a third was given a placebo. In the two groups given antibiotics, resistance levels rose by 50 percent.
The group given the placebo saw no increase in antibiotic resistance.
In Dr. Gerald Herring’s antibiotic toolbox, he has six options.
That’s six different chances to treat a bacterial infection in children.
“In general, the more antibiotics we use, the higher incidence of bacteria becoming resistant to antibiotics,” said Herring, a physician at Mackinaw Trail Pediatrics in Cadillac.
Another concern is that overusing antibiotics at a young age can cause children to become sensitized to a drug and result in allergic reactions, Herring said.
All of a sudden, six options could be cut in half.
The Centers for Disease Control calls antibiotic resistance one of the world’s most pressing public health problems. Overuse can mean longer-lasting illnesses, more doctor visits or extended hospital stays. Illnesses once easily treated could become much more difficult to remedy.
“A lot of patients still think they need antibiotics for colds,” Herring said. “There are a lot of misconceptions out there in the public.”
Take for example ear infections. It’s something Herring sees all the time as a pediatrician. When treating a child, Herring said he asks himself if the body can deal with an infection or if it needs some help.
Yet, 80 percent of ear infections heal on their own and in about the same time as if an antibiotic were used, Herring said.
It becomes more pressing to use antibiotics for an ear infection if a child has a high fever or if things are not improving after a few days. Not using antibiotics mean careful observation and treating the child’s symptoms.
For adults, doctors have more options when it comes to antibiotics but Herring said it’s the same situation.
“It’s a question of rethinking for physicians and re-educating of patients to teach them they don’t always need antibiotics,” he said.
Dr. James Wilson, Medical Director for District Health Department No. 10, said doctors weigh the risks versus the benefits when determining if an antibiotic is necessary. It means thinking short, intermediate and long term.
“Generally, it’s not good to be on antibiotics for a long time,” he said.
Like anything else, Wilson said microbes are constantly evolving and they will mutate if it can make them more resistant to antibiotics.
While there are many beneficial alternative treatment options, Wilson said there’s not always an incentive to use them under the U.S. medical system.
Likewise, alternative therapies are not regulated by the Food and Drug Administration, meaning it’s difficult to get information on the risks and benefits, he said.
Your local connection
What are bacteria and viruses?
Bacteria are single-celled organisms found everywhere. Many are not harmful but some can trigger illnesses, such as strep throat and some ear infections.
Viruses are smaller than bacteria and cause illnesses by invading healthy cells and reproducing.
What kinds of infections are caused by viruses and should not be treated with antibiotics?
Colds, flu, most coughs and bronchitis, sore throats (except those resulting from strep throat).
How do I know if an illness is caused by a viral or bacterial infection?
It is difficult, consult with a physician.
What is antibiotic resistance?
Antibiotic resistance occurs when bacteria change in a way that reduces or eliminates the effectiveness of antibiotics. These resistant bacteria survive and multiply, causing more harm, such as longer illness, more doctor visits and a need for more expensive and toxic antibiotics.
When do I need to take antibiotics?
Antibiotics should only be used when prescribed by a doctor to treat bacterial infections.
What can I do to avoid antibiotic resistant infections?
Talk to your doctor about antibiotic resistance. Ask if an antibiotic is likely to be effective in treating your illness.
Do not demand an antibiotic when a doctor determines one is not appropriate. Ask what else you can to do help relieve your symptoms.
How can a child be protected from antibiotic-resistant bacteria?
Use only if a doctor determines it will be effective. Antibiotics will not cure most colds, coughs, sore throats or runny noses. Children fight off colds on their own.
Source: Centers for Disease Control
Philosophies about antibiotics are changing.
While antibiotics are great to treat disease, there is a drawback. In a nation where people have become increasingly reliant on antibiotics, bacteria have become increasingly resistant to the drugs.
In the medical community, beginning to change the way things are done truly begins by changing attitudes.
Oftentimes, patients enter a doctor’s office insistent on receiving antibiotics.
In a study performed using patients with strep throat, two groups were given antibiotics while a third was given a placebo. In the two groups given antibiotics, resistance levels rose by 50 percent.
The group given the placebo saw no increase in antibiotic resistance.
In Dr. Gerald Herring’s antibiotic toolbox, he has six options.
That’s six different chances to treat a bacterial infection in children.
“In general, the more antibiotics we use, the higher incidence of bacteria becoming resistant to antibiotics,” said Herring, a physician at Mackinaw Trail Pediatrics in Cadillac.
Another concern is that overusing antibiotics at a young age can cause children to become sensitized to a drug and result in allergic reactions, Herring said.
All of a sudden, six options could be cut in half.
The Centers for Disease Control calls antibiotic resistance one of the world’s most pressing public health problems. Overuse can mean longer-lasting illnesses, more doctor visits or extended hospital stays. Illnesses once easily treated could become much more difficult to remedy.
“A lot of patients still think they need antibiotics for colds,” Herring said. “There are a lot of misconceptions out there in the public.”
Take for example ear infections. It’s something Herring sees all the time as a pediatrician. When treating a child, Herring said he asks himself if the body can deal with an infection or if it needs some help.
Yet, 80 percent of ear infections heal on their own and in about the same time as if an antibiotic were used, Herring said.
It becomes more pressing to use antibiotics for an ear infection if a child has a high fever or if things are not improving after a few days. Not using antibiotics mean careful observation and treating the child’s symptoms.
For adults, doctors have more options when it comes to antibiotics but Herring said it’s the same situation.
“It’s a question of rethinking for physicians and re-educating of patients to teach them they don’t always need antibiotics,” he said.
Dr. James Wilson, Medical Director for District Health Department No. 10, said doctors weigh the risks versus the benefits when determining if an antibiotic is necessary. It means thinking short, intermediate and long term.
“Generally, it’s not good to be on antibiotics for a long time,” he said.
Like anything else, Wilson said microbes are constantly evolving and they will mutate if it can make them more resistant to antibiotics.
While there are many beneficial alternative treatment options, Wilson said there’s not always an incentive to use them under the U.S. medical system.
Likewise, alternative therapies are not regulated by the Food and Drug Administration, meaning it’s difficult to get information on the risks and benefits, he said.
Your local connection
What are bacteria and viruses?
Bacteria are single-celled organisms found everywhere. Many are not harmful but some can trigger illnesses, such as strep throat and some ear infections.
Viruses are smaller than bacteria and cause illnesses by invading healthy cells and reproducing.
What kinds of infections are caused by viruses and should not be treated with antibiotics?
Colds, flu, most coughs and bronchitis, sore throats (except those resulting from strep throat).
How do I know if an illness is caused by a viral or bacterial infection?
It is difficult, consult with a physician.
What is antibiotic resistance?
Antibiotic resistance occurs when bacteria change in a way that reduces or eliminates the effectiveness of antibiotics. These resistant bacteria survive and multiply, causing more harm, such as longer illness, more doctor visits and a need for more expensive and toxic antibiotics.
When do I need to take antibiotics?
Antibiotics should only be used when prescribed by a doctor to treat bacterial infections.
What can I do to avoid antibiotic resistant infections?
Talk to your doctor about antibiotic resistance. Ask if an antibiotic is likely to be effective in treating your illness.
Do not demand an antibiotic when a doctor determines one is not appropriate. Ask what else you can to do help relieve your symptoms.
How can a child be protected from antibiotic-resistant bacteria?
Use only if a doctor determines it will be effective. Antibiotics will not cure most colds, coughs, sore throats or runny noses. Children fight off colds on their own.
Source: Centers for Disease Control
Tuesday, June 12, 2007
Return of the White Plague
By Howard Markel
Sunday, June 10, 2007; Page B01
Andrew Speaker, the 31-year-old Atlanta lawyer with a bad case of wanderlust and a worse case of tuberculosis, isn't just a media sensation. He's also the personification of a time machine, returning us to a not-so-distant era when diseases that we now casually assume are treatable claimed thousands of lives. And that grim part of our past could become our future.
Speaker got plenty of press as he was ordered into federal quarantine, having crisscrossed the Atlantic on commercial flights while infected with extensively drug-resistant tuberculosis (XDR-TB). But what hasn't garnered nearly enough attention is a sober consideration of just how deadly tuberculosis can be. The rising worldwide number of XDR-TB cases like Speaker's may herald the end of a glorious 60-year holiday from many common and highly contagious diseases -- such as polio, measles and cholera -- that once routinely ravaged vast swaths of humanity.
For those of you who consider tuberculosis a thing of the distant past, let me tell you a story. As a young man in 1913, Eugene O'Neill, the future playwright and winner of the Nobel and Pulitzer prizes, was confined for five months to a TB sanatorium. His family considered the initial diagnosis practically a death sentence. They had a point: Tuberculosis was then the leading cause of death for Americans ages 20 to 45. But by living under an enforced regimen of rest, fresh air and exercise, and by eating a diet rich in fat and protein, O'Neill recovered. A young woman he met and fell in love with in the sanatorium was not nearly so fortunate. Emaciated, pale and weak, she entered her last bloody round of violent coughing 18 months later. Writing about her death, O'Neill described tuberculosis as a cruel game of drawing straws, with more short straws than long ones.
The ancient Greeks had a wonderful word to describe tuberculosis's ravages: phthisis, which describes a living body that shrivels with intense heat as if placed on a flame. Later, the Romans applied the Latin word "consumere" -- to eat up or devour -- to the malady. Indeed, when O'Neill's TB was diagnosed, the disease was still referred to as "consumption." This is precisely what untreated (or untreatable) tuberculosis does. It consumes with a passionate and incisive energy; it slowly, inexorably devours the very structure of the lungs and other critical organs, with the single goal of conquering its host -- but not until its progeny have had the opportunity to travel to and settle in the lungs of another human, to start the horrific process all over again.
Ironically, there has long been a disturbing tendency to romanticize the white plague, as tuberculosis is also known. It is, after all, the malady that carried away the poet John Keats and the scribbling Bronte sisters; the illness that rang down the final curtain on Moliere, Voltaire and Chekhov. And, of course, there are those operas by Verdi and Puccini featuring heroines struck down in their prime by tuberculosis. When reflecting on this artistic history, the late literary critic Susan Sontag once called tuberculosis an "aphrodisiac," a disease with "extraordinary power of seduction."
But in real life, tuberculosis is a messy, agonizing and debilitating ordeal. Once the tubercle bacilli gain the momentum to proceed unchecked through the body, there is no romance to be found. The actual experience of tuberculosis is one of exhaustion, not literary inspiration; drenching bouts of sweating, not hypersexual allure; groaning, not arias; a cough punctuated by uncontrollable spurts of blood, not the lover's kiss. This is the nightmarish reality of tuberculosis that O'Neill and his peers understood all too well -- and the one we so easily forget.
As doctors have long known, and as the rest of the world is beginning to appreciate, TB is very much alive and well. It began to rise again in developed nations in the 1980s, largely as a result of funding cuts for TB prevention and treatment programs and the emergence of the AIDS pandemic. The reemergence of tuberculosis has been most devastating, however, in impoverished nations, particularly ones where HIV/AIDS is prevalent, because AIDS significantly increases a person's susceptibility to tuberculosis. As TB cases have multiplied, so have the numbers of people either inadequately or incompletely treated -- which, in turn, has led to the emergence of drug-resistant strains of the microbe that causes the disease.
Our understanding of the prevalence of XDR-TB is somewhat sketchy. Nevertheless, the transformation of a once treatable disease into an infectious foe as deadly as it was when Eugene O'Neill was confined to his 1913 sanatorium is the worst nightmare of those charged with protecting public health. XDR-TB has appeared 49 times in the United States between 1993 and 2006 and is of particular concern in Eastern Europe, South Africa and Asia.
In the fall of 2006, the World Health Organization declared XDR-TB to be a global emergency and beseeched the wealthiest nations to contribute $95 million by the end of this year to contain it. But many billions more are needed to thoroughly treat the millions of cases of drug-sensitive tuberculosis so that those patients don't become resistant to standard antibiotics.
Today, more than one-third of the world's more than 6 billion people have been exposed to the tuberculosis germ. Five to 10 percent of them, or at least 100 million, will develop symptomatic TB. Each will infect 10 to 20 people before they are either successfully treated or they die. Last year, active -- and contagious -- tuberculosis was diagnosed in more than 8.8 million people. Approximately 420,000, or 5 percent, of them have a drug-resistant strain that requires several more medications than drug-sensitive cases do; about 30,000 of these 420,000 cases are even more difficult and expensive to treat, the highly lethal XDR-TB.
TB is not the only disease once close to eradication that is experiencing a scary renaissance. Drug-resistant strains of syphilis have reportedly been on the rise; and strains of once-conquered germs such as staph and strep have developed powerful and broad resistance to just about every antibiotic known and, as a result, wreak havoc on unsuspecting hospital patients. In the never-ending dance between humans and microbes, we have been leading for only about half a century. These deadly germs are evolving, mutating and revising their structure to reclaim the upper hand in their powers of infection.
We live in a risky world menaced by war, terrorism, economic inequities and global warming, to name a few major threats. But ask any doctor what keeps him awake at night, and he will probably tell you about emerging and reemerging infectious diseases such as XDR-TB. Which brings me back to Andrew Speaker's not so excellent adventure.
Aside from the disagreements over which health officer said what, arguments about the loopholes between federal, state and local health regulations, or the media ruckus over whether Speaker was just a guy trying to have a nice wedding or a modern-day Typhoid Mary with a law degree, one obvious point demands our attention. Tuberculosis is a bad disease, and it's contagious. International air travel poses real risks in the spread of tuberculosis. Coughing, sneezing, singing, yelling and even laughing can spread TB germs. People contract tuberculosis after prolonged exposure (eight hours or more) to someone with the illness. This is the same length of time as most transoceanic flights, where passengers breathe re-circulated air for hours on end.
Those infected have a moral imperative not to put others in harm's way, even though it may mean postponing a wedding and a honeymoon. This has been a truism since Roman times. Salus populi suprema lex esto, went their saying: Let the public's health be the supreme law.
So, if you're confronted with the slightest chance of spreading a terrible infection (and with tuberculosis, that determination can take many weeks), assume that you are contagious until proven otherwise. Failure to follow that simple rule eats away at the foundation of public health surveillance and modern medical care. One only wishes that before Speaker embarked upon the first of many flights last month, he had recalled an admonition he must have heard from his mother or kindergarten teacher: If you are sick, stay home.
Someone's life may depend on it.
howard@umich.edu
Howard Markel, a professor of communicable diseases and the history of medicine at the University of Michigan, is the author of "When Germs Travel."
Sunday, June 10, 2007; Page B01
Andrew Speaker, the 31-year-old Atlanta lawyer with a bad case of wanderlust and a worse case of tuberculosis, isn't just a media sensation. He's also the personification of a time machine, returning us to a not-so-distant era when diseases that we now casually assume are treatable claimed thousands of lives. And that grim part of our past could become our future.
Speaker got plenty of press as he was ordered into federal quarantine, having crisscrossed the Atlantic on commercial flights while infected with extensively drug-resistant tuberculosis (XDR-TB). But what hasn't garnered nearly enough attention is a sober consideration of just how deadly tuberculosis can be. The rising worldwide number of XDR-TB cases like Speaker's may herald the end of a glorious 60-year holiday from many common and highly contagious diseases -- such as polio, measles and cholera -- that once routinely ravaged vast swaths of humanity.
For those of you who consider tuberculosis a thing of the distant past, let me tell you a story. As a young man in 1913, Eugene O'Neill, the future playwright and winner of the Nobel and Pulitzer prizes, was confined for five months to a TB sanatorium. His family considered the initial diagnosis practically a death sentence. They had a point: Tuberculosis was then the leading cause of death for Americans ages 20 to 45. But by living under an enforced regimen of rest, fresh air and exercise, and by eating a diet rich in fat and protein, O'Neill recovered. A young woman he met and fell in love with in the sanatorium was not nearly so fortunate. Emaciated, pale and weak, she entered her last bloody round of violent coughing 18 months later. Writing about her death, O'Neill described tuberculosis as a cruel game of drawing straws, with more short straws than long ones.
The ancient Greeks had a wonderful word to describe tuberculosis's ravages: phthisis, which describes a living body that shrivels with intense heat as if placed on a flame. Later, the Romans applied the Latin word "consumere" -- to eat up or devour -- to the malady. Indeed, when O'Neill's TB was diagnosed, the disease was still referred to as "consumption." This is precisely what untreated (or untreatable) tuberculosis does. It consumes with a passionate and incisive energy; it slowly, inexorably devours the very structure of the lungs and other critical organs, with the single goal of conquering its host -- but not until its progeny have had the opportunity to travel to and settle in the lungs of another human, to start the horrific process all over again.
Ironically, there has long been a disturbing tendency to romanticize the white plague, as tuberculosis is also known. It is, after all, the malady that carried away the poet John Keats and the scribbling Bronte sisters; the illness that rang down the final curtain on Moliere, Voltaire and Chekhov. And, of course, there are those operas by Verdi and Puccini featuring heroines struck down in their prime by tuberculosis. When reflecting on this artistic history, the late literary critic Susan Sontag once called tuberculosis an "aphrodisiac," a disease with "extraordinary power of seduction."
But in real life, tuberculosis is a messy, agonizing and debilitating ordeal. Once the tubercle bacilli gain the momentum to proceed unchecked through the body, there is no romance to be found. The actual experience of tuberculosis is one of exhaustion, not literary inspiration; drenching bouts of sweating, not hypersexual allure; groaning, not arias; a cough punctuated by uncontrollable spurts of blood, not the lover's kiss. This is the nightmarish reality of tuberculosis that O'Neill and his peers understood all too well -- and the one we so easily forget.
As doctors have long known, and as the rest of the world is beginning to appreciate, TB is very much alive and well. It began to rise again in developed nations in the 1980s, largely as a result of funding cuts for TB prevention and treatment programs and the emergence of the AIDS pandemic. The reemergence of tuberculosis has been most devastating, however, in impoverished nations, particularly ones where HIV/AIDS is prevalent, because AIDS significantly increases a person's susceptibility to tuberculosis. As TB cases have multiplied, so have the numbers of people either inadequately or incompletely treated -- which, in turn, has led to the emergence of drug-resistant strains of the microbe that causes the disease.
Our understanding of the prevalence of XDR-TB is somewhat sketchy. Nevertheless, the transformation of a once treatable disease into an infectious foe as deadly as it was when Eugene O'Neill was confined to his 1913 sanatorium is the worst nightmare of those charged with protecting public health. XDR-TB has appeared 49 times in the United States between 1993 and 2006 and is of particular concern in Eastern Europe, South Africa and Asia.
In the fall of 2006, the World Health Organization declared XDR-TB to be a global emergency and beseeched the wealthiest nations to contribute $95 million by the end of this year to contain it. But many billions more are needed to thoroughly treat the millions of cases of drug-sensitive tuberculosis so that those patients don't become resistant to standard antibiotics.
Today, more than one-third of the world's more than 6 billion people have been exposed to the tuberculosis germ. Five to 10 percent of them, or at least 100 million, will develop symptomatic TB. Each will infect 10 to 20 people before they are either successfully treated or they die. Last year, active -- and contagious -- tuberculosis was diagnosed in more than 8.8 million people. Approximately 420,000, or 5 percent, of them have a drug-resistant strain that requires several more medications than drug-sensitive cases do; about 30,000 of these 420,000 cases are even more difficult and expensive to treat, the highly lethal XDR-TB.
TB is not the only disease once close to eradication that is experiencing a scary renaissance. Drug-resistant strains of syphilis have reportedly been on the rise; and strains of once-conquered germs such as staph and strep have developed powerful and broad resistance to just about every antibiotic known and, as a result, wreak havoc on unsuspecting hospital patients. In the never-ending dance between humans and microbes, we have been leading for only about half a century. These deadly germs are evolving, mutating and revising their structure to reclaim the upper hand in their powers of infection.
We live in a risky world menaced by war, terrorism, economic inequities and global warming, to name a few major threats. But ask any doctor what keeps him awake at night, and he will probably tell you about emerging and reemerging infectious diseases such as XDR-TB. Which brings me back to Andrew Speaker's not so excellent adventure.
Aside from the disagreements over which health officer said what, arguments about the loopholes between federal, state and local health regulations, or the media ruckus over whether Speaker was just a guy trying to have a nice wedding or a modern-day Typhoid Mary with a law degree, one obvious point demands our attention. Tuberculosis is a bad disease, and it's contagious. International air travel poses real risks in the spread of tuberculosis. Coughing, sneezing, singing, yelling and even laughing can spread TB germs. People contract tuberculosis after prolonged exposure (eight hours or more) to someone with the illness. This is the same length of time as most transoceanic flights, where passengers breathe re-circulated air for hours on end.
Those infected have a moral imperative not to put others in harm's way, even though it may mean postponing a wedding and a honeymoon. This has been a truism since Roman times. Salus populi suprema lex esto, went their saying: Let the public's health be the supreme law.
So, if you're confronted with the slightest chance of spreading a terrible infection (and with tuberculosis, that determination can take many weeks), assume that you are contagious until proven otherwise. Failure to follow that simple rule eats away at the foundation of public health surveillance and modern medical care. One only wishes that before Speaker embarked upon the first of many flights last month, he had recalled an admonition he must have heard from his mother or kindergarten teacher: If you are sick, stay home.
Someone's life may depend on it.
howard@umich.edu
Howard Markel, a professor of communicable diseases and the history of medicine at the University of Michigan, is the author of "When Germs Travel."
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