Sep. 18, 2008) — Vital components of modern medicine such as major surgery, organ transplantation, and cancer chemotherapy will be threatened if antibiotic resistance is not tackled urgently, warn experts on bmj.com.
A concerted global response is needed to address rising rates of bacterial resistance caused by the use and abuse of antibiotics or "we will return to the pre-antibiotic era", write Professor Otto Cars and colleagues in an editorial.
All antibiotic use "uses up" some of the effectiveness of that antibiotic, diminishing the ability to use it in the future, write the authors, and antibiotics can no longer be considered as a renewable source.
They point out that existing antibiotics are losing their effect at an alarming pace, while the development of new antibiotics is declining. More than a dozen new classes of antibiotics were developed between 1930 and 1970, but only two new classes have been developed since then.
According to the European Centre for Disease Prevention and Control, the most important disease threat in Europe is from micro-organisms that have become resistant to antibiotics. As far back as 2000, the World Health Organisation was calling for a massive effort to address the problem of antimicrobial resistance to prevent the "health catastrophe of tomorrow".
So why has so little been done to address the problem of resistance, ask the authors?
Antibiotics are over prescribed, still illegally sold over the counter in some EU countries, and self medication with leftover medicines is commonplace.
There are alarming reports about serious consequences of antibiotic resistance from all around the world. However, there is still a dearth of data on the magnitude and burden of antibiotic resistance, or its economic impact on individuals, health care, and society. This, they suggest, may explain why there has been little response to this public health threat from politicians, public health workers, and consumers.
In addition, there are significant scientific challenges but few incentives to developing new antibiotics, state the authors.
The authors believe that priority must be given to the most urgently needed antibiotics and incentives given for developing antibacterials with new mechanisms of action. In addition, "the use of new antibiotics must be safeguarded by regulations and practices that ensure rational use, to avoid repeating the mistakes we have made by overusing the old ones", they say.
They point out that reducing consumer demand could be the strongest force to driving change—individuals must be educated to understand that their choice to use an antibiotic will affect the possibility of effectively treating bacterial infections in other people.
But, they claim, the ultimate responsibility for coordination and resources rests with national governments, WHO and other international stakeholders.
Not only is there an urgent need for up-to-date information on the level of antibiotic resistance, but also for evidence of effective interventions for the prevention and control of antibiotic resistance at national and local levels, while more focus is needed on infectious diseases, they conclude.
--------------------------------------------------------------------------------
Adapted from materials provided by BMJ-British Medical Journal, via EurekAlert!, a service of AAAS.
Source: ScienceDaily
Showing posts with label antibiotic resistance. Show all posts
Showing posts with label antibiotic resistance. Show all posts
Saturday, September 27, 2008
Wednesday, February 6, 2008
E. Coli on the Rise, Aided by Factory Farms, Antibiotic Overuse
E. coli is not going away anytime soon. As a matter-of-fact, U.S. food safety officials say the potential for dangerous E. coli bacteria is on the rise again with the potential greatest in spinach and other fresh foods. Since 2006, when an E. coli outbreak in spinach swept the nation, outbreaks of the bacteria have become more varied, likely because of the growing trend in raw fruits and vegetable consumption, which can harbor dangerous bacteria, HealthDay, reported in a syndicated story appearing in USA Today.
In the last two years, a variety of pathogens in food have killed at least three people, sickened more than 1,300 others, and touched nearly every state in the country as well as Canada, HealthDay reported. The problem is difficult to police because the food-surveillance system is outdated, under-funded, and overwhelmed by the emergence of mega-farms, mega-distribution centers, and mega-transporters, HealthDay said. “Before, it was just bad produce coming from one farm,” said Michael Hansen, a senior scientist with Consumers Union.
Couple this with the overarching problem with infectious diseases which are now becoming more resistant to bacteria because of antibiotic overuse and abuse. We overuse or misuse antibiotics; bacteria mutate, changing just enough to ensure antibiotics have no effect on them and giving them a wide berth to spread with ever more power. Although tempting, preventative antibiotic regimes only worsen the epidemic and strengthen the bacteria. And while new drugs are emerging, it’s just a matter of time before super bugs will become resistant to them, too. In many cases, they have.
Antibiotic resistance is so pervasive that scientists now report having found evidence of drug-repelling E. coli in Arctic birds as remote as the polar ice cap. It seems migratory fowl that circumnavigate the globe along centuries-old flyways passed the bacteria. Scientists in Sweden traveled to vast regions of the frigid ice cap in search of species they hoped had been spared exposure to drug-resistant strains and were surprised to discover widespread antibiotic-resistant E. coli in Arctic-dwelling birds never previously exposed to the drugs. This study added credence to the notion that antibiotic resistance is global and no region is unscathed.
In addition to the spread of E. coli and the growing resistance of the infection to traditional medications, it seems that there is emerging data that the negative health effects of E. coli can remain for months and years later. It was believed that once we recover from a food-related contamination that we are healed and the illness is gone. Not so. According to recent research, these illnesses can have long-term, lasting effects that can either linger for months or years or can show up months or years after the original illness. As part of their studies, researchers found that some children who suffered severe cases of E. coli developed health problems later in life, such as kidney problems, high blood pressure, and kidney failure; the health problems appeared as late as 10 to 20 years later. The research also found people who suffered salmonella or shigella can find themselves suffering with arthritis later in life and, for those who exhibited mild campylobacter, a type of paralysis can strike following the initial complaints.
In the last two years, a variety of pathogens in food have killed at least three people, sickened more than 1,300 others, and touched nearly every state in the country as well as Canada, HealthDay reported. The problem is difficult to police because the food-surveillance system is outdated, under-funded, and overwhelmed by the emergence of mega-farms, mega-distribution centers, and mega-transporters, HealthDay said. “Before, it was just bad produce coming from one farm,” said Michael Hansen, a senior scientist with Consumers Union.
Couple this with the overarching problem with infectious diseases which are now becoming more resistant to bacteria because of antibiotic overuse and abuse. We overuse or misuse antibiotics; bacteria mutate, changing just enough to ensure antibiotics have no effect on them and giving them a wide berth to spread with ever more power. Although tempting, preventative antibiotic regimes only worsen the epidemic and strengthen the bacteria. And while new drugs are emerging, it’s just a matter of time before super bugs will become resistant to them, too. In many cases, they have.
Antibiotic resistance is so pervasive that scientists now report having found evidence of drug-repelling E. coli in Arctic birds as remote as the polar ice cap. It seems migratory fowl that circumnavigate the globe along centuries-old flyways passed the bacteria. Scientists in Sweden traveled to vast regions of the frigid ice cap in search of species they hoped had been spared exposure to drug-resistant strains and were surprised to discover widespread antibiotic-resistant E. coli in Arctic-dwelling birds never previously exposed to the drugs. This study added credence to the notion that antibiotic resistance is global and no region is unscathed.
In addition to the spread of E. coli and the growing resistance of the infection to traditional medications, it seems that there is emerging data that the negative health effects of E. coli can remain for months and years later. It was believed that once we recover from a food-related contamination that we are healed and the illness is gone. Not so. According to recent research, these illnesses can have long-term, lasting effects that can either linger for months or years or can show up months or years after the original illness. As part of their studies, researchers found that some children who suffered severe cases of E. coli developed health problems later in life, such as kidney problems, high blood pressure, and kidney failure; the health problems appeared as late as 10 to 20 years later. The research also found people who suffered salmonella or shigella can find themselves suffering with arthritis later in life and, for those who exhibited mild campylobacter, a type of paralysis can strike following the initial complaints.
Antibiotic resistance: A global phenomenon
Scientists have discovered antibiotic-resistant bacteria in the Arctic, suggesting that drug-resistance has spread into the farthest reaches of nature - an alarming prospect for future healthcare.
The researchers from Sweden studied antimicrobial drug resistance in Escherichia coli isolated from Arctic birds to 17 antimicrobial drugs, detecting resistance to 14 of them.
“We were extremely surprised,” said Björn Olsen, Professor of Infectious Diseases at Uppsala University and at the Laboratory for Zoonosis Research at the University of Kalmar.
“We took samples from birds living far out on the tundra and had no contact with people. This further confirms that resistance to antibiotics has become a global phenomenon and that virtually no region of the earth, with the possible exception of the Antarctic, is unaffected.”
The team took samples from 97 birds in north-eastern Siberia, northern Alaska, and northern Greenland and cultivated them directly in laboratories the researchers had installed onboard the icebreaking ship they used to reach the Arctic. Samples were further analysed at the microbiological laboratory at the Central Hospital in Växjö, Sweden.
The researchers suggest the reason for the resistance is that immigrating birds have passed through regions in Southeast Asia, for example, where there is a great deal of antibiotic pressure and carried with them the resistant bacteria to the tundra.
Professor Olsen told Laboratory News: “The fact that an isolate from a juvenile Western sandpiper sampled far from human settlements on the tundra had resistance to cefadroxil, cefuroxime, and cefpodoxime, a resistance pattern commonly seen in clinical isolates, supports the theory of introduction by migration and transfer of bacteria between birds.”
In a paper published in the journal Emerging Infectious Diseases, the team goes further to suggest that migrating birds carrying antibiotic-resistant bacteria can then infect isolated human communities, using the Bolivian community of 130 Guaraní Indians as an example. This community is located at an altitude of 1,700m and can only be reached by a 3-hour steep climb. Nevertheless, high rates of drug-resistant E. coli were found in this community, although exposure to antimicrobial drugs in the area had been limited.
“A possible explanation for the unexpectedly high carriage rate of drug-resistant E. coli in the Indian community in Bolivia is the importation of drug-resistant isolates by migratory birds,” said Jonas Bonnedahl, a physician specialising in infectious diseases in Kalmar and one of those participating in the expedition.
He added: “Our findings show that resistance to antibiotics is not limited to society and hospitals but is now spreading into the wild. Escalating resistance to antibiotics over the last few years has crystallised into one of the greatest threats to well-functioning health care in the future.”
The researchers from Sweden studied antimicrobial drug resistance in Escherichia coli isolated from Arctic birds to 17 antimicrobial drugs, detecting resistance to 14 of them.
“We were extremely surprised,” said Björn Olsen, Professor of Infectious Diseases at Uppsala University and at the Laboratory for Zoonosis Research at the University of Kalmar.
“We took samples from birds living far out on the tundra and had no contact with people. This further confirms that resistance to antibiotics has become a global phenomenon and that virtually no region of the earth, with the possible exception of the Antarctic, is unaffected.”
The team took samples from 97 birds in north-eastern Siberia, northern Alaska, and northern Greenland and cultivated them directly in laboratories the researchers had installed onboard the icebreaking ship they used to reach the Arctic. Samples were further analysed at the microbiological laboratory at the Central Hospital in Växjö, Sweden.
The researchers suggest the reason for the resistance is that immigrating birds have passed through regions in Southeast Asia, for example, where there is a great deal of antibiotic pressure and carried with them the resistant bacteria to the tundra.
Professor Olsen told Laboratory News: “The fact that an isolate from a juvenile Western sandpiper sampled far from human settlements on the tundra had resistance to cefadroxil, cefuroxime, and cefpodoxime, a resistance pattern commonly seen in clinical isolates, supports the theory of introduction by migration and transfer of bacteria between birds.”
In a paper published in the journal Emerging Infectious Diseases, the team goes further to suggest that migrating birds carrying antibiotic-resistant bacteria can then infect isolated human communities, using the Bolivian community of 130 Guaraní Indians as an example. This community is located at an altitude of 1,700m and can only be reached by a 3-hour steep climb. Nevertheless, high rates of drug-resistant E. coli were found in this community, although exposure to antimicrobial drugs in the area had been limited.
“A possible explanation for the unexpectedly high carriage rate of drug-resistant E. coli in the Indian community in Bolivia is the importation of drug-resistant isolates by migratory birds,” said Jonas Bonnedahl, a physician specialising in infectious diseases in Kalmar and one of those participating in the expedition.
He added: “Our findings show that resistance to antibiotics is not limited to society and hospitals but is now spreading into the wild. Escalating resistance to antibiotics over the last few years has crystallised into one of the greatest threats to well-functioning health care in the future.”
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.
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.
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.
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
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
We're near top of killer bug table
By Anne-Marie Walsh
Saturday June 09 2007
Irish hospitals come seventh in a league table of incidents of the deadly infection across 29 countries, according to new EU figures.
The research confirms that patients are highly exposed to the hospital-based bacteria and the rate of infection has not improved since 2001.
Only six other countries, Romania, Cyprus, Malta, Portugal, the UK and Greece (in that order), have a higher rate of the antibiotic-resistant infection.
However, a spokesperson for the ECDC pointed out that the Irish figures could be misleading.
"One of the reasons that Ireland and the UK have relatively high levels of MRSA is that they are quite active in monitoring it," he said.
"Some other EU countries may not be looking as hard or monitoring it as well."
But he added: "Compared with Ireland, the Netherlands and Scandinavia have been quite successful in preventing MRSA.
The level of MRSA in Ireland has risen in the last 10 years and has levelled off."
The investigation by the EU Centre for Disease Prevention and Control (ECDC) shows that the rate of MRSA went up by 1pc in the latest available year's data.
It is at the same level it was at in 2001, and 3pc higher than the 1999 rate of 39pc, suggesting that Government initiativeson eradication have had little impact.
The ECDC warned last night that the spread of hospital-acquired infections was now the main disease threat in Europe.
It said that, if the present "rapid negative development" was not halted, mankind would soon lose one of its most important weapons against infectious disease - antibiotics.
MRSA (methicillin-resistant staphylococcus aureus) is one of the bugs in the staphylococcus aureus family of bacteria that cannot be treated with drugs.
It made up 42pc of the 1,360 detected infections in this family of bacteria in Ireland in 2005.
This represented 571 people, according to the authors of the pioneering report from the ECDC.
The rest of the cases infected with the staphylococcus aureus bacteria could be treated with drugs.
MRSA is among the forms of superbugs from the staphylococcus aureus family of bacteria that are resistant to antibiotics.
They can live on the skin and in the nose and cause a variety of illnesses including meningitis and septicaemia.
If the bacteria enters the bloodstream, it can be extremely dangerous and is potentially fatal if it belongs to the variety that is resistant to antibiotics.
The ECDC report on infectious diseases ranked countries based on the proportion of S-aureus infections found to be antibiotic-resistant.
Romania topped the table with the highest proportion of the superbug, at over 60pc.
Every year, around 3m people in the EU catch a healthcare-associated infection, of whom around 50,000 die.
One in every 10 patients admitted to hospital in the EU will catch an infection there.
"One of the biggest challenges we face is the emergence of new microbes against which our defences are weak, or even non-existent," said Markos Kyprianou, European Commissioner for Health.
"Pandemic preparedness is, and must remain, a priority for the EU."
- Anne-Marie Walsh
Saturday June 09 2007
Irish hospitals come seventh in a league table of incidents of the deadly infection across 29 countries, according to new EU figures.
The research confirms that patients are highly exposed to the hospital-based bacteria and the rate of infection has not improved since 2001.
Only six other countries, Romania, Cyprus, Malta, Portugal, the UK and Greece (in that order), have a higher rate of the antibiotic-resistant infection.
However, a spokesperson for the ECDC pointed out that the Irish figures could be misleading.
"One of the reasons that Ireland and the UK have relatively high levels of MRSA is that they are quite active in monitoring it," he said.
"Some other EU countries may not be looking as hard or monitoring it as well."
But he added: "Compared with Ireland, the Netherlands and Scandinavia have been quite successful in preventing MRSA.
The level of MRSA in Ireland has risen in the last 10 years and has levelled off."
The investigation by the EU Centre for Disease Prevention and Control (ECDC) shows that the rate of MRSA went up by 1pc in the latest available year's data.
It is at the same level it was at in 2001, and 3pc higher than the 1999 rate of 39pc, suggesting that Government initiativeson eradication have had little impact.
The ECDC warned last night that the spread of hospital-acquired infections was now the main disease threat in Europe.
It said that, if the present "rapid negative development" was not halted, mankind would soon lose one of its most important weapons against infectious disease - antibiotics.
MRSA (methicillin-resistant staphylococcus aureus) is one of the bugs in the staphylococcus aureus family of bacteria that cannot be treated with drugs.
It made up 42pc of the 1,360 detected infections in this family of bacteria in Ireland in 2005.
This represented 571 people, according to the authors of the pioneering report from the ECDC.
The rest of the cases infected with the staphylococcus aureus bacteria could be treated with drugs.
MRSA is among the forms of superbugs from the staphylococcus aureus family of bacteria that are resistant to antibiotics.
They can live on the skin and in the nose and cause a variety of illnesses including meningitis and septicaemia.
If the bacteria enters the bloodstream, it can be extremely dangerous and is potentially fatal if it belongs to the variety that is resistant to antibiotics.
The ECDC report on infectious diseases ranked countries based on the proportion of S-aureus infections found to be antibiotic-resistant.
Romania topped the table with the highest proportion of the superbug, at over 60pc.
Every year, around 3m people in the EU catch a healthcare-associated infection, of whom around 50,000 die.
One in every 10 patients admitted to hospital in the EU will catch an infection there.
"One of the biggest challenges we face is the emergence of new microbes against which our defences are weak, or even non-existent," said Markos Kyprianou, European Commissioner for Health.
"Pandemic preparedness is, and must remain, a priority for the EU."
- Anne-Marie Walsh
Saturday, June 9, 2007
NEWS RELEASE-FDA Science Board to Meet on June 14
News Release
FOR IMMEDIATE RELEASE
P07-100
June 8, 2007
Media Inquiries:
301-827-6242
Consumer Inquiries:
888-INFO-FDA
The U.S. Food and Drug Administration's (FDA) Science Board will hold a public meeting on June 14, 2007. The board, an advisory committee to the FDA, provides the agency with expert outside advice on specific technical issues, as well as emerging issues within the scientific community, industry, and academia. Members counsel the agency on regulatory science, the formulation of an appropriate research agenda, and on upgrading FDA's scientific and research facilities.
"Science provides the foundation for FDA's regulatory decisions," said Janet Woodcock, M.D., FDA's deputy commissioner and chief medical officer. "Science and technology are creating products with enormous promise and, frequently, considerable challenges. This in-depth review of our scientific capacity is critical to assuring that FDA will continue to meet the regulatory challenges of the future."
Members of the board will address food protection, the agency's interim safety/risk assessment of melamine, a report on the Antimicrobial Resistance Monitoring System (NARMS), and an agency-wide review of FDA science. For a complete agenda, briefing documents, and a list of subject matters experts that serve as advisors to the subcommittee and their affiliations, please see: www.fda.gov/ohrms/dockets/ac/oc07.htm#ScienceBoard.
The board, chaired by Kenneth Shine, M.D., University of Texas System, Austin, is composed of nine members. Other members include: Gail H. Cassell, Ph.D., Eli Lilly and Company, Indianapolis; Susan Kay Harlander, Ph.D., BT Safety, LLC, Eden Prairie; Lonnie King, D.V.M., Centers for Disease Control and Prevention, Atlanta; Barbara J. McNeil, M.D., Ph.D., Harvard Medical School, Boston; David R. Parkinson, M.D., Biogen Idec, San Diego, Calif.; F. Xavier Pi-Sunyer, M.D., St. Luke's-Roosevelt Hospital Center, New York; Allen D. Roses, M.D., GlaxoSmithKline, Research Triangle Park, N.C.; and Larry D. Sasich, Pharm.D., consumer representative, Erie, Pa.
Last year, the board established the Subcommittee for the Review of FDA Science to determine whether the FDA's current science portfolio is properly positioned to deal new regulatory challenges stemming from developments in science and technology.
During the daylong meeting, the Subcommittee will provide an update on the progress of their review. The subcommittee, chaired by Gail H. Cassell, Ph.D., of Eli Lilly and Company, will submit a draft written report of its preliminary findings to the board this summer. The subcommittee has asked 28 scientific subject-matter experts, drawn from government, industry and academia, to contribute to the report.
The Science Board meeting is scheduled for June 14 from 8 a.m. to 4:30 p.m. at the Holiday Inn, 2 Montgomery Village Ave., Gaithersburg, Md.
Public comments can be submitted; please see the Federal Register notice for this meeting for more information: www.fda.gov/OHRMS/DOCKETS/98fr/E7-9737.htm.
####
FOR IMMEDIATE RELEASE
P07-100
June 8, 2007
Media Inquiries:
301-827-6242
Consumer Inquiries:
888-INFO-FDA
The U.S. Food and Drug Administration's (FDA) Science Board will hold a public meeting on June 14, 2007. The board, an advisory committee to the FDA, provides the agency with expert outside advice on specific technical issues, as well as emerging issues within the scientific community, industry, and academia. Members counsel the agency on regulatory science, the formulation of an appropriate research agenda, and on upgrading FDA's scientific and research facilities.
"Science provides the foundation for FDA's regulatory decisions," said Janet Woodcock, M.D., FDA's deputy commissioner and chief medical officer. "Science and technology are creating products with enormous promise and, frequently, considerable challenges. This in-depth review of our scientific capacity is critical to assuring that FDA will continue to meet the regulatory challenges of the future."
Members of the board will address food protection, the agency's interim safety/risk assessment of melamine, a report on the Antimicrobial Resistance Monitoring System (NARMS), and an agency-wide review of FDA science. For a complete agenda, briefing documents, and a list of subject matters experts that serve as advisors to the subcommittee and their affiliations, please see: www.fda.gov/ohrms/dockets/ac/oc07.htm#ScienceBoard.
The board, chaired by Kenneth Shine, M.D., University of Texas System, Austin, is composed of nine members. Other members include: Gail H. Cassell, Ph.D., Eli Lilly and Company, Indianapolis; Susan Kay Harlander, Ph.D., BT Safety, LLC, Eden Prairie; Lonnie King, D.V.M., Centers for Disease Control and Prevention, Atlanta; Barbara J. McNeil, M.D., Ph.D., Harvard Medical School, Boston; David R. Parkinson, M.D., Biogen Idec, San Diego, Calif.; F. Xavier Pi-Sunyer, M.D., St. Luke's-Roosevelt Hospital Center, New York; Allen D. Roses, M.D., GlaxoSmithKline, Research Triangle Park, N.C.; and Larry D. Sasich, Pharm.D., consumer representative, Erie, Pa.
Last year, the board established the Subcommittee for the Review of FDA Science to determine whether the FDA's current science portfolio is properly positioned to deal new regulatory challenges stemming from developments in science and technology.
During the daylong meeting, the Subcommittee will provide an update on the progress of their review. The subcommittee, chaired by Gail H. Cassell, Ph.D., of Eli Lilly and Company, will submit a draft written report of its preliminary findings to the board this summer. The subcommittee has asked 28 scientific subject-matter experts, drawn from government, industry and academia, to contribute to the report.
The Science Board meeting is scheduled for June 14 from 8 a.m. to 4:30 p.m. at the Holiday Inn, 2 Montgomery Village Ave., Gaithersburg, Md.
Public comments can be submitted; please see the Federal Register notice for this meeting for more information: www.fda.gov/OHRMS/DOCKETS/98fr/E7-9737.htm.
####
Friday, June 8, 2007
Battle-Hardened Bacteria
When Andrew Speaker boarded an Air France flight for Paris last month carrying a form of extensively drug-resistant tuberculosis, he became a global pariah--both for the lethal bug in his system and for the folly of exposing other people to it. But while Speaker may have been reckless, the blame for the emergence of drug-resistant bugs like the one he is incubating falls partly on the rest of us. For years public-health officials have been raising the alarm about how our overreliance on antibiotics is breeding a generation of superbugs, increasingly resistant to the medicines designed to kill them. The problem has only gotten worse as antibiotic use has expanded to agriculture, where cattle, chicken and fish are routinely treated with the drugs to keep infectious diseases in check.
According to the Centers for Disease Control and Prevention, more than 70% of the bacteria that cause infections in hospitals are resistant to at least one antibiotic. Methicillin-resistant Staphylococcus aureus (MRSA), which causes boils or pimples on the skin, is only the latest superbug to make the rounds and has appeared in dozens of high school and college athletic locker rooms, as well as in three NFL locker rooms. Drug-resistant tuberculosis cases, including those of the variety affecting Speaker, have risen along with peaks in AIDS cases, as people with weakened immune systems are especially vulnerable to infection with multiple bugs.
The only way to thwart the bacteria, say public-health officials, is to curb the use of antibiotics. That's not likely to happen, with antibacterial hand sanitizers now in handy pocket packs and few folks willing to tough out a throat or ear infection without pharmaceutical help. The more the bugs come into contact with such agents, the faster bacteria find ways to mutate around them.
And that points to a fundamental weakness of current antibiotics. All exploit the fact that the best agents to kill bacteria come from other bacteria. Each species makes toxins that can either kill other species or arrest their growth, and existing antibiotics are modified versions of these natural defenses. But that is just the kind of biological arms race that microbes and other living things excel at adapting to. So researchers working on the next generation of antibiotics are taking advantage of new knowledge about bacterial genetics and a better understanding of the resistance process to stay one step ahead of the ever changing bugs.
One way to do this is to confuse the bacteria, hitting them with not just one natural toxin but two. At Vertex Pharmaceuticals in Cambridge, Mass., scientists are developing a new class of antibiotics that targets a pair of enzymes the microbes depend on to copy their genes and reproduce. Adapting in two directions at once slows down the bacteria enough to give the drug time to work. "Mathematically, it becomes much harder for the bacteria to develop resistance to different targets at the same time," says Dr. John Alam, the company's chief medical officer.
Another strategy is to ambush the bacteria with an unlikely ally: viruses. Vincent Fischetti at Rockefeller University is enlisting the help of bacteriophages, viruses that infect only bacterial cells, leaving human ones alone. They hijack the bacterium's genetic machinery and within minutes start to pump out hundreds of copies of themselves. When enough progeny build up inside the cell, the phages produce an enzyme that chews through the cell wall, causing it to explode with the force of a popping champagne cork and spew out the viral intruders.
Treating humans with live viruses--even ones that shouldn't harm us--is always risky, so Fischetti decided to isolate just the bacteria-puncturing enzyme and use it to kill bacteria from the outside. So far, he has developed compounds against pneumococcus, streptococcus and anthrax and hopes to eventually treat infected patients by squirting the enzymes in nasal-spray form weekly.
None of these agents are quite ready for the pharmacy yet, and until they are, researchers are focusing on new ways to maximize the power of drugs we do have. By studying bacterial DNA, scientists at the Naval Research Laboratory are decoding the genetic battle plans that the bugs use to develop resistance. These secrets can help doctors prescribe antibiotics more effectively by knowing which strains are most susceptible to which drugs.
As the TB scare reminded us, that's important in a world in which superbugs can quickly go global. Bacteria may be resourceful things, but science, while slower, can be smarter. It's just a matter of knowing your enemy--and packing the right weapons. [This article contains a complex diagram. Please see hardcopy or pdf.] USING A VIRUS TO ATTACK BACTERIA 1 A bacteriophage is a virus that infects bacteria but not human cells
Bacteriophage
Genes
2 It inserts its genetic material into a bacterial cell
Bacterium
Viral genes
3 The bacterium is hijacked into producing new viruses
4 After about 45 minutes, the viruses produce a lytic enzyme, which causes the bacterial cell wall to burst
5 The enzyme can be purified from these viruses or manufactured to be used as an antibiotic-like agent to kill bacteria
Lytic enzyme
Ruptured bacterial cell wall
Source: Vincent Fischetti, Ph.D., Rockefeller University
TIME Diagram by Joe Lertola
According to the Centers for Disease Control and Prevention, more than 70% of the bacteria that cause infections in hospitals are resistant to at least one antibiotic. Methicillin-resistant Staphylococcus aureus (MRSA), which causes boils or pimples on the skin, is only the latest superbug to make the rounds and has appeared in dozens of high school and college athletic locker rooms, as well as in three NFL locker rooms. Drug-resistant tuberculosis cases, including those of the variety affecting Speaker, have risen along with peaks in AIDS cases, as people with weakened immune systems are especially vulnerable to infection with multiple bugs.
The only way to thwart the bacteria, say public-health officials, is to curb the use of antibiotics. That's not likely to happen, with antibacterial hand sanitizers now in handy pocket packs and few folks willing to tough out a throat or ear infection without pharmaceutical help. The more the bugs come into contact with such agents, the faster bacteria find ways to mutate around them.
And that points to a fundamental weakness of current antibiotics. All exploit the fact that the best agents to kill bacteria come from other bacteria. Each species makes toxins that can either kill other species or arrest their growth, and existing antibiotics are modified versions of these natural defenses. But that is just the kind of biological arms race that microbes and other living things excel at adapting to. So researchers working on the next generation of antibiotics are taking advantage of new knowledge about bacterial genetics and a better understanding of the resistance process to stay one step ahead of the ever changing bugs.
One way to do this is to confuse the bacteria, hitting them with not just one natural toxin but two. At Vertex Pharmaceuticals in Cambridge, Mass., scientists are developing a new class of antibiotics that targets a pair of enzymes the microbes depend on to copy their genes and reproduce. Adapting in two directions at once slows down the bacteria enough to give the drug time to work. "Mathematically, it becomes much harder for the bacteria to develop resistance to different targets at the same time," says Dr. John Alam, the company's chief medical officer.
Another strategy is to ambush the bacteria with an unlikely ally: viruses. Vincent Fischetti at Rockefeller University is enlisting the help of bacteriophages, viruses that infect only bacterial cells, leaving human ones alone. They hijack the bacterium's genetic machinery and within minutes start to pump out hundreds of copies of themselves. When enough progeny build up inside the cell, the phages produce an enzyme that chews through the cell wall, causing it to explode with the force of a popping champagne cork and spew out the viral intruders.
Treating humans with live viruses--even ones that shouldn't harm us--is always risky, so Fischetti decided to isolate just the bacteria-puncturing enzyme and use it to kill bacteria from the outside. So far, he has developed compounds against pneumococcus, streptococcus and anthrax and hopes to eventually treat infected patients by squirting the enzymes in nasal-spray form weekly.
None of these agents are quite ready for the pharmacy yet, and until they are, researchers are focusing on new ways to maximize the power of drugs we do have. By studying bacterial DNA, scientists at the Naval Research Laboratory are decoding the genetic battle plans that the bugs use to develop resistance. These secrets can help doctors prescribe antibiotics more effectively by knowing which strains are most susceptible to which drugs.
As the TB scare reminded us, that's important in a world in which superbugs can quickly go global. Bacteria may be resourceful things, but science, while slower, can be smarter. It's just a matter of knowing your enemy--and packing the right weapons. [This article contains a complex diagram. Please see hardcopy or pdf.] USING A VIRUS TO ATTACK BACTERIA 1 A bacteriophage is a virus that infects bacteria but not human cells
Bacteriophage
Genes
2 It inserts its genetic material into a bacterial cell
Bacterium
Viral genes
3 The bacterium is hijacked into producing new viruses
4 After about 45 minutes, the viruses produce a lytic enzyme, which causes the bacterial cell wall to burst
5 The enzyme can be purified from these viruses or manufactured to be used as an antibiotic-like agent to kill bacteria
Lytic enzyme
Ruptured bacterial cell wall
Source: Vincent Fischetti, Ph.D., Rockefeller University
TIME Diagram by Joe Lertola
Subscribe to:
Posts (Atom)
