Thursday, November 26, 2015

Gene that resists last resort antibiotics discovered

Contributed by Siddarth David & Dr. Tamhankar

Scientists in China have found increased levels of resistance to an antimicrobial drug colistin a polymyxin used when other drugs have failed, according to a report in the journal Lancet Infectious Diseases. The study analyzed various samples taken from patients who had presented infections in two hospitals.

The researchers found that colistin resistance was caused by a gene called MCR-1. This gene was found on a piece of bacterial DNA that can be transferred between bacteria. The study found the MCR-1 gene in E. coli collected from 15% of raw meat samples and 21% of animals tested from 2011-14. The gene was also found in E. coli from 1% of hospital inpatients in China.


The study recommends that the use of polymixin should be restricted in agriculture, as we could end up with a situation where doctors are forced to say, "Sorry, there is nothing I can do to cure your infection". This finding critically underscores the need for better surveillance, strategies for judicious use of antibiotic and development of national antibiotic protocols across countries. 

Wednesday, October 28, 2015

Contributed by Siddarth David & Dr. Tamhankar

A study published in the published in the Journal of the Paediatric Infectious Diseases Society has shown rising rate of infections, particularly prevalent among children between under the age of 5. After analysing a nationwide data base of reports from microbiology laboratories from 1991-2011, the study showed the increase of prevalence of "extended-spectrum beta-lactamase" (ESBL) producing bacteria and resistance to third-generation cephalosporins was highest among children under 5 years.


This means treatment with last-resort antibiotics such as carbapenems translating to longer hospital stays, higher health care costs, and increased mortality. The Centres for Disease Control (CDC) in the US, had called for stronger steps to counter ESBL-producing bacteria in 2013, given the significant threat they pose to public health in the US. The study also calls for more research into defining the risk factors for these infections in children, their prevalence in different settings, and their molecular epidemiology. 

Thursday, October 8, 2015

New Blood Test to potentially identify Antibiotic resistant infection in an Hour

Contributed by Siddarth David and Dr. Tamhankar

Given that identifying and treating blood infections that are antibiotic resistant takes up to three days, researchers Brigham Young University, Utah, USA are in the process of  developing a speedier blood test to detect such infections. 

Working on a fund from the National Institutes of Health, of the US Department of Health and Human Services, the researchers have developed an opto-fluidic microchip. The device is still in  design but will first filter out a sample's blood cells to isolate bacteria and DNA from the bacteria will be extracted, sequenced and scanned for matches with known sequences of drug-resistant strains. Potentially harmful bacteria DNA will get flagged with fluorescing molecules.

After perfecting and testing the technology it should be available in the next few years, this can significantly reduce the time for detecting antibiotic-resistant infections and mortality associated with it. 

Monday, September 21, 2015

Plain Soaps as effective as Antibacterial Soaps: Study

Contributed by Siddarth David and Dr. Tamhankar

A study conducted by researchers in the College of Life Sciences and Biotechnology, Korea University, Seoul  has shown that there was no significant difference (p > 0.05) between washing hands with plain soap and antibacterial soaps. The study published in the Journal of Antimicrobial Chemotherapy showed that when 20 strains of bacteria, including Streptococcus, Staphylococcus, Listeria and MRSA were exposed to one soap of regular formation and one containing 0.3 percent triclosan for the recommended 20 seconds of hand washing, there was no difference in the amount of bacteria killed by the two varieties.

The study reported significant difference in killing more germs in the triclosan soap only after nine hours, which was a rather long period for washing of hands said the study. The study was also was experimented with 16 participants using both the soaps and again no difference was found.

The study does raise questions on the effectiveness of the use antibacterials in soaps, and if further research validates the finding of the Korean study, shifting to the traditional and cheaper soap and water for hand washing could reduce unnecessary antibacterial use in daily life.  

Tuesday, September 15, 2015

UK drafts Guidelines for changing public behaviour to reduce antibiotic resistance

Contributed by Siddarth David and Dr. Tamhankar

The National Institute for Health and Care Excellence (NICE) in the UK last week released its draft guidelines aimed at the general population in order to address the challenge on antimicrobial resistance in the country. The statutory body has drafted these guidelines complimenting the guidelines on antibiotic stewardship which were published last month to be implemented in the UK.


The draft guidelines which are open for public consultation, emphasize the need for public awareness to reduce risk-related behaviours among the general public. It reports that basic hygiene guidance such as hand-washing can reduce majority of infectious diseases like cough and cold which account for one-fifth of the days lost at work in the UK rather than depend on antibiotics for treatment. 

The draft guidelines also state that when people seek medical advice for self-limiting conditions, they should be told how they could treat their symptoms themselves and explained why they are not being prescribed antibiotics. The draft guidelines are commendable in having recognized that the patient and the public at large also have an important role to play in tackling antibiotic resistance. Once finalized it could be used as advocacy tool for other countries across the world to push for robust policies on the issue. 

Sunday, September 6, 2015

South-Asian countries assess progress of Antimicrobial strategies in the region

Contributed by Dr. Tamhankar and Siddarth David

Health ministers of 11 countries in South Asia are meeting from today in Dili, Timor-Leste for the 68th WHO Regional Committee for South East Asia. An important agenda is the implementation of action plan for antimicrobial resistance by the 11 countries in the region.

The meeting conducted by the highest policy making body of the WHO in the region meets once a year to discuss, deliberate and plan health priorities and action policies for the entire region. Given the critical global challenge posed by antibiotic resistance, it features high in the agenda of this year's Regional Committee Meeting. 

It will be especially significant as it would be an opportunity to review the commitments and progress made by the 11 countries on the resolution passed in the May 2015 World Health Assembly in Geneva that every member country would have to develop and implement national action plans for  controlling antibiotic resistance in their respective countries by May 2017. 

Wednesday, September 2, 2015

US creates new database to track antibiotic resistance

Contributed by Dr. Tamhankar and Siddarth David

The U.S. Centers for Disease Control and Prevention (CDC) have released a new tool that tracks the spread of antibiotic resistance in the country. The" National Antimicrobial Resistance Monitoring System (NARMS): Human Data" (http://wwwn.cdc.gov/narmsnow/) covers data for the last 20 years with interactive maps both bacteria-wise and antibiotic-wise helping for comparisons between states and overall national resistance rates.


This is in response to growing  demand in the US by various academicians , government officials and civil society groups for more data on antibiotic resistance in the US. This is a welcome step ahead, as data to determine the extent and nature of the problem is essential in the process of addressing antibiotic resistance.

Monday, August 24, 2015

" 9 out of 10 GPs say they feel pressured to prescribe antibiotics": NICE, UK

Contributed by" Dr. Tamhankar and Siddarth David

On August 18, 2015, the National Institute for Health and Care Excellence (NICE) in the UK released its first guidelines on antimicrobial stewardship "Antimicrobial stewardship: systems and processes for effective antimicrobial medicine use". https://www.nice.org.uk/guidance/ng15 The NICE is the statutory body in the UK that provides national guidance and advice to improve health and social care.

The Guidelines are designed to promote judicious antibiotic use by reviewing prescribing and resistance data and providing feedback, education and training to prescribers. The NICE reports that " 9 out of 10 GPs say they feel pressured to prescribe antibiotics, and 97% of patients who ask for antibiotics are prescribed antibiotics”. The Guidelines have been aimed at health practitioners, pharmacists, nurses and provider organisations.


The current edition of the Lancet has an editorial on the strengths and weaknesses of the Guidelines. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)61522-7/fulltext The NICE guidelines are pioneering antibiotic stewardship in the UK, which is particularly significant given that the UK lags way behind countries like Sweden and Norway in implementing policies to address antibiotic resistance. The NICE Guidelines are a welcome step to global measures on antibiotic stewardship and hopefully would push other countries to take notice and follow with their own guidelines.

Friday, April 10, 2015

MRSA from smokers' lung may be more dangerous and resistant says research from University of California

Article contributed by Dr. Akilesh Ramasamy & Dr. A. J. Tamhankar

MRSA (Methicillin Resistant Staphylococcus Aureus), a deadly resistant pathogen, can become deadlier when exposed to cigarette smoke, says Laura Alexander and her team, from University of California, San Diego School of Medicine based to their experimental study.

They exposed the bacteria to cigarette smoke extracts and found that MRSA, though engulfed by macrophages, was not effectively killed by the macrophages.

The first requirement of a pathogen to be able to cause a disease is the ability to adhere to tissues, because when they adhere to the tissues, they are able to then invade inside. The MRSA exposed to cigarette smoke extracts revealed better adherence capabilities which means they can stick to tissues more tenaciously and able to cause deadly infection. They were able to duplicate these findings on a mouse model as well. The MRSA exposed to cigarette smoke were also resistant to killing by antibiotic peptides.

Even though definitive study from humans is not available, it may be possible that MRSA infections / pathogens present in lungs of a smoker can be more deadlier and tenacious. This can have devastating effects as smoking is widely prevalent and even non smokers are often exposed to large quantities of second hand smoke.

Source: The New Indian Express

Read The ``TRUE LIFE STORY``of a family infected with MRSA