April 23, 2018
Antibiotic resistance explained. CDDEP Director Ramanan Laxminarayan was featured in a video on Fit, a popular Indian health and lifestyle website. The video explains how antibiotic resistance develops and its implications for the future of human health and healthcare. [Fit]
A robust South Asia strategy to eliminate tuberculosis. Addressing numerous complex factors simultaneously will be necessary for the elimination of TB globally. In a review article, researchers associated with the Global Antibiotic Resistance Partnership outlined priorities for research in diagnostics, treatment, and prevention. The researchers argue that South Asia, with 40 percent of the world’s TB cases, has both the patient numbers and the robust scientific resources needed to tackle research in treatment, diagnostic technology, legal and regulatory strategies, infrastructure improvements, treatment adherence, and financing. [Multidisciplinary Respiratory Medicine]
Worrisome XDR typhoid epidemic in Pakistan. The first documented outbreak of extensively drug-resistant (XDR) typhoid will likely spread beyond Pakistan, according to scientists who have genetically analyzed the pathogen. Of the 850 cases reported so far, four have resulted in deaths. In the UK, an ill traveler was diagnosed with the illness but fortunately the infection was contained. A newly approved typhoid vaccine is being used on an emergency basis to prevent infection in 250,000 Pakistani children, and plans are underway to provide the vaccine in other developing countries. Before this outbreak, only a handful of sporadic cases of XDR typhoid had been reported globally. [Mbio, New York Times, EurekAlert]
War and resistance in Yemen: disrupted medical care and hard-to-treat infections. Conditions of war in Yemen–damaged medical facilities, reduced access to antibiotics, disrupted supply lines, hunger, poor hygiene, and broken infrastructure–have given rise to widespread antibiotic resistance. In a hospital operated by Doctors Without Borders in Aden, Yemen, over sixty percent of inpatients are colonized or infected with drug-resistant organisms. Drug-resistant infections take nearly four times as long and are more costly to treat and are a major cause of death in Middle Eastern countries impacted by war. Refugees, military personnel, and civilians alike are affected. [New York Times]
Super superbugs in Middle East Gulf Nations. High-risk clones ofCarbapenem-resistant Pseudomonas aeruginosa (CRPA)have been found spreading rapidly in Saudi Arabia, the United Arab Emirates, Oman, Qatar, and Bahrain. Of ninety-five isolates, ninety showed resistance to both imipenem and meropenem, while five isolates were resistant to only one of the two agents. The same 95 CRPA isolates were also found to be resistant to other antibiotics as follows: ceftazidime (60%), aztreonam (39%), gentamicin (62%), amikacin (50%), ciprofloxacin (80%) and piperacillin/tazobactam (43%). Identical clones have been found in several cities according to the study. [Journal of Medical Microbiology, University of Queensland Press Release, UQ Faculty of Medicine Video]
Mycobacterium ulcerans cases increasing in Australia. The sharp increase in M. ulcerans infections in the Australian state of Victoria has led scientists to call for an “exhaustive examination” of human cases and their etiology. The Mycobacterium, which causes painful skin ulcers in humans, has been found in stagnant water, possum feces, mosquitoes, and aquatic insects in affected areas, and has also infected koalas, dogs, and cats. Reported human infections have increased sharply in recent years. 156 cases were reported in the first ten months of 2016, and 236 cases were reported during the same period in 2017, an increase of 51 percent. [The Guardian, Medical Journal of Environment]
Pediatric tuberculosis detection: trained rats reduce false-negative TB sputum tests. Pediatric tuberculosis detection is notoriously difficult as children are less able to produce enough sputum for testing and their specimens are often paucibacillary. In a study in Tanzania, trained African giant pouched rats were found to increase detection of Mycobacterium tuberculinum by 67.6% in children aged 1 to 5 and 62.8% in children aged 1 to 14. [Pediatric Research, Healio]
Reducing the reservoir of transmissible malaria parasites using mass drug administration. Researchers conducted a cluster-randomized controlled trial in Uganda to study the effects of intermittent preventive treatment of schoolchildren with the drug dihydroartemisinin-piperaquine (DP) on malaria transmission. Comparing cross-sectional community surveys before and after treatment with DP, researchers found a statistically significant difference of 4 percentage points of parasite prevalence. [Lancet Global Health, Lancet Global Health]
Tuberculosis progression can be predicted with gene test. A genetic test was able to predict progression of tuberculosis in household contacts of active cases in a trial conducted in South Africa, Ethiopia, and Gambia. Investigators used RNA sequencing and PCR tests to identify a four-marker gene (GAS6, SEPT4, BLK and CD1C) signature that was correlated to progression to disease within 24 months of post-exposure follow-up. The results could help target prophylactic treatment to individuals whose TB infection is deemed likely to progress to active disease. [Healio, American Journal of Respiratory and Critical Care Medicine]
Mice potential reservoirs for antibiotic resistant bacteria. A study of mice living in residential buildings in New York City identified several gastrointestinal disease-causing agents, including Shigella, Salmonella, Leptospira, Clostridium difficile, and Escherichia coli. Genes coding for resistance to fluoroquinolones and β-lactam drugs were also found to be widely distributed in the mice. [Scientific American, mBio]
EU surveys veterinarians, farmers, and other animal health professionals on antimicrobial resistance. The European Joint Action on Antimicrobial Resistance and Healthcare Associated Infections (EU-JAMRAI) has launched a survey to collect information about effective guidelines, measures, or tools to increase responsible use of antibiotics and to decrease use of antibiotics. The survey is part of Work Project 7 of the EU-JAMRAI, which focuses on “Appropriate Use of Antimicrobials in Humans and Animals.” [EU-JAMRAI]
Image Credit: Nischal Masand 270164 on Unsplash.com
