A Way Our of Our Antibiotic Crisis

August 28, 2015 by

July 24, 2015

By Medical Discovery News

A petri dish

Antibiotic resistance occurs when strains of bacteria that infect people – such as staph, tuberculosis, and gonorrhea – do not respond to antibiotic treatments. In America, 2 million people become infected with resistant bacteria every year and at least 23,000 die each year because of those infections. If nothing is done to stop or slow the resistance of bacteria to antibiotics, the World Health Organization (WHO) warns that we will find ourselves in a post-antibiotic world, in which minor injuries and common infections will be life-threatening once again.

The crisis arose primarily from three conditions. First, when people are given a weeks’ worth of antibiotics and stop taking them as soon as symptoms improve, they often expose the bacteria causing their infection to the medicine without killing it. This allows the bacteria to quickly mutate to further avoid the effects of the antibiotic. Second, antibiotics are over-prescribed. Most common illnesses like the cold, flu, sore throat, bronchitis, and ear infection are caused by viruses, not bacteria, so antibiotics are essentially useless against them. Yet they are prescribed 60-70 percent of the time for these infections. This once again provides bacteria in the body unnecessary contact with antibiotics. Third, tons of antibiotics are used every year in the agriculture industry. They are fed to livestock on a regular basis with feed to promote growth and theoretically for good health. But animals are also prone to bacterial infections, and now, to antibiotic-resistant bacteria, which spreads to humans who eat their meat or who eat crops that have been fertilized by the livestock. The good news is that the Food and Drug Administration (FDA) is working to focus antibiotic use on bacterial infections and regulate its use in livestock.

An easy solution to this problem might be to create new antibiotics, but it’s not that simple. It takes an average of 12 years and millions of dollars to research new antibiotics and make them available on the market, which is a huge investment considering they are normally only taken for up to 10 days. But there’s an even bigger challenge: microbiologists can only cultivate about 1 percent of all bacteria in the lab, including specimens that live in and on the human body. The ability to grow diverse bacteria is important because most antibiotics actually come from bacteria, produced as a defense against other microbes.

Slava Epstein, a professor of microbial ecology at Northeastern University, came up with an ingenious approach to solving this problem. He speculated that we are unable to grow these bacteria in the lab because we were not providing the essential nutrients they needed to grow. Working with soil bacteria, which are a huge source for developing antibiotics, he created the iChip. The iChip allows bacteria to grow directly in soil, which is their natural environment, while being monitored.

To date, about 24 potential antimicrobials have been identified from 50,000 bacteria that remain unable to grow in the lab. With possibly billions of bacteria left to grow and examine, the number of new drugs awaiting discovery is seemingly endless.

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The Catastrophe of Antibiotic Resistance

March 17, 2015 by

March 6, 2015

By Medical Discovery News

The Catastrophe of Antibiotic Resistance

The World Health Organization has categorized antibiotic resistance as “a major global threat” and multidisciplinary research teams estimate it could lead to 10 million deaths each year by 2050. Bacteria that cause disease in humans can become resistant to the drugs used to treat them, and this poses a growing problem to public health.

Antibiotics were first introduced in the 1940s with the discovery and development of penicillin and saved many people from otherwise life-threatening infections. This one class of drugs has had an incredible impact on decreasing the severity of infections and saving lives.

Lately antibiotics have become overused and misused, which has allowed bacteria to mutate in ways that render antibiotics relatively powerless. Bacteria were one of the earliest life forms on Earth and remain one of the most successful, present everywhere from Arctic glaciers to geothermal springs. Because they are masters of adaptation, exposure to antibiotics causes the bacteria to accumulate mutations that will allow them to ignore the action of the antibiotics. That’s why doctors should only prescribe an antibiotic in the likelihood of a bacterial infection, and why it’s important to take all of the prescribed doses of an antibiotic. Otherwise, you can give the bacteria enough contact with the antibiotic to mutate but not enough to kill them, and they can come back stronger.

Half the use of antibiotics does not come from a doctor’s office or hospital, but a farm. Chickens, pigs, cows, and other livestock raised for food production are fed antibiotics to prevent infections and for faster weight gain. Many countries now ban this practice, and in 2013 the U.S. Food and Drug Administration (FDA) asked pharmaceutical companies to voluntarily curtail the sale of antibiotics directly to famers. Today, 26 pharmaceutical companies will only issue antibiotics for animals with a veterinarian’s prescription.

Infections by drug-resistant bacteria can be twice as likely to result in hospitalization and death. And while some bacteria are resistant to a single antibiotic, others are resistant to many. Methicillin-resistant Staphylococcus aureus (MRSA), multi-drug-resistant Neisseria gonorrhea, and multi-drug-resistant Clostridium difficile are superbugs taking a devastating toll worldwide. Some bacteria have mutated against all forms of antibiotics normally used to treat them, leaving no effective treatment options. Such infections are occurring around the globe in both rich and developing countries.

Legislation in the U.S. Congress proposes to permanently ban antibiotics that are used in humans from being used in livestock as well.  However, some argue that there is not a clear link between the antibiotic-resistant bacterial strains generated in livestock practices and those seen in human disease, which requires more intense research to answer. Whatever the outcome, the emergence and spread of antibiotic-resistant bacteria must be stopped. We also desperately need to develop new antimicrobials human use.

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First in the No. 2 Business

June 13, 2014 by

June 13, 2014

By Medical Discovery News

Antibiotic resistance among disease-causing bacteria is a growing and dangerous problem. Bacteria resistant to one or antibiotics, like Staph and Strep, are approaching catastrophic levels. Bacteria so resistant to common antibiotics that few if any drugs are available to treat them have been dubbed superbugs. One widely feared bacterium, called Clostridium difficle or C. diff for short, causes intestinal disease so severe that it can become life-threatening. It kills almost 15,000 Americans every year, mostly the elderly. Super-resistant forms of this microbe are almost impossible to treat with antibiotics. 

This bacterium produces a powerful toxin that destroys intestinal cells and can rupture small blood vessels. It also causes abnormal intestinal behavior, mainly excess water that produces diarrhea. It’s an unpleasant and painful prospect for those infected with C. diff. 

Roughly 5-15 percent of the population carries this bacterium in their digestive system naturally, but it is kept in check by the rest of the bacterial population. But an underlying disease, antibiotics, another infection, or chemotherapy can weaken bacterial systems, allowing C. diff to expand into an infection. And a super-resistant version of C. diff can be a real problem.

As gross as it may sound, fecal transplants are getting lots of attention as an option for C. diff infections. First tried in the late 1950s, the rationale for this approach is that the disease occurs because the bacterial populations are disrupted, so providing a source of normal bacteria restores the ecology of the intestine and prevents C. diff from growing. 

Where exactly does one find fecal matter for such a transplant? It’s not as if anyone wants to ask family or friends to share their poop. Actually, there are major regulatory obstacles for fecal transplants. For instance, the fecal source must test negative for disease-causing bacteria, viruses, and parasites. Basically, it’s not something anyone can find at Whole Foods or on Amazon.

So a group of enterprising graduate students at the Massachusetts Institute of Technology (MIT) who observed a friend’s struggle with C. diff formed a company to distribute safe, certified fecal matter for transplant. OpenBiome collects, tests, and distributes fecal matter like a blood bank distributes blood. Samples are certified by Food and Drug Administration (FDA) procedures, which cost about $3,000. Then they are frozen at super-cold temperatures (-112 degrees) and shipped to hospitals and physicians. Currently, the company operates as a nonprofit and only collects a shipping and processing fee for transplant material.

We already know that our normal bacterial systems, which together make up our microbiome, help protect us from skin, urogenital, and oral diseases. Changes in our microbiome may also contribute to an underlying disease like diabetes. There is still much to be discovered about these organisms that call our bodies home, especially since we house 10 times more microbes than our own cells!

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Overuse of Antibiotics on Farms

August 2, 2012 by

By Medical Discovery News

July 21, 2012

 

 

 

Resistance to antibiotics has become a crisis that is overall alarmingly ignored. Some scientists believe without new antibiotics, medicine as practiced now will have to fundamentally change. Doctors struggle to control bacterial infections that continually evolve into lethal killers because current antibiotics are useless against them.

Bacteria have grown resistant because antibiotics have been overprescribed for the past 50 years and patients often quit taking antibiotics as soon as symptoms go away, giving bacteria an introduction to the antibiotic without killing them. Several bacteria are now considered super bugs, meaning they’re resistant to multiple antibiotics. Recent numbers show these super bacteria killed nearly 100,000 Americans in one year alone.

While doctors in the U.S. are becoming more aware and restrained in prescribing antibiotics, they account for less than 20 percent of the antibiotics used. The rest, more than 80 percent (28 million pounds), go to agriculture. But this massive amount of antibiotics is not being used to treat sick animals. Instead, subtherapeutic levels are routinely injected or added to animal water and feed to boost livestock weight and compensate for the unsanitary, packed conditions of commercial American farms.

These conditions create the perfect petri dish to produce resistant bacteria. As bacteria multiply in these tight, unsanitary conditions, the animals such as chickens, turkeys, pigs and cattle are treated with common human antibiotics that include streptomycin, kanamycin, and millions of pounds of penicillin. Studies show long-term subtherapeutic levels of antibiotics may be more conducive to producing resistant bacterial strains than the short-term, high-level antibiotic treatments of humans.

These bacteria, which thrive in the intestinal tract of animal, can contaminate human food  during slaughter, processing, and food preparation. The result is that more people die from foodborne illnesses. Looking at outbreaks caused by antibiotic-resistant bacteria over the past several decades, the Center for Science in the Public Interest concluded the responsible bacteria were resistant to 14 different antibiotics. Of those, seven are classified by the World Health Organization as critically important to human medicine and eight as highly important.

The issue has become critical enough that the EU banned the use of penicillin for animal growth, then in 2006 banned the use of all antibiotics for animal growth on farms. Though the Food and Drug Administration tried at one time to follow the EU’s move by banning penicillin use, farm lobbyists prevailed. Now the FDA is asking pharmaceutical companies to voluntarily limit the sale of antibiotics to farms to just medical treatments and only through a veterinarian (they are now available through retail stores open to the public).

This pits the FDA against the powerful agriculture industry, which defends the practice as a proven way to produce economical animal-based food products. They argue that banning antibiotics will raise food costs astronomically.

But follow-up studies in countries such as Sweden and Denmark show better handling of farm animals led to a decrease in the need for antibiotics, and retail prices on meat did not rise dramatically. Denmark cited just a one percent rise in pork prices.

Ignoring the problem is not an option as people continue to die from bacterial infections that can’t be treated by existing antibiotics, especially since many drug companies have stopped developing new, more powerful antibiotics.

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