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| New superbugs spreading from South Asia: study |
| 2010-08-12 |
| PARIS (AFP) – Plastic surgery patients have carried a new class of superbugs resistant to almost all antibiotics from South Asia to Britain and they could spread worldwide, researchers reported Wednesday. This is why you should take your antibiotics until the end of the prescription, not just until you feel better. This is why you don't just pump livestock full of them at the drop of a hat. This is why you take them only when you need them. One of these bugs stand a chance of bringing back biblical-style plagues. Or dying from a hangnail. Well, it was nice while it lasted. Many hospital infections that were already difficult to treat have become even more impervious to drugs thanks to a recently discovered gene that can jump across different species of bacteria. This so-called NDM-1 gene was first identified last year by Cardiff University's Timothy Walsh in two types of bacteria -- Klebsiella pneumoniae and Escherichia coli -- in a Swedish patient admitted to hospital in India. Worryingly, the new NDM-1 bacteria are resistant even to carbapenems, a group of antibiotics often reserved as a last resort for emergency treatment for multi-drug resistant bugs. In the new study, led by Walsh and Madras University's Karthikeyan Kumarasamy, researchers set out to determine how common the NDM-1 producing bacteria were in South Asia and Britain, where several cases had turned up. Checking hospital patients with suspect symptoms, they found 44 cases -- 1.5 percent of those screened -- in Chennai, and 26 (eight percent) in Haryana, both in India. They likewise found the superbug in Bangladesh and Pakistan, as well 37 cases in Britain, where several patients had recently travelled to India or Pakistan for cosmetic surgery. "India also provides cosmetic surgery for other Europeans and Americans, and it is likely that NDM-1 will spread worldwide," said the study, published in the British medical journal The Lancet. NDM-1 was mostly found in E. coli, a common source of community-acquired urinary tract infections, and K. pneumoniae, and was impervious to all antibiotics except two, tigecycline and colistin. In some cases, even these drugs did not beat back the infection. Crucially, the NDM-1 gene was found on DNA structures, called plasmids, that can be easily copied and transferred between bacteria, giving the bug "an alarming potential to spread and diversify," the authors said. "Unprecedented air travel and migration allow bacterial plasmids and clones to be transported rapidly between countries and continents," mostly undetected, they said. The emergence of these new drug-resistant strains could become a serious global public health problem as the major threat shifts toward a broad class of bacteria -- including those armed with the NDM-1 gene -- known as "Gram-negative", the researchers warn. "There are few new anti-Gram-negative antibiotics in development, and none that are effective against NDM-1," the study said. NDM-1 stands for New Delhi metallo-beta-lactamase-1. Johann Pitout from the University of Calgary in Canada said patients who have medical procedures in India should be screened for multi-resistant bacteria before they receive care in their home country. |
| Posted by:gorb |
| #11 People in hospital are much more likely to have multiple concurrent infections, and people with weakened immune systems are much more likely to pass on an infection to others. Basically hospitals create optimum conditions for the spread of resistant bugs and transfer of resistance across different species. Hospital acquired infections is a huge problem. |
| Posted by: phil_b 2010-08-12 21:14 |
| #10 In a word, Iblis, yes. This happens in all animals, all the time. A little unsettling but true. Mutant strains coming exclusively from hospitals and weak people? Not "always" Iblis. But your point is well taken. If a resistant strain takes off in a weak person it can increase its numbers and the possibility of contagion exponentially in a few days. Plus, there are lots of other weak people around (it's a hospital, after all) whose immunity is less than optimal. Plus those people are being visited by relatives and friends and treated by large numbers of health professionals. So naturally the opportunity for resistant strains to have a ground zero in that environment is better than society at large. Phil, I had forgotten plasmids.. Good point. |
| Posted by: no mo uro 2010-08-12 20:27 |
| #9 Does that mean I'm carrying around strains of TB and Staph just waiting to mutate into super bugs and kill...someone else? And then why do those resistant strains always seem to come from hospitals and people in a weakened state from other factors? |
| Posted by: Iblis 2010-08-12 19:41 |
| #8 On a related topic, I'd like to hear someone explain how taking antibiotics when you are not sick can produce resistant strains. Back when I took biology you actually had to have bacteria present in order to do this. Answer - Your body is full of harmless and even beneficial bacteria. Taking antibiotics will create the opportunity for resistance to develop. Although developing resistance is an extremely low probability event, but multiple billions of bugs by millions of people taking unessesary antibiotics and someone somewhere will eventually develop resistance. Once resistance occurs, the mechanism gets filed away in the genetic code available to be switched on when needed (in the harmless bacteria). At some point in the future a strain of the harmless bug with the resistance mechanism co-infects a person with some harmful infection and the resistance mechanism gets transferred to the harmful bug. From memory via plasmids. Resistance is generally through multiple (although a small number of) steps. So the more people taking antibiotics, the faster the individual resistance steps occur and the sooner they get the opportunity to combine into full resistance. |
| Posted by: phil_b 2010-08-12 19:16 |
| #7 Good question, Iblis, and one which has a fairly simple answer. Many infections are not of exotic bugs, but overgrowth of ones that are always present in the body in non-threatening numbers. Changes in the immune system or changes in the ratio of one particular bacteria to another often trigger rapid growth and infection of what would otherwise be a normal part of your usual bioload. These are sometimes called opportunistic infections. Thus, if you are taking an antibiotic at ANY time, there are lots and lots of species of bacteria in your body (skin, mouth, colon, genitals) which are there, not causing any problems at the moment, but building up resistance to whatever you are taking. If at some future time they DO grow out of control, any resistance they gained from being exposed when they were in a harmonious and non-narmful mode will be retained. |
| Posted by: no mo uro 2010-08-12 18:49 |
| #6 You don't see much ink on the topic, but HIV has played a huge role in developing resistant strains. As the disease weakened the body's defenses these guys were succumbing to all kinds of infections which they could no longer fight off. Bugs any healthy person would shrug off. Doctors pumped them full of antibiotics to keep them alive longer. Maybe extended life a few months. In the meantime, it created the perfect environment to incubate resistant strains. With new HIV treatments this is less of a problem now, but the damage is done. On a related topic, I'd like to hear someone explain how taking antibiotics when you are not sick can produce resistant strains. Back when I took biology you actually had to have bacteria present in order to do this. |
| Posted by: Iblis 2010-08-12 17:10 |
| #5 Oh, the joys of globalism. Kill the US economically and bring back biblical plagues at the same time. Joy oh joy. |
| Posted by: Black Charlie Chinemble5313 2010-08-12 11:37 |
| #4 Antibiotic resistance is widely mis-understood. Basically resistance occurs once only and then the resistance mechanism spreads through the population of that bacteria and often other bacteria (species). So while not taking the full course of antibiotics may facilitate the spread of resistant strains, it doesn't, except in very rare circumstances, cause resistance. The real problem is that there is little money in developing new antibiotics, while the costs are enormous. In part this is due to international conventions that allow developing countries to produce generics without paying royalties. |
| Posted by: phil_b 2010-08-12 08:41 |
| #3 Media alert. Panic Alert. There are issues, true. Including that the Indian surgeons and the Thai dental practitioners are operating in a free market. Can't have that. Must have control. Just keep remembering that around 100,000 people die in the US annually from mistakes in hospitals. The media breathlessly reported every death from Iraq while 20 times as many were dying in their own institutes of medical care. |
| Posted by: Procopius2k 2010-08-12 07:45 |
| #2 "This is why you take them only when you need them." One of the biggest problems in medicine today is this issue. Overuse of antibiotics in situations when they will do nothing at all has allowed many antibiotics to become obsolete decades before they would have otherwise by getting the bugs tolerant. Especially a problem with young mommies who think that antibiotics are some sort of automatic thing that you give to kids whenever they have a sniffle to get rid of/prevent colds, which are essentially all caused by various types of virus organisms that aren't affected by antibiotics in any way. I actually once overheard two young mommies talking in a grocery store, and one of them was complaining about her kid's pediatrician's reticence to prescribe an antibiotic for her kid's cold. The other mommy responded without missing a beat that she should just lie and tell the doc the kid had green mucus to get the magic potion (her words). I have my own ideas about exactly why this willful ignorance exists and persists, but that is a topic for another thread. Unfortunately, in many communities, there'll be one or two less-than-ethical pediatric docs who will figure out this ignorant demand by parents is a potential money maker, and will attract lots of patients who are kids of parents like that, so they gleefully write, write, write for these medications, creating yet another generation of abusers whose resistant bacteria are a threat to us all. Talk to docs at college clinics and they'll tell you that the minute many students get sick with anything they'll head straight for the infirmary and DEMAND that they be given an antibiotic. It might be a good idea for those state boards who monitor overprescription of pain pills to do the same with antibiotics. The lives they save may be yours or mine, ultimately. |
| Posted by: no mo uro 2010-08-12 05:57 |
| #1 Thanks again, Diversity! |
| Posted by: Solomon Snish5988 2010-08-12 05:42 |