Researchers Discover Colistin-Heteroresistant Germs In the US (arstechnica.com) 75
An anonymous reader quotes a report from Ars Technica: For the first time, researchers have discovered strains of a deadly, multidrug-resistant bacterium that uses a cryptic method to also evade colistin, an antibiotic used as a last-resort treatment. That's according to a study of U.S. patients published this week by Emory University researchers in the open-access microbiology journal mBio. The wily and dangerous bacteria involved are carbapenem-resistant Klebsiella pneumoniae or CRKP, which are already known to resist almost all antibiotics available, including other last-line antibiotics called carbapenems. The germs tend to lurk in clinical settings and can invade the urinary tract, bloodstream, and soft tissues. They're members of a notorious family of multidrug-resistant pathogens, called carbapenem-resistant Enterobacteriaceae (CRE), which collectively have mortality rates as high as 50 percent and have spread rapidly around the globe in recent years. A 2013 report by the Centers for Disease Control and Prevention estimated that there were more than 9,300 CRE infections in the U.S. each year, leading to 600 deaths. Both the CDC and the World Health Organization have listed CRE as one of the critical drug-resistant threats to public health, in need of "urgent and aggressive action."
In the new study, the Emory researchers discovered two strains of CRKP -- isolated from the urine of patients in Atlanta, Georgia -- that can also resist colistin. But they do so in a poorly understood, surreptitious way. At first, they appear vulnerable to the potent antibiotic in standard clinical tests, but with more advanced testing and exposure to the drug, they reveal that they can indeed survive it. In mice, the strains caused infections that couldn't be cured by colistin and the mice died of the infections. Mice infected with typical CRKP were all saved with colistin. So far, there's no evidence of CRKP infections surprisingly turning up resistant to colistin during treatment in patients. But the authors, led by microbiologist David Weiss, say that may be because the evidence is difficult to gather, and the data so far is cause for concern. The researchers concluded that the findings "serve to sound the alarm about a worrisome and under-appreciated phenomenon in CRKP infections and highlight the need for more sensitive and accurate diagnostics."
In the new study, the Emory researchers discovered two strains of CRKP -- isolated from the urine of patients in Atlanta, Georgia -- that can also resist colistin. But they do so in a poorly understood, surreptitious way. At first, they appear vulnerable to the potent antibiotic in standard clinical tests, but with more advanced testing and exposure to the drug, they reveal that they can indeed survive it. In mice, the strains caused infections that couldn't be cured by colistin and the mice died of the infections. Mice infected with typical CRKP were all saved with colistin. So far, there's no evidence of CRKP infections surprisingly turning up resistant to colistin during treatment in patients. But the authors, led by microbiologist David Weiss, say that may be because the evidence is difficult to gather, and the data so far is cause for concern. The researchers concluded that the findings "serve to sound the alarm about a worrisome and under-appreciated phenomenon in CRKP infections and highlight the need for more sensitive and accurate diagnostics."
Great news! (Score:5, Funny)
Now we don't have to worry about artificial intelligence wiping us out.
Re: Great news! (Score:2)
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schure cautioned:
I don't think there's so much we can do to fight antibiotic resistance. Remember this video? https://youtu.be/plVk4NVIUh8 [youtu.be]
MDs who gave in to their patients' demands for antibiotic prescriptions to treat viral infection, such as colds and influenza - neither of which are in any way affected by antibiotics of any kind - bear a certain amount of responsibility for the rapidly-decreasing effectiveness of our antibiotic arsenal. Farmers are still more responsible, since they routinely use massive amounts of antibiotics in animal feed. (In cattle country, USA feed stores all display tetracycline and amphicillin powd
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Acting in the best interests of their patients is what doctors get paid to do. They have extensive training, knowledge, and first-hand experience to rely on.
Antibiotics are indicated for viral infections because they prophylactically prevent secondary infections. It's not because doctors are conspiring to eradicate mankind.
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dcollins117 blathered:
Acting in the best interests of their patients is what doctors get paid to do. They have extensive training, knowledge, and first-hand experience to rely on.
-1 Offtopic.
Antibiotics are indicated for viral infections because they prophylactically prevent secondary infections. It's not because doctors are conspiring to eradicate mankind.
Bullshit [jamanetwork.com], bullshit [nih.gov], bullshit [nih.gov].
And don't put words in my mouth. I never said or implied the widespread (mal)practice of prescribing antibiotics for viral infections was a conspiracy. It's not. It is - or was, at any rate - extremely common, especially among GPs, however.
As to why the practice is/was so prevalent, the internists with whom I've discussed the issue (all of whom are bitterly critical of their fellow MDs for engaging in it) have fairly unanimously agreed that the
Re: Great news! (Score:1)
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Serious question: how is this allowed? These are prescription-only pharmaceuticals right? I can't just walk into a drugstore and pick up a bottle of either of these antibiotics without a prescription.
Is there some part of the law that controls access to these that explicitly exemp
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I stated:
Prompting Swave An deBwoner to exclaim:
Serious question: how is this allowed? These are prescription-only pharmaceuticals right? I can't just walk into a drugstore and pick up a bottle of either of these antibiotics without a prescription.
Is there some part of the law that controls access to these that explicitly exempts feed stores?
Large-animal veterinarians routinely write multiple-refill prescriptions for bulk-purchase antibiotics for livestock farmers and ranchers. Their local feed store keeps a copy of those prescriptions on file, so their customers can buy antibiotics in bulk without being inconvenienced by the need to hand over a new prescription form each time they visit. It's a "good ol' boy" thing.
Googling the question brings me to an article that states that pet stores routinely sell prescription antibiotics without prescription:
http://www.nejm.org/doi/full/10.1056/NEJM200207183470319 [nejm.org]
https://www.smithsonianmag.com/science-nature/here-are-reasons-you-shouldnt-take-fish-antibiotics-180964523/ [smithsonianmag.com]
I am amazed.
Pet antibiotics - and especially those for fish - are a different issue. As are p
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There is. Stop using antibiotics when you have a simple cold. Restrict them to serious and life-threatening situations only. Stop using antibiotics for improving meat yields in farming. And start research again in finding more, if needed entirely on public money.
All that requires a little less greed and selfishness and more understanding of what is going on. Hence I am not hopeful. As a general rule, people are stupid, greedy and arrogant. Antibiotic resistances are just one of the symptoms of that.
Re: Great news! (Score:2)
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A new supergerm gets discovered at nearby Emory at the same time a CDC researcher disappears and we see an unusual spike in flu deaths? Someone get Art Bell on the phone, pronto!
The US health care industry is TO BLAME. (Score:5, Interesting)
Why is that, you ask ?
Slack sterile procedures and a mentality that makes profit the over arching goal.
I wouldn't willingly be an in-patient in ANY hospital in the US, because of the two factors above.
And yes, there are other countries, such as Germany and Switzerland, where they are far more careful about sterile procedures. I have first-hand experience which backs up my claim, which I will cite below.
I sat for weeks waiting outside the ICU ( intensive care unit ) at a major US hospital, while a family member was stricken with a serious illness and was bedridden in that ICU. As I watched, not one single doctor stopped at the alcohol scrub station which was outside the ICU, prior to entering the ICU. Nearly all the nurses DID stop and scrub. The doctors were ( obviously ) in a hurry, and since they have more authority than most other hospital staff, it was unlikely anyone was going to take them to task for not scrubbing. Do you think those doctors carried pathogens with them into the ICU ? If you doubt that, you're either very naive or just plain stupid.
The US health care system is badly messed up. Many doctors want to make lots of money, and time IS money. Until the authorities step up and take action about the slack sterile procedures used in US hospitals, this mess is going to get worse. What's really bad about it is that the pathogens are evolving and, in essence, the US hospitals are a "training ground" which produces pathogens which are resistant to ALL available antibiotic drugs. If you don't think that is a big deal, imagine what the world was like before penicillin, when even a simple infection could and did often mean death.
I have a number of friends who ARE physicians who work in hospital environments, and every one of these people agrees with me that there is a problem with sterile procedures in the US health care system. None of them wants to stand up and raise hell about it because they could find themselves without a job at that hospital as a direct result. It's a hell of a mess. Personally I think government intervention is required, along with very substantial civil and criminal penalties, before the problem is dealt with in an effective manner.
Cue the Slashdot knowitalls, who will try to tell me I am wrong about the above. The thing is, I am not wrong and all of us are in jeopardy because of the current state of affairs. One in-patient hospital visit could be all it takes to underscore that reality. DO you feel lucky ?
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I expect its the farming industry, actually. (Score:5, Interesting)
For many, many years the farming industry has subjected livestock to continual doses of antibiotics. This makes animals the perfect breeding ground for antibiotic-resistant bacteria.
Our medical industry foresaw this long ago and put a ban on the routine use of antibiotics on human patients as a preventative measure; using them only after diagnosis of something that specifically needs them for treatment. The farming industry did not follow suit, because it is much cheaper for them to keep animals in unsanitary conditions and just continually pump them full of antibiotics so they don't get diseased.
I didn't see anything in the summary specifically saying whether or not this is a likely origin of the resistant bacteria, so I don't know for sure. But I do know that we as a culture continue to abide a medically disastrous approach to keeping our meat prices low, and we are going to really suffer as a result of it.
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"so I don't know for sure."
Well that certainly didn't stop you from blaming the farming industry now did it?
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The poster presented a hypothesis along with a rationale for it, and admitted that he didn't have compelling evidence of a connection in this specific case.
And the best you can do is pass moral judgment on the post for this very admission?
Amazing.
Re: I expect its the farming industry, actually. (Score:2)
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If they are the "perfect breeding ground", why is it that my plans for word domination are constantly thwarted by antibiotic resistant cows who are also bacteria resistant?
Seriously, if penguins are a better culture medium, is there any other megalomaniacal evil genius who can confirm it?
Currently, we are using ferrets, and the results are less than spectacular.
Re:The US health care industry is TO BLAME. (Score:4, Insightful)
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What's wrong with Slovenia?
Nothing, but it lacks the budget to set up the kind of health care that Americans would expect. Yet that doesn't stop it from, apparently, offering better healthcare anyway.
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Seems to be referring to this.
https://m.youtube.com/watch?v=... [youtube.com]
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https://goo.gl/images/JtmScY [goo.gl]
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I'd eat a Jain if I were starving.
Thought & Prayers (Score:2)
Not to worry, thoughts and prayers will save the worthy amongst us.
This resistance is hardly unexpected. Organisms evolve to resist threats and antibiotics are a threat.
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Well, if you put cooks into positions of power in your country that not only question the validity of evolution and development in organisms but also that bacteria can make you sick, you get what you deserve.
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Well, if you put cooks into positions of power in your country
Putting cooks in power is a half-baked idea. Perhaps you should have attended the primary debates so you could give them a grilling, but you probably had too much on your plate. I think we're all toast now as a result.
Anyway, food for thought.
Reasons for this are multifold... (Score:1)
First of all, there are way too many products out there that contain anti-bacterial compounds, starting with hand soaps all the way up. it is OUR fault that we came to this point of having incurable infections. Just like we built immunity to things, so do bacteria and we keep exposing them to all these compounds that are added to everything. The industry is to blame for that.
Next, the "pharmas" probably have better and stronger, more effective cures but they are all shelved. To them it's all about profit an
The real reason for this (Score:5, Insightful)
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Different set of problems from meat.
The guy above has it right. U.S. Doctors at hospitals are lax about sterile conditions outside of operations. It's been found repeatedly. There are signs up to remind them. They ignore them at least some of the time.
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A useless coward said...
> I'm sure that only happens in the US . Beyond your bigotry, there are actual studies that show that nearly half of British women have fecal matter on their hands due to not washing after visits to the bathroom. With cultural proclivities such as that, they probably see a higher intersection with their doctor population. The other question to ask is how well are they sterilizing their tools (i.e. flash autoclave is becoming the standard to save time).
Okay.
First. As a certain bar
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Laxity around sterile conditions in an environment where antibiotics are in use to kill germs which result in 99.999999% of the germs being killed instead of 100% of the germs being killed breeds germs which are resistant to both sterilization procedures and to antibiotics. They are also bread by germs being carelessly reintroduced to patients who are 'well' and have low levels of antibiotics left in their system.
U.S. doctors were too convinced of the power of pills and antibiotics and too ignorant of how
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All due to market fundamentalism in the US (Score:4, Interesting)
The factors that some posters above have mentioned all point back to factors that are in place because of extreme market fundamentalism, (i.e. neoliberalism) in the US:
1. Slack sterile procedures in hospitals - oh no, we can't force hospitals to fix this because hospital profits.
2. Vast abuse of antibiotics in animal farming - oh no, we can't force meat producers to fix this because industrial agriculture profits.
3. Abuse of antibiotics by doctors, patients, and consumers - oh no, we can't force everyone to only use antibiotics when absolutely necessary because pharmaceutical profits.
In other words, the neoliberal answer to this issue so far has been: we can't fix it because it would affect profits. Just keep on dying.
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I stand by my point. Sure, patients do demand them, and the doctors go along probably for fear of lawsuits, but there is also a heavy profit motive on the other end to not do anything about that detrimental demand.
If someone is selling a lot of something, there's a profit to be made. Pfizer milked Zithromax (azythromycin) for all it was worth. That antibiotic was extremely popular (wikipedia says it was the most prescribed antibiotic in 2010) and they milked it so much that it's losing its effectiveness (m