Archive for category: Multidrug resistance

“Antibiotics were undoubtedly one of the most important medical developments of the 20th century. At the same time, however, they are becoming one of the great challenges of the 21st century. Thanks to very loose prescription practices for human patients as well as extensive use of antibiotics in animal husbandry, so-called multi-drug resistant bacteria are now rampant worldwide—especially in industrialized nations with excellent medical care. These are pathogens that are immune to many antibiotics. In the USA, a bacterial gene has now been found for the first time that confers resistance to so-called ‘last resort’ antibiotics, i.e., the most effective and strongest existing antibiotics.

Salmonella are bacteria associated with food poisoning. Normally, a Salmonella infection is usually a matter of patience—eventually, it disappears again. Not dangerous, but unpleasant. The situation is different for particularly young or old people, as well as people with weakened immune systems. For them, Salmonella infections can be a risk, which is why antibiotics are frequently prescribed.

And here we come to a problem: like many other bacteria, Salmonella have also developed resistance to most antibiotics. More precisely, to pretty much all except colistin, an antibiotic that is now considered the last drug treatment option for Salmonella infections. And now it looks as if this drug will not be effective for much longer either. Researchers in the USA have discovered a gene that gives Salmonella the ability to defend itself against colistin. This makes the bacterium virtually untreatable with antibiotics.

Gene originates from China
The gene is known as mcr-3.1 and has been on the watchlist of many scientists for years. Now it appears to have surfaced in the USA for the first time.

“Public health officials have known about this gene for some time. In 2015, they saw that mcr-3.1 had moved from a chromosome to a plasmid in China, which paves the way for the gene to be transmitted between organisms. For example, E. coli and Salmonella are in the same family, so once the gene is on a plasmid, that plasmid could move between the bacteria and they could transmit this gene to each other. Once mcr-3.1 jumped to the plasmid, it spread to 30 different countries, although not – as far as we knew – to the US,” says Siddhartha Thakur, one of the authors of the study.

The gene was discovered during routine screenings used to identify new multi-drug resistant bacterial strains. The mcr-3.1 gene was found in a stool sample taken back in 2014 from a patient who contracted a Salmonella infection in China. Theoretically, the gene is capable of transferring to the significantly more dangerous E. coli bacterium.

The spread of this gene is another step toward super-resistant bacteria. However, new antibiotics are constantly being developed, and research is also being conducted into other treatment methods for multi-drug resistant bacteria.”

Source: https://www.trendsderzukunft.de/medizin-dieses-gen-laesst-salmonellen-resistent-gegen-alle-antibiotika-werden/amp/

“Your own child has a fever, is in pain, is coughing—what should you do? Seeing a doctor would be advisable, but for parents in Kenya’s slums this is often not possible. Instead, they buy cheap antibiotics—with dangerous consequences.”

Rose Midecha does not know what to do anymore. Her little baby, Collins, has been ill for three months. Without a break. He coughs and sneezes. Midecha keeps giving him medication. “I went to the pharmacy and bought antibiotics,” says the 37-year-old. When they ran out, he was still unwell, so she got new ones for him. But they only relieve the symptoms briefly, and then Collins becomes seriously ill again. Before long, his mother will reach for the next antibiotic.

Midecha lives with her two children in the Mathare slum in Nairobi. Hygiene conditions in the poor neighborhoods are bad—there is rubbish on the streets, often also feces. Access to clean water is limited, and there are no functioning drainage systems. Added to this is the high population density. Bacteria spread easily here and cause illness. Antibiotics are often used to treat these illnesses.

A study in the Kibera low-income neighborhood in Nairobi found that between 70% and 87% of the households surveyed had taken antibiotics within a year. By comparison, a study found that in Brandenburg, antibiotics were prescribed in an average of 6.5% of households in one year.

Midecha gets the antibiotics from the local vendors around the corner. They operate out of small corrugated-metal huts with a selection of medicines. In most cases, the vendors have no pharmaceutical training—often not even a sales license. Here, antibiotics are inexpensive and easily available without a prescription. Midecha has no other option. “I would go to the hospital, but I can’t. If I get work, I have to take it,” says the single mother.

“If I spend the whole day waiting at the hospital, who will earn the money even just for my children’s porridge?” Midecha asks. In addition, the hospital visit itself costs money—and Midecha does not have it. She works as a domestic helper, earning just enough for the rent on her shack, food, and childcare. (….)

In addition to the high consumption of antibiotics in Mathare or Kibera, the medicines are often of poor quality or used incorrectly. All of this promotes resistance. “The low-income neighborhoods are a hotspot for antibiotic resistance,” says Sam Kariuki, Director of Research and Development at the Kenya Medical Research Institute (KEMRI). According to the researcher, bacteria are present in the environment and pass resistance on to one another. “When many antibiotics are then given—of varying quality, or even counterfeit—these neighborhoods become like an incubator for resistant bacteria.”

In Kenya, hospitals are feeling the growing problem. At Kijabe Hospital, staff have observed for more than ten years that the rate of resistant bacteria is increasing. They have developed new treatment standards and monitor resistance much more closely so that they still have effective medicines available.”

Source: https://www.tagesschau.de/ausland/kenia-nairobi-antibiotikaresistenz-101.html
By Caroline Hoffmann, ARD Studio Nairobi

We are now finding the effects of excessive antibiotic use even in the Antarctic. Researchers have detected hundreds of different resistance genes in the soil in Antarctica. This gene confers resistance to antibiotics on bacteria. Even the super-gene blaNDM-1, which was detected in India a few years ago, was found. This demonstrates how quickly resistance is spreading worldwide.

Antibiotics are becoming ineffective as multi-resistant pathogens that are immune to several classes of antibiotics develop worldwide. These multi-resistant pathogens are now found not only in humans and animals but also in soil and water.

The multi-resistant “superbug” NDM-1 strain is particularly dangerous.
This strain was discovered in India a few years ago and is immune to all common classes of antibiotics and emergency antibiotics of the carbapenem group. This resistance is caused by the blaNDM-1 gene.

A research group led by David Graham from Newcastle University analyzed 40 soil samples taken in 2013 along the Kongsfjorden in northwestern Spitsbergen. Multi-resistant pathogens are now found even in this pristine ecosystem on Earth.
131 different resistance genes were identified. . “These genes provide protection against nine different classes of antibiotics, including aminoglycosides, macrolides, and beta-lactams, which are used to treat many infections,” Graham reports.
The super-gene blaNDM-1 was also found.

This demonstrates that antibiotic resistance genes have now spread to even the most remote corners of the Earth. This shows how quickly and extensively antibiotic resistance has spread by now.

The researchers suspect that the resistance genes were mainly introduced to Spitsbergen by birds. (Environment International, 2019)

Source: Newcastle University