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  1. #1
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    New superbug could make antibiotics 'redundant'

    A new superbug being brought into Britain by patients having surgery abroad could make antibiotics redundant, researchers have warned.


    By Rebecca Smith, Medical Editor
    Published: 6:30AM BST 11 Aug 2010


    The bug is resistant to the class of antibiotics known as Carbapenems which are reserved for use when all other antibiotics have failed Photo: JOHN TAYLOR

    The new bug is resistant to almost all antibiotics and there are none in development which can combat it meaning it is likely to spread worldwide, according to international experts.

    There have been 37 cases in Britain and scientists writing in the journal Lancet Infectious Diseases warn it has an 'alarming potential to spread and diversify'.

    The bug, an enzyme called New Delhi-Metallo-1 (NDM-1), has been found in patients travelling to Asia for cosmetic surgery, cancer treatment and transplants and returning to Britain for further care. The bug was found attached to E.coli bacteria that cause urinary tract and respiratory infections.
    However the enzyme can easily jump from one bacterium to another and experts fear it will start attaching itself to more dangerous diseases causing them to become resistant to antibiotics.
    The bug is even resistant to the class of antibiotics known as Carbapenems which are reserved for use when all other antibiotics have failed.
    The Daily Telegraph highlighted last year how the bug had then been found in 22 patients in Britain and government scientists had issued an alert to hospitals to test for it and limit its spread.
    Now an international team of experts have tracked NDM-1 in India, Pakistan, Bangladesh, and Britain and found the disease is more widespread than previously thought.
    Between 2007 and 2009 they found there had been 37 patients in Britain with the disease.
    Co-authors of the research, Prof Timothy Walsh from Cardiff University, and Prof David Livermore, from the Health Protection Agency, wrote in the paper: "The NDM-1 problem is likely to get substantially worse in the foreseeable future....
    "The potential for wider international spread and for NDM-1 to become endemic worldwide, are clear and frightening."
    Antibiotics are available to buy without prescription in many countries in Asia and this is thought to have encouraged resistance to develop as many infections are exposed to the drugs without being properly killed.
    The team found NDM-1 carried by young women with urinary tract infections but not other illness and in patient who are vulnerable after having kidney transplants and cancer treatment.
    A victim of a road traffic accident in India developed an infection with NDM-1 in the bones of his fractured foot and another was infected in their wound after a 'tummy tuck' operation.
    Prof Livermore said: "These are not bacteria that are historically very harmful to humans but medicine has got better at keeping people alive with conditions that would normally have killed them and they can be exploited by these bacteria.
    "The risk is that you have an enzyme with very major resistant and if it combined with a particularly nasty bacterium, then that would be a concern."

    http://www.telegraph.co.uk/health/he...redundant.html

  2. #2
    Mid
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    What is NDM-1 bacteria, the new superbug threat?
    Tim Edwards
    AUGUST 11, 2010



    Briefing: Researchers have identified at least one bacterium that is resistant to all known antibiotics


    The World Health Organisation yesterday announced that the swine flu pandemic is over. Unfortunately, there is a new threat: NDM-1 bacteria.

    Lancet Infectious Diseases reports that 50 cases of people infected with this new superbug - potentially more of a risk to hospital patients than the notorious MRSA - have so far been identified.

    The researchers warn that the potential for NDM-1 bacteria to become endemic worldwide is "clear and frightening" and say we must develop new drugs to fight the threat now.

    WHAT IS NDM-1?

    NDM-1 is an enzyme produced by certain bacteria, which allows them to neutralise the harmful effects of carbapenems, one of the most powerful types of antibiotics available to doctors.

    WHERE DID IT COME FROM?

    The clue is in the name. New Delhi metallo-ß-lactamase-1 has been identified in UK patients who had recently travelled to India or Pakistan for medical treatment - often cosmetic surgery. When these people were later treated in UK or US hospitals, NDM-1 passed to other patients.

    WHAT IS A SUPERBUG?

    Antibiotics are our most effective weapon against bacterial diseases such as tuberculosis, cholera and Black Death. However, bacteria have been developing resistance to antibiotics since they were first used commercially in the 1930s. These 'superbugs' - such as Methicillin-resistant Staphylococcus aureus (MRSA) - use proteins called enzymes to neutralise antibiotics.

    Scientists are continually trying to develop new classes of antibiotic to meet the threat of these superbugs in an ongoing arms race. NDM-1, which makes bacteria resistant to one of our most powerful antibiotic classes, carbapenems, is a particular worry because there are currently no new types of antibiotics in the development pipeline that will be effective against it.

    WHAT IS THE THREAT?

    Enzymes such as NDM-1 are produced by strands of DNA which bacteria are known to transfer between one another. Currently two bacteria have been host to the NDM-1 enzyme: Escherichia coli and Klebsiella pneumonia (above), both of which are found in the human gut and are normally harmless.

    However, they can both cause urinary tract infections and blood poisoning, while the latter, as its name suggests, can cause pneumonia.

    Professor David Livermore, from the Health Protection Agency, said: "These are not bacteria that are historically very harmful to humans, but medicine has got better at keeping people alive with conditions that would normally have killed them and they can be exploited by these bacteria."

    The worry is that the gene for NDM-1 production will be transferred to a type of bacterium that is resistant to all other antibiotics - and that is easily spread between patients. Such a development would constitute a nightmare scenario.

    CAN IT BE TREATED AT ALL?

    Patients with an NDM-1 infection can be treated with a cocktail of antibiotics, the idea being that it is unlikely a bacterium could be resistant to all of them.

    However, researchers have found at least one NDM-1 bacterium that is resistant to all known antibiotics. The key to stopping the spread will be identifying new cases early and insisting on good hygiene in hospitals: disinfecting medical instruments and ensuring doctors and nurses wash their hands with antibacterial soap.

    IS THIS A GLOBAL PROBLEM?

    NDM-1 bacteria are widespread across the Indian subcontinent and have also been reported in the UK, US, Canada, Netherlands and Australia.

    IS ANYONE DEVELOPING A CURE?

    Most new antibiotics currently under development are effective only against gram-positive bacteria such as the more famous superbug MRSA. Unfortunately, bacteria that carry the NDM-1 enzyme are gram-negative.

    The UK's Health Protection Agency says: "Multi-resistant gram-negative bacteria pose a notable public health risk and it remains important that the pharmaceutical industry continues to work towards developing new treatment options".

    thefirstpost.co.uk
    Last edited by Mid; 12-08-2010 at 10:31 AM. Reason: formatting

  3. #3
    Thailand Expat Ripley's Avatar
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    Casual use of antbiotics

    Casual, unprescribed use of antibiotics is to blame. Thailand's selling them over the counter is a bad policy.
    People have no idea that popping a few antibiotics does nothing for a head cold virus.

    A full course is required in order to fully kill bacterial infections .

    Overuse of anti bacterial soap, sanitizers, etc contribute.
    Some bacteria are good and keep other bacteria in check.
    When you constantly kill all the germs, you force mutation to survive.

    Stop picking your nose and teeth with your fingers or even rubbing your eyes if you don't want to catch upper-respiratory virus .

  4. #4
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    Human resistance to antibiotics could bring "the end of modern medicine

    Human resistance to antibiotics could bring "the end of modern medicine as we know it", WHO claim
    The world is entering an antibiotic crisis which could make routine operations impossible and a scratched knee potentially fatal, the head of the World Health Organisation has claimed.

    Humans being are becoming increasingly resistant to antibiotics Photo: JOHN TAYLOR

    Margaret Chan, director general of the WHO, warned that humans have become so resistant to common antibiotics that it could bring about “the end of modern medicine as we know it.”
    As a result, she claimed, every antibiotic ever developed is at risk of becoming useless, making once-routine operations impossible.
    This would include many of the breakthrough drugs developed to treat tuberculosis, malaria, bacterial infections and HIV/AIDS, as well as simple treatments for cuts.
    Speaking to a conference of infectious disease experts in Copenhagen, Dr Chan said we could be entering into a “post-antibiotic era”.
    Replacement medicines could become more expensive, with longer periods of treatment required to bring about the same effect, she added.

    Dr Chan said: “Things as common as strep throat or a child’s scratched knee could once again kill.
    “Antimicrobial resistance is on the rise in Europe and elsewhere in the world. We are losing our first-line antimicrobials.
    “Replacement treatments are more costly, more toxic, need much longer durations of treatment, and may require treatment in intensive care units.
    “For patients infected with some drug-resistant pathogens, mortality has been shown to increase by around 50 per cent.
    “A post-antibiotic era means, in effect, an end to modern medicine as we know it.”
    The stark warning comes shortly after the World Health Organisation published a new book warning of the “global crisis”, entitled “The evolving threat of antimicrobial resistance.”
    It reads: “Bacteria which cause disease react to the antibiotics used as treatment by becoming resistant to them, sooner or later.
    “A crisis has been building up over the decades, so that today many common and life-threatening infections are becoming difficult or even impossible to treat, sometimes turning a common infection into a life-threatening one.”
    The paper blamed the current situation largely on the misuse of antibiotics, which are not prescribed properly and used too frequently and for too long.
    It added that an “inexorable increase in antimicrobial-resistant infections, a dearth of new antibiotics in the pipeline and little incentive for industry to invest in research and development” had led to a need for innovation”.
    The WHO has now appealed to governments across the world to support research into the antimicrobial resistance

    Human resistance to antibiotics could bring "the end of modern medicine as we know it", WHO claim - Telegraph

  5. #5
    Mid
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    Quote Originally Posted by some fok wit at the Telegraph

    humans have become so resistant to common antibiotics
    there's something I never knew

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    ^Thais will never know it, for sure...

  7. #7
    Mid
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    err .........

  8. #8
    Mid
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    interesting , nobody ?

  9. #9
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    The Telegraph and The Mail have such appallingly shitty standards of science reporting that although any one story might (perhaps) have brushed by truth on the way to the newsstands, I think it's always best to operate a general rule-of-thumb and ignore anything they say.

  10. #10
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    anybody with a smidgin of medical knowledge will understand how relevant that article is, especially to those who live in thailand where antibiotics are sold over the counter and overprescribed by doctors here in a way that would be considered criminally negligent in many countries.

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    Just a bit of general knowledge will suffice.

  12. #12
    Tonguin for a beer
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    True enough, I am amazed at how doctors prescribe anti biotics for everything here. They give them to me but I wait to see if I am getting better before taking them It's crazy how many pills you walk out of the hospital with here.

  13. #13
    Cenosillicaphobiac
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    Quote Originally Posted by Mid View Post
    Quote Originally Posted by some fok wit at the Telegraph

    humans have become so resistant to common antibiotics
    there's something I never knew


    It's good to know that we're becoming resistant to antibiotics. Now we just have to get more resistant to the bloody diseases.

  14. #14
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    I wonder who is such an idiot to change the text of the Telegraph.

    The Telegraph article speak of nothing as ridiculous as human resistance to antibiotics. It is about bacteria who become resistant to antibiotics.

    I wonder what kind of disturbed mind would go to the trouble of changing the text to post it here?

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    maybe the same disturbed mind that digs holes in the basement!!!

  16. #16
    Mid
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    So the fokwits at the Telegraph have corrected their error .

    The OP is not altered , it is as originally posted and thus there are a few here who suffer from severe reading comprehension difficulties to put it kindly .

  17. #17
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    its all a bit pedantic, the contents of the article are very valid, even if the headline could cause confusion to nitpickers.

  18. #18
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    Quote Originally Posted by crippen
    Human resistance to antibiotics could bring "the end of modern medicine as we know it",
    it is not humans that are becoming resistant but the bacteria to human antibiotics

  19. #19
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    Bulletin of the World Health Organization
    Race against time to develop new antibiotics


    The second part of a series of three news features on antimicrobial resistance looks at how the antibiotics pipeline is drying up while resistance to existing drugs is increasing. Theresa Braine reports.

    Bulletin of the World Health Organization 2011;89:88–89. doi:10.2471/BLT.11.030211

    Within a few days of scraping his leg in a scooter accident in 2009, nine-year-old Brock Wade was in hospital fighting for his life with a methicillin-resistant Staphylococcus aureus (MRSA) infection. Once the infection – caused by one of the bacteria most often resistant to antibiotics – had been diagnosed, doctors put him on five different antibiotics. “After a month in the hospital, and against all odds, Brock recovered and was well enough to come home,” says his mother Rhonda Bailey-Wade on the web site of the Infectious Diseases Society of America (IDSA).

    Scenarios such as this IDSA case study are increasingly being played out all over the world. But not all the thousands of patients that contract drug-resistant bacterial infections every year are as lucky as Brock. And the problem looks set to get worse. While infectious agents are becoming more and more resistant to the medicines that are currently in use, not enough drugs are being developed to combat them.


    Courtesy of Infectious Diseases Society of America
    Young Brock Wade spent a month in hospital fighting an antibiotic-resistant infection.
    “MRSA continues to be a major cause of community-acquired antibiotic resistant infections,” says Dr Brad Spellberg, one of the authors of the 2004 IDSA report Bad bugs, no drugs. “However, because companies in the late 1980s and early 1990s recognized the threat of MRSA, starting in 2000 we did get new MRSA drugs. Right now, we have reasonable antibiotics to treat MRSA. As resistance catches up with them, in the future we will have problems again.”

    There are many reasons. One is scientific. “The low-hanging fruit has been picked,” says Spellberg. “But the concept that we’ve exhausted the pantry is ridiculous. Now we have to dig deeper, think harder and more cleverly.”

    Another reason is commercial. Antibiotics, in particular, have a poor return on investment because they are taken for a short period of time and cure their target disease. In contrast, drugs that treat chronic illness, such as high blood pressure, are taken daily for the rest of a patient’s life. “Companies have figured out that they make a lot more money selling the latter drugs than they do selling antibiotics,” Spellberg says, highlighting the lack of incentive for companies to develop antibiotics.

    That’s why many companies have stopped developing antibiotics altogether. Only five major pharmaceutical companies – albeit five of the biggest – GlaxoSmithKline, Novartis, AstraZeneca, Merck and Pfizer, still had active antibacterial discovery programmes in 2008, according to an article published in the journal Clinical Infectious Diseases in January 2009.

    Adding to the grim picture, a comprehensive study of antibiotic development, covering innovative, small firms, as well as pharma giants, found in 2008 that only 15 antibiotics of 167 under development had a new mechanism of action with the potential to meet the challenge of multidrug resistance. Most of those were in the early phases of development, according to the study entitled The bacterial challenge: time to react.

    But there is hope. “Given that the antibiotics we have available today were discovered as growth byproducts of bacteria that we can culture, and that we’ve cultured less than 1% of the bacteria on our planet, there are many potential solutions out there,” Spellberg says.


    WHO/Chadin Tephaval
    Checking vials of biological samples at Thailand’s National Institute of Health in Bangkok.
    A variety of biological solutions have yet to be fully explored, such as phage therapy and the potential use of the lytic enzymes found in mucus and saliva to kill pathogens (as described by researchers in an article published in October 2010 in the Institute of Physics’ journal Physical Biology).

    Another example is that of researchers at GlaxoSmithKline who recently described a novel class of antibacterial agents that target type IIA topoisomerases. The article was published in Nature in August 2010. “This investigational compound class has activity against a broad spectrum of Gram-positive and Gram-negative bacteria,” says Dr Mick Gwyn, the study’s lead author and a researcher in antibacterial drug discovery at GlaxoSmithKline.

    Antimicrobial resistance is the inevitable consequence of prescribing antibiotics. “Whatever infections we treat, the bacteria that are part of our normal flora are always exposed to these antibiotics,” says Dr Hajo Grundmann, chair of infectious diseases and epidemiology at the University of Groningen and head of the Department of Bacteriology at the National Institute of Public Health in the Netherlands. “Simply by surviving the onslaught of antibiotics, they are developing more clever ways to overcome the most sophisticated and advanced antibiotics.”

    There are no global data on the number of cases, including fatal ones, of resistant bacterial infections. According to the 2008 study, every year at least 25 000 patients in the European Union alone die from an infection caused by multidrug-resistant bacteria and estimated additional health-care costs and productivity losses are at least 1.5 billion Euros.

    Some of the most resistant infections are caused by Gram-negative Acinetobacter, and by certain strains of Klebsiella and Pseudomonas species, according to Spellberg. These bacteria cause a variety of illnesses ranging from hospital-acquired pneumonia, bloodstream infections, urinary tract infections from catheters, abdominal infections and even meningitis in people who have had head and spine procedures, for example, epidurals during labour.

    “Anywhere in the body can be hit by these bugs. And the issue is that without effective antibiotics the death rate is much higher,” says Spellberg.


    WHO/Chadin Tephaval
    A laboratory technician at Thailand’s National Institute of Health in Bangkok.
    The outbreak of resistant strains of Escherichia coli (E. coli) – a common cause of food poisoning – carrying a gene called NDM1 (New Delhi metallo-β-lactamase) in India in 2010, which spread to other countries, is a case in point. Until recently such completely resistant bacteria have only been found in hospitals, Spellberg says, but “now we’re starting to see virtually or totally pan-resistant bacteria spilling into the community”.

    The solution may lie not only in scientific discovery but also in the economic incentives for developing drugs. “I think that Congress understands that this is now a market failure and that economic incentives are needed to correct the market failure,” he says.

    Public–private partnerships could provide one solution, according to a May 2010 commentary in the British Medical Journal, such as the GlaxoSmithKline research partnerships with the Wellcome Trust and with the United States Defence Threat Reduction Agency.

    Referring to “the twin challenges of conserving the effectiveness of existing antibacterial drugs and developing new ones”, authors of the British Medical Journal article Anthony So, Melissa Furlong and Andreas Heddini of Swedish-based nongovernmental organization, ReAct, write that “delinking research and development costs from drug pricing and the return that drug companies receive on investment could correct misaligned economic incentives”.

    This delinking of research costs and drug pricing is something that industry may be prepared to accept, according to Richard Bergström, director-general of LIF, the trade association for the research-based pharmaceutical industry in Sweden.

    “Incentives that separate the financial return from the use of a product are the only way to change this behaviour,” said Bergström at a conference held at Uppsala University in September 2010. “Intelligent pull incentives, such as advance commitments and prizes, provide financial rewards to the developer that are not based on the volume of use of the novel antibiotic. With the right set-up, pharma companies will have no incentive to drive use. Maybe they will not do any promotion at all. Use would be agreed with public policy-makers, purchasers and national health systems.”

    Bergström called for a “global compact” similar to the one used for the United Nations programme for good governance and sustainable development enshrined in Millennium Development Goal 7. This agreement “could focus on the agreed and gradual introduction – and responsible marketing and use of – new agents”.

    “A global compact would require that not only industry but also governments, physicians and pharmacists join forces to preserve the new medicines that our children and grandchildren need,” said Bergström. “No single tool will solve the problem. What is really needed is a collection of incentives that address the multiple obstacles to success.”

    This year the World Health Organization is devoting World Health Day on 7 April to raising awareness around the issue of antimicrobial resistance. More information is available at: http://www.who.int/world-health-day

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    A bit worrying that the article I just copied changed! I thought it was a bit daft at the time.

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    March 14 was the 70th anniversary of the first saving of a human life through the use of antibiotics. My understanding is that agricultural use of antibiotics is more to blame than overprescription.

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    Quote Originally Posted by good2bhappy
    it is not humans that are becoming resistant but the bacteria to human antibiotics
    Yes...that's a bit more accurate...

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    Quote Originally Posted by Mid
    So the fokwits at the Telegraph have corrected their error . The OP is not altered , it is as originally posted
    In that case I apologize to the thread opener.

    Quote Originally Posted by taxexile
    its all a bit pedantic, the contents of the article are very valid, even if the headline could cause confusion to nitpickers.
    It was not just the headline. That mistake was at least twice in the text of the article. And the mistakes make the article completely invalid.

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    Quote Originally Posted by taxexile View Post
    anybody with a smidgin of medical knowledge will understand how relevant that article is, especially to those who live in thailand where antibiotics are sold over the counter and overprescribed by doctors here in a way that would be considered criminally negligent in many countries.
    Indonesia Sama Sama but different.

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    I think some of you will find this interesting:
    Tom Levenson talks with Maryn McKenna: author of SUPERBUG: The Fatal Menace of MRSA (Free Press/Simon & Schuster, 2010), an investigation of the global epidemic of drug-resistant staph, which received the 2011 Science in Society Award
    Maryn McKenna Tom Levenson VS Science 03/28 by Virtually Speaking Science | Blog Talk Radio
    “You can lead a horticulture but you can’t make her think.” Dorothy Parker

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