Uganda Tackles High Levels of Antibiotic Resistance

bertramhall · Oct 3, 2015

http://www.voanews.com/content/uganda-tackles-antibiotic-resistance/2989423.html

Scientists say that most typical bacteria are resistant to antibiotics. Such diseases as pneumonia and tuberculosis require more sophisticated antibiotics to cure, This is caused by lack of medical personal who would prescribe medicine that`s why people take more than they need. Bacteria become more resistant. This could provoke bacteria mutations all over the world.

waltky · Oct 14, 2015

The correct sequence of administering antibiotics may help to prevent bacteria from becoming resistant to them...

Method developed to fight antibiotic resistance using current antibiotics
Oct. 12, 2015 - Using a mathematical model to determine the correct sequence of administering antibiotics may help to prevent bacteria from becoming resistant to them.

The increasing number of bacteria resistant to antibiotics poses a problem, however researchers at the Moffitt Cancer Center devised a mathematical model to determine the correct sequence of antibiotic treatment to counter resistance. The researchers believe treating bacteria with combinations of antibiotics over time may reduce or even eliminate resistant organisms. "Our results suggest that, through careful ordering of antibiotics, we may be able to steer evolution to a dead end from which resistance cannot emerge," said Daniel Nichol, a doctoral student at the University of Oxford and researcher at the Moffitt Cancer Cancer, in a press release.

Antibiotics are increasingly less effective against infections, however the right combinations given in the right order may be able to turn back the tide on pathogen resistance to the drugs.

Researchers used a Markov matrix to determine the probability of E.coli to survive in antibiotics, analyzing 15 antibiotics for efficacy based on the mathematical model. They found that 70 percent of combinations of two to four drugs promoted resistance to the antibiotics. The order drugs are administered makes a significant difference, researchers wrote in the study, because certain combinations have the ability to either promote or prevent bacteria from evolving to survive antibiotic treatment.

Careless, or at least less careful, use of unnecessarily strong antibiotics can help promote the development of resistance, they said, suggesting that more research be done on the most effective combinations to treat specific bacteria. "Our results can be easily tested in the laboratory, and if validated could be used in clinical trials immediately, as all of the compounds we studied are FDA approved and commonly prescribed," said Dr. Jacob Scott, of Moffitt's radiation oncology and integrated mathematical oncology departments. The study is published in PLOS: Computational Biology.

http://www.upi.com/Health_News/2015...rent-antibiotics/6771444665377/?spt=slh&or=11
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See also:

Breast cancer drug helps immune response against MRSA
Oct. 13, 2015 - The drug's immune-boosting ability was shown in lab in experiments with mice.

The breast cancer drug tamoxifen boosts the immune system, and was shown to be effective against Methicillin-resistant Staphylococcus aureus, or MRSA, in lab experiments, according to researchers at the University of California San Diego. Tamoxifen, which blocks estrogen receptors in breast tissue, is used by hundreds of thousands of women and men with advanced breast cancer. The drug's known effects on other cells led researchers to study other ways to use it. "While known for its efficacy against breast cancer cells, many other cell types are also exposed to tamoxifen," said Dr. Victor Nizet, a professor of pediatrics and pharmacy at the UCSD, in a press release. "The 'off-target effects' we identified in this study could have critical clinical implications given the large number of patients who take tamoxifen, often every day for years."

Tamoxifen helped mice infected with Methicillin-resistant Staphylococcus aureus, or MRSA, live about five times as long as those treated with a control drug.

For patients with estrogen-receptor positive breast cancer, tamoxifen blocks the receptors, helping make other treatments such as chemotherapy and radiation more effective. Researchers focused, however, on the drug's 'off-target effect' on the production of a type fatty molecule called ceramide that enhances the ability of white blood cells called neutrophils to engulf and defeat bacteria. In the lab, researchers found that neutrophils treated with tamoxifen produced three times more neutrophil extracellular traps, or NETs, a group of proteins, enzymes and peptides neutrophils use to kill bacteria.

The researchers treated mice with tamoxifen to test its ability to boost the immune system. After exposing the rodents to MRSA, another dosage of tamoxifen was given and the mice were monitored for five days. Although none of the control mice live more than a day, about 35 percent of the mice treated with tamoxifen survived for five days. Five times fewer MRSA were found in peritoneal fluid taken from the mice's abdomens. "The threat of multidrug-resistant bacterial pathogens is growing, yet the pipeline of new antibiotics is drying up," Nizet said. "We need to open the medicine cabinet and take a closer look at the potential infection-fighting properties of other drugs that we already know are safe for patients." The study is published in Nature Communications.

http://www.upi.com/Health_News/2015...onse-against-MRSA/3711444738169/?spt=slh&or=7
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waltky · May 19, 2016

New weapon against MRSA?...

Extract from Antarctic Sponge Could Open New Front against MRSA
May 18, 2016 - Scientists find natural chemical in creature living in frigid Antarctic waters that could kill increasingly prevalent antibiotic-resistant bacteria

A sponge that thrives in frigid Antarctic waters could provide a powerful new weapon against MRSA, a sometimes fatal infection that has become highly resistant to antibiotics. Scientists from the University of South Florida Center for Drug Discovery and Innovation search the world for natural chemicals with pharmaceutical potential. Center director Bill Baker collected samples of a sponge called Dendrilla membranosa from the Southern Ocean. His team extracted a substance they named darwinolide, modified its chemical composition, and tested it against the bacteria that cause MRSA.

A sponge called Dendrilla membranosa is found near Palmer Station, Antarctica, and shows promise against MRSA, a sometimes fatal infection highly resistant to antibiotics.

Writing in the journal Organic Letters, they report that only 1.6 percent of the bacteria survived and grew. MRSA methicillin-resistant Staphylococcus aureus was once a serious problem only in health care settings, such as hospitals and nursing homes. But the infection is now found in locker rooms, gyms and schools. It is especially dangerous because it can cause infections almost anywhere in the body, from the skin to the lungs to the lining of the heart. It has developed resistance to the most powerful antibiotics in the medical arsenal.

MRSA bacteria, like many other bacteria, form a biofilm around them as a protective shell. Antibiotics have a hard time penetrating that shell to kill the bacteria inside. Darwinolide appears to attack the biofilm. That, say the researchers, suggests "that darwinolide may present a highly suitable scaffold for the development of urgently needed, novel, anti-biofilm-specific antibiotics."

http://www.voanews.com/content/extract-antartic-sponge-weapon-mrsa-antibiotics/3335539.html
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waltky · Jun 22, 2016

Workers in Uganda Coerced Into HIV, STI Screenings...

Domestic Workers in Uganda Coerced Into HIV, STI Screenings
June 22, 2016 In Uganda, its common to bring women into households to help with chores such as cleaning, cooking and childcare. Yet many say that they have been coerced into undergoing screenings for HIV and sexually-transmitted infections. Advocates say the testing is a harbinger of discrimination and even sexual exploitation.

Most middle class homes in Uganda hire some form of house help. But domestic workers are increasingly being required to submit to health screenings as a precondition to employment. Domestic workers and labor advocates say the women are routinely tested for sexual-transmitted infections, including HIV. Lydia Bwiite, a lawyer with the Platform for Labor Action, investigates rights abuses of workers in Uganda. Even those who say 'yes I consented' it is a forceful thing... We have always encouraged domestic workers for their own benefit, even without forcing them, to go and test for the HIV. You remain with your results. It is up to you. When you find out, please look after yourself appropriately... But when you drag me from your home, take me to a clinic and test me and actually won't let me look at my results, the consent is not there, said Bwiite. Staff at clinics that administer the tests confirmed the phenomenon but said they werent authorized to be interviewed.

Legal issues

Several employers also declined to speak on microphone but told VOA that they demand the screening because they want to know if someone around their child has HIV. Yet dismissal, rather than health care, is often the result of a positive test. The clinics acknowledge that the patients consent is required to disclose test results. But some domestic workers here are under the legal age of consent and many do not speak English. The 2014 HIV and AIDS Prevention and Control Act makes disclosing an HIV status to anybody but the patient illegal. It also prohibits workplace discrimination based on HIV status.

A doctor draws blood to check for HIV/AIDS at a mobile testing unit in a suburb of Ugandas capital, Kampala

HIV is transmitted via direct contact with the bodily fluids of an infected person. HIV is not transmitted via casual contact. Benon Kisgenyi, the undersecretary with the Ministry of Gender, Labor and Social Developments says health screenings for domestic workers can be a red flag for sexual exploitation. Many times those people are accused in courts of being available to the men in the house. And the ladies therefore would want to see if it ever happens, maybe God forbid, I shouldn't pick up the STI or the HIV/AIDS from her. So I would consider that an abuse, said Kisgenyi.

Consequences

Mariam, who has been a nanny for seven years, says when she was tested, the results went directly to her employer. Although she had a clean bill of health, a former colleague wasn't so lucky, Like for example, one of the nannies was tested. I think it was her second year she was taken for test. And then they found she was HIV positive," she said. "And you know the bosses they meet their friends. So the bosses started spreading her name, So and so is like this. Now it is difficult for her to get a job. Because they know she is already HIV positive. And now she got treatment and she's okay [but] because her name was spoiled she can't be employed anywhere. She's one of our friends but there's no way we can help her. That fear of receiving a bad reputation also keeps women from reporting sexual abuse. Advocates say that more legal protections are needed for domestic workers. However, workers who feel their rights are being violated are encouraged to visit their district labor office.

http://www.voanews.com/content/domestic-workers-uganda-hiv-screening/3386776.html
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waltky · Jul 1, 2016

Deadly Drug-resistant Yeast is emerging in hospital settings globally...

Deadly Drug-resistant Yeast Poses New Threat
July 01, 2016 | A highly drug-resistant and potentially fatal yeast strain called Candida auris is emerging in hospital settings around the world. The yeast has shown resistance to three of the most commonly prescribed antifungal drugs: fluconazole, amphotericin B and caspofungin.

U.S. public health officials are urging doctors and nurses to be on the lookout for the dangerous pathogen, which can be fatal in 30 percent to 60 percent of infected patients. The yeast strain has been found in nine countries on four continents since 2009, including one possible infection in the United States in 2013. It was first identified in Japan in 2009 in a person with an ear infection. Other countries with confirmed infections are India, South Africa, Kuwait, Pakistan, South Korea, Colombia, Venezuela and the United Kingdom.

The U.S. Centers for Disease Control and Prevention sent an alert warning of the potential threat of C. auris in the U.S. and globally. Tom Chiller, chief of the mycotic diseases branch at the CDC, which monitors and studies fungal infections, told VOA the drug-resistant strain of C. auris "sounds pretty nasty." However, Chiller said, he hasn't heard of any clusters or outbreaks of C. auris, making it "very, very rare."

U.S. public health officials are urging doctors and nurses around the world to be on the lookout for a highly drug-resistant yeast strain called Candida auris.

Invasion through wounds

C. auris poses the greatest risk to hospitalized patients with diabetes and people with large vein catheters. Patients who are taking antibiotics or antifungal medications or who are in intensive care are also at risk. The yeast infection can get inside the body through open wounds. Once inside, it can infect the bloodstream, causing organ failure.

Identifying the culprit

Officials with the CDC say the biggest problem in spotting C. auris is that it mimics other more harmless, treatable yeast infections, such as those of the genitals, skin or throat. Common yeast infections can be identified through conventional testing, but the specialized, molecular detection methods necessary for identifying C. auris are not available to all hospitals. This raises the concern that cases are not being identified in other countries.

What to do

U.S. public health officials recommend that patients infected with C. auris have their own hospital rooms, which should be disinfected regularly. The CDC also recommends that doctors immediately report suspected infections to local and federal health authorities.

http://www.voanews.com/content/deadly-drug-resistant-yeast-new-threat-worldwide/3400701.html
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scarlet witch · Jul 2, 2016

The only issue is nannies in Africa will frequently breastfeed babies they are caring for, I was breastfed by an African nanny as a baby on occasion, pre mass HIV days. The HIV screenings are necessary if done for caring for children

waltky said: ↑

Workers in Uganda Coerced Into HIV, STI Screenings...

Domestic Workers in Uganda Coerced Into HIV, STI Screenings
June 22, 2016 In Uganda, its common to bring women into households to help with chores such as cleaning, cooking and childcare. Yet many say that they have been coerced into undergoing screenings for HIV and sexually-transmitted infections. Advocates say the testing is a harbinger of discrimination and even sexual exploitation.
Click to expand...

waltky · Sep 25, 2016

Experts get together to decide what to do about Falling Effectiveness of Antibiotics...

Top Officials Gather at UN to Address Falling Effectiveness of Antibiotics
September 22, 2016 | WASHINGTON Dire warnings about the growing problem of antimicrobial resistance worldwide prompted an urgent high-level meeting at the United Nations in New York Wednesday. Thousands of attendees, including heads of state, representatives of the private and public sector, NGOs and the pharmaceutical industry came together to discuss the proper use and misuse of antibiotics and what to do about it.

Antimicrobial resistance occurs when antibiotics and other drugs that were once used successfully to treat bacteria, viruses, parasites and fungi no longer work to fight infections. Used improperly, the once-miracle drugs cause microbes to develop mutations that render them ineffective. The misuse and overuse of antimicrobials in treating human ailments is not the only source of the problem. Antibiotics are widely used in farming and to treat animals. Traces of the drugs from human waste and drug manufacturing leech into the soil, contaminating wells, rivers and other sources of water used for bathing and drinking. Each year, millions of people die for lack of effective treatment for diseases such as tuberculosis and pneumonia.

Earlier this month, the World Bank issued a report on the economic implications of antimicrobial resistance. The report, entitled Drug Resistant Infections: A Threat to Our Economic Future, concluded that antimicrobial resistance has the potential to cause a level of global economic damage possibly worse than the 2008 financial crisis. The published research showed low-income countries could lose more than 5 percent of their gross national product, pushing as many as 28 million people in developing countries into poverty by 2050. Unlike the 2008 financial crisis, the World Bank went on to say there would be no prospects for a cyclical recovery in the medium term, as the costly impact of antimicrobial resistance would continue.

Antibiotic pills. Antimicrobial resistance occurs when antibiotics and other drugs that were once used successfully to treat bacteria, viruses, parasites and fungi no longer work to fight infections. Used improperly, the once-miracle drugs cause microbes to develop mutations that render them ineffective.

Adrian Thomas, head of market access and global public health for the drug manufacturer Johnson and Johnson, remembered the slow initial response to last years Ebola outbreak in West Africa. Thousands of people died before international and local health agencies and officials mobilized resources to tackle the problem. Thomas said something similar could happen on a massive scale, causing widespread human misery, death and economic instability to nations if antimicrobial resistance is not addressed on a global scale. We can predict today that thats going to happen. We know resistance is killing people today all over the world and will just kill more people and will cost more. We need to invest in it now, today, not wait for it to get worse, said Thomas. Johnson and Johnson was one of about a dozen drug manufacturers represented at the high level U.N. meeting.

The companies pledged to try to achieve four goals by the year 2020. They include helping to make sure that antimicrobials are used correctly by people who need them by developing better diagnostics tests, increasing access to effective, not counterfeit, drugs, lessening the environmental impact of drug manufacturing and increasing collaboration with government organizations to develop new antibiotics and vaccines. People often say, well, whos going to pay for this? And the answer is if we dont do it, were going to pay for it anyway. So, this should be seen by governments, by society, by the industry as a really strong investment decision to start working and solving these problems now, said Thomas. The World Health Organization, World Bank and other entities affiliated with the U.N. will work to pull together a plan of actions and report back to the general assembly in 2018 on ways to fight antimicrobial resistance, a growing global menace.

http://www.voanews.com/a/top-offici...ing-effectiveness-of-antibiotics/3520272.html
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crank · Sep 25, 2016

It's because people from certain cultures see them as a cheap miracle cure, and quick fix. Every time they sneeze they pop ABs.

waltky · Dec 2, 2016

Children risk contracting drug-resistant infections after taking antibiotics...

Infections in children linked to antibiotics
Fri, Dec 02, 2016 - Children are at substantially increased risk of contracting drug-resistant infections in the months after taking a course of antibiotics, a British public health official said.

Paul Cosford, medical director at Public Health England, on Wednesday told members of parliament that children are 12 times more likely to contract drug-resistant infections in the three months after being prescribed antibiotics, suggesting that their unnecessary use poses a direct risk to individual patients, as well as a broader threat to society as a whole. Weve got good evidence that if you or I have a course of antibiotics now, within three months our risk is three times to get a resistant infection of some sort because weve had the antibiotics affecting all the organisms in our bodies, he told the Science and Technology Select Committee.

He said the figures, based on two major reviews, highlighted the need to continue driving down reliance on the drugs. There is a growing body of evidence that taking antibiotics makes it more likely that your next infection will be a resistant one, so prudent use of these life-saving medicines is essential, he told reporters. The study cited by Cosford, in fact found that children who had urinary tract infections (cystitis) were 13.23 times as likely to have contracted drug-resistant strains if they had been given antibiotics in the previous six months. In a previous survey, 90 percent of general practitioners said they come under pressure from patients to hand out the antibacterial medication, while 45 percent said they had done so knowing it would not help.

Mark Woolhouse, professor of infectious disease at the University of Edinburgh, said that the figures matched his qualitative experience from the clinic. Antibiotics pose a risk of subsequent illness, because the drugs do not uniquely target the infection, but also eradicate useful bacteria in the gut, he said. In the ecological niche that opens up after a course of antibiotics, opportunistic infections can spring up. Antibiotics are a good thing when prescribed correctly, but they can have longer-term disadvantages of all kinds, Woolhouse said.

http://www.taipeitimes.com/News/world/archives/2016/12/02/2003660435
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waltky · Mar 7, 2017

Doctors Concerned about Potential Post-antibiotic Era...

Doctors Alarmed by Post-antibiotic Future
March 04, 2017 | WASHINGTON — Unless new antibiotics are developed quickly, people will once again die from common infections. The World Health Organization has issued an urgent call for scientists to develop these new drugs, and for governments to fund the research.

Dr. Trish Perl, chief of infectious diseases at University of Texas Southwestern Medical Center, said if there are no effective antibiotics, it will affect the entire practice of medicine. “You all of a sudden understand what it was like to practice medicine maybe 50, 70, 80 years ago, when there weren't antibiotics,” Perl said. Without antibiotics, surgery will become much more dangerous. Doctors will be unable to treat diseases caused by E. coli, a bacterium that causes urinary tract infections and diarrhea. Even a virus such as the flu, which can lead to bacterial pneumonia, will mean these viruses will ultimately claim even more lives.

New antibiotics needed

New antibiotics are urgently needed against bacteria that pose the greatest threat to human health. Those most at risk: residents of nursing homes, hospital patients, and children. Children may have weaker immune systems than adults, and they receive smaller doses of antibiotics than adults do. “For the longest time we've had a number of different antibiotics in the pipeline at any given time, so whenever we ran out of the ability to use one, we would move to the next one," Dr. Michael Bell, an expert in drug-resistant pathogens at the Centers for Disease Control and Prevention, told VOA. But that's no longer possible. Joe Larsen, the director of biological, chemical and radiological and nuclear countermeasures at the Department of Health and Human Services, said his department drew up a list of pathogens several years ago that were becoming resistant to antibiotics.

Funding needs to change

“There are antibiotics in the pipeline, but the numbers are insufficient ... to deal with the increasing rates of antibiotic-resistant bacteria,” he said. Larsen's department invests in pharmaceutical and bio-tech firms to make drugs, vaccines and diagnostics for public health emergency preparedness. Larsen is hopeful that a new antibiotic will be approved by the Food and Drug Administration later this year. He also said two to three more antibiotics are being developed that should be available in a year or two. The WHO said it's too expensive for pharmaceutical companies to develop new antibiotics on their own because they wouldn't recoup their investment. Larsen agrees that the way antibiotics are commercialized needs to change.

Bacteria are constantly changing

One reason is that the more an antibiotic is used, the less effective it becomes. That's because bacteria are constantly changing and finding new ways to resist the drugs that kill them. Once they find a way, they can pass on the gene so other bacteria can become drug-resistant as well. To preserve the effectiveness of an antibiotic, Larsen said the profits from selling these drugs can't be linked to the volume of sales the way the market normally works. He said the solution lies in public-private partnerships between governments and pharmaceutical or biotech firms. In the meantime, antibiotic resistance is very real. Lauri Hicks, who leads research on antibiotic use and resistance trends at the CDC, said, “We are seeing greater than 2 million episodes of antibiotic resistant infections each year in the U.S. alone. Twenty-three thousand of these episodes result in death.”

Don’t overuse antibiotics

The Centers for Disease Control and Prevention has asked hospitals and doctors to be careful not to overuse antibiotics. But beyond overuse, Bell, of the CDC, said there are other reasons these drugs are being rendered powerless. “Antibiotic resistance is being generated by not only using too many antibiotics, but also by spread of infection by lack of hygiene, from unintended contact with soiled surfaces, so the infection-control side is equally important,” he said. Patients can also help. On its website, the CDC says to take antibiotics as prescribed and finish the prescription, even if you feel better. Still, urgent action on a global level is needed to prevent the catastrophe that a post-antibiotic era would cause.

http://www.voanews.com/a/doctors-alarmed-by-post-antibiotic-future/3749034.html
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waltky · Dec 8, 2017

WHO released $623,000 from its emergency fund to finance the action...

WHO: Rapid Action Brings Quick End to Marburg Outbreak in Uganda
December 08, 2017 — Rapid action prevented the spread of the deadly Marburg virus just weeks after it was first detected in Uganda, the World Health Organization reports.

The first case of the disease in the African country was confirmed October 17, when laboratory tests found the death of a 50-year-old woman was due to the Marburg virus. "Within 24 hours of being informed by the Ugandan health authorities in early October, WHO deployed a rapid response team to the remote mountainous area and we have financed the immediate support and scaled up the response in Uganda and Kenya," said World Health Organization spokeswoman, Fadela Chaib. WHO released $623,000 from its emergency fund to finance the action.

A medical worker wearing full protective equipment decontaminates a cup used by a man being quarantined after coming into contact in Uganda with a carrier of the Marburg virus, a hemorrhagic fever from the same family as Ebola, at the Kenyatta National Hospital in Nairobi, Kenya

Marburg is a highly fatal disease caused by a virus from the same family as that of Ebola. It can be transmitted from person to person by bodily fluids, and can cause bleeding, fever, vomiting, diarrhea and other symptoms. This was the fifth outbreak of Marburg virus in a decade, and lessons have been learned from those outbreaks, as well as from the West African Ebola epidemic that killed more than 11,000 people. "Marburg is very infectious," Chaib said. "It was also important to trace all the contacts of this first case and to follow them for a period of 21 days, plus 21 days just to make sure that there [are] no other cases being detected."

WHO reports three people died over the course of the outbreak, which affected two districts in eastern Uganda near the Kenyan border. Surveillance and contact tracing on the Kenyan side of the border by the Kenyan Ministry of Health and its partners also prevented cross-border spread of the disease, according to WHO.

https://www.voanews.com/a/rapid-action-quick-end-marburg-outbreak-uganda-who/4155679.html
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Uganda Tackles High Levels of Antibiotic Resistance

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