Health Service and Superbugs

Antibiotic resistance is one of the greatest challenges facing health services around the world, numerous reports have told us over the past year.

 

Currently, 700,000 people a year die because their conditions are resistant to the antibiotics traditionally administered to tackle them, and this figure will rise to 10 million within decades unless a solution is found.

 

Studies suggest CPE kills about 40 per cent of those
who become infected, especially older, frail patients.

 

In Ireland, progress has been made in reducing the level of infections caused by organisms that were a significant concern a decade ago. Superbugs such as MRSA haven’t gone away, but the number of patients infected during hospital stays has declined steadily.

However, the ground on which the battle against antibiotic resistance is fought constantly changes, and so new organisms have emerged to create problems in the overcrowded, overstretched Irish health system.

Worryingly, the threat they pose is ever greater, because many of them are resistant to all but the most potent antibiotics and they are difficult, if not impossible, to eradicate.

Of particular concern is the emergence of what is termed carbapenemase-producing Enterobacteriaceae (CPE), which results in some cases of bacteria being resistant to all conventionally-used antibiotics. The carbapenemases are enzymes that work by inactivating antibiotics.

Gut Bugs - Support Cancer Drugs

Bacteria living deep inside the digestive system seem to alter how cancer drugs work, a study suggests.

Immunotherapies - which harness the body's own defences to fight tumours - can clear even terminal cancer in a small proportion of patients.
However, a small study by the University of Texas found those harbouring a more diverse community of gut bugs are more likely to benefit.
Cancer Research UK said understanding gut bugs had "great potential".
The human body is home to trillions of micro-organisms - estimates suggest our own tissues are so heavily outnumbered that our bodies are just 10% human.

And a growing wealth of studies shows these microbes can influence our immune systems and have been implicated in auto-immune diseases and allergies.



Higher Levels
Immunotherapies are one of the most exciting breakthroughs in treating cancer. They work by taking the brakes off the immune system to help it to attack tumours more easily.
The research group compared the gut bacteria in 23 patients who responded to the therapy and 11 who did not.
Dr Jennifer Wargo, a melanoma surgeon and scientist, told the BBC News website: "We found a night-and-day difference in the diversity of bacteria species in the faecal samples."
The study, presented at the National Cancer Research Institute's Cancer Conference in Liverpool, found Ruminococcus bacteria in much higher levels in those that responded to treatment.
It suggests that it may be possible to boost the effectiveness of immunotherapy by altering the balance of bacteria in the gut.

'Scratch the Surface'

Procedures such as a trans-poo-sion - a transplant of faecal matter containing beneficial bacteria - are already used as a treatment for some diseases.

Dr Wargo added: "It is hugely plausible I think - we still need to dig a little deeper, but I think we're on to something.
"I think it really does shape our body's immune response as a whole and to cancer."
It is not yet clear if the differences in bacteria are the cause of the better response.
People with diets containing more fruit and vegetables tend to have a richer set of gut bugs, so it is possible that it is those with a healthier lifestyle that respond better to therapy.
"It might point to a healthy diet increasing your chances, which I think would be a great message," she added.
Sir Harpal Kumar, chief executive of Cancer Research UK, said: "Our bodies are filled with trillions of bacteria, and we are just beginning to scratch the surface of understanding their great potential.
"It's really interesting and exciting to see new evidence emerge on the close connection between the immune system and the bacteria living in our guts. As this, and several other studies, have shown, manipulating these bacteria could be exploited in future to help patients respond better to treatment."

Alarm Raised at Resistant Infection!

US health officials have reported the first case in the country of a patient with an infection resistant to all known antibiotics, and expressed grave concern that the superbug could pose serious danger for routine infections, if it spreads.
"We risk being in a post-antibiotic world," said Thomas Frieden, director of the US Centers for Disease Control and Prevention, referring to the urinary tract infection of a 49-year-old Pennsylvania woman who had not travelled within the prior five months.

The superbug reportedly contains a gene called mcr-1 that confers resistance to colistin

Mr. Frieden, speaking at a National Press Club lunch in Washington, DC, said the infection was not controlled even by colistin, an antibiotic that is reserved for use against "nightmare bacteria."
The infection was reported yesterday in a study appearing in Antimicrobial Agents and Chemotherapy, a publication of the American Society for Microbiology.
It said the superbug itself had first been infected with a tiny piece of DNA called a plasmid, which passed along a gene called mcr-1 that confers resistance to colistin.
"(This) heralds the emergence of truly pan-drug resistant bacteria," said the study, which was conducted by the Walter Reed National Military Medical Center. "To the best of our knowledge, this is the first report of mcr-1 in the USA."
The patient visited a clinic on 26 April 2016 with symptoms of a urinary tract infection, according to the study, which did not describe her current condition.
Authors of the study could not immediately be reached for comment.
The study said continued surveillance to determine the true frequency of the gene in the United States is critical.
"It is dangerous and we would assume it can be spread quickly, even in a hospital environment if it is not well contained," said Dr. Gail Cassell, a microbiologist and senior lecturer at Harvard Medical School.
But she said the potential speed of its spread will not be known until more is learned about how the Pennsylvania patient was infected, and how present the colistin-resistant superbug is in the United States and globally.
In the United States, antibiotic resistance has been blamed for at least 2 million illnesses and 23,000 deaths annually.
The mcr-1 gene was found last year in people and pigs in China, raising alarm.
The potential for the superbug to spread from animals to people is a major concern, Dr. Cassell said.
For now, Dr. Cassell said people can best protect themselves from it and from other bacteria resistant to antibiotics by thoroughly washing their hands, washing fruits and vegetables thoroughly and preparing foods appropriately.
Experts have warned since the 1990s that especially bad superbugs could be on the horizon, but few drug makers have attempted to develop drugs against them.

Team from Sligo, make MRSA breakthrough

A team of scientists, led by Professor Suresh C Pillai from IT Sligo, have made a breakthrough which will allow everyday items such as smartphones and door handles to be protected against deadly bacteria including MRSA and E Coli.
The group’s research was published today in the journal Scientific Reports.
The nanotechnology has a 99.9% kill rate and uses an agent that kills micro-organisms or inhibits their growth.
Anything made from glass, metallic surfaces and ceramics can be protected, including computer or tablet screens, smartphones, ATMs, door handles, TVs, toilet seats and fridges.

The Sligo researchers said it will be of particular use in hospitals and medical facilities.
It could also be used in swimming pools, on public transport, and on sneeze guards protecting food in delis and restaurants, as well as in clean rooms in the medical sector.
The discovery is the culmination of almost 12 years of research by a team of scientists led by Pillai, initially at the Centre for Research in Engineering Surface Technology in DIT and then at IT Sligo’s Nanotechnology Research Group.
DCU, the University of Surrey and Kastus Technologies were also involved in the research.
“It’s absolutely wonderful to finally be at this stage. This breakthrough will change the whole fight against superbugs. It can effectively control the spread of bacteria,” Pillai said.

Every single person has a sea of bacteria on their hands. The mobile phone is the most contaminated personal item that we can have.

“Bacteria grows on the phone and can live there for up to five months. As it is contaminated with proteins from saliva and from the hand, it’s fertile land for bacteria and has been shown to carry 30 times more bacteria than a toilet seat.”
   

UV light
As there is nothing that will effectively kill antibiotic-resistant superbugs completely from the surface of items, scientists have been searching for a way to prevent the spread.
This has been in the form of building or ‘baking’ antimicrobial surfaces into products, during the manufacturing process.
However, until now these materials were toxic or needed UV light, in order to make them work.

“The challenge was the preparation of a solution that was activated by indoor light rather than UV light and we have now done that,” Pillai said.
The new water-based solution can be sprayed on to any glass, ceramic or metallic surface during the production process, rendering the surface 99.9% resistant to superbugs like MRSA, E coli and other fungi. The solution is sprayed on the product — such as a smartphone glass surface — and then ‘baked’ into it, forming a surface that is transparent, permanent and scratch-resistant.

Gut bacteria that protect against food allergies identified

The presence of Clostridia, a common class of gut bacteria, protects against food allergies, a new study in mice  finds.

 By inducing immune responses that prevent food allergens from entering the bloodstream,Clostridia minimize allergen exposure and prevent sensitization -- a key step in the development of food allergies. The discovery points toward probiotic therapies for this so-far untreatable condition, report scientists from the University of Chicago, Aug 25 in the Proceedings of the National Academy of Sciences.

Although the causes of food allergy -- a sometimes deadly immune response to certain foods -- are unknown, studies have hinted that modern hygienic or dietary practices may play a role by disturbing the body's natural bacterial composition. In recent years, food allergy rates among children have risen sharply – increasing approximately 50 percent between 1997 and 2011 -- and studies have shown a correlation to antibiotic and antimicrobial use.

"Environmental stimuli such as antibiotic overuse, high fat diets, caesarean birth, removal of common pathogens and even formula feeding have affected the microbiota with which we've co-evolved," said study senior author Cathryn Nagler, PhD, Bunning Food Allergy Professor at the University of Chicago. "Our results suggest this could contribute to the increasing susceptibility to food allergies."

The study, "Commensal bacteria protect against food allergen sensitization," was supported by Food Allergy Research & Education (FARE) and the University of Chicago Digestive Diseases Research Core Center. 

View full article here

Cork discovery raises hopes for obesity treatment

Dr Susan Joyce and Dr Cormac Gahan

A team of scientists in Cork has made a significant discovery about how bacteria in the gut regulate weight and cholesterol levels.

The research, by a team at the Alimentary Pharmabiotic Centre in University College Cork, may in time lead to the development of probiotics that control obesity, high cholesterol and diabetes.

The researchers analysed a bacterial protein that modifies bile acid in the gut.

They found that increased levels of the protein can lead to reduced cholesterol levels and weight gain in mice.

The protein, called bile salt hydrolase, is made by gut bacteria and changes the chemical properties of bile acids in the gut.

According to the group, led by Dr Cormac Gahan and Dr. Susan Joyce, research by others has shown that these bile acids act as signals that can influence metabolism.

But what the Irish researchers have shown is that bacteria in the gut can specifically influence this process.

The scientists must now see what relevance this study, conducted in mice, has in humans.

But they are hopeful it will lead to the development of probiotics with specific uses.

"The findings may be used as a basis for the future selection of probiotics or dietary interventions which target this mechanism to regulate weight gain or high cholesterol," said Dr Joyce.

"We now have the potential for matching probiotic strains with specific end-user needs. Work is under way to determine how this system operates in humans."

The Science Foundation Ireland funded research is published in the international journal Proceedings of the National Academy of Sciences.

View Press Release here