Rampant use of antibiotics making pneumonia a killer

Payal Gwalani, TNN | Nov 6, 2012,

NAGPUR: More incidences of a disease generally equip doctors to manage it better. However, it is the opposite in case of pneumonia, especially the one acquired at the hospitals. Doctors blame indiscriminate use of antibiotics, which has made the pathogens causing this disease more resistant, for making this condition a potentially fatal one.

These were among the many topics discussed during a symposium and clinical meeting of Academy of Medical Sciences on pneumonia held ahead of the World Pneumonia  Day that falls on November 9. While Dr PP Joshi and Dr Amol Sagdeo presented some interesting cases, Dr Ravindra Sarnaik, Dr Sanjeev Mehta, Dr Shrinivas Samavedam, Dr Yagnesh Thakkar and Dr Nainesh Patel  spoke about the various aspects of managing the disease.

President of AMS Dr Rajan Barokar said other than the known viral originated pneumonia, bacterial and fungal pneumonia is increasingly being reported. "Managing pneumonia and its higher form - acute respiratory distress syndrome (ARDS) - is a challenge for the critical care team," he said. Agreeing with this, Dr Chandrashekhar Cham, secretary of AMS, added that secondary infections of this kind acquired at hospitals are emerging as big killers in ICUs. Dr Sarnaik said with many ailments coexisting, the treatment gets more complicated and longer.

Dr Samavedam informed that 40 per cent patients visiting OPD have respiratory infections while 15 per cent have pneumonia. "A lot of cases do not even get reported as they occur at places where medical services may not be well developed," he said. He warned that parents must be cautious when children have fever that persists for more than two days or is acquired after returning from a holiday or after consuming outside food.

Dr Mehta gave the example of France where government rewards the doctors who give least number of antibiotics and make the patients aware about their misuse. "The pathogens that cause hospital acquired infections are immune to many of the common antibiotics. This has given rise to stronger microbes that are lurking around the hospital. Instead of trying different medications, doctors must send the cultures for laboratory tests to decide the course of drugs," said Dr Thakkar.

Dr Patel spoke of a newly emerging form of pneumonia that has resulted from high resistance among the pathogens called health care associated infections. "This means that the disease, even if acquired outside the hospital or in the community, becomes difficult to treat due to resistance from the organisms causing them," he explained.

Dr SK Deshpande blamed lack of hygiene and overcrowded living spaces for this phenomenon. "Urban slums and a general apathy towards cleanliness have made this situation so bad," he said.

Times of India

Antibiotic Resistance Killing Off Bees

Antibiotic Resistance Killing Off Bees

BY EMMA GOLDBERG

CONTRIBUTING REPORTER

Tuesday, November 6, 2012

Yale researchers have identified a potential culprit in a nationwide increase of honeybee deaths — resistance to an important antibiotic.

In the Oct. 30 issue of the mBio journal, Yale professor of ecology and evolutionary biology Nancy Moran published a study showing that beneficial bacteria found in the guts of honeybees have acquired genes that make bees resistant to tetracycline, an antibiotic used to prevent colony-destroying infections and other bacterial diseases. Moran’s research identified eight tetracycline-resistant genes in American honeybees that were absent in honeybee populations where such antibiotic treatment is banned, suggesting that use of tetracycline has genetically altered beneficial bacteria and made colonies more prone to infection.

“We noticed that the [first] colony collapses happened in 2006, which is when the antibiotic was first introduced,” Moran told the News. “But it’s really a very speculative concept right now.”

Researchers in Moran’s lab are looking to confirm the link they have established between antibiotics and colony collapses so as to impact policy-making in the beekeeping community.

“The beekeepers are interested in healthy bees. If we can show that antibiotics affect honey production or colony survival, we can draw their attention,” Moran said.

To test bee genes for resistance to antibiotics, researchers in Moran’s lab isolated all of the bacterial DNA in bee guts and transferred them into independent DNA molecules called plasmids. These plasmids were then put into E. coli and sequenced so that the tetracycline-resistant genes could be identified. To determine how different bee populations interact with antibiotics, researchers used a technique called polymerase chain reaction to amplify bee DNA samples collected from various locations in the United States, New Zealand, the Czech Republic and Switzerland.

“We found that bees from the USA, which had a long treatment history [with tetracycline], carried the most resistant genes,” said Waldan Kwong GRD ’16, one of the authors of the paper and a researcher in Moran’s lab.

If confirmed, Moran’s research could have wide-reaching impact on American crop growth and production. Honeybee pollination plays a critical role in the $15 billion U.S. agriculture industry. The industry has been plagued by recent bee colony collapses, due primarily to bees’ contraction of the bacterial disease foul brood.

University of California, Davis apiculture professor Norman Gary stressed the magnitude of the colony collapse disorder.

“Only recently has the true value of honeybees been appreciated by people in this country,” Gary told the News. “The colony collapse disorder is a complex issue and many scientists are advancing theories to explain its cause.”

Kwong said he hopes the research conducted in Moran’s lab will encourage beekeepers to exercise caution when introducing new antibiotics into bee colonies.

“Beekeepers and the general public should be aware that application of antibiotics not only affects pathogens but also the normal healthy microbes that coexist with the host,” he said. He added, however, that further research and consultation with the beekeeping community are needed before any new policies can be introduced and implemented.

Gary said bee die-offs are likely the result of multiple factors rather than a single central cause. “In the scientific community we’re hoping that honeybees will develop a resistance to the cause of the colony collapses,” he said.

Moving forward, researchers in Moran’s lab are studying the health benefits and hazards posed by gut bacteria in bees. They are studying the microbes that have become resistant to tetracycline to understand the beneficial functions they perform, such as pathogen defense, as well as the negative impact they can have on bees’ immune systems.

“We want to understand how bacteria function in bees,” Moran said. Her lab is currently working on an experiment that exposes bees to antibiotics and analyzes their long-term effects. Though she said the team has evidence that bacteria can help bees digest food, Moran said they hope to discover other health benefits bacteria provide bees.

“It’s basic work, but nothing like it has ever been done before,” she said.

The lead author of the paper was former Yale postdoctoral researcher Baoyu Tian, and other authors included Yale researchers Nibal H. Fadhil and J. Elijah Powell. The research was funded through a grant from the National Science Foundation.

Yale Daily News

Synthesis and structure-activity relationship of a novel class of 15-membered macrolide antibiotics known as '11a-azalides'

August 2012

Sugimoto T, Tanikawa T, Suzuki K, Yamasaki Y.

Source

Medicinal Research Laboratories, Taisho Pharmaceutical Co. Ltd, 1-403 Yoshino-cho, Kita-ku, Saitama-shi, Saitama 331-9530, Japan.

Abstract

Macrolide antibiotics are widely prescribed for the treatment of respiratory tract infections; however, the increasing prevalence of macrolide-resistant pathogens is a public health concern. Therefore, the development of new macrolide scaffolds with activities against resistant pathogens is urgently needed. An efficient method for reconstructing the erythromycin A macrolactone skeleton has been established. Based on this methodology, novel 15-membered macrolides, known as '11a-azalides', with substituents at the C12, C13, or C4″ positions were synthesized and their antibacterial activities were evaluated. These derivatives showed promising antibacterial activities against erythromycin-resistant Streptococcus pneumoniae. Among them, the C4″ substituted derivatives had the most potent activity against erythromycin-resistant S. pneumoniae.

Science Direct

A situational analysis of antimicrobial drug resistance in Africa: are we losing the battle?

July 2012

Kimang'a AN.

Source

Sub-department of Medical Microbiology, Faculty of Science, Jomo Kenyatta University of Agriculture and Technology. P.O. Box 62000-00100, Nairobi-Kenya. Email: kinyerere@yahoo.com.

Abstract

BACKGROUND:

The first arrival of a sizable shipment of penicillin at the North African Theatre of Operations for USA military use in 1943 was a landmark that turned a new chapter of antibiotic use in Africa. Over the past decade the expansion of resources and the technological advances have meant that much larger quantities of drugs are available in developing countries than ever before. As a result, many more individuals are receiving necessary treatment or therapy than just ten years ago. This very welcome event is accompanied by the terrible irony that increases in drug availability and use can promote drug resistance and render the same life-saving drugs ineffective.

METHODS: 

The study focused on bacterial pathogens. One hundred and three relevant literatures were identified from the PubMed online database. The coverage included research articles concerning antimicrobial resistance involving subjects of an African country.

RESULTS:

Resistant bacteria are on a war path and evidently have acquired an edge over us. Our actions are evidently fuelling the resistance. The indiscriminate use of antibiotics in humans and livestock, wrong and substandard prescriptions by unqualified 'medical personnel' together with poor diagnosis or lack of it are all adding fuel to the already fired train of resistant microbes.

CONCLUSION:

To win the war and turn tables as we did with the discovery of penicillin and other antimicrobials in the 1940s, then we must all act now. Antimicrobial stewardship programs-Education, training of laboratory personnel and investment in laboratory infrastructure development are desirable in these situations.

PubMed