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Showing posts with label antibiotics. Show all posts
Showing posts with label antibiotics. Show all posts

Tuesday 6 May 2014

Clean hands save lives, wash your hands to combat germs!

PETALING JAYA: The role of hand hygiene in preventing the spread of drug-resistant germs is the focus of the World Health Organisation’s annual “SAVE LIVES: Clean Your Hands” campaign this year.

Launched yesterday, the campaign is in line with WHO’s recently-released report on Antimicrobial Resistance: Global Report on Surveillance.

How bacteria become resistant
Bacteria grow resistant to antibiotics through natural selection. When drugs are used, some organisms may have ways of surviving. As they reproduce or pass DNA to other bacteria, those traits become more common, weakening antibiotics’ power.

The report states that there are increasingly more types of bacteria which cannot be killed by antibiotics. The report also stated that no one in the world is safe from this menace.

However, WHO also reported that should compliance with hand hygiene in health facilities increase from under 60% to 90%, there could be up to a 24% reduction in the infection of methicillin-resistant Stap­hylococcus aureus (MRSA).

MRSA, most commonly contracted in hospitals, is rapidly becoming more difficult to treat with current drugs.

“Whether it is the hands of the patient, their visitors or the healthcare team, people must remember to practise good hand hygiene in a healthcare setting, especially in hospitals,” said Patient Safety Council of Malaysia member Dr Milton Lum.

Good hand hygiene means washing the hands thoroughly with soap and water before and after touching a patient.

“Everyone has germs on his or her body so despite our good intentions in visiting our sick relatives or friends, we may actually pass on a bug unintentionally,” said Dr Lum.

Patients for Patients Safety Malaysia chairman J. Manvir said he believed that patients should also wear masks to protect themselves from airborne infections.

“Children under 12 should not be visiting patients, especially in hospitals.

“You may not be able to teach them to practise good hand hygiene but you can keep them at home to prevent them from passing on an infection to the patient as well as preventing them from getting ill,” said Manvir.

Antibiotic resistance has been around since the 1940s when the first antibiotic, penicillin, allowed doctors to kill off the many bacteria that were the source of different infections.

However, subsequent misuse of penicillin accelerated the natural evolution of the bacteria, resulting in the microbes becoming resistant.

Contributed by Tan Shiow Chin The Star/Asia News Network

Related post:

The world's leading health organization is sounding serious alarm bells about the problem of antibiotic resistance.

Monday 5 May 2014

WHO's Alarm Bells: Antibiotic Resistance Now a 'Major Threat to Public Health'

The world's leading health organization is sounding serious alarm bells about the problem of antibiotic resistance.


In its first report on the issue ever, the World Health Organization (WHO) is sounding alarms about the issue of antibiotic resistance and the global public health threats it poses to our increasingly interconnected world.

"The problem is so serious that it threatens the achievements of modern medicine. A post-antibiotic era—in which common infections and minor injuries can kill—is a very real possibility for the 21st century," the report states.

Antibiotic resistance occurs when bacteria no longer die when treated with antibiotics. As a result, doctors have to use stronger, more potent antibiotics, and the more those are used, the more resistance bacteria develop to those as well. The WHO is warning that we're reaching a point in which the strongest antibiotics doctors have in their arsenal, the "treatment of last resort" drugs as they're called, no longer work.

And in fact, it's no longer just bacteria that are becoming resistant. The WHO has stopped referring to the problem as "antibiotic resistance" and now calls it "antimicrobial resistance," to encompass other organisms, such as viruses and parasites, that no longer respond to the drugs of choice. Namely, treating the viruses tuberculosis and HIV, and malaria (a parasite), has become harder as these diseases become resistant to medications. Even H1N1, the so-called "swine flu" that reached pandemic levels in 2009, has begun developing resistance to potent antiviral drugs.

Resistance Is a Worldwide Problem

One of the major points of the report is that diseases that used to be restricted to certain locales are now spreading internationally:

Among their key findings:
• Resistance to the treatment of last resort for life-threatening infections caused by a common intestinal bacteria, Klebsiella pneumonia—carbapenem antibiotics—has spread to all regions of the world. K. pneumoniae is a major cause of hospital-acquired infections such as pneumonia, bloodstream infections, infections in newborns and intensive-care unit patients. In some countries, because of resistance, carbapenem antibiotics would not work in more than half of people treated for K. pneumoniae infections.

• Treatment failure to the last resort of treatment for gonorrhea—third generation cephalosporins—has been confirmed in Austria, Australia, Canada, France, Japan, Norway, Slovenia, South Africa, Sweden and the United Kingdom. More than 1 million people are infected with gonorrhoea around the world every day.

• People with MRSA (methicillin-resistant Staphylococcus aureus) are estimated to be 64 percent more likely to die than people with a non-resistant form of the infection. MRSA, which can cause septic bloodstream infections when exposed to broken skin, is one of the most common "community-acquired" resistant infections, meaning you're likely to pick it up anywhere other people are—your gym, place of worship, a nearby park or even at schools. In the Americas, as many as 90 percent of staph infections are reported to be MRSA.

• There hasn't been a new class of antibiotics developed since the late 1980s.

We Can't Track What We Don't Know

The WHO is calling on countries all over the world to step up their surveillance of these deadly infections, something that happens rarely, if at all. An investigative report, "Hunting the Nightmare Bacteria," that ran on the PBS program Frontline in October 2013 revealed that public health officials in the U.S. have little to no data on the extent of antimicrobial resistance in this country. Healthcare facilities aren't required to report outbreaks, the report found, and many don't because they don't want to scare people or have to deal with bad PR.

“It is frankly embarrassing that we as a country do not know where resistance is occurring, how bad the problem is for various organisms or who’s using what antibiotics when,” Brad Spellberg, MD, an infectious disease doctor at Harbor-UCLA Medical Center, said in the documentary.

The Centers for Disease Control and Prevention has estimated that antimicrobial resistant infections hit two million people a year and kill at least 23,000. But the WHO notes that in most countries around the world, including the U.S., often only the most severe infections are documented and minor community-acquired infections (which can get passed along repeatedly and wind up as a severe infection) go unreported.

Clean Up the Food Supply!

For quite possibly the first time, the WHO also called out the food industry for its contribution to antimicrobial resistance. " The use of antibiotics in animal husbandry—including in livestock, poultry and fish farming—are leading to increasing recognition that urgent action is needed to avoid inappropriate use, and to reduce antibiotic usage in animal husbandry and aquaculture, as well as in humans," the report states. In the U.S., 80 percent of antibiotics sold go into animal feed to prevent infections in healthy animals or to speed growth. And we're not alone. "In many countries, the total amount of antibiotics used in animals (both food-producing and companion animals), measured as gross weight, exceeds the quantity used in the treatment of disease in humans," the authors found.

The same classes of antibiotics used on these animals are the same as those given to humans. In particular, fluoroquinolones, antibiotics used widely in the poultry industry, are increasingly ineffective against urinary tract infections caused by drug-resistant E. coli bacteria, which have been detected on all forms of supermarket meat, and against MRSA soft-tissue and skin infections.

Numerous groups in the U.S. have sued the Food and Drug Administration to revoke its approvals in animals for antibiotics that are valuable for humans. The agency's only response has been to set voluntary guidelines for the industry.

What You Can Do

Despite the damage factory farming has done to antibiotic effectiveness, the WHO and other public health officials insist that the first line of defense in controlling the problem of antimicrobial resistance is the healthcare setting: Stopping doctors from giving patients antibiotics for conditions they aren't designed to treat, for instance, when you're given antibiotics for a cold that's caused by a virus, not bacteria.

• Don't automatically ask for antibiotics when you feel sick and visit a doctor.

• If your doctor prescribes an antibiotic, ask if there's an alternative before just accepting the advice. Some doctors feel compelled to offer the drugs to make people feel better, but asking for an alternative can open up a dialogue about other options.

• When you do need an antibiotic, take the full course, even if you're feeling better.

• Wash your hands frequently to protect yourself from community-acquired infections, and keep your hands away from your nose, eyes and mouth, where infections can enter.

Contributed by  By EMILY MAIN

 Where Health Meets Life


Alarm bells over antibiotic resistance 

The World Health Organisation’s most comprehensive report to date sounds a warning that we are entering a world where antibiotics have little effect.

THE World Health Organisation (WHO) has sounded a warning that many types of disease-causing bacteria can no longer be treated with the usual antibiotics and the benefits of modern medicine are increasingly being eroded.

The comprehensive 232-page report on anti-microbial resistance with data from 114 countries shows how this threat is happening now in every region of the world and can affect anyone in any country.

Antibiotic resistance – when bacteria evolve so that antibiotics no longer work to treat infections – is described by the report as “a problem so serious that it threatens the achievements of modern medicine”.

“A post-antibiotic era, in which common infections and minor injuries can kill, far from being an apocalyptic fantasy, is instead a very real possibility for the 21st century,” said Dr Keiji Fukuda, WHO assistant director-general who coordinates its work on anti-microbial resistance.

“Without urgent, coordinated action, the world is headed for a post-antibiotic era in which common infections and minor injuries which have been treatable for decades can once again kill.

“Effective antibiotics have been one of the pillars allowing us to live longer, live healthier, and benefit from modern medicine.

“Unless we take significant actions to improve efforts to prevent infections and also change how we produce, prescribe and use antibiotics, the world will lose more and more of these global public health goods and the implications will be devastating.”

The report, “Antimicrobial Resistance: Global Report on Surveillance”, shows that resistance is occurring in many bacteria causing different infections.

It focuses on antibiotic resistance in seven bacteria responsible for common, serious diseases, such as bloodstream infections (sepsis), diarrhoea, pneumonia, urinary tract infections and gonorrhoea.

What is especially alarming is that the bacteria’s resistance has also breached “last resort” antibiotics, which are the most powerful medicines that doctors resort to when the usual ones do not work.

When patients do not respond to the usual medicines (known as first-line or first-generation medicines), doctors prescribe newer (second line medicines) which also usually also cost more.

When these also don’t work, newer and often more powerful (but sometimes with also more side effects) antibiotics are used, and they are even more expensive.

If these third-line or “last resort” medicines are not available or too costly for the patient, or if they don’t work on a patient because of antibiotic resistance, the patient remains ill or dies if the infection is a serious one.

New antibiotics have been discovered in the past to treat infections when the old ones became useless due to resistance.

But these discoveries dried up in the past 25 years.

The last completely new classes of anti-bacterial drugs were discovered in the 1980s.

Pathogens that are becoming increasingly resistant including to the more powerful antibiotics include E. coli, K. pneumonia, S. aureus, S. pneumonia, salmonelia, shigella and n. gonorrhoeae.

Key findings from the report include:

> Resistance to the treatment of last resort for life-threatening infections caused by a common intestinal bacteria, K. pneumonia — carbapenem antibiotics — has spread worldwide.

K. pneumoniae is a major cause of hospital-acquired infections such as pneumonia, bloodstream infections, infections in newborns and intensive-care unit patients.

In some countries, because of resistance, carbapenem antibiotics would not work in more than half of people treated for K. pneumoniae infections;

> Resistance to one of the most widely used antibacterial medicines for the treatment of urinary tract infections caused by E. coli – fluoroquinolones – is very widespread.

In the 1980s, when these drugs were first introduced, resistance was virtually zero.

In many countries today, this treatment is ineffective in more than half of patients;

> The sexually transmitted disease, gonorrhoea may soon be untreatable unless there are new drugs. Treatment failure to the last resort of treatment for gonorrhoea – third generation cephalosporins – has been confirmed in several countries; and

> Antibiotic resistance causes people to be sick for longer and increases the risk of death.

For example, people with MRSA (methicillin-resistant Staphylococcus aureus) are estimated to be 64% more likely to die than people with a non-resistant form of the infection.

There are many cases of patients being infected by MRSA in hospitals.

The report also gives useful information on the worrisome building up of resistance in four serious diseases — tuberculosis, malaria, HIV and influenza.

A major factor accelerating resistance is in the animal husbandry sector, where there is a liberal use of antibiotics mainly to promote the growth of the animals used for food, for commercial purposes.

This builds up resistance in the bacteria present in the animals.

These resistant germs are passed on to humans who consume the meat.

The report has a small section on the animal-food chain, which has been identified as a major problem.

The European Union has banned the use of antibiotics as growth promoters in animals, but it is still allowed in other countries.

A WHO press release on the report calls for some actions. These include:

> Setting up basic systems in countries to track and monitor the problem;

> Preventing infections from happening in the first place to reduce the need for antibiotics;

> Only prescribing and dispensing antibiotics when they are truly needed, and prescribing and dispensing the right antibiotic(s) to treat the illness;

> Patients using antibiotics only when prescribed by a doctor and completing the full prescription; and

> Developing new diagnostics, antibiotics and other tools to stay ahead of emerging resistance.

Contributed by Global Trends by Martin Khor

Martin Khor is executive director of the South Centre, a research centre of 51 developing countries, based in Geneva. You can e-mail him at director@southcentre.org. The views expressed are entirely his own.

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Thursday 20 February 2014

Do You need jabs, antibiotics?


OUR population is getting more and more educated and knowledgeable. With the convenience of internet and smart phone, information can be assessed anytime and anywhere.

Facebook and Google have become the source of reference for most people. Many can now be “experts” in many specialised fields, including engineering, law and even medicine.

Nowadays, the medical practitioners enounter some patients who are so-called internet savvy, and refuse antibiotics and vaccines.

This issue arose due to the spread of such information in the internet, claiming antibiotics could lead to “superbug” and are associated with many adverse effects, while vaccines could cause autism or death.
Well, the risks of administration of both drugs are certainly debatable.

What we know for a fact is that since Alexander Flemming discovered penicillin and the pox vaccine, many lives were saved.

Nevertheless, I am not in the position to comment on the good and bad of both antibiotics and vaccines. But, it is more important for the general public to understand more about the need for antibiotics and vaccines.

Antibiotics or more specifically antibacterial, is a medicine indicated to kill (bactericidal) or inhibit the growth (bacteriostatic) of the bacteria.

There are various types of antibiotics with different mode of actions and indications. Strictly speaking, the mechanism of action for antibiotics is rather complicated.

However, it works mainly to counter attack the rapid reproduction of bacterial colonies, so that our immune system has enough time to defeat the illness.

Thus, the usage of antibiotics is strictly limited to the bacterial infection. In common clinical conditions, like acute exudative tonsillitis, abscess formation and urinary tract infection, antibiotics are strongly prescribed.

It must be understood that antibiotics have no role in curing diseases caused by fungus, virus or other parasites.

Therefore, it should not be overprescribed in cases like common cough and cold, flu and fungal infection of skin.

As for vaccines, they are biological preparations that help to boost immunity. Its primary focus is on disease prevention. It is always better to prevent a disease than to treat it.

Vaccines work by introducing the weakened form of “disease germ” into the body. The body will respond by producing antibodies to fight these invaders. At this stage, technically, the immune system is being sensitised. If the actual disease germ attacks the body, more antibodies will be produced to destroy the real enemy.

Vaccines are responsible for the control of many infectious diseases that were once common in this country and around the world, including polio, measles, diphtheria, pertussis (whooping cough), rubella (German measles), mumps, tetanus, Hepatitis B and Haemophilus influenzae type b (Hib).

Many patients question the need for further vaccination as diseases such as diphtheria, pertussis are very rare these days.

Furthermore, there are people that do not get vaccination, yet able to live healthily until old age. This is the myth behind “herd immunity”.

Herd immunity serves as a preventive barrier as most of the population had been vaccinated, thus, the disease is contained from spreading. If herd immunity is compromised, the widespread of the disease may occur.

A piece of advice to all, a little knowledge is a dangerous thing. Before you start to tell doctors about the negative effects of antibiotics and vaccines, why not, give them a chance to explain to you before you make a decision.

Contributed by DR H.B. CHEE, Muar, Johor The Star/Asia News Network

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Monday 18 March 2013

Superbug lurking! Drug resistance now a nightmare!

Top health officials in the UK and US warn that resistance of bacteria to medicines is a catastrophe and nightmare, and as serious a threat as terrorism and climate change.



MANY a Malaysian has lost a family member because of an infection contracted during an operation while in a hospital.

Several office colleagues and friends have told me that a close relative had died after being infected by a superbug that was so toxic that it could not be eliminated by antibiotics.

This, in essence, is the problem of antibiotic resistance – that a bacterium can evolve and change so that it becomes immune to the medicines given to a sick patient that are meant to kill it.

When a bacterium becomes resistant to one antibiotic, scientists develop a more powerful antibiotic to kill it. But bacteria can then change to also become immune to the new medicine.

When the dangerous pathogens out-run the drugs developed to combat them, humanity is at risk of losing the race between life and death.

Equally problematic is that many of these incurable diseases are contracted when patients stay in hospitals, especially during operations.

In the past two weeks, two top health officials – the Chief Medical Officer of the United Kingdom Dame Sally Davies and the director of the United States Centres for Disease Control and Prevention (CDC) Dr Thomas Frieden – have sounded the alarm bells.

Davies, the top health official in the UK, warned of a looming “catastrophe” of antibiotic resistance being so widespread that we would be back to a 19th century medical situation, a pre-antibiotic era when many diseases were difficult or impossible to treat.

Frieden evoked a “nightmare” scenario, a “very serious” problem caused by the advance of highly drug-resistant bacteria known as CRE.

A major cause of the acceleration of antibiotic resistance is the inappropriate use of the medicines and the inadequate action (or even inaction) of health authorities.

Drug companies often over-promote the use and sales of their medicines; some doctors over-prescribe or wrongly prescribe antibiotics (sometimes for the wrong ailment); and patients who are not informed enough sometimes pressure their doctors for antibiotics for a quick cure and often do not use the medicines properly by not completing the course of medicines.

There’s not enough action to make the public aware of the proper use of antibiotics, and not enough regulations (or their implementation) to ensure drug companies and medical personnel sell or prescribe the medicines properly.

The alarm raised by the two top health officials was aimed at pushing the regulators and also the patients into action.

Davies, during media interviews, even placed antibiotic resistance on par with terrorism and climate change as critical risks facing the nation.

She said: “Antimicrobial resistance poses a catastrophic threat. If we don’t act now, any one of us could go into hospital in 20 years for minor surgery and die because of an ordinary infection that can’t be treated by antibiotics.

“Routine operations like hip replacements or organ transplants could be deadly because of the risk of infection.

“That’s why governments and organisations across the world, including the World Health Organisation and G8, need to take this seriously.”

Although there has been a great reduction in cases in English hospitals of MRSA (methicillin-resistant Staphylococcus aureus), which is a skin disease, this has been replaced by many times more cases of gram-negative bacteria which are found in the gut.

These bacteria include E. coli and Klebsiella (which causes pneumonia) which are resistant to many drugs.

Besides the new drug-resistant pathogens, resistance is also emerging in old pathogens.

In particular, the report cites tuberculosis, which has re-emerged in Europe in the form of new strains that are resistant to many or even all available drugs.

Another classical disease with increasing drug resistance is gonorrhoea.

Davies’ 152-page report also warned of a “discovery void” with few new antibiotics developed in the past two decades.

“While a new infectious disease has been discovered nearly every year over the past 30 years, there have been very few new antibiotics developed leaving our armoury nearly empty as diseases evolve and become resistant to existing drugs,” said a press release on the report.

Meanwhile, Frieden warned about the rapid spread of CRE or the carbapenem-resistant variety of Enterobacteriaceae, a gro­up of more than 70 bacteria which dwell in the gut, including Klebsiella, Salmonella, Shigella and E. coli.

Carbapenems are powerful drugs that are used as a last resort when the bacteria have become resistant to other drugs.

The occurrence of resistance has risen four-fold in 10 years.

According to Frieden, CRE was found in 4.6% of hospitals and 17.8% of long-term care in 2012.

While resistance is building up, there have been few new antibiotics.

No new classes of antibiotics have been developed since 1987, and none is in the pipeline across the world, said Davies.

“Antimicrobial resistance is a ticking time-bomb not only for the UK but also for the world.
“We need to work with everyone to ensure the apocalyptic scenario of widespread antimicrobial resistance does not become a reality. This threat is arguably as important as climate change.”

 

GLOBAL TRENDS By MARTIN KHOR
Foot-Notes:

Superbug lurking

 No, not this “Superbug.” W’ere talking about something much more sinister!

Patients receiving long-term or complex medical care in hospitals and nursing homes are at the greatest risk for CRE infection.

The bug is spread mainly by unclean hands, but medical devices like ventilators and catheters increase the risk of infection because they allow the bacteria to get deep into a patient’s body, Frieden said. - RYOT

Overprescribing of antibiotics creates superbugs

These bugs are named and defined by their resistance to the Carbapenem class of antibiotics. Unlike previous superbugs, there are no 'last resort' antibiotics after resistance develops and these stop working.

CRE infections can lead to pneumonia, meningitis, wound infections, sepsis and a host of deadly infections.

"CRE are nightmare bacteria," said Dr. Tom Frieden, director of the U.S. Centers for Disease Control.

"Our strongest antibiotics don’t work and patients are left with potentially untreatable infections."

Resistance to antibiotics continues to be an issue worldwide, with overprescribing and overuse of broad-spectrum antibiotics being the main culprits.

In this week’s Lancet magazine, UK's chief medical officer Dame Sally Davis, said that that antibiotic resistance is "as great a threat to our future as terrorism."

That's because routine surgeries, treatments for cancer and autoimmune disease all leave patients vulnerable to superbug infections.

"If we don't take action then we may all be back in an almost 19th century environment where infections kill us as a result of routine operations. We won't be able to do a lot of our cancer treatments or organ transplants," Davis warned.

The problem is that much of the antibiotic resistance occurs in developing countries where antibiotics are readily available, resources scarce and education around resistance non-existent.

“Antibiotic stewardship has to be a global effort in order to make an impact on resistance,” said Romney, the medical microbiologist in Vancouver.

In addition, no new major antibiotics have been made since the late 1980's because antibiotics can have a short lifespan before superbugs become resistant, making them unprofitable for pharmaceutical companies when compared to the other drugs.

But there is hope. Over the last decade, recognition of antibiotic resistance has led to decreased rates of other superbug classes such as Methicillin-resistant staphylococcus aureus (MRSA) in parts of Canada. - CBS