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A study published today in MiBio lends further weight to the growing theory that using animal antibiotics in livestock contributes to drug resistance among human bacteria.
Methicillin-resistant Staphylococcus aureus, or MRSA, is a strain of Staph that's resistant to methicillin - the drug most commonly used to treat Staph infections.
Using a detailed DNA mapping technique, researchers at the Translational Genomics Research Institute (TGen) in Arizona were able to trace one of these superbugs - MRSA CC398 - to its origins, discovering that the human strain of this bacteria developed its drug resistance in animals rather than in people.
Often referred to as "pig-MRSA" or "livestock-associated MRSA," the strain is known to affect humans who have been exposed to live animals, such as farmers or veterinarians. But this study found that CC398 was originally a human bacteria, susceptible to antibiotics, before it spread to animals and then back to people. By the time it returned to humans it had picked up two souvenirs: resistance to methicillin and resistance to tetracycline - a drug often used to treat Staph infections in patients allergic to the penicillin class of antibiotics, which includes methicillin.
Because both tetracycline and penicillins are commonly administered to food animals, the study finds that it is likely that the use of these drugs in livestock gave this Staph bacteria the exposure it needed to develop resistance to these drugs.
In 2010, Tetracycline - used to promote growth and prevent the spread of disease - comprised over 42 percent of all antibiotics administered to food-producing animals in the United States. That year 12,328,520 pounds of the drug were given to animals, while just over 100,000 pounds of the drug are sold for human use. And while over 1.9 million pounds of penicillin were sold for animal use in 2010, approximately 1.5 million pounds are distributed for human use.
Both of these drugs are crucial for treating human Staph infections, says Dr. Lance Price, lead author of the study and Director of TGen's Center for Food Microbiology and Environmental Health.
"Methacyline's a really good antibiotic for treating these kinds of infections," he told Food Safety News in an interview. "But a substantial portion of the population is allergic to penicillin and they need alternative drugs like tetracycline. But 69% of the staph we see is resistant to tetracycline."
Price says that animal feeding operation provide the perfect setting for the growth of antibiotic-resistant bacteria. According to the Centers for Disease Control and Prevention, MRSA is easily transmitted in settings where factors it calls the "5 Cs" are present: crowding, frequent skin-to-skin contact, compromised skin (cuts or abrasions), contamination or lack of cleanliness.
"A CAFO (Concentrated Animal Feeding Operation) is the place where these 5 Cs are most prevalent," says Price. "And the single worst thing you could do is add antibiotics to that environment. It's the cocktail for creating superbugs."
Once these superbugs are created, there's no telling where they can go, Price says. While most cases of CC398 come from direct contact with livestock, some human cases cannot be traced to live animals, raising the question of where they came from. Other humans? Contaminated meat?
Several studies have shown MRSA to be prevalent on our meat and poultry. A study published in the Journal of Food Protection in October of last year found Staph bacteria in 29 percent of grocery store ground meats. And a study led by Price released earlier that year discovered Staph on almost one half of grocery store meats and poultry after putting samples in a bacteria enrichment broth to make Staph more detectable. Half of these contaminated meats were carrying a multi-drug resistant strain of Staph.
Price says the transmission of MRSA from meat to humans is an area that needs more research.
"There is definitely drug-resistant Staph in our food supply and probably in high concentrations. We still don't know whether it's a good route of exposure for people," he explains. "I think that's something we've really got to dedicate some research to."
For now though, Price says the upshot of his research is that antibiotics should be saved for treatment, not growth or prevention.
"We should be using antibiotics prudently, both in human antibiotics and animal production," he notes. "We should only be using them to treat infections - and it should be a last resort - because we're heading towards a time when our antibiotics won't work anymore, and we have to do everything we can to preserve the ones we have."
Timebomb of 'impossible to treat' diseases in UK as experts see a rise in antibiotic-resistant infections
Country could see 'massive' rise of drug-resistant bacteria
- Antibiotic-resistance medicine's equivalent of climate change
By Kerry Mcqueeney
A rise in antibiotic-resistant blood poisoning - caused by the E.coli bacteria - is posing such a huge risk that experts fear the country could be facing a timebomb of diseases that are impossible to treat.
The growth of antibiotic-resistance has become so serious that experts now say it is as much of a threat to global health as the emergence of new diseases such as Aids and pandemic flu.
It is now such a cause for concern that health professionals believe the issue has become the medicine world's equivalent to climate change, it has been reported.
On the rise: The E.coli bacteria is thought to be behind the massive increase in antibiotic-resistant blood poisoning
According to the Independent, Professor Peter Hawkey said common infections are threatening to turn into untreatable diseases by the 'slow but insidious growth' of resistant organisms.
The clinical microbiologist, and chair of the Government's antibiotic-resistance working group, told the Independent: 'It is a worldwide issue - there are no boundaries.
Antibiotics are no more effective in treating sinus infections than over-the-counter drugs, says study
Last updated at 12:51 PM on 16th February 2012
A new study will only add to the misery of millions suffering painful symptoms of sinus infection: antibiotics do little to alleviate the problem.
The study, published in the latest version of the Journal of the American Medical Association, adds weight to the long-held belief that GPs' willingness to prescribe antibiotics increased infections' resistance to drugs.
Researchers studied 166 patients suffering sinus infection and gave them all a week's supply of over-the-counter medication.
Bad news for sufferers: A study has found that a course of antibiotics does little to alleviate the painful symptoms of sinus infections
Half of the patients were also given a 10-day course of the antibiotic amoxicillin, while the other half were given a placebo.
The researchers checked whether symptoms - facial pain, cough, runny or blocked nose - showed any significant improvement between the two groups.
Patients were checked at predetermined intervals over four weeks.
Over-prescription: The study backs up the long-held belief that GPs are reducing the effectiveness of antibiotics by prescribing them for all kinds of ailments
The results of the study show that - a week into the study - there was a marginal change for the better in the antibiotic group.
But researchers ruled that there was little noticeable relief in symptoms - certainly not enough for antibiotics to be ruled any more effective than over-the-counter medicine.
It is an important result, as the research leaders say one in five antibiotic prescriptions in the U.S. are for sinus infections.
Sinus infection: Inflammation of the airways can lead to headache, facial pain, a cough and blocked nose
Study author Dr Jane Garbutt, a research associate professor of medicine and pediatrics at Washington University School of Medicine in St. Louis, told WebMD: 'I think the data are something like 90 per cent of people that go to a doctor's office and receive this diagnosis will be given an antibiotic prescription.'
'I think that we should try and significantly reduce that percentage.'.
But doctors believe it would be too hasty to write off antibiotics, pointing to the fact that Dr Garbutt's study only focussed on amoxicillin, to which infections have a high resistance.
New York ear, nose and throat specialist Dr Linda Dahl said antibiotics such as Augmentin, Levaquin, and Biaxin could still be effective.
Her advice to patients suffering from sinus infection was to stick it out with over-the-counter decongestants for a week or two, adding: 'If you've been sick for two weeks and have been taking decongestants, it's probably not going to get better on its own.'
Natural substances excellent choices to combat ‘superbugs’
Orem Holistic Health Examiner
The U.S. Centers for disease control considers the growing problem of antimicrobial resistance a major public health crisis and the Utah Department of Health has called the problem a significant threat to the citizens of Utah.
A number of factors are contributing to this mounting problem including the use of antibacterial hand soaps, the unnecessary prescribing of antibiotics for viral infections and the overuse of antibiotics in livestock to encourage faster growth.
By many accounts, the war between drugs and bacteria is being won by the bacteria. Bacteria adapt and grow stronger until some are resistant to most, if not all, available antibiotics. These formidable pathogens are frequently referred to as “superbugs.”
Fortunately, many natural antimicrobial substances exist that bacteria are not becoming resistant to. The difference between antibiotic drugs and natural antimicrobial agents is that the natural agents have hundreds – even thousands – of chemicals that the bacteria have to become resistant to. If the bacteria adapts to one chemical, another steps in its place to fight the bacteria.
In the February 6, 2012edition of the Journal of Antimicrobial Chemotherapy, Danish researcher Jes Gitz Holler, Ph.D. discovered just such a natural substance in the Chilean avocado plant.
Specifically, the University of Copenhagen researcher found that this natural substance was effective against yellow staphylococci, or Staphylococcus aureus,when combined with tradiational antibiotic treatment.
Yellow staphylococci is the most common cause of wound infections that results from an operation. Skin infection is the most common outcome of a staphylococci infection, though if it enters the bloodstream or bones serious diseases may occur, such as pneumonia, endocarditis – a serious infection of one of the four heart valves – and osteomylitis – infection of the bones.
Resistant bacteria are able to expel antibiotics before the antibiotics can take effect through an efflux pump. Holler explains that the substance he identified inhibits this defense mechanism and allows the antibiotic to successfully destroy the bacteria.
Another group of natural substances known to exert potent antimicrobial effects is essential oils. In a 2001 study, published in the same journal, scientists tested the vapors of 14 essential oils against five common drug-resistant pathogens.
Of the fourteen essential oils tested, each showed antimicrobial activity, with cinnamon bark, lemongrass and thyme showing the greatest affect at the lowest dosage.
According to materials provided by the University of Copenhagen Holler states, "the drug industry is not pursuing research into new antibiotics. It is simply too expensive relative to possible earnings, and there is more money in drugs to treat chronic diseases such as diabetes. Therefore, the bacteria are winning the race -- resistance increases and treatment options are scarce. Research will have to find new paths and natural substances are one of them."
As drug manufacturers abandon antibiotic research for more lucrative drug markets, natural antimicrobial compounds will become more vital in the war on bacteria.
Many bacteria are growing more resistant to antibiotic drugs.
Hepatitis C Now Kills More Americans Than HIV
February 20, 2012
By Steven Reinberg
HealthDay Reporter
MONDAY, Feb. 20 (HealthDay News) — Deaths from hepatitis C have increased steadily in the United States in recent years, in part because many people don’t know they have disease, a new government report says.
More Americans now die of hepatitis C than from HIV, the AIDS-causing virus, according to 1999-2007 data reviewed by the U.S. Centers for Disease Control and Prevention (CDC). And most of those dying are middle-aged.
“These data underscore the urgent need to address the health threat posed by chronic hepatitis B and C in the United States,” said investigator Dr. Scott Holmberg, chief of the Epidemiology and Surveillance Branch in CDC’s Division of Viral Hepatitis.
About 3.2 million Americans are infected with hepatitis C, a major cause of liver cancer and cirrhosis, the CDC authors said. An estimated one-half to three-quarters of infected adults are unaware they have the disease, which progresses slowly.
Hepatitis C is spread through injection drug use, from blood transfusions received before routine blood-screening began in 1992, and through sexual contact. In some cases, it passes from mothers to infants.
“Chronic hepatitis is a leading and preventable cause of premature death in the United States,” Holmberg said. “Over time, leaving viral hepatitis untreated can lead to costly care and treatments, and lifetime costs can total hundreds of thousands of dollars. However, early detection and intervention can be cost-effective and save lives.”
The new study highlights the need to increase hepatitis awareness and the critical importance of testing, Holmberg said. Screening will increase diagnoses and treatment, thereby reducing hepatitis-related deaths, he said.
The report is published in the Feb. 21 issue of the Annals of Internal Medicine.
Using death records from 1999 to 2007, researchers collected data on some 22 million Americans, looking for those who died from hepatitis B, C and HIV.
The investigators found deaths from hepatitis C surpassed deaths from HIV (15,000 from hepatitis C versus 13,000 from HIV). They also found that deaths from hepatitis C and B are mostly among the middle-aged.
“Seventy-three percent of hepatitis C deaths were reported among those 45 to 64 years old,” Holmberg said. “As the population living with hepatitis C in the United States — 66 percent of whom were born between 1945 and 1964 — has aged and entered a high-risk period of life for hepatitis C-related disease, deaths associated with hepatitis C have increased substantially.”
Vaccines exist for hepatitis B, but not for hepatitis C. If current trends continue, by 2030 deaths from hepatitis C are expected to reach 35,000 a year, researchers say.
According to Dr. Eugene Schiff, director of the Center for Liver Diseases at the University of Miami Miller School of Medicine, “the study is important because it documents and authenticates what we knew.” But, “what we need right now, particularly for hepatitis C, is routine screening,” noted Schiff, who was not involved with the study.
Dramatic changes are under way in the treatment of hepatitis C, he pointed out. Current treatment involves a cocktail of drugs, including antivirals and interferon, which many people cannot tolerate.
In about two years, interferon-free treatment will be available, Schiff said. This means higher cure rates with fewer side effects, which will make treatment tolerable by most patients, he explained.
“What’s going to happen is what happened with HIV — test and treat,” Schiff said. “Patients will be given an interferon-free regimen with cure rates approaching 100 percent,” he predicted.
Another study in the same journal issue found that the most up-to-date treatment for hepatitis C can cost $60,000, but may be cost-effective, according to Stanford University health policy researchers.
In a study led by Jeremy Goldhaber-Fiebert, an assistant professor of medicine at the School of Medicine, investigators developed a computer model to assess the cost-effectiveness of a new treatment for hepatitis C. Their model showed that for people with advanced disease the cost was justified in terms of results.
The treatment involves use of two drugs called protease inhibitors — boceprevir (brand name Victrelis) and telaprevir (brand name Incivek) — in addition to interferon and an antiviral.
While the new treatment is expensive and may cause side effects, it could reduce patients’ risks for cancer and liver transplants, thereby avoiding those costly events and possibly helping patients live longer, better lives, the researchers pointed out in a journal news release.
Yet another study in the journal recommends one-time screening of all those born between 1945 and 1965, instead of waiting until symptoms appear.
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