A Global Threat Caused by Antibiotic Resistance

Antibiotic Resistance Threats in the US

Overuse of antibiotics has helped create bacteria that are outliving the drugs used to treat them: CDC

The fast-growing antibiotic resistance is an extremely dangerous problem. The antibiotic-resistant bacteria have been described as “nightmare bacteria” that “pose a catastrophic threat” to people throughout the world.

Threat Level: URGENT

From top: 1. Clostridium difficile (C. difficile) causes life-threatening diarrhea. These infections mostly occur in people who have had both recent medical care and antibiotics. Often, C. difficile infections occur in hospitalized or recently hospitalized patients.  2. Untreatable and hard-to-treat infections from carbapenem-resistant Enterobacteriaceae (CRE) bacteria are on the rise among patients in medical facilities. CRE have become resistant to all or nearly all the antibiotics we have today. Almost half of hospital patients who get bloodstream infections from CRE bacteria die from the infection.  3. Neisseria gonorrhoeae causes gonorrhea, a sexually transmitted disease that can result in discharge and inflammation at the urethra, cervix, pharynx, or rectum.

Each year in the United States, at least 2 million people become infected with bacteria that are resistant to antibiotics, and at least 23,000 people die each year as a direct result of these infections. Many more people die from other conditions that were complicated by an antibiotic-resistant infection.

In addition, almost 250,000 people who are hospitalized or require hospitalization get Clostridium difficile each year, an infection usually related to antibiotic use. C. difficile causes deadly diarrhea and kills at least 14,000 people each year. Many C. difficile infections and drug-resistant infections can be prevented.

How Bacteria Become Resistant

“When bacteria are exposed to antibiotics, they start learning how to outsmart the drugs. This process occurs in bacteria found in humans, animals, and the environment. Resistant bacteria can multiply and spread easily and quickly, causing severe infections. They can also share genetic information with other bacteria, making the other bacteria resistant as well. Each time bacteria learn to outsmart an antibiotic, treatment options are more limited, and these infections pose a greater risk to human health.” Read more…

“Antibiotic resistance is rising for many different pathogens that are threats to health,” said CDC Director. “If we don’t act now, our medicine cabinet will be empty and we won’t have the antibiotics we need to save lives.”

Urgent Threats

• Clostridium difficile
• Carbapenem-resistant Enterobacteriaceae (CRE)
• Drug-resistant Neisseria gonorrhoeae

Serious Threats

• Multidrug-resistant Acinetobacter
• Drug-resistant Campylobacter
• Fluconazole-resistant Candida (a fungus)
• Extended spectrum β-lactamase producing Enterobacteriaceae (ESBLs)
• Vancomycin-resistant Enterococcus (VRE)
• Multidrug-resistant Pseudomonas aeruginosa
• Drug-resistant Non-typhoidal Salmonella
• Drug-resistant Salmonella Typhi
• Drug-resistant Shigella
• Methicillin-resistant Staphylococcus aureus (MRSA)
• Drug-resistant Streptococcus pneumoniae
• Drug-resistant tuberculosis

Microorganisms with a threat level of SERIOUS. Antibiotic Resistance Threats in the United States 2013. Source: CDC

Concerning Threats

• Vancomycin-resistant Staphylococcus aureus (VRSA)
• Erythromycin-resistant Group A Streptococcus
• Clindamycin-resistant Group B Streptococcus

A “ticking time bomb”

The danger posed by growing resistance to antibiotics is ‘as big a risk as terrorism,’ the UK medical chief, Professor Sally Davies has warned, describing the threat as a “ticking time bomb.” See video.

Related Links

• ‘Virtually Untreatable’ Tuberculosis Poses Global Threat March 25, 2013
• Superbugs Invasion Has Begun May 19, 2012

• Super Superbug C. difficile March 23, 2010

TB and other Superbug Related Links

• TDR-TB Outbreak in India January 17, 2012
• Mysterious Outbreak of E. coli in 6 States June 9, 2012

• Legionella Outbreak in Scotland: 1 Dead, 16 Critical Posted on June 6, 2012
• States of Emergency Declared in Ontario Towns Posted on May 29, 2012
• The second reported victim of necrotizing fasciitis bacteria   Posted on May 17, 2012

• Gonorrhea: First superbug strain found Posted on July 12, 2011
• Resurgence of C. difficile in Ontario, Canada Posted on July 4, 2011
• New superbug spreading from India Posted on August 11, 2010
• Malaria parasites resist old drugs, need new ones! May 29, 2009
• Global Health Alert: New Zealand MRSA Infections Up 3,500 pct March 15, 2009
• “Flesh Eating Bacteria” Linked to NSAIDs September 19, 2009
• Sudden worldwide increase in antibiotic-resistant bacterium December 28, 2009

Suspected Meningococcal Kills in 2 Hours

DISASTER CALENDAR SYMBOLIC COUNTDOWN: 1,288 Days Left

[September 5, 2012] Mass die-offs resulting from human impact and the planetary response to the anthropogenic assault could occur by early 2016. 

• SYMBOLIC COUNTDOWN: 1,288 Days Left to the ‘Worst Day’ in Human History…

Global Disasters/ Significant Events

• Wellington, New Zealand.  Suspected meningococcal disease in New Zealand killed a Wellington schoolgirl two hours after ‘plague-like’ rashes appeared on her body. Amanda Crook, aged 12, became ill on Monday. She developed a rash at 3:00pm and was pronounced dead by 5:00 pm, just two hours later, despite being vaccinated, reports said.
  • ”. . . the aftermath of what it did to her – that wasn’t my daughter. It was almost like she had been attacked by the plague, that’s how horrific it was,” her mother told media.
  • “You’d think there would be warning, but there was just nothing. Even once she got to hospital and got antibiotics, she was talking. We thought she was coming right. [Suddenly] her heart, I think, just gave in.”
  • “It’s like it just selects its victims. I feel like we are dealing with the grim reaper,” said her mother.
  • “She was immunised, that’s what I don’t understand. But they don’t always work and to me that’s not fair. I just keep thinking I’m going to wake up. I feel like someone is going to shake me awake.”

Amanda Crook-Barker, 12, died in under two hours after showing symptoms of  suspected meningococcal disease, despite being vaccinated. Photo: Supplied by victim’s family, via local media. 

Meningococcal disease is a severe bacterial infection of the bloodstream or meninges (a thin lining covering the brain and spinal cord) caused by the meningococcus bacteria.

The disease has a fatality rate of about 10 percent, if identified and treated immediately. The survivors,  however, can expect permanent damage including brain injury and limb amputation.

‘Five confirmed cases of meningococcal disease have been reported across the Auckland region in the past week,’ said a report.

Dr Jeannette Adu-Bobie, an expert on meningococcal vaccines, contracted meningitis while working in NZ govt. Wellington lab. and had both legs, left arm and the digits of her right hand amputated. Source: Apartheid Fort New Zealand

Continued…

Related Links

• Post-antibiotic era emerging
• Was Dr Adu-Bobie a Victim of Biological Weapons Experiments?

Global Disasters: Links, Forecasts and Background

• The First Wave of World’s Collapsing Cities
• Back to the Primordial Future
• The Fate of Energy Dinosaurs
• Mass Die-offs

• 2010 Disasters [Links to 2010 Disaster Calendar]
• Mega Disasters
• 2011 Disaster Calendar
• 2012 Disaster Calendar

GLOBAL WARNING

• WARNING: Human impact 2.85 x Earth’s diminishing carrying capacity
• WARNING: RAPID DECLINE IN PROGRESS!

Superbugs Invasion Has Begun

Post-antibiotic era emerging

A wide range of infectious bacteria are evolving, which even the most potent medicines cannot treat.

The Super Superbug C. difficile

The deadliest superbug is the antibiotic-resistant bacterium, Clostridium difficile, which a new super superbug on the rise, killing three times as many people as MRSA.

C. difficile infections have increased since 2007, according to a report.

“During a 24-month period, there were 847 cases of C. difficile infections in the 28 hospitals and the rate of C. difficile infection was 25 percent higher than the rate of infection due to MRSA.”

Latest figures from the Health Protection Agency show there were 55,681 cases of Clostridium difficile infection reported in patients aged 65 years and above in England in 2006. (Source: SIMeL Italy)

The bacteria are naturally present in the intestine but kept under control by other bacteria. Antibiotics can kill some of these, allowing C.difficile to take hold. Image source and other images. Click image to enlarge.

Related Links:

• Quarterly UK Clostridium difficile and MRSA figures
• Education on MRSA, C-Difficile, Latest news and infection related articles
• Infection Prevention and Control (IPAC)

• “Flesh Eating Bacteria” Linked to NSAIDs
• Should We Be Afraid of MRSA?
• MRSA: ACT II
• NZ Sees Surge in Flesh-Eating Disease Cases

Staphylococcus Aureus

The best known SUPERBUG is the methicillin-resistant Staphylococcus aureus, MRSA. About 2 percent of the population in the U.S.  carry an antibiotic-resistant strain of staph, the National Institutes of Health has reported.

MRSA was discovered in the United Kingdom in 1961, but it is now a global concern. MRSA (also known as CA-MRSA, community-acquired MRSA, and HA-MRSA, hospital-acquired MRSA) is a variation of a common bacterium, which has evolved as a “superbug” with the ability to resist treatment with antibiotics, including methicillin and penicillin.

According to Centers for Disease Control and Prevention (CDC), MRSA is responsible for 94,000 serious infections and nearly 19,000 deaths each year in the United States. [In comparison, the AIDS virus killed about 12,500 Americans  in 2005. ]

Necrotizing fasciitis

Necrotizing fasciitis is a complication of severe group A streptococcal infection (GAS) (Streptococci pyogenes), which could lead to additional complications resulting in shock, organ failure and death.

CDC has estimated that necrotizing fasciitis causes about 15,000 infections each year in the United States, resulting in up to 3,000 deaths. UNFORTUNATELY,  “intensive surveillance efforts for necrotizing fasciitis in the United States have not been conducted since 1991,” according to the Department of Health Services.

“It usually begins with a cut or maybe a major surgery or just some trauma we experience in our everyday life,” according to a doctor.

“Necrotizing fasciitis can spread through touch contact from person to person or if you touch something that is contaminated,” said the doctor, adding that up to 50% of people “have no known entrance point.” That is  the victim does not need an open sore to acquire the deadly bacteria.

NEW NT-MRSA Strains

The Emerging Infectious Diseases of U.S. Centers for Disease Control and Prevention discovered a new strain of methicillin-resistant Staphylococcus aureus (MRSA), which is responsible to more than 20 percent of all human MRSA infections in the Netherlands.

“Persons working or living in close contact with pigs or cows are at increased risk of becoming colonized and infected with MRSA. Infections can be severe, as is indicated by the hospital admission rate.”

According to other research MRSA was also prevalent in Canadian pigs and pig farmers. Full report

H041

H041 is a superbug strain of gonorrhea which was discovered by a Swedish researcher, Magnus Unemo, who received the samples from his colleagues in Kyoto, Japan.

The strain is said to be extremely resistant to all cephalosporin-class antibiotics—the only antibiotics still effective in treating gonorrhea.

He described the discovery as “alarming” and “predictable.”

“Since antibiotics became the standard treatment for gonorrhea in the 1940s, this bacterium has shown a remarkable capacity to develop resistance mechanisms to all drugs introduced to control it,” he said.

The fact that the new strain had been found in Japan also follows an alarming pattern, he told reporters.

“Japan has historically been the place for the first emergence and subsequent global spread of different types of resistance in gonorrhea [more than 600,000 new cases recorded annually,]” he said.

In the past few years trends of gonorrhea drug resistance have emerged in Australia, China, Hong Kong and other Asian countries.

The H041 “first emerged in Japan in 1999 and began spreading around the globe from there, arriving in California in 2008 and moving across to the East Coast by last year.”

Gonorrhea

Gonorrhea is a common sexually-transmitted disease (STD), caused by the bacteria Neisseria gonorrhoeae.

An electron micrograph of gonorrhea bacteria. Image courtesy http://women.webmd.com/slideshow-pelvic-pain-causes

Related Links

• Antibiotic-Resistant Gonorrhea (ARG)
• NZ women are world’s most promiscuous

Other Superbugs on the Move

Tuberculosis (TB). The once cured by antibiotics, about 5 percent of the reported cases of TB [12 million cases reported in 2010, including 1.4 million fatalities] have become multidrug resistant, according to WHO.

The Food-borne Bugs: Escherichia Coli (E. coli) and Salmonella

“During the past decade, the emergence of drug-resistant E. coli has dramatically increased. As a consequence, the management of [urinary tract infections] UTIs, which was previously straightforward, has become more complicated; the risks for treatment failure are higher, and the cost of UTI  treatment is increasing,” said a report.

Hospital-borne pathogens: ESKAPE

The six hospital-bourne bacteria, Enterococcus, Staphylococcus, Klebsiella, Acinetobacter, Pseudomonas and Enterobacter, are escaping antibiotics.

These pathogens are associated with vulnerable patients which acquire the infections from hospital equipment and surgical implants.

Global Disasters: Links, Forecasts and Background

• The First Wave of World’s Collapsing Cities
• Back to the Primordial Future
• The Fate of Energy Dinosaurs
• Mass Die-offs

• 2010 Disasters [Links to 2010 Disaster Calendar]
• Mega Disasters
• 2011 Disaster Calendar
• 2012 Disaster Calendar

Gonorrhea: First superbug strain found

“Superbug” strain of gonorrhea has been discovered by Sweden – Japan researchers

The strain is said to be resistant to all the common antibiotics

The superbug strain was discovered by a Swedish scientist Magnus Unemo, who received the samples from his colleagues in Kyoto, Japan.

The strain is said to be extremely resistant to all cephalosporin-class antibiotics—the only antibiotics still effective in treating gonorrhea.

He described the discovery as “alarming” and “predictable.”

“Since antibiotics became the standard treatment for gonorrhea in the 1940s, this bacterium has shown a remarkable capacity to develop resistance mechanisms to all drugs introduced to control it,” he said.

The fact that the new strain had been found in Japan also follows an alarming pattern, he told reporters.

“Japan has historically been the place for the first emergence and subsequent global spread of different types of resistance in gonorrhea,” he said.

In the past few years trends of gonorrhea drug resistance have emerged in Australia, China, Hong Kong and other Asian countries.

Gonorrhea

Gonorrhea is a common sexually-transmitted disease (STD), caused by the bacteria Neisseria gonorrhoeae.

An electron micrograph of gonorrhea bacteria. Image courtesy http://women.webmd.com/slideshow-pelvic-pain-causes

The infection is readily transmitted when an infected person has ANY type of sex. The infection is spread by contact with the mouth, vagina, penis, or anus.

This was a newborn with gonococcal ophthalmia neonatorum caused by a maternally transmitted gonococcal infection.Unless preventative measures are taken, it is estimated that gonococcal ophthalmia neonatorum will develop in 28% of infants born to women with gonorrhea. It affects the corneal epithelium causing microbial keratitis, ulceration and perforation. Source: CDC/J. Pledger. Click image to enlarge

The lesion on this patient’s left hand was due to the systemic dissemination of the Neisseria gonorrhoeae bacteria. Though sexually transmitted, and involving the urogenital tract initially, a Neisseria gonorrhoeae bacterial infection can become disseminated systemically, manifesting itself as a cutaneous erythematous lesion anywhere on the body. Source: CDC/Dr. S. E. Thompson, VDCD./J. Pledger

Gonorrhea—Rates, United States, 1941–2009

Reported Gonorrhea rates in the United States, 1941–2009. Source: CDC 

Gonorrhea—Rates by State, United States and Outlying Areas, 2009

The total rate of gonorrhea for the United States and outlying areas (Guam, Puerto Rico, and Virgin Islands) was 97.8 per 100,000 population. Source: CDC

What is gonorrhea?

[Sourced from CDC] Gonorrhea is a sexually transmitted disease (STD). Gonorrhea is caused by Neisseria gonorrhoeae, a bacterium that can grow and multiply easily in the warm, moist areas of the reproductive tract, including the cervix (opening to the womb), uterus (womb), and fallopian tubes (egg canals) in women, and in the urethra (urine canal) in women and men. The bacterium can also grow in the mouth, throat, eyes, and anus.

Why Treat the Gonorrhea?

Gonorrhea can spread to the blood or joints. This condition can be life threatening. In addition, people with gonorrhea can more easily contract HIV, the virus that causes AIDS. HIV-infected people with gonorrhea can transmit HIV more easily to someone else than if they did not have gonorrhea.

Gonorrhea can affect the anus, eyes, mouth, genitals, or throat.

In men, gonorrhea can cause epididymitis, a painful condition of the ducts attached to the testicles that may lead to infertility if left untreated.

In women, Pelvic Inflammatory Disease (PID) can lead to serious consequences including infertility.

PID occurs when certain bacteria, such as chlamydia or gonorrhea, move upward from a woman’s vagina or cervix (opening to the uterus) into her reproductive organs.

About 750,000 women each year in the United States develop PID.

What Next?

• A major challenge to monitoring emerging antimicrobial resistance of N. gonorrhoeae is the substantial decline in capability of laboratories to perform essential gonorrhea culture techniques required for antibiotic susceptibility testing. This decline results from an increased use of newer non-culture-based laboratory technology, such as a diagnostic test called the Nucleic Acid Amplification Test (NAAT). Currently, there is no reliable technology that allows for antibiotic susceptibility testing from non-culture specimens. Increased laboratory culture capacity is needed. ~CDC

Global Scope

About 340 million new cases of STD including syphilis, gonorrhea, chlamydia and trichomoniasis are reported each year among the 15 to 49 age group, World Health Organization estimates.

Related Links

• Antibiotic-Resistant Gonorrhea (ARG)
• NZ women are world’s most promiscuous

Trick or Treat-ment Concern

Trick designed to warrant more Internet censorship, or genuine concern about misuse of antibiotics

The “Twitter-Antibiotics Misuse” report comes amid  findings by Britain’s health authorities linking the spread of syphilis to Facebook.  See Facebook, Security and Syphilis.

The question now is whether the following is a genuine concern about the proper use of antibiotics or a new ploy designed to warrant more Internet censorship and additional control over the dissemination of information.

NOTES:
1. The report is co-authored with a commercial organization: MixedInk (New York, NY)
2. Antibiotics are prescription drugs; they are NOT available as over-the-counter medicine in  most parts of the world.
3. In this public release only Twitter is mentioned by name.

Public information release by Elsevier Health Sciences

Misinformation about antibiotics can travel to large audience via Twitter: study

Washington, March 30, 2010 – Misunderstandings about proper use of antibiotics have the potential to spread widely through social networks such as Twitter, according to a report in the April issue of AJIC: American Journal of Infection Control, the official publication of the Association for Professionals in Infection Control and Epidemiology, Inc. (APIC). Researchers from Columbia University and MixedInk (New York, NY) studied the health information content of Twitter updates mentioning antibiotics to determine how people are sharing information and assess the proliferation of misinformation. The investigation explored evidence of misunderstanding or misuse of antibiotics.

“Research focusing on microblogs and social networking services is still at an early stage,” Daniel Scanfeld, MS, MA, and colleagues state in the article. “Further study is needed to assess how to promote healthy behaviors and to collect and disseminate trustworthy information using these tools.” The authors stress that because health information is shared extensively on such networks, it is important for health care professionals to have a basic familiarity with social networking media services, such as Twitter. They add that such services can potentially be used to gather important real-time health data and may provide a venue to identify potential misuse or misunderstanding of antibiotics, promote positive behavior change, and disseminate valid information.

Using content analysis of 52,153 Twitter status updates (“tweets”) mentioning antibiotics between March 13, 2009, and July 31, 2009, researchers categorized each tweet into one of 11 groups: general use, advice/information, side effects/negative reactions, diagnosis, resistance, misunderstanding and/or misuse, positive reactions, animals, wanting/needing, cost and other.

Once categories were established, 1,000 status updates were selected randomly from the complete list of 52,153 tweets and analyzed. The full list of tweets was further explored for cases of misunderstanding or abuse with a search for the following combinations: “flu + antibiotic(s),” “cold + antibiotic(s),” “leftover + antibiotic(s),” “share + antibiotic(s),” and “extra + antibiotic(s)”.

The most common category was “general use,” including a range of updates about taking antibiotics, often simply mentioning the number of days remaining on a prescription and a desire that the antibiotics begin helping soon. The second most common category was “advice and information.” Some updates included the transfer of personal advice or information, such as “get antibiotics if its [sic] serious” or “Garlic generally good, but not specific to strep…” The third most prevalent category was “side effects/ negative reactions,” which included a variety of complaints and side effects from taking the medication. Examples of side effects ranged from the general, such as, “those antibiotics made me want to die,” to the more specific, “I am on antibiotics that make me want to vomit.” Negative reactions generally revolved around inconveniences, such as not being able to drink alcohol or sensitivity to the sun.

The authors also found that while the category of “misunderstanding and/or misuse” only comprised about 700 of the more than 52,000 tweets, such misunderstandings could easily spread to a large audience due to the nature of information flow through the Twitter network. The most popular word combination in this category was “flu + antibiotics,” with 345 status updates including misinformation reaching a total of 172,571 followers. The next most popular word combination was “cold + antibiotics,” with 302 status updates reaching a total of 850,375 followers.

“As people change how they interact, going from passive consumption to active creation of content on the Internet, social networks have become increasingly important sources of information,” said Cathryn Murphy, RN, PhD, CIC, APIC 2010 president. “These findings are a reminder that we need to continue to monitor networks such as Twitter and explore ways to positively impact public health using social networks.”

Related Links:

• ‘Google Civilization’ Collapsing from Disinformation