FIRE-EARTH Presentation: Antibiotic Resistance [Part I]

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Parasites, Pathogens, Booming Untreatable Infections

[Prepared by FIRE-EARTH Science Team.]

• The Presentation is available from FIRE-EARTH PULSARS.
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Infectious Diseases Kill 1,448 Chinese in October: Report

EMERGING & RE-EMERGING INFECTIOUS DISEASES
DEADLY CONTAGIOUS DISEASES
SCENARIOS 993, 797, 444, 080, 011, 01
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Infectious Diseases kill 1,448 Chinese, sicken more than 608,000 in October

[Reported cases of] infectious diseases in mainland China killed  at least 1,448 people and sickened more than 609,000 people in October, Xinhua quoted the health officials as saying.

Plague, a Category A infectious disease, killed at least two people, said the report.

Infectious diseases in Category B were responsible for the bulk of the fatalities (1,421 cases reported), with Hepatitis, tuberculosis, syphilis, dengue and diarrhea being the deadliest.

Category C infectious diseases killed 25 people in October, said China’s National Health and Family Planning Commission.

National Institute of Allergy and Infectious Diseases (NIAID) classifies the Emerging Infectious Diseases in categories A, B and C as follows:

Category A pathogens are those organisms/biological agents that pose the highest risk to national security and public health because they

• Can be easily disseminated or transmitted from person to person
• Result in high mortality rates and have the potential for major public health impact
• Might cause public panic and social disruption
• Require special action for public health preparedness

Category A Priority Pathogens

• Bacillus anthracis (anthrax)
• Clostridium botulinum toxin (botulism)
• Yersinia pestis (plague)
• Variola major (smallpox) and other related pox viruses
• Francisella tularensis (tularemia)
• Viral hemorrhagic fevers
  • Arenaviruses
    • Junin, Machupo, Guanarito, Chapare (new in FY14), Lassa, Lujo (new in FY14)
  • Bunyaviruses
    • Hantaviruses causing Hanta Pulmonary syndrome, Rift Valley Fever, Crimean Congo Hemorrhagic Fever
  • Flaviruses
    • Dengue
  • Filoviruses
    • Ebola
    • Marburg

Category B pathogens are the second highest priority organisms/biological agents. They

• Are moderately easy to disseminate
• Result in moderate morbidity rates and low mortality rates
• Require specific enhancements for diagnostic capacity and enhanced disease surveillance

Category B Priority Pathogens

• Burkholderia pseudomallei (melioidosis)
• Coxiella burnetii (Q fever)
• Brucella species (brucellosis)
• Burkholderia mallei (glanders)
• Chlamydia psittaci (Psittacosis)
• Ricin toxin (Ricinus communis)
• Epsilon toxin (Clostridium perfringens)
• Staphylococcus enterotoxin B (SEB)
• Typhus fever (Rickettsia prowazekii)
• Food- and waterborne pathogens
  • Bacteria
    • Diarrheagenic E.coli
    • Pathogenic Vibrios
    • Shigella species
    • Salmonella
    • Listeria monocytogenes
    • Campylobacter jejuni
    • Yersinia enterocolitica
  • Viruses
    • Caliciviruses
    • Hepatitis A
  • Protozoa
    • Cryptosporidium parvum
    • Cyclospora cayatanensis
    • Giardia lamblia
    • Entamoeba histolytica
    • Toxoplasma gondii
    • Naegleria fowleri (new in FY14)
    • Balamuthia mandrillaris (new in FY14)
  • Fungi
    • Microsporidia
• Mosquito-borne encephalitis viruses
  • West Nile virus (WNV)
  • LaCrosse encephalitis (LACV)
  • California encephalitis
  • Venezuelan equine encephalitis (VEE)
  • Eastern equine encephalitis (EEE)
  • Western equine encephalitis (WEE)
  • Japanese encephalitis virus (JE)
  • St. Louis encephalitis virus (SLEV)

Category C pathogens are the third highest priority and include emerging pathogens that could be engineered for mass dissemination in the future because of

• Availability
• Ease of production and dissemination
• Potential for high morbidity and mortality rates and major health impact

Category C Priority Pathogens

• Nipah and Hendra viruses
• Additional hantaviruses
• Tickborne hemorrhagic fever viruses
  • Bunyaviruses
    • Severe Fever with Thrombocytopenia Syndrome virus (SFTSV), Heartland virus
  • Flaviruses
    • Omsk Hemorrhagic Fever virus, Alkhurma virus, Kyasanur Forest virus
• Tickborne encephalitis complex flaviviruses
  • Tickborne encephalitis viruses
  • European subtype
  • Far Eastern subtype
  • Siberian subtype
  • Powassan/Deer Tick virus
• Yellow fever virus
• Tuberculosis, including drug-resistant TB
• Influenza virus
• Other Rickettsias
• Rabies virus
• Prions
• Chikungunya virus
• Coccidioides spp.
• Severe acute respiratory syndrome associated coronavirus (SARS-CoV), MERS-CoV, and other highly pathogenic human coronaviruses (new in FY14)
• Antimicrobial resistance, excluding research on sexually transmitted organisms*
  • Research on mechanisms of antimicrobial resistance
  • Studies of the emergence and/or spread of antimicrobial resistance genes within pathogen populations
  • Studies of the emergence and/or spread of antimicrobial-resistant pathogens in human populations
  • Research on therapeutic approaches that target resistance mechanisms
  • Modification of existing antimicrobials to overcome emergent resistance
• Antimicrobial research, as related to engineered threats and naturally occurring drug-resistant pathogens, focused on development of broad-spectrum antimicrobials

*NIAID Category C Antimicrobial Resistance—Sexually Transmitted Organisms Excluded

• Bacterial vaginosis, Chlamydia trachomatis, cytomegalovirus, Granuloma inguinale, Hemophilus ducreyi, hepatitis B virus, hepatitis C virus, herpes simplex virus, human immunodeficiency virus, human papillomavirus, Neisseria gonorrhea, Treponema pallidum, Trichomonas vaginalis

 

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