Hospitals face new superbug threat, scientists warn

[Al-khiyal]

Hospitals face new superbug threat, scientists warn

May 7, 2008 -- Hospitals face a new superbug threat with the rise of a potentially lethal microbe that is at least as hard to treat as MRSA, scientists warned today.

There were 1,000 cases of blood poisoning caused by Stenotrophomonas maltophilia, or Steno, in the UK last year, of which around 300 were fatal, said researchers from the Wellcome Trust and Bristol University.

Some strains of Steno, which is difficult to remove by normal cleaning, are resistant to all available antibiotics. This makes them as dangerous as the current two deadliest superbugs, MRSA and Clostridium difficile.

Dr Matthew Avison, from the University of Bristol, who co-led the research team, said: "This is the latest in an ever-increasing list of antibiotic-resistant hospital superbugs. The degree of resistance it shows is very worrying. Strains are now emerging that are resistant to all available antibiotics, and so new drugs capable of combating these pan-resistant strains are currently in development."

Steno flourishes in moist environments, such as taps and shower heads. But the greatest risk to patients comes when it grows into a biofilm coating on catheters and ventilation tubes and from there enters a patient's bloodstream or lungs.

Those most at risk are weakened patients, such as people undergoing chemotherapy, adults with cystic fibrosis and older people in intensive care. Steno infections can cause blood poisoning (septicaemia) or pneumonia.

The Health Protection Agency (HPA), which monitors infectious diseases in the UK, played down the risk posed by Steno, noting that it caused less than 1% of hospital acquired infections. A spokeswoman said the bug usually only affected patients who were already "very sick" and never infected healthy people.

She added: "The infection does not spread in the manner of MRSA or C diff. There is little spread between patients, and infections are mostly caused by one-off strains. Usually if more than one person on a ward is infected it will not be by the same strain."

The most recent HPA figures show there were 773 cases of blood poisoning caused by Steno infections in 2006, a rise of 160 since 2002.

The research team mapped out a complete blueprint of Steno's genetic code sequence, or genome, which they hope will lead to the development of more effective drug treatments.

Dr Lisa Crossman, of the Wellcome Trust's Sanger Institute in Hinxton, Cambridgeshire, said knowing the bug's genome should help combat Steno's ability to stick to surfaces like catheters and ventilators, form biofilms, and fight its drug resistance.

She said: "For example, if we know which proteins cause it to stick to surfaces, we could try to develop biochemical compounds that interfere with this interaction. If we understand its antibiotic resistance mechanisms, we might be able to design inhibitors that block them."

The map of Steno's genome is published today in the Genome Biology journal.

A Department of Health spokesman said: "Clean and safe treatment in the NHS is a top priority for the government.

"Stenotrophomonas does not cause infections in healthy people, but can cause infections in patients who are seriously ill with other conditions, especially lung problems.

"NHS staff have worked extremely hard to drive down the number of hospital-acquired infections and the Healthcare Commission is now inspecting each and every acute trust against the hygiene code to ensure that all NHS organisations take appropriate precautions to protect patients."

[Al-khiyal]

Antibacterial wipes can spread superbugs: study

LONDON, June 3, 2008 (Reuters) - Disinfectant wipes routinely used in hospitals may actually spread drug-resistant bacteria rather than kill the dangerous infections, British researchers said on Tuesday.

While the wipes killed some bacteria, a study of two hospitals showed they did not get them all and could transfer the so-called superbugs to other surfaces, Gareth Williams, a microbiologist at Cardiff University, said.

The findings presented at the American Society of Microbiology's General Meeting in Boston focused on bacteria that included methicillin-resistant Staphylococcus aureus, or MRSA.

"What we have found is there is a high risk," Williams, who led the study, said by telephone. "We need to give guidance to the staff on how to use the wipes because we found there is a possibility of cross transfer."

MRSA infections can range from boils to more severe infections of the bloodstream, lungs and surgical sites. Most cases are associated with hospitals, nursing homes or other health care facilities.

The superbug can cause life-threatening and disfiguring infections and can often only be treated with expensive, intravenous antibiotics.

Experts have been saying for years that poor hospital practices spread dangerous bacteria, and yet many studies have shown that health care workers, including doctors and nurses, often fail to even wash their hands as directed.

The findings from a study of intensive care units at two Welsh hospitals suggest that even cleaning with antimicrobial wipes may not be enough depending on how staff use them.

The researchers found that many health care workers cleaned multiple surfaces near patients, such as bed rails, monitors and tables with a single wipe and risked sweeping the infections around rather than cleaning them up.

"We found that the most effective way to prevent the risk of MRSA spread in hospital wards is to ensure the wipe is used only once on one surface," Williams said.

[Cheba_Mami]

Time to make and search for new antibiotics. and invest more money it those researchlines.

[Al-khiyal]

Thinking ahead: Bacteria anticipate coming changes in their environment

June 9, 2008 -- A new study by Princeton University researchers shows for the first time that bacteria don't just react to changes in their surroundings - they anticipate and prepare for them. The findings, reported in the June 6 issue of Science, challenge the prevailing notion that only organisms with complex nervous systems have this ability.

"What we have found is the first evidence that bacteria can use sensed cues from their environment to infer future events," said Saeed Tavazoie, an associate professor of molecular biology, who conducted the study along with graduate student Ilias Tagkopoulos and postdoctoral researcher Yir-Chung Liu.

The research team, which included biologists and engineers, used lab experiments to demonstrate this phenomenon in common bacteria. They also turned to computer simulations to explain how a microbe species' internal network of genes and proteins could evolve over time to produce such complex behavior.

"The two lines of investigation came together nicely to show how simple biochemical networks can perform sophisticated computational tasks," said Tavazoie.

In addition to shedding light on deep questions in biology, the findings could have many practical implications. They could help scientists understand how bacteria mutate to develop resistance to antibiotics. They also may help in developing specialized bacteria to perform useful tasks such as cleaning up environmental contamination.

In one part of the study, the researchers studied the behavior of E. coli, the ubiquitous bacterium that travels back and forth between the environment and the gut of warm-blooded vertebrates. They wanted to explain a long-standing question about the bug: How do its genes respond to the temperature and oxygen changes that occur when the bacterium enters the gut?

The conventional answer is that it reacts to the change - after sensing it - by switching from aerobic (oxygen) to anaerobic (oxygen-less) respiration. If this were true, however, the organism would be at a disadvantage during the time it needed to make the switch. "This kind of reflexive response would not be optimal," Tavazoie said.

The researchers proposed a better strategy for the bug. During E. coli's life cycle, oxygen level is not the only thing that changes - it also experiences a sharp rise in temperature when it enters an animal's mouth. Could this sudden warmth cue the bacterium to prepare itself for the subsequent lack of oxygen?

To test this idea, the researchers exposed a population of E. coli to different temperatures and oxygen changes, and measured the gene responses in each case. The results were striking: An increase in temperature had nearly the same effect on the bacterium's genes as a decrease in oxygen level. Indeed, upon transition to a higher temperature, many of the genes essential for aerobic respiration were practically turned off.

To prove that this is not just genetic coincidence, the researchers then grew the bacteria in a biologically flipped environment where oxygen levels rose following an increase in temperature. Remarkably, within a few hundred generations the bugs partially adapted to this new regime, and no longer turned off the genes for aerobic respiration when the temperature rose.

"This reprogramming clearly indicates that shutting down aerobic respiration following a temperature increase is not essential to E. coli's survival," said Tavazoie. "On the contrary, it appears that the bacterium has "learned" this response by associating specific temperatures with specific oxygen levels over the course of its evolution."

Lacking a brain or even a primitive nervous system, how is a single-celled bacterium able to pull off this feat? While higher animals can learn new behavior within a single lifetime, bacterial learning takes place over many generations and on an evolutionary time scale, Tavazoie explained. To gain a deeper understanding of this phenomenon, his team developed a virtual microbial ecosystem, called "Evolution in Variable Environment." Each microbe in this novel computational framework is represented as a network of interacting genes and proteins. An evolving population of these virtual bugs competes for limited resources within a changing environment, mimicking the behavior of bacteria in the real world.

To implement this framework, the researchers had to deal with the sheer scale and complexity of simulating any realistic biological system. They had to keep track of hundreds of genes, proteins and other biological factors in the microbial population, and observe them as they varied over millions of time points. "Simulations at this scale and complexity would have been impossible in the past," said Tagkopoulos. Even with the vast number crunching power the supercomputers provided by the University's computational science and engineering support group, their experiments took nearly 18 months to run, said Tagkopoulos.

In this virtual world, microbes are more likely to survive if they conserve energy by mostly turning off the biological processes that allow them to eat. The challenge they face then is to anticipate the arrival of food and turn up their metabolism just in time. To help them along, the researchers gave the bugs cues before feeding them, but the cues had to appear in just the right pattern to indicate that food was on its way.

"To predict mealtimes accurately, the microbes would have to solve logic problems," said Tagkopoulos, a fifth-year graduate student in electrical engineering and the principal architect of the Evolution in Variable Environment framework.

And sure enough, after a few thousand generations, an ecologically fit strain of microbe emerged which did exactly that. This happened for every pattern of cues that the researchers tried. The feeding response of these gastronomically savvy bugs peaked just when food was offered, said Tagkopoulos.

When the researchers examined a number of fit virtual bugs, they could at first make little sense out of them. "Their biochemical networks were filled with seemingly unnecessary components," said Tagkopoulos. "That is not how an engineer would design logic-solving networks." Pared down to their essential elements, however, the networks revealed a simple and elegant structure. The researchers could now trace the different sequences of gene and protein interactions organisms used in order to respond to cues and anticipate mealtimes. "It gave us insights into how simple organisms such as bacteria can process information from the environment to anticipate future events," said Tagkopoulos.

The researchers said that their findings open up many exciting avenues of research. They are planning to use similar methods to study how bacteria exchange genes with one another (horizontal gene transfer), how tissues and organs develop (morphogenesis), how viral infections spread and other core problems in biology.

"What is really exciting about our discovery is that it brings together and establishes deep connections between the traditionally separate fields of microbial ecology, network evolution and behavior," said Tavazoie.

[Al-khiyal]

Study: Honey can kill superbugs

LONDON, England, July 1, 2009 (CNN) -- Honey has been used to treat wounds since ancient times, but recent years have seen a surge of medical interest in the sticky stuff. Manuka honey has been the subject of particular interest, with the results of a study just published by Sydney University finding that it has powerful antibacterial properties, and is even effective against antibiotic-resistant bacteria.

Associate Professor Dee Carter, from Sydney University's School of Molecular and Microbial Biosciences said: "Our research is the first to clearly show that these honey-based products could in many cases replace antibiotic creams on wounds and equipment such as catheters. Using honey as an intermediate treatment could also prolong the life of antibiotics. Most bacteria that cause infections in hospitals are resistant to at least one antibiotic, and there is an urgent need for new ways to treat and control surface infections." She added: "We don't quite know how these honeys prevent and kill infections, but a compound in them called methylglyoxal seems to interact with a number of other unknown compounds in honey to prevent infectious bacteria developing new strains that are resistant to it."

Honey is a complex substance, containing up to 800 compounds and its complexity means it has been difficult to pinpoint exactly how it kills bacteria. Manuka is a type of honey that is made by bees pollinating the flowers of the Manuka bush, a member of the Leptospermum family that grows naturally in New Zealand. Now, an Australian company is claiming to have produced the world's most potent medical-grade antibacterial honey, made by bees pollinating the Australian jellybush, also a member of the Leptospermum family. Australia's Medi Bioactive Honey Company claims its Berringa antibacterial honey has twice the antibacterial content of normal manuka honey, and has launched the product in the UK.

Dr Rose Cooper of the University of Wales Cardiff School of Health Sciences has researched honey's antibacterial action and has written a book called Honey in Modern Wound Management. Cooper told CNN that there are many components in honey that contribute to its antibacterial nature. She says its high sugar content, low water content and low pH are all factors. Additionally, some honey produces hydrogen peroxide, which can kill bacteria. Since 2004, Britain's National Health Service has licensed the use of manuka-honey wound dressings and sterilized medical grade manuka-honey creams.

[amalgamate]

simple honey? Subhanallah tabarak Allah a7san al khaliqeen!

[Al-khiyal]

New superbug resistant to antibiotics and more difficult to tackle than MRSA

August 12, 2009 -- Hospitals have been put on alert about a group of new superbugs brought into the UK by patients returning home after surgery abroad, including cosmetic treatments and organ transplants. The virulent new strains of drug resistant bacteria, which are much harder for doctors to tackle than MRSA or Clostridium difficile, have killed two people and left 18 others seriously ill in 12 months. At least 17 hospitals in England and Scotland have seen cases, prompting the Health Protection Agency to issue a warning about what it calls "a notable public health risk". The bacteria can cause wound infections, septicaemia, pneumonia and gastroenteritis and are posing real problems for the NHS because they are proving resistant to all the usual antibiotics.

This year hospitals have reported seeing the infections in at least nine UK nationals who appear to have acquired them while staying in hospitals in India and Pakistan after having "tummy tuck" surgery, liver and kidney transplants or surgery following a car crash. Previous cases have emerged in holidaymakers who picked up the bacteria while hospitalised in Greece and Turkey after a moped accident. But doctors are worried because the latest strains, known as enterobacteriaceae, produce enzymes that attack and counteract powerful antibiotics called carbapenems which the NHS relies on as its last line of defence against particularly damaging infections.

The HPA admits that tackling the threat posed by the bacteria "presents major challenges, [as most of them] are resistant to all standard intravenous antibiotics for treatment of severe infections". John McConnell, editor of the medical journal the Lancet Infectious Diseases, said: "There's the potential for this to become a substantial problem of antibiotic resistance within UK hospitals, and there's not much we can do at the moment. Compared to MRSA or C difficile or a regular pneumonia-type infection this is pretty small beer, purely in terms of the number of cases so far. But small beer is the way that things like MRSA started. These cases could be the start of what could go on to be a major cause of healthcare-acquired infections." The situation is so serious that the HPA is urging pharmaceutical companies to urgently start producing drugs that are effective against these types of bacteria. McConnell said the government should offer financial incentives. Dr David Livermore, the HPA's director of antimicrobial research, said doctors had been forced to fall back on two drugs which had previously been abandoned. However, one of them, Polymyxin is very toxic, which means doctors have to be very careful about the doses they give.

The bugs are four categories of carbapenem-destroying enzymes known as carbapenemases. The HPA's antibiotic resistance monitoring and reference laboratory (ARMRL) "urges hospitals to be vigilant to multiresistant gram-negative bacteria in patients with recent hospital contact in the Indian subcontinent as well as the eastern Mediterranean". Samples from any patients testing positive should be sent to the lab for further investigation. Israel and the U.S. are also classed as countries which have been "a repeated source of introduction to the UK", says the HPA.

Scientists at the ARMRL are alarmed by the recent emergence of the New Delhi Metallo-1 enzyme, which has been found in patients who have been operated on in New Delhi in India and Karachi in Pakistan. However, while they warn that that strain has "been repeatedly imported into the UK from the Indian subcontinent" they are also concerned that "there may now also be UK circulation since some affected patients have no immediately identifiable overseas links". In 2007 two unconnected patients at an unnamed Scottish hospital tested positive for enterobacteriaceae, prompting speculation that a local reservoir was the source of the infection. Livermore said the NDM-1 variant had proved resistant to all usual antibiotics used in severe infections. "We are getting to our last line of antibiotics. Over the past one and a half years we have seen more and more cases. There have been two fatalities [this year], but we can't say if [carbapenem resistance] was the direct cause as they were people who were very unwell." Some 77,000 Britons travelled abroad for surgery or cosmetic or dental treatment in 2006 and it is estimated 150,000 will do so this year.

What are these new infections that are starting to kill and damage people?

They are a group of new superbugs which are resistant to carbapenems, the strong and usually effective antibiotics which doctors reserve to tackle the most virulent infections. The bacteria produce enzymes called carbapenemases which break down the carbapenems.

Why are these bacteria such a problem?

Because they are incredibly difficult to combat and have been "repeatedly imported" into the UK from India, Pakistan, Greece, Turkey and elsewhere, says the Health Protection Agency. The latest NDM-1 strain resists all standard antibiotics usually deployed in the NHS.

What damage do they do to human health?

They infect people who are already vulnerable because their immune system is weakened, especially people who have recently had surgery. They cause wound infections, septicaemia, pneumonia, gastro-enteritis and even death.

Could they prove as big a threat as MRSA and Cdifficile?

They certainly could turn out to be a major new source of healthcare-associated infections, which may lead to deaths and injuries, according to John McConnell, editor of The Lancet Infectious Diseases.