Tag Archives: antimicrobial

A team of researchers from the European Antimicrobial Resistance Surveillance Network (EARS-Net) estimates that over 33,000 people die each year from antibiotic-resistant infections in Europe. They noted that the increasing burden of these infections is similar to that of tuberculosis, HIV, and influenza combined.

The study published in The Lancet Infectious Diseases looked into the incidence of five types of infections caused by antibiotic-resistant bacteria in 31 European Union/European Economic Activity (EU/EEA) countries and calculated the impact using the number of cases, attributable deaths, and overall health burden. This study is the first to estimate the burden of all types of infections with antibiotic-resistant bacteria and express it in DALYs.

The authors say the findings clearly show the health impact of antibiotic resistance in Europe and emphasizes the need for collaboration and coordination of EU/EEA countries to address the increasing public health problem of antibiotic resistance.

The study focused on eight species of bacteria frequently isolated from blood or cerebrospinal fluid (CSF) using EARS-Net data collected from 2015 from each of the 31 EU/EEA countries. The five types of infections were bloodstream infections (BSIs), urinary tract infections (UTIs), respiratory tract infections (RTIs), surgical site infections (SSIs), and other infections. The pathogens studied were colistin-resistant, carbapenem-resistant, or third-generation cephalosporin-resistant Escherichia coli and Klebsiella pneumoniae, methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant Enterococcus faecalis and Enterococcus faecium.

Here are some of the 10 most dangerous antibiotic-resistant pathogens globally

 

The annual number of cases and incidence rate, the number of attributable deaths and attributable mortality rate, and the number and rate of disability-adjusted life-years (DALYs) were calculated using computational models. DALYs are particularly important because it gives an indication of the overall burden of disease. The researchers estimated that 671,689 infections were caused by the selected antibiotic-resistant bacteria in the EU/EEA countries in 2015, with 33,110 attributable deaths and 874,541 total DALYs. These corresponded to an incidence rate of 131 infections per 100,000 population, an attributable mortality rate of 6.44 deaths per 100,000 population, and 170 DALYs per 100,000 population. As a comparison, tuberculosis, HIV, and influenza altogether account for 183 DALYs per 100,000 population. As expected, the burden of antibiotic-resistant infections was highest among children under the age of 1 and adults over the age of 65.

Four drug-resistant bacteria had the largest impact, accounting for 67.9% of the DALYs per 100,000 population. This includes third-generation cephalosporin-resistant E coli, MRSA, carbapenem-resistant Pseudomonas aeruginosa, and third-generation cephalosporin-resistant K pneumoniae. Almost two-thirds of the infections (426,277, 63.5%) were associated with healthcare and accounted for 72.4% of attributable deaths and 74.9% of DALYs. The study also showed that the burden of antibiotic-resistant bacteria is focused on countries in southern and eastern Europe, where antibiotic consumption tends to be higher. Italy and Greece were the most affected countries, accounting for a combined 21.3% of total DALYs. When the team applied the same method to EARS-Net data from 2007, they found that the number of deaths attributable to antibiotic-resistant bacteria had more than doubled, from 11,144 in 2007 to 27,249 in 2015.

The US Centers for Disease Control and Prevention (CDC) published a report in 2013 that used 2011 surveillance to provide estimates of the burden of antibiotic resistance in the United States. That report showed that antibiotic-resistant infections affected over 2 million people a year, with 23,000 attributable deaths. The current EARS-Net incidence of antibiotic-resistant infections is 2.6 times higher than the CDC study with the attributable mortality 1.22 times higher.

A related commentary by Dr. Evelina Tacconelli and Dr. Maria Pezzani of the University of Verona strongly emphasized the urgent need for greater political commitment and dedicated resources for combating drug-resistant infections. They suggested approaches including a definition of a Europe-wide standard for antibiotic usage in hospitals and the community. They also proposed the establishment of a rate of resistance for specific antibiotics whereby countries would have to take urgent action, the creation of a minimum gold standard for infection control measures, and identification of annual targets for each country’s national antimicrobial resistance plans.

Breastmilk protects infants from antibiotic-resistant bacteria and improves preemies’ brain development

Via Pixabay/badarsk

A new study from the University of Helsinki showed that babies breastfed for at least six months have less antibiotic-resistant bacteria in their gut compared with infants breastfed for a shorter period of time. Moreover, the study showed that antibiotics used by mothers increased the number of antibiotic-resistant bacteria in infants.

Schematic by MeMed.

Schematic by MeMed.

Bacteria resistant to antibiotics are everywhere — including the human gut, regardless of whether a person has taken antibiotics or not. Antibiotic resistance (or antimicrobial resistance, a.k.a. AMR) is one of the main global threats to public health. Being colonized by opportunistic pathogens carrying antibiotic resistance genes (ARGs) increases the risk of acquiring infections that are difficult to treat. Worldwide, an estimated 214,000 neonatal deaths each year are due to septic infections caused by antibiotic-resistant pathogens. Bacteria resistant to antibiotics are transmitted between individuals similar to how bacteria, viruses and other pathogens are: through direct contact or through food.

In this recently completed study, the researchers investigated the amount and quality of bacteria resistant to antibiotics in breast milk and the gut of mother-infant pairs, resulting in three important findings.

  1. Infants who were breastfed for at least six months had a smaller number of resistant bacteria in their gut than babies who were breastfed for a shorter period or not at all. This shows that breastfeeding seems to be able to protect infants from such bacteria.
  2. Antibiotic treatment of mothers during delivery increased the amount of antibiotic-resistant bacteria in the gut of infants. The effect was still noted even six months post-delivery and post-treatment.
  3. Breast milk also contains bacteria that are resistant to antibiotics and the mother is likely to pass these bacteria on to the child through milk. However, breastfeeding reduced the number of resistant bacteria in the infant gut — an indication of the benefits of breastfeeding for infants.

— 8 months —
The baby now weighs about 4 3/4 pounds. His layers of fat are filling him out, making him rounder, and his lungs are well developed.

Another study by investigators at the University of Edinburgh reported that babies born before their due date (premature infants, also known as preemies) show better brain development when fed breast milk rather than formula. Premature birth has been linked to an increased risk of problems with learning and thinking skills in later life, which are thought to be linked to alterations in brain development.

mri-scan

The investigators studied magnetic resonance imaging (MRI) brain scans from 47 babies who had been born before 33 weeks gestation with scans that took place when they reached term-equivalent age. The team also collected information about how the infants had been fed while in intensive care — either formula milk or breast milk from either the mother or a donor. They found that babies who exclusively received breast milk for at least three-quarters of the days they spent in the hospital showed improved brain connectivity compared with others. The effects were greatest in babies who were fed breast milk for a greater proportion of their time spent in intensive care. The study suggests that brain development in the weeks after preterm birth is improved in babies who receive greater amounts of breast milk.

Image credits: Public Domain Pictures.

Breast milk is the perfect nutrition for a baby, providing all the proteins, fats, vitamins, minerals, and enzymes that a young body needs to stay healthy. Unfortunately, rates of breastfeeding and breastmilk consumption are well below desired levels. Only 40% of infants worldwide are breastfed exclusively until they are at least six months old, as the World Health Organization (WHO) recommends. The reasons are complex, but in many countries, lack of education, together with aggressive marketing by makers of baby formula, has contributed to a decline in breastfeeding.

Antimicrobials do more harm than good, according to statement signed by 200 researchers

Researchers warn against using antimicrobial soaps. Image credits: Darren Hester / Flickr.

If you’re using antimicrobial soaps, you might want to reconsider that. Sure, you think you’re doing the best, but according to a statement published in a peer-reviewed journal called Environmental Health Perspectives by over 200 scientists and health professionals, you’re not doing anyone any favors. In fact, you might be doing more harm than good.

The paper, signed by people from 29 different countries, discusses not only the lack of evidence related to the benefits of antimicrobial soaps but also the health and ecological hazards associated with them. They also released this cute video which showcases the gist of their publication.

“People think antimicrobial hand soaps offer better protection against illness. But generally, antimicrobial soaps perform no better than plain soap and water,” said Barbara Sattler, RN, DrPH, FAAN, environmental health professor at the University of San Francisco.

The two most famous and widely used antimicrobial substances are the infamous triclosan and triclocarban. For starters, both substances are endocrine disruptors, which means they interfere with important hormonal processes. This can directly or indirectly affect our immune system as well as our brain — thyroid, testosterone, and estrogen regulation are especially affected. A large study has also linked triclosan, which is also used in other products like detergents, to cancer. They also end up, in a variety of forms, in natural environments, causing significant damage. To make things even worse, we are facing a global drug-resistance crisis, largely powered by our overuse of antimicrobial products. But perhaps the most important reason why you shouldn’t use antimicrobial soaps is that they don’t work.

Study after study has shown that washing your hands with water and regular soap (be it cold or warm water) is just as effective as using antimicrobial soaps. There are very few — if any — proved benefits, and yet people still opt for such products. Thankfully, the U.S. Food and Drug Administration (FDA) ruled that 19 different antimicrobial chemicals, including triclosan and triclocarban, were not effective, and there is no evidence they are safe either. So they effectively banned these substances from soaps, but like a hydra with many heads, other antimicrobial substances popped up to replace them — and these substitutes may be even worse. To make things even worse, it’s not just soaps. Nowadays, antimicrobials appear in a number of products you’d never expect them, such as paints, exercise mats, flooring, apparel, food storage containers, home textiles, electronics, kitchenware, school supplies, and countertops.

 “I was happy that the FDA finally acted to remove these chemicals from soaps. But I was dismayed to discover at my local drugstore that most products now contain substitutes that may be worse,” said Arlene Blum, PhD, Executive Director of Green Science Policy Institute.

This is why Blum, Sattler, and hundreds of other researchers signed this statement (which you can read here): to tell people they don’t work and to avoid them whenever possible.

“Customers may think added antimicrobials are a way to reduce infections, but in most products there is no evidence that they do,” said Ted Schettler, MD, MPH, Science Director of the Science and Environmental Health Network. In 2016, Dr. Schettler authored a report on antimicrobials in hospital furnishings for the nonprofit Health Care Without Harm.

Seriously, any soap will do just fine. Image via Pixabay.

The problem, or at least a big part of the problem, is that a simple name can be so powerful: antimicrobial. Who doesn’t like that? Who doesn’t want to eliminate germs? What parent wouldn’t opt for an antimicrobial soap, compared to just a soap? But we shouldn’t fall for that. Names can be tricky, and marketing can be even trickier. Don’t fall for that. Trust the scientists, not the marketers.

The statement also includes several recommendations, both for consumers and policy makers, which we’ll present here:

  • Avoid the use of triclosan, triclocarban, and other antimicrobial chemicals except where they provide an evidence-based health benefit (e.g., physician-prescribed toothpaste for treating gum disease) and there is adequate evidence demonstrating they are safe.
  • Where antimicrobials are necessary, use safer alternatives that are not persistent and pose no risk to humans or ecosystems.
  • Label all products containing triclosan, triclocarban, and other antimicrobials, even in cases where no health claims are made.
  • Evaluate the safety of antimicrobials and their transformation products throughout the entire product lifecycle, including manufacture, long-term use, disposal, and environmental release.

The bottom line is pretty simple: wash your hands with water and soap, avoid antimicrobials. Read the labels of products and see what they contain. Don’t fall for an attractive name. Follow the science.

Journal Reference: Rolf U. Haiden et al — The Florence Statement on Triclosan and Triclocarban. DOI:10.1289/EHP1788