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Colistin is a last resort antibiotic used against multi-drug resistant pathogens. Now scientists have found a strain of bacterium that can evade it.
For the first time, researchers have discovered strains of a deadly, multidrug-resistant bacterium that uses a cryptic method to also evade colistin, an antibiotic used as a last-resort treatment. That's according to a study of US patients published this week by Emory University researchers in the open-access microbiology journal mBio.
The wily and dangerous bacteria involved are carbapenem-resistant Klebsiella pneumoniae or CRKP, which are already known to resist almost all antibiotics available, including other last-line antibiotics called carbapenems. The germs tend to lurk in clinical settings and can invade the urinary tract, bloodstream, and soft tissues. They're members of a notorious family of multidrug-resistant pathogens, called carbapenem-resistant Enterobacteriaceae (CRE), which collectively have mortality rates as high as 50 percent and have spread rapidly around the globe in recent years. A 2013 report by the Centers for Disease Control and Prevention estimated that there were more than 9,300 CRE infections in the US each year, leading to 600 deaths. Both the CDC and the World Health Organization have listed CRE as one of the critical drug-resistant threats to public health, in need of "urgent and aggressive action."
That's what we knew about CRKP before this week.
In the new study, the Emory researchers discovered two strains of CRKP—isolated from the urine of patients in Atlanta, Georgia—that can also resist colistin. But they do so in a poorly understood, surreptitious way. At first, they appear vulnerable to the potent antibiotic in standard clinical tests, but with more advanced testing and exposure to the drug, they reveal that they can indeed survive it. In mice, the strains caused infections that couldn't be cured by colistin and the mice died of the infections. Mice infected with typical CRKP were all saved with colistin.
(Score: 2) by Runaway1956 on Monday March 12 2018, @04:00PM (8 children)
To put that into some kind of perspective, ask yourself, "How many "hospitals" are left?" In my corner of Southwest Arkansas, the hospitals have shrunk, and they are just surviving by offering reduced services. Childbirth is NOT hospital care any more, for instance. All women who plan to deliver in the presence of a doctor and medical staff now go to the regional medical facility. Most people have to drive a lot further, just to be confined inside of a huge megalith where the windows don't open. Whatever happened to the old prescription of sunshine and fresh air? It's history.
This huge building, large enough to house thousands of patients, is sealed. Air is recirculated, over and over. Maintenance never has been so great that cleaning guaranteed that all pathogens were killed. Not in Hipocrates day, and not today. The medical profession had a lot of sunshine and fresh air, and they used it. We've entirely ended that practice.
And, all of that goes hand in hand with my earlier assertion that we are all but intentionally breeding those scarier pathogens.
(Score: 0) by Anonymous Coward on Monday March 12 2018, @05:38PM (3 children)
There are 5500 hospitals in the US. Wikipedia lists at least 68 in Arkansas. Google maps shows a hospital in ever major city in southwest AR.
What are you going on about again?
(Score: 2) by Runaway1956 on Monday March 12 2018, @05:56PM (2 children)
Wikipedia is somewhat confused. The terms "hospital" and "regional medical center" are not exactly synonymous. As pointed out, all childbirths now go to the RMC - not one hospital in the area does them. All "major trauma" goes to the RMC. The tributary hospitals often look into the ambulance, and direct the ambulance to proceed to Wadley, or St. Michael's.
What do you think of when you think "hospital"? A huge building, five, ten, twenty stories high? Maybe a quarter mile long, and an eighth of a mile wide? That is fairly descriptive of an RMC. Now, a "hospital" may be only as large as family's home. Ten, twelve beds, and a lot of personal care. Personal, as in, the personnel probably know you. Did I mention open windows, and lots of sunshine?
Try reading, before you jump to conclusions. A regional medical facility is not a substitute for a hospital. In point of fact, TFA points to these medical facilities as breeding grounds for the scary pathogens. Those pathogens don't survive very well outside of those huge megaliths.
(Score: 2) by vux984 on Monday March 12 2018, @07:16PM (1 child)
I'm trying to figure out what YOU mean by hospital. When I think of hospital, yeah, I generally think of a larger well equipped facility, capable of handling medical emergencies, trauma, capable of performing major surgeries, and capable of providing care for patients in critical condition. I think that's what most people think a hospital is.
Your 10-12 beds, lots of fresh air, and people that know you -- sounds like maybe a small hospice, for palliative care, or maybe a rehabilitation / recovery center. Or perhaps a rural tributary hospital that doubles as the local medical clinic but can also can do some emergency care or at least stabilize cases before routing them to a bigger more distant facility. But those big edifices you seem to be calling an "RMC" are what most people think of as hospitals. You mentioned 'Wadley" ... as in "
https://www.wadleyhealth.org/156/content/about-us [wadleyhealth.org]
You seem to be making distinction that only you recognize.
(Score: 2) by Runaway1956 on Monday March 12 2018, @08:11PM
Refer to the fine article again. The superbugs breed in those big hospitals. They don't find the environment in small hospitals to their liking. Little River Memorial has one floor, and maybe twenty rooms, an ER, a surgery, radiology, and that's pretty much it. People don't contract flesh eating diseases there. Despite it's age, LRM is pretty open and airy - it's not a closed in dungeon like Wadley or St. Michaels. The only link I'm finding for Little River hospital is their facebook page. I guess they don't waste money on web page designers? https://www.facebook.com/pages/Little-River-Memorial-Hospital/156622407711132 [facebook.com]
(Score: 1) by khallow on Monday March 12 2018, @06:43PM (3 children)
Ok. Sounds like it's not a problem then, particularly given your take on hospitals.
Got to agree with that. You don't get pathogens with resistance to exotic antibiotics from farms.
(Score: 2) by FatPhil on Monday March 12 2018, @10:20PM (2 children)
That's strange, as the CDC has repeatedly said that farms are an important contributor to the evolution of antibiotic-resistant pathogens.
Great minds discuss ideas; average minds discuss events; small minds discuss people; the smallest discuss themselves
(Score: 1) by khallow on Tuesday March 13 2018, @11:43AM
Huh, I thought that colistin wouldn't be in use in agriculture, but turns out I was wrong [qz.com].
(Score: 0) by Anonymous Coward on Tuesday March 13 2018, @08:42PM
ahem,
http://journals.plos.org/plosone/article/comment?id=info:doi/10.1371/annotation/3fa14cda-558f-4e36-bc12-6eb634863762 [plos.org]
Show us how farming has impacted closed ecosystems such as the above.