Travelers to the tropics are more prone to acquiring superbacteria than previously thought:
Exploring exposure to superbacteria, researchers at the University of Helsinki and Helsinki University Hospital got unexpected results from an international collaborative study conducted in real time among 20 travelers to Southeast Asia. All the participants were found to contract superbacteria within a week after arriving in the destination. A detailed sequence analysis showed that the traveler group acquired a variety of superbacteria comprising over 80 different strains altogether.
Before the corona pandemic, tens of millions international travelers annually headed to the tropics, getting exposed to local intestinal bacteria. A total of 20-70% of those returning from the tropics carry - for the most unknowingly - ESBL[*]-producing bacteria resistant to multiple antibiotics. The likelihood of acquiring such superbacteria depends on destination and health behavior abroad. The risk is greatest in South and Southeast Asia, and a substantial increase is associated with contracting travelers' diarrhea and taking antibiotics while abroad.
An investigation led by professor of Infectious diseases Anu Kantele at Helsinki University together with MD Esther Kuenzli from Swiss Tropical and Public Health Institute involved a real-time scrutiny of superbacteria acquisition among a group of 20 Europeans over a three-week visit to Laos. The participants' daily stool samples were initially screened on site in Vientiane, Laos, and later, in Europe, the superbacteria strains isolated were analyzed in detail by whole-genome sequencing.
[...] In Laos, daily stool samples from the participants were analyzed locally in the Lao-Oxford-Mahosot Hospital-Wellcome Trust -Research laboratory. Had samples only been collected before and after travel, the proportion of superbacteria carriers had been approximately 70%. Daily real-time scrutiny already while abroad revealed, however, that all travelers had contracted a superbacter within a week after arrival.
The findings varied day by day. While some participants carried superbacteria for several days, others had a couple of days' breaks after which superbacteria were found again. Part of the travelers acquired several strains.
[...] Increasing resistance is also being witnessed by research: the proportion of travelers carrying these bacteria is growing. Usually acquisition of ESBL or other superbacteria does not cause any symptoms. After travelers return home, the strains usually disappear over time. Carriers can, however, pass these bacteria on to others. Among a small proportion, the superbacteria cause a symptomatic infection, most typically a urinary tract infection. Treatment of infections caused by superbacteria is more challenging than of those caused by sensitive bacteria. In some cases, the infection may even turn out life-threatening.
Antibiotic use during travel further adds to the risk of carriage: favouring the resistant bacteria, antibiotic treatment makes space for newcomers.
[*] ESBL extended-spectrum beta-lactamases (ESBLs):
Enterobacterales are a large order of different types of bacteria (germs) that commonly cause infections both in healthcare settings and in communities. Examples of germs in the Enterobacterales order include Escherichia coli (E. coli) and Klebsiella pneumoniae.To survive the effects of antibiotics, germs are constantly finding new defense strategies, called "resistance mechanisms." For example, some Enterobacterales can produce enzymes called extended-spectrum beta-lactamases (ESBLs). ESBL enzymes break down and destroy some commonly used antibiotics, including penicillins and cephalosporins, and make these drugs ineffective for treating infections.
This resistance means that there are fewer antibiotic options available to treat ESBL-producing Enterobacterales infections. In many cases, even common infections, such as urinary tract infections, caused by ESBL-producing germs require more complex treatments. Instead of taking oral antibiotics at home, patients with these infections might require hospitalization and intravenous (IV) carbapenem antibiotics.
Carbapenems are one of the few remaining antibiotics that can treat ESBL-producing germs, but resistance enzymes that destroy these antibiotics are on the rise, too. The more we rely on this important class of antibiotics, the greater the risk of spreading resistance to them.
Journal Reference:
Prof Anu Kantele, MD, Esther Kuenzli, MD, Steven J Dunn, PhD, [et al]. Dynamics of intestinal multidrug-resistant bacteria colonisation contracted by visitors to a high-endemic setting: a prospective, daily, real-time sampling study, The Lancet Microbe (DOI: 10.1016/S2666-5247(20)30224-X)
(Score: -1, Flamebait) by Anonymous Coward on Wednesday March 03 2021, @06:18AM (1 child)
Save Myanmar.
Dismember China.
(Score: 0) by Anonymous Coward on Wednesday March 03 2021, @06:31AM
Bomb Laos. Again [history.com].
From space. With nukes. You know the rest.
(Score: 0) by Anonymous Coward on Wednesday March 03 2021, @07:24AM (2 children)
I think we can all agree it's not one of the most sanitary regions on the planet also, right?
(Score: 0) by Anonymous Coward on Wednesday March 03 2021, @07:30AM (1 child)
No, we cannot. Have you seen what Americans do, with their "not wearing masks" and "sharing germs via large caliber firearms"? I think, that just like their predecessors, the Native Americans, they have not developed the proper immunities, from isolation and a lack of interaction with the rest of the planet. They deserve to die, and I am sending crates of superbacter infected blankets their way!
(Score: 0) by Anonymous Coward on Wednesday March 03 2021, @08:47PM
don't cry to murica when the chinks put you in a zoo like they do with the Uyghers
(Score: 5, Informative) by inertnet on Wednesday March 03 2021, @10:20AM (9 children)
24 Years ago I walked though some rice fields in Southeast Asia. The next morning I noticed that I had a fever, because I had chills when I drank some water while it was hot outside. The fever got worse and 2 days later my lower leg was swollen, so I told the locals that I needed to see a doctor and showed them my leg. They saw a tiny wound under my foot, I guess a parasite got to me in a rice field. The response was: "ah, we've got something for that", so curious as I am I wanted to know what they meant, before seeing an actual doctor. Someone was sent away and returned after a while with one large penicillin pill which they crumbled and smeared on my foot, plus 3 penicillin capsules, without any prescription. So I sent the guy back for 7 more capsules because I knew that superbacteria arise from unfinished treatments. My leg was cooled with herbs and flowers, wrapped in banana leaves. After 2 days I was cured, never saw a doctor for it.
So they bought me 3 penicillin capsules instead of a full treatment, which could have resulted in another superbacteria, if I had been naive about it.
(Score: 1, Interesting) by Anonymous Coward on Wednesday March 03 2021, @10:45AM (2 children)
Considering that parasites are not bacteria infections .... hint: you rarely get rapid onset of symptoms from a parasitical infection.
It's **not** how it works. It's prime example of little knowledge being dangerous.
The resistance is almost never from incomplete treatments since the infection is eradicated anyway. The primary way you see resistance in the environment is through animal farms. The 2nd method is from your poop and urine -- low amounts of antibiotics are leaking. The resistance built in your body because you take incomplete course of drugs is a very small subset but it's blamed because it's easy to blame "NOT FOLLOWING INSTRUCTIONS!". (aside, for diseases like TB, yes, this would be primary way because TB is resistant to treatment in general, but we are not talking TB here, we are talking about general resistance). If we were actually serious about antibiotic resistance, we would have injection-only antibiotics.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3234384/ [nih.gov]
So, for your infection type, the 4 pills treatment would be probably better and have lower chance of producing resistance. Anyway....
(Score: 2) by inertnet on Wednesday March 03 2021, @01:54PM
I know about the dangers of antibiotics in livestock, my own country has a set of rules to limit its use. Farmers are allowed to use antibiotics prescribed by veterinarians, but (Google translate): "Livestock farmers are not allowed to deliver animals for slaughter that contain residues of antibiotics". Years ago we had a clenbuterol scandal in Europe and people got wiser since then. But sadly not all countries have sane laws for antibiotic use in livestock, or enforce them properly.
(Score: 2) by Immerman on Thursday March 04 2021, @03:57PM
If we were serious about antibiotic resistance, we would ban the use of antibiotics in food animals. *Especially* the use of "preventative" antibiotics, which are extremely common. Increasing ambient environmental antibiotic levels is a wonderful way to breed more antibiotic resistant diseases.
However, for human-specific diseases that's less relevant - an incomplete course of antibiotics is pretty much the only way a bacteria that mostly only survives for long in the human body is going to get exposed to them and survive (antiseptics is a different issue, since bacteria will encounter them in the environment)
(Score: 2) by wisnoskij on Wednesday March 03 2021, @02:09PM (1 child)
I think that answers my question. I was going to ask, why would poor countries be flooded with super bacteria, certainly they have access to less antibiotics they we do and we still use the stuff quite liberally.
But I guess it makes sense, we probably shower them with the stuff as a general cure all. Like literally, just dump parachutes out of low flying planes shower.
Also, I am pretty sure the antibiotics would not have killed the actually parasite, only the bacteria it brought with it, I hope you took some anti-parasite medication.
(Score: 2) by krishnoid on Wednesday March 03 2021, @07:10PM
Liberally, but not liberally enough. We can't get people to finish antibiotic courses in developed nations; what are the odds that you can make people do that in poorer/less educated countries? Can't help but think these sorts of problems are why specific food prohibitions and maybe some of the other weird ones, and maybe ritual as well, are part of religious, er, 'prescriptions':
Makes sense, right?
(Score: 0) by Anonymous Coward on Wednesday March 03 2021, @10:05PM (3 children)
I am curious where you got 10 pills of unknown size were the proper "course of treatment" for an unknown strain of bacteria.
For everyone else, Penicillin only works well on gram-positive bacteria. It is also a β-lactam, which is the kind of antibiotic mentioned in TFA.
(Score: 2) by inertnet on Wednesday March 03 2021, @10:47PM (2 children)
I have no idea where they got the medicine, someone was told to get them in a language I didn't speak. I just trusted their very convincing attitude that they had a cure for me, they showed no doubt at all. When I saw 'penicillin' on the strip I was convinced that they'd probably be right.
(Score: 0) by Anonymous Coward on Thursday March 04 2021, @06:25AM (1 child)
You didn't answer my question. I'm asking where you came up with the idea that 10 of those particular pills was the "proper course of treatment."
(Score: 2) by inertnet on Thursday March 04 2021, @11:41AM
Sorry, I didn't understand your question originally. I got that from memory, from a treatment during childhood probably. I now vaguely remember that was probably 8 capsules, so I got on the safe side with 10.
(Score: 1, Insightful) by Anonymous Coward on Wednesday March 03 2021, @10:26AM
1. large population density so large poop density too
2. warm, so microbial activity is high too
3. you can get medicine from street vendors (lack of regulation)
So you have a recipe for high adaptation rate to low level antibiotics already. And then you add idiot tourists that know even less than the uneducated locals taking antibiotics for diarrhea....
So.... 70% going to 100%? Is that the big increase? You know, you take something that is already everywhere and then you are surprised it's everywhere a little more.
Finally, why are we calling these "superbacteria". They are not any super. They just adapted to the shit we use to try to kill them. Life has been doing this for billions of years. It's not about to stop.
(Score: 2) by HiThere on Wednesday March 03 2021, @03:18PM
I don't think this study is going to cause current assumptions to be altered. But it may provoke a better study. 20 is too small a sample size to conclude much of anything. It is, however, enough to suggest "This is worth looking into.".
Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
(Score: 2) by Phoenix666 on Wednesday March 03 2021, @04:10PM (1 child)
Drink bottled water. Peel fruit before eating it. Don't have unprotected sex with prostitutes.
The backpacker guides all say this, and it's worth following their advice.
If you do that, though, there's no particular risk in travelling to SE Asia.
Washington DC delenda est.
(Score: 0) by Anonymous Coward on Wednesday March 03 2021, @11:29PM
》If you do that, though, there's no particular risk in travelling to SE Asia.
Apart from the jihadi Muslims, of course.
(Score: 0) by Anonymous Coward on Wednesday March 03 2021, @08:59PM
https://en.wikipedia.org/wiki/Clavulanic_acid [wikipedia.org]
Clavulanic acid is a β-lactam drug that functions as a mechanism-based β-lactamase inhibitor. While not effective by itself as an antibiotic, when combined with penicillin-group antibiotics, it can overcome antibiotic resistance in bacteria that secrete β-lactamase, which otherwise inactivates most penicillins.
Clavulanic acid was patented in 1974.[1]
Learn biology, people. Without this knowledge, these days, you are blind cattle, led by the noses or goaded off the cliff.