Antibiotic-resistance- Key source is infected medical devices finds CDC report

Infections related to medical devices are a key source of antibiotic resistance than infections associated with surgical procedures.

According to a report by the US Centers for Disease Control and Prevention (CDC), antibiotic resistance is more prevalent in healthcare-associated infections (HAIs) related to the use of medical devices than in HAI associated with surgical procedures. The report is published in the journal- Infection Control and Hospital Epidemiology.

Also, HAIs acquired in long-term acute care facilities are more likely to be antibiotic-resistant than those in short-stay acute care hospitals, while data from a separate report indicates that antibiotic resistance is more prevalent in adult HAIs than it is pediatric hospital infections.

The report underscores the importance of tracking antimicrobial resistance, particularly in vulnerable populations such as long term acute-care hospitals and intensive care units.

These data show that the threat of exposure to bacteria that are resistant to antibiotics extends across the nation. The data also serves as an urgent call for healthcare facilities and public health agencies to intensify their efforts to prevent the emergence and spread of antimicrobial resistance, said an epidemiologist at the CDC.

The study aimed to describe common pathogens and antimicrobial resistance patterns for healthcare-associated infections (HAIs) that occurred during 2015-2017 and were reported to the CDC's National Healthcare Safety Network (NHSN).

The study involved data from more than 5,600 hospitals in the CDC's NHSN. The data cover central-line-associated bloodstream infections, catheter-associated urinary tract infections, ventilator-associated events and surgical-site infections reported to the NHSN by 5,626 acute care hospitals, long-term acute care hospitals, and inpatient rehabilitation facilities from 2015 through 2017. The report is the 4th summary of NHSN pathogen and antibiotic susceptibility data, and the CDC's most detailed HAI surveillance effort to date.

The data can be used to help hospitals improve control and prevention strategies and provide direction for new drug development.

In their analysis, CDC researchers identified the most commonly reported pathogens associated with these infections, and for each HAI type and each location, calculated the percentage of pathogens with non-susceptibility to selected antibiotics. Device-associated HAIs and the pathogens connected with them were stratified by hospital ward.

Key findings of the study include-
Germs in adult and pediatric facilities varied by infection type and care location.
The most common HAI bacteria among adult patients were E coli (18%). Staphylococcus aureus (12%) and Klebsiella ( (9%).

A companion report on pediatric health-care-associated infections, with data from 2,454 facilities, found the most prevalent pathogens among pediatric patients were Staphylococcus aureus (15%), E Coli (12%) and coagulate-negative-staphylococci (12%).

The Dr. said the increasing availability of clinical and laboratory data in electronic form provides new opportunities to quickly identify resistance to antibiotic therapies and to inform antibiotic stewardship programs. Appropriate resources should be allocated to ensure proper infection prevention methods of devices and the environment across the healthcare continuum.

The study " Antimicrobial-resistant pathogens associated with adult healthcare-associated infection:  Summary of data reported to the National Healthcare Safety Network, 2015-2017, is published in the journal Infection Control and Hospital Epidemiology.

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Read more at Speciality Medical Dialogues: Antibiotic-resistance- Key source is infected medical devices finds CDC report https://speciality.medicaldialogues.in/antibiotic-resistance-key-source-is-infected-medical-devices-finds-cdc-report/

Gastric Obstruction – Causes, Symptoms & Treatments

Your bowels are tasked with removing waste and toxins from your body, as well as absorbing salts, liquids, nutrients, indigestible vitamins. They do it to extract all possible nutrients that weren’t digested in the stomach and maintain the balance of electrolytes in your system.
When your bowels are not functioning well, they collect the waste and toxins they’re supposed to get rid of, resulting in various diseases and health issues. If left undiagnosed and untreated, obstructed bowels lead to kidney and liver-related health problems. In this article, you’ll learn all you need to know about bowel obstruction, symptoms that should serve as warning signals, and the natural home remedies needed to fix and prevent it.

What causes gastric obstructions?
The reasons for obstructed bowels are plentiful, such as hernias, cysts, tumors, etc. Another reason is overeating foods that are harmful to our bodies, such as food rich in preservatives and other chemicals. These chemicals lead to a buildup of mucus in the guts, which releases toxins that can damage the body. Another cause is a buildup of fecal matter or foreign bodies in the lower intestine.
Bezoars can also cause gastric obstructions. Bezoars are a fibrous lump that forms in the stomach, and the most common type is formed of undigested pieces of food. They are mainly composed out of plant cellulose, most common in unripe fruit and persimmons.
Men are in a higher risk group for contracting phytobezoars in their stomachs, with symptoms that include upper gastric pains, feeling full soon after beginning to eat, nausea, vomiting, lack of appetite and loss of weight. Symptoms only appear in 10-25% of the cases, making phytobezoars hard to diagnose, and can lead to gastric obstructions.
What happens when your gastrointestinal system is obstructed?
When the small intestine is blocked, it will begin contracting in order to move its content beyond the obstruction, which can lead to frequent diarrhea. In later stages, it will become less effective, causing a buildup of water and electrolytes that can lead to dehydration.
The obstruction will also create pressure on the intestinal walls, and if left untreated – will only get worse. This can lead to venous drainage obstruction, a rising of the diaphragm, and a suppression of the lungs’ function. The obstruction itself will aid in the bacterial buildup, in particular, E-Coli, Klebsiella, and Enterococcus Faecalis. The bacteria colonies will grow very quickly, increasing the chances of gangrene and intestinal punctures.

Patients lose their ability to pass feces and gasses along the intestine, causing swelling and increasing stomach pains. The large intestine will expand due to the buildup of bacterium, liquids, feces and gasses.

Which symptoms can indicate an obstruction?
Symptoms can be evidence of obstruction caused be stomach cramping or phytobezoars. Once you notice these symptoms, it is recommended that you pay a visit to your family doctor, to evaluate the nature of the obstruction. Not all symptoms may appear, but they will appear in these general groups:

• Constipation, diarrhea, flatulence, lethargy and swelling.
• Headaches, memory loss, blurred vision.
• Burning sensation in the upper digestive system.
• Weight gain, lack of energy and indigestion.
• Ulcers in the stomach and Duodenum, ulcerative colitis and stomach inflammation.
• Urinary tract infections and inflammation of the kidneys.
• Constant colds, allergies, joint pains and chronic diseases                                       Treatments:
  The most basic treatment is hooking the patient up to an IV, which can only be performed by a doctor. In some cases, the obstructions can be relieved by using a nasogastric tube, and in severe cases, an operation will be required. An enema may help in some cases, but if performed incorrectly – can lead to internal bleeding.
  The simplest, natural treatment for intestinal obstruction is eating 1-3 tablespoons of flax seeds, combined with 100-15ml of Kefir (a type of fermented milk drink) for three days. Flax seeds help the body dispose of fecal matter, mucus and parasites. Additionally, flax seeds can help prevent several forms of cancer, heart diseases, diabetes, and even help lower cholesterol levels. Kefir contains many probiotic bacteria, enzymes, vitamin B12 and proteins, all of which are good for your body. Kefir also helps in restoring the gastric biome and is lactose-free.
  To clear your intestines from obstructions, add kefir and flax seeds to your breakfast in this manner:
  
  • 1st week: 100ml of kefir and one tablespoon of flax seeds
  • 2nd week: 100ml of kefir and two tablespoons of flax seeds
  • 3rd week: 150ml of kefir and three tablespoons of flax seeds
  Additionally, drink at least two liters of water every day.
  
  
  Prevention:
  The best way to unblock a phytobezoar obstruction is by eating food that is high in protein and low in fiber. Once the blockage is gone, follow these dietary tips to heal and prevent reoccurrences.
  
• Beverages: It is advised that you keep your body well hydrated. Drink fruit-shakes, water, and sports drinks that are rich in electrolytes. Avoid high-fat dairy.
• Dairy: Stick to low-fat or fat-free products.
• Grains and bread: Fiber from whole grain tends to slow down the digestive process. Focus on plain white bread, pasta, and regular grain.
• Fruits and vegetables: Boiled or canned fruits and vegetables are the way to go. Avoid eating the skin. Watermelon, melons, and bananas can be consumed fresh. Avoid high-fiber fruits and vegetables.
• Meat and meat substitutes: Protein is essential to the healing process. Stick to skinless chicken or turkey meat. Other kinds of lean meat, such as fish, eggs and tofu are also good.
• Other: Avoid fried foods and use as little butter as possible. Boiled or steamed foods are the most recommended. Minimize the use of seasoning and fatty sauces and dressings.
   
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WHO publishes list of antibiotic-resistant bacteria to speed up drug research

The World Health Organisation (WHO) has published its first-ever list of antibiotic-resistant “priority pathogens”, a catalogue of 12 bacteria families that pose a great threat to human health.

The list was drawn up in a bid to guide and promote research and development (R&D) of new antibiotics, as part of WHO’s efforts to address growing resistance among bacteria to medicines currently in use. It highlights the threat of gram-negative bacteria that have inculcated the ability to resist treatment, and are capable of passing on genetic material that allows other microbes to become drug-resistant as well. Consequently, ailments such as urinary tract infections – which were eminently treatable until a few years ago – have now become life-threatening.

“This list is a new tool to ensure that R&D responds to urgent public health needs,” says Dr Marie-Paule Kieny, WHO’s assistant director-general for health systems and innovation. “Antibiotic resistance is growing, and we are fast running out of treatment options. If we leave it to market forces, the new antibiotics we urgently need won’t be developed in time.”

The WHO list is divided into three categories: critical, high and medium priority. The most critical group includes multidrug resistant bacteria that target hospitals, nursing homes and patients dependent on life-preserving devices such as ventilators and blood catheters. They include Acinetobacter, Pseudomonas and various Enterobacteriaceae (such as Klebsiella, E coli, Serratia and Proteus). They can cause deadly infections such as bloodstream infections and pneumonia. These bacteria have become resistant to a large number of antibiotics, including carbapenems and third-generation cephalosporins – the best available option for treating multi-drug resistant bacteria.

The second and third tiers in the list – the high and medium priority categories – contain other increasingly drug-resistant bacteria that cause more common diseases such as gonorrhoea and food poisoning due to salmonella.

The matter will come up at a meeting of G20 health experts in Berlin this week. “We need effective antibiotics for our health systems. We have to take joint action today for a healthier tomorrow. Therefore, we will discuss and bring the G20’s attention to the fight against antimicrobial resistance. WHO’s first global priority pathogen list is an important new tool to secure and guide R&D related to new antibiotics,” says Mr Hermann Gröhe, federal minister of health, Germany.

The list is intended to spur governments to put in place policies that incentivise basic science and advanced R&D by both publicly funded agencies and private sector entities investing in new antibiotic discovery. It will provide guidance to new R&D initiatives such as the WHO/Drugs for Neglected Diseases initiative (DNDi) Global Antibiotic R&D Partnership, which is engaging in the not-for-profit development of new antibiotics.

Tuberculosis, which has become increasingly resistant to traditional treatment in recent years, was not included in the list because it is targeted by other dedicated programmes. Other bacteria that were not included, such as streptococcus A and B and chlamydia, have low levels of resistance to existing treatments and do not currently pose a significant public health threat.

The list was developed in collaboration with the Division of Infectious Diseases at the University of Tübingen, Germany, using a multi-criteria decision analysis technique vetted by a group of international experts. The criteria for selecting pathogens on the list were: How deadly their infections are; whether their treatment requires long hospital stays; how frequent is their resistance to existing antibiotics; how easily they spread from animal to animal, animals to humans, and from person to person; whether they can be prevented (e.g. through good hygiene and vaccination); how many treatment options remain; and whether new antibiotics to treat them are already in the R&D pipeline.

“New antibiotics targeting this priority list of pathogens will help reduce deaths due to resistant infections across the world,” says Prof Evelina Tacconelli, head of the infectious diseases division at the University of Tübingen and a major contributor to the list. “Waiting any longer will cause further public health problems and dramatically impact patient care.”

While more R&D is vital, it’s not enough to curb bacterial resistance to drugs. To address the issue, the authorities must ensure better prevention of infections and appropriate use of existing antibiotics in humans and animals – besides rational application of new drugs developed in the future.

India has been doing its bit to combat the problem too. “The threat of anti-microbial resistance is very real, and we always knew it was coming. This is why we have been working to combat the threat for a while now. A national action plan to tackle it is underway, and should be out anytime,” said a senior researcher at the National Centre for Disease Control.

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Novel device detects bacteria and suggests apt antibiotic

An interdisciplinary team of engineers and pharmaceutical researchers at the University of Alberta has invented a device that can rapidly identify harmful bacteria and can determine whether it is resistant to antibiotics. The device could save precious hours in patient care and public health, and prevent the spread of drug-resistant strains of bacteria. The team's findings can help in detecting bacteria and measure their susceptibility to antibiotics in small confined volumes.
The device was designed to look for and trap different types of bacteria and find out which antibiotics are most effective against them. Rather than growing bacterial cultures then testing them, the microscopic device relies on nano-scale technology for fast results.
The main feature of the device is a cantilever, a plank that resembles a diving board that has a microfluidic channel 25 times smaller than the width of a hair etched on its surface. The channel is coated with biomaterials, like antibodies, that harmful bacteria like E. coli or Listeria in fluid samples stick to.
When bacteria are caught, the device sends out three different signals to the researchers. When bacteria is detected, the cantilever's mass changes, and it bends, explained researcher Thomas Thundat.
"So, this gives us two signals: the mass change and the bending action by shining infrared light on the bacteria, a third signal is sent. If the bacterial absorbs the light, it begins to vibrate, generating a minute amount of heat that sends a confirmation signal. Having three detection methods means there is no ambiguity".
"By monitoring the interaction of light and bacteria, we can get highly selective detection of bacteria," said Faheem Khan, another expert.
With the bacteria trapped in the cantilever, different antibiotic drugs can be added to the device. Changes in the intensity of tiny oscillations of the cantilever signal will inform the researchers whether the bacteria are alive or dead. The researchers then know which antibiotics the bacteria are susceptible to.
"We're trying to find a way to fight bacterial resistance to drugs and prevent or at least decrease the spread of drug-resistant strains," said Hashem Etayash, a researcher. Adding, "We're able to do several tests in a very short period of time and we can quickly identify bugs that can resist antibiotics." 

 The device can be used to test extremely small fluid samples, millions of times smaller than a rain droplet. The size of the device is advantageous when you only want a very small sample, in settings such as a neonatal intensive care unit, or in situations where only very small samples are available.

The research was published in Nature Communications journal. 

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Predatory bacteria may wipe out 'superbugs'

Predatory bacteria - that eat others of their kind - could be a new weapon in the fight against drug-resistant bacteria or 'superbugs', a new study suggests.
A naturally occurring predatory bacterium is able to work with the immune system to clear multi-drug resistant Shigella infections in zebrafish, researchers from Imperial College London and Nottingham University in the UK said.
It is the first time the predatory bacterium Bdellovibrio bacteriovorus has been successfully used as an injected anti-bacterial therapy and represents an important step in the fight against drug-resistant infections, or 'superbugs'.
Shigella infection is responsible for over 160 million illnesses and over one million deaths every year - and is a common cause of travellers' diarrhoea.
Cases of drug-resistant Shigella are also on the rise as, although the diarrhoea usually clears up without treatment, antibiotics are often used even in mild cases to stop the diarrhoea faster.
To investigate Bdellovibrio's ability to control drug resistant Gram-negative infections, researchers injected zebrafish larvae with a lethal dose of Shigella flexneri strain M90T, resistant to both streptomycin and carbenicillin antibiotics.
Bdellovibrio was injected into the larvae's infection site and a decrease in the number of Shigella was seen.
In the absence of Bdellovibrio, zebrafish were unable to control the replication of Shigella and levels of the bacteria rose.
"This study really shows what a unique and interesting bacterium Bdellovibrio is as it presents this amazing natural synergy with the immune system and persists just long enough to kill prey bacteria before being naturally cleared," said Serge Mostowy, from Imperial College London.
"It's an important milestone in research into the use of a living antibiotic that could be used in animals and humans," Mostowy said.
Bdellovibrio can invade and kill a range of Gram-negative bacteria, such as E coli and Salmonella, in the natural environment.
Previous research has shown that it can reduce pathogen numbers in the stomach of chickens when taken as an oral therapy, but there is growing need to develop therapies to target infections in wounds and organs. 

 Successful use of Bdellovibrio highlights its potential uses in tackling a range of drug-resistant Gram-negative bacterial infections that can develop in hospital patients.


"This has been a truly ground-breaking collaboration that shows therapeutic Bdellovibrio in action inside the translucent living zebrafish," Professor Liz Sockett, from The University of Nottingham said. 

 "The predatory action of the Bdellovibrio breaks the Shigella-pathogen cells and this stimulates the white blood cells; redoubling their 'efforts' against the pathogen and leading to increased survival of the zebrafish 'patients'," said Sockett.

The study was published in the journal Current Biology.
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Superbugs hinder kidney infection treatment

Increase in antibiotic-resistant bacteria or superbugs is making it more difficult to treat a common but severe kidney infection, a new study has found. 

Pyelonephritis - infection of the kidney usually caused by E coli bacteria and which can start as a urinary tract infection - causes fever, back pain and vomiting.

About half of people infected require hospitalisation. If not treated with effective antibiotics, it can cause sepsis and death, researchers said. 

In the study led by researchers at University of California, Los Angeles (UCLA) based on data from 10 large hospital emergency departments around the US, almost 12 per cent of people diagnosed with pyelonephritis had infections resistant to the standard class of antibiotic used in treatment - fluoroquinolone. 

That is up from 4 per cent in a similar study conducted a decade ago, researchers said. 

In some cities, and among some people with certain risk factors  such as international travel or recent hospitalisation or treatment with an antibiotic  fluoroquinolone resistance rates exceeded 20 per cent. 

The study also documented the emergence of infections caused by a specific strain of E coli that is resistant to additional types of antibiotics, severely limiting treatment options. 

That strain, dubbed ESBL for the antibiotic-destroying enzymes it produces (extended-spectrum beta-lactamases), was not detected in the previous study. 

The enzymes were first detected in 1979 and are most often found in developing nations, researchers said. 

Currently, there are only a few intravenous antibiotic options to treat ESBL-related infections, and no oral antibiotics that are consistently effective, they said. 

"This is a very real example of the threat posed by the emergence of new antibiotic-resistant strains of bacteria, which greatly complicates treatment of infection," said Dr David Talan, the study's lead author. 

The study included 453 people diagnosed with kidney infection. The participants were diagnosed between July 2013 and December 2014 in 10 emergency departments at large hospitals. 

Talan and his colleagues recommended the development of new medications and new guidelines calling for treatment with different types and combinations of antibiotics.

The study was published in the journal Emerging Infectious Diseases.

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The Stomach Germs You Need to Avoid!

The Stomach Germs You Need to Avoid! With population numbers rising, one thing that is becoming more common is catching infections and passing them on to the people around us. One common form of infection comes from a group of bacteria that are found in many foods and animal feces, which means we have to constantly be careful and follow some basic rules to avoid. It is important to understand what these germs are and what they do, and most of all - how to avoid them! E. Coli The E. Coli germ lives in the colon of people and animals such as cows, sheep and goats. Usually, the bacteria is not harmful and is required for the routine activities of the digestive system, but when some touch occurs with feces, there is a risk of infection. The bacteria usually travels through uncooked meat, polluted water and unpasteurized dairy products.   Symptoms of infection from E Coli include severe diarrhea, stomach aches and vomiting which can last between 5 to 10 days. Also, E Coli bacteria may cause urinary infections, with women being especially susceptible.    Although the vast majority of E Coli bacteria aren't dangerous, there are strands which can cause bloody diarreas, kidney malfunction and even death.   To avoid infection, be sure to properly cook your meat, wash fruit and vegetables thoroughly before eating or cooking them and avoid drinking unpasteurized milk and juice. Make sure to clean your hands well after going to the rest room and to thoroughly clean kitchenware and work surfaces that came in contact with uncooked meat.     Campylobacter Campylobacter jejuni is a species of bacteria commonly found in animal feces. It is one of the most common causes of human gastroenteritis in the world. Food poisoning caused by Campylobacter species can be severely debilitating, but is rarely life-threatening.   C. jejuni is commonly associated with poultry, and it naturally colonizes the digestive tract of many bird species. One study found that 30% of European starlings in farm settings in Oxfordshire, United Kingdom, were carriers of C. jejuni. It is also common in cattle.   Avoid contaminated drinking water and unpasteurized milk, which provide an efficient means for distribution. Contaminated food is a major source of isolated infections, with incorrectly prepared meat and poultry as the primary source of the bacteria.   The causative agent of the relatively rare bacterial disease, listeriosis, a serious infection caused by eating food contaminated with the bacteria. The disease affects primarily pregnant women, newborns, adults with weakened immune systems, and the elderly.   Listeria Listeria germs are found in the soil and in water, and so can appear on raw foods such as fruit and vegetables, raw meat and fish as well as unpasteurized dairy products. Unlike other bacteria, this species can also grow and spread in the relatively low temperatures of the average fridge.   Most Listeria bacteria are handled by the immune system before they can cause infection, but some 'get away' and cause Listeriosis.    Symptoms of listeriosis include fever, shivers, headaches and vomiting. People at high risk to suffer from a listeria infection are pregnant women and their fetuses, adults over 50 and people who have a weak immune system.   Listeriosis may not affect a lot of people, research suggests that every year it affects about 1,600 people globally. However, out of those 1600, 260 die.   To avoid infection, we repeat our advice to scrub vegetables and fruit before eating, clean any spills in the kitchen, especially raw meat juices.    Vibrio The Vibrio Parahaemolyticus germs live in salt water, and are often found in uncooked seafood. They may cause food poisoning which will in turn cause watery diarrhea, stomach cramps, nausea, vomiting, fever and shivers. Severe cases will cause blood and mucus to appear in the feces.   People who eat fish and uncooked seafood may be infected within 24 hours, while the symptoms may last 3-5 days. Severe infections are rare, but people with a weak immune system are at high risk.   These infections can usually be avoided by thoroughly cooking fish and seafood.   Toxoplasma According to the CDC, millions of people around the world carry the Toxoplasma gondii parasite. However, only a few of us suffer any symptoms, due to a robust immune system. That said, there are people who develop texeoplasmosis and may suffer a severe infection.    The symptoms, like those of the flu, might be weakness, fever, muscle pain and enlarged lymph nodes.    Like the ones before, the risk groups are pregnant women and people with a weak immune system. The parasite can cause more severe diseases though, which may harm the brain, eyes, liver and lungs.   The toxoplasma gondii bacteria is found in a large variety of animals, but it can only breed in the stomach of a cat. That is why cats are considered the main spreaders. Cats usually catch the parasite by eating raw meat, unwashed vegetables or by contact with other cat feces which contain the eggs of the parasite.   To prevent infection, the CDC recommends cooking your food safely and avoiding low heats, wash your hands while handeling raw food, and to avoid unclean water and cat feces.    Salmonella Salmonella is a group of bacteria usually found in uncooked poultry, eggs, beef and sometimes unwashed fruit and vegetables. Touching food or animals that came in contact with the bacteria might cause an inflammation in your digestive system. This inflammation is called salmonellosis and its symptoms include fever, diarrhea, stomach and head aches which can last between 4 and 7 days.   Most people heal without treatment, but for the elderly, babies and people with chronic diseases, Salmonellosis can spread in the blood, with deadly results.   To avoid infection, avoid eating uncooked eggs, meat and poultry not fully cooked, and keep your raw meat separate from the cooked meat. Also wash everything that came into contact with uncooked foods.     Norovirus This virus can do harm to the stomach and bowels, and is often called 'stomach flu'. The bacteria are usually found in contaminated food or beverages, but can also be passed by touching surfaces or other people carrying it.   The virus can cause an inflammation in the bowels (gastritis). The symptoms include Fatigue, headaches, nausea, stomach pain, vomiting, diarrhea and fever that tend to last a few days. Most people overcome the disease, but it's important to drink enough fluids to replace what you lost.   To avoid infection, always clean your hands with soap after handling foods, and disinfect work surfaces in the kitchen and restroom.       THIS IS ONLY FOR INFORMATION, ALWAYS CONSULT YOU PHYSICIAN BEFORE HAVING ANY PARTICULAR FOOD/ MEDICATION/EXERCISE/OTHER REMEDIES. PS- THOSE INTERESTED IN RECIPES ARE FREE TO VIEW MY BLOG- HTTP:GSEASYRECIPES.BLOGSPOT.COM/  FOR INFO ABOUT KNEE REPLACEMENT, YOU CAN VIEW MY BLOG- HTTP://KNEE REPLACEMENT-STICK CLUB.BLOGSPOT.COM/ FOR CROCHET DESIGNS HTTP://MY CROCHET CREATIONS.BLOGSPOT.COM