Nowhere to hide from drug resistant super bugs – latest find

CAPE TOWN — Dogged research has uncovered the alarming speed with which antibiotic resistant genes can spread across the globe. The discovery of one such gene in the soil of a Norwegian archipelago – originally uncovered in India three years earlier and 8,000 miles away, illustrates the maxim that you can run, but you can't hide. Superbugs, or multi-drug resistant strains, are a growing threat to every facet of medicine globally. Infections they cause result in high mortality and morbidity. This is because there are few, if any, pharmaceutical and antimicrobial options to treat them. An editorial in the SA Medical Journal five years ago said the drug pipeline was running dry and warned of a 'nil-antibiotic' era. "It's a scary thought – no effective antimicrobial agent available anywhere in the world," it said, urging better surveillance in hospitals where the strains are commonly spread. The authors advice for best practice? "Good antimicrobial stewardship – select an appropriate drug and optimise its dose and duration to cure an infection, while minimising toxicity and conditions that might select for resistant bacterial strains. The empiric choice of antimicrobials should cover the most likely pathogens, endemic to the specific location." Except when it crops up in icy Norway… – Chris Bateman___STEADY_PAYWALL___.Superbug From India Spread Far and Fast, Study Finds.By Brianna Abbott(The Wall Street Journal) An antibiotic-resistant gene originally discovered in bacteria from India was found 8,000 miles away in a remote Arctic environment, according to a new study. Researchers believe the gene, found in bacteria in the soil of a Norwegian archipelago, made the trek in less than three years, highlighting the speed with which antibiotic resistance can spread on a global scale.Antibiotic resistance is a persistent and growing global health concern. At least 700,000 people die globally each year from antibiotic-resistant infections, according to a 2014 report from the British government. As some bacteria have evolved to fight off even last-resort treatments, that number is on track to increase as much as 10-fold in the coming decades, according to the report.These so-called superbugs have spread through hospitals and health-care facilities due to overuse of antibiotics in medicine and in farming. But they also crop up throughout the environment via water and food, carried in the guts of animals or humans, researchers say. Resistance without human intervention continuously occurs as bacteria evolve genes to compete with each other – a process millions of years older than humans. All of these factors make it difficult for scientist to track exactly how some antibiotic-resistant genes emerge and proliferate."We're trying to understand these other factors that come into play," said David Graham, an ecosystems engineer at Newcastle University in the UK and lead researcher on the study. "If we don't know the pathways, we can't come up with the right solutions."Dr. Graham and his team collected soil samples from eight locations in Svalbard, a Norwegian island chain in the Arctic Ocean. The team chose an isolated area with minimal human impact to discount human antibiotic use. The team then analysed the DNA from the bacteria and other organisms in the dirt."The arctic is a perfect microcosm for studying pathways," said Clare McCann, an environmental engineer at Newcastle University in the UK and first author on the study. "You can very quickly and easily discount any human use there."Researchers found 131 genes linked to antibiotic resistance. That level of genetic diversity isn't unusual, says Dr. Graham, though two genes and their high abundance specifically caught the team's attention. The gene called pncA creates resistance to the tuberculosis drug pyrazinamide. The other gene produces the notorious "superbug" protein NDM-1.New Delhi metallo-beta-lactamase-1, or NDM-1, makes some certain gut bacteria resistant to the last-resort group of antibiotics known as carbapenems. Since its discovery in 2008, NDM-1 has spread to over 100 countries, including the US. "This is a gene that's causing havoc in hospitals," said Gerry Wright, the director of the Institute for Infectious Disease Research at McMaster University in Canada, who wasn't involved with the study.The gene was found only in soil samples that had high nutrient levels, reflecting the presence of plants and animal faeces, meaning that NDM-1 was most likely transported to the environment via animals or other mechanisms, the researcher said, rather than having developed there on its own..Researchers were analysing samples that had been collected in 2013. NDM-1 emerged in Indian groundwater in 2010, so researchers believe that the gene made the 8,000 mile journey to the Arctic in just three years. "This gene has spread around the world so incredibly fast," said Dr. Wright. "It's something that's not surprising to me, but it should be frightening to everybody."It isn't just the speed that concerns scientists; it is also the location. "What's terrible is that we're talking about a really remote place, a place that we don't think of as a hotbed of antibiotic resistance," said Martin Blaser, the chairman of the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria, who wasn't involved in the research. "This is really bad news."Researchers can't exactly say how the superbug gene arrived in the Arctic, though it may have been picked up in the guts of migratory seabirds. Although NDM-1 won't harm humans while it is in the soil, the finding is important for those who track how genes spread."This moves us forward in our quest to understand the global distribution of these genes," said Jill Mikucki, an assistant professor of microbiology at the University of Tennessee, who wasn't involved in the research.The gene pncA seemed to have developed in the Arctic on its own, researchers say, because it was found in all of the soil samples regardless of nutrient level. Because the gene is resistant to tuberculosis drugs, researchers believe there is the potential to find a tuberculosis-fighting antibiotic in the soil that may have prompted the resistance to develop. "If there is a gene out there with resistance, there is almost certainly an organism that can counterbalance that," said Dr. Graham.Finding undiscovered antibiotics in soil is a possibility – that is how the first antibiotics were discovered, and researchers are currently working to pull undiscovered antibiotics from dirt. But as of right now, the evolutionary struggle with antibiotic resistance is one that modern medicine is losing. "We really rely on antibiotics, and this resistance thing is only going in one direction. It's getting worse," said Dr. Wright. "You can run, but you can't hide."

Nowhere to hide from drug resistant super bugs – latest find

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