Tag Archives: Antibiotic resistant bacteria

Researchers Uncover How Bacteria is Able to Shut Its Doors to Antibiotics

Drug-resistant infections have been a growing concern across the medical and pharmaceutical industries. In the United States alone, approximately 23,000 people die each year from infections that are resistant to antibiotics. Now, researchers may know why this happens.
New findings from researchers at Imperial College London show that these bacterial infections are able to reject antibiotics by “closing tiny doors in their cell walls.”

By understanding how these cells are able to shut the doors, the researchers said this could provide new understandings for drugmakers to develop treatments that will “pick the locks” of the closed doors. The result of the research was published today in Nature Communications In the study, the Imperial College researchers, who are focused on antibiotic resistance, looked at the bacterium Klebsiella pneumoniae, which causes infections in the lungs, blood and wounds of people in hospitals. Patients that have compromised immune systems are especially vulnerable to this bacterium. The researchers said K. pneumoniae is becoming increasingly resistant to antibiotics, particularly a family of drugs called Carbapenems, which are used in hospitals when others have failed or are ineffective. Because of this resistance to the powerful antibiotics, the World Health Organization listed Carbapenem-resistant K. pneumoniae as a critical problem.

The researchers found that K. pneumoniae is able to resist Carbapenems by shutting down it surface pores, which is how the antibiotics typically attack the bacteria. The team compared the structures of K. pneumoniae bacteria that were resistant to Carbapenems to those that weren’t and found the resistant bacteria had modified or absent versions of a protein that creates pores in the cell wall. Resistant bacteria have much smaller pores, blocking the drug from entering, the researchers said in a statement.   Joshua Wong, from the Department of Life Sciences at Imperial and first author of the study, said with the growing threat of antibiotic-resistant bugs like K. pneumoniae, it’s important to understand how it happened in order to provide “vital insights that could allow new strategies and drugs to be designed.”

There is some good news though from this finding. The researchers said that the bacteria grow at a much slower rate when its doors are closed due to its inability to absorb nutrients while being attacked by the antibiotics.

Those closed doors will present a challenge to drug developers. Gad Frankel, head of the study team, said the ability of the bacteria to shut its doors to the antibiotics will also provide a mechanism to counteract many other drugs. He said that ability will be difficult to get around.
“However, we hope that it will be possible to design drugs that can pick the lock of the door, and our data provide information to help scientists and pharmaceutical companies make these new agents a reality,” Frankel said in a statement.

Over the past few years, there have been multiple stories about the rise of drug-resistant pathogens. Recently, a dangerous fungal infection known as  Candida auris reared its head in a New York hospital. The facility had to tear out part of the room a patient was housed in due to the spread of the fungal infection, which can be fatal. With growing concerns about the rise of drug-resistant bacteria, multiple companies are developing new forms of antimicrobials to take on serious health concerns, such as carbapenem-resistant enterobacteriaceae, Clostridium difficile, better known as C. diff, or Staphylococcus infections

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Antibiotic Resistance; Drug resistant infections will kill an extra 10 million a year by 2050 unless serious actions are taken

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This is a worldwide topic that will take everyone working together to create change………..

Drug resistant infections will kill an extra 10 million people a year worldwide – more than currently die from cancer – by 2050 unless action is taken, a study says.

They are currently implicated in 700,000 deaths each year.


Reported by the BBC News:  The analysis, presented by the economist Jim O’Neil,  said the costs would spiral to $100tn (£63tn).

He was appointed by Prime Minister David Cameron in July to head a review of antimicrobial resistance.  Mr O’Neill told the BBC: “To put that in context, the annual GDP [gross domestic product] of the UK is about $3tn, so this would be the equivalent of around 35 years without the UK contribution to the global economy.”

The reduction in population and the impact on ill-health would reduce world economic output by between 2% and 3.5%.  The analysis was based on scenarios modelled by researchers Rand Europe and auditors KPMG. They found that drug resistant E. coli, malaria and tuberculosis (TB) would have the biggest impact.  In Europe and the United States, antimicrobial resistance causes at least 50,000 deaths each year, they said. And left unchecked, deaths would rise more than 10-fold by 2050.

He coined the acronyms Bric (Brazil, Russia, India and China) and more recently Mint (Mexico, Indonesia, Nigeria and Turkey).He said the impact of the would be mostly keenly felt in these countries. “In Nigeria, by 2050, more than one in four deaths would be attributable to drug resistant infections, while India would see an additional two million lives lost every year.”

The review team believes its analysis represents a significant underestimate of the potential impact of failing to tackle drug resistance, as it did not include the effects on healthcare of a world in which antibiotics no longer worked. Joint replacements, Caesarean sections, chemotherapy and transplant surgery are among many treatments that depend on antibiotics being available to prevent infections.

The review team estimates that Caesarean sections currently contribute 2% to world GDP, joint replacements 0.65%, cancer drugs 0.75% and organ transplants 0.1%. This is based on the number of lives saved, and ill-health prevented in people of working age. Without effective antibiotics, these procedures would become much riskier and in many cases impossible.

The review team concludes that this would cost a further $100tn by 2050. Mr O’Neill said his team would now be exploring what action could be taken to avert this looming crisis.

This would include looking at:

  • how drug use could be changed to reduce the rise of resistance
  • how to boost the development of new drugs
  • the need for coherent international action concerning drug use in humans and animals

He noted that China would be hosting the G20 summit in 2016 and said he hoped this issue would be a focus of discussion.’Compelling’ He said scientists seemed more certain that drug resistance would be a major problem in the short term, than they were over climate change.    Prof Dame Sally Davies, chief medical officer for England, said: “This is a compelling piece of work, which takes us a step forward in understanding the true gravity of the threat.”

The review team concludes that solving the problem of drug resistance will be far cheaper than doing nothing and there was “cause for optimism” that the right steps could be taken. This included university researchers and biotech entrepreneurs “teeming with ideas” including new drugs, vaccines and alternative therapies such as antibodies.

InvestmentLaura Piddock, professor of microbiology at the University of Birmingham, is focusing her research on bacteria such as E. coli and salmonella, which are responsible for a growing level of drug resistant infections. Both are so-called gram-negative bacteria, which have a complex cell wall that acts as a barrier to drugs. If they do penetrate the wall, they are “vacuumed out” by the cell.  She said: “My team is looking at what are the switches in those bacteria which turn that vacuum cleaner off, and at molecules which would have the same effect. If we can do that, we can make the bacteria sensitive to antibiotics.” Prof Piddock said there had not been enough global investment in finding new drugs. She said: “It is very difficult to find drugs against bacteria like E.coli because they are so naturally resistant. “We need more investment and new business models to ensure the pipeline is filled with promising molecules, to ensure that we can solve this problem, and make sure the drugs are there when patients need them.

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  Article written by Fergus Walsh Fergus Walsh Medical correspondent

11 December 2014

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Combating Antibiotic-Resistant Bacteria – By Executive Order – Task Force To Be Organized

Released 18th of September 2014

Executive Order — Combating Antibiotic-Resistant Bacteria


By the authority vested in me as President by the Constitution and the laws of the United States of America, I hereby order as follows:

Section 1. Policy. The discovery of antibiotics in the early 20th century fundamentally transformed human and veterinary medicine. Antibiotics save millions of lives each year in the United States and around the world. The rise of antibiotic-resistant bacteria, however, represents a serious threat to public health and the economy. The Centers for Disease Control and Prevention (CDC) in the Department of Health and Human Services (HHS) estimates that annually at least two million illnesses and 23,000 deaths are caused by antibiotic-resistant bacteria in the United States alone.Detecting, preventing, and controlling antibiotic resistance requires a strategic, coordinated, and sustained effort. It also depends on the engagement of governments, academia, industry, healthcare providers, the general public, and the agricultural community, as well as international partners. Success in this effort will require significant efforts to: minimize the emergence of antibiotic-resistant bacteria; preserve the efficacy of new and existing antibacterial drugs; advance research to develop improved methods for combating antibiotic resistance and conducting antibiotic stewardship; strengthen surveillance efforts in public health and agriculture; develop and promote the use of new, rapid diagnostic technologies; accelerate scientific research and facilitate the development of new antibacterial drugs, vaccines, diagnostics, and other novel therapeutics; maximize the dissemination of the most up-to-date information on the appropriate and proper use of antibiotics to the general public and healthcare providers; work with the pharmaceutical industry to include information on the proper use of over-the-counter and prescription antibiotic medications for humans and animals; and improve international collaboration and capabilities for prevention, surveillance, stewardship, basic research, and drug and diagnostics development.

The Federal Government will work domestically and internationally to detect, prevent, and control illness and death related to antibiotic-resistant infections by implementing measures that reduce the emergence and spread of antibiotic-resistant bacteria and help ensure the continued availability of effective therapeutics for the treatment of bacterial infections.

Sec. 2. Oversight and Coordination. Combating antibiotic-resistant bacteria is a national security priority. The National Security Council staff, in collaboration with the Office of Science and Technology Policy, the Domestic Policy Council, and the Office of Management and Budget, shall coordinate the development and implementation of Federal Government policies to combat antibiotic-resistant bacteria, including the activities, reports, and recommendations of the Task Force for Combating Antibiotic-Resistant Bacteria established in section 3 of this order.

Sec. 3. Task Force for Combating Antibiotic-Resistant Bacteria. There is hereby established the Task Force for Combating Antibiotic-Resistant Bacteria (Task Force), to be co-chaired by the Secretaries of Defense, Agriculture, and HHS.

(a) Membership. In addition to the Co-Chairs, the Task Force shall consist of representatives from:

(i) the Department of State;

(ii) the Department of Justice;

(iii) the Department of Veterans Affairs;

(iv) the Department of Homeland Security;

(v) the Environmental Protection Agency;

(vi) the United States Agency for International Development;

(vii) the Office of Management and Budget;

(viii) the Domestic Policy Council;

(ix) the National Security Council staff;

(x) the Office of Science and Technology Policy;

(xi) the National Science Foundation; and

(xii) such executive departments, agencies, or offices as the Co-Chairs may designate.

Each executive department, agency, or office represented on the Task Force (Task Force agency) shall designate an employee of the Federal Government to perform the functions of the Task Force. In performing its functions, the Task Force may make use of existing interagency task forces on antibiotic resistance.

(b) Mission. The Task Force shall identify actions that will provide for the facilitation and monitoring of implementation of this order and the National Strategy for Combating Antibiotic-Resistant Bacteria (Strategy).

(c) Functions.

(i) By February 15, 2015, the Task Force shall submit a 5-year National Action Plan (Action Plan) to the President that outlines specific actions to be taken to implement the Strategy. The Action Plan shall include goals, milestones, and metrics for measuring progress, as well as associated timelines for implementation. The Action Plan shall address recommendations made by the President’s Council of Advisors on Science and Technology regarding combating antibiotic resistance.

(ii) Within 180 days of the release of the Action Plan and each year thereafter, the Task Force shall provide the President with an update on Federal Government actions to combat antibiotic resistance consistent with this order, including progress made in implementing the Strategy and Action Plan, plans for addressing any barriers preventing full implementation of the Strategy and Action Plan, and recommendations for new or modified actions. Annual updates shall include specific goals, milestones, and metrics for all proposed actions and recommendations. The Task Force shall take Federal Government resources into consideration when developing these proposed actions and recommendations.

(iii) In performing its functions, the Task Force shall review relevant statutes, regulations, policies, and programs, and shall consult with relevant domestic and international organizations and experts, as necessary.

(iv) The Task Force shall conduct an assessment of progress made towards achieving the milestones and goals outlined in the Strategy in conjunction with the Advisory Council established pursuant to section 4 of this order.

Sec. 4. Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria. (a) The Secretary of HHS (Secretary), in consultation with the Secretaries of Defense and Agriculture, shall establish the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria (Advisory Council). The Advisory Council shall be composed of not more than 30 members to be appointed or designated by the Secretary.

(b) The Secretary shall designate a chairperson from among the members of the Advisory Council.

(c) The Advisory Council shall provide advice, information, and recommendations to the Secretary regarding programs and policies intended to: preserve the effectiveness of antibiotics by optimizing their use; advance research to develop improved methods for combating antibiotic resistance and conducting antibiotic stewardship; strengthen surveillance of antibiotic-resistant bacterial infections; prevent the transmission of antibiotic-resistant bacterial infections; advance the development of rapid point-of-care and agricultural diagnostics; further research on new treatments for bacterial infections; develop alternatives to antibiotics for agricultural purposes; maximize the dissemination of up-to-date information on the appropriate and proper use of antibiotics to the general public and human and animal healthcare providers; and improve international coordination of efforts to combat antibiotic resistance. The Secretary shall provide the President with all written reports created by the Advisory Council.

(d) Task Force agencies shall, to the extent permitted by law, provide the Advisory Council with such information as it may require for purposes of carrying out its functions.

(e) To the extent permitted by law, and subject to the availability of appropriations, HHS shall provide the Advisory Council with such funds and support as may be necessary for the performance of its functions.

Sec. 5. Improved Antibiotic Stewardship. (a) By the end of calendar year 2016, HHS shall review existing regulations and propose new regulations or other actions, as appropriate, that require hospitals and other inpatient healthcare delivery facilities to implement robust antibiotic stewardship programs that adhere to best practices, such as those identified by the CDC. HHS shall also take steps to encourage other healthcare facilities, such as ambulatory surgery centers and dialysis facilities, to adopt antibiotic stewardship programs.

(b) Task Force agencies shall, as appropriate, define, promulgate, and implement stewardship programs in other healthcare settings, including office-based practices, outpatient settings, emergency departments, and institutional and long-term care facilities such as nursing homes, pharmacies, and correctional facilities.

(c) By the end of calendar year 2016, the Department of Defense (DoD) and the Department of Veterans Affairs (VA) shall review their existing regulations and, as appropriate, propose new regulations and other actions that require their hospitals and long-term care facilities to implement robust antibiotic stewardship programs that adhere to best practices, such as those defined by the CDC. DoD and the VA shall also take steps to encourage their other healthcare facilities, such as ambulatory surgery centers and outpatient clinics, to adopt antibiotic stewardship programs.

(d) Task Force agencies shall, as appropriate, monitor improvements in antibiotic use through the National Healthcare Safety Network and other systems.

(e) The Food and Drug Administration (FDA) in HHS, in coordination with the Department of Agriculture (USDA), shall continue taking steps to eliminate the use of medically important classes of antibiotics for growth promotion purposes in food-producing animals.

(f) USDA, the Environmental Protection Agency (EPA), and FDA shall strengthen coordination in common program areas, such as surveillance of antibiotic use and resistance patterns in food-producing animals, inter-species disease transmissibility, and research findings.

(g) DoD, HHS, and the VA shall review existing regulations and propose new regulations and other actions, as appropriate, to standardize the collection and sharing of antibiotic resistance data across all their healthcare settings.

Sec. 6. Strengthening National Surveillance Efforts for Resistant Bacteria. (a) The Task Force shall ensure that the Action Plan includes procedures for creating and integrating surveillance systems and laboratory networks to provide timely, high-quality data across healthcare and agricultural settings, including detailed genomic and other information, adequate to track resistant bacteria across diverse settings. The network-integrated surveillance systems and laboratory networks shall include common information requirements, repositories for bacteria isolates and other samples, a curated genomic database, rules for access to samples and scientific data, standards for electronic health record-based reporting, data transparency, budget coordination, and international coordination.

(b) Task Force agencies shall, as appropriate, link data from Federal Government sample isolate repositories for bacteria strains to an integrated surveillance system, and, where feasible, the repositories shall enhance their sample collections and further interoperable data systems with national surveillance efforts.

(c) USDA, EPA, and FDA shall work together with stakeholders to monitor and report on changes in antibiotic use in agriculture and their impact on the environment.

(d) Task Force agencies shall, as appropriate, monitor antibiotic resistance in healthcare settings through the National Healthcare Safety Network and related systems.

Sec. 7. Preventing and Responding to Infections and Outbreaks with Antibiotic-Resistant Organisms. (a) Task Force agencies shall, as appropriate, utilize the enhanced surveillance activities described in section 6 of this order to prevent antibiotic-resistant infections by: actively identifying and responding to antibiotic-resistant outbreaks; preventing outbreaks and transmission of antibiotic-resistant infections in healthcare, community, and agricultural settings through early detection and tracking of resistant organisms; and identifying and evaluating additional strategies in the healthcare and community settings for the effective prevention and control of antibiotic-resistant infections.

(b) Task Force agencies shall take steps to implement the measures and achieve the milestones outlined in the Strategy and Action Plan.

(c) DoD, HHS, and the VA shall review and, as appropriate, update their hospital and long-term care infectious disease protocols for identifying, isolating, and treating antibiotic-resistant bacterial infection cases.

Sec. 8. Promoting New and Next Generation Antibiotics and Diagnostics. (a) As part of the Action Plan, the Task Force shall describe steps that agencies can take to encourage the development of new and next-generation antibacterial drugs, diagnostics, vaccines, and novel therapeutics for both the public and agricultural sectors, including steps to develop infrastructure for clinical trials and options for attracting greater private investment in the development of new antibiotics and rapid point-of-care diagnostics. Task Force agency efforts shall focus on addressing areas of unmet medical need for individuals, including those antibiotic-resistant bacteria CDC has identified as public and agricultural health threats.

(b) Together with the countermeasures it develops for biodefense threats, the Biomedical Advanced Research Development

Authority in HHS shall develop new and next-generation countermeasures that target antibiotic-resistant bacteria that present a serious or urgent threat to public health.

(c) The Public Health Emergency Medical Countermeasures Enterprise in HHS shall, as appropriate, coordinate with Task Force agencies’ efforts to promote new and next-generation countermeasures to target antibiotic-resistant bacteria that present a serious or urgent threat to public health.

Sec. 9. International Cooperation. Within 30 days of the date of this order, the Secretaries of State, USDA, and HHS shall designate representatives to engage in international action to combat antibiotic-resistant bacteria, including the development of the World Health Organization (WHO) Global Action Plan for Antimicrobial Resistance with the WHO, Member States, and other relevant organizations. The Secretaries of State, USDA, and HHS shall conduct a review of international collaboration activities and partnerships, and identify and pursue opportunities for enhanced prevention, surveillance, research and development, and policy engagement. All Task Force agencies with research and development activities related to antibiotic resistance shall, as appropriate, expand existing bilateral and multilateral scientific cooperation and research pursuant to the Action Plan.

Sec. 10. General Provisions. (a) This order shall be implemented consistent with applicable law and subject to the availability of appropriations.

(b) Nothing in this order shall be construed to impair or otherwise affect:

(i) the authority granted by law to an executive department or agency, or the head thereof; or

(ii) the functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.

(c) This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.

(d) Insofar as the Federal Advisory Committee Act, as amended (5 U.S.C. App.) (the “Act”), may apply to the Advisory Council, any functions of the President under the Act, except for that of reporting to the Congress, shall be performed by the Secretary in accordance with the guidelines issued by the Administrator of General Services.


September 18, 2014.