The growing risk of superbugs

Penicillin, followed by a range of antibiotics, revolutionised medicine. Many of us are alive thanks to antibiotics. But evolution, and the overuse and misuse of antibiotics, are leading to bugs that can beat antibiotics, and this poses major risks for the future.

Two years ago (Guardian):  Almost untreatable superbug CPE poses serious threat to patients, doctors warn

Doctors are warning that the rise of an almost untreatable superbug, immune to some of the last-line antibiotics available to hospitals, poses a serious threat to patients.

The number of lab-confirmed cases of the bug, called carbapenemase-producing Enterobacteriaceae (CPE), rose from three to nearly 2,000 in the 12 years to 2015, according to Public Health England (PHE). But that may be far short of the real number because hospitals are not compelled to report suspected cases. PHE admits it does not know where the infections are coming from or how many people are dying.

CPE is carried harmlessly in the gut, but may kill if it enters the bloodstream through a wound of a patient who is already sick or frail, which makes it a real danger in hospitals. About 40-50% of patients with a CPE bloodstream infection die. CPE is not untreatable, but it is difficult as antibiotic combinations or older, more toxic drugs have to be used.

Experts have warned that antibiotic resistance is a major threat to the world and could turn the clock back on medical advances by making some surgery, such as heart transplants, impossible.

From 2014 (BBC):  Superbugs to kill ‘more than cancer’ by 2050

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.

But while we keep hearing of the risks of climate change this risk is not publicised much. And it is a problem here in new Zealand, now.

Newsroom:  Can we save our sickest from superbugs?

In 2015, a New Zealand-born woman in her early twenties contracted a superbug called Carbapenemase-producing Enterobacteriaceae (CPE).

She wasn’t the first New Zealander to have it, but she was the first known Kiwi to catch it at her house, not overseas or in hospital.

Since her CPE wasn’t hurting her, the young woman had no reason to suspect she was a carrier when she went to Middlemore Hospital with an injury. She spent 13 days in hospital without anyone noticing she was colonised by an almost untreatable superbug, one which health authorities view as one of the world’s most serious emerging infectious disease threats.

In September 2016, a United States woman died after being infected with a strain of CPE resistant to 26 different antibiotics, including colistin. A recent study in China, where antibiotic overuse is widespread, reported that bacteria resistant to colistin were in the guts of 15 percent of people on average and as high as 33 percent in one province.

While New Zealand doesn’t seem to have the colistin-resistant version, in the 11 months to November, the Crown Research Institute ESR counted 71 CPE cases, more than twice as many as in 2017. That included a baby who’d caught it from its mother, and an unexplained cluster of cases around Wellington.

Before Christmas, Juliet Gerard, the Prime Minister’s Chief Science Adviser, warned New Zealand was in the early stages of a CPE epidemic.

Unfortunately, there are no new treatments on the way anytime soon. According to a 2017 article in the New Zealand Medical Journal, “the prospects of new antibiotics becoming available to treat CPE over the short- to medium-term are poor.”

The overuse of antibiotics is a major problem here.

Although the World Health Organisation is pushing a global effort to shrink antibiotic use, human efforts seem to move much slower than the microbes. There are still many countries where animals eat antibiotics routinely, even when they aren’t sick, and human overuse is widespread, too.

Statistics from ESR show total antibiotic consumption in New Zealand increased by 50 percent from 2006 to 2012, with kids under five and adults over 80 consuming the most per capita.

Juliet Gerard has echoed the microbiologists’ 2017 call for an urgent national response to CPE. “New Zealand is in the early stages of an epidemic of…CPE that requires a coordinated infection control response at the national level across the entire New Zealand health sector,” says last year’s fact sheet.

She has also pointed out some serious gaps in New Zealand’s response to the problem so far.

What New Zealand needs urgently to fight superbugs, according to the office of the Prime Minister’s Chief Science Adviser:

– A detailed assessment of current use of antibiotics, appropriateness of use, and the extent of antibiotic resistance in humans and animals.

– Laboratory-based surveillance in both humans and animals to identify emerging and persisting patterns of antibiotic resistance.

– Comprehensive use of recording systems for prescribing and dispensing statistics;

– Data on environmental isolates (bacteria in the environment).

– Research on the best ways to contain the crisis.

– A widespread and continuing education programme to healthcare professionals, trainees, the public, and in schools on the dangers of inappropriate prescribing.

– Response systems and pathways to investigate and respond to significant changes over time in antibiotic resistance in both humans and animals.

– A nationally coordinated infection prevention and response plan to address epidemic transmissible antibiotic resistance threats such as CPE in healthcare facilities. This must include surveillance and response systems and pathways for responding to outbreaks and increases in incidence.

Perhaps what is needed to get the superbug the attention it deserves is for a study to find that superbugs will get worse as the climate warms up.

 

 

 

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15 Comments

  1. The Newsroom article is recommended by the Chief Science Advisor:

    Reply
  2. Corky

     /  25th February 2019

    ”Unfortunately, there are no new treatments on the way anytime soon.”

    Well, that’s an absolute lie.

    1- Vitamin C therapy
    2- Colloidal Silver at 20 plus ppm. Even with NZ regulations limiting ppm to 10, great success is achieved.

    There are many other treatments like dermal magnesium oil and other exotic and cutting edge treatments that would blow what’s left of Griffs mind.😃

    Interesting to note yesterday on ZB, a spokesperson for some clinic, named doctors (MD) around the country using Vitamin C as an adjunct for cancer treatment.

    Whether those doctors appreciated that call-out would be interesting to know. Doctors dislike other doctors who stray off the god given correct path of medical practice.

    It’s a real shame VC has been associated with cancer politics, when in actual fact fighting killer infections should be the point research for MS medicine.

    Reply
    • Mother

       /  25th February 2019

      I think I’ve seen colloidal silver on a NZ Cult list! That frightened me of course.

      I have found it useful too, but like with anything, caution must apply.

      Is it correct that the human is the only mammal that does not store Vit C?

      I see parallels with our medical attitudes and our social attitudes. Many thinking people from the 1960’s onwards would naturally understand not to overdo antibiotics but it’s not till decades later that scientific studies vindicate their caution, practised quietly and unassumingly over decades by ‘ordinary’ people. It’s the same with social issues. It will now take a few decades before we have scientific ‘proof’ that pandering to foolish ideas such as gender fluidity is cruel.

      I know of a man who believed that the Lord told him to insist on the highest dose of chemotherapy possible. Doctors advised that it would kill most people. It worked for him.

      Reply
      • Blazer

         /  25th February 2019

        Good Lord!!!👀

        Reply
      • Corky

         /  25th February 2019

        ”I think I’ve seen colloidal silver on a NZ Cult list! That frightened me of course.”

        And so it should, Mother. A talking bottle of colloidal silver is no doubt demon possessed.
        Holy water, salt, sulphuric acid to stop manifestations, and an old time Catholic priest who actually believes in the rites of exorcism should set your mind at ease.

        Good Luck.

        Reply
        • Mother

           /  25th February 2019

          Corky, you already know that all my hope and trust is in the Lord Jesus Christ. I have no need for any pretend priest, whether old time or new fangled nor man designed rites of exorcism to ‘set my mind at ease.’

          There is one Church of which I am a valued member. You jumped onto my jesting re colloidal silver and strange-ified it. Do you want to discuss Church matters with me? Do you want to know about prayer?

          Reply
          • Corky

             /  25th February 2019

            ”Do you want to discuss Church matters with me? Do you want to know about prayer?’

            Thankyou,but no. There’s nothing you could teach me about metaphysics and occultism.

            Reply
            • Mother

               /  25th February 2019

              Corky! Are you into the dark side? You need help. Seriously, this is serious stuff for an individual. Or are you joking?

            • Kitty Catkin

               /  25th February 2019

              No, he’s showing off again, pretending to know something that he almost certainly doesn’t. Look at his other claims and see if you believe this one.

      • Kitty Catkin

         /  25th February 2019

        Colloidal silver is on the NZ cult list because it makes ‘new age’ type claims that are far-fetched and untrue. It’s illegal in Canada and restricted in other countries because it makes these claims that don’t work.It can’t be sold if it makes health claims.

        I don’t know about other animals, but people can’t store Vitamin C. There’s little point in taking it. The large doses used in trials for cancer are another matter and need to be proved. Cancer frequently goes into remission which has nothing to do with treatment.

        Anyone who took or had sulphuric acid thrown at them could well die; it’s a corrosive poison. Anyone who used it would be charged and rightly so,

        Reply
        • Mother

           /  25th February 2019

          Ah…some sense and science and normality. Thank you Kitty.

          Some people swear by Vit C as a pick me up. I think it must be different for each person.

          Some people eat copious amounts of fruit. Others enjoy good health without desiring fruit.

          Reply
          • Kitty Catkin

             /  25th February 2019

            Someone my mother knew, a young woman the same age as herself and a mother of young children, had cancer which spread and couldn’t be cured. She went home, knowing that she was dying…but went into spontaneous remission instead and lived for many years. She was old when I last heard of her ! Cancer treatments like Vitamin C can seem brilliant, but need to be more widely tested to ensure that it’s not remission.

            Vitamin C may be a pick-me-up, but it won’t last.

            Reply
  3. NOEL

     /  25th February 2019

    Years ago when MRSA was in focus I was a patient in one of the old 8 bed wards.
    Everyone who was admitted was at some stage tested.
    The toilets were set up with three different colours.
    Red for positive, yellow for yet to be tested and green for cleared.
    One guy was packing his bags rather quickly on discharge and after discussion he had admitted he was in a febrile state on admission and had misread the instruction.

    Reply
    • Kitty Catkin

       /  25th February 2019

      You’d have to sit down on a dunny seat as soon as the other person stood up to catch anything; they wouldn’t have time to pull their trousers or knickers back up.

      Reply
  4. Kitty Catkin

     /  25th February 2019

    I can’t believe that antibacterial soaps are still sold when the danger is so well known.

    Reply

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