Tag: antibiotic resistance

Categories : Antibiotics PaediatricsTags :

Last-line Antibiotics at Risk as Children’s Resistance Rises

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Photo by Ben Wicks on Unsplash

Antimicrobial resistance in children is rising globally and will worsen over the next decade, threatening the effectiveness of life‑saving antibiotics, according to a world-first monitoring platform.

The findings, led by Murdoch Children’s Research Institute (MCRI) in collaboration with the University of Sydney, Clinton Health Access Initiative (CHAI) and The Chinese University of Hong Kong, analysed more than 106 000 infection samples from children, aged up to 18 years, across 82 countries, discovering that antibiotic resistance increased in every region between 2004 and 2022. Babies and children in intensive care and countries with fewer healthcare resources were the most affected.

Published in JAMA Pediatrics, the research found the increase is being driven largely by Gram-negative bacteria responsible for severe infections such as sepsis and pneumonia. Resistance rose most sharply to critical ‘Watch’ and ‘Reserve’ antibiotics, which the World Health Organization (WHO) classifies to limit overuse and help preserve their effectiveness when first-line treatments fail.

MCRI Associate Professor Penelope Bryant said the findings highlighted a widening gap between recommended antibiotic use and real‑world effectiveness, reinforcing the urgent need for improved surveillance, targeted antimicrobial stewardship and better access to effective antibiotics for children.

Forecasting future antimicrobial resistance

The newly launched AMR in Kids website, created by the study team, allows clinicians, researchers and policymakers to explore antibiotic resistance by country, bacteria and antibiotic class. It also provides region and pathogen-specific forecasts to 2035, helping researchers to identify emerging threats, inform treatment decisions and help guide public health planning.

MCRI and University of Sydney Dr Yanhong Jessika Hu said by combining almost two decades of global data with forecasting, the platform could identify where resistance was likely to emerge before it becomes an even greater clinical challenge.

Antimicrobial resistance occurs when bacteria evolve to withstand antibiotic treatment. As resistant bacteria emerge and spread through communities, infections become harder to treat. Children are especially vulnerable as they experience high rates of bacterial infections and have fewer antibiotic options than adults. In 2021, about 840,000 deaths in children under five years were associated with antimicrobial resistance.

“Antimicrobial resistance is one of the biggest threats to children’s health globally, but until now we haven’t had a clear picture of how it’s changing specifically in children,” Dr Hu said. “The AMR in Kids platform addresses a major gap by developing region and pathogen-specific forecasts for the next decade.”

Forecast modelling by the platform suggests that by 2035, some of the most dangerous pathogens could become highly resistant to last‑line treatments.

CHAI Senior Clinical Director Associate Professor Joseph Harwell said, “Better data is essential, but children can’t wait for perfect data. We need to use the best available evidence to guide action now.”

The research found two types of Gram-negative bacteria were driving antimicrobial resistance globally. Acinetobacter baumannii, which commonly causes hospital acquired bloodstream infections and pneumonia, showed the highest overall resistance. Klebsiella, causing urinary tract infections and liver abscesses, recorded the fastest increase, particularly in Southeast Asia, Eastern Europe and the Western Pacific. Alarmingly, resistance to last‑line carbapenem antibiotics is projected to rise substantially by 2035, reaching 82 per cent and 35 per cent, for each superbug, respectively.

Turning data into global action

Associate Professor Bryant said despite facing unique treatment challenges, children had been overlooked in global antibiotic resistance surveillance.

“Rising resistance to first- and now second-line drugs is the clinical reality for children,” she said. “Making antibiotic resistance in children visible, through AMR in Kids, is the first step towards changing its trajectory. By understanding where resistance is emerging and how it’s changing, we can better protect children now and preserve the effectiveness of antibiotics into the future.”

But Associate Professor Bryant said more action was needed on the global stage and measures specifically targeted towards children.

“In low-income countries we need to address unregulated antibiotic use and poor sanitation,” she said. “These countries need better access to diagnostic techniques and first-line antibiotics. Encouraging, Australia’s Department of Foreign Affairs and Trade has brought together experts including from the University of Melbourne and the WHO to develop solutions in the Western Pacific.

“In high-income countries, antibiotic overuse must be tackled across farming, veterinary, primary care and hospital settings, while infection control remains critical.

“We also need child-friendly antibiotic formulations, clearer dosing guidance and funding for trials on safely reducing antibiotic use. Consumers can help by talking with their GP about the risks of overprescribing antibiotics.”

Source: Murdoch Children’s Research Institute

Categories : AntibioticsTags :

An Unusual Antibiotic Pairing Is a New Breakthrough in Antimicrobial Resistance

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Pseudomonas bacteria. Source: Wikimedia CCO

A Monash University-led study has found that an unusual pairing of two commonly used antibiotics can kill and stop the spread of resistance in a highly drug-resistant bacterium, Pseudomonas aeruginosa, which can cause life-threatening bloodstream infections, pneumonia and meningitis.

Published in The Lancet Microbe, Monash Institute of Pharmaceutical Sciences (MIPS) researchers used a validated laboratory infection system in which they were able to expose bacterial samples from infected patients to simulated antibiotic dosing regimens, as would actually occur in hospitalised patients.

The discovery of the combination regimen of two so-called β-lactam antibiotics – the most commonly used antibiotics class against serious infections – comes in the context of the World Health Organization’s designation of Pseudomonas aeruginosa as a high-priority pathogen requiring rapid and sustained action.

Antimicrobial resistance (AMR) is one of the top global public health threats and was directly responsible for 1.14 million deaths in 2021. The impact of AMR puts many of the gains of modern medicine at risk, including jeopardising procedures and treatments such as surgery, caesarean sections and cancer chemotherapy.

AMR occurs when bacteria change over time and no longer respond to previously successful antibiotic treatments. Bacteria that develop AMR to several of the commonly used antibiotics can cause infections that are harder to treat, increasing the risk of disease spread, severe illness and death.

The development of new antibiotics has not kept pace with the rapid rise in AMR, which means some bacteria, such as Pseudomonas aeruginosa, have become resistant to essentially all available antibiotics.

Co-lead author, Associate Professor Cornelia Landersdorfer from MIPS, said their method was applied to the combination regimen of two β-lactam antibiotics, as well as treatments with each of the antibiotics alone. The combination regimen was very successful, as it resulted in much faster and generally substantially greater killing of bacteria than each antibiotic alone. In addition, the combination regimen very substantially suppressed resistance to both antibiotics.

Subsequently, a mathematical model, utilising quantitative systems pharmacology (QSP), was developed to describe the data from the infection system, and predict likely outcomes in patients. QSP models incorporate biological information, such as genetic information, to describe and predict how medicines work against disease in the human body.

“The QSP modelling approach coupled with genomic analysis performed in hospitals could represent a step towards optimising and personalising antibiotic regimens against life-threatening infections caused by Pseudomonas aeruginosa,” Associate Professor Landersdorfer said.

“This research is important because previous approaches to selecting an antibiotic regimen do not account for important pre-existing bacterial characteristics, including mutations, that can influence resistance emergence in bacterial patient isolates of important pathogens such as Pseudomonas aeruginosa.”

The QSP model in the current study is the first to incorporate information on the various resistance mechanisms present in bacterial samples from infected patients before treatment, and those which emerge during therapy with an antibiotic.

The developed QSP model describes the full time-course of bacterial growth, bacterial killing and emergent antibiotic resistance across multiple Pseudomonas aeruginosa strains isolated from patients. Importantly, the model also incorporates the contributions of various resistance mechanisms, including resistance mutations, to the emergent resistance.

The predictive potential of the novel QSP model developed in the study offers the future possibility of tailoring an antibiotic regimen to the specific resistance and other characteristics of the bacterial strain causing a serious infection in a patient.

First author, Dr Siobhonne Breen from MIPS said, “resistance of Pseudomonas aeruginosa emerges rapidly even to new antibiotics when used as a single therapy. Therefore, it is important to identify optimal antibiotic combination treatments that maximise killing of the bacteria and suppress the development of further resistance”.

Co-lead author Associate Professor Antonio Oliver from the Instituto de Investigación Sanitaria Illes Balears (IdISBa) and Hospital Son Espases, Palma de Mallorca, Spain said the research indicates that “by identifying resistance characteristics through rapid diagnostics, a therapy adapted to the individual pathogen and infected patient is an exciting future prospect”.

Read the research paper: doi.org/10.1016

Source: Monash University

Categories : Antibiotics Infection ControlTags :

Shiga-producing E. coli Growing More Resistant to Antibiotics

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Resistance to antimicrobial agents is rising among human infections with Escherichia coli bacteria that produce the Shiga toxin, according to a study analysing data from nearly 2000 infections in the United States between 2010 and 2021.

The increase in resistance points to a need for antibiotic stewardship in the food production chain as well as in human health, says study leader Csaba Varga, a professor of pathobiology at the University of Illinois Urbana-Champaign.

“Shiga toxin–producing E. coli is a type of foodborne bacteria that can cause anything from mild diarrhoea to very serious illness. About 100 000 people in the U.S. get sick from this strain each year, and some end up in the hospital,” Varga said. “The biggest concern is for children under five years of age, who are more likely to develop serious complications, such as kidney failure.”

Varga and graduate student Tarjani Bhatt used data reported by the U.S. Centers for Disease Control and Prevention, which collects the information through a national surveillance system. They focused on the E. coli strain O157, which produces the Shiga toxin responsible for the majority of severe illnesses. They looked at 1995 samples collected between 2010 and 2021 to see whether there was any change in antimicrobial resistance rates over time, and whether there were any patterns in age or geography.

“Most of the previous studies have looked at snapshots in time, not how resistance changes year by year. We didn’t have a clear picture of long-term trends, whether resistance was increasing, decreasing or staying the same,” Varga said. “Resistance doesn’t stay in one place; it moves through people, animals and the environment. Our study helps fill those gaps by looking at when, where and in whom resistance is emerging over time.”

The group found that, while overall resistance remains low, it has steadily increased over time – especially for the common antibiotics tetracycline and sulfisoxazole. They also found that resistance varied by geographical region and by age group, with younger adults in their 20s and 30s most likely to have infections resistant to some antibiotics.

The most mystifying aspect of the findings is that antibiotics are not typically recommended for Shiga-producing E. coli infections, Varga said. Though the treatment kills the bacteria, that action triggers the release of more Shiga toxin, making the illness more dangerous and increasing the risk for serious complications. Antibiotics are avoided unless the patient has another severe infection at the same time.  

“Even though we don’t usually treat this infection with antibiotics, we’re still seeing resistance emerging and spreading, which tells us these bacteria are being exposed to antibiotics somewhere along the way,” Varga said.

The researchers propose a “One Health” approach to the issue, taking into account not only human health and antibiotic use, but animals and environment as well, particularly because the illness is foodborne.

“Better antibiotic stewardship in agriculture, along with food safety and environmental controls, will be key to slowing this trend. What happens on farms, in food production and in the environment can directly impact human health. Prevention has to happen from farm to fork,” Varga said.

Source: University of Illinois at Urbana-Champaign

Categories : AntibioticsTags :

Latest Antibiotic Discovery Offers New Way to Kill drug-Resistant Bacteria

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Drug-resistant Salmonella. Credit: CDC on Unsplash

Researchers at McMaster University have discovered a new antibiotic that kills some of the world’s most dangerous and drug-resistant bacteria – and does so by targeting a previously unknown vulnerability, opening the door to an entirely new class of treatments.

The new compound, called manikomycin, was identified by a team led by McMaster Professor Gerry Wright and has shown early effectiveness against priority pathogens including Salmonella, E. coli and Klebsiella.

Unlike any antibiotic currently used in clinics, it works by blocking the exit site of the ribosome, the protein-producing machinery found inside every bacterial cell.

The discovery, published today in Nature, marks the fourth new antibiotic candidate from Wright’s lab in just over a year, underscoring a promising new approach to drug discovery at a time when antibiotic resistance is a growing global threat.

“Not a single antibiotic prescribed in clinics today does what manikomycin does,” says Wright, a member of the Michael G. DeGroote Institute of Infectious Disease Research. “Not azithromycin, not tetracycline – none of them.”

“So we’ve not only found a brand-new drug candidate, but we’ve also established a brand-new target in bacteria that could potentially be exploited with other new drugs.”

It’s the latter part of the discovery that has researchers most excited. Wright notes that because most antibiotics in use today target the same handful of vulnerabilities on the ribosome, bacteria have evolved broad defence strategies against such attacks. However, drugs that attack a different part of the ribosome – the exit site – leave them defenceless.

“Even newly discovered drugs that attack those same old targets may quickly face resistance,” says Wright, a professor in McMaster’s Department of Biochemistry and Biomedical Sciences.

“But across the history of medicine, we’ve put absolutely no selective pressure on this particular target, so bacteria have no existing resistance mechanisms for manikomycin.”

Wright likens the ribosome to a factory assembly line. Finished components, he says, must be moved off the line before the next piece can advance. Manikomycin blocks the exit lane, causing the entire assembly process to jam and eventually grind to a halt. And, without the ability to produce proteins, bacteria cannot survive.

The discovery of manikomycin builds on work that began more than 75 years ago, when scientists first discovered that the soil bacterium Streptomyces rimosus produced oxytetracycline, a powerful new drug that would help usher medicine into the antibiotic age.

While the breakthrough was one of several like discoveries made in the mid-1900s, S. rimosus and related bacteria have long since been abandoned as a potential source of new antibiotics.

“There is an overwhelming perception in science that these bacteria have been mined completely dry – that we’ve found all there is to find,” Wright says. “Our lab has found that this is not at all the case.”

Wright’s group, working with collaborators at the University of Illinois Chicago and the University of Hamburg in Germany, used an advanced laboratory technique called fractionation to uncover the new antibiotic.

By filtering out oxytetracycline and other abundant compounds from the chemical mixtures produced by S. rimosus, the researchers were able to isolate scarcer molecules that had gone unnoticed over the years.

Manpreet Kaur, a postdoctoral fellow in Wright’s lab and first author on the new study, says that finding a viable new drug candidate this way signals new opportunities for antibiotic discovery.

“There is likely so much still to be discovered through fractionation,” says Kaur. “Revisiting the extracts of even-well studied bacteria like Streptomyces may lead to similar discoveries in the future.”

Wright’s team is now advancing manikomycin toward clinical development. They have already shown that the new antibiotic is not toxic to human cells, and that it works well in a lab-controlled model of infection – both key milestones on the early development pathway.

They are now working on optimiaing the drug’s “residency time” – or how long it stays active in the body – and have produced 60 derivatives, with plans to push the best one forward.

“We’re excited about this molecule’s potential,” Wright says. “There’s a clear path forward, and we may even be able to expand its spectrum so that it eventually affects even more bacteria, too.”

Source: McMaster University

Categories : PaediatricsTags :

New Study Finds Many Neonatal Deaths in SA Are Preventable

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New post-portem study reveals over 80% of infection-related neonatal deaths in South Africa are preventable.

Photo by William Fortunato on Pexels

A groundbreaking study published in The Lancet Infectious Diseases Journal has identified that the vast majority of neonatal (newborn infant in the first 28 days of life) deaths caused by infections in South Africa and other low-and-middle-income countries could be prevented through improved clinical care and targeted medical interventions. The research, conducted by the Child Health and Mortality Prevention Surveillance (CHAMPS) network, utilised innovative post-mortem techniques that enables accurate identification of causes of death in low-resource settings. To provide the most granular look to date at what is killing newborns in these regions, more than 2600 neonatal deaths were analysed using minimally invasive tissue sampling (MITS).

The study, titled “Post-mortem characterisation of pathogen-specific causes of infection-related deaths in African and south Asian neonates: a prospective, observational, multicentre study which included a major surveillance site in Soweto, South Africa”, has revealed that infections are involved in 44% of neonatal deaths across multiple sites in Africa and South Asia, underscoring an urgent need to strengthen infection prevention, diagnosis, and treatment strategies. Crucially, an expert panel determined that over 80% of these infection-related deaths were preventable under current or improved facility-based conditions.

Key Findings for South Africa:

  • Dominant Hospital Pathogens: In South Africa, Acinetobacter baumannii was the overwhelming driver of hospital-acquired infections, contributing to 74.3% of presumed hospital-acquired neonatal deaths.
  • Community-Acquired Threats: Group B Streptococcus (GBS) was identified as the leading cause of community-acquired neonatal deaths in South Africa, accounting for 30.6% of such cases, followed by Escherichia coli at 24.7%.
  • Emerging Fungal Risks: South Africa was the only site to report specific life-threatening fungal infections, including Candidozyma auris and Nakaseomyces glabratus, in the causal pathway to death.
  • Preventability: The modifiable factors identified to reduce these deaths include improvements in infection prevention and control (50.8%), clinical care (50.7%), and antenatal and obstetric care (42.2%).

The findings reveal that current empirical antibiotic treatments may be insufficient, particularly in high-burden settings where antimicrobial resistance is rising. The study also shows that infections often occur alongside other conditions such as prematurity and birth complications, indicating that neonatal deaths are driven by multiple, interconnected factors.

 “These findings indicate an urgent need to review empirical antibiotic treatment for neonatal infections,” said Prof Shabir A. Madhi, Director of the South African Medical Research Council Vaccines and Infectious Diseases Analytics Research (Wits VIDA) Unit and lead author of the study. “The high prevalence of multidrug-resistant pathogens like K. pneumoniae and A. baumannii suggests our current standard protocols may no longer be sufficient. Alarmingly, some of these bacteria are resistant to all classes of antibiotics currently available.”

Nearly half of all deaths in children under five occur in the neonatal period, with the highest burden in Africa and South Asia. Importantly, local data further underscores the urgency of action. Within the Soweto and Thembelihle surveillance population, the neonatal mortality rate is estimated at 16.0 deaths per 1000 live births, significantly higher than both South Africa’s national estimate of 10 per 1000 and the Sustainable Development Goal (SDG) 2030 target of 12 per 1000 live births.

These findings highlight persistent inequalities in maternal and child health outcomes, even within urban settings, and reinforce the need for targeted, evidence-based interventions.

The MITS technique used at Wits VIDA uses needle biopsies rather than full autopsies to collect biological specimens. This method proved far more effective than traditional antemortem diagnostics, which failed to identify a pathogen in up to 73% of suspected sepsis cases in South Africa.

The study provides one of the most comprehensive, pathogen-specific analyses of neonatal deaths to date and ultimately, the study highlights a powerful opportunity. That most infection-related neonatal deaths are preventable. The CHAMPS consortium concludes that prioritising new maternal vaccines and strengthening hospital infection control are essential steps to reducing the high burden of neonatal mortality.

CHAMPS South Africa consistently shares its granular research findings with the National Department of Health (NDoH) through various channels to ensure this detailed evidence assists in developing targeted strategies to prevent neonatal infections. These data, which provide a precise look at the pathogens responsible for mortality, are intended to help the NDoH refine empirical antibiotic protocols and strengthen hospital infection control measures. Beyond policy-level engagement, CHAMPS collaborates with local communities to raise awareness regarding prevention strategies, specifically emphasizing the importance of early antenatal care booking and consistent attendance. By focusing on these modifiable factors, the initiative seeks to improve obstetric care and reduce the number of babies born “too soon or too small,” addressing the preterm birth complications that frequently underlie neonatal deaths.

 About CHAMPS: The Child Health and Mortality Prevention Surveillance (CHAMPS) network is a global collaboration funded by The Gates Foundation. It aims to provide accurate data on the causes of childhood death to inform policy and save lives in high-mortality regions.

Link to the study in The Lancet Infectious Diseases Journal.

Source: Wits University

Categories : Respiratory DiseasesTags :

Good News on Long-term Cure Rates of Multidrug-resistant Tuberculosis

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Tuberculosis bacteria. Credit: CDC

A new national cohort study from Latvia, conducted in collaboration with researchers from the clinical tuberculosis infrastructure (ClinTB) at the German Center for Infection Research (DZIF) at the Research Center Borstel, Leibniz Lung Center (FZB), provides important insights into the treatment of multidrug-resistant tuberculosis (MDR-TB). The study shows that long-term disease-free survival rates are significantly higher than previous standard indicators suggest. The results, published in the renowned journal The Lancet Regional Health Europe, are based on the analysis of data from 1299 adult patients treated between 2005 and 2021.

Multidrug-resistant tuberculosis poses a significant challenge to healthcare systems worldwide. Whilst the effectiveness of treatment is traditionally assessed on the basis of treatment outcomes at the end of therapy, the new study shows that these criteria underestimate the actual long-term success of treatment. According to WHO standard definitions, only 4.8% of patients in Latvia were considered cured. However, during long-term follow-up, 76.9% of those affected remained permanently relapse-free.

The researchers linked clinical data with national registry information for long-term follow-up, enabling them, for the first time, to systematically evaluate long-term treatment outcomes in a former European country with a high incidence of MDR-TB. A key factor in treatment success was the use of at least three effective drugs in the individual treatment regimen.

Furthermore, the analysis showed that very short treatment durations of less than nine months, using the treatment options available at the time, were associated with an increased risk of relapse or death. Treatment durations of between ten and seventeen months, however, achieved comparable results to longer courses of treatment. After the end of the observation period, MDR-TB treatments became more effective. Today, the treatment duration for MDR-TB has aligned with the six months required for drug-sensitive tuberculosis.

“The study underscores the importance of long-term follow-up in MDR-TB and suggests that tuberculosis control programmes should broaden their measures of success. Including recurrence-free survival rates allows for a more realistic assessment of the quality of care and the actual benefit to patients,” says Sophie Meier, a medical PhD student at the FZB and the University of Lübeck under DZIF researcher Professor Christoph Lange. 

“The findings also support the role of expert panels, known as consilia, in selecting treatments and assessing treatment success for MDR-TB. In Latvia, the decisions made by the consilium were significantly superior to the results obtained by applying WHO definitions for MDR-TB treatment outcomes. Consilia are also an element of effective ‘antimicrobial stewardship’ against the development of new antibiotic resistance,” says PD Dr Thomas Brehm from the FZB and University Medical Center Hamburg-Eppendorf (UKE), DZIF researcher and senior author of this study.

The findings of this study provide important impetus for future treatment strategies for MDR-TB and support the use of individualised treatment regimens with sufficiently effective drugs. Prospective studies are now required to test these findings in the context of new, shortened treatment regimens using modern active substances. If necessary, the definitions of treatment outcomes for MDR-TB will need to be revised.

Source: German Center for Infection Research

Categories : HospitalsTags :

Asymptomatic Colonisers Drive the Spread of Drug-resistant Infections in Hospitals

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The computer model improves on traditional methods like contact tracing by inferring asymptomatic carriers in the spread of antibiotic-resistant infections

Photo by Hush Naidoo Jade Photography on Unsplash

A new analytical tool can improve a hospital’s ability to limit the spread of antibiotic-resistant infections over traditional methods like contact tracing, according to a new study led by researchers at Columbia University Mailman School of Public Health and published in the peer-reviewed journal Nature Communications. The method infers the presence of asymptomatic carriers of drug-resistant pathogens in the hospital setting, which are otherwise invisible.

Antimicrobial resistance (AMR) is an urgent threat to human health. In 2019, 5 million deaths were associated with an AMR infection globally.

The inference framework developed by Columbia Mailman School researchers is the first to combine several data sources – patient mobility data, clinical culture tests, electronic health records, and whole-genome sequence data – to predict the spread of an AMR infection in the hospital setting. In the study, the researchers used five years of real-world data from a New York City hospital. They focused on carbapenem-resistant Klebsiella pneumoniae (CRKP), an AMR bacterium with a high mortality rate. The framework draws on the four data sources to model the spread of CRKP infections, from individual to individual over time.

Levels of CRKP colonisation in healthcare facilities vary by location but can reach up to 22 percent of patients. However, hospitals do not routinely screen for CRKP, and surveillance relies on testing patients who are either symptomatic or suspected of coming into contact with symptomatic patients, overlooking asymptomatic colonisers.

“Many antimicrobial-resistant organisms colonise people without causing disease for long periods of time, during which these agents can spread unnoticed to other patients, healthcare workers, and even the general community,” says the study’s first author, Sen Pei, PhD, assistant professor of environmental health sciences at Columbia Mailman School. “Our inference framework better accounts for these hidden carriers.”

The researchers used the inference framework to estimate CRKP infection probabilities despite limited data on infections. They found that combining the four data sources led to more accurate carrier identification. Furthermore, using data simulations, they found that the framework was more successful at preventing the spread of infections after isolating carriers than traditional approaches based on an individual’s time in the hospital, the number of people they came in contact with, and/or whether the people they came in contact with were identified as having infections.

Using the inference model, isolating 1% of patients on the first day of each week (10–13 patients per week) reduces 16% of positive cases and 15% of colonisation; isolating 5% of patients on the first day of each week (50–65 patients per week) reduces 28% of positive cases and 23% of colonisation. For comparison, using contact tracing – a typical approach in clinical settings (ie, screening close contacts of positive patients) – isolating 1% of patients reduces 10% of positive cases and 8% of colonisation; isolating 5 percent of patients reduces 20% of positive cases and 16% of colonisation.

The new study builds on a study in PNAS that introduced a method that more accurately predicts the likelihood that individuals in hospital settings are colonised with methicillin-resistant Staphylococcus aureus (MRSA) than existing approaches. The new study is a significant advance over the previous study because it now includes patient-level electronic health records and whole-genome sequence data, which allows more precise identification of silent spreaders. While the inference model improves on traditional methods, it remains challenging to eliminate AMR pathogens in hospitals due to their widespread community circulation, limited hospital surveillance, and high false-negative rates in clinical culture tests. However, there is room for improvement; a future study aims to look at the spread of AMR using ultra-dense sequencing.

Source: Columbia University Mailman School of Public Health

Categories : AntibioticsTags :

Study Finds High Rates of Antibiotic-resistant Bacteria in Raw Milk

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In Pakistan, 50% of strains of a common milk bacterium, Staphylococcus epidermidis, were multi-drug resistant

Cultured Staphylococcus epidermidis isolates from raw milk samples on MSA. Image credit: Inamullah and colleagues, Abdul Wali Khan University Mardan, Pakistan, CC-BY 4.0

Raw cow and sheep milk is frequently contaminated with antibiotic-resistant bacteria that could pose a threat to human and animal health, reports a new study led by Tahir Usman of Abdul Wali Khan University Mardan, Pakistan, published November 12, 2025 in the open-access journal PLOS One.

In Pakistan, over 95% of milk is consumed in its raw form, which has not been pasteurized to kill off harmful bacteria. Milk can become contaminated by bacteria through improper handing or from infections in the teat, called subclinical mastitis. The overuse of antibiotics to treat subclinical sumastitis has led to the emergence of multidrug-resistant bacterial strains, which could then be transmitted to humans through raw milk.

In the new study, researchers investigated the risk posed by Staphylococcus epidermidis, a subclinical mastitis-causing bacteria that often does not lead to visible symptoms in the cow, but results in contaminated, lower-quality milk. They collected 310 milk samples, about half from cattle and half from ewes, and tested them for subclinical mastitis. They also isolated strains of Staphylococcus epidermidis from the milk samples and screened them for antibiotic resistance. About one quarter of the samples showed evidence of subclinical mastitis and almost 13% (1 in 8) were contaminated with Staphylococcus epidermidis. Strikingly, 95% of Staphylococcus epidermidis bacteria isolated from the milk were resistant to penicillin and erythromycin, and half were resistant to three or more antibiotics.

In humans, Staphylococcus epidermidis is a common, generally harmless inhabitant of the skin, but the researchers point out that multi-drug resistant Staphylococcus epidermis bacteria in raw milk could spread antimicrobial resistance to more harmful pathogens, like Staphylococcus aureus, the MRSA pathogen.

The study’s findings underscore the high rates of subclinical mastitis in cattle and ewes, and indicate that Staphylococcus epidermidis might be an important pathogen impacting both animal health and food safety. The high rates of antibiotic resistance observed in the samples also emphasize the urgent need for improved antibiotic stewardship in agriculture to prevent the rise of multi-drug resistant strains.

The authors add: “The presence of multidrug-resistant Staphylococcus epidermidis in raw milk highlights how on-farm antibiotic use directly shapes public health risks. These findings emphasize the urgent need for responsible antibiotic use and improved hygiene practices in the dairy sector to reduce the risk of antimicrobial resistance transmission through the food chain.”

Provided by PLOS

Categories : Antibiotics PaediatricsTags :

‘Alarming’ Rise in Newborn Babies with Antibiotic-resistant Infections, Researchers Find

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Photo by Christian Bowen on Unsplash

Researchers are calling for an urgent overhaul of diagnostic and treatment guidelines for infections in newborn babies, after a University of Sydney-led study revealed frontline treatments for sepsis are no longer effective to treat the majority of bacterial infections. 

The study, published in The Lancet Regional Health – Western Pacific, analysed almost 15 000 blood samples collected from sick babies in 2019 and 2020 at 10 hospitals across five countries in Southeast Asia, including Indonesia and the Philippines. 

It found that most infections were caused by bacteria unlikely to respond to the currently applied WHO recommended treatments. These were developed using data from high-income countries, instead of using localised data which could be more accurate and therefore effective. 

“Our study highlights the causes of serious infections in babies in countries across Southeast Asia with high rates of neonatal sepsis, and reveals an alarming burden of AMR that renders many currently available therapies ineffective for newborns,” said senior author Associate Professor Phoebe Williams, a Senior Lecturer and NHMRC Fellow in the Sydney School of Public Health.

“Guidelines must be updated to reflect local bacterial profiles and known resistance patterns. Otherwise, mortality rates are only going to keep climbing.”

The problem is further compounded by a lack of new antimicrobial medications in development for infants and babies, added co-author Michelle Harrison, PhD candidate and Project Coordinator of NeoSEAP in the Sydney School of Public Health. 

“It takes about 10 years for a new antibiotic to be trialled and approved for babies,” Harrison said.

“With so few new drug candidates in the first place, we need a significant investment in antibiotic development.”

Gram-negative bacteria responsible for 80% of infections

For the samples which tested positive for fungal or bacterial infections, the team analysed whether they were caused by gram-positive or gram-negative bacteria – referring to the structure of the bacteria’s cell wall which influences how likely it is to develop and acquire antibiotic resistance. 

Gram-negative bacteria like E. coli, Klebsiella and Acinetobacter were responsible for nearly 80% of infections and are more likely to develop (and spread) antibiotic resistance.

“These bugs have long been considered to only cause infections in older babies, but are now infecting babies in their first days of life,” said Associate Professor Williams. 

When treating babies, doctors don’t have time to wait for lab tests to confirm the exact cause of the infection, and often make an educated guess from published data, most often based on high-income populations, to guide treatment. These tests are also frequently delayed or falsely negative due to the difficulty of collecting blood samples.

Harrison explained that the findings showcase the importance of locally relevant data to guide routine medical decision-making.

“We need more region-specific surveillance to guide treatment decisions. Otherwise, we risk reversing decades of progress in reducing child mortality rates,” she said.

“Our results also revealed fungal infections caused nearly one in 10 serious infections in babies – a much higher rate than in high-income countries. 

“We need to ensure doctors are prescribing treatments that have the best chance at saving a baby’s life.”

Source: University of Australia

Categories : AntibioticsTags :

New Antibiotic to Fight C. Diff Proves Effective in Clinical Trial

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Clostridioides difficile. Credit: CDC

As the effectiveness of antibiotics meant to fight the deadly superbug Clostridioides difficile wanes, a research team at the University of Houston is seeing positive results of a new antibiotic on the scene – ibezapolstat – which is proving successful in fighting these infectious bacteria in clinical trials.

C. diff is a leading cause of death from gastroenteritis, causing gastrointestinal illness ranging from diarrhoea and abdominal pain to toxic megacolon, sepsis and death.

Until now the frontline treatments for C. diff have been the antibiotics vancomycin, with a sustained clinical cure of 42% to 71%, and fidaxomicin at 67%.

And yet, a superbug would not be so deadly if it was not able to outlive the very medicines meant to destroy it.

“Both vanco and fidaxo are associated with emerging antimicrobial resistance. C. difficile infection recurrence is associated with increased mortality, decreased quality of life and higher healthcare costs. New antibiotics are urgently needed,” said Kevin Garey, Professor of Drug Discovery at the University of Houston College of Pharmacy and senior author on recent clinical trial results with ibezapolstat published in Lancet Microbe.

C. diff infections often return when the natural balance in the gut stays disrupted – good bacteria like Bacillota, Bacteroidota, and Actinomycetota are reduced, while harmful types like Pseudomonadota increase. These changes can weaken the gut’s defences, causing a loss of the kind of bacteria that helps break down bile acids. When that happens, harmful bacteria can easily take over.

“Ibezapolstat’s mechanism of action helps restore the healthy microbiota that causes C. diff recurrence” said study lead author Taryn A. Eubank, research assistant professor of Pharmacy Practice and Translational Research at UH.

Enter ibezapolstat

Ibezapolstat has a way of working that kills harmful C. difficile bacteria without harming the good bacteria in the gut that protect against C. diff infections.

“A randomized, double-blind, active-controlled study showed high rates of initial clinical cure in participants treated with ibezapolstat, with no recurrence,” reports Garey.

“Ibezapolstat was found to be safe, well tolerated, and was associated with the preservation of key health-promoting bacteria responsible for bile acid homoeostasis, a key component in preventing recurrent C. difficile infection.”

Eubank added, “This helps confirm the important anti-C diff recurrence properties of Ibezapolstat.”

Ibezapolstat is being developed by Acurx Pharmaceuticals progressing towards phase III clinical trials. The study was conducted at 15 centres, primarily outpatient clinics and hospitals in the United States. Participants were aged 18–90 years, with diarrhoea and a confirmed diagnosis of mild or moderate C. difficile infection.

“The findings of our study support further clinical development of ibezapolstat into phase III clinical trials and eventual use in our patients,” said Garey.

Source: University of Houston