Tag: antibiotic resistance

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

Categories : Antibiotics GastrointestinalTags :

Special Lactic Acids Reduce Antibiotic Resistance in Infants

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Photo by William Fortunato on Pexels

Infants with high levels of antibiotic-resistant bacteria face a greater risk to their health if they need to be treated with antibiotics when they contract infectious diseases during their first year of life. Now, researchers at the Technical University of Denmark have discovered a way to combat antibiotic-resistant bacteria by nourishing a special subgroup of bifidobacteria found in the gut.

The research project, recently published in the renowned journal Nature Communications, points to a new, natural strategy for combating antibiotic resistance: supporting the good bacteria in the gut from the very first months of life.

“We document that special lactic acids produced by bifidobacteria play a key role in keeping antibiotic-resistant bacteria at bay, which is important for reducing the risk of resistance genes being transferred to other bacteria in the gut. Resistance genes can jump from one type of bacteria to another, and the more bacteria with resistance that are present in the gut, the greater the chance that they will encounter other bacteria and transfer resistance genes to them,” says postdoc Ioanna Chatzigiannidou from DTU Bioengineering, who participated in the research project.

The study of gut bacteria is based on 547 stool samples from 56 children and their mothers, who were followed over a five-year period.

A matter of life and death for infants

Professor Susanne Brix Pedersen from DTU Bioengineering is the head of the research project and explains that the new knowledge about bifidobacteria can be better utilized in society when researchers have developed a rapid test for use in the first weeks of a child’s life, so that parents can check whether their child already has these bifidobacteria naturally or would benefit from receiving a supplement containing them.

“It will be very important if we can strengthen their ability to handle antibiotic-resistant bacteria from the first weeks of a child’s life. This is especially true in the first year of life where infants are exposed to many infectious diseases due to an immature immune system, and when it is a matter of life and death if they have many antibiotic-resistant bacteria, for instance the pneumonia bacteria Klebsiella pneumoniae, making it difficult to treat pneumonia with certain antibiotics,” says Susanne Brix Pedersen.

There is a lot of research into antibiotic resistance, and Susanne Brix Pedersen is also involved in another study, BEGIN, which is based in the paediatric department at Aarhus University Hospital, where researchers are investigating whether a dietary supplement containing beneficial bifidobacteria can strengthen the immune system of newborn babies. So far, the trial has involved 300 women and their newborn babies, who are given either a placebo or a dietary supplement containing the special bifidobacteria.

Source: Technical University of Denmark

Categories : Antibiotics Pain ManagementTags :

Paracetamol and Ibuprofen Linked to Antibiotic Resistance

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Study evaluated nine common medications used in old age care homes

Photo by Kampus Production

New research from the University of South Australia shows that the trusted staples of paracetamol and ibuprofen are quietly fuelling one of the world’s biggest health threats: antibiotic resistance.

In the first study of its kind, researchers found that ibuprofen and paracetamol are not only driving antibiotic resistance when used individually but amplifying it when used together.

Assessing the interaction of non-antibiotic medications, the broad-spectrum antibiotic ciprofloxacin, and Escherichia coli, researchers found that ibuprofen and paracetamol significantly increased bacterial mutations, making E. coli highly resistant to the antibiotic.

It’s an important finding that has serious health implications, particularly for people in aged care homes, where multiple medications are regularly administered.

The World Health Organization reports that antimicrobial resistance is a global threat to public health, and that bacterial resistance was directly responsible for 1.27 million global deaths in 2019.

Lead researcher UniSA’s Associate Professor Rietie Venter says the findings raise important questions about the risks of polypharmacy in aged care.

“Antibiotics have long been vital in treating infectious diseases, but their widespread overuse and misuse have driven a global rise in antibiotic-resistant bacteria,” Assoc Prof Venter says.

“This is especially prevalent in residential aged care facilities, where older people are more likely to be prescribed multiple medications – not just antibiotics, but also drugs for pain, sleep, or blood pressure – making it an ideal breeding ground for gut bacteria to become resistant to antibiotics.

“In this study we looked at the effect of non-antibiotic medicines and ciprofloxacin, an antibiotic which is used to treat common skin, gut or urinary tract infections.

“When bacteria were exposed to ciprofloxacin alongside ibuprofen and paracetamol, they developed more genetic mutations than with the antibiotic alone, helping them grow faster and become highly resistant. Worryingly, the bacteria were not only resistant to the antibiotic ciprofloxacin, but increased resistance was also observed to multiple other antibiotics from different classes.

“We also uncovered the genetic mechanisms behind this resistance, with ibuprofen and paracetamol both activating the bacteria’s defences to expel antibiotics and render them less effective.”

The study assessed nine medications* commonly used in residential aged care: ibuprofen, diclofenac, paracetamol, furosemide, metformin, atorvastatin, tramadol, temazepam, and pseudoephedrine.

Assoc Prof Venter says the study shows how antibiotic resistance is a more complex challenge than previously understood, with common non-antibiotic medications also playing a role.

“Antibiotic resistance isn’t just about antibiotics anymore,” Assoc Prof Venter says.

“This study is a clear reminder that we need to carefully consider the risks of using multiple medications – particularly in aged care where residents are often prescribed a mix of long-term treatments.

“This doesn’t mean we should stop using these medications, but we do need to be more mindful about how they interact with antibiotics – and that includes looking beyond just two-drug combinations.”

The researchers are calling for further studies into drug interactions among anyone on long-term medication treatment regimes so we can gain a greater awareness of how common medications may impact antibiotic effectiveness.

Source: University of South Australia

Categories : Antibiotics PaediatricsTags :

Probiotics for Preterm Babies Lowered Antibiotic-resistant Bacteria in the Gut

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Photo by Hush Naidoo on Unsplash

Preterm babies with very low birth weight who received a probiotic alongside antibiotics had fewer multidrug resistant bacteria and a more typical gut microbiome, a new study shows.

The paper published in Nature Communications is the result of a trial testing probiotics among a group of 34 pre-term babies born with a very low birth weight, under 1500g representing around 1-1.5% of babies born around the world. The study sequenced gut bacteria from the babies during the first three weeks after birth.

The collaborative study led by Professor Lindsay Hall and Dr Raymond Kiu from the University of Birmingham found that among babies who received a probiotic treatment of a certain strain including Bifidobacterium alongside antibiotics, levels of typical bacterial strains associated with early-life gut microbiota were at levels typical among full-term babies, reducing both the abundance of antibiotic resistance genes and the number of multi-drug resistant bacteria in the gut.

In the context of the global AMR crisis, this is a major finding, especially for NICUs where preterm infants are especially vulnerable. Probiotics are now used in many neonatal ICUs around the UK, and the WHO have recommended probiotic supplementation in preterm babies. Our paper shows how beneficial this intervention can be for babies born prematurely to help them give their gut a kickstart, and reduce the impact of concerning pathogens taking hold.Professor Lindsay Hall – University of Birmingham

There were lower levels of drug-resistant pathogens including Enterococcus associated with risks of infections and longer hospital stays. Babies who received probiotics also saw higher levels of certain positive bacteria found naturally in the gut.

Among babies who didn’t receive probiotics, analysis of the gut bacteria found that while some differences occurred between those receiving antibiotics or not, both groups saw a dominant microbiome develop that included key bacteria (pathobionts) that can cause health problems including life-threatening infections during the crucial period after birth, as well as in later life.

Professor Lindsay Hall from the University of Birmingham and a group leader at Quadram Institute Bioscience, and senior corresponding author of the study said: “We have already shown that probiotics are highly effective in protecting vulnerable preterm babies from serious infections, and this study now reveals that these probiotics also significantly reduce the presence of antibiotic resistance genes and multidrug-resistant bacteria in the infant gut. Crucially, they seem to do so selectively – targeting resistant strains without disrupting non-resistant strains that might be beneficial.

“In the context of the global AMR crisis, this is a major finding, especially for NICUs where preterm infants are especially vulnerable. Probiotics are now used in many neonatal ICUs around the UK, and the WHO have recommended probiotic supplementation in preterm babies.

“Our paper shows how beneficial this intervention can be for babies born prematurely to help them give their gut a kickstart, and reduce the impact of concerning pathogens taking hold.”

Dr Raymond Kiu from the University of Birmingham, first and co-corresponding author of the paper said: “Sequencing technology has now confirmed that probiotic Bifidobacterium rapidly replicates in the preterm gut during the first three weeks of life. Importantly, this successful colonisation drives the maturation of the gut microbiota and is linked to a noticeable reduction in multi-drug-resistant pathogens – pointing to its pivotal role in improving neonatal health. Our findings also shed light on the complex interactions between antibiotics, probiotics, and horizontal gene transfer (HGT) in shaping the early-life microbiome.

“We believe this research lays the groundwork for future studies exploring the role of probiotics in antimicrobial stewardship and infection control among preterm populations.”

Source: University of Birmingham

Categories : AntibioticsTags :

Bacterial Stress Drives the Development of Antibiotic Resistance

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Photo by CDC on Unsplash

Antibiotics are supposed to wipe out bacteria, yet the drugs can sometimes hand microbes an unexpected advantage.

A new Nature Communications study from Rutgers Health shows that ciprofloxacin, a staple treatment for urinary tract infections, throws Escherichia coli into an energy crisis that saves many cells from death and speeds the evolution of full‑blown resistance.

“Antibiotics can actually change bacterial metabolism,” said first author Barry Li, a student at Rutgers pursuing a dual doctoral degree for physician–scientists. “We wanted to see what those changes do to the bugs’ chances of survival.”

Li and senior author Jason Yang focused on adenosine triphosphate (ATP), the molecular fuel of cells. When ATP levels crash, cells experience “bioenergetic stress.” To mimic that stress, the team engineered E. coli with genetic drains that constantly burned ATP or its cousin nicotinamide adenine dinucleotide (NADH). Then, they pitted both the engineered strains and normal bacteria against ciprofloxacin.

The results surprised the researchers. The drug and the genetic drains each slashed ATP, but rather than slowing down, the bacteria revved up. Respiration soared, and the cells spewed extra reactive‑oxygen molecules that can damage DNA. That frenzy produced two troubling outcomes.

First, more of the bacteria cells survived.

In time‑kill tests, ten times as many stressed cells survived a lethal ciprofloxacin dose compared with unstressed controls. These hardy stragglers, called persister cells, lie low until the drug is gone and then rebound to launch a new infection.

People have long blamed sluggish metabolism for persister cell formation.

“People expected a slower metabolism to cause less killing,” Li said. “We saw the opposite. The cells ramp up metabolism to refill their energy tanks, and that turns on stress responses that slow the killing.”

Follow‑up experiments traced the protection to the stringent response, a bacterial alarm system that reprograms the cell under stress.

Second, stressed cells mutated faster to evolve antibiotic resistance.

While persisters keep infections smoldering, genetic resistance can render a drug useless outright. The Rutgers group cycled E. coli through escalating ciprofloxacin doses and found that stressed cells reached the resistance threshold four rounds sooner than normal cells. DNA sequencing and classic mutation tests pointed to oxidative damage and error‑prone repair as the culprits.

“The changes in metabolism are making antibiotics work less well and helping bacteria evolve resistance,” said Yang, an assistant professor at the medical school and Chancellor Scholar of microbiology, biochemistry & molecular genetics.

Preliminary measurements show that gentamicin and ampicillin also drain ATP in addition to ciprofloxacin. The stress effect may span very different pathogens, including the pathogen Mycobacterium tuberculosis, which is highly sensitive to ATP shocks.

If so, the discovery casts new light on a global threat. Antibiotic resistance already contributes to 1.27 million deaths a year. Strategies that ignore the metabolic fallout of treatment may be missing a key lever.

The findings suggest several changes for antibiotic development and use.

First, screen candidate antibiotics for unintended energy‑drain side effects. Second, pair existing drugs with anti‑evolution boosters that block the stress pathways or mop up the extra oxygen radicals. Third, reconsider the instinct to blast infections with the highest possible dose. Earlier studies and the new data both hint that extreme concentrations can trigger the very stress that protects bacteria.

“Bacteria turn our attack into a training camp,” Yang said. “If we can cut the power to that camp, we can keep our antibiotics working longer.”

Li and Yang are planning on testing compounds that soothe bioenergetic stress in the hope of turning the microbial energy crisis back into an Achilles’ heel rather than a shield.

Source: Rutgers University

Categories : AntibioticsTags :

South Africa Needs to do More to Tackle Antimicrobial Resistance, Warn Experts

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This is a “pandemic which is wreaking havoc, is not being attended to properly and not being taken seriously enough”

Source: Unsplash CC0

By Liezl Human

A group of infectious disease and public health experts are calling on the Department of Health and Minister Aaron Motsoaledi to reintroduce a national action plan addressing antimicrobial resistance (AMR).

An open letter from over 70 doctors, scientists and public health advisors states that antibiotic resistance is becoming a “growing threat” in the country and poses a threat to universal health coverage through the National Health Insurance.

Read the open letter

Latest figures show that over one-million deaths a year worldwide are directly caused by AMR. This number is projected to increase. Nearly five-million people die with an antibiotic-resistant infection. Over the next 25 years, nearly 40-million people are projected to die from AMR. 

The second edition of the South African Antimicrobial Resistance National Strategy Framework, from 2018-2024, has expired. The plan acknowledged that antimicrobial resistance is “a serious and growing global health security risk”.

The open letter also called on the department to reinstate a ministerial advisory committee on AMR or to establish a similar scientific body.

“The lack of a robust scientific advisory body limits the government’s capacity to develop evidence-based policies,” the letter reads. The establishment of a scientific body would “empower the government to make strategic, data-driven decisions to combat this pressing health threat effectively”.

The former Ministerial Advisory Committee was disbanded in November 2023.

Marc Mendelson, an infectious disease specialist at Groote Schuur Hospital who has been outspoken about the threat of AMR for many years, said: “AMR is a current pandemic which is wreaking havoc, is not being attended to properly and not being taken seriously enough in South Africa.”

Mendelson said that there are “more and more people having to be treated for highly resistant bacterial infections in our healthcare system”. AMR leads to an increase in morbidity, mortality, hospital costs, and also has socio-economic consequences, he said. Common medical interventions such as surgery “becomes much riskier” with AMR.

Department of Health spokesperson Foster Mohale said that the department would only comment once the letter was formally presented, which is expected to happen at 5pm on Thursday.

Republished from Spotlight under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Read the original article.