The prevention paradox: E. coli versus Klebsiella

The prevention paradox, as described in 1981, is the “seemingly contradictory situation where the majority of cases of a disease come from a population at low or moderate risk of that disease, and only a minority of cases come from the high risk population (of the same disease). This is because the number of people at high risk is small”, see. In our world this reflects the question how to prevent transmission of ESBL-producing E. coli (ESBL-EC) or K. pneumoniae (ESBL-KP), or both. A new study may help to decide. Continue reading

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What about E. coli ST131?

One of the faces of the global antibiotic resistance crisis is Escherichia coli ST131, frequently portrayed as a pandemic clone, combining hypervirulence, ciprofloxacin resistance and ESBL production. A recent study in Genome Research, a journal you may not read every month, though, sheds a whole new light on this “superbug”. Continue reading

No more antibiotics for animals

That’s what the WHO stated this week, and it was based on a study, in Lancet Planetary Health. In most news items that I saw animal antibiotic use was directly linked to human infections caused by antibiotic resistant bacteria. A journalist even asked if eating meat was safe. Although most of us (including me) support reduction of unnecessary antibiotic use, it’s worth reading this excellent meta-analysis, initiated by WHO. Did this study answer the burning research question “to what extent does animal antibiotic use influence infections in humans?“ Continue reading

Making MRSA carriage a crime?

A new chapter has been added to our successful MRSA Search and Destroy policy. Yesterday, a healthcare professional, providing homecare to elderly, testified on Dutch television (item starts @ 12.30 minutes) how unnoticed MRSA carriage had influenced her and her family’s life. It is very laudable that she was willing to share her experience, but it was kind of spooky that she felt that she could only do this if unrecognizable, as if the underworld was still after her and her family. Apparently, MRSA carriage has become a criminal or shameful thing. Continue reading

The antibiotic resistance crisis resolved by bacteriophages (part 2)

Earlier this week I blogged on the potential (yet poorly proven) effects of bacteriophages as salvage therapy for infections caused by AMR, and stated: “Phages and their active enzymes are proteins that evoke an immunological host response when injected, and up till now all attempts to circumvene those unwanted effects have failed.” Two recent case reports challenge part of that statement. Continue reading

The antibiotic resistance crisis resolved by bacteriophages

I am regularly asked why we don’t treat infections caused by multidrug resistant bacteria with bacteriophages. Last Friday, the same question made it to the best viewed talkshow on Dutch television (The World Turns On), and in about 10 minutes the global threat of antibiotic resistance was resolved. Here is how….  Continue reading

Being prepared for the next pandemic

One of the first things you learn in medical school (or at least the oldest thing I remember from that time) is that the next flu pandemic can happen any time, now! You can’t argue with it, and it holds for all pathogens with pandemic potential. Pandemics (or what could become one) are threatening (think of Ebola and SARS) and usually give rise to many questions, such as what is the optimal diagnostic approach, treatment and prevention strategy. Research plans emerge, but before the studies can start, the pandemic is over, and hardly anything has been learned. That, now, should end. Continue reading