Chinese carbapenamases: Fly like an eagle

I blogged on mcr-1 (colistin resistance) in China last week, to share the latest reassuring data. Well, the paper on which todays’ blog is printed will be used to wrap tomorrows’ market fish (typical Dutch expression). Nicolle Stoesser (Oxford) send me the latest news, coming from a Nature Microbiology study providing evidence for the potential of spread of carbapenamases by flies and birds. Not reassuring at all, and potentially with major consequences. Continue reading

Colistin resistance and mortality

 

My previous blog on “mcr-1 and the end of the world” evoked responses on the important effects of colistin resistance on patient outcome, referring to a new study in CID with the following abstract closure: “Importantly, mortality was increased in patients with colistin-resistant isolates.” The wording is correct, but I’m afraid that it will be interpreted incorrectly. Continue reading

Mcr-1 and the end of the world

If you read this, you may well be concerned about antibiotic resistance and consider reducing the burden of disease caused by AMR as one of your professional goals. Broad attention helps us to fight the problem: it creates awareness and funds for research. So, how do we cope with data that may jeopardize these ambitions (raising awareness fort he problem AMR)? Here is the eaxmple of mcr-1. Continue reading

ESBL on meat: be aware of filet Americain

Tabloids have repeatedly warned the people for superbugs on chicken meat, after researchers had convincingly shown that the chicken filets that we buy are contaminated with ESBL-producing bacteria, mainly E. coli. Widely considered a public health threat, it was a decisive argument to insist on reductions in antibiotic use in the agricultural industry in the Netherlands. Yet, whether meat contamination constitutes a risk for human health is unknown. This was now quantified, with surprising results. Continue reading

Attacking the fecal veneer*

What an excellent start of 2017. A great study from the USA today in Lancet: In a pragmatic cluster-randomized crossover study they tested 4 patient room cleaning strategies on the effectiveness to reduce acquisition with relevant bacteria for the incoming patients. The conclusion states that “enhanced terminal room disinfection decreases the risk of pathogen acquisition.” Yet, this paper is so “data-dense” that you must read the methods (and supplements) to get the picture. In one shot: Not for C. diff, may be for MRSA and yes for VRE. Continue reading

The end of antibiotics

antibiogram-mueller-hinton

A case of pan-drug resistant NDM-producing K. pneumoniae CPE that resulted in a fatal infection in a US woman has prompted a lot of coverage and discussion on both sides of the Atlantic. Although this report is concerning, not least because the patient succumbed to the infection, this is hardly a new scenario. There are parts of the world where pan-drug resistant CPE are commonplace and have been for years (for example parts of India, the likely country of origin of the organism in this case). Before getting to the case report in detail, let’s take a moment to review this case series from India, published in 2014. 13 patients with pan-drug resistant Gram-negative bacteria (7 of whom were infected with K. pneumoniae, 4 of these 7 died) were reported in a specialist cancer treatment centre over 18 months over 2012/13. This evidence, from half a decade ago, shows that pan-drug resistant CPE is by no means a new phenomenon! Continue reading

ESPAUR 2016: an early Christmas present

espaur-2016

I am just getting around to reading (well detail-scanning the exec summary) of the ESPAUR report. My main reflection is what a fantastic resource this reporting stream offers us: to have freely accessible, regular, accurate, national data on antimicrobial resistance and usage, and other related indicators is pretty unique!

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