antimicrobial resistance

WAAW 2022: A focus on prevention (IPC and vaccination)

Jon Otter (@jonotter) antimicrobial resistance , , , , , ,

Was delighted to introduce our series of events planned to coincide with World Antibiotic Awareness Week 2022 earlier today. I gave a short talk on why preventing infection via IPC measures and vaccination needs to be a cornerstone of our strategy to turn the time on antimicrobial resistance (slides here).

I also shot a short video to get us thinking about how the language we use will influence the degree to which we connect with the various stakeholders that need to collaborate to address antimicrobial resistance:

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On the origin of multidrug-resistant Gram-negative bacteria (MDR-GNB)

marcbonten Antibiotic resistance, antimicrobial resistance, CRE, Epidemiology, ESBL, GNBSI, Hand hygiene, Infection Prevention and Control, MDR-GNR, publication, Transmission, Whole genome sequencing

The colour of the global crisis of antibiotic resistance is red (if te Gram stain is your reference). In rich countries we have ESBL-producing Enterobacterales (mainly E. coli), but the real problem are carbapenemase-producing strains (Klebsiella, Pseudomonas and Acinetobacter) that are already endemic in lower and middle-income countries. The unanswered question is “where did these resistant bacteria come from”? Animals or bathrooms? Continue reading →

The infinite trio from South Africa

marcbonten Acinetobacter, Antibiotic resistance, antimicrobial resistance, CRE, MDR-GNR, Meetings

Last week I had the pleasure of attending the 8th FIDSSA Congress in Johannesburg (Federation of Infectious Diseases Societies of Southern Africa). I was invited to talk on infection control in the Netherlands, SDD and empiric antibiotic strategies in ICU. I never felt more distance between my habitat and that of my hosts. It surpassed the 3732 miles in the air. I learned a lot; from how it is to go into military conflict areas to identify Ebola cases, fighting a cholera outbreak after a tropical cyclone in Mozambique to the infinite trio, which stands for carbapenem resistant Klebsiella, Pseudomonas and Acinetobacter. Continue reading →

A pore way of dying (for MDR-GNB)

marcbonten Antibiotic resistance, antimicrobial resistance, MDR-GNR, publication, Science

The lack of new antibiotics for Gram-negative bacteria is one of the cornerstones of the global crisis of antibiotic resistance. The quest is finding a molecule with antibacterial activity that can pass the double-layered cell wall and that manages to remain in the cell long enough to kill. New lab-based studies suggest that such antibiotics may already exist, and that the solution to activate them is widely available, and for free. As these findings were published in not-so-well-known-and-hardly-read journals for clinicians, such as EMBO journal and Scientific Reports, here follows the summary for dummies (written by a dummy). Continue reading →

Summer break – don’t go near the water?

marcbonten Antibiotic resistance, antimicrobial resistance, Contamination, Environment, environmental contamination, environmental hygiene, publication, Water

I trust you are enjoying a well-deserved summer break or packing your bags to take off. In case you missed this paper in the daily list of new ones on biorxiv, it tells you where to swim safely and where not. Elena Buelow, from Germany, a former PhD student in our lab in Utrecht and now post-doc in Limoges, France, reported. So, if you are floating quietly in a pittoresque small river and you see a hospital building on the hill near the next bend in the river, are you still in safe waters? Continue reading →

Studying bacteriophages: catch-22

marcbonten Antibiotic resistance, antimicrobial resistance, Bacteriophages

As posted previously, bacteriophage therapy is making a remarkable come-back, if measured in media attention. It is portrayed as safe and effective in treating infections where antibiotics fail. Yet, well-designed controlled studies either lack or failed to demonstrate benefits. All we have are case reports, with – with no exception – spectacular results. But that doesn’t make bacteriophages part of our daily options for treatment. And thus, desperate patients pay thousands of euros for bacteriophages in Georgia, Poland and Belgium for self-treatment, while – at the same time – all of us seem to agree that efficacy and safety should be determined. Continue reading →

The war against CPE

marcbonten Antibiotic resistance, antimicrobial resistance, CRE, MDR-GNR, publication

An interesting publication on the control of CPE last week. Not in Nature, Science of Journal of Hospital Infection, but in the “Staatsblad van het Koninkrijk der Nederlanden”. The paper, “Besluit van 26 april 2019, houdende aanpassing van het Besluit publieke gezondheid vanwege een meldingsplicht voor Carbapenemaseproducerende Enterobacteriaceae”, with King Willem-Alexander as first author, implies that on April 26th it was decided that from July 1st 2019 on, by law, all CPE detected in the Netherlands must be notified, see. A next step in our war against CPE.

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The winner takes it all  for S. aureus

marcbonten Antibiotic resistance, antimicrobial resistance, Bacteriophages, communication, Conferences, Infection Prevention and Control, interventions, Meetings, MRSA

As usual, some of the most interesting presentations at ECCMID were in the late-breakers “clinical trials” session. Four of 5 presentations were on treatment or prevention of S. aureus infection, the other one on oral treatment in patients with refractory fungal disease. With all respect to fungi, the meat was in the aureus, with nothing less than a Shakespearian tragedy. Continue reading →

From crowded house to ESBL-free house

marcbonten Antibiotic resistance, antimicrobial resistance, communication, Epidemiology, ESBL, MDR-GNR

A few weeks ago, Jon Otter blogged about a novel risk factor for ESBL Enterobacterales (ESBL-E) carriage, a “crowded house”, based on his work recently published in CMI: among 1,633 subjects in the catchment area of South-East London a crowded house, was associated with ESBL-E carriage, with an odds ratio of 1.5 (95% CI 1.1-2.2). Jon hinted towards future community-based interventions to reduce ESBL-E carriage and his blog naturally reached our research meeting. Continue reading →

What urine can tell you

marcbonten Antibiotic resistance, antibiotic stewardship, antimicrobial resistance, communication, Epidemiology, guidelines, interventions, publication

Urine should not be seen as a useless excretion product. Doping experts know, as do clinical microbiologists. In two recently published studies zillions of urine cultures were drained from computer systems and linked to primary care data, yielding very interesting findings. One study from Israel quantified the effects of direct and indirect fluoroquinolone use on antibiotic resistance in E. coli, see also our comments to that study. The second comes from the UK, the country that has an ambition to reduce Gram-negative bacterial bloodstream infection rates by 50%, because of increasing BSI rates. This study may provide both the reason for the problem and the direction to meet that ambition. Continue reading →