The antibiotic resistance crisis resolved by bateriophages (part 4)

Yesterday at ECCMID was the long-awaited presentation of the Phagoburn trial: A randomized controlled trial of bacteriophages against Pseudomonas aeruginosa infections in burn wound patients. Bacteriophages have regained considerable attention recently. Proposed as an answer to the rising problems in treating bacterial infections by some, others have remained sceptic due to the absence of evidence of effectiveness coming from well-designed studies, see parts 1, 2 & 3. The Phagoburn trial, though, would the first to deliver high-quality data. So what was presented? Continue reading

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The reality of AMR in Greece

This week I attend the general assembly of COMBACTE, this year in Athens. COMBACTE stands for COMBatting AntibiotiC resistance in Europe (www.combacte.com) and is part of the New Drugs for Bad Bugs (ND4BB) program of the Innovative Medicines Initiative. Our local host is professor George Daikos, who opened the meeting with an overview of the epidemiology of antibiotic resistance in his country. Continue reading

How to predict ESBL (part 5)

A brief update on the ESBL predict study, after the last update  from 6 months ago. Tim Deelen from our group is still running the show and we are still seeking hospitals for participation. It’s for free, it’s easy, relevant and fun! We passed the 5,500 episodes and we learn a lot, including how countries deal with the ethical aspects of this study. Continue reading

The antibiotic resistance crisis resolved by bacteriophages (part 3)

Last October Dutch people were “informed” about the potential of bacteriophages. In short, “bacteriophages work where antibiotics fail because of resistance in critically ill patients, something that is already known for 100 years, and that is neglected by modern medicine”. Some questions were raised, see here and here, but curretly Dutch physicians receive many/daily requests from patients on phage therapy and the most desperate patients pay thousands of euros to seek help abroad, without reimbursement from health insurance. Last week, we had invited the most experienced clinical experts and scientists acting at the cutting edge of preclinical bacteriophage research. Here is my impression of the clinical part. Continue reading

From collateral damage to collateral sensitivity

“Every disadvantage has an advantage” is one of the many brilliant quotes from the late Dutch philosopher Johan Cruijff. This now also seems to hold for antibiotic resistance. The conventional belief is that resistance development is unidirectional: pathogens cumulatively acquire resistance traits, until being a multidrug resistant superbug. This now seems not always true; resistance development to antibiotic A, may – at the same time – increase susceptibility to antibiotic B, a phenomenon called “collateral sensitivity” that may help us in treating chronic infections. Continue reading

What’s up for 2018?

I hope you enjoyed Christmas time and wish you all the best for this year. From my side, I will continue to reflect what I meet professionally, what surprises me, confirms what I thought to know or what confirms my ignorance. In 2017 I did that 41 times (a surprise to me!) and here are some trending topics that will most likely return in 2018. Continue reading

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