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
MDR-GNR
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
How to predict ESBL (part 4)
Two months ago I provided an update on the ESBL-predict study that Tim Deelen from our group coordinates. In short: Every hospital in the world can participate, through a user-friendly electronic CRF (in a secured environment), in the validation of 2 scoring systems to predict that sepsis is caused by ESBL-producing bacteria. Only relevant for those of us that are not yet ready to start meropenem/amikacine for every patient that starts with antibiotics! This tool may help, …. if reliable. We passed the 3,000 episodes! Here is a short update and info for those that want to join. Continue reading
Houston, we have a problem
While the world was watching the Texas water ballet with Melanie Trump on stiletto heels, about 1500 people died in South-East Asia because of floodings. And while the western world is searching for another irrelevant mcr-gene, Patrick Musicha soberly describes the true antibiotic resistance crisis in Malawi, see. It is becoming more and more obvious that antibiotic resistance will be the next plague for the least privileged on earth. Continue reading
Dead bacteria cannot mutate
As a young and angry PhD student I was confronted with the concept of Selective Digestive Decontamination (SDD). That was in the early nineties (previous millennium). Coming from the field of microbiology I expected that SDD would increase antibiotic resistance. It were intensivists that told me not to worry: “antibiotics in SDD kill bacteria and dead bacteria cannot mutate”. They may have been right, suggests a new study. Continue reading
How to predict ESBL (part 3)
Six weeks ago I introduced the ESBL-predict study that Tim Deelen from our group coordinates. Every hospital in the world can participate through a user-friendly electronic CRF (in a secured environment). My blog-invitation to particpate worked and some sites already started. In June >1,000 episodes were entered! Here is a short update and info for those that want to join. Continue reading
The rocket-science of a CPE screen & isolate policy
Last weeks’ blog from Jon Otter on the practice of CPE screening and isolation raised some interesting comments (on twitter) emphasizing the difficulties in policy making for infection control. The two comments that struck me were: (1) … screening for CPE sounds logical “but does it work in long-term care facilities with high-levels of endemicity?” And “I use it in my hospital, but face difficulties in convincing others because of lacking scientific evidence for CPE.” Continue reading
Water, water everywhere (or nowhere?)
A new paper by Hopman and colleagues (Andreas is also another author but is being modest) has evaluated the effect of removing sinks from the ICU. The trigger for this intervention was an outbreak caused by an ESBL-Enterobacter that could be related to contaminated sinks. The study looked at what happens if you remove all water sources from the ICU, and all water-related activities were migrated to a tap water-free solution. Continue reading
Looking back to see the post-antibiotic era
Now online in Lancet ID an impressive and important retrospective study describing the faith of 437 patients with BSI caused by carbapenamase-producing Enterobacteriaceae (CPE). When scanning the conclusions of your weekly diarrhea of new papers (as I do) this one might have escaped your attention: (in short) “Appropriate therapy is good. Combination therapy too. Patients with BSIs due to CPE should receive active therapy.” Yet, there is much more interesting stuff in this paper. Continue reading
Reflections on Infection Prevention and Control 