Jun
27
2020

A New Antibiotic, Teixobactin Can Overcome Antibiotic-Resistant Superbugs

A new antibiotic, teixobactin can overcome antibiotic-resistant superbugs. The discovery of teixobactin took place in 2015. It is a peptide with 11 amino acid units. Teixobactin is derived from a gram-negative bacterium, Eleftheria terrae. It is the first of a new class of antibiotics that can kill superbugs. Two examples, for instance are methicillin-resistant Staphylococcus aureus and resistant Mycobacterium tuberculosis. Researchers have been battling with difficult solubility of teixobactin and problems synthesizing this peptide in the laboratory. Teixobactin binds to the membranes of the bacteria it fights. This is a new mechanism for this new class of antibiotics, different from conventional antibiotics.

Mechanisms of fighting bacteria resistant to conventional antibiotics

But it is exactly this quality that is necessary to fight the antibiotic-resistant bacteria. The researchers showed that teixobactin binds weakly to a component of the bacterial cell wall, called “Lipid II”. But they found a second mechanism, namely blocking precursors of cell membrane synthesis in the bacteria they fight. Because of these unique mechanisms it is possible for them to fight a multitude of bacteria resistant to conventional antibiotics. Teixobactin has a unique molecular structure, which makes it difficult for resistant bacteria to develop resistance to it.

Antibiotic resistance

Resistance to antibiotics is a worldwide problem. There are several factors that worked together to make antibiotic resistance such a big issue. For instance, in the past many doctors prescribed antibiotics for any viral cold, even knowing that antibiotics only work against bacteria. Aside from this, the agricultural practice of using antibiotics as a growth stimulator is also an important factor for antibiotic resistance to develop. It is the bacteria that become resistant, not the human body. Several clinical entities involving resistant bacteria exist that show the magnitude of the problem.

Flesh-eating disease

Necrotizing fasciitis (or flesh-eating disease) can develop when you swim in contaminated waters and the bacterium, Vibrio vulnificus enters through skin sores or wounds. The CDC warns that you should stay out of salt water or brackish water, if you have a skin wound. The flesh-eating bacteria, Vibrio vulnificus can become very aggressive, once it has entered the body. Right now, 1 out of 5 people who get infected will die and many people require ICU treatment. Others need limb amputations. All of this can happen within only 1 or 2 days of becoming ill. The hope is that with the development of teixobactin as an injectable medication or as an oral pill there will no longer be deaths, amputations and scarring due to this bacterium, as the antibiotic will very quickly eradicate Vibrio vulnificus. I have previously written about what hospitals can do to fight superbugs.

The most common antibiotic-resistant bacteria

Here is a brief review of the most common antibiotic-resistant bacteria.

Mycobacterium tuberculosis

Since the 1950’s and 1960’s tuberculosis was treatable with a combination of two antibiotics over a period of six months to two years. But in the last 10 years more and more resistant strains of tuberculosis have developed. This is called multi-drug-resistant TB. In 2013 statistics showed that 3.7% of newly diagnosed tuberculosis cases were multi-drug-resistant TB. Many of these cases can be traced back to prisons and homeless shelters.

Methicillin-resistant Staphylococcus aureus (MRSA)

MRSA has become a common resistant bacterium that can present with difficult to treat boils in the skin, but also as a fulminant infection as necrotizing fasciitis (or “flesh-eating disease”). About 1/3 of the cases of flesh-eating disease are caused by MRSA.

Clostridium difficile (C. difficile)

This gut bacterium is naturally resistant to many antibiotics. The rest of the gut bacteria usually suppress the growth of C. difficile. But many patients can get overgrowth of C. difficile in their gut following treatment with antibiotics. Recolonization with probiotics can help to reintroduce a balanced bowel flora. In the US about 500,000 individuals come down every year with diarrhea due to C. difficile. This leads to approximately 15,000 deaths yearly.

Vancomycin-resistant Enterococci (VRE)

Physicians find enterococci in the gut and the female genital tract of patients. They can become resistant when the patient is treated with vancomycin for another infection. The VRE can then become a problem of its own with difficult to treat infections in the genital tract of females, the gut or in wounds from surgery. It has become a problem in immunocompromised patients.

The gonorrhea causing bacteria

In the last 70 to 80 years Neisseria gonorrhoea, the cause of gonorrhea, has been treated with only one antibiotic, but gradually the bacterium developed antibiotic-resistance. Lately, with more and more resistant strains of Neisseria gonorrhoea, the CDC has recommended to treat gonorrhea with two overlapping antibiotics.

Carbapenem-resistant Enterobacteriaceae (CRE)

There are two problem bugs among this category of enterobacteria, Klebsiella species and Escherichia coli (E. coli). These bacteria reside in hospitals where they can accumulate and are present in patients with immune system compromise. Medical devices like catheters and ventilators transmit these bacteria. Once a patient is sick with CRE, there is a danger of blood poisoning (septicemia), which has a high death rate.

How do regular antibiotics kill bacteria and how can they become resistant?

Normally, when antibiotics are not resistant, they interfere with the cell membrane production of the bacteria. Specifically, conventional antibiotics prevent bacteria from synthesizing a molecule, called peptidoglycan. Without peptidoglycan bacteria are not stable enough to survive in humans. But there are other mechanisms as explained in this link how antibiotics manage to kill bacteria.

Now I like to address the question how bacteria can become resistant to conventional antibiotics. This happens with overuse of antibiotics, i.e. prescribing antibiotics when a person suffers from a viral illness where antibiotics do not work. Other overuse comes from agriculture where cattle in feed lots get antibiotics as growth promoters. The FDA is strongly criticizing this practice, because residuals of antibiotics in beef can alter the bowel flora in man. The antibiotics kill all the sensitive bacteria. But the resistant bacteria, that have undergone mutations and adapted to the antibiotics, will survive.

Why teixobactin and analogues can avoid resistance

Since the detection of teixobactin many analogues have been synthesized. A new antibiotic, teixobactin can overcome antibiotic-resistant superbugs. The teixobactin analogues need more fine tuning, but they will be a breakthrough in the treatment of resistant bacteria. As this peptide attacks two targets on bacteria, it is not easy for bacteria to develop resistance against these new antibiotics.

A New Antibiotic, Teixobactin Can Overcome Antibiotic-Resistant Superbugs

A New Antibiotic, Teixobactin Can Overcome Antibiotic-Resistant Superbugs

Conclusion

Resistant bacteria have become a serious health concern in the last decade. Physicians overprescribing antibiotics and farmers feeding antibiotics to cattle in feedlots as growth promoters were the driving forces. In 2015 came the breakthrough and discovery of teixobactin. This is a peptide with 11 amino acid units. Teixobactin is a derivative of a gram-negative bacterium, Eleftheria terrae. A new antibiotic, teixobactin can overcome antibiotic-resistant superbugs. In the meantime, researchers have been able to improve solubility by developing teixobactin analogues. More research is necessary. But all of the researchers who work in this field claim that this will very soon be extremely useful for patients with super bugs. This super-antibiotic will be a weapon fighting super bugs. Before the release of this medication clinical trials will be the next step.

Jun
06
2020

Adequate Vitamin D Level Strengthens the Immune System

The Covid-19 coronavirus crisis is teaching us that an adequate vitamin D level strengthens the immune system.

When we age, our resistance to infections weakens, but this may be because our immune system needs more vitamin D3. I have reviewed the super powers of vitamin D3 before in 2014. In the past the thought was that the human body would need only 400 IU of vitamin D3 every day to cure rickets. And these were the daily vitamin D3 recommendations from medical authorities for several decades. Gradually it became known that for cancer prevention, infection prevention, cardiovascular illness prevention and for diabetes prevention much higher doses of vitamin D3 were necessary. As pointed out in the previous link, almost 50% of the world population is deficient in vitamin D. This is due to a lack of exposure to sunlight and due to inadequate supplementation with vitamin D3.

History of vitamin D

Dr. Adolf Windaus received the Nobel prize for chemistry in 1928. It was to acknowledge “… his studies on the constitution of the sterols and their connection with vitamins”. His work involved the metabolism of vitamin D and the precursors of vitamin D.

Rickets

As the above link shows, rachitic children were treated since the mid 1800’s with cod liver oil and since the early 1900’s also with ultraviolet light. But we know now that 400 IU of vitamin D3 per day is just enough to cure rachitic children, but it is not enough to strengthen the immune system to fight influenza viruses or the Covid-19 coronavirus. I will discuss further below what vitamin D blood levels are important to achieve a healthy state of the immune system.

Adequate vitamin D level strengthens the immune system

The immune system is very complicated and consists of many cell types that interact with each other and the rest of the body. It is important to recognize that the innate immune system immediately inactivates intruding viruses. But the vitamin D blood concentration has to be high enough. The acquired immunity consists of antibodies that are produced by B cells. The antibodies were produced during prior infections that you have survived and you are now immune to. However, other antibodies that circulate in your blood may have originated from vaccines you received in the past (whooping cough, measles, tetanus, diphtheria etc.). With the Covid-19 coronavirus it is the innate immunity that plays the biggest role until a vaccine will be found in the future.

Vitamin D is a hormone

This 2013 paper explains that vitamin D is a hormone that stimulates its own vitamin D receptor. This is a nuclear receptor that has close relations to the cell DNA and can stimulate more than 900 polypeptides. They are messenger molecules that are involved in a variety of physiological functions. One of the key functions is the immune system. This link explains that T cells that have vitamin D receptors can develop into cytotoxic T cells (also known as “killer T cells”). They are important in fighting cancer, but also parasites.

The key is that the hormone vitamin D can release more than 100 polypeptides that have the power to fight virus attacks including the Covid-19 coronavirus.

Three mechanisms how vitamin D works against the virus

The researchers outlined 3 mechanisms of how vitamin D works:

  • Maintaining tight epithelial junctions making it more difficult for the Covid-19 coronavirus to penetrate.
  • “Killing enveloped viruses through induction of cathelicidin and defensins.” These powerful antiviral polypeptides can kill viruses that have invaded the blood stream within 1 to 2 days.
  • “…And reducing production of proinflammatory cytokines by the innate immune system, thereby reducing the risk of a cytokine storm leading to pneumonia.” It is people who get the viral pneumonia that are at a high risk of death. By bringing the blood level up to the higher range of normal, between 50 and 80 ng/mL, patients that have encountered Covid-19 coronavirus are more likely to survive.

Two polypeptides, cathelicidin and defensins

Again, I like to emphasize that it is not vitamin D that has a direct effect on the virus. It is two polypeptides, cathelicidin and defensins, which are powerful antiviral polypeptides, that are released by vitamin D.

They can kill viruses that have invaded the blood stream and can eliminate the cytokine storm. This all happens very fast, within only 1 to 2 days. But you have to have an adequate vitamin blood level for this to occur (about 50-80 ng/mL).

Sources of vitamin D

First of all, vitamin D is readily absorbed from food. But there are not many foods that contain enough vitamin D for the immune system. The ones that contain vitamin D are as follows:

  • “Fatty fish, like tuna, mackerel, and salmon.
  • Foods fortified with vitamin D, like some dairy products, orange juice, soy milk, and cereals.
  • Beef liver.
  • Cheese
  • Egg yolks. “

Sun induced amount of vitamin D

Secondly, vitamin D can be synthesized in the skin from exposure to sunlight. But for this to happen all the necessary enzymes need to be present.  This link explains that many older people above the age of 65 have low vitamin D blood levels because of a lack of sun exposure and a lack of cutaneous synthesis because of enzyme issues.

Vitamin D supplements

The most reliable source of vitamin D are vitamin D3 supplements. When people supplement with the same dose of vitamin D3 there will be people who get higher vitamin D blood levels than others, as absorption in the gut is different for different people.  The ones who have relatively low vitamin D blood levels are often called “slow vitamin D absorbers”. But when the vitamin D3 dosage is increased even those people will reach the recommended high normal range (50-80 ng/mL).

Vitamin D blood level

The vitamin D blood test has the scientific name “25-hydroxy vitamin D level”. This is now the recognized gold standard for determining who is deficient or has normal levels with respect to vitamin D. The following 2013 publication has studied the vitamin D level of 1,470 healthy Swiss men and women, 60 years or older. Vitamin D levels were classified as severely deficient when the level was below 10 ng/mL. The vitamin D level was deficient between 10 and 20 ng/mL. The level was insufficient when between 21 and 29 ng/mL. A level above 30 ng/mL is normal.

8 % of the subjects were severely insufficient and 66% had insufficient vitamin D levels. Only 26.1% of the subjects had normal levels. Over 50% of healthy older Swiss (above the age of 70) had insufficient vitamin D levels.

Which vitamin D level is safe and which is not?

A peer-reviewed publication of the effects of vitamin D in health and disease contains 269 references.

What vitamin D level is optimal? This question was reviewed in this paper.

  • Below 15 ng/mL the immune system is paralyzed
  • With a level above 30 ng/mL the immune system is working
  • A level of 50-80 ng/mL has the immune system working optimally
  • Above 150 ng/mL toxic vitamin D levels start
  • With 300 ng/mL severe toxicity begins

Vitamin D toxicity

It is only with high levels of vitamin D (more than 150 ng/mL) that you have to worry about high calcium levels in the blood or kidney stones (toxic levels). But the key is to not exceed 80 ng/mL regarding the vitamin D blood level. This gives you a lot of flexibility before you reach toxic levels (above 150 ng/mL). For those who want more information, here is a thorough, peer reviewed publication about vitamin D toxicity with 59 references.

Vitamin D supplement compliance

The question is why not more people take adequate vitamin D3 supplements.  We know that vitamin D can prevent so many chronic diseases including serious viral infections. The answer is complex, but it includes a fear of the population of vitamin toxicity (kidney stone and high calcium levels). However, as pointed out before, this occurs only above a vitamin D level of 150 ng/mL. With proper vitamin D blood level monitoring you never reach toxic levels of vitamin D.

Denial

Denial likely is another major factor. People feel that if they have a balanced diet, they would be protected from vitamin D insufficiency. As pointed out before this is a grave error to think as our food does not contain sufficient vitamin D to strengthen our immune system.

False security with low doses of vitamin D

Finally, there are people who think that low doses of vitamin D, like 1000 IU of vitamin D daily, would be enough. But it is not enough. This is why testing vitamin D blood levels is so important. It is a reality check. The blood level must be in the high normal range (50-80 ng/mL). At this level the immune system functions optimally.

Compliance issues

In this context there was an interesting study done by LifeExtension, a company that publishes monthly health magazines. In this study the company examined the vitamin D blood levels of LifeExtension members. They are the ones who should be knowledgeable in how important it is to have good, preventative vitamin D blood levels. The study showed that 38% of the vitamin D test results were less than 30 ng/mL. In addition, 69% of the vitamin D tests were less than 40 ng/mL. Finally, 85% of the vitamin D test results were less than 50 ng/mL. What this means is that LifeExtension members were non-compliant when it came to taking regular adequate vitamin D3 doses. This resulted in levels that were too low for the majority to protect them from the Covid-19 coronavirus.

Covid-19 coronavirus infections and vitamin D blood level

There is a tight relationship between vitamin D blood levels and the strength of the immune system. Essentially, coronavirus mortality measures who is vitamin D deficient. Without enough vitamin D on board the virus penetrates into the blood stream and penetrates the lining of the respiratory tract. Next the cytokine storm develops, which leads to viral pneumonia. Higher doses of vitamin D3 will mitigate the course of Covid-19 coronavirus.

Adequate Vitamin D Level Strengthens the Immune System

Adequate Vitamin D Level Strengthens the Immune System

Conclusion

The Covid-19 coronavirus pandemic has taught us how important an intact immune system is to survive the virus when you get it. We do know for some time how closely related a good vitamin D level is with the functioning of the immune system. I have reviewed here what a desirable vitamin D level is and how we can achieve this with oral vitamin D3 supplements. The goal is to achieve a vitamin D level in the upper range of normal (50-80 ng/mL). With a level like this the virus cannot penetrate the mucous membranes of the respiratory tract and even if it did, it cannot produce a cytokine storm in the blood that would lead to the deadly viral pneumonia or to blood clots. When the virus invades the bloodstream, vitamin D releases powerful antiviral polypeptides that can kill viruses within 1 to 2 days.

Literature

Here are some peer-reviewed publications on vitamin D:

 

May
09
2020

Vitamin D Is the Definitive Link

Vitamin D deficiency caused rickets in the past, but now we know that vitamin D is the definitive link for other health problems. The lack of it is the reason for numerous illnesses. A search in my website gives you more than 170 blogs where I am discussing the effect of vitamin D. These describe how vitamin D is the definitive link in a lot of different diseases. In a 2015 study from Brazil the authors noted that a critical vitamin D blood level was 12 ng/mL. All these critically ill patients received treatment in an ICU setting. In vitamin D blood levels of 12 ng/mL the mortality rate was 32.2%. A control group of ICU patients with more than 12 ng/mL had a mortality rate of only 13.2%. The authors concluded that a low vitamin D level on ICU admission was an independent risk factor for mortality in this critically ill patient group.

A few diseases where low vitamin D is the definitive link for a poor outcome

In patients, who have arthritis, cardiovascular disease, breast cancer, diabetes, osteoporosis, influenza and others, the laboratory tests that shows their 25-hydroxy vitamin D level, are usually below 15 ng/mL. This link has 269 peer reviewed references.

2015 Italian study showed that microvascular complications in diabetes patients were high, if the vitamin D3 blood levels were low. If patients had high levels of vitamin D, there were no complications such as retinopathy or nephropathy. But if levels were below 20 ng/mL, damages were significant in the capillaries of the eyes and kidneys.

Multiple sclerosis

It has been known for some time that in the northern hemisphere MS is more common because of the lack of sunshine, which in turn leads to less vitamin D3 production in the skin. Multiple sclerosis (MS) is an autoimmune disease where immune cells attack the lining of nerves. Both nerve cells and immune cells have vitamin D receptors. It appears that vitamin D calms down immune cells and remission of an MS relapse is more likely.

Dr. Fitzgerald and colleagues published a study in JAMA Neurology in 2015. Results of this study showed marked differences between MS patients with high and low vitamin D levels.

Multiple sclerosis rates with high and low vitamin D levels

Patients with the highest vitamin D blood levels (more than 40 ng/mL) had the lowest rates of new MS lesions. Previous studies found that a low blood level of vitamin D (less than 25 ng/mL) had an association with a higher risk of developing MS. Dr. Fitzgerald’s study showed that a 20 ng/mL (50.0-nmol/L) increase in serum vitamin D levels associated with a 31% lower rate of new MS lesions. Patients with the highest vitamin D level of more than 40 ng/mL (100 nmol/L) had the lowest amount of new MRI lesions (47% less than the patients with the lowest vitamin D levels).

Dementia and Alzheimer’s disease

A 2014 study showed that patients with a low vitamin D level had a connection with a high risk of dementia and Alzheimer’s disease.

Specifically, the researchers found the following observations.

  • Vitamin D level of less than 10 ng/mL: 122% increased risk of Alzheimer’s
  • A vitamin D level of 10 to 20 ng/mL: 51% increased risk of Alzheimer’s

Vitamin D is the definitive link for the immune system

In a publication of 2006 Dr. John Cannell and co-workers have reviewed why influenza has seasonal outbreaks. They found that the innate immune system was very dependent on vitamin D. Those who did not get enough sunlight in the northern hemisphere during January, February, March and April have an average 25-hydroxy vitamin D level of only 15 to 17 ng/mL. In contrast, from July to September the same volunteers had vitamin D levels of 24 to 29 ng/mL. The authors stressed that this was the reason why spring flus in the late winter/early spring season are common, but disappear in summer.

Vitamin D requirements for immune system is 2000 IU or more per day

Vitamin D is essential for the functioning of the innate and adaptive immune system. They also are the reason why children are not as affected by influenza viruses as adults are. Dr. Cannell said: “The innate immunity of the aged declined over the last 20 years due to medical and governmental warnings to avoid the sun. While the young usually ignore such advice, the elderly often follow it”. Had the older patients taken higher doses of vitamin D3 every day, their immunity would have been as strong as the children’s immunity. The publication cites another paper that found that 2000 IU per day or more will strengthen the immune system. Note that this is a higher dose than  treating rickets. Treatment of rickets responds to only 400 IU of vitamin D3 per day.

Mechanism of action of vitamin D in infectious diseases like influenza or Covid-19 coronavirus

Here is evidence from US researchers that states that higher doses of vitamin D3 will mitigate the course of influenza and of Covid-19 coronavirus. The researchers outlined that vitamin D has 3 effects:

  1. Maintaining tight epithelial junctions making it more difficult for the Covid-19 coronavirus to penetrate them.
  2. “Killing enveloped viruses through induction of cathelicidin and defensins.” These powerful antiviral polypeptides can kill viruses that have invaded the bloodstream within 1 to 2 days.
  3. “…And reducing production of proinflammatory cytokines by the innate immune system, thereby reducing the risk of a cytokine storm leading to pneumonia.” People who get viral pneumonia are at a high risk of death. By bringing the vitamin D blood level up to the higher range of normal, between 50 and 80 ng/mL, patients that have encountered Covid-19 coronavirus are more likely to survive.

Criticism of high dose vitamin D treatment

A common criticism of treatment with higher doses of vitamin D is that people would develop high blood calcium levels and would get kidney stones. Three recent studies have demystified this. A 2012 study looked at patients who were in the higher range of calcium levels, but deficient in vitamin D. They were treated with vitamin D3 und closely supervised. The calcium levels did not change after 1 year of high doses of vitamin D.

This 2018 study observed that there is a small amount of kidney stone formers who will form kidney stone with or without vitamin D3 treatment.  However, the large majority of patients do not form kidney stones with vitamin D treatment and their blood calcium levels stay the same before and after vitamin D treatment.

Toxic vitamin D blood levels

Toxic levels of vitamin D blood levels are above150 ng/mL, or 375 nmol/L. The therapeutic levels discussed here are well below these toxic levels.

Placebo controlled New Zealand study fails to show kidney stones

A placebo-controlled study from New Zealand went on for 3.3 years. 100,000 IU of vitamin D3 monthly (3333 IU per day on average) in the experimental group were compared to a placebo group. There were no vitamin D induced kidney stones and also no changes in calcium levels.

In past studies regarding vitamin D toxicity were done. But with these investigations there were many confounding factors that led to false results.  The investigators at those times mistakenly thought that they were side-effects of vitamin D. Up to this day conventional medicine often warns of hypercalcemia and kidney stones with vitamin D treatment. While the patient is on higher vitamin D levels, the physician can do blood and urine tests to see whether or not there is any concern.

Polypeptides released by vitamin D

There are more than 100 polypeptide hormones that are controlled by vitamin D. The most important ones for control of bacterial and viral infections are the defensin family and the cathelicidin family of polypeptides. They are instrumental in preventing the cytokine storm with a Covid-19 coronavirus infection treated with high vitamin D doses.

Decades after the original description of vitamin D researchers found out that vitamin D actually is a hormone.

There are vitamin D hormone receptors on almost every cell of the body. Vitamin D integrates the body cells and they respond as one unit. It is only recently that researchers found out about the release of polypeptides, particularly defensin and cathelicidin. They are  vital in the defence against the Covid-19 Coronavirus and the various flu types.

Vitamin D Is the Definitive Link

Vitamin D Is the Definitive Link

Conclusion

The detection of vitamin D originally occurred when rickets was examined. But later researchers found that vitamin D has hormone qualities.

You can prevent several diseases, like arthritis, cardiovascular disease, breast cancer, diabetes, osteoporosis and influenza. But you must take adequate amounts of vitamin D to bring the vitamin D blood level up. 25-hydroxy vitamin D blood levels are now recognized as the standard test to measure whether you have enough vitamin D on board. When it comes to fighting infections the vitamin D blood level has to be above 30 ng/mL (above 75 nmol/L). At this level the immune system will release defensin and cathelicidin polypeptides. These are powerful antiviral and antibacterial substances that can even fight Covid-19 coronavirus.

High vitamin D therapy is safe

With careful monitoring of blood vitamin D levels side effects of high vitamin D dosages were not found. Conventional medicine keeps on repeating old studies with confounding errors. This scares people, and as a result they don’t want to take enough vitamin D for prevention. Hypercalcemia and kidney stones were NOT found in randomized newer studies. As long as the vitamin D level does not exceed 50-80 ng/mL (or 125-200 nmol/L) vitamin D therapy is perfectly safe.

Jan
18
2020

Antibiotics In Children Can Trigger Allergies And Asthma Later In Life

Whoever treats a child’s cold must know that antibiotics in children can trigger allergies and asthma later in life. This is what a study released on Dec. 20, 2019 has shown. The researchers examined records of 798,426 children seen at the Department of Defense TRICARE health care program. They were born between 2001 and 2013. The physicians examined the children later again for allergies. The more antibiotics the children received in childhood, the more severe the youngster’s allergies were later in life.

More details about the study

The researchers found that different antibiotic types had different risks to cause allergic reactions later in life.

  • Penicillin: 1.3-fold risk
  • Penicillin with a β-lactamase inhibitor: 1.21-fold risk
  • Macrolides: 1.28-fold risk)
  • Cephalosporins: 1.19-fold risk
  • Sulfonamides: 1.06-fold risk

The type of allergies that the children developed later in life were food allergies, anaphylaxis, asthma, atopic dermatitis, allergic rhinitis, allergic conjunctivitis or contact dermatitis. The researchers stressed that their finding indicated an association between taking antibiotics and developing allergies later. It was not a causal relationship.

Food allergies in more detail

Anaphylaxis

This allergic condition is an emergency and requires immediate medical attention. It can occur when the body overreacts to peanuts or penicillin. It can occur with foods, and the reaction is sudden and severe. The symptoms may include wheezing, shortness of breath, a cough or tightness in the throat. The blood pressure may drop leading to light-headedness and passing out. The skin may show hives, swelling and a rash. The digestive symptoms may be nausea, vomiting and diarrhea. Other symptoms may involve itching eyes, headaches, anxiety and a feeling of impending doom.

Asthma

Airborne grass and tree pollens, mold spores and dust, but also peanuts and other strong allergens can trigger an asthma attack. The symptoms can be shortness of breath, wheezing, tightness in the chest, trouble falling asleep because of coughing and being short of breath.

Atopic dermatitis (eczema)

Often atopic dermatitis starts below the age of 5 and can last until late adolescence or adulthood. The symptoms can be dry skin, itching red patches of skin and thickened scaly skin. Allergic contact dermatitis is common in patients with atopic dermatitis.

Allergic rhinitis

People who suffer from allergic rhinitis are sensitized to particles in the air like grass and tree pollen, molds or cigarette fumes. They develop a stuffy nose, itching and watery eyes, sneezing and swelling around the eye lids. An allergist can do skin scratch tests to find out what the patient is allergic to. Subsequently, if the allergies are strong, the allergist may decide to start desensitization with allergy shots.

Allergic conjunctivitis

A person who is allergic to pollen and mold spores will react to this when in contact with it and often develop allergic conjunctivitis. An eye inflammation will develop within a few minutes leading to swelling of the conjunctiva around the eye ball. The eyes end up looking red, itching, burning and being watery.

Contact dermatitis

Contact dermatitis develops when your body brushes against a substance that your body has been previously sensitized to. One example is poison ivy contact dermatitis. But many other substances can cause similar reactions: solvents, shampoos, permanent wave solutions and rubbing alcohol. In addition, plants, bleach and detergents, fertilizers, pesticides and airborne substances (sawdust, dust from woollen materials) can also do the same.

The gut biome

Dr. Purvi Parikh is an allergist and immunologist at NYU Langone Health in New York. She was not involved in the study, but commented to it as follows: “One reason why there might be an association is because our microbiome, specifically in our gut, plays a large role in our immune systems. Antibiotics are known to not only kill the bacteria that are causing an infection, but also ‘good’ bacteria our immune system needs to protect us from developing allergic or autoimmune diseases.”

Treat bacterial infections with antibiotics when needed

She went on to say: “Overall, parents should know that this study shows an association but not necessarily cause and effect. So, if a child truly needs an antibiotic for a bacterial infection, they should not withhold it due to fear of allergic disease. However, on that same note, one should not over use antibiotics if not needed – for a virus or a cold – as there may be long-term consequences from over use.”

Antibiotics In Children Can Trigger Allergies And Asthma Later In Life

Antibiotics In Children Can Trigger Allergies And Asthma Later In Life

Conclusion

A new study showed that antibiotics can cause allergies and asthma later in life. The reason seems to be that our gut bacteria react to the antibiotics and the gut dysbiosis (disbalance of the gut bacteria) persists, when the antibiotics have been discontinued. The immune system can then react in ways that are detrimental to the child and adolescent. Anaphylaxis, asthma, atopic dermatitis, allergic rhinitis, allergic conjunctivitis or contact dermatitis are all different manifestations of allergies that can develop later in life. At this point we only know that there is an association between these allergic manifestations and the antibiotic use in childhood. More clinical trials will need to shed a light on what causes allergies in some children, but not in others.

Mar
23
2019

Immune System Can Trigger chronic fatigue syndrome

A study from February 2019 stated that the immune system can trigger chronic fatigue syndrome. Specifically, researchers observed that interferon treatment in hepatitis C patients could lead to chronic fatigue syndrome in 33% of patients.

Interferon treated hepatitis C patients can develop chronic fatigue syndrome

In this cased 54 patients with hepatitis C received treatment with Interferon. 18 of them (33%) developed chronic fatigue syndrome, which persisted. 57 control did not develop it. With this in mind, patients were examined at baseline, during the 6 months to 1-year Interferon treatment and 6 months following the end of the treatment.

It was noted that baseline interleukin levels (IL-6 and IL-10) were higher in the fatigued patients. Interferon treatment worsened the interleukin levels, and the interleukin levels stayed high from then on. Moreover, symptoms of pain from chronic fatigue syndrome also stayed with the patients after the treatment had ended.

Patients with chronic fatigue syndrome have a viral illness in the beginning

The lead researcher, Carmine Pariante, professor of biological psychiatry at King’s College London, noted the following. Before patients come down with chronic fatigue syndrome they frequently have a major infection or a flu virus. This certainly mobilizes an interferon response from their immune system. Professor Pariante said that it is the overstimulation of the immune system that leads to an overproduction of interferon, which likely causes chronic fatigue syndrome.

In the US an estimated 836,000 to 2.5 million Americans present with chronic fatigue syndrome according to the CDC.

The observation described above confirms the theory that a chronic stimulation of the immune system likely underlies the development of chronic fatigue syndrome. It was the patients undergoing treatment for hepatitis C with interferon, persistently high IL-6 and IL-10 levels together with pain symptoms that caused chronic fatigue syndrome.

Example of a patient with chronic fatigue syndrome

A 19-year old patient with chronic fatigue syndrome (CFS) explained that her CFS kept her hostage inside. When she gets dressed it feels like there is a blackness going over her eyes. She cannot lead a conversation or speak as she has absolutely no energy. So, the only thing she can do is to lie down and exist. Her pain and fatigue is  debilitating. She feels that her body and brain are unable to recover from even the smallest effort. About 25% of CFS cases are severe cases. This means that they are house bound, bedridden and wheelchair dependent.

Immune System Can Trigger chronic fatigue syndrome

Immune System Can Trigger chronic fatigue syndrome

Conclusion

The cause of chronic fatigue syndrome (CFS) has been a mystery for a long time. But a new UK research study has shed some light on a hyperactive immune system that may cause CFS. The research team found that 33% of patients with hepatitis C who received treatment with interferon developed CFS. When lab tests analyzed their blood values, they had developed high interleukin levels (IL-6 and IL-10). This was a sign for an overstimulation of the immune system. Other patients who did not develop CFS normalized their interleukin levels. The control patients had no changes in interleukins.

Overactive immune system can trigger chronic fatigue syndrome

The researchers are of the opinion that an overactive immune system is responsible for the development of CFS. Chronic fatigue syndrome is a devastating multi-system chronic disease with pain and weakness. A significant number of patients suffer from permanent disability. The researchers hope that with more research they may be able to find a solution and treatment protocol. Presently no form of treatment is available.

Oct
06
2018

Health Risks After Hurricanes

We hear a lot about the dangers of hurricanes when they are in a region, but very little regarding health risks after hurricanes. I thought it would be interesting to review all of the health risks in a blog.

Health risks during a hurricane

A lot of the health risks during a hurricane are directly related to the risks from the wind severity, the amount of rain per hour and the physical damage from the hurricane. The excessive wind can uproot trees and they may fall right onto a house. This happened in the beginning of hurricane Florence. The amount of rain that comes down in a short time frame can be astounding. It causes flooding, which together with the high wind speeds can make you lose your footing. There is flying debris, torn away pieces of wood and drywall that can become a hazard to any person. It is a hazard that could kill you right there. It is best to be out of the way of a hurricane, if you can at all. But you need to watch hurricane predictions on the Internet or the news, so you know what is going on long before the hurricane arrives. This gives you enough time to travel away from the danger zone. People who live on islands need to be particularly proactive, so that they get out of harms way in time.

Be safe from floodwaters

If you live in a low-lying area, it is safer for you to leave and go to a shelter before the hurricane hits. Otherwise you end up drowning. Being on top of your house in a hurricane is dangerous as the roof may fly off any minute from the force of the wind. You are also the target of flying debris, wood pieces and other flying objects.

Contaminated water is one of the major health risks after hurricanes

With hurricane Maria in 2018 it appeared in the first few days that only 16 to 18 people had died from the physical effects of the hurricane in Puerto Rico. But in the subsequent weeks and months people died en masse because of infections from contaminated drinking water. It is unbelievable that huge water supplies had been brought in by FEMA following the hurricane Maria, but it was not distributed to the people who needed it. The total death toll is now around the 3000 mark. FEMA calculated this by subtracting 13,000 deaths due to natural causes from the total deaths of 16,000. The difference is about 3,000 deaths, attributable to hurricane Maria.

Providing clean drinking water important

Providing clean drinking water should be the first priority following a hurricane. This will prevent that people get the typical water-born bacterial and viral illnesses following a hurricane.

One patient in Puerto Rico with chronic emphysema was on a breathing machine. The interruption of electricity as a result of hurricane Maria meant his death. Some people are so vulnerable that the interruption of electricity ends their life.

Communicable diseases from floodwaters

The WHO has brought out a fact sheet regarding communicable diseases from floodwaters. People need to be aware that floodwaters are contaminated and avoid them as much as possible. However, they also point out that unless you have bruises or cuts where bacteria from contaminated waters could grow the danger is smaller than generally believed.

Mold from water damage to houses

After hurricane Katrina in New Orleans 2005 there was a lot of mold growth in houses that were flooded. This caused an overwhelming odor that was difficult to cope with. Bleach water removes mold initially until a professional crew can clean it up at a later date. I mention this here because following a hurricane there will not be enough professional people around to help. Mold is particularly devastating for asthmatics and people with chronic respiratory conditions. These people need evacuation from such living environments until the house is clean from molds. Flare-ups of asthma and chronic obstructive pulmonary disease can be deadly. Under normal circumstances people with respiratory problems can manage, but these people are at a severe risk of dying from an aggravation of their underlying conditions. Hurricane Katrina will be remembered for this.

Living in destroyed homes

Often with a direct hit of hurricane the roofs of homes are missing. The hurricane ripped them off and they literally flew away. A home without a roof is prone to water damage from future precipitation. There is the danger of mouse and rat infestation. Birds can enter and partake in the leftover meals. Their droppings may contain contagious bacteria like salmonella causing typhoid fever. Builders  work hard and long hours; it can take months or years before life is normal again. It may be wiser to live with a relative for a few months until the house is in livable condition again. When electricity is restored and the water lines are functioning again, there may still be an issue about getting safe drinking water and uncontaminated water to have showers and baths. Also, without proper shelter there are risks of mosquitoes transferring communicable diseases. This happened in the Dominican Republic.

Malaria in the Dominican Republic

In September 2004 Hurricane Jeanne struck the Dominican Republic. Subsequently there was more flooding from heavy rainfalls. The end result was a mini-epidemic of 17 cases of malaria, because the flooded areas gave the mosquitoes more breeding ground to multiply. Fortunately no one died, as all the malaria cases responded to chloroquine and primaquine. But some patients had to be treated in the Intensive Care Unit of a hospital. As already mentioned there are other water born illnesses that can cause diarrhea, vomiting and fever. These people need to get immediate access to a hospital where the medical staff will rehydrate them intravenously. Otherwise they could die.

Health Risks After Hurricanes

Health Risks After Hurricanes

Conclusion

Hurricanes pose enormous problems for the communities where landfall occurs. Close to the eye of the hurricane are the worst structural damages to properties and trees. But even miles away from that there can be flooding due to excessive winds and rain. Most people are reasonable during the initial phase when the hurricane hits. This means they stay inside so they can protect themselves from the direct impact of the storm. But hurricanes can pull roofs off and people can get hurt.

Illnesses from contaminated water

Later there is a disruption of the electrical supply as well as the water supply. The restoration of the utilities may take days or weeks. Immediately you depend on fresh and clean water supply, and when you run out, there may not be enough fresh water available. Illnesses from contaminated water become a huge problem at that point. This is where a lot of mortality comes from in the aftermath of a hurricane.

If you can, it is wiser to escape this all by visiting a relative far away from the hurricane area. In this case you must leave well in time before the hurricane hits. You can check with the authorities when it would be safe to return home. At least you know that you have survived. Everything else can wait. You will gradually take care of it. But it may take a long time for things to return to normal.

Aug
25
2018

The Downside Of Living To 100

A review article has examined longevity and reviewed the downside of living to 100. In their 80’s about 10% of the population live in nursing homes, but among centenarians 55% are residing in nursing homes. They are often very lonely, as their social circles have shrunk as they aged.

Common diseases of older people

Osteoarthritis makes it difficult for people to get around, it causes chronic pain and it can also be the reason for falls. In 1990 there were 213.4 cases of osteoarthritis per 100,000. 26 years later, in 2016 there were 232.1 cases of osteoarthritis per 100,000 people.

Chronic obstructive pulmonary disease (COPD) has been falling, because less people smoke cigarettes now. Statistics show 1667 cases of COPD per 100,000 in 1990, but only 945 cases of COPD per 100,000 in 2016.

Diarrhea and common infections have dropped sharply from 8951 per 100,000 in 1990 to 3276 per 100,000 in 2016.

What other common diseases do older people get?

There are a number of common diseases that affect the elderly.

Osteoarthritis

Osteoarthritis of the hips and the knees are common, but it can affect every joint in the body. In the end stage knee replacements or hip replacements may be necessary. But before a total knee replacement or total hip replacement can even come into consideration, the person’s heart needs a thorough checkup to ensure that it is safe for the patient to undergo surgery under a general anesthetic.

Heart disease

Older people often have heart disease.

When coronary arteries are narrowed, heart attacks occur. Cardiologists can place stents, so that previously narrowed coronary arteries receive normal blood flow. Following such a procedure the patient may live for another 10 to 15 years.

There are also heart valve calcifications. The aortic valve is particularly endangered. A heart surgeon may be able to replace a diseased aortic valve by a porcine valve.

The nervous system of the heart transmits electrical signals from the sinus node to the muscle fibers, which can get diseased. Heart rhythm problems may necessitate the insertion of a pacemaker.

Finally, the heart may enlarge, but pump less blood than before. This condition is congestive heart failure. The 5-year survival for this condition is only 50.4%. Unfortunately there is very little the doctor can do for patients like this.

Cancer

The older we get, the more DNA mutations we accumulate. At one point cancer develops. If the diagnosis happens at an early stage there is a good chance that surgery can remove a cancerous growth, and the patient survives. But there are cancers that are notoriously difficult to recognize in the early stages. These are: cancer of the pancreas, kidney cancer, stomach cancer and certain types of leukemias.

Respiratory diseases

Those who smoked earlier in life may develop chronic obstructive pulmonary disease (COPD). It is a chronically disabling lung disorder. Often these individuals have to carry an oxygen tank with them wherever they go. The 5-year survival rate for people with COPD is 40 to 70%.

Osteoporosis

Osteoporosis is a disease where the bone is brittle. Spontaneous bone fractures can occur at the wrists, the upper thigh bone (femoral fractures) or in the vertebral bones. Women in menopause are hormone deficient and this contributes to calcium depletion of the bones. Lately research has shown that vitamin K2 and vitamin D3 are necessary for a normal calcium metabolism. Briefly, 200 micrograms of vitamin K2 and 5000 IU of vitamin D3 every day are the necessary dosage that the body can absorb calcium from the gut, eliminate it from the blood vessels and deposit it into the bone. Calcium is present in milk products and milk. If a person does not consume enough milk products a supplement of 1000 mg of calcium daily does make sense.

Alzheimer’s

The older we get, the more likely it is an onset of Alzheimer’s or dementia. Between the ages of 90 to 94 there is a yearly increase of Alzheimer’s of 12.7% per year. The group from age 95 to 99 years has a yearly increase of Alzheimer’s of 21.2% per year. Persons aged 100 years and older have an increase of Alzheimer’s by 40.7% per year. What this means is that essentially there is a doubling of Alzheimer’s every 5.5 years. We do not have all of the answers why this is happening and why Alzheimer’s develops. But we do know that diabetics are more likely to develop Alzheimer’s. High blood sugar levels and high insulin levels seem to lead to the precipitation of the tau protein in the brain, which causes Alzheimer’s.

Diabetes

When diabetes is not well controlled, there is accelerated hardening of the arteries. This can cause heart attacks and strokes. Longstanding diabetes can affect the kidneys (diabetic nephropathy, kidney damage) and can lead to hardening of the leg arteries. Often the only treatment left is a below knee amputation. Blindness from uncontrolled diabetes is common and pain from diabetic neuropathy as well.

Diabetics have an average life expectancy of 77 to 81 years. However, if they pay attention to their blood sugars and manage their diabetes closely they can live past the age of 85.

Falls and balance problems

As people age, their balance organ is not functioning as well. Also, people with high blood pressure medication may have postural hypotensive episodes that can lead to falls.

There may be a lack of cognitive functioning and misjudging of steps, ledges and irregularities in the floor. When a person has brittle bones from osteoporosis and they fall, a hip fracture is very common. At a higher age surgery for a hip fracture is dangerous. It can have a mortality of 50%.

Obesity

A person with obesity has a life expectancy that is 10 years less than a person without obesity. The reason for this is that with obesity This is so, because the risk of heart attacks, strokes, cancer, arthritis and diabetes is increased.

Depression

Older people often get depressed. It even has its own name: involutional depression. People can get into a state of mind, where they think negatively. Depressed people feel that they have nothing to live for. They lost friends; they are shut in because they can’t drive a car any more. This type of depression needs treatment by a psychologist or psychiatrist. The danger of leaving depression untreated is that the person may get suicidal. In older people depression is often precipitated by physical health problems.

Oral health

When teeth are not looked after, gingivitis and periodontitis can develop. Infected gums can shed bacteria into the blood and this can affect the heart valves. Endocarditis, the infection of heart valves, is a cardiological emergency. Prolonged antibiotic therapy is necessary to overcome this condition.

Poverty

Poverty has real consequences. The aging person may not have access to the optimal medical care facility because of a lack of funds. But even at a younger age there is evidence that people are healthier when they are wealthier.

Shingles

Older people often get shingles, even if they had chickenpox or shingles as a child. This is evidence that the immune system is getting weaker. Shingles in an older person should alarm the treating physician that there could be an underlying cancer. Due to that knowledge a cancer-screening tests should be part of the medical exam. In addition, a varicella vaccine should be offered to the patient to build up immunity.

The Downside Of Living To 100

The Downside Of Living To 100

Conclusion

Living to 100 is often glorified in the press. Maybe you have seen a 90-year old jogger completing a marathon, or you saw an 85-year old couple ballroom dancing. But what they don’t show you is what I summarized here, the less glamorous things about living to 100. You may get a heart attack or a stroke. Osteoarthritis may affect you how you walk. Congestive heart failure may make you get short of breath when you walk upstairs. Then there are various cancer types that are difficult to diagnose early.

If you have smoked in the past, you may suffer from chronic obstructive pulmonary disease (COPD), which leaves you breathless.

Other illnesses

Osteoporosis can lead to spontaneous fractures. Because the bone has a lack of calcium, this is difficult to treat and takes a long time to heal.

Alzheimer’s is ever so much more common when you approach the year 100. There are other medical conditions you can get: obesity, diabetes and depression. When you get shingles for the second time, it may mean that your immune system is getting weak and a cancer-screening test should be done.

There are some downsides when you approach the age of 100.

Know your risks and be vigilant

You may keep your physician busy checking out various age-related illnesses, but more importantly, get regular check-ups and tests. Any condition is easier to treat with an earlier diagnosis! The message for anybody reading this is very simple. Prevention through healthy living is something you can actively pursue. Keep your body and your mind busy. Enjoy time with friends and family instead of living a solitary existence. See the glass that is half full instead of viewing it as half empty. Stick to a healthy diet. Knowing all the risks is not a scare but a call to being vigilant. Knowledge is powerful and will help you to enjoy your golden years feeling well and happy.

Aug
04
2018

Phage Therapy Against Superbugs

Introduction

Phage therapy against superbugs is the latest concept in treating infections. Antibiotic resistance has developed into a huge clinical problem. Every year in the US about 2 million people have infections from antibiotic resistant bacteria, and 23,000 people die as result of it. Certainly, there is a desperate need to find alternative treatment options to treat antibiotic resistant infections. One such option is to use phages, a specific form of viruses to treat antibiotic resistant bacteria. Here is a scientific overview regarding the use of phages for the treatment of antibiotic resistant infections.

History of phages

The observation of phages attacking bacteria goes back more than 100 years. The French Canadian microbiologist, Félix Hubert d’Herelle (1873–1949) described in 1917 what bacteriophages are. He also coined the term of “phage therapy” for the treatment of bacteria with phages. Dr. d’Herelle recognized phages to be virus-like organisms that attacked bacteria and could kill them. When Fleming detected antibiotics, phage research came to a halt. Drug companies invented more and more antibiotics, as it was easier to kill bacteria this way. But now with emerging resistances of bacteria to antibiotics, there is a sudden revival of the 100-year old research on phages. The problem is that there has not been much clinical experience with phage therapy against super bugs until lately. In 1923 Dr. d’Herelle co-founded the Eliava Institute in what is now Tbilisi, Georgia. This institute has the world’s most comprehensive database on phage therapy in man.

Two clinical examples of phage therapy against superbugs

Chronic prostatitis due to superbug

Pranav Johri, a Canadian of Indian descent was suffering of a chronic prostate infection. Physicians had used five different antibiotics, but all to no avail. His doctor told him that he had a chronic prostatitis problem for which there was no cure. But Pranav saw another specialist who determined that Pranav had a prostatitis due to a superbug, which was resistant against all the common antibiotics. Pranav traveled to the Eliava Institute in Tbilisi, Georgia. He paid 6000.00 CAD and had three treatments. After the first treatment his temperature became normal for the first time in months, and his chronic pain subsided. He and his wife were so excited that they felt like celebrating. They did sightseeing, went out to restaurants and enjoyed their travels, all things he was unable to do for months. Pranav had finally received a cure with phage therapy to his chronic prostate infection.

Enteric infection due to superbug

Tom Patterson who had visited Egypt in 2015 together with his wife fell ill on the last night of his holiday. Eventually he went into a hospital in his hometown, San Diego. The doctors told him that he would likely die. He had acquired a multi-antibiotic resistant infection. He was slipping in and out of consciousness. His wife, Steffanie Strathdee, an infectious disease epidemiologist, remembered having heard about phage therapy during a virology class during her training in Toronto. Tom received two separate phage cocktails that two separate research teams in the US had prepared for his condition. He received the first dosage into his abdomen.

Intravenous phage therapy

The second administration was intravenously. There are only a handful of patients who had received treatment with phage therapy in the US; he is probably the first one who received phage therapy intravenously. A few days later he woke up. He had to relearn basic life skills like swallowing and speaking. But he made a full recovery from a serious disease with multi-antibiotic resistant bacteria. The University of California San Diego School of Medicine had helped Tom to recover from his illness. They announced at the end of June 2018 that they would be opening the Center for Innovative Phage Applications and Therapeutics in San Diego.

Modern phage technology

Basically phages are viruses that specialize in killing bacteria. They exist in nature wherever bacteria grow and help that they do not over-proliferate.  But they can be useful in fighting difficult to treat bacterial infections as well, like pseudomonas ear infections, Clostridium difficile gut infections or Methicillin-resistant Staphylococcus aureus infections in skin wounds. In the former Soviet Union and in the Eliava Institute in Tbilisi, Georgia, extensive phage research has accumulated valuable data over decades. In the West physicians relied on the power of antibiotics, and phages stayed on the back-burner of the research lab.

Genetic engineering of phages and toxins produced by phages

Combining phage research and genetic engineering research we are entering a new era of manufacturing biological compounds that can kill bacteria similar to antibiotics. Here is a review article of this new exciting field. I only include this link to show that researchers are now getting a handle on phages. They can be genetically modified to specifically attack one kind of bacterium. The DNA of the phage can be isolated and injected into bacteria. I do not expect you to understand all of what is discussed in this link.

Phage Therapy Against Superbugs

Phage Therapy Against Superbugs

Conclusion

As a result phages are more and more in use to treat difficult chronic infections where bacteria have become resistant to multiple antibiotics. It requires a team of experts who are familiar with phage cocktails. The cocktail is a careful combination of various phages that will fight the antibiotic resistant infection.The composition of it has to be according to the bacteria present in the patient’s bacterial flora. As shown with two clinical examples very sick patients can recover relatively quickly from their chronic infections. After this breakthrough more and more centers for phage therapy will open and this should help reduce the death rate from antibiotic-resistant infections.

Jun
30
2018

Dangers That Can Lurk In Beach Sand

A recent article has pointed out that there are 5 dangers that can lurk in beach sand. There are invisible bacteria that can pose a problem. But there are also parasites, fungi and parasitic roundworms. Here is a review of these common dangers.

Dangers that can lurk in beach sand: hookworms

In February 2018 a Canadian couple from Windsor/Ont. came back from a beach holiday in Punta Cana, Dominican Republic. They brought with them parasites in their feet from walking barefoot on infested beaches in the Caribbean. This parasite is known to lay larvae into the sand that can survive there for several days. When beach goers walk barefoot the condition is right for the larvae to attach to the bare feet and puncture the skin. The full-grown hookworm can then develop and produce the symptoms described in the link (rash, itching, pain). The larvae of it are called “larvae migrans”, or in plain English the disease has the name “creeping eruption“. The best medicine for this condition is the anti-parasitic medication Ivermectin, the “wonder drug” from Japan. Originally developed in Japan, Ivermectin is available in the US, but not in Canada.

Dangers that can lurk in beach sand: Gut bacteria

A California study found that several gut bacteria were present in California beaches. Salmonella, Campylobacter, Shigella, Pseudomonas aeruginosa, Staphylococcus aureus, Aeromonas, and Vibrio parahaemolyticus, human viruses (adenovirus, enterovirus, norovirus, and hepatitis A virus), amoeba, and protozoa were all cultured from beach sand. However, it is difficult to prove that any one of these pathogens would have caused any gastrointestinal upset. Just picking up one of these bugs on your skin does not mean you will come down with that particular infection. It makes sense though to wash your hands or take a shower after your beach walk. But the study noticed that there was a difference in the infection rate. There were those who only had casual contact with beach sand. Others were digging into sand or buried themselves in sand. The latter group was more likely to come down with gastrointestinal infections shortly after their beach outing.

Dangers that can lurk in beach sand: superbug MRSA

According to the California study cited above there were 2.7% of beach sand samples on California’s beaches that contained MRSA bugs. These are the cause of flesh-eating disease. MRSA stands for methicillin-resistant Staphylococcus aureus. When there is a cut in the skin, this antibiotic resistant bug can pose a big problem. On the other hand, it is not known whether the mere existence of MRSA on the skin actually poses a danger. Researchers do not know at the present time whether or not this will cause flesh-eating disease. But they recommend that after a beach visit it is a good idea to take a shower, as this will cleanse the skin to a large extent of any pathogenic bacteria and viruses.

Dangers that can lurk in beach sand: fungi

The types of fungi that can hide in the beach sand belong to the group of dermatophytes. Common fungal skin infections are caused by the dermatophytes, Trichophyton rubrum, which is a very common dermatophyte, is the culprit that causes nail fungus, ringworm; jog itch and athlete’s foot. Other fungi around beaches are Aspergillus and Candida that affect mostly people with a weak immune system. Aspergillus may be responsible for lung infections and Candida for yeast infections.

Dangers that can lurk in beach sand: roundworms

Roundworms become a problem on beaches where dogs are allowed. The main problem is Toxocara canis, a parasitic roundworm. The roundworm normally lives in the gut of dogs. But dog feces from roundworm-infested dogs contain lots of eggs, which can get into soil along with the dog feces. People can inadvertently swallow contaminated sand. An Australian study found roundworm-infested samples among 266 random beach samples. They found that there were not as many positive samples when there were only adult dogs allowed on beaches. In contrast, they found a lot more positive roundworm samples in beaches were puppies were allowed.

Dangers That Can Lurk In Beach Sand

Dangers That Can Lurk In Beach Sand

Conclusion

We associate pristine beaches with nature, health and relaxation. Knowing of these scientific studies we would do well to not let our guards down. Think about the ocean water: is it safe or could it be the cause of contamination of the beach sand? Then think about the beach itself. Is it a busy beach with lots of people that may contribute to contamination of the beach sand? Are dogs allowed or not? There may be dogs that defecate and deposit eggs of roundworms. Or there may be larvae from the creeping eruption, a parasitic disease. Other dangers can lurk in the sand: methicillin-resistant Staphylococcus aureus, a bacterium that is an antibiotic resistant bacterium that can cause flesh-eating disease. Other bacteria may be buried in the sand that can cause various gastrointestinal upsets.

Being more careful around beaches

Having these thoughts in mind may help you to be more careful about the beach and shower off after you leave the beach. It is also not a bad idea to wear sandals on the beach to prevent direct contact of your skin with the beach sand. It is also obvious that the beach towel on which you lay on the sand is no longer “clean”. Wash it after your beach outing, or choose the option to relax on a cot. Wherever you travel this summer, have a safe journey!

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Apr
07
2018

Antibiotic Resistant Bacteria Killed By Teixobactin

Antibiotic resistant bacteria killed by teixobactin would be a dream for infection specialists. In the last few decades drug resistance among antibiotics has become a major problem in chronic care homes and hospitals. Fortunately in January 2018 a publication announced that a research team from Lincoln, Great Britain was successful in synthesizing a new antibiotic, called teixobactin.

Origin of teixobactin

First of all, teixobactin is a peptide, and it comes from a soil bacterium that was difficult to culture. But a new culture method made it possible to isolate teixobactin. Subsequently the biochemists were able to create the identical antibiotic synthetically.

This moment likely is as important as the original discovery of penicillin. Experiments in the Petri dish and in mice show that teixobactin is a broad spectrum antibiotic, has no toxicity and treats all of the problem bugs that are associated with drug resistance. To the clinician it is a dream come true. For decades they hoped for an effective treatment for drug resistant bacteria. And now this seems to materialize. In the US there are 2 million drug resistant infections every year. More than 23,000 patients die from them every year.

Six problem bugs that are drug resistant

There are currently 6 problem bugs that have developed resistance. 1 in 4 nursing home patients may have one of these resistant bugs: carbapenem-resistant Enterobacteriaceae, methicillin-resistant Staphylococcus aureus (MRSA), ESBL-producing Enterobacteriaceae, vancomycin-resistant Enterococcus (VRE), multidrug-resistant Pseudomonas aeruginosa and multidrug-resistant Acinetobacter.

3 years ago a research team showed that teixobactin killed MRSA and VRE.  The underlying publication by Ishwar Singh and colleagues described how cyclic peptides their research team has successfully synthesized teixobactin analogues. He said that these findings may “lead to the first new class of antibiotic drug in 30 years”.

Mouse experiments using teixobactin analogues

The next level of evidence came from mouse experiments. Ten analogues of teixobactin were tested on mice that had infections due to drug resistant bacteria.

One team working at the Singapore Eye Research Institute could show that mice that had Staphylococcus aureus keratitis (infection of the cornea with bacteria) achieved a cure of this infection with synthetic teixobactin. An additional observation was that the amount of swelling (edema) and inflammation that is part of the infection was quickly resolving with teixobactin. This additional anti-inflammatory effect of teixobactin is an asset that will be a necessity, when it comes to treating infections in patients.

At this point there have been no clinical trials. This is the next step before physicians can prescribe teixobactin for their patients. Dr. Singh said, “We are probably around six to ten years away from a drug that doctors can prescribe to patients”.

New antibiotic treats

antibiotic resistant tuberculosis

In addition to teixobactin there is another story that gives hope for cases of resistant tuberculosis. In an Iranian publication from August 2017 it is described how compounds from the Persian shallot have full antibiotic activity against known drug resistant E.coli strains.

The same antibiotic derived from Persian shallot is also effective against resistant tuberculosis. Dr. Sanjib Bhakta and Professor Gibbons from Great Britain said that their ability to synthesize the effective antibiotics is a great breakthrough. Prof. Gibbons said: “Natural products from plants and microbes have enormous potential as a source of new antibiotics. Nature is an amazingly creative chemist, and it is likely that plants such as the Persian shallot produce these chemicals as a defence against microbes in their environment. Dr. Bhakta and I will be dedicating our research to discovering new antibiotics and understanding how they function.”

Persian shallot-derived antibiotics

Dr. Bhakta tested the Persian shallot-derived antibiotics against various drug-resistant bacteria. There were inhibitory effects on Escherichia coli, Klebsiella pneumoniae, multidrug resistant Staphylococcus aureus and Proteus mirabilis. But the most impressive inhibition (inhibiting growth by 99.9%) was against the tuberculosis bacterium, Mycobacterium tuberculosis. Consequently this is a significant finding as drug-resistant tuberculosis strains have been on the rise killing a lot of people.

Antibiotic Resistant Bacteria Killed By Teixobactin

Antibiotic Resistant Bacteria Killed By Teixobactin

Conclusion

Research has opened a door to a new era that will be ready for prime time in 6 to 8 years. Research has identified two groups of new antibiotics, synthetic teixobactins and Persian onion-derived antibiotics. They are both effective in preliminary in vitro and in vivo mouse experiments against drug-resistant bacteria. The most important effects are against Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE) and antibiotic resistant tuberculosis (Mycobacterium tuberculosis). At this stage there is an urgent need to conduct clinical trials to get FDA approval for these new antibiotics. With this approval the new antibiotics are ready for use in clinical medicine against drug-resistant infections. In the antibiotic field no such finding of that significance has occurred in the last 30 years. In the US more than 23,000 patients die from them every year. It is high time that there is a cure for these infections.

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