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July 29th, 2010

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High Alert

Antibiotics in the clinical pipeline in 2011

May 22nd, 2011

Butler MS et al. – The emergence of multi–drug–resistant bacteria and the lack of new antibiotics in the antibiotic drug development pipeline, especially those with new modes of action, is a major health concern. read more

The world is running out of antibiotics, WHO says By Susan Scutti, CNN Updated 6:01 PM ET, Tue September 19, 2017

September 22nd, 2017

Too few new antibiotics are under development to combat the threat of multidrug-resistant infections, according to a new World Health Organization report published Tuesday. Adding to the concern: It is likely that the speed of increasing resistance will outpace the slow drug development process.
As of May, a total of 51 antibiotics and 11 biologicals — medical products often made from natural sources — are being developed, the new report said.
“The idea is that biologicals could replace use of antibiotics, which could help in overcoming the resistance problem,” Peter Beyer, an author of the report and senior adviser to the WHO’s Department of Essential Medicines and Health Products, wrote in an email.

Seemingly, this large number of potential new drugs should suffice, yet it is not nearly enough.
First, just 33 of the antibiotics in the pipeline target priority pathogens. This year, the WHO published a list of a dozen “priority pathogens”: 12 separate families of antibiotic-resistant bacteria that pose the greatest threat to human health.
Among the priority pathogens is a drug-resistant tuberculosis, which kills about 250,000 people around the world each year, and a variety of multidrug resistant strains — Acinetobacter, Pseudomonas and various Enterobacteriaceae — which are responsible for infections in hospitals and nursing homes and among patients whose care requires ventilators and catheters.

WHO: These 12 bacteria pose greatest risk to human health
Of the 33 potential medicines for treating priority bug infections, only eight are innovative treatments. The other 25 are simple modifications of existing families of antibiotics. At best, then, the 25 will serve as short-term solutions since it is expected bacteria will quickly adapt to and resist these new (though somewhat familiar) drugs, according to the WHO.
“It is difficult to speculate why companies develop specific new medicines,” Beyer noted. “But in general many new treatments do not necessarily constitute advances over existing treatments.”

Superbug C. auris identified in 122 people across 7 states, CDC says
TB infections require a combination of at least three antibiotics, according to the new report, yet only seven of the new TB medicines are even in clinical trials. Soon, there will be a serious lack of treatment options for this infection, the report warns.
The same is true for gram-negative pathogens, which can cause severe, often deadly infections typically in hospitals and nursing homes.

This STD is becoming ‘smarter’ and harder to treat
Gram-negative bacteria have more complex cell walls than gram-positive, explained Beyer. “In a nutshell, it is more complex to develop a novel antibiotic that can penetrate the complex gram-negative cell wall and stay inside the bacterium,” he wrote.
Finally, the WHO sees too few oral antibiotics being developed. These are necessary “to target the critical priority pathogens (and) be accessible in low- and middle-income countries,” Beyer noted.

Researchers amplify antibiotic of last resort hoping to halt superbugs
To address the problem of developing new antibiotics, the WHO and the Drugs for Neglected Diseases Initiative set up the Global Antibiotic Research and Development Partnership. However, new drugs alone cannot combat the threat of antimicrobial resistance. The WHO is also working to improve infection prevention and control while developing guidance for the responsible use of antibiotics.
“Always seek medical advice before taking antibiotics and then always follow the advice of the health-care professional,” Beyer noted.
The new report is a “fantastic (and very useful!) summary” of the antibiotic situation, wrote Bill Hanage, an associate professor of epidemiology at Harvard T.H. Chan School of Public Health, in an email. Hanage, who has also published studies of antibiotic resistance, was not involved in the new report.
Although the risk of getting a completely resistant infection is low in the United States, about 2 million people each year become infected with “resistant enough” bacteria that are harder to treat, Hanage said. And every year, more than 20,000 people die of these infections.
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“More resistant infections don’t just mean you or someone you care about is more likely to die from one, they also mean healthcare will get even more expensive,” Hanage said. “Many of the procedures we take for granted in medicine, from cancer treatments to surgeries, depend on our ability to handle infections that happen in the course of treatment.”
The number of new drugs in development is simply not enough, he said.
“The great majority will not make it into the hands of doctors or your treatment,” Hanage wrote. “As the report states, for drugs to be used in humans they have to pass 3 hurdles, the phase 1, 2 and 3 trials. Drugs entering that pipeline have just a 14% chance of getting all the way through to be used in humans.”


Researchers identify 27 viruses that can persist in semen

September 15th, 2017

Salam AP, Horby PW. Emerg Infect Dis. 2017;doi:10.3201/eid2311.171049.

A recent analysis revealed that 27 viruses from a wide range of virus families may persist in human semen.
Alex P. Salam, MBChB, MSc , clinician and clinical researcher with the United Kingdom Public Health Rapid Support Team, and Peter W. Horby, MBBS, PhD, professor of emerging infectious diseases and global health at the University of Oxford, said their findings underscore the need for additional research to determine whether these viruses remain viable in semen and for how long.
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“The presence of viruses in semen is probably more widespread than currently appreciated, and the absence of virus in genital secretions should not be assumed for traditionally nonsexually transmitted viruses,” they wrote in Emerging Infectious Diseases. “The investigation of virus detection and persistence in semen across a range of viruses is useful for clinical and public health reasons, in particular for viruses that lead to high mortality or morbidity rates or to epidemics.”
According to the researchers, blood-testes/deferens/epididymis barriers are “imperfect” in preventing viruses in blood from crossing into the male reproductive tract. The viruses are able to survive within testes because the immune response is restricted to enable survival of sperm.
To further investigate the persistence of viruses in semen, the researchers performed a large PubMed search limited to studies on viruses capable of causing viremia. They identified studies of 27 viruses that were detected in human semen, many of which lacked data on sexual transmission. Viruses that were found in semen included adenoviruses; transfusion-transmitted virus; Lassa fever virus; Rift Valley fever virus; Ebola virus; Marburg virus; GB virus C; hepatitis B and C viruses; Zika virus; cytomegalovirus; Epstein Barr virus; human herpes viruses 6, 7 and 8; human simplex viruses 1 and 2; varicella zoster virus; mumps virus; adeno-associated virus; BK virus; JC virus; simian virus 40; HIV; human T-cell lymphoma virus 1; simian foamy virus; and chikungunya virus.
“These 27 viruses come from diverse families, suggesting that the presence of many viruses in semen is unlikely to be exclusively dependent on specific or conserved viral epitopes, [the] ability of virus to replicate within the male reproductive tract, or common mechanisms of immune evasion,” the researchers wrote. “Other factors that may also influence whether viruses exist in semen are level of viremia, inflammatory mediators (altering blood-barrier permeability), systemic immunosuppression, male reproductive tract immune responses, presence of sexually transmitted diseases, and the virus structural stability.”
Several other viruses were detected in human testes and may also be detectable in semen, including influenza virus, lymphocytic choriomeningitis virus, phlebotomus fever virus, coxsackie B virus, echovirus, dengue virus, systemic acute respiratory syndrome virus, parvovirus, smallpox virus, vaccinia virus and rubella virus, according to the researchers.
“Given these findings, the following questions need to be addressed: which viruses are shed and remain viable in semen, for how long, and at what concentrations? The answers to these questions have implications for risks for sexual transmission and, therefore, embryonic infection, congenital disease, miscarriage, and effects on epidemiologic transmission models,” the researchers wrote. – by Stephanie Viguers
Disclosure: Infectious Disease News was unable to confirm relevant financial disclosures at the time of publication.

Telavancin shows superior activity to vancomycin with multidrug-resistant Staphylococcus aureus in a range of in vitro biofilm models

May 21st, 2013

Smith K et al. – The activity of telavancin was compared with vancomycin against methicillin–resistant Staphylococcus aureus (MRSA) in planktonic culture and biofilms grown using a range of in vitro models. Despite differences between the models evaluated, telavancin typically demonstrated improved efficacy over vancomycin, indicating the potential value of the agent in the treatment of biofilm–mediated infections caused by S. aureus, especially multidrug–resistant isolates.

European Journal of Clinical Microbiology & Infectious Diseases, 05/10/2013 Clinical Article

Staphylococcus aureus Leukotoxin GH Promotes Inflammation

September 5th, 2012

Malachowa N et al. – The findings indicate that S. aureus leukotoxins enhance the host inflammatory response and influence the outcome of infection. read more

Acquisition of spores on gloved hands after contact with the skin of patients with Clostridium difficile infection and with environmental surfaces in their rooms.

September 5th, 2012

Guerrero DM, Nerandzic MM, Jury LA, Jinno S, Chang S, Donskey CJ.
Source University Hospitals of Cleveland Case Medical Center, Cleveland, OH. read more

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