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April 29, 2009

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Scientist: “superbugs” resist all drugs, portend pandemic

March 31, 2008
Courtesy Society for General Microbiology
and World Science staff

Doc­tors are run­ning out of treat­ments for trau­ma vic­tims and crit­ic­ally ill pa­tients be­cause of in­fec­tions from drug re­sist­ant mi­crobes – even af­ter re­sort­ing to medicines thrown out 20 years ago be­cause of se­vere side ef­fects, sci­en­tists are re­port­ing.

A cluster of the bac­te­ria Aci­ne­to­bac­ter bau­man­ni (Cour­tesy CDC/ Ja­nice Carr)
“Doc­tors in many coun­tries have gone back to us­ing old an­ti­bi­otics that were aban­doned... be­cause their tox­ic side ef­fects were so fre­quent and so bad,” said Mat­thew Fala­gas of the Alfa In­sti­tute of Bi­o­med­i­cal Sci­ences in Ath­ens, Greece and Tufts Uni­vers­ity School of Med­i­cine in Bos­ton, Mass.

“But su­per­bugs like Acine­to­bac­ter have chal­lenged doc­tors all over the world by now be­com­ing re­sist­ant to these old­er and con­sid­ered more dan­ger­ous med­i­cines.” Fala­gas is set to re­port the find­ings at April 1 at the So­ci­e­ty for Gen­er­al Mi­cro­bi­ol­o­gy’s annual meet­ing this week in Ed­in­burgh.

“Even col­istin,” an an­ti­bi­ot­ic disco­vered 60 years ago, “has re­cently been used as a sal­vage rem­e­dy to treat pa­tients with Acine­to­bac­ter in­fec­tions,” said Fala­gas. “And it was suc­cess­ful for a while, but now it oc­ca­sion­ally fails due to re­cent ex­ten­sive use that has caused the bac­te­ria to be­come re­sist­ant, lead­ing to prob­lem su­per­bugs… re­sist­ant to all avail­a­ble an­ti­bi­otics.”

Re­cent work by Greek re­search­ers has re­vealed Acine­to­bac­ter is more deadly than pre­vi­ously thought, Fala­gas added: it does­n’t just cause se­vere in­fec­tions, it kills un­ex­pectedly high num­bers of pa­tients. Acine­to­bac­ter can cause pneu­mo­nia, skin and wound in­fec­tions and some­times men­in­gi­tis.

The sci­en­tists iden­ti­fied a range of drug re­sist­ant strate­gies be­ing used by the bac­te­ria, in­clud­ing the pro­duc­tion of chem­i­cals which can in­ac­ti­vate the drug treat­ments, cell pumps that can bail out the drug mo­le­cules from in­side bac­te­ri­al cells mak­ing them in­ef­fec­tive, and mu­tat­ing the drug tar­get sites. This makes the drug mo­le­cules miss spe­cif­ic re­gions of the bac­te­ri­al cells that they were aim­ing for.

“There have al­ready been se­vere prob­lems with crit­ic­ally ill pa­tients due to Acine­to­bac­ter bau­man­nii in­fec­tions in var­i­ous coun­tries,” said Fala­gas. “In some cases we have simply run out of treat­ments and we could be fac­ing a pan­dem­ic.”

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Doctors are running out of treatments for trauma victims and critically ill patients because of infections from drug resistant microbes – even after resorting to using medicines thrown out 20 years ago because of severe side effects, scientists are reporting. “Doctors in many countries have gone back to using old antibiotics that were abandoned 20 years ago because their toxic side effects were so frequent and so bad,” said Matthew Falagas of the Alfa Institute of Biomedical Sciences in Athens, Greece and Tufts Un iversity School of Medicine, Boston, Mass. “But superbugs like Acinetobacter have challenged doctors all over the world by now becoming resistant to these older and considered more dangerous medicines.” Falagas reported the findings at April 1 at the Society for General Microbiology’s 162nd meeting held this week in Edinburgh. “Even colistin,” an antibiotic discovered 60 years ago, “has recently been used as a salvage remedy to treat patients with Acinetobacter infections,” said Falagas. “And it was successful for a while, but now it occasionally fails due to recent extensive use that has caused the bacteria to become resistant, leading to problem superbugs… resistant to all available antibiotics.” Recent work by Greek researchers has revealed Acinetobacter is more deadly than previously thought, Falagas added: it doesn’t just cause severe infections, it kills unexpectedly high numbers of patients. Acinetobacter can cause pneumonia, skin and wound infections and sometimes meningitis. The scientists identified a range of drug resistant strategies being used by the bacteria, including the production of chemicals which can inactivate the drug treatments, cell pumps that can bail out the drug molecules from inside bacterial cells making them ineffective, and mutating the drug target sites making the drug molecules miss specific regions of the bacterial cells that they were aiming for. “There have already been severe problems with critically ill patients due to Acinetobacter baumannii infections in various countries”, said Falagas. “In some cases we have simply run out of treatments and we could be facing a pandemic.”