'Superbug from India resistant to all available antibiotics'

January 16, 2017

Washington, Jan 16: A woman in the US died after being infected by a superbug during her visit to India, say doctors who found that the "nightmare" bacteria was resistant to all available antibiotics.

bacteriaThe infection was caused by carbapenem-resistant Enterobacteriaceae (CRE), a multidrug-resistant organism associated with high mortality.

While CRE are not new to the US, what was new in this case is that the infection was resistant or non-susceptible to all available antimicrobial drugs, researchers said.

The 70-year-old patient in the US was admitted to an acute care hospital last year after an extended trip to India.

She was given a primary diagnosis of systemic inflammatory response syndrome, likely resulting from an infected right hip seroma. The infection was serious; none of the 14 antibiotics physicians used to treat the woman worked.

After the CRE - identified as Klebsiella pneumoniae - was confirmed by lab testing, an isolate from a wound specimen was sent to the CDC for further susceptibility testing and to determine the mechanism of resistance.

That testing confirmed the presence of New Delhi metallo-beta-lactamase (NDM-1), an enzyme that directly breaks down carbapenems, a powerful class of antibiotics that are often used to treat multidrug-resistant infections.

The US Centres for Disease Control and Prevention's antimicrobial testing showed the isolate was resistant to 26 different antibiotics, including all aminoglycosides and polymixins - another class of last-resort antibiotics.

It was also intermittently resistant to tigecycline, an antibiotic developed specifically to overcome drug-resistant organisms. Essentially, there were no treatment options.

Meanwhile, the patient's condition was deteriorating quickly. She died of septic shock in early September last year, less than two months after admission. The woman had been in India for two years and had been hospitalised at least four times there for a right femur fracture and a subsequent hip fracture.

"We feel comfortable saying that she most likely obtained the bug in India," said Lei Chen, senior epidemiologist with the Washoe County Health District in the US.

CRE have been labelled as a "nightmare" bacteria not only because they are already resistant to most antibiotics, but also because they spread easily in hospital settings.

The enzymes that enable resistance are carried on mobile pieces of DNA known as plasmids that can spread to other types of bacteria. NDM-1 enzyme is particularly mobile, researchers said.

"It's what we call a promiscuous plasmid, that seems to move easily between species," said Alex Kallen, a CDC medical epidemiologist.

When CRE bacteria enter the bloodstream, they can be deadly. CRE bacteria kill up to half of patients who get bloodstream infections from them.

NDM-1 was originally identified in 2009 in a Swedish patient who had been hospitalised in India.

The research was published in CDC's Morbidity and Mortality Weekly Report (MMWR).

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Agencies
April 15,2020

Dear parents, if you want your children to have proper sleep, read this carefully. Joining a growing list of studies that tell parents to shun devices at bed-time, researchers say that children who use devices and decide what time they go to sleep, achieve less sleep and feel more sleepier the following day than their peers.

The study of children in this age-group (aged 11 to 13 years), published in the New Zealand Medical Journal, found most (72 per cent) of the 163 students interviewed by University of Otago researchers achieved recommended guidelines of an average 9 to 11 hours sleep nightly over one week.

"But that also means that almost one in four students did not achieve sleep within these guidelines, which highlights an area for improvement," said study researcher Kate Ford.

However, consistent with previous research in 15 to 17-year-old New Zealanders, the study results show less sleep on the nights where devices are used in the hour before bed.

According to the researchers, students who used devices before going to sleep were also more likely to report that they felt sleepy the following morning. Watching television before bed had no significant effect on sleep length.

There were also some interesting observations over the weekends where students went to bed later but woke later achieving similar sleep length to the school days, the researchers said.

A small group of students (six per cent) who reported less than seven hours of sleep, including a small number reporting not sleeping at all, according to the study,

Therefore, while the average across the week of 72 per cent of students reporting adequate sleep is reassuring, it is far from the goal of every child achieving sleep within the recommended guidelines," Ford said.

Dr Paul Kelly, head of the Sleep Health Service at Canterbury District Health Board, supervised the study and explained that the foundations for good health are based on proper nutrition, regular exercise and good sleep quality.

Sleep quality is often overlooked as a contributory factor to poor health.

"The study findings suggest the need for parental guidance around bedtimings and moderation of the use and availability of electronic devices before bed," Kelly said.

"Respect and protect your sleep, as good daytime functioning is reliant on adequate sleep," Kelly added.

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Agencies
April 28,2020

As the world grapples with the impact of the novel coronavirus, daily interaction with the outside world --- public and retail spaces, restaurants, educational institutions, and even with each other has been and will continue to be reoriented prioritising personal hygiene and public health.

The sensibilities are building towards and leading to major changes in how the country's food service industry is expected to operate.

Based on a recent consumer survey by restaurant tech platform, Dineout, Indian diners are now ranking safety assurances and premier hygiene as top factors when it comes to choosing a restaurant to dine in.

The survey by Dineout conducted across 20 cities revealed that in a post-COVID-19 era, 81 per cent diners will prefer digital menus at restaurants, while 77 per cent of people will continue to want to dine out.

The survey found that 23 per cent people would prefer continuing with delivery/takeaway and online payment becomes the most preferred option with 60 per cent votes.
 
Diner's response to Contactless Dining:

 

Over 96 per cent demand better waitlist management
 
81 per cent consumers would rather scan a QR on their phone to place an order instead of handling physical menus or tablet-based digital menus.
 
After a dining experience, 60 per cent prefer seamless wallet-based digital payments over cash/cards 85 per cent would choose a digital valet over waiting in possibly contaminated public spaces and 84 per cent would prefer offering digital feedback over physical feedback collection.

 

What do people want to eat?
 
The report also revealed that most of India has been craving Pizza since the lockdown, except in Chennai, Hyderabad and Kolkata where their popular and indigenous Biryani recipes reign supreme. 
 
Which restaurants are diners waiting to go to?
 
77 per cent respondents claimed that they are waiting to dine out with friends and family once the lockdown is lifted.
 
Big Chill, Barbeque Nation and Social emerged as favourites in Delhi, while Mumbaikars picked Global Fusion, Poptates and Asia Kitchen. Bangaloreans miss going to pubs like Toit, Vapour and Barbeque Nation.
 
Aminia, Arsalan and Momo I Am emerge as the top picks in Kolkata.
 
Contrary to popular belief, Delhitties picked vegetarian over non-vegetarian food.
 
Bangaloreans and Lucknowis would rather have their drinks over food.
 
Besides the new parameters for restaurant selection, the factors deciding consumer delight have also seen a major overhaul as hygiene takes precedence. Consumers would prefer that the total number of reservations in a certain period be limited with the option to pre-select the seating, ample amounts of sanitisers at tables along with UV sanitised utensils whenever possible.
 
Hygiene ratings with detailed hygiene information, regular hygiene checks & usage of mask and disposable gloves by waiters are likely to be the new standard, with diners expecting service personnel to sanitise tables & chairs after every use.
 
Dineout recently unveiled the �contactless dining suite' to help restaurants survive and thrive in a post-COVID-19 world. The brand will also provide PPE Safety Kits to Restaurants to help ensure hygiene measures and is facilitating COVID free certification for restaurants through a licensed lab to ensure all microbiological tests are in place before restaurants restart post the lockdown.

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Agencies
June 10,2020

Early treatment with the antiviral drug remdesivir has been found to reduce viral load and prevent lung disease in macaques infected with SARS-CoV-2 that causes COVID-19, according to a study.

The findings, published in the journal Nature on Tuesday, support the early use of remdesivir treatment in patients with COVID-19 to prevent progression to pneumonia.

Researchers from the National Institutes of Health in the US noted that remdesivir has broad antiviral activity and has been shown to be effective against infections with SARS-CoV and MERS-CoV in animal models.

The drug is being tested in human clinical trials for the treatment of COVID-19, they said.

Researcher Emmie de Wit and colleagues investigated the effects of remdesivir treatment in rhesus macaques, a recently established model of SARS-CoV-2 infection.

Two sets of six macaques were inoculated with SARS-CoV-2.

One group was treated with remdesivir 12 hours later -- close to the peak of virus reproduction in the lungs -- and these macaques received treatment every 24 hours until six days after inoculation.

In contrast to the control group, the researchers found that macaques that received remdesivir did not show signs of respiratory disease, and had reduced damage to the lungs.

Viral loads in the lower respiratory tract were also reduced in the treated animals; viral levels were around 100 times lower in the lower-respiratory tract of remdesivir-treated macaques 12 hours after the first dose, they said.

The researchers said that infectious virus could no longer be detected in the treatment group three days after initial infection, but was still detectable in four out of six control animals.

Despite this virus reduction in the lower respiratory tract, no reduction in virus shedding was observed, which indicates that clinical improvement may not equate to a lack of infectiousness, they said.

Dosing of remdesivir in the rhesus macaques is equivalent to that used in humans, the researchers noted.

They cautioned that it is difficult to directly translate the timing of treatment used in corresponding disease stages in humans, because rhesus macaques normally develop only mild disease.

However, researchers said the results indicate that remdesivir treatment of COVID-19 should be initiated as early as possible to achieve the maximum treatment effect.

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