'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
January 16,2020

Thiruvananthapuram, Jan 16: Kerala Tourism on Wednesday shared a recipe of a popular meat dish in the Central Travancore region of Kerala, Beef Ularthiyathu, which is a special delicacy in the region.

Taking to its Twitter handle, the Kerala Tourism wrote, "Tender chunks of beef, slow-roasted with aromatic spices, coconut pieces, and curry leaves. A recipe for the most classic dish, Beef Ularthiyathu, the stuff of legends, from the land of spices, Kerala."

The State Tourism also shared the recipe of the delicacy with Twitteratis.

The tweet which has garnered 3.5 thousand likes so far had received a mixed response

While some said "beef is not Kerala's culture", others termed the recipe 'a match made in heaven".

Dr Vireandta Jilowa wrote, "Surprised to see it, that beef is being consumed despite BJP government in the Centre."

"We are not slaves of BJP at the Centre....people eat whatever they like in this state, including beef, pork, mutton and fish," another user Tatheesh Vijayakumar wrote.

In 2017, The Minister for Environment, Forest and Climate Change Harsh Vardhan had ordered that the ministry has notified the Prevention of Cruelty to Animals (Regulation of Livestock Markets) Rules, 2017 to ensure that the sale of cattle is not meant for slaughter purposes.

Regulating animal trade is a state business, but animal welfare is a central subject.

In lieu of this, there was widespread opposition of the order, with many states openly denying accepting the notification.

Porotta and Kappa biriyani with beef are counted as delicacies by Keralites. 

Also Read: The Art of Prepping Meat

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Agencies
March 25,2020

The practice of washing your hands for 20 seconds is one of the best preventive measures you can take to avoid the spread of any virus including coronavirus as recommended by the WHO.

The modern day concept of handwashing was introduced by Hungaraian doctor Ignaz Semmelweis, in 19-th century Vienna. Semmelweis proposed the practice of washing hands with chlorinated lime solutions in 1847 while working in the city's general hospital.

Decades later, in the modern times too the practise has not lost it's relevance. To connect with savvy consumers the message is being sent through social media? But social media can also be a dark place where misinformation is rampant; consumers can end up being misguided and compromised on sensitive issues like health and hygiene.

Dettol, recently kickstarted its #HandWashChallenge on TikTok aiming to raise awareness on four simple steps of handwashing. Strategically aimed at creating awareness among audience, a unique song has been created pairing it extremely well with the hashtag #HandWashChallenge. The hashtag filter has a branded Dettol strip across the top with the hashtag and names the steps involved in washing hands. The user can dance out the steps to the challenge and share it with their friends to further amplify the message on hygiene and safety.

Commenting on the same, Pankaj Duhan, Chief Marketing Officer, RB Health South Asia said, "We are elated with the response to the #HandWashChallenge, it has definitely become one of the most successfully led initiatives by any of our brands at RB. Understanding the consumer's mindset is of the utmost importance to us, therefore our campaign communication is built in a way that creates meaningful conversations to drive awareness amongst consumers. The participation by TikTok users across India has helped deliver the right message in a more engaging and interactive manner.

"I personally would like to encourage more and more people to join this global health & hygiene educational exercise. Together, let us all build a healthier nation, four steps at a time."

He further said, "Over the past couple of weeks we have witnessed a lot of misinformation floating around hygiene practices, especially over the internet. Realizing the gravity of the issue and being the responsible brand, we felt it was our prerogative to initiate this awareness campaign."

The campaign witnessed several quirky activities on each day leading to increased consumer interest. Joining the force were some of Bollywood's popular celebrities like Kartik Aaryan and Urvashi Rautela among several other TikTok influencers who have millions of followers on the platform. As part of Phase II, Dettol plans to take the challenge global by encouraging more users to participate while the audience worldwide.

The challenge has witnessed over 18 Billion views and generated over 123K user participation videos in one week of starting the campaign.

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Agencies
June 29,2020

Washington DC, Jun 29: Young children with narrow retinal artery diameters were more likely to develop higher blood pressure, and children with higher blood pressure levels were more likely to develop retinal microvascular impairment during early childhood, according to a new study.

The first study to show this connection in children was published today in Hypertension, an American Heart Association journal.

High blood pressure, the main risk factor for the development of cardiovascular disease (CVD), can manifest as early as childhood, and the prevalence of high blood pressure among children continues to rise. In previous studies, analysis of blood vessels in the retina has shown promise as a predictor of CVD risk among adults. In the study titled, "Retinal Vessel Diameters and Blood Pressure Progression in Children," researchers sought to predict the development of high blood pressure in children over four years based on retinal blood vessel measurements.

"Hypertension continues as the main risk factor for the development of cardiovascular diseases and mortality," says Henner Hanssen, M.D., the study's lead author and a professor in the department of sport, exercise and health at the University of Basel in Switzerland. 

"Primary prevention strategies are needed to focus on screening retinal microvascular health and blood pressure in young children in order to identify those at increased risk of developing hypertension. The earlier we can provide treatment and implement lifestyle changes to reduce hypertension, the greater the benefit for these children."

Researchers screened 262 children ages six to eight from 26 schools in Basel, Switzerland, in 2014, for baseline blood pressure and retinal arterial measurements. Both measures were taken again in 2018. Blood pressure measurements at both baseline and follow-up were performed in a sitting position after a minimum of five minutes of rest and were categorized based on the American Academy of Pediatrics' blood pressure guidelines. These guidelines utilize the same measurements as the American Heart Association/American College of Cardiology 2017 Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults.

Results from the analysis indicate: children with narrower retinal vessel diameters at baseline developed higher systolic blood pressure at follow-up; retinal vessel diameters could explain 29 -31 per cent of the changes in systolic blood pressure progression between 2014 and 2018; children with higher blood pressure levels at baseline developed significantly narrower arteriolar diameters at follow-up, depending on weight and cardiorespiratory fitness; and initial blood pressure measures explained 66-69 per cent of the change in retinal arteriolar diameter from baseline to follow-up.

"Early childhood assessments of retinal microvascular health and blood pressure monitoring can improve cardiovascular risk classification. Timely primary prevention strategies for children at risk of developing hypertension could potentially counteract its growing burden among both children and adults," said Hanssen.

Researchers noted limitations of their study include that they could not confirm blood pressure measurements over a single 24-hour period, so they would not account for "white coat" hypertension, a condition where patients have high blood pressure readings when measured in a medical setting.

Developmental stage including puberty status of each child was not accounted for in the study, as well as genetic factors or birth weight - variables that could impact blood pressure development and microvascular health.

In addition, reference values for appropriate retinal vessel diameters in children do not currently exist, so future studies are needed to determine age-related normal values during childhood.

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