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News That Matters

03/12/2022 ---- 06/12/2022

Researchers have just caught bacteria sidestepping antibiotic treatment with a never-before-seen trick. Bacteria's talent for developing resistance against antibiotics is a rapidly growing health threat. This ability has ancient origins and allows drug-resistant bacterial infections like gonorrhoea to kill 1.3 million people globally yearly. Examples of strategies exploited by bacteria are: direct inactivation of the antibiotics, preventing drugs from accumulating in their system, and changing the antibiotic's targets, making them ineffective. Bacteria need their folates - a vitamin complex necessary for protein and DNA production - to develop and reproduce successfully. Some antibiotics block folate production to stop bacteria from growing and treat the infection. While investigating how a type of Streptococcus responds to antibiotics, Telethon Kids Institute microbiologist Kalindu Rodrigo and colleagues discovered a new mechanism for antibiotic evasion. Streptococcus commonly causes sore throats and skin infections but can also lead to systemic illnesses like scarlet fever and toxic shock syndrome. Scientists found a mechanism of resistance where, for the first time, the bacteria could take folates directly from its human host when blocked from producing their own. Streptococcus was acquiring folate, already processed, from outside its cells as these molecules are abundant in our bodies. The process completely bypasses the action of sulfamethoxazole, an antibiotic that inhibits folate synthesis within the bacteria, thus rendering the drug ineffective. The discovery's extent may impact preclinical research for antibiotics treatments. Indeed, bacteria that succumb to antibiotics in laboratory tests, where alternative folate sources are unavailable, may still thrive in their hosts' bodies. This study implies that most methods today may be inadequate for detecting resistance to some antibiotics.

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Infection by the bacterium C. difficile (CDI) is a severe and potentially deadly disease that impacts people across the globe. CDI causes debilitating symptoms such as severe diarrhoea, fever, stomach tenderness or pain, loss of appetite, nausea and colon inflammation. The U.S. Centers for Disease Control and Prevention declared CDI a public health threat requiring urgent and immediate action. The infections cause an estimated half a million illnesses and tens of thousands of deaths annually in the U.S. alone. It is often the start of a vicious recurrence cycle, implying a significant burden for patients and the healthcare system. It has been estimated that up to 35% of CDI cases recur after initial diagnosis, and people who have had a recurrence are at significantly higher risk of further infections. After the first recurrence, it has been estimated that up to 65% of patients may develop a subsequent recurrence. On November 30, the Food and Drug Administration (FDA) approved "Rebyota", commercialized by Ferring pharmaceuticals. What makes this drug exceptional and a first of its kind is its manufacturing and delivery method. The drug is manufactured in Minnesota from stool donations screened for dozens of infections and viruses. Health professionals deliver the therapy via the rectum as a one-time procedure. The studies worth the FDA approval demonstrated that 70% of patients taking Rebyota saw their symptoms resolve after eight weeks, compared with 58% of patients getting a placebo. The new treatment is only for patients who have already taken a course of antibiotics for recurrent infections. The condition is more common in seniors and people with weakened immune systems.

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