Antibiotic breakthrough could turn the tables in battle against superbugs

[muriel_volestrangler]

Source: The Guardian

Scientists have discovered a new class of antibiotic using a revolutionary procedure hailed as a game changer in the hunt for medicines to fight drug-resistant infections. The antibiotic, called teixobactin, kills a wide range of drug-resistant bacteria, including MRSA and bugs that cause TB and a host of other life-threatening infections.

It could become a powerful weapon in the battle against antimicrobial resistance, because it kills microbes by blocking their capacity to build their cell walls, making it extremely difficult for bacteria to evolve resistance.

“Teixobactin kills exceptionally well. It has the ability to rapidly clear infections,” said research leader Kim Lewis, director of the Antimicrobial Discovery Center at Northeastern University in Boston, US.
...
In studies on mice, the new antibiotic wiped out infections of Staphylococcus aureus and Streptococcus pneumoniae, which can cause life-threatening blood and lung infections. It was also effective against Enterococcus, which can infect the heart, prostate, urinary tract and abdomen.

Read more: http://www.theguardian.com/science/2015/jan/07/antibiotic-drug-resistance-teixobactin

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Some good news for a day that could use it.

[deurbano]

1. Sounds like really good news!

When my daughter spent 5 months in the hospital last year, she had lowered immunity from chemo and had also developed a Stage 4 pressure ulcer-- and we were always so worried she would develop a drug resistant infection (in addition to her already serious issues).

[Avalux]

2. This sounds promising. I love that they've been able to culture it in a natural environment.

Years of work ahead before the public will ever see it; big pharma will need to get involved. A couple of drawbacks - IV only and will only kill gram + bacteria, but anything novel is GOOD.

[CaliforniaPeggy]

3. This is very good news!

I hope it works out.

K&R

[Fred Friendlier]

4. The most important part of the article:

Most antibiotics are isolated from bacteria or fungi that churn out lethal compounds to keep other microbes at bay. But scientists have checked only a tiny fraction of bugs for their ability to produce potential antibiotics because 99% cannot be grown in laboratories.

Lewis’s group found a way around the problem by developing a device called an iChip that cultures bacteria in their natural habitat. The device sandwiches the bugs between two permeable sheets. It is then pushed back into the ground where the microbes grow into colonies.

The team not simply found a new antibiotic but developed a technique for identifying [potentially] entire new classes of antibiotics.

Which is awesome! And let us hope that this time around we are wise enough to use antibiotics appropriately and avoid recreating the resistance issue.

[Chemisse]

5. I hope this works - and if it does - I hope they guard it!

Don't give it out for just anything, and don't give it to the meat companies to fatten up the livestock!

[happyslug]

6. Not effective against "Gram Negative Bacteria" such as Gonorrhoeaa or Syphillis

Last edited Thu Jan 8, 2015, 10:08 AM - Edit history (1)

Another shortcoming of teixobactin is that it only works against bacteria that lack outer cell walls, known as Gram-positive bacteria, such as MRSA, Streptococcus and TB. It doesn’t work against Gram-negative bacteria, which include some of the most worrying antibiotic-resistant pathogens, such as Klebsiella, E. coli and Pseudomonas.

Gonorrhoeae is one such "Gram Negative Bacteria":

http://biology.kenyon.edu/slonc/bio38/stancikd_02/What_is_Neisseria_gonorrhoeae.html

Gonorrhoeae is Quickly becoming resistant to most antibiotics:

http://www.cdc.gov/Std/gonorrhea/arg/default.htm

Syphilis is another:

https://microbewiki.kenyon.edu/index.php/Treponema_pallidum

Through Syphilis has NOT developed the antibiotic resistance of Gonorrhea (Penicillin still works on Syphilis, provided it has not entered the brain. It takes Syphilis three months to enter the brain, thus if caught early Penicillin will work on Syphilis. Tetracycline, first used in 1954 will attack Syphilis once it has entered the brain for unlike Penicillin, Tetracycline can also enter the brain).

http://www.clinicalcorrelations.org/?p=5134

[still_one]

11. Absolutely right. A simple urinary tract infection of e-coli could easily go septic if the

antibiotics to treat it are resistant to it.

I wish they would also pursue bacterial phages in trying to solve the problem of bacterial resistance to antibiotics

[jeff47]

12. Yes, but should be effective against MRSA. (nt)

[du_grad]

14. Syphilis is caused by a Spirochete

I am a clinical microbiologist with over 35 years of experience. Spirochetes do not stain with the Gram staining methodology; therefore they are not considered "Gram negative" or "Gram positive" for that matter.

Neisseria gonorrhoeae is a Gram negative diplococcus that causes the STD gonorrhea. Neisseria are not enteric organisms and are not in the same "grouping" as Klebsiella pneumoniae/oxytoca, E. coli and other enterics (glucose fermenting bacteria). Pseudomonas is NOT an enteric but it IS a Gram negative non-glucose fermenting bacteria. It is usually treated with different classes of drugs than enterics are treated with.

Our lab (and most large labs) rarely culture for GC (gonorrhea) anymore (but we are able to do so - depends on the specimen and the way the ordering physician submits the specimen and order). We use DNA amplification testing for GC and Chlamydia. While this will detect the organisms' DNA, it does not GROW the organisms. Hence, susceptibility testing is not performed, as you need the actual organism to perform susceptibility testing. The advantage to the DNA method is much faster turnaround time for results. There are a number of companies making kits for this method. Our lab batches them once a day, but newer DNA kits are coming out to perform these in a continuous load format where you can walk away and get results in just hours. If you culture for the organism, it usually takes two days to show up on plates (it does not grow quickly) and another day to perform identification, as you usually must subculture one of the colonies to get enough growth to perform ID's and susceptibilities. TAT thus becomes three days . From the CDC:

"Challenges
A major challenge to monitoring emerging antimicrobial resistance of N. gonorrhoeae is the substantial decline in the capability of many clinicians and laboratories to perform essential gonorrhea culture techniques required for antibiotic susceptibility testing. This decline results from an increased use of newer non-culture-based laboratory technology, such as a diagnostic test called the Nucleic Acid Amplification Test (NAAT). Currently, there is no well-studied reliable technology that allows for antibiotic susceptibility testing from non-culture specimens. Increased laboratory culture capacity is needed."
http://www.cdc.gov/std/gonorrhea/arg/basic.htm

Microbiology is very complicated. I would suspect that if/when this comes to market it will only be used by Infectious Disease physicians and will be extremely expensive. Hospital formularies will include it only if ID wants it. There will be lots of pressure to NOT use it unless absolutely necessary because of cost. Hospitals are only reimbursed by Medicare for a flat DRG amount for Medicare patients. Unfortunately the elderly get a lot of these extremely resistant infections, when they end up in ICU with many chronic illnesses and cannot speak for themselves. Families want to "do everything" for their loved ones and they end up in a rock and a hard place with horrible infections. Patients who have cancer also end up with these nasty bugs, and if their insurance doesn't pay for them their family may go bankrupt trying to add just one more month to a loved one's life. These new antibiotics also have side effects. Many of them tend to wipe out bowel flora and patients end up in serious Clostridium difficile infections in their bowels due to overgrowth of this organism, which is also becoming resistant to Metronidazole and Vancomycin - first line treatments for this organism.

While I applaud Big Pharma for developing new antibiotics, consumers must decide how far they will go to use them.

[happyslug]

15. I am NOT a Micobilogist, that is why I looked and cited before I posted

I have heard stories of Antibiotic resistant syphilis for decades but stories only NOT actual cases. Like a lot of "Horror Stories", they may be some facts behind it, but in reality not true

Thanks for the input, I have heard of Spirochetes before (and that Syphilis was a Spirochete) but this is the first time I read about "Gram Positive" and "Gram Negative" thus I had to look at those terms in references to these two diseases that should have been eliminated decades ago, but have survived.

As you said the area is complicated and I will defer to the experts in this area of science, but people also have to have an idea of what this means, as you pointed out this probably NOT be a pill, but kept in reserve for those cases nothing else is working on. That is what people need to know and that as such it is NOT to be used causally as Penicillin has been since its introduction. Again thanks for the input we on DU need more expert opinion in areas of Science that most of us read about but do not really study, thus thanks for the input.

[du_grad]

17. You're quite welcome :-)

Bacteria are divided into Gram positives and Gram positives, based on the color that they stain with Gram Stain. The stain was invented by Christian Gram in 1884, and has not changed much to this day. How bacteria stain depends on whether their cell wall will admit the stain or not. Antibiotics work in different ways for Gram negatives and Gram positives. I am surely no expert when it comes to that stuff. I read out cultures and report them, but as far as the cellular actions of antibiotics I have a vague idea and that is it.

http://en.wikipedia.org/wiki/Gram_staining - info on Gram staining

I would suspect if and when this antibiotic becomes commercially available, it will be an intravenous one, kept for intractable infections for which nothing else works.

Some bacteria like Spirochetes, will not take up the Gram stain (a four step process - crystal violet, Gram's iodine, decolorization, safranin counterstain). The only way you can really see Spirochetes is by darkfield examination, which is rarely done anymore. Syphilis is currently diagnosed by a blood test. If caught in the early stages it is totally curable.

http://www.cdc.gov/std/syphilis/default.htm

http://www.cdc.gov/std/syphilis/stdfact-syphilis.htm

We perform many Gram stains per day in a clinical microbiology laboratory. Wound and respiratory infections get a smear made directly from the specimen that is read and reported out. This gives the doctor a preview of how good of a specimen was collected (presence or absence of white cells, squamous epithelial cells [surface skin vs. deep wound], and what type of bacteria, if present, are in the specimen. If a patient is septic ("blood poisoning&quot a blood culture is drawn and incubated in the laboratory. Blood from the patient is put into a liquid media, incubated for at least 5 days, and put onto instruments that monitor whether growth occurs. If the instrument flags a bottle as positive, we immediately pull it off the machine, make a Gram stain of the liquid, and report to the nurse/physician what bacterial morphology we see, so that proper antibiotics can be started. If we see Gram positive cocci in clusters or chains, different antibiotics will be started than if we see, for example, Gram negative rods.

http://www.cdc.gov/sepsis/basic/qa.html

Gram stain results help to determine proper treatment on a daily basis world-wide.

[markpkessinger]

7. Very good news indeed!

I lost a friend a few years ago at the age of 35 to a hospital-acquired antibiotic-resistant strain of staph. Scary stuff!

[TalkingDog]

8. How long do they give it before nature does what nature does and the targets evolve?

Because that's what's going to happen.

[muriel_volestrangler]

9. As Fred Friendlier says above, the method used to discover this antibiotic is new

and that may mean that many more may be discovered in the future.

[bemildred]

10. I agree that the culture method is likely more of a game changer than the drug itself.

There is a vast world of microbial life all around and in us, and it has much to teach us once we learn to listen.

[prayin4rain]

13. Shew! n/t

[blackspade]

16. Wow!