Podcasts about Colistin

In this episode, Emily Heil, PharmD, MS, BCIDP, AAHIVP; Laila Woc-Colburn, MD; and Trevor Van Schooneveld, MD, FSHEA, FACP, discuss their approach to managing infections involving carbapenem-resistant Acinetobacter baumannii (CRAB), including: Mechanisms for β-lactam resistanceAdditional resistance mechanisms and virulence factors2023 IDSA guidance recommendations for moderate to severe CRAB infectionsThe latest clinical data by antimicrobial therapy/regimen:SulbactamMeropenem and colistinCarbapenem, sulbactam, and polymyxin BTetracyclinesCefiderocolSulbactam/durlobactam and carbapenems Program Director:Trevor Van Schooneveld, MD, FSHEA, FACP Professor, Division of Infectious DiseasesProgram Director, Infectious Diseases FellowshipMedical Director, Antimicrobial Stewardship ProgramUniversity of Nebraska Medical CenterOmaha, NebraskaFaculty:Emily Heil, PharmD, MS, BCIDP, AAHIVPAssociate ProfessorDepartment of PharmacyUniversity of Maryland School of PharmacyID Clinical Pharmacy SpecialistUniversity of Maryland Medical CenterBaltimore, MarylandLaila Woc-Colburn, MDAssociate ProfessorDivision of Infectious DiseasesEmory University School of Medicine Atlanta, GeorgiaContent based on a CME program supported by an educational grant from Merck & Co., Inc., Rahway, NJ, USA.Follow along with a downloadable slideset at: https://bit.ly/476v2wILink to full program: https://bit.ly/40Mmicz

In this episode, David van Duin, MD, PhD, FIDSA, FAST, discusses new data on complicated clinical infections presented at ECCMID 2023, including:Gram-negative resistancePharmacokinetic and clinical outcomes in patients receiving meropenem/vaborbactam for KPC-producing carbapenem-resistant Enterobacterales infectionsComparative study of cefiderocol- vs colistin-containing regimens for CRAB VAP with concomitant bacteremiaReal-world use of imipenem/cilastatin/relebactam for the treatment of infections caused by multidrug-resistant organismsAntimicrobial stewardshipSafety and efficacy of antibiotic de-escalation from an antipseudomonal β-lactam in patients with Enterobacterales BSIs in SIMPLIFYThe SOAB study comparing clinical outcomes of switching to oral antibiotics after IV lead-in therapy vs continuing IV therapy in patients with Enterobacterales BSIsData from REGARD-VAP on outcomes of shortened antibiotic treatment for VAP guided by clinical criteriaInvestigational agentsOpen-label study following ATTACK of patients with colistin-resistant CRAB infections receiving sulbactam/durlobactamSummary of findings from EAGLE-2 and EAGLE-3 of gepotidacin for uncomplicated UTI treatmentPost hoc DOOR analysis of SURE-2 of sulopenem for the treatment of complicated UTIs Faculty: David van Duin, MD, PhD, FIDSA, FAST Professor of Medicine Director, Immunocompromised Host Infecious Diseases Program Division of Infectious Diseases University of North Carolina Chapel Hill, North Carolina Content based on an online CME/CE program supported by an independent educational grant from Shionogi Inc. Link to full program: https://bit.ly/3niXGJ6Link to downloadable slides: https://bit.ly/3Hx0ppn

Tidal Volume is a podcast from ATS Peds focusing on core concepts of pediatric pulmonology. The goal is to bring in depth focus on these core concepts for residents, fellows, early career pulmonologists or even senior faculty looking for a refresher.In episode 7, Ryan Thomas MD from Michigan State University discusses tracheobronchitis in children with tracheostomy tubes with Dan Craven MD and Moshe Prero MD from Case Western Reserve University/Rainbow Babies and Children's Hospital and Alexander Gipsman MD from Children's Hospital  of Philadelphia. We discuss their review article Tracheobronchitis in children with tracheostomy tubes: Overview of a challenging problem and why they decided to write on this topic.  We also discuss the importance of tracheobronchitis in this patient population, the risk factors for infection, the microbiology of the airway,  and the diagnosis and treatment of tracheobronchitis in children with tracheostomy tubes.  Guests:  Daniel Craven, MD, Case Western Reserve UniversityMoshe Prero, MD, Case Western Reserve UniversityAlexander Gipsman, MD, Children's Hospital of Philadelphia Host:  Ryan Thomas, MD,  Michigan State University ReviewersChristina Barreda, MD, University of Wisconsin Elizabeth Fiorino, MD, Hofstra University Production/EditingRyan Thomas, MD,  Michigan State University Contact Information:TidalVolumeATSPeds@gmail.com Twitter Accounts:Ryan Thomas, MD@MSUPedsPulm@ATSPeds References  Gipsman A, Prero M, Toltzis P, Craven D. Tracheobronchitis in children with tracheostomy tubes: Overview of a challenging problem. Pediatr Pulmonol. 2022 Apr;57(4):814-821. Akangire G, Manimtim W, Nyp M, et al. Factors leading to rehospitalization for tracheostomized and ventilator-dependent infants through 2 years of age. J Perinatol. 2017;37(7):857-863. Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control. 2008;36(5):309-332.  Griese M, Felber J, Reiter K, et al. Airway inflammation in children with tracheostomy. Pediatr Pulmonol. 2004;37(4):356-361.  Willson DF, Conaway M, Kelly R, Hendley JO. The lack of specificity of tracheal aspirates in the diagnosis of pulmonary infection in intubated children. Pediatr Crit Care Med. 2014;15(4):299-305.  Cline JM, Woods CR, Ervin SE, Rubin BK, Kirse DJ. Surveillance tracheal aspirate cultures do not reliably predict bacteria cultured at the time of an acute respiratory infection in children with tracheostomy tubes. Chest. 2012;141(3):625-631.  Rusakow LS, Guarín M, Wegner CB, Rice TB, Mischler EH. Suspected respiratory tract infection in the tracheostomized child: the pediatric pulmonologist's approach. Chest. 1998;113(6):1549-1554.  Goldstein I, Wallet F, Nicolas-Robin A, Ferrari F, Marquette CH, Rouby JJ. Lung deposition and efficiency of nebulized amikacin during escherichia coli pneumonia in ventilated piglets. Am J Respir Crit Care Med. 2002;166(10):1375-1381.  Herrmann G, Yang L, Wu H, et al. Colistin-tobramycin combinations are superior to monotherapy concerning the killing of biofilm Pseudomonas aeruginosa. J Infect Dis. 2010;202(10):1585-1592.  Tamma PD, Turnbull AE, Milstone AM, Lehmann CU, Sydnor ER, Cosgrove SE. Ventilator-associated tracheitis in children: does antibiotic duration matter? Clin Infect Dis. 2011;52(11):1324-1331.  Chastre J, Wolff M, Fagon JY, et al. Comparison of 8 vs 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial. JAMA. 2003;290(19):2588-2598.  Silva RC, Ojano-Dirain CP, Antonelli PJ. Effectiveness of pediatric tracheostomy tube cleaning. Arch Otolaryngol Head Neck Surg. 2012;138(3):251-256.  Morrison JM, Hassan A, Kysh L, Dudas RA, Russell CJ. Diagnosis, management, and outcomes of pediatric tracheostomy-associated infections: A scoping review. Pediatr Pulmonol. 2022 May;57(5):1145-1156.  Jutras C, Autmizguine J, Chomton M, et al. Inhaled antibiotics for the prevention of respiratory tract infections in children with a tracheostomy. Front Pediatr. 2021;9:633039.

Microbe Mail recorded a collaborative episode with the ID:IOTS podcast. Jame, Callum and I talk about the challenge of multidrug resistant Gram negative bacterial infections, particularly from the perspective of a low- middle income setting, with poor access to the newer antimicrobial agents. Callum is a medical microbiology and infectious diseases registrar working in Edinburgh, Scotland who has recently completed a medical education fellowship. Jame is an ex-Scottish newly Oxford, England, based infectious diseases and clinical pharmacology.You can find Jame and Callum's podcast here: https://idiotspodcasting.buzzsprout.com/ Links: References:Metallo-β-lactamase resistance in Enterobacteriaceae is an artefact of currently utilized antimicrobial susceptibility testing methods Best practices: Appropriate use of the new β-lactam/β-lactamase inhibitor combinations, ceftazidime-avibactam and ceftolozane-tazobactam in South AfricaColistin Monotherapy versus Colistin plus Meropenem Combination Therapy for the Treatment of Multidrug-Resistant Acinetobacter baumannii Infection: A Meta-AnalysisIDSA AMR Guidance ESCMID Gram Negative Treatment Guidelines Visit the Microbe Mail website to sign up for updates E-mail: mail.microbe@gmail.comInstagram: Microbe_Mail Twitter: @microbemail

Jame and Callum are joined by Vin from Microbe Mail to discuss the management of Difficult to Treat Resistance (DTR) Gram negative infections in South Africa.If you haven't already check out Microbe mail for a high quality infection podcast linking the lab and clinical management.... wait that sounds familiar!Vin is a associate Professor in Clinical Microbiology at the University of the Witwatersrand, Johannesburg, South Africa and a practising clinical microbiologist with the National Health Laboratory Service. She is passionate about microbes (of course), antimicrobial resistance, antimicrobial stewardship, diagnostics, healthcare associated infections, fungal infections, One Health...let's just say it's a very long list!References:Metallo-β-lactamase resistance in Enterobacteriaceae is an artefact of currently utilized antimicrobial susceptibility testing methods Best practices: Appropriate use of the new β-lactam/β-lactamase inhibitor combinations, ceftazidime-avibactam and ceftolozane-tazobactam in South AfricaColistin Monotherapy versus Colistin plus Meropenem Combination Therapy for the Treatment of Multidrug-Resistant Acinetobacter baumannii Infection: A Meta-AnalysisSupport the showQuestions, comments, suggestions to idiotspodcasting@gmail.com or Tweet us @IDiots_podPrep notes for completed episodes can be found here: https://1drv.ms/u/s!AsaWoPQ9qJLShugmB2EOm8FMePNBtA?e=IKApb5If you are enjoying the podcast please leave a review on your preferred podcast app!Feel like giving back? Donations of caffeine gratefully received!https://www.buymeacoffee.com/idiotspod

On this episode, Maui tackles Ray Liotta, Dominican Republic, Elon Musk, Russia, Colistin, Cockroach Coitus, Jonny Depp, MCR-1, Aerosols and a whole lot more! [ *INSTANT CLASSIC ] —— *Please rate and review MAW — 5 Stars for cultural purposes, let's grow this Bunsen burner. You can also listen to MAW on Spotify, Google podcasts, Stitcher, TuneIn or your favorite podcast app... MAW is literally everywhere! MAW is an XO thing, so show Love: xoroyalty.net —— One more thing... “Might As Well” is hosted and produced by mysterious South African comedian, Maui Maw. It's not for the politically correct. Thank you for Listening. P.S. COMEDY! ℗ 2022 XO LUXURY GOODS

Welcome to our slightly delayed April episode! For this one, we bring you an interview with Dr. Celia Souque, an evolutionary biologist with a love for board games. We talk with her about evolution, antibiotic resistance and her great outreach board game project "Drugs vs. bugs" where she worked to design not only an educational tool, but also a beautiful, fun, and engaging game for anyone to play. In the news section, we first comment on a recent research article looking into the role of silver in re-sensitizing colistin-resistant bacteria. Then we move into a recent review paper making a case for the how-to, relevance, and importance of qualitative research in the field of antimicrobial stewardship. Two different but equally interesting reads. Are you ready? Let's dive in! Check relevant links in the show notes at www.uac.uu.se/the-amr-studio/episode37/. Follow our updates on twitter on www.twitter.com/uac_uu with #theAMRstudio hashtag! Theme music by Henrik Niss: www.tinyurl.com/henriknissspotify.

Antibiotic resistance has long been considered one of the greatest threats to global health. More recently, we're seeing growing public awareness around the overuse of antibiotics used in the US livestock system - a system that produces much of our meat supply. Widespread antibiotic use on US farms has evolved from something that only a small group of advocates and scientists worried about to something many more people are talking about now. The term antibiotic free is showing up on products and supermarkets and the way fast food chains are advertising their products. With drug resistant pathogens or superbugs, as some people know them, now being called the slower moving pandemic, it's time to check in on both how the science and the policy are evolving in this important part of our food system. And there's no one better than our guest to help deal with this. Dr. David Wallinga is senior health officer for the Food, Agriculture and Health, Healthy People & Thriving Communities Program at NRDC, the Natural Resources Defense Council, a leading environmental organization. David is a physician, and has led the way on connecting science with policy in the area of food and environment. He is highly regarded for his work on antibiotics and the food supply. Interview Summary   So David, I recorded a podcast with you many years ago when I was at Yale University. We were discussing this important topic, and boy, a lot's been discovered since then. So it'll be nice to dig in and get updated. So again, thanks for being with us. I've really long admired your work and your passion and your ability to communicate what is pretty complex science in this area. So, David, how did the use of antibiotics in the food supply begin? What are the origins of the story?   Well, a book that came out in 2014 told a really compelling story that I'd never heard before (The Chain: Farm, Factory, and the Fate of our Food). And it seems to suggest that it started with the Hormel Company, the makers of SPAM, who were trying to keep up with demand for the SPAM product after world war II, and was having trouble. And one of the things they did was to reach out to researchers from the University of Minnesota to see if feeding antibiotics, these new miracle drugs, through animal feed to chickens and pigs could have an effect of them putting on weight faster, which they thought might be the case. And at least initially that did turn out to be true. So at Hormel Institute, this is what they called it, the collaboration between the researchers and the company continues today and is very involved with the University of Minnesota, as well as the Mayo clinic.   That's so interesting that the story began with not only using antibiotics to prevent or help cure disease, but just to make the animals grow faster and produce more meat.   Well, they didn't actually start off to prevent disease, that wasn't mentioned anywhere, at least in Genoway's account. The thought was not to use them to treat disease, but rather they reasoned that if they could use the antibiotics to kill off some of the gut bacteria, then the animals would be able to divert more energy into growing. So really, it was always designed from the get go to put on weight in animals that were otherwise healthy.   Oh, that's so interesting. So, how widely used are antibiotics in the food supply?   Well, flash forward many decades, they're extremely widely used globally and in the US. Globally researchers estimated 70% of all the medically important antibiotics - and by that, I mean, ones that are used in livestock as well as in people - so about 70% or more are used on farms, especially in livestock production. In the US it's about the same amount, roughly two-thirds.   Oh, those are staggering numbers. So what are the up and downsides of this big use?   I see few upsides actually. People for time immemorial have been raising animals without antibiotics quite successfully. And there are still ways to raise them even at large scale, without antibiotics as we can get into later.   What about that assumption that the antibiotics produce more efficient meat production and make the animals grow faster, etc.?   I don't really see much evidence for that. When you actually look at the efficiency, there have been some studies of what's happened in Europe. They've really been very deliberate about reducing and eliminating antibiotic use that's not needed. And what they found is you can do it for the most part, without affecting productivity. And you can do it without any impact on cost either or very little impact on cost, including to the consumer. And when you factor in the public health benefit of just avoiding antibiotic use in the first place, it really comes out as a win-win.   Well, that's very important information. So what are the downsides?   Well, the downsides come from a couple of things. One is the vast majority of the antibiotics that are being used in livestock are put into their feed or in their drinking water. So that means you're feeding them on a pretty regular basis to entire herds. And the equivalent would be, I suppose, mass dosing human beings, whether or not they needed antibiotics, because you thought that some of those people might need them. Like putting it in a drinking supply for a city. You're just creating many more little breeding grounds for resistant bacteria. And that's exactly what we're doing on US livestock farms. We're creating perfect storm conditions for breeding superbugs, and then spreading them throughout the farm environment. And ultimately in the worst case, to the human population as well.   And how dangerous are these?   Well, they're really dangerous. We can't separate the superbugs and farms easily from the superbugs and hospitals. And in many cases, they're the same species of bacteria. We're talking about salmonella and staphylococcus and E. coli and drug resistant strains of these are killing large numbers of people in hospitals and outside of hospitals. So the CDC periodically updates these numbers, but the last numbers we have are that every year there's about 2.8 million or more drug resistant infections in the US and they contribute to at least 35,000 deaths a year, and maybe as many as 162,000 deaths a year in the US. Now, globally, if we don't do a better job about using antibiotics smarter, there's estimates that globally by the year 2050 there might be 10 million deaths a year. Ten million deaths, and trillions of dollars in costs.   Let me ask you this question. How do these bugs spread from the farms out there into the broader world? Is it through the food itself?   Well, for one thing, bugs, whether they're viruses or bacteria, don't really respect the same kind of boundaries between farms and hospitals and communities that we believe exist. The bugs travel pretty freely between them all. And so they get from animals to people in a variety of ways. First of all, as I said, the antibiotics are put into feed and the feed gets pooped out by the animal and ends up in the manure. So anywhere the manure goes, whether it's manure dust blowing in the wind, manure runoff into streams, or people just handling the animals and then taking the traces of that manure home with them, all of those can spread drug residues, but also a resistant bacteria. The genes in the bacteria are what make them resistant. Those can travel in all those environments as well. Maybe the thing people worry most about is on food. And in fact, in the US and in other places too, we have programs that test raw meat and poultry looking for signs of resistance. And the bad news is that it's fairly ubiquitous. Virtually anywhere we look, with a fair amount of frequency, we see evidence for resistance and resistant bacteria on those raw meats. Now, ideally, people would be using really good hygiene when they're in the kitchen, handling those meats. They would be cooking the meat really well, but that's not a failsafe. If it were, we wouldn't be having millions of cases of food poisoning every year, but we do.   Pertinent to that, I just saw a news report today - and you may not have seen it yourself - and I'm just quoting from it. It said that a gene that causes bacteria to be resistant to the one of the world's most important antibiotics, Colistin, has been detected in sewer water in Georgia. What do you make of that?   I say it's not at all surprising. Colistin is what we call a drug of last resort. We've been using up a limited supply of these miracle antibiotics for decades. It's very hard to come up with new ones. We're not investing in making new ones, and I'm not even sure we can make new ones. So we have to keep the old ones safe for as long as possible. But more and more, the bacteria are resistant to a lot of the older antibiotics like penicillins and tetracyclines. So we've got a few of the newer ones, namely Colistin, and some what are called next generation cephalosporins and fluoroquinolones. But those two are spurring resistant. And now we have examples of superbugs that are basically resistant to everything, they're untreatable. Now, thankfully, those are pretty far and few between for now. But we can see the writing on the wall. And when those start to break out and multiply, we're going to have a lot bigger increases in deaths and cases.   Well, it's a pretty scary picture. So let's talk about how things are changing. Is my perception that consumers are growing more aware of this issue accurate, and is this affecting corporate practices?   Yeah, it's accurate. I've been working on this exact issue for over 20 years. When we started public awareness, we did polling, public awareness was very low. For one thing, science literacy is not what it should be in general. People just have a lot of misconceptions about what drug resistance is. There's a common misconception that people are resistant to the drugs, and that's not the case. So what we're talking about is not eating foods contaminated with the drugs themselves, we're talking about using these drugs too much, whether in human medicine or on farms, and creating the conditions that make drug resistant bacteria multiply. And they multiply very, very quickly and then spread. And as a result, our farm environments, our streams, our sewage, as you said, and our meat and food supply are all contaminated now with drug resistant bacteria. And they're spreading, and that's the problem. And people are getting aware of it because like COVID, eventually more and more people have loved ones who are getting sick with hard to treat infections or even dying.   So, tell me how corporations are responding to this public awareness. It is changing things in the food supply chain by let's say fast food restaurants or big food sellers?   Well, groups like NRDC and our partner groups, we've been advocating for quite a while now to some of the countries and the world's biggest fast food chains, restaurant chains, and the like, to do a couple of things. One, make commitments to use fewer antibiotics in their supply chains. We know it's possible. We can get into how we know that later, but we know it's possible. And those are the biggest purchasers of those meat and poultry suppliers. So presumably if they ask their vendors to sell them product that's produced with fewer antibiotics, some of the vendors will find a way to do it. That whole strategies worked pretty well for chicken production, for example. In part companies like Tyson and Purdue got out early and discovered that in fact, they could raise broiler chickens almost without any antibiotics at all, it turns out. And so now, well above 90% of the chicken produced today in the US is produced with no antibiotics at all, or very few antibiotics. And you had mentioned at the top of the podcast, seeing labels like antibiotic free at the supermarket, that's mainly on chicken. It turns out it's been really much, much harder to see any kind of leadership by companies in pork or beef production. And the fast food chains too, have been really slow by and large too. And with just a few exceptions to commit to buying and serving pork or beef raised without routine antibiotics. Now, the exceptions are places like Chipotle, for example, or some of the smaller chains. But if you're talking about big places like Wendy's, McDonald's, Burger King, they really have been slow to make any forward progress at finding ways to reduce antibiotic use in their supply chains.   So such significant changes occurred in the chicken sector, why not in beef and pork?   Well, there's practical reasons with a big caveat. The practical reason is that a modern chicken only lives for six weeks. So all you've got to do is create conditions where you can get those fast-growing birds from the egg to the chicken, then from the chick to the slaughterhouse in just six weeks. So that makes it a little bit easier to control conditions for that long. Pigs and cows live a lot longer. The time to slaughter for a mature hog is about six months. The time to slaughter for a cow that goes from a calf stage then goes to a feed lot and gets fattened up, about a year and a half, maybe longer, maybe shorter, but it's a lot longer than a chicken. Now, with that said, have other countries found ways to produce chickens and cows with no or very few antibiotics? Well, yes, they have. Even pretty industrial producers of pork like Denmark and the Netherlands are using these medically important drugs at a rate that's one fifth, one sixth, one seventh, as much as what the US uses. So let me just repeat that. The US pig and pork industry has seemed to be using four or five, six or more times as many antibiotics on a milligram per kilogram basis as do their counterpart industries in other countries.   So this is a good segue to ask about the role of government in that picture in your mind.   Yeah, good question. The role of government is one, to protect the public. And here it's good to go back to basics. When it comes to superbugs and the spread of resistance, we know what the biggest problem is. The biggest problem is using antibiotics, and especially overusing antibiotics. And that doesn't matter if we're talking about the clinic or the hospital or the farm. Wherever you're overusing drugs when you don't need to, you're helping create the spread of resistance. And so that job number one for government should be to track the problem, to find ways to reduce antibiotics, to avoid using antibiotics, and also we argue, to set targets. And then if you've got a program in place to track the use of antibiotics, you'll be able to tell whether you're meeting your target or not. Now, sadly, the US doesn't do any of those things. Much of Europe is doing all of those things, and quite successfully. And so one of the things we're doing at NRDC with partners is we're jumping into the failure of the US agencies to protect the public. And we're doing their work for them. We're tracking antibiotic use on farms and the way that Europe does. And then we're comparing the overuse in US farms to much, much lower levels of use across much, if not all of Europe.   Bio:   Dr. David Wallinga is a physician with more than 20 years of experience in writing, policy, and advocacy at the intersection of food, communities, and health. His work on food and farming as an ecologically-based system has laid the groundwork for understanding them as important social and environmental determinants of health. He has worked to address the impact of federal pesticide policies and practices on child brain health; to change Farm Bill policies that promote overproduction and overconsumption of junk food calories and have helped fuel a rise in obesity; and to reverse the enormous overuse of antibiotics in industrial-style U.S. livestock production, its contribution to a “slow-moving” pandemic of superbug bacteria, and the federal policies that incentivize these practices. Dr. Wallinga advocates for policies that promote production of good food for communities that is more accessible, safe, and nutritious; more resilient, climate-friendly livestock production that is also safer for downstream communities; and investments in food systems and rural communities based on equity and fairness. He completed his medical school education at the University of Minnesota. He also holds a bachelor's degree in political science from Dartmouth College and a master's degree in public affairs from Princeton University. He lives in St. Paul, Minnesota, but is descended from Iowans.  

As a professor and researcher, Dr. Karriker has been working with swine disease diagnosis and treatment, as well as assessing new intervention strategies for the pig industry. He points out that genes that are resistant against some antibiotics such as Colistin could already exist, but at a low level, since this antibiotic has not been used so widely. However, it is very complex to cite the causes of the introduction of new resistant genes, since many factors are involved. Do you agree?

Right now, we can fight off a wide range of bacterial infections using antibiotics. But those antibiotics are becoming increasingly ineffective, and antibiotic use on factory farms is partially to blame.  In this episode, Lance Price and Cindy Liu, two public health researchers, explain that we give animals a steady dose of antibiotics in their feed, hoping to stave off disease in cramped, unsanitary conditions. But as a result, the bacteria in these animals develop resistance to antibiotics. But they have some suggestions for how we could make our antibiotics last. Further listening and reading:  Sigal Samuel has written in depth about the antibiotic risks posed by our factory farms. Liu and Price’s full study is worth a read, as is this Wired writeup of its findings. The episode mentions some of the work that Canada and Denmark have done to combat this resistance problem. It also digs into the use of the antibiotic Colistin in Chinese farms, and the subsequent spread of resistance. We always want to hear from you! Please send comments and questions to futureperfect@vox.com.  Subscribe to Future Perfect on Apple Podcasts, Spotify, or your favorite podcast app to automatically get new episodes of the latest season each week. This podcast is made possible thanks to support from Animal Charity Evaluators. They research and promote the most effective ways to help animals. Featuring: Byrd Pinkerton (@byrdala), podcast producer, Vox Martha Nelson (@swientist), epidemiologist, National Institutes of Health Juergen Richt (@juergenricht), professor of veterinary medicine, Kansas State University Host: Sigal Samuel (@SigalSamuel), staff writer, Vox  More to explore: Follow all of Future Perfect’s reporting on the Future of Meat. Subscribe to Vox’s Future Perfect newsletter, which breaks down big, complicated problems the world faces and the most efficient ways to solve them. Follow Us: Vox.com Learn more about your ad choices. Visit megaphone.fm/adchoices

Dr. Issmat Kassem is an Assistant Professor of Food Microbiology Safety at the University of Georgia. He sounds the alarm about an antibiotic-resistant gene called MCR-1 that's making its way from the poultry industry into humans at an alarming rate and how this will lead to millions of deaths across the Middle East, Asia and the world. He explains why Colistin should be banned from agriculture and why we should be investing in alternatives to antibiotics.

Dr. Issmat Kassem is an Assistant Professor of Food Microbiology Safety at the University of Georgia. He sounds the alarm about an antibiotic-resistant gene called MCR-1 that's making its way from the poultry industry into humans at an alarming rate and how this will lead to millions of deaths across the Middle East, Asia and the world. He explains why Colistin should be banned from agriculture and why we should be investing in alternatives to antibiotics.See omnystudio.com/listener for privacy information.

We welcome the summer at The AMR Studio! This month, we bring you a deep conversation with Dr. Johan Bengtsson Palme from the CARe center in Gothenburg about the role of the environment in the AMR problem and how his group focuses on studying it. Dive deep into this essential part of "one health" that is so frequently talked about. In the news, we feature two recent UAC articles! Our PhD student Viktor Rognås has published his work on understanding the pharmacokinetics of colistin in very sick patients, while our PhD student Gbemisola Allwell-Brown has published her first article looking into the trends of antibiotic use in 73 low- & middle-income countries. Congrats guys! We hope you enjoy this episode and see you again in July! Check relevant links and material at www.uac.uu.se/the-amr-studio/episode19/. Follow our updates on twitter on www.twitter.com/uac_uu with #theAMRstudio hashtag! Theme music by Henrik Niss: www.tinyurl.com/henriknissspotify.

For Episode 30 of the Deep Fried Neurons Podcast, I sat down with Dr. Vasudev Menon, a professor of Biology and Drama at Symbiosis School of Liberal Arts to explore the issue of anti-biotics in the chicken sold commercially in the cities of India. We talk broadly about the wide spread administration of Colistin in Poultry Farms, and it's grim far reaching effects on our bodies and public health. Besides that, Vasudev talks about English theatre in Pune and his latest production of Henry Ibsen's "Ghosts" coming to a Venue near soon. Articles I was talking in reference to: https://www.theguardian.com/environment/2018/feb/01/indias-farmed-chickens-dosed-with-worlds-strongest-antibiotics-study-finds https://www.livemint.com/Industry/yt5eE5hqMLYP1px2d63Q1K/Govt-may-ban-antibiotic-colistin-used-to-fatten-chicken.html The Drama Queens Facebook Page: https://www.facebook.com/thedramaqueenspune/ Support us on Patreon: https://www.patreon.com/deepfriedneurons Follow me on social media: https://www.instagram.com/deepfriedneurons/ https://www.facebook.com/DeepFriedNeurons Vocals for the intro by: Shivangi Kale Go Check out her YouTube Channel: https://www.youtube.com/channel/UCahrQbx1bX5NUeVVJhb_rfw

In this podcast, Dr. Todd Miano summarizes the article, "Attributable Risk and Time Course of Colistin-Associated Acute Kidney Injury" on behalf of his co-authors.

In this podcast, Dr. Todd Miano summarizes the article, "Attributable Risk and Time Course of Colistin-Associated Acute Kidney Injury" on behalf of his co-authors.

Esta semana hablamos del resultado del Estudio AIDA, que busco evaluar el uso de colistina versus la combinación de colistina y meropenem en el tratamiento de infecciones por gérmenes Gram-negativos resistentes a carbapenemicos, pero cuyos resultados, como explicaremos, son básicamente relevantes para el caso de infecciones por Acinetobacter sp. resistentes a carbapenemicos.   Referencias: Mical Paul y colaboradores. Colistin alone versus colistin plus meropenem for treatment of severe infections caused by carbapenem-resistant Gram-negative bacteria: an open-label, randomised controlled trial. Lancet Infect Dis.  Feb 15, 2018.   Frase de la Semana: Recurrimos nuevamente a Mark Twain para la frase de esta semana. Escritor, humorista, empresario, editor y conferencista estadounidense. Entre sus novelas se encuentran Las aventuras de Tom Sawyer (1876) y su secuela, Las aventuras de Huckleberry Finn (1885), esta última a menudo llamada "La gran novela estadounidense". “Es más fácil engañar a la gente que convencerlos de que han sido engañados”.

Interview with Barbara E. Murray, MD, author of Infectious Disease Expert Sees Threat From Colistin-Resistant Superbug

Interview with Barbara E. Murray, MD, author of Infectious Disease Expert Sees Threat From Colistin-Resistant Superbug  

The arrival in the US of plasmid-mediated resistance to colistin antibiotics, a last line of defense against many gram-negative bacilli, and a quorum sensing system in a eukaryote are topics of this episode hosted by Vincent, Michael, and Michele. Image: Etest used to determine the minimum inhibitory concentration of an antibiotic for a particular bacterium. Hosts: Vincent Racaniello, Michael Schmidt, and Michele Swanson.  Subscribe to TWiM (free) on iTunes, Stitcher, RSS, or by email. You can also listen on your mobile device with the Microbeworld app. Links for this episode E. coli with mcr-1 on a plasmid in the US (AAC) Emergence of plasmid mediated colistin resistance in China (The Lancet) Major breach in last line of defense (The Lancet) Resistance plasmid families in Enterobacteriaceae (AAC) EUCAST MIC breakpoints (ClinCalc) Role of ASM in microbial resistance one, two (bLogphase) Quorum sensing in fungi (Cell Host Microbe) Image credit Letters read on TWiM 129 This episode is brought to you by CuriosityStream, a subscription streaming service that offers over 1,400 documentaries and non­fiction series from the world's best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/m​icrobe ​and use the promo code MICROBE​. Send your microbiology questions and comments (email or mp3 file) to twim@microbe.tv 

A new superbug has scientists concerned after a Pennsylvania woman develops a urinary tract infection that is resistant to Colistin, an antibiotic of last resort. More and more, antibiotic resistance is becoming a challenge for doctors everywhere, where does that leave you if you were off the grid? Plus, depression is a big problem in good times or bad, and what can you do if you want to avoid drugs to treat it? Dr. Alton, part of Jack Spirko's Survival Podcast Expert Council, answers questions from a listener with the problem. Also, Dr. Alton joins the call to cancel the Olympics with 150 other practitioners who thinks it's a dumb idea to send half a million tourists to the epicenter of an epidemic zone. As a special added treat, our good friend Clint Jivoin of Naked and Afraid joins us at a recent event to talk about his experiences on the show and his plans for the future. All this and more on the Doom and Bloom Survival Medicine Hour with Joe and Amy Alton...  

A new superbug has scientists concerned after a Pennsylvania woman develops a urinary tract infection that is resistant to Colistin, an antibiotic of last resort. More and more, antibiotic resistance is becoming a challenge for doctors everywhere, where does that leave you if you were off the grid? Plus, depression is a big problem in good times or bad, and what can you do if you want to avoid drugs to treat it? Dr. Alton, part of Jack Spirko's Survival Podcast Expert Council, answers questions from a listener with the problem. Also, Dr. Alton joins the call to cancel the Olympics with 150 other practitioners who thinks it's a dumb idea to send half a million tourists to the epicenter of an epidemic zone. As a special added treat, our good friend Clint Jivoin of Naked and Afraid joins us at a recent event to talk about his experiences on the show and his plans for the future. All this and more on the Doom and Bloom Survival Medicine Hour with Joe and Amy Alton...  

Zur Beurteilung der Resistenzlage aerober Bakterien des Wirtschaftsgeflügels wurden von September 2006 bis April 2008 insgesamt 2462 bakterielle Isolate aus Routineuntersuchungen von Organ- und Tupferproben auf deren in-vitro-Resistenzverhalten gegenüber antibiotischen Wirkstoffen hin untersucht. Von den erfassten Bakterienstämmen stammten 2227 von Mastküken oder Broilern, und die übrigen von Legehennenküken, Legehennen, Peking- und Moschusenten. Mit dem Agardiffusionstest erfolgte eine qualitative Beurteilung der Keime als resistent, intermediär oder sensibel. Von einem Teil dieser Bakterien wurde parallel hierzu die Antibiotikaempfindlichkeit mittels Bouillon-Mikrodilution bestimmt. Dabei wurden die entsprechenden MHK-Werte erhoben und beurteilt. Die qualitativen Ergebnisse beider Testmethoden wurden verglichen. Die Testdurchführung erfolgte auf der Grundlage von CLSI-Vorgaben. Im Ergebnis konnte ein Überblick über die aktuelle Antibiotikaempfindlichkeit bakterieller Keime des Wirtschaftsgeflügels im Einzugsbereich der Klinik für Vögel der LMU München erhoben werden. Unterschiede zu Ergebnissen anderweitiger Untersuchungen in Deutschland sind teilweise gegeben; so ergab sich in der vorliegenden Arbeit aus der MHK-Bestimmung für E. coli mit jeweils knapp 60 % sensiblen Isolaten eine höhere Resistenz gegenüber Enrofloxacin und Trimethoprim-Sulfamethoxacol, während sich Staph. aureus mit jeweils fast 80 % sensiblen Isolaten als deutlich empfindlicher gegenüber Ampicillin und Penicillin erwies. Es zeigt sich daher die Notwendigkeit Klinik- oder ggf. Praxiseigener Monitoring-programme, um den behandelnden TieräztInnen für eine antibiotische Erst- oder Notfallbehandlung von Geflügelbestände eine geeignete Entscheidungsgrundlage geben und damit den Anforderungen an einen vernünftigen Antibiotikaeinsatz gerecht werden zu können. Ampicillin und Penicillin zeigten die breiteste Wirksamkeit gegenüber grampositiven Bakterien. Über 85 % der untersuchten Keime waren empfindlich gegenüber diesen Antibiotika. Bei gramnegativen Keimen erwies sich Colistin als das am häufigsten wirksame Antibiotikum, mehr als 94 % der Isolate wurden als sensibel beurteilt. Die Resistenzlage vieler Bakterien des Geflügels stellte sich jedoch als relativ unsicher heraus. Daher sind Resistenztests für eine wirksame antibiotische Behandlung von Nutzgeflügelbeständen unabdingbar. Nur so kann ein falscher oder unnötiger Antibiotikaeinsatz vermieden und der Verbraucher vor resistenten Keimen tierischer Herkunft geschützt werden. Im Vergleich beider Testmethoden unterschieden sich die qualitativen Ergebnisse in 13,8 % der Fälle. In 9 % der Fälle lag ein kleiner Fehler (minor error) vor. Aufgrund der guten Korrelation der Ergebnisse wird gefolgert, dass sich beide Methoden gleichermaßen für die Resistenztestung bakterieller Keime des Geflügels eignen und einen Platz in der Routine- und Notfalldiagnostik haben. Die Problematik fehlender geflügelspezifischer Grenzwerte ist unabhängig von der Methode vorhanden. Die Bouillon-Mikrodilution zur Erhebung quantitativer und vergleichbarer MHK-Werte stellt aber die Methode der Wahl für das Resistenzmonitoring dar. Dabei sollte jedoch beachtet werden, dass eine möglichst große Anzahl an Konzentrationsstufen getestet werden sollte, da die erhobenen MHK-Werte zum Teil über einen großen Bereich verteilt lagen.

Audio Journal of Medicine, September 21st, 2007 Reporting from: 47th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), Chicago, 2007 Colistin Use Linked to Outbreak of Rare Hospital Infection RAMON GUEVARA, Los Angeles County Department of Public Health REFERENCE: Abstract K-1942/ICAAC Congress 2007 Chicago 16-20 September A report on a hospital outbreak involving a rare pathogen, which was presented at ICAAC, may have an important message for the whole field of infection control. Elizabethkingia Meningoseptica was found in a Los Angles hospital outbreak in 2006 and its emergence was linked to the use of colistin. So was this antibiotic selecting for the pathogen? Derek Thorne spoke with Ramon Guevara of Los Angeles County Department of Public Health.

ZUSAMMENFASSUNG Die Anwendung antimikrobieller Wirkstoffe in der Human- und Veterinärmedizin hat zu einer Selektion und Anreicherung antibakteriell resistenter Mikroorganismen geführt. Die Bedeutung tierischer Lebensmittel bei der Übertragung von Bakterien auf den Menschen wurde bereits des öfteren beschrieben. In Europa sind die meisten Y. enterocolitica-Stämme, die bei humanen Gastroenteritiden isoliert werden, vom Bioserotyp 4/O:3. Für menschliche Infektionen stellen symptomlos infizierte Schweine das wichtigste Erregerreservoir dar, dabei gilt Schweinefleisch als wichtigste Kontaminationsquelle. In der Literatur wurde bisher nur über eine Empfindlichkeitsbestimmung von Y. enterocolitica 4/O:3 in Deutschland berichtet. Aus diesem Grund befasste sich diese Studie mit dem Resistenzverhalten dieser Bakterien unter Anwendung zweier unterschiedlicher Methoden. Mittels Agardiffusionsverfahren wurden 200 Stämme (60 humane und 140 porcine) auf die antimikrobiellen Wirkstoffe Ampicillin, Amoxicillin/Clavulansäure, Cefotaxim, Aztreonam, Chloramphenicol, Colistin, Erythromycin, Gentamicin, Streptomycin, Nalidixinsäure, Ciprofloxacin, Tetracyclin, Sulphamethoxazol, Sulphamethoxazol/Trimethoprim und Trimethoprim getestet. Im Anschluss wurden 110 der gleichen Stämme (31 humane und 79 porcine) mittels Bouillon-Mikrodilutionsverfahren untersucht. Die im Handel erhältlichen Mikrotiterplatten wurden vom Nationalen Veterinärinstitut Schwedens bezogen und enthielten die antimikrobiellen Wirkstoffe Ampicillin, Cefotaxim, Ceftiofur, Chloramphenicol, Florfenicol, Gentamicin, Kanamycin, Streptomycin, Nalidixinsäure, Ciprofloxacin, Tetracyclin, Sulfamethoxazol und Trimethoprim. Mittels Agardiffusionstest wurden gegen fünf Wirkstoffe Resistenzen ermittelt. 98,0 % der untersuchten Yersinien waren gegen Ampicillin, 92,5 % gegen Erythromycin, 7,0 % gegen Streptomycin, 2,0 % gegen Sulphamethoxazol und nur 1 Stamm (0,5 %) war gegen den Kombinationswirkstoff Sulphamethoxazol/Trimethoprim resistent. Mittels Mikrodilutionsverfahren wurden bei drei von 13 getesteten Wirkstoffen Resistenzen ermittelt. So waren 97,2 % gegen Ampicillin, 15,5 % gegen Streptomycin sowie 1 Stamm (0,9 %), aus einer humanen Stuhlprobe, gegen Sulphamethoxazol resistent. Dieser Stamm war sowohl mittels Agardiffusions- als auch mittels Mikrodilutionsverfahren multiresistent. Es konnte kein wesentlicher Unterschied zwischen den Resistenzergebnissen humaner und porciner Stämme festgestellt werden. Von den 110 Yersinien waren die Ergebnisse von 82 Stämmen, mittels Agardiffusions- und Bouillon-Mikrodilutionsverfahren, übereinstimmend. Bei 28 Y. enterocolitica-Stämmen wurden unterschiedliche Resultate ermitelt. In 6 Fällen handelte es sich um größtmögliche Fehler, 4 mal sind große und 18 mal geringfügige Fehler aufgetreten. Dabei ist bei dem Vergleich der Ergebnisse der MHK-Wert als der verlässlichere anzusehen. Aus diesem zuletzt genannten Grund und da die Mikrodilution im Gegensatz zur Agardiffusion quantitative Ergebnisse liefert, was für eine effektive Therapie von Bedeutung ist, sollten Empfindlichkeitsbestimmungen mittels Mikrodilution durchgeführt werden. Insgesamt betrachtet, zeigen die Ergebnisse dieser Studie, dass Y. enterocolitica- Stämme 4/O:3 gegenüber den meisten antibakteriellen Wirkstoffen empfindlich sind und nur vereinzelt Resistenzen gegen antimikrobielle Wirkstoffe aufweisen. Des Weiteren ist zu sagen, dass bei Y. enterocolitica-Stämmen 4/O:3, die im süddeutschen Raum isoliert wurden, die Resistenzsituation zum derzeitigen Zeitpunkt nicht problematisch ist und mit den Ergebnissen anderer weltweit durchgeführten Untersuchungen übereinstimmt.

Die vorliegende Arbeit beschäftigt sich mir der Frage nach der Effektivität von inhalativ appliziertem Colistin und Tobramycin bei Patienten mit Cystischer Fibrose. Es handelt sich um eine retrospektive Analyse von 308 Therapieepisoden bei 71 Patienten. Basis ist die Gegenüberstellung positiver und negativer Effekte. Als positiv werden die Eradikation oder die Konzentrationsabnahme der Erreger im Sputum gewertet, negativ sind Gleichbleiben und die Zunahme der Konzentration sowie die Superinfektion unter Therapie. Unter Tobramycin dominieren die positiven Effekte. Sie werden begünstigt, wenn Tobramycin bei jungen Patienten, in frühen Krankheitsstadien eingesetzt wird, sowie bei Besiedelung durch noch nicht mukoide Pseudomonas aeruginosa-Stämme, bei Tobramycin-sensitiven Erregern und hoher Dosierung bis zu 2x300 mg/d. Im Gegensatz dazu dominieren bei Inhalation von Colistin die negativen Effekte. In keinem Fall unterschied sich die Wirkung von derjenigen der Kontrollepisoden. Anders als bei Tobramycin ließ sich für Colistin keine Korrelation zwischen der Empfindlichkeit und dem Verlauf der Konzentration der Erreger feststellen. Dies deutet auf eine zu niedrige Dosierung von Colistin hin. Sie kann jedoch im Gegensatz zur Situation bei Tobramycin wegen der Nebenwirkungen nicht wesentlich erhöht werden. Bei der CF werden Antibiotika auch zur Prophylaxe, d.h. zum Verhindern einer Kolonisation mit P.aeruginosa eingesetzt. Weder bei Colistin- noch bei Tobramycin-Inhalation konnte ein prophylaktischer Effekt festgestellt werden.