resistance - JASE Medical

Silent Pandemic – Antibiotic Resistance

A dire warning from health leaders across the world are calling the silent pandemic- antimicrobial resistant (AMR) infections. According to the World Health Organization AMR is one of the top ten leading global threats to health facing humanity in the world.

CDC estimates about 47 million antibiotic courses are prescribed for infections that don’t need antibiotics, like colds and the flu, each year. That adds up to approximately 28% of all antibiotics prescribed. In addition, A study published in the Lancet found that antimicrobial resistance was the direct cause of 1.27 million deaths worldwide.

An ever-increasing number of bacteria, fungi and parasites are becoming resistant to commonly prescribed antibiotics, with some resistant to many different antibiotics.  In some cases, antibiotics are not effective, leading to impossible to treat infections. This is a chilling scenario we are facing.

Antibiotic resistance (AMR) occurs through either genetic mutation or by acquiring resistance genes- where the antibiotic resistance genes are transferred to the next generation.

Some of the most widespread and common examples include:

  • methicillin-resistant Staphylococcus aureus (MRSA) (The most common)
  • vancomycin-resistant Enterococcus (VRE)
  • multi-drug-resistant Mycobacterium tuberculosis (MDR-TB)
  • carbapenem-resistant Enterobacteriaceae (CRE) gut bacteria

Broad spectrum antibiotics- The good and the bad

Broad spectrum antibiotics are being used in more and more AMR cases. These are antibiotics that act on the two major bacterial groups, gram-positive and gram-negative or any antibiotic that acts against a wide range of disease-causing bacteria. They are lifesaving when no other antibiotic therapy is working.

 They do come, however with their own set of whole set of detrimental, long lasting health effects. Some of these include resistance to pathogens, altered gut microbiota and immune system dysfunction. This is especially detrimental in young children. Broad spectrum antibiotics can alter gut microbiota which in turn will disrupt and affect immune function and growth of the child.

Promising research to fight antibiotic resistance

A protein in antibiotic resistant bacteria called DsbA helps fold resistance proteins into the right shapes to neutralize antibiotics. This was discovered by researchers, including experts from Imperial College London, led by Dr Despoina Mavridou assistant professor in Molecular Biosciences at the University of Texas at Austin. By disrupting the DBsA protein the team was successful in neutralizing the antibiotic resistant protein. In addition the pathogen was more sensitive to common antibiotics. As of this writing, research has been limited to outside the human body. The team now plans on finding an inhibitor that can be safely used in humans providing the same effect.

How to prevent AMR

Until research can successfully develop therapies for AMR, staying healthy and using antibiotics only when necessary are our options. Also, avoid crowds during outbreaks. And if sick, stay home!

The most effective way to prevent AMR is to boost immune system through:

  • Quality sleep- Sleep is when the body actively heals and restores health. Practice sleep hygiene
  • Exercise- At least 30 minutes several times a week of active walking or other form of exercise can help boost immune system, regulate mood and decrease appetite
  • Avoid sugar-Sugar and refined carbohydrates help feed pathogenic bacteria
  • Vitamin D (with k2)- Vitamin D supports a strong immune system. Talk with your healthcare provider about vitamin D supplementation and checking vitamin D levels to make sure you are reaching optimum vitamin D levels
  • Avoid and manage stress- Deep breathing exercises can help when unable to avoid stressful situations.
  • Practice personal hygiene- wash hands after going to store, before eating, and any time your are exposed to anyone who is ill.

- Brooke Lounsbury, RN

Medical Content Writer

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How do Antibiotics Work? Part 4

The best way to take antibiotics is to never need them. But that isn’t always an option. However, there are some steps you can take to strengthen your immune system so that you and your loved ones can fight off illness. The recent outbreak of deaths from group A strep– which is usually treated with Amoxicillin, is currently in short supply. This highlights the fragility of our nations drug supply. Check this site for current drug shortages- if a medication you are taking is on the list contact your care provider to get your medications refilled, and if available ask for a years supply of your meds.

8 tips to strengthen your immune system

  1. Get good quality sleep

According to the Sleep foundation good quality sleep enhances both the innate and adaptive immune system responses. Non rapid eye movement, known as NREM is deep sleep slows the body’s processes allowing more energy to be directed at healing. Sleep is such an important topic that it really needs its own post.

  1. Cut back on sugar

Professor of immunobiology at Yale, Ruslan Medzhitov performed experiments on mice- after infecting the mice with the bacteria Listeria monocytogenes he fed one group fat and proteins. They lived. The group he fed simple carbohydrates died.  Conversely, when the mice were infected with an influenzas virus and fed fats and proteins, they were more likely to die compared to the mice fed simple carbohydrates. In other words, balance is the key. If unsure if you have a viral or bacterial infection it is best to just cut out excess sugar.

  1. Increase fresh fruits and vegetables

Up to 80% of our immune system is housed in lymphoid tissue in your intestines, It is called gut associated lymph tissue (GALT) By eating fiber rich foods the beneficial bacteria help the immune system do its job. In addition, a study found that eating a diverse diet high in fiber rich foods can help combat antibiotic resistance. There needs to be more research in this area of study, however initial results are promising.

In addition, several varieties of mushrooms are known to improve immune system function and are being studied for their cancer fighting properties.

  1. Drink plenty of water

Water helps flush toxins out of the body, both through elimination and mucus membranes.

The bloodstream is comprised mostly of water. To help the body fight infection keeping hydrated helps the white blood cells do their job- fight infections.

  1. Avoid alcohol and smoking–

Both can decrease immunity

  1. Keep your vitamin D levels up

Vitamin D is well known to help fight infections. Be sure that when you take vitamin D (which is really not a vitamin, it is a steroid hormone) be sure to add vitamin K2, also known as MK 7, This is important, because this helps avoid calcium buildup in your arteries.

  1. Reduce and manage stress

Stress raises our cortisol levels which in turn suppresses the immune response to pathogenic invaders.

  1. Exercise to boost immunity

Research shows that 20–40 minutes of moderate-intensity exercise per day is adequate to provide a positive boost to the immune system. Exercise helps circulate the infection fighting cells in the body.

If you still need an antibiotic Jase has you covered

The 5 antibiotics in the Jase case can cover a wide range of bacterial illnesses. If in doubt contact Jase provider for guidance, part of the outstanding service Jase offers is unlimited follow up for questions about antibiotic use.

 Let’s take a look at some of the infections Jase antibiotics cover:

  • Amoxicillin-clavulanate 875 mg tablets (28 tablets)

When amoxicillin is not available due to current shortages this antibiotic can be substituted. Other uses include group A strep, sinusitis, pneumonia, ear infections, bronchitis, urinary tract infections, and infections of the skin

  • Azithromycin 250 mg tablets (6 tablets)

Bacterial pneumonia, ear and sinus infections, skin infections, Travelers diarrhea, urinary tract infection

  • Ciprofloxacin 500 mg tablets (28 tablets)

Bioterrorism infections from anthrax, Tularemia or plague exposure

Travelers diarrhea

  • Doxycycline 100 mg capsules (120 capsules)

Bioterrorism infections from anthrax, Tularemia, or plague exposure

Skin infection, tetanus, bites (animal or human)

  • Metronidazole 500 mg tablets (30 tablets)

bacterial vaginosis, diarrhea (caused by giardia and clostridioides difficile), giardiasis, tetanus, and trichomoniasis

 

- Brooke Lounsbury

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.
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How do Antibiotics Work? Part 3

In part 1 we reviewed how antibiotics work, part 2 what biofilms are and their role in antibiotic resistance. In part 3 we will review:

  • When antibiotics are needed and when they aren’t appropriate
  • Distinguish between an allergic reaction to an antibiotic and the symptoms the infection is treating

When antibiotics are needed and when they aren’t appropriate

Antibiotic stewardship is one of the most pressing health issues of our time. As pathogens mutate and evade antibiotic therapy, we are forced to use more potent antibiotics. The use of antibiotics when not necessary is leading to devastating consequences. Antibiotic resistance, AKA antimicrobial resistance happens when germs like bacteria or fungi no longer respond to the drugs designed to kill them. According to the CDC: “About 47 million antibiotic courses are prescribed for infections that don’t need antibiotics, like colds and the flu, in U.S. doctors’ offices and emergency departments each year. That’s about 28% of all antibiotics prescribed in these settings.”

In the U.S., more than 2.8 million antimicrobial-resistant infections occur each year. A list of the antimicrobial resistant infections are listed on the CDC website. Some are familiar to the general population such as MRSA- Methicillin resistant Staphylococcus aureus, and VRE- Vancomycin resistant Enterococci. Some not so familiar-Drug resistant Candida and Carbapenem-resistant Acinetobacter for example. A full list of CDCs watchlist can be found here.

Antibiotics are indicated when:

A bacteria or fungal infection has taken over the body, either systemically (in the body) or topically-skin and tissues. Entry points can be a break in the skin, respiratory inhalation, eyes. Ears, mouth, urogenital route, or ingestion. They are not needed in all cases, sometimes our body can fight off the infection. If you own a Jase case check with your care provider when in question. They are not appropriate for viral illnesses such as colds, flu, covid, etc. Sometimes a viral infection will lower the body’s immune defenses allowing an opportunistic bacterial or fungal infection to take over as in the case of a viral pneumonia to bacterial pneumonia. At that point an antibiotic may be needed.

Distinguish between an allergic reaction to an antibiotic and the symptoms the infection is treating

Penicillin, the most commonly reported antibiotic allergy is less common than believed to be.

This is a great you tube video on penicillin allergies

According to the CDC: Although 10% of the population in the U.S. reports a penicillin allergy, less than 1% of the population is truly penicillin allergic.

The difference between a side effect and allergy

Side effects to antibiotics

  • Nausea, vomiting
  • Diarrhea
  • Mild rash
  • Photosensitivity
  • Vaginal yeast infection
  • Thrush

Allergic reaction to antibiotics- Seek medical care immediately

  • Severe rash/hives
  • Peeling skin
  • Anaphylactic reactions such as:
  • Respiratory distress/wheezing
  • Throat closing/tightness

- Brooke Lounsbury

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.
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How do Antibiotics Work? Part 2

In part 1 the history of antibiotics and how they work was reviewed. This week we will look at

  • The role of biofilms in bacteria and why these present a challenge to our modern-day arsenal of antibiotics
  • Antibiotic resistance challenges

The role of biofilms in bacteria and why these present a challenge to our modern-day arsenal of antibiotics

What are biofilms?

It wasn’t until the 1970s that biofilms were found to play a role in bacterial infections in cystic fibrosis patients. Bacterial biofilms are clusters of bacteria that are attached to a surface and/or to each other and embedded in a self-produced matrix of fibrin like proteins or polysaccharides.

The matrix attaches to a surface and manufactures a slimy substance that offers protection that live within the biofilm. This substance is called the Extracellular Matrix (ECM)

The ECM matrix includes proteins, polysaccharides, glycolipids, glycoproteins, and DNA. There can be more than one bacterium or microbe in the matrix which can transfer genetic material between them. This promotes adaptation of the microbes.

For instance, Staphylococcus aureus can form biofilm in four different ways- from polysaccharides to protein/DNA to fibrin to amyloid biofilms. The biofilm protects the bacterium from penetration of any invasive substances that would kill it. This can make the bacteria highly resistant to antibiotics where it can hide within this matrix and can re emerge after antibiotic therapy to reinfect the host.

The National Institutes of Health (NIH) revealed that among all microbial and chronic infections, 65% and 80%, respectively, are associated with biofilm formation. Of note is that biofilms can form on living and nonliving surfaces such as indwelling catheters, implanted medical devices, and protheses.

Common bacteria associated with Biofilm

Staphylococcus aureus

The most common infection associated with implants and medical devices. These devices are very susceptible to biofilm infection. Removal of the implant or device can help bring the infection under control in some instances, however some bacteria are usually dislodged upon removal and take up residence in other parts of the body.

Pseudomonas aeruginosa

According to PubMed  “Pseudomonas aeruginosa is an opportunistic human pathogen causing devastating acute and chronic infections in individuals with compromised immune systems. Its highly notorious persistence in clinical settings is attributed to its ability to form antibiotic-resistant biofilms.” It is found in both indwelling medical devices, catheters, ventilators and in humans.

P aeruginosa is also a major cause of hospital acquired infections, ranging from ventilator associated pneumonia to cystic fibrosis patients succumbing to this infection and diabetics with non-healing ulcers.

Escherichia coli

A major cause of urinary tract infections and can be difficult to eradicate.

Biofilm-associated diseases of different body systems and their affected organs.

Some of the more common biofilm associated diseases include:

  • Otitis media- ear infection
  • Cardiac valve-Infective endocarditis
  • Arteries- Atherosclerosis
  • Salivary glands- Salivary duct stones
  • Gastrointestinal tract- Inflammatory bowel disease and colorectal cancer
  • Skin and underlying tissue- Wound infections
  • Vagina- Bacterial vaginosis
  • Uterus and fallopian tubes- Chronic endometritis
  • Mamary glands- Mastitis
  • Nasal cavity and paranasal sinuses- Chronic rhinosinusitis
  • Throat, tonsils, adenoids, larynx and vocal cords- Pharyngitis and laryngitis
  • Respiratory- Upper and lower airways- Cystic fibrosis, pseudomonas pneumonia
  • Mouth- dental caries

Antibiotic resistance challenges

As we enter a world where antibiotic resistance becomes more commonplace there are a few measures we can take to help alleviate this.

The 4 Rs of home antibiotic therapy:

  1. Right person- don’t share antibiotics
  2. Right route- by mouth, injection or topical
  3. Right time- and how often to take
  4. Right dose- don’t skip or save antibiotics, finish entire course of therapy

Research points to taking low doses of or not completing antibiotic therapy can cause antibiotic resistance- the pathogenic (disease causing) bacteria aren’t all the way eradicated. This, in turn allows the bacteria time to mutate and develop resistance to the antibiotic.

  • Use antibiotics appropriately

Antibiotics treat bacteria and, in some cases, parasitic and fungal infections. They do not treat viruses. Overuse and not used appropriately has led to antibiotic resistance. This in turn forces the practitioner to use stronger antibiotics with more side effects.

  • Biofilm disruptors

Combination drug therapies are sometimes used to combat biofilm.

There is a growing body of evidence that some spices and foods can act as biofilm disruptors, allowing antibiotics to reach the pathogenic bacteria. One is turmeric. Others include oil of oregano and cranberry, used in urinary tract infections.

- Brooke Lounsbury

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.
Order Today

Recent Posts

Keeping you informed and safe.

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