Search Results for: antibiotic
In light of the ongoing Ebola outbreak, NewPublicHealth recently launched an in-depth look at the current state of several infectious diseases and efforts to stem Ebola and other outbreaks. Tomorrow night the PBS documentary series Frontline will air “The Trouble with Antibiotics” (10 p.m. EST), taking a look at antibiotic use on American farms and the death of a patient being treated at the National Institutes of Health (NIH) three years ago who succumbed to a superbug the NIH was unable to treat.
According to the program’s correspondent, David Hoffman, a former journalist with the Washington Post, 70 percent of U.S. antibiotics are used on farms and are linked to at least some of the two million people who become ill and the more than twenty thousand people who die of antibiotic resistance each year.
NewPublicHealth recently spoke with Hoffman about the project.
NewPublicHealth: What made you interested in the topic of antibiotic resistance?
David Hoffman: In 2012, the Clinical Center at the National Institutes of Health disclosed the details of an outbreak of resistant bacteria in the hospital during 2011. It was a remarkable story in which advanced genomics from an NIH institute were used to unravel the mystery of how the organism had spread, and the hospital took extraordinary measures to combat it. This led to a 2013 Frontline film about the growing problem of resistance in human health, “Hunting the Nightmare Bacteria.” While working on “Hunting.”’ we heard a lot about antibiotics in animal agriculture. But the issues were complex and needed time for serious examination. We decided to devote our next film to answering some of the questions and that process took about a year.
As the number of cases and deaths soar, the Ebola outbreak in West Africa is rightfully front and center in the news, both in terms of the disease’s progress and of the need for funds and manpower. However, infectious disease specialists are urging public health leaders to also stay vigilant in preventing and handling outbreaks of many other infectious diseases. Earlier this month, the White House issued the first ever executive order on antibiotic resistance to help prevent the 20,000 U.S. deaths that occur each year because of infections are resistant to available antibiotics.
Writer David Olsen reported last week in GlobalHealthHub that, based on figures from the World Health Organization (WHO) and UNAIDS, at least three disease in West Africa are currently claiming more lives than Ebola: Malaria, tuberculosis and AIDS. No one is suggesting a slow down in the Ebola efforts—in fact public health experts are urging ever greater ramping up—but as Olsen points out, “another of [Ebola’s] terrible legacies may be that it will distract attention and resources from other diseases that are killing far more people worldwide.”
Over the next few weeks NewPublicHealth will be doing a series of research and outbreak updates on several infectious diseases and their impact in both the United States and globally, starting today with HIV/AIDS.
This Saturday was HIV/AIDS awareness day for U.S. gay and bisexual men. According to the U.S. Centers for Disease Control and Prevention (CDC), one in five gay men in 20 major cities is estimated to be HIV positive, with about one third not knowing they are positive. The Kaiser Family Foundation (KFF) estimates that, based on CDC data, 12-13 percent of gay men are HIV positive and that there is evidence that the situation is worsening. Between 2008 and 2010, the CDC reported new infections rose 12 percent overall among gay men, and 22 percent among younger gay men, with the highest increases among men of color.
A new survey released late last week by KFF found that at a time when infections among gay and bisexual men are on the rise, more than half of gay and bisexual men say they are not personally concerned about becoming infected; only three in ten say they were tested for HIV within the last year, despite CDC recommendations for at least annual testing, with even more frequent testing recommended by many health departments.
Following the Announcement of New Antibiotic Resistance Initiative, Advocates Call for Increased Emphasis on Prevention in Livestock
Despite growing awareness of the dangers, antibiotic resistance continues to sicken two million Americans and kill 23,000 each year, according to a 2013 report from the U.S. Centers for Disease Control and Prevention. Late last week the Obama administration announced a series of efforts targeting the public health issue. Among them:
- A Cabinet-level task force to create a national action plan on antibiotic resistance
- Improved federal oversight of antibiotic use in the United States, including better tracking of outbreaks
- Incentives for developing new generations of antibiotics aimed at treating currently resistant microbes
- A $20-million prize for the development of a rapid diagnostic laboratory test that doctors can use to identify highly resistant bacterial infections
Many in the public health field are quick to note that more should be done to address a key source of antibiotic resistance—widespread use of antibiotics to prevent infection and promote growth in livestock. There have been concerns that, in addition to over-prescription by physicians overuse, of the antibiotics in farm animals has also contributed to the growing trend of antibiotic resistance. A recent study found that livestock workers can harbor resistant bacteria acquired on the job and introduce it into the community.
Ed Silverman, who writes the Pharmalot blog for the Wall Street Journal, said that an administration report calls for the U.S. Food and Drug Administration (FDA), the U.S. Department of Agriculture, the National Science Foundation and the U.S. Department of Homeland Security to work together to develop an analytic model to assess the relationship between antibiotic use in livestock and the development of antibiotic resistance. The FDA currently has voluntary guidelines for livestock producers on limiting antibiotic use that go into effect in 2016, but advocates had hoped for an actual ban.
>>Bonus Link: The Association for Professionals in Infection Control and Epidemiology (APIC) has released a useful infographic for public health professionals and physicians to share with consumers about their roles in preventing antibiotic resistance.
EBOLA UPDATE: Obama to Announce New Ebola Plan Tomorrow
(NewPublicHealth is monitoring the public health crisis in West Africa.)
President Obama is expected to make an announcement tomorrow detailing the United States’ increased involvement in combatting the Ebola outbreak in West Africa. The plan would likely involve an increased U.S. military presence; the government has already committed approximately $100 million related to protective equipment for health care workers; food; water; and medical and hygiene equipment. More than 2,400 people have so far died in the outbreak. Read more on Ebola.
HHS: $295M to Expand Health Services for 1.5M New Patients
Late last week, the U.S. Department of Health and Human Services (HHS) announced $295 million in funds to enable 1,195 health centers across the country to hire approximately 4,750 new staff, stay open later and expand their services to cover areas such as oral health, behavioral health, pharmacy and vision services. The funds are available through the Affordable Care Act. HHS estimates that this will help 1.5 million new patients. “These funds will enable health centers to provide high-quality primary health care to more people including the newly insured, many of whom may be accessing primary care for the first time,” said HHS Secretary Sylvia M. Burwell, in a release. Read more on the Affordable Care Act.
Study: 11 Million Unnecessary Antibiotic Prescriptions for Kids Annually
Physicians prescribe antibiotics for kids approximately twice as often than they are needed, contributing to the growing problem of antibiotic resistance, according to a new study in the journal Pediatrics. Researchers analyzed a selection of studies published between 2000 and 2011, as well as data on children examined at outpatient clinics, finding that an estimated 27 percent of U.S. children with infections of the ear, sinus area, throat or upper respiratory tract had illnesses caused by bacteria, yet antibiotics were prescribed for approximately 57 percent of these visits. They estimate that there are more than 11 million such unnecessary prescriptions for kids each year. Read more on prescription drugs.
Study: Global Child TB Rates 25 Percent Higher than Previously Realized
The true number of children who develop tuberculosis (TB) each year in the 22 countries with the worst TB rates is nearly 25 percent higher than the World Health Organization (WHO) estimated as recently as 2012, according to a new study in The Lancet Global Health. Researchers used mathematical modeling to determine that approximately 650,000 children in these countries develop TB each year; the WHO estimate was 530,000. The study also determined that approximately 15 million children are exposed to TB every year and 53 million are living with latent TB infections which can become infectious active TB. While the findings are troubling, they also indicate promising ways to reduce the risk. "Our findings highlight an enormous opportunity for preventive antibiotic treatment among the 15 million children younger than 15 years of age who are living in the same household as an adult with infectious TB,” said lead author Peter Dodd, MD, from the University of Sheffield in the United Kingdom, in a release. "Wider use of isoniazid therapy for these children as a preventative measure would probably substantially reduce the numbers of children who go on to develop the disease." Read more on global health.
Severe Obesity Can Cut a Person’s Lifespan by Nearly 14 Years
Severe obesity can take nearly 14 years off a person’s life, according to a new study in the journal PLOS Medicine. Using data from 20 previous studies, researchers determined that severe obesity—defined as a body mass index (BMI) greater than 40—can cut lives short by anywhere from 6.5 to 13.7 years, due to increased risk of health problems such as heart disease, cancer and diabetes. "We found that the death rates in severely obese adults were about 2.5 times higher than in adults in the normal weight range," said lead investigator Cari Kitahara, a research fellow at the U.S. National Cancer Institute, according to HealthDay. Approximately 6 percent of U.S. adults are severely obese; severe obesity accounts for approximately 509 deaths per 100,000 men annually and 382 deaths per 100,000 women annually. Read more on obesity.
HHS: $100M for 150 New Community Health Centers
The U.S. Department of Health and Human Services (HHS) has announced approximately $100 million in available funds for communities to expand access to affordable, high-quality primary care through an estimated 150 new community health centers in 2015. Currently there are approximately 1,300 health centers with more than 9,200 service sites providing care to more than 21 million people in the United States and its territories. The centers, made possible under the Affordable Care Act (ACA), have also helped approximately 4.7 million people enroll for ACA coverage. Read more on community health.
Report: Food Sodium Levels at Many Top Chains Continue to Be Unhealthily High
From 2009 to 2013, the nation’s top restaurant chains reduced the sodium in their foods by an average of only 1.5 percent annually, according to a new report from the nonprofit Center for Science in the Public Interest (CSPI). In a review of 136 meals from 17 chains, researchers determined that approximately 79 percent of the 81 adult meals contained more than 1,500 milligrams (mg) of sodium—or one mg more than the U.S. Centers for Disease Control and Prevention recommends as a full day’s limit. The study also found efforts to reduce sodium to be inconsistent, with some chains actually increasing the amounts over the studied time period. CSPI Executive Director Michael F. Jacobson said the findings indicate that the U.S. Food and Drug Administration’s “wait-and-see” approach to sodium in packaged and restaurant food doesn’t work and that a new approach is needed. Read more on nutrition.
CDC: Antibiotic-resistant Foodborne Germs Remain a Serious Public Health Issue
New data from the U.S. Centers for Disease Control and Prevention (CDC) indicates both positive and negative trends in the ongoing public health fight against antibiotic-resistant foodborne germs, which contribute to an estimated 430,000 U.S. illnesses every year. According to the data, multi-drug resistant Salmonella—which causes approximately 100,000 U.S. illnesses annually—decreased over the past decade, but Salmonella typhi resistance to certain drugs increased by 68 percent in 2012, meaning one of the common treatments for typhoid fever may not be effective. “Our latest data show some progress in reducing resistance among some germs that make people sick but unfortunately we’re also seeing greater resistance in some pathogens, like certain types of Salmonella,” said Robert Tauxe, MD, MPH, deputy director of CDC’s Division of Foodborne, Waterborne, and Environmental Diseases. “Infections with antibiotic-resistant germs are often more severe. These data will help doctors prescribe treatments that work and to help CDC and our public health partners identify and stop outbreaks caused by resistant germs faster and protect people’s health.” Read more on food safety.
Four Communities to Share $120M in HUD Grants for Community Revitalization
Four U.S. communities will split nearly $120 million in U.S. Department of Housing and Urban Development (HUD) grants earmarked for the redevelopment of severely distressed public or HUD-assisted housing and their surrounding neighborhoods. "HUD's Choice Neighborhoods Initiative supports local visions for how to transform high-poverty, distressed communities into neighborhoods of opportunity," said HUD Secretary Shaun Donovan. "By working together, with local and state partners we will show why neighborhoods should always be defined by their potential—not their problems. Together, we will work to ensure that no child's future is determined by their zip code and expand opportunity for all."
The four communities are:
- Columbus (Ohio) Metropolitan Housing Authority — Columbus, Ohio
- Housing Authority of the City of Norwalk/Norwalk (Conn.) Redevelopment Agency
- City of Philadelphia, Office of Housing & Community Development/Philadelphia Housing Authority
- Housing Authority of the City of Pittsburgh/City of Pittsburgh
Read more on housing.
HHS: Common Sports Injuries Mean High Costs for People Without Insurance
The ASPE Office of Health Policy, part of the U.S. Department of Health and Human Services (HHS), has released a new issue brief analyzing the incidence and average health care charges associated with common sports injuries. The injuries range from minor sprains and strains to more serious injuries such as broken bones and concussions, where direct medical bills can be significant, placing an especially heavy burden on people without health insurance. Such individuals could be made to pay not just out-of-pocket costs, but also providers’ full stated charges. Breaking down health care costs by age and sometimes gender, the brief found, for example, that the average cost to fix a leg fracture for a person 10-19 years old was $4,689 and for those ages 25-40 was $3,403. Read more on injury prevention.
CDC: Drexel Meningitis Death Linked to Princeton Outbreak
Researchers at the U.S. Centers for Disease Control and Prevention have confirmed through “genetic fingerprinting” that a Drexel University student who died March 10 from meningitis died from the same serogroup B meningococcal strain that previously caused an outbreak at Princeton University. Health department officials confirmed that the Drexel student had been in close contact with Princeton students a week before becoming ill, indicating that the strain may still be present in the Princeton University community. Health officials have already administered antibiotic prophylaxis to prevent additional cases of meningococcal disease in people who had been close to the Drexel student. No new cases have since been reported. Read more on infectious diseases.
Study: ICU Survivors Face Heightened Risk for Mental Health Problems
Critically ill people who survive a stay in a hospital intensive care unit (ICU) are at heightened risk for mental health problems such as depression and anxiety in the following months, according to a new study in the Journal of the American Medical Association. Examining the records of more than 24,000 Danish ICU patients, researchers found that in the three months post-discharge that about 0.5 percent had a new diagnosis—which was 22 times higher than the rate in the general population. Approximately 13 percent received a new prescription for a psychiatric medication, including antidepressants and drugs for anxiety and insomnia, during that period. Researchers said the findings indicate that as doctors become better at saving the lives of critically ill patients, more people will also be at risk for problems beyond their physical health. Read more on mental health.
Majority of Youth C. Difficile Infections Linked to Doctor Visits
Antibiotics prescribed in a doctor’s office for other conditions are associated with the majority of Clostridium difficile infections, according to a new study in the journal Pediatrics. Researchers from the U.S. Centers for Disease Control and Prevention (CDC) determined that 71 percent of the cases for youth ages 1-17 were linked to the visits, rather than to overnight stays in health care facilities; two-thirds of adult cases are linked to hospital stays. The findings raise the profile of ongoing efforts to reduce unnecessary prescriptions. “Improved antibiotic prescribing is critical to protect the health of our nation’s children,” said CDC Director Tom Frieden, MD, MPH. “When antibiotics are prescribed incorrectly, our children are needlessly put at risk for health problems including C. difficile infection and dangerous antibiotic resistant infections.” Read more on prescription drugs.
Study: Even Slightly Elevated Blood Pressure Can Do Cardiovascular Damage Over Time
Even slightly elevated blood pressure that does not rise to the clinical definition of hypertension can do cardiovascular damage over time, according to a new study in the Journal of the American Medical Association. Researchers at the University of Oklahoma Health Sciences Center analyzed blood pressure data on more than 4,600 participants, all of whom had their readings tracked over 25 years from young adulthood to middle age. They placed the participants in five blood pressure trajectory categories:
- Low-stable: blood pressure that starts low and stays low
- Moderate-stable: blood pressure that begins only slightly elevated and stays that way
- Moderate-increasing: blood pressure begins only slightly elevated and increases over time
- Elevated-stable: blood pressure that starts at elevated levels, but does not increase
- Elevated-increasing: blood pressure that begins elevated and increases over time
The study determined that participants in the moderate-stable group were 44 percent more likely to have coronary artery calcification than those in the low-stable group. Read more on heart health.
Study: Men Die Earlier in More Patriarchal Societies
Gender differences when it comes to mortality rates are higher in more patriarchal societies, meaning women’s rights are good for men’s health, according to a new study in the American Psychological Association’s Evolutionary Behavioral Sciences. Utilized sociodemographic and mortality data from the World Health Organization, researchers from the University of Michigan (UM) School of Public Health found that men living in the top 25 percent most-patriarchal societies were 31 percent more likely to die than men in the least patriarchal quartile, compared to mortality rates for women. Researchers noted that the study only included societies with infrastructures capable of providing reliable data, so the difference could be even more pronounced. Possible explanations include:
- Males in societies where they are more socially dominant tend to engage in riskier behaviors that can lead to death.
- These societies tend to have more resources and social status concentrated in a smaller group of elite men, and men with greater control of resources and social status historically have had more reproductive success.
- In their quest for social dominance, men will go up against other men to gain power and engage in forms of competitive, and sometimes dangerous, behavior.
"Gender inequality is inherently related to inequality in general, and this is bad for both men and women's health, though especially harmful to men in increasing the risk of death," said UM researcher Daniel Kruger. Read more on health disparities.
CDC: Reducing High-risk Antibiotic Prescriptions Could Also Reduce Deadly Infections
The most recent Vital Signs report from the U.S. Centers for Disease Control and Prevention (CDC) finds that if prescriptions of high-risk antibiotics in hospitals were reduced by just 30 percent, then there could be as many as 26 fewer cases of deadly diarrhea infections with Clostridium difficile. “Improving antibiotic prescribing can save today’s patients from deadly infections and protect lifesaving antibiotics for tomorrow’s patients,” said CDC Director Tom Frieden, MD, MPH. “Health care facilities are an important part of the solution to drug resistance and every hospital in the country should have a strong antibiotic stewardship program.” As part of its ongoing efforts to improve antibiotic prescribing, the CDC has release a checklist of seven core elements for hospitals:
- Leadership commitment: Dedicate the necessary human, financial, and IT resources.
- Accountability: Appoint a single leader responsible for program outcomes. Physicians have proven successful in this role.
- Drug expertise: Appoint a single pharmacist leader to support improved prescribing.
- Act: Take at least one prescribing improvement action, such as requiring reassessment of prescriptions within 48 hours to check drug choice, dose, and duration.
- Track: Monitor prescribing and antibiotic resistance patterns.
- Report: Regularly report prescribing and resistance information to clinicians.
- Educate: Offer education about antibiotic resistance and improving prescribing practices.
Read more on infectious diseases.
Poorer Women Most Likely to Be Caught in ‘Vicious’ Caregiving, Financial Well-being Cycle
Low-income women are at increased risk of finding themselves caught in a “vicious cycle” of parental caregiving and financial well-being, according to a new study in The Journals of Gerontology. While women of better financial means can afford additional caregiver assistance and better health care for aging parents, poorer women lack those options. "People who had less household income and less financial resources were more likely to take care of their parents so there is this cycle that they cannot get out of—they are poor, then taking care of parents, then being poor and taking care of their parents—there's this kind of cycle," said lead author Yeonjung Lee, a researcher and professor at the Faculty of Social Work at the University of Calgary in Alberta, Canada, according to Reuters. Read more on aging.
Young Skin Cancer Survivors at Heightened Risk for Other Cancers
Younger skin cancer survivors are at increased risk for additional cancer types later in life, according to a new study in the journal Cancer Epidemiology, Biomarkers & Prevention. A review of data of more than 500,000 people with a history of nonmelanoma skin cancer found that while all age groups were at heightened risk for melanoma and other types of cancers, the increase was especially significant for people under the age of 25, who were 23 times more likely to develop cancer than people who had never had nonmelanoma cancer. The risk was 3.5 times higher for nonmelanoma survivors ages 25-44, 1.74 times higher for those ages 45-59 and 1.32 times higher for those older than 60. The types of cancer they are at risk for include melanoma skin cancer, and cancers of the breast, colon, bladder, liver, lung, brain, prostate, stomach and pancreas. Read more on cancer.
Decrease in Pediatric Antibiotic Leveling Off
The number of children taking antibiotics has decreased over the past decade, but that decrease has stalled in recent years in certain age groups and geographic locations, according to a study in Pediatrics. Researchers reviewed pharmacy and outpatient claims over a 10-year period (2000 to 2010) in three health plans located in three different geographic locations to determine the number of antibiotics dispensed each year for children ages 3 months to 18 years. Although the overall antibiotic-dispensing rate in each age group and health plan was lower in 2009-2010 than in 2000-2001, the rate of decline in antibiotic use has slowed. The highest rate of antibiotic use was in children age 3 months to less than 24 months of age in all years of the study.
The study authors say the previous downward trend in antibiotic use in children may have reached a plateau, and continued improvements in judicious antibiotic dispensing are needed. Read more on pediatrics.
NHTSA Gives Okay for Vehicle to Vehicle Communication to Help Prevent Crashes
The National Highway Traffic Safety Administration has announced that it will begin taking steps to allow vehicle-to-vehicle (V2V) communication technology for light vehicles, which will allow vehicles to "talk" to each other and ultimately avoid many crashes by exchanging basic safety data, such as speed and position, ten times per second.
The safety applications currently being developed provide warnings to drivers so that they can prevent imminent collisions, but do not automatically operate any vehicle systems, such as braking or steering, although NHTSA is also considering future actions on active safety technologies that rely on on-board sensors.
V2V communications can provide the vehicle and driver with 360-degree situational awareness to address additional crash situations — including those, for example, in which a driver needs to decide if it is safe to pass on a two-lane road (potential head-on collision), make a left turn across the path of oncoming traffic, or in which a vehicle approaching at an intersection appears to be on a collision course. In those situations, V2V communications can detect threats hundreds of yards from other vehicles that cannot be seen, often in situations in which on-board sensors alone cannot detect the threat. Read more on transportation.
Many Hospital ICUs Don't Follow Infection Prevention Rules
While most hospitals have evidence-based guidelines in place to prevent health care-associated infections in intensive care units (ICUs), clinicians often fail to follow them according to new research from the Columbia University School of Nursing published in the American Journal of Infection Control. The study, on over 1600 ICUs, found lax compliance in intensive care units where patients are more likely to be treated with devices linked to preventable infections – such as central lines, urinary catheters and ventilators.
The study focused on three of the most common preventable infections — central line-associated bloodstream infections, ventilator-associated pneumonia, and catheter-associated urinary tract infections and determined that despite decades of research, establishing best practices for prevention of these infections, approximately one in 10 hospitals lack checklists to prevent bloodstream infections, and one in four lack checklists to help avoid pneumonia in ventilator patients, and that in hospitals with checklists, they are followed only about half of the time.
Health care-associated infections kill an estimated 100,000 Americans a year and result in over $30 billion in excess medical costs, according to the Centers for Disease Control and Prevention. Read more on injury prevention.