Here’s How Bad Antibiotic Resistance Has Gotten Over the Past 20 Years
By Julia Ries
- Antibiotic resistance has doubled in the last 20 years.
- Additionally a new study found one patient developed resistance to a last resort antibiotic in a matter of weeks.
- Health experts say antibiotic prescriptions should only be given when absolutely necessary in order to avoid growing resistance.
Over the past decade, antibiotic resistance has emerged as one of the greatest public health threats.
Antibiotics have been used to prevent and treat bacterial infections since the 1940s when doctors first discovered the powerful drugs could save people's lives.
But in recent decades overuse and misuse has resulted in infectious bacteria becoming resistant to these common drugs. Today, researchers have more details on just how severe antibiotic resistance has become and found evidence that we've reached a frightening new milestone.
New research published in the journal Antimicrobial Agents and Chemotherapy today discovered that resistance to one of the last resort drugs used to treat extremely drug-resistant Pseudomonas aeruginosa can develop a lot more quickly than we originally thought.
A patient infected with Pseudomonas aeruginosa (P. aeruginosa) — a bacteria that can cause a range of infections, including urinary tract infections, bone and joint infections, and respiratory infections — developed resistance to the antibiotic ceftolozane-tazobactam in just 22 days.
This discovery follows another European study, which found that resistance to antibiotics commonly used to treat a range of stomach infections has nearly doubled in 20 years
In fact, resistance to commonly used antibiotics — such as clarithromycin — is increasing at 1 percent each year, according to those findings, which researchers presented Monday at UEG Week Barcelona 2019.
Resistance Has Soared
Antibiotics can be extremely helpful and even lifesaving when used appropriately. But many health experts are concerned that if we continue to overuse and misuse them, they'll lose their abilities to treat infections.
"There is concern that continued antibiotic resistance could lead us to a 'post-antibiotic world' in which infections are no longer treatable. This problem has been likened to a global public health threat on the level of that presented by climate change," Dr. Stanley Deresinski, an infectious disease doctor with Stanford Health Care, told Healthline.
To measure just how resistant the population has become to antibiotics and identify which treatments can be used in the future, researchers conducted surveys on how effectively people responded to various antibiotics in 1998, 2008 and most recently, in 2018.
For the 2018 survey, the researchers studied 1,232 patients from 18 countries in Europe who had contracted a Helicobacter pylori (H. pylori) infection, a harmful bacterium associated with gastric ulcer, lymphoma and gastric cancer.
The researchers determined that resistance to the antimicrobial clarithromycin — which is commonly used to treat H. pylori — had grown from 9.9 percent in 1998 to 21.6 percent in 2018.
In addition, resistance to other powerful antibiotics has grown significantly as well. The resistance rate for levofloxacin has risen to 17 percent, and the rate for metronidazole to 42 percent.
Lastly, the researchers noticed that resistance to amoxicillin, tetracycline and rifampicin compounds increased as well.
According to the study, the rates of resistance were highest in Southern Italy (37 percent), Croatia (35 percent) and Greece (30 percent).
Meanwhile, resistance rates in the United States have also soared, according to health experts.
"To see some countries with over 1/3 of all H. pylori infections resistant to clarithromycin (one of a combination of antibiotics used to treat H. pylori) is shocking. Things have been moving this way in the U.S., with estimates of clarithromycin resistance bordering 19 percent," says Dr. Arun Swaminath, the director of the inflammatory bowel disease program at Lenox Hill Hospital in New York.
If the United States doesn't become more prudent with antibiotic use, what's happening in southern Italy and Croatia could soon be our own future, Swaminath said.
Here’s Why It Happens
The more we use antibiotics, the higher the prevalence of antimicrobial resistance is, explains Dr. Richard Martinello, a Yale Medicine infectious diseases expert.
"The use of antibiotics forces the evolution of resistant bacteria, and growth of these resistant bacteria are favored when antibiotics are present," says Martinello.
Essentially, that bacteria mutates into a version that's developed resistance, allowing them to survive and multiply in the presence of antibiotics.
And, as microbes become more resistance to antibiotics, doctors encounter a higher number of patients with infections that cannot be treated with antibiotics, Martinello said, adding that this can frequently lead to death or other potentially permanent health complications.
What Can Be Done
According to the health experts, we need to slow down the use of antibiotics and use them only when necessary.
"Physicians prescribing antibiotics need to exercise discretion and only prescribe antibiotics when they may help patients. It has been estimated that in the upwards of 50 percent of prescriptions for antibiotics are for health conditions, such as colds, which will not be helped by antibiotics," Martinello said.
Additionally, patients also need to recognize the limitations of antibiotics.
"There is a patient expectation that antibiotics are cure-alls for colds, sore throats, URIs, diarrhea to name a few," says Dr. Theodore Strange, the associate chair of medicine at Staten Island University Hospital.
Patients must only use them as prescribed and should return any unused antibiotics to their pharmacy.
"Antibiotics are necessary only when indicated for specific bacterial diseases and should be of the appropriate type, in the appropriate dose, [for] the appropriate amount of time," Strange said. "They are not 'cure-alls' for all."
The Bottom Line
Antibiotic resistance has emerged as one of the greatest threats to public health in recent years. Now, new research shows just how big of a threat it is.
A new study found that resistance to commonly used antibiotics has nearly doubled in 20 years. Another found that resistance to antibiotics is developing faster than ever, with one patient becoming resistant in just 22 days.
Health experts agree that in order to mitigate the issue, people need to use antibiotics only when necessary.
Reposted with permission from our media associate Healthline.
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EcoWatch Daily Newsletter
By Zahida Sherman
Cooking has always intimidated me. As a child, I would anxiously peer into the kitchen as my mother prepared Christmas dinner for our family.
Falling in Love With Food All Over Again<p>Slowly, through my most intimate relationships with friends and partners, I began to see the beauty — and rewards — of cooking.</p><p>I got tired of giving in to defeat and always bringing chips or paper products to social gatherings. I started asking my mom to send me her Christmas and Thanksgiving recipes. I even volunteered to host Thanksgiving dinner at my place.</p><p>Each time I heard my loved ones sing the praises of the foods I prepared for them, I felt a tinge more confident that I could carry out our traditions my way.</p><p>In reaching out to other relatives for their favorite recipes, I learned that they had a little help of their own. They didn't rely solely on their ancestral cooking instincts. They turned to Black chefs for guidance.</p><p>These 7 cookbooks by Black chefs have inspired my family and fed us in nutrients, joy, and spiritual sustenance. They're also helping me overcome my personal fears of cooking.</p>
Get CookingWhether you're in recovery from cooking fears like me, or are just looking to expand your culinary confidence with dishes honoring Black heritage, these Black chefs are here to support you on your journey.Turn on some music, give yourself permission to make mistakes, and throw down for yourself or your loved ones. Glorious flavors await you.
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By Tara Lohan
The conclusion to decades of work to remove a dam on the Middle Fork Nooksack River east of Bellingham, Washington began with a bang yesterday as crews breached the dam with a carefully planned detonation. This explosive denouement is also a beginning.
The History<p>The Middle Fork Nooksack drains glacier-fed headwater streams that run off the icy summit of 10,778-foot Mt. Baker. The Middle Fork joins the North Fork and then the mainstem of the Nooksack River, which travels to Bellingham Bay and Puget Sound. The entire Nooksack watershed stretches 830 square miles across Washington and into British Columbia.</p>
A Plan Comes Together<p>The Middle Fork dam is not a pool dam built for water storage. Much of the time, water flows over the top until dam operators drop a floodgate to divert water to new locations. That water travels about 14 miles through tunnel and pipeline to Mirror Lake, then Anderson Creek, and to Lake Whatcom before finally being delivered to residents' taps.</p><p>Before removing the dam, engineers had to move the water intake 700 feet upstream and situate it at an elevation that still enabled city water withdrawals throughout the year, regardless of flow conditions.</p><p>They also needed to make sure that the rushing water didn't sweep up fish and accidentally send them through the water-supply system.</p><p>"The solution required a fairly complex design in the intake structure, including a fish exit pipe out of that structure to put fish back into the river in a way that meets current environmental permit standards," explains LaCroix.</p>
Project layout for the removal of the Middle Fork Nooksack diversion dam and rebuilding of water intake. City of Bellingham<p>Despite the cost and the work, she says, being able to continue to meet their municipal water obligations while opening up habitat for threatened species has been a win-win.</p><p>"I think there's a lot of benefits to having a dam removal versus fish passage — the main one being that you get a free-flowing river that can be a dynamic ecosystem and change over time," she says. "A static fish ladder just can't provide that same level of ecosystem benefit."</p>
Restoration Success<p>Despite local authorities' championing dam removal on the Middle Fork, the project has largely flown under the radar, overshadowed in the Pacific Northwest by heated discussions about a much larger potential project — removing <a href="https://www.seattletimes.com/seattle-news/feds-reject-removal-of-4-snake-river-dams-in-key-report/" target="_blank">four federal hydroelectric dams on the lower Snake River</a>, a major tributary of the Columbia River.</p><p>Proponents of dam removal there see it as the best chance for recovering threatened salmon populations, including Chinook, which could help starving Southern Resident killer whales. Those dams also provide irrigation water, barge navigation and hydropower, so there's been more pushback against removal efforts.</p><p>Previous dam removals around the country, however, have proved successful at aiding fish recovery and river restoration.</p><p>Most notably the 1999 demolition of <a href="https://therevelator.org/edwards-dam-removal/" target="_blank">Edwards Dam on Maine's Kennebec River</a> restored the annual run of alewives, a type of herring essential to the food web. The fish run has gone from zero to 5 million in the two decades since dam removal. Blueback herring, striped bass, sturgeon and shad have also extended their reach. And the resurgence has brought back osprey, bald eagles and other wildlife, too.</p><p>The overwhelming success of river restoration on the Kennebec helped to spur a nationwide dam removal movement that's now seen 1,200 dams come down since 1999. Last year a record <a href="https://www.americanrivers.org/conservation-resource/a-record-26-states-removed-dams-in-2019/" target="_blank">90 dams</a> were removed in 26 states, including <a href="https://therevelator.org/cleveland-forest-dam-removal/" target="_blank">20 dams in California's Cleveland National Forest</a>.</p>
Spider excavators remove on dam on San Juan Creek in California's Cleveland National Forest. Julie Donnell, USFS<p>The results have been seen in the Pacific Northwest, as well, which boasts the largest dam removal thus far in the country. In 2011 and 2014, the demolition of <a href="https://therevelator.org/elwha-dam-removal/" target="_blank">two dams</a> on Elwha River, which runs through Washington's Olympic National Park, opened up 70 miles of habitat that had been blocked for a century. Scientists have started seeing all five species of salmon native to the river coming back, particularly Chinook and coho. Bull trout, they've observed, have increased in size since the dams were removal.</p>
Benefits on the Middle Fork Nooksack<p>McEwan hopes to see a similar outcome on the Middle Fork.</p><p>Like the Elwha the Middle Fork Nooksack is a relatively pristine river with little development, and dam removal is expected to provide a big boost to fish. The additional miles of spawning habitat are important, but so is the temperature of that water.</p><p>The dam removal will open access to cold upstream waters, which are ideal for salmon and getting harder to come by as climate change warms waters and reduces mountain runoff.</p><p>"This is really great for the climate change resiliency for these species," says McEwan.</p><p>Steelhead will get back 45% of their historic habitat in the river, and scientists expect Chinook populations to increase in abundance by 31%.</p><p>That <em>could</em> help Southern Resident killer whales.</p><p>"When you get to the ocean, it's a little bit of a black box in terms of what you can model and say definitively is going to help, but more fish is better for orcas," McEwan says.</p><p>Upstream habitat will see benefits, too.</p><p>Oceangoing fish like salmon enrich their bodies with carbon and nitrogen while at sea. When they return to their natal rivers to spawn and die, the marine-derived nutrients they carry back upriver become important food and fertilizer for both riverine and terrestrial ecosystems — aiding everything from trees to birds to bears.</p><p>"Once the fish start making their way back, it will start changing the whole ecological system," says Delgado.</p><p><span></span>But any ecological benefit from salmon restoration, either in the ocean or the upper watershed, won't be immediate.<br></p><p>"The population of salmon on the Middle Fork is so low that we expect it's going to take quite a while to rebound," she says. "But the big picture is that what's good for salmon is good for the region — our history and our destiny are intricately intertwined."</p><p>After decades of work, that process of restoration has finally begun.</p>
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A new tool called The Food Systems Dashboard aims to save decision makers time and energy by painting a complete picture of a country's food system. Created by the Johns Hopkins' Alliance for a Healthier World, the Global Alliance for Improved Nutrition (GAIN), and the U.N. Food and Agriculture Organization (FAO), the Dashboard compiles food systems data from over 35 sources and offers it as a public good.
By Manuela Callari
It can grow to a maximum of six inches (16 centimeters), change color depending on mood and habitat, and, like all seahorses, the White's seahorse male gestates its young. But this tiny snouted fish is under threat.
Building an Ocean Seahorse Destination<p>Seahorses are found in tropical and temperate coastal water worldwide, but are most abundant around Australia, China and the Philippines. </p><p>Trade in the tiny creatures is strictly regulated because of their use in traditional medicine, aquariums and their sale as dried curios. But because they are poor swimmers and cannot easily move elsewhere, habitat loss is a particular threat for these curious animals. </p><p>Seahorses wrap their tails around seagrass and corals to avoid being carried away on currents. They use the habitat to spawn and hide from predators such as crabs, while also feeding on riches of plankton and small crustaceans living in the reef.</p><p><span></span>Where corals aren't available, <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/aqc.1217" target="_blank">scientists</a> found seahorses taking up residence in fishing nets and old crab traps abandoned at the bottom of the ocean. </p>
Mixing With the Locals<p>Baby seahorse mortality is high in the wild because they are easily caught, so those bred in the protected environment of the aquarium weren't ready to be released into the wild until early May.</p><p>The team released 90 new arrivals into Sydney Harbor, placing some directly into the purpose-built hotels, and others onto a net that wild seahorses had already settled on.</p><p>Before setting them free, the researchers marked each young seahorse with a fluorescent tag with unique IDs inserted just beneath the skin to track how they get on in the different environments. </p><p>"The most exciting part was being able to put these animals into the wild and then go back a month later and still see them surviving and growing," said McCracken. </p><p>The seahorses will be old enough to mate and reproduce around October or November 2020. And researchers hope that by then, they will be able to breed with the wild population. </p>
Building a Global Seahorse Hotel Chain<p>With seahorses everywhere facing the loss of their coral reef homes, similar projects have sprung up in places like Greece and South Africa, home to the world's most endangered seahorse, the Knysna seahorse. </p><p>"The endangered South African seahorse is benefiting from something quite similar, even though it wasn't intentional," said Peter Teske, professor at the Department of Zoology, University of Johannesburg.</p><p>In the South African <a href="https://www.researchgate.net/publication/322649251_An_endangered_seahorse_selectively_chooses_an_artificial_structure" target="_blank">case</a>, seahorses have bedded down in "Reno mattresses" — wire cages filled with rocks — that were used to build a new marina. Researchers from NGO Knysna Basin Project found the structures acted as a refuge for the animals.<span></span></p><p><span></span>While Teske describes the seahorse hotels as "a positive news story" and a great way to create public awareness of conservation, he added that establishing artificial habitats in some areas will only prevent the extinction of local populations.</p><p>"For a complete recovery, it is necessary to give the natural habitat a chance to regenerate," said the seahorse expert. </p>
Underwater Mascot<p>In Australia, the researchers hope the project could provide an opportunity to raise awareness not only of the plight of the Sydney seahorses but the other animals with which it shares its ocean habitat.</p><p>The waters around Sydney and the east coast are rich in biodiversity and include several threatened species like the weedy seadragon — a relative of the seahorse — and the grey nurse shark. Like the seahorse, they're also under pressure from pollution, ocean traffic and habitat loss through storms and coastal construction. </p><p>"It's a good thing to get people's support and interest. The seahorses are a useful vehicle to get people concerned if the harbor is in trouble," said David Booth, professor of marine ecology at the University of Technology Sydney who is also working on the project. </p><p>The hotels have become an attraction for divers hoping to catch a glimpse of these small but near mythical creatures. </p><p>"Everyone loves seahorses," added Booth, "they are so popular." </p>
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