Stewardship / Resistance Scan for Aug 29, 2016

MCR-1 on the Arabian Peninsula
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Drug-resistant fungal infections

MCR-1 found for the first time on the Arabian Peninsula

An international team of researchers is reporting the first case of the colistin-resistance gene MCR-1 on the Arabian Peninsula.

In a study published in the International Journal of Infectious Diseases, the researchers reported that out of 75 colistin-resistant Enterobacteriaceae strains isolated from clinical cases in Bahrain, Kuwait, Oman, Saudi Arabia, and the United Arab Emirates, 4 Escherichia  coli isolates were found to harbor the MCR-1 gene on mobile pieces of DNA known as plasmids. Two of the isolates were from blood samples; the two others were from urine and a bed sore.

The researchers noted that the plasmids on the four isolates all carried various genes that confer resistance to carbapenem and beta-lactam antibiotics, with one of the isolates expressing high levels of carbapenem resistance. Besides colistin—which is considered an antibiotic of last resort—all four strains were uniformly resistant to third-generation cephalosporins, tetracycline, trimetoprime/sulfamethoxasole and gentamicin.

The researchers also said that one of the plasmids identified is the first found in a human E coli isolate to carry both MCR-1 and resistance genes to other classes of antibiotics. The findings are a concern because they suggest antibiotics commonly used in humans could facilitate the spread of MCR-1-carrying bacteria.

The MCR-1 gene was first identified in China in 2015, when researchers detected its presence in E coli samples from food, food animals, and humans. Since then, it's been found in bacteria in more than 30 countries.
Aug 26 Int J Infect Dis study

British scientists warn about drug-resistant fungal infections

UK scientists say that fungal infections are becoming increasingly resistant to the drugs used to treat them and warn that deaths will likely increase with rising resistance.

Fungi can cause a host of illnesses, from minor skin infections such as ringworm to more dangerous conditions like valley fever. While many of these conditions can be treated easily, fungal infections become more of a threat when they occur in people with compromised immune systems, like cancer patients, HIV patients, and premature babies. They're also a bigger problem in developing nations.

The Guardian reports that UK doctors are becoming increasingly alarmed about rising resistance to a class of antifungal agents known as azoles, which are used to treat a variety of fungal infections. Fungal resistance is similar to antibiotic resistance, but experts say it may be even more worrisome because there are far fewer drugs to treat fungal infections than there are antibiotics to treat bacterial infections.

"We cannot afford to lose the few drugs we have—particularly as very little funding is being made available for research into fungi and fungal infections," said Adilia Warris, MD, co-director of the Centre for Medical Mycology at Aberdeen University.

Warris and other experts said the widespread use of fungicides on agricultural crops is one of the factors in rising fungal resistance.

Fungal infections take more than 1.3 million lives each year globally, according to Rutgers University scientists.
Aug 26 Guardian story
Dec 23, 2013 Rutgers news release "Attacking fungal infection, one of world's major killers"

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