Stewardship / Resistance Scan for Feb 23, 2017

Resistant malaria in Africa
Antibacterial skin lotion

Scientists report first case of artemisinin-resistant malaria in Africa

The first known case of malaria resistant to the essential drug artemisinin was reported yesterday in the New England Journal of Medicine.

An international team of experts said that a 43-year-old man was diagnosed as having malaria caused by the Plasmodium falciparum parasite in January 2013. He had returned to China after a 20-month stay in Equatorial Guinea the previous month, where he had been treated for the disease six times.

The researchers performed whole-genome sequencing to determine that the P falciparum was of African origin and had not been recently imported from elsewhere. Equatorial Guinea has a perennially high rate of malaria, and artemisinin combination therapy (ACT) is commonly used for treating patients, the authors note.

"The spread of artemisinin resistance in Africa would be a major setback in the fight against malaria, as ACT is the only effective and widely used antimalarial treatment at the moment," said study author Arnab Pain, PhD, according to a news release from Saudi Arabia's King Abdullah University of Science & Technology (KAUST).
Feb 22 N Engl J Med study
Feb 22 KAUST news release


Skin lotion with antibiotics derived from skin bacteria shows promise

Scientists have identified two new antibiotics produced from beneficial skin bacteria and added them to skin lotion to treat Staphylococcus aureus infections, according to a study yesterday in Science Translational Medicine.

Researchers from the University of California San Diego (UCSD) School of Medicine screened thousands of colonies of bacteria found on the skin of volunteers to find out how many demonstrated antimicrobial properties. They found that some strains of beneficial bacteria produce two types of antimicrobial peptides (AMPs), and colonization of pigskin or mice with these two AMPs reduced S aureus replication, even that of methicillin-resistant S aureus, a common resistant pathogen.

The lab-isolated AMPs were more effective at eliminating S aureus than their naturally occurring counterparts and produced the best results when administered in combination. In addition, the AMPs did not reduce healthy bacteria found on the skin, such as Propionibacterium acnes, S epidermidis, and Corynebacterium minutissimum.

The researchers then conducted a small trial on five patients who had atopic dermatitis, which is exacerbated by S aureus. The phase 1trial involving personalized lotions containing the AMPs was intended to test for safety and efficacy only, but all five patients had a significant decrease in S aureus on their skin, the authors reported.

The technique has already been approved by the US Food and Drug Administration, the authors wrote, and a phase 2 trial is being launched, according to a UCSD press release.
Feb 22 Sci Transl Med study
Feb 22 UCSD press release

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