Friday, 22 August 2014

Ebola Outbreak Underestimated

The World Health Organization says the ongoing Ebola outbreak may be worse than their official numbers show and notes that it’s still considering the use of several experimental therapies.

As experts continue to grapple with the ongoing Ebola outbreak that’s crippling the West African countries of Guinea, Liberia, and Sierra Leone, the World Health Organization (WHO) is expressing concern that the reported numbers of suspected and confirmed cases of infection “vastly underestimate the magnitude of the outbreak.” In a statement issued last week (August 14), the WHO outlined its outbreak-response objectives, noting that “the outbreak is expected to continue for some time.”

During a recent press conference, Joanne Liu, international president of Doctors Without Borders, guessed it would take officials around six months to contain the outbreak, Reuters reported.

In the meantime, healthcare officials continue to weigh experimental treatment options as biotech firms developing Ebola drugs that have not yet been tested in the clinic are running out of supplies. In an e-mail to ScienceInsider, the WHO said it is considering administering the blood of people who’ve survived Ebola infection to those who fall ill to the virus. “Convalescent serum is high on our list of potential therapies and has been used in other outbreaks,” the organization told Science.

Still, when treating Ebola-infected patients, “there is not a lot of extra time to experiment with unproven therapies,” wrote Armand Sprecher, an epidemiologist and public health specialist at Doctors Without Borders, in New Republic. “We cannot subject our patients to all of the possible things that might work. We have to choose wisely.”
Posted by Tim Sandle

Strategic Cold Chain Management: USP, EC and Evolving Regulations

A new free eBook on meeting USP and EU GDP regulatory requirements has been issued by Vaisala.

According to Vaisala: “learn the latest revisions from the U.S. Pharmacopeial Convention (USP) Good Distribution Practices (GDP) according to the European Commission. This eBook provides simple, applicable recommendations on how to apply these guidances.”

For details, see: Vaisala.

Posted by Tim Sandle

Thursday, 21 August 2014

FDA - Expedited Programs for Serious Condition



Guidance for Industry on Expedited Programs for Serious Conditions-Drugs and Biologics

FDA is announcing the availability of a guidance for industry entitled “Expedited Programs for Serious Conditions—Drugs and Biologics”.

This guidance provides a single resource for information on FDA's policies and procedures related to the following expedited programs for serious conditions: (1) Fast track designation, (2) breakthrough therapy designation, (3) accelerated approval, and (4) priority review designation.

The guidance describes threshold criteria generally applicable to expedited programs, including what is meant by serious condition, unmet medical need, and available therapy. This guidance also discusses considerations for expedited development and review such as manufacturing and product quality, nonclinical studies, and clinical inspections. In addition, this guidance aligns CDER's criteria for priority review designation with CBER's criteria. Only products intended to treat a serious condition are eligible for priority review (unless otherwise eligible under specific statutory provisions).

For over 30 years, expediting the availability of promising therapies to patients with serious conditions has been a priority for FDA. With the passage of the Food and Drug Administration Safety and Innovation Act (FDASIA) (Public Law 112-122), FDA is expanding its efforts to expedite development and review of therapies intended to treat patients with serious conditions.

For more details, see FDA.

Posted by Tim Sandle

Wednesday, 20 August 2014

Ways to protect against Ebola


Ebola virus disease (EVD) has rarely been out of the headlines over recent weeks. This infectious disease has been causing panic across a number of African countries. Recently, Liberia declared a state of emergency and the outbreak has also hit Sierra Leone, Nigeria and Guinea. Meanwhile, a number of international aid workers have been infected and there are concerns that the disease could spread further.

Initially transmitted to people from wild animals such as forest antelope, chimpanzees and fruit bats, EVD spreads through the human population via person-to-person contact and it has a fatality rate of up to 90 per cent. People remain infectious as long as their blood and secretions contain the virus, and this can be up to seven weeks after they recover.

Individuals are at risk of contracting EVD if they have direct contact through broken skin or mucous membranes with the blood secretions, organs or other bodily fluids of infected individuals. Indirect contact with environments contaminated with these fluids can also lead to infection.

This means that, unless strict infection control precautions are in place, healthcare workers are in danger of falling ill with the disease if they treat patients with suspected or confirmed Ebola. There is not yet a licensed specific treatment or vaccine available.

Unprecedented

EVD first appeared in humans in 1976, but the current outbreak has proved particularly problematic. Indeed, it is the deadliest to date and has caused the World Health Organisation to announce an international health emergency. Meanwhile, the medical charity Medecins Sans Frontieres has described the outbreak as “unprecedented” in terms of the way the cases are scattered hundreds of kilometres apart across Guinea.

Reducing the risk of infection

Because there is not yet an effective treatment for the disease, it is particularly important for affected communities to take protective measures to reduce the risk of infection. Information plays a crucial role in the battle against EVD. People must understand the importance of avoiding close physical contact with infected patients, and this includes the burial of the dead.

In addition, strict rules must be observed in healthcare settings. For example, because the early symptoms of the disease may be non-specific, it is vital that personnel apply standard precautions with all patients, regardless of their initial diagnoses. These measures include basic hand hygiene, respiratory hygiene and the use of personal protective equipment.

As well as these standard precautions, healthcare workers should adhere to more specific infection control measures to avoid exposure to bodily fluids, as well as to any environments that may be contaminated. For example, such personnel should wear face shields or medical masks and goggles. They should also wear a clean, non-sterile long-sleeved gown and gloves.

Meanwhile, samples taken from suspected human and animal EVD cases for diagnoses in laboratories should only be handled by trained staff and they should be processed in suitably equipped environments.

Of course, all environments that are exposed to suspected and confirmed EVD patients must be thoroughly cleaned and disinfected on a continual basis. This is fundamental in the fight against the disease.

Strict hygiene control

Strict hygiene control measures can prove highly effective in preventing EVD cases, but in order to achieve the best results, people need all the relevant information and supplies.

The disease belongs to the virus family Filoviridae, which are filamentous enveloped viruses. These viruses can be rendered inactive by agents that target their lipid envelopes. This means that surface active biocides like the quaternary biocides found in Clinell Universal, as well as highly oxidative biocides such as the peracetic acid found in Clinell Sporicidal, can be effective in targeting EVD. It is now simple to access these infection control products. Firms such as Steroplast stock a selection of supplies, including Clinell Universal Wipes and Spray. These products can be used for the disinfection of surfaces, skin and equipment.

Such wipes and sprays are quick and easy to use and they can help to stop the spread of the disease. Other useful infection control products include surgical gloves, aprons, clinical waste bags and hand gels.



 Posted by Tim Sandle

Growing microbes from the human microbiome

By employing the use of a specially designed glass chip with tiny compartments, Caltech researchers have provided a way to target and grow specific microbes from the human gut. This is a key step in understanding which bacteria are helpful to human health and which are harmful.

Researchers started looking for bacterial species that contained a set of specific genetic sequences. To grow these microbes, the researchers turned to SlipChip, a microfluidic device. SlipChip is made up of two glass slides, each the size of a credit card, that have tiny etched grooves which become channels when the grooved surfaces are stacked atop one another. When a sample is added to the interconnected channels of the SlipChip, a single "slip" of the top chip will turn the channels into individual wells, with each well ideally holding a single microbe. Once sequestered in an isolated well, each individual bacterium can divide and grow without having to compete for resources with other types of faster-growing microbes.

The researchers then grew a compartment full of his target microbe in the SlipChip, and then they split the compartment in half. One half contains the live organism and the other half is sacrificed for its DNA to confirm that the sequence is that of the target microbe.

For further details, refer to the following paper:

L. Ma, J. Kim, R. Hatzenpichler, M. A. Karymov, N. Hubert, I. M. Hanan, E. B. Chang, R. F. Ismagilov. Gene-targeted microfluidic cultivation validated by isolation of a gut bacterium listed in Human Microbiome Project's Most Wanted taxa. Proceedings of the National Academy of Sciences, 2014; DOI: 10.1073/pnas.1404753111

Posted by Tim Sandle

Tuesday, 19 August 2014

Antibiotic Resistance Among Foodborne-Illness Germs a Mixed Bag: CDC

Report found reduced resistance to treatments with some bugs, more resistance among others

"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," Dr. Robert Tauxe, deputy director of the division of foodborne, waterborne and environmental diseases at the U.S. Centers for Disease Control and Prevention, said in an agency news release.TUESDAY, July 1, 2014 (HealthDay News) -- There's good news and bad news about antibiotic resistance among the germs that cause foodborne illnesses, a new U.S. government report released Tuesday shows.

Each year, antibiotic-resistant infections from foodborne germs cause about 430,000 illnesses in the United States, according to the CDC.

The agency's latest data, from 2012, show that multidrug-resistant salmonella, which causes about 100,000 illnesses a year, decreased during the past 10 years and resistance to two important types of antibiotics -- cephalosporins and fluoroquinolones -- remained low.

However, the rate of resistance to quinolone drugs in Salmonella typhi -- which causes typhoid fever -- rose to 68 percent in 2012. This means that this class of drugs, one of the most common treatments for typhoid fever, may no longer be effective.

The CDC also said that about 20 percent of Salmonella Heidelberg infections were resistant to the cephalosporin drug ceftriaxone. S. Heidelberg has been linked to recent outbreaks of illness associated with poultry.

Ceftriaxone resistance makes severe salmonella infections harder to treat, especially in children, the CDC noted.

Among the other findings:
  • Campylobacter resistance to the antibiotic ciprofloxacin remained at 25 percent, despite a 2005 ban on the use of the antibiotic enrofloxacin in poultry. Ciprofloxacin and enrofloxacin are both fluoroquinolone antibiotics.
  • Shigella resistance to ciprofloxacin (2 percent) and azithromycin (4 percent) increased, but no strains were resistant to both drugs.
  • Resistance to fluoroquinolones remained low. However, 50 percent of infections resistant to the fluoroquinolone drug nalidixic acid were caused by Salmonella enteritidis, the most common salmonella type.

Resistance to nalidixic acid -- used in laboratory testing for resistance -- is related to decreased susceptibility to a widely used fluoroquinolone drug ciprofloxacin, the CDC said in its release.

Many of the nalidixic acid-resistant Salmonella enteritidis infections among Americans are acquired when they travel to other countries.

SOURCE: U.S. Centers for Disease Control and Prevention, news release, July 1, 2014 (thanks to Brian Mathews for the story tip)

Posted by Tim Sandle

Monday, 18 August 2014

Advances in GC-MS Analysis of Pesticides

A new e-book of interest has been released. In the book, authors from the US Department of Agriculture, academia, and a European Union Reference Laboratory discuss advances in the analysis of pesticide residues using gas chromatography–mass spectrometry (GC–MS) methods.

Articles include discussions of:
  • How to improve detection limits and reduce matrix interferences to extend the range of pesticides that can be analyzed with GC
  • The advantages of negative chemical ionization (NCI) instead of electron ionization (ESI)
  • Using tandem mass spectrometry in SRM mode to improve selectivity
  • Lowering detection limits through large-volume injection (LVI) using cold on-column injection or a programmable-temperature vaporizer
  • The benefits of using an accurate-mass database for screening pesticides by GC-TOF-MS
  • A comparison of qualitative and quantitative results obtained using GC­–TOF-MS and GC-triple-quadrupole MS
  • Sample preparation using QuEChERS with acetonitrile extraction and dispersive solid-phase extraction (dSPE)
  • An evaluation and comparison of three dSPE sorbent combinations, comparing cleanup efficiency and contaminant recovery

For details see: Advanstar

Posted by Tim Sandle

Emergence of new antibiotics


Resistance also increases the cost of health care with lengthier stays in hospital and more intensive care required. This one aspect has seen a step-forward in relation to the unveiling of two new antibiotics. The first of the new antibiotics is called Dalvance. This is an intravenous drug that can treat skin and soft tissue infections. The second drug is called Oritavancin. Oritavancin is a lipoglycopeptide with bactericidal activity against Gram-positive bacteria. The drug was the subject of a clinical trial study led by G. Ralph Corey of Duke University, and the success was announced in the June 2014 edition of the journal The New England Journal of Medicine.

Although the emergence of two new antibiotics is promising, and will no doubt save many lives, their emergence represents also highlights the lack of progress in relation to other fields of medicine and how far there is still to go in the battle against bacterial ‘superbugs’.

A review of two new classes of antibiotics to treat skin infections forms the basis of a paper by Tim Sandle for the journal Clinical Journal of Microbiology and Pathology.

The reference is:

Sandle, T. (2014) Emergence of New Antibiotics. J Micro Patho Volume 1, Issue 1: 001

The paper can be accessed here.

Posted by Tim Sandle

Sunday, 17 August 2014

Clean Air and Containment Review



A new edition of Clean Air and Containment Review is available (issue 19). The features in the new edition include:


Main features
Isolators and the User Requirement Specification (URS):
How to avoid making your solicitors rich and your company poor
Tim Coles
Abstract →
A history of isolator and containment technology
Part 2: Flexible film isolators
Doug Thorogood
Abstract →
The HEPA filter installation leak test:
Factors influencing the test result and assessing the risk of a pass
Stephen Ryan
Abstract →
Regulatory reflections
Non-sterile pharmaceutical manufacturing:
USP chapter in development
Tim Sandle
Book review
Review of 'Pharmaceutical Regulatory Inspections' edited by Madhu Raju Saghee
James H Filer

For further details see CACR.

Posted by Tim Sandle

Oldest ever parasite egg found



The discovery of a schistosomiasis parasite egg in a 6200-year-old grave could provide the first evidence that agricultural irrigation systems in the Middle East contributed to disease burden.
The egg has been found in a grave at a prehistoric town by the Euphrates river in Syria. The egg was found in the pelvic area of the burial where the intestines and bladder would have been during life.
Schistosomiasis is a disease caused by several species of flatworm parasites that live in the blood vessels of the bladder and intestines. The parasite spends part of its life cycle in snails that live in warm fresh water, before leaving the snail to burrow through the skin of people wading or swimming in the water. Today it is estimated that over 200 million people around the world are infected.
The research suggests that the parasite may have been spread by the introduction of crop irrigation in ancient Mesopotamia, the region along the Tigris-Euphrates river system that covers parts of modern-day Iraq, Iran, Kuwait, Syria, and Turkey. Irrigation systems were starting to be introduced in Mesopotamia around 7,500 years ago. It is possible that these irrigation systems, that distributed water to crops, may have triggered the beginning of the disease burden of schistosomiasis some 6,000 years ago.
The finding also means that the parasite infected humans there at least a thousand years earlier than previously thought.
The finding has been published in the journal The Lancet Infectious Diseases. The paper is titled “Prehistoric schistosomiasis parasite found in the Middle East.”

Posted by Tim Sandle

Saturday, 16 August 2014

FDA approves new antibiotic


A second new drug to treat methicillin-resistant Staphylococcus aureus (MRSA) has been approved under the U.S. Food and Drug Administration's (FDA) new fast-track incentive program.
The first of the new antibiotics released under the scheme is called Dalvance. This is an intravenous drug that can treat skin and soft tissue infections, and the launch was reported on by Digital JournalDalvance is intended to treat acute bacterial skin and skin structure infections.
News of the second medication was released at the end of June 2014. The drug is known as Sivextro or tedizolid phosphate. The antibiotic has been approved for intravenous or oral use to treat severe MRSA. According to U.S. News and Health Report, the drug was clinically tested in more than 1,300 adults with serious skin infections. Here Sivextro was found to be as effective as linezolid, an antibiotic currently in use that has a similar mechanism of action.






Both antibiotics were developed and approved through FDA’s new Generating Antibiotic Incentives Now (GAIN) program, which offers incentives such as extended exclusivity to manufacturers of new antibiotics.
Under this scheme, the New York Times reports that at least two antibiotics may soon follow. Cubist Pharmaceuticals, the manufacturers of Sivextro, have also reported that the FDA are reviewing ceftozolone, an antibiotic candidate that aims to treat complicated urinary tract and intra-abdominal infections. Second, a clinical trial by researchers at Duke University tested the antibiotic oritavancin to treat acute skin infections. The initial results appear encouraging.

Posted by Tim Sandle

Friday, 15 August 2014

What is being done about antibiotic resistance?

Humans face the very real risk of a future without antibiotics. The implications of this are that life expectancy could fall due to people dying from diseases that are readily treatable today. This is the warning issued in a new paper by Tim Sandle.
Over the past year, various reports have been issued which highlight the problem of antibiotic resistant bacteria and the risks to human health. While this is worrying for the public, what are scientists actually trying to do about it?
Writing in an editorial for the journal Microbiology & Infectious Diseases, Digital Journalist Tim Sandle has outlined some of the different types of research that are taking place.
Though many governments are placing restrictions on antibiotic use, this is too little, too late. The current situation has made the quest for new antibiotics and antibiotic alternatives a matter of great importance.
Examples highlighted by Dr. Sandle include:
The use of pulsed light
Scientists have successfully used technology that disinfects food products to destroy antibiotic resistant bacteria around the site of burns. When someone becomes badly burnt, standard burn treatment involves removal of burned tissue, skin grafts, and the application of antiseptic and antimicrobial dressings to prevent and treat infection. Here antibiotic-resistant bacteria present a major risk to the patient, partly due to the increasing failure of many types of antibiotics. Pulsed electrical fields (PEFs) have been used for decades to preserve food by destroying bacteria. It works by destroying the bacterial membrane. To explore the technology’s application of burns, scientists applied a multidrug resistant strain of a bacterium to small third-degree burns that had been made on the backs of anesthetized mice. The results are promising.
Screening the world's resources of valuable molecules
This is a slow process requiring the testing of new molecules as potential antibiotics. One main centre of analysis is the laboratory of Kenneth Keiler (from Penn State University, USA). The research team here has examined 663,000 different molecules against a strain of Escherichia coli bacteria. The researchers have monitored how the chemicals affect the growth and survival of the bacterium. From this, forty-six potential chemicals have been selected. It is a long process, but some encouraging results are emerging.
New bacteria killing chemical
A new antibacterial agent, termed as Peptide-conjugated phosphorodiamidate morpholino oligomers (PPMO) is being examined. The chemical has the ability to silence the expression of specific genes within bacterial cells, thereby stopping them from gorwing.
Working on a new broad spectrum antibiotic
There is a good candidate drug called SQ109. This compound attacks the tuberculosis bacterium. Scientist are currently looking to see how the drug can be modified to target other pathogens from yeast to malaria. By targeting multiple pathways, the scientists are of the opinion that this reduces the probability of pathogens becoming resistant.
Adding silver to existing antibiotics
Taking another approach, some scientists contend that adding silver to existing antibiotics can increase their effectiveness. Here researchers have explained the cellular processes by which the precious metal weakens bacteria and makes them more susceptible to antibiotics.
Although these different research paths are interesting, the menacing threat of emerging and developing antibiotic resistance by a growing number of different types of bacteria presents a serious problem for society.

Posted by Tim Sandle

Thursday, 14 August 2014

E. coli evolves antibiotic tolerance


Subject to repeated exposure to the antibiotic ampicillin, populations of Escherichia coli quickly evolve tolerance for the drug, springing back to life once antibiotic treatment has stopped, according to a new study.

A new, worrying report has emerged in relation to the battle against antibiotic resistance. Researchers repeatedly exposed cultures of E. coli to high concentrations of ampicillin. Within as few as 10 cycles, the team found that some bacteria had survived the antibiotic treatments by lengthening the period of time they stay dormant.

Ampicillin is an oral antibiotic useful for the treatment of a number of bacterial infections. It is effective for ear infections and respiratory infections. It is also sometimes used for the treatment of urinary tract infections, meningitis, and salmonella infections.

Scientists have noted over the past few years that resistance to ampicillin is increasingly common among the bacteria responsible for such infections. Now E. coli can be added to the list. Traditionally, E. coli has been resistant to ampicillin. Or, rather, in this case, "antibiotic tolerance." The study highlights the importance of antibiotic tolerance, which allows bacteria to survive even high levels of antibiotics by remaining dormant. As to the reason for this, by exploring the genetic basis of this adaptation, the researchers identified three genes that seemed to play a functional role in antibiotic tolerance.

Escherichia coli is a Gram-negative, rod-shaped bacterium that normally inhabits the intestines of humans and animals. Not all strains of E. coli are pathogenic, but ones that are contribute to one of the leading causes of foodborne illnesses.

The study was conducted at The Hebrew University of Jerusalem in Israel, and the findings have been published in the journal Nature. The paper is titled "Optimization of lag time underlies antibiotic tolerance in evolved bacterial populations."

Posted by Tim Sandle

Wednesday, 13 August 2014

Reviewing fungal classification


Fungi that digest wood in novel ways could fuel new avenues of research on cellulosic ethanol, and suggest a need to move beyond traditional classification systems.

Fungi that digest wood are typically categorized as white rots, which degrade both lignin and cellulose, or brown rots, which only have enzymes that act on cellulose. But two newly sequenced species are capable of digesting lignin, even though they lack the enzymes typically found in white rots, according to a study published in PNAS.

The species, Botryobasidium botryosum and Jaapia argillacea, appeared to be white-rot fungi based on the microscopic patterns they created in decomposing wood. “But at the molecular level, we found that the key enzymes considered markers of white-rot fungi were missing,” said Igor Grigoriev of the US Department of Energy (DOE) Joint Genome Institute (JGI) in Walnut Creek, California, who led the work.

The results suggest “a continuum rather than a dichotomy between the white-rot and brown-rot modes of wood decay,” and highlight the need for a more nuanced categorization of rot types, according to the authors. Identifying the decay mechanisms in these new species could also have practical applications in the production of cellulosic biofuels, said Grigoriev.

“There was a lot of suspicion within the scientific community that the decay mechanisms wouldn’t be as straightforward as they’re currently classified, but the data wasn’t quite there,” said fungal biologist Dan Eastwood of Swansea University in Wales, who was not involved with the work. “This study brings more genomes to the point where we are plugging important gaps to say it’s more complicated than [just two kinds of rot].”

Eastwood likened the structure of wood to that of reinforced concrete, where lignin forms the concrete, and cellulose the iron rods that run through and support the structure. Brown-rot fungi digest only the cellulose, leaving behind a dark-colored, brittle mass of lignin. White-rot fungi often digest lignin first, leaving behind long strands of cellulose in a fibrous mass. The two kinds of decay create different porous structures in wood.

For the present study, Grigoriev and his colleagues compared the genomes of 33 basidiomycetes, a group which encompasses most wood-decaying species, including four newly-sequenced species. A phylogenetic analysis of the plant-biomass-decomposing enzymes used by these organisms showed that two of the new species were closely related to a model white-rot fungus, Phanerochaete chrysosporium, and could decompose crystalline cellulose even though they lacked the lignin peroxidases typically used by white rots.

The microscopic structures created by the two rots are “a result of these processes,” Grigoriev explained. “The lignin peroxidases were the key distinction,” he said. “Now we see the different phenotypes even with the lack of these enzymes.”

The work “lays a lot of significance only to two exceptional fungi, so I would not totally abandon the dichotomic separation of wood rotting fungi,” said microbiologist Annele Hatakka, a professor at the University of Helsinki, Finland, who was not involved in the study.

Hattaka agreed that the term “white rot” should be used only to describe fungi that degrade all the components of wood—lignin, cellulose, hemicellulose, and other polymers. But she highlighted a need for more genome data on common white rots. “We have too few genomes of the most typical white-rot fungi,” she wrote in an e-mail. “More than 90 [percent] of wood-decaying fungi are traditional white rots. We should have many more common white-rot fungal genomes, for example to see the significance of laccase, which was once considered the most typical characteristic of white-rot fungi.”

The wood-decay mechanisms used by these new species also reveal their evolutionary history. In a 2012 Science paper, the researchers showed that a white-rot species was likely the common ancestor of both rots; brown rot fungi then branched out from this ancestor on several separate occasions, the authors proposed.

“The evolution that allowed an organism to break down wood for the first time, only occurred once, as far as we know,” said Eastwood. “Very few things can break down wood.”

Understanding the enzymatic and non-enzymatic mechanisms that these fungi use to decompose lignin could inform biofuel industries, according to Grigoriev. Manufacturing ethanol from cellulose frequently requires lignocellulose digestion, a step that remains a major challenge. Bio-refineries to convert lignocellulose to fuels were not commercially viable as of a 2011 report from the National Academies of Sciences.

“As we move towards a bio-based economy, it is important to understand biological processes that convert plant biomass into biofuels,” said Grigoriev. “We’re trying to use genomics to learn to build the machinery for a bio-based economy.”

R. Riley et al., “Extensive sampling of basidiomycete genomes demonstrates inadequacy of the white-rot/brown-rot paradigm for wood decay fungi,” PNAS, doi:10.1073/pnas.1400592111, 2014.

Source: The Scientist

Tuesday, 12 August 2014

The Wound Microbiome

Knowing precisely the microbes present in a wound could greatly aid in the prevention and treatment of infections. This is especially important when dealing with the severe injuries that soldiers can suffer in combat.

Tending to injured soldiers in combat is “among the most complex and challenging seen in modern medicine,”  according to Eric Elster, a professor and chairman of the Uniformed Services University’s surgery department, who has discussed the subject in an interview with the Los Angeles Times.

In the July 2014 issue of the Journal of Clinical Microbiology, Elster and his colleagues report on a method for rapidly detecting the microbiota of U.S. service members hurt in combat. Their paper is titled "Microbial profiling of combat wound infection through detection microarray and next-generation sequencing".

For the study, the researchers analyzed tissue samples taken from 44 soldiers who had been wounded in Iraq or Afghanistan and subsequently evacuated. The most common microbe they detected, present in about a quarter of the wounds, was one called Acinetobacter baumannii. Interestingly, the bacteria they found to be associated with wounds that healed (as opposed to those that would not) are known to colonize the gut. These included Bacteroides, E. coli, Salmonella, and Enterobacter. The research also showed that wound healing was not particularly influenced by the total number of bacteria (the 'bioburden'); the biggest factor were the types of bacteria present. 

“This may reflect changes in immunoregulation and remodeling of the wound, where a microenvironment that is progressing toward healing is an amenable niche to distinct classes of bacteria from an environment that is immunologically distant from successful resolution,” the authors wrote in their report.

Outlining thus further Elster told the LA Times: “Studies such as this one will allow us to better understand the interaction between the body and pathogens, and develop new treatment strategies."
Posted by Tim Sandle