Thursday 31 March 2022

Optimizing Disinfection to Prevent Spread of Antibiotic Resistance in Wastewater


Image: Antibiotic-resistant bacteria, such as Staphylococcus aureus, abound in our wastewater effluents where they could be spreading the resistance gene to other (pathogenic) bacteria. Scientists have now begun to explore ways of preventing this via optimal disinfection processes | Photo courtesy: Prawny on Pixabay

Scientists map the degradation of antibiotic resistance gene mecA by common disinfectants to find ways to minimize the spread of resistance in waterbodies


Antibiotic-resistant bacteria have become a global threat today, owing in part to the efficiency with which resistance spreads among them. Some of this spread happens in waterbodies—and our wastewater systems are no exception. A group of scientists from Korea and the US has now conducted some of the groundwork needed to optimize disinfection processes and minimize the spread of antibiotic resistance through waterbodies.


For nearly a century, improvement in human healthcare has depended heavily on the efficiency with which we can treat bacterial diseases. But today, antibiotic resistance—the ability of certain mutant super-bacteria to block out antibiotics—poses a major threat to healthcare, food security, and overall social development worldwide, threatening to upend much of the progress our civilization has achieved.


Scientists are now urgently attempting to tackle this problem from various angles. Professor Yunho Lee at Gwangju Institute of Science and Technology (GIST), Korea, whose contribution is published in the American Chemical Society’s Environmental Science and Technology, is looking at it from the point of view of his field of research—wastewater treatment. “Bacteria, including antibiotic-resistant bacteria and their resistance genes, abound in various aquatic environments. These are therefore dangerous breeding grounds for antibiotic resistance, where through a process called horizontal gene transfer, resistant bacteria could transfer the resistance gene to other bacteria, which could then increase the antibiotic resistance levels among the members of the bacterial community, including pathogens. We could reduce this occurrence, however, if we determined which disinfectants and how much of them could safely and efficiently kill the resistant bacteria and gene in our drinking water and wastewater effluents.”


As an initial step towards achieving this, Prof. Lee and his team studied the effects of various amounts of chlorine, ozone, and ultraviolet radiation on the degradation of both extracellular and intracellular (contained within bacteria) methicillin (a type of penicillin) resistance gene, mecA, of the bacteria Staphylococcus aureus in water. Based on high resolution observations using scanning electron microscopy and an analysis of the effect of the disinfectants on the reaction dynamics and cell structure, the scientists developed a reaction kinetics model for each disinfectant versus mecA in addition to a method for measuring the degradation rates. Their experiments verified the effectiveness of their models and method.


“Our findings are a key step in determining the optimal conditions for wastewater disinfection process operations for eliminating mecA and mitigating the spread of antibiotic resistance through our municipal wastewater systems,” says Prof. Lee. “In this way, our research significantly contributes to public health protection against infection by antibiotic-resistant bacteria.”


Moreover, Prof. Lee is hopeful that their models can be applied to other segments of double stranded DNA as well, such as those of certain viruses. Thus, newer approaches like these could hopefully lead to sustainable solutions to the looming antibiotic resistance problem and more in the near future.


Posted by Dr. Tim Sandle, Pharmaceutical Microbiology Resources (

Wednesday 30 March 2022

We’re Only Just Starting to Understand COVID’s Impact on Labs


Nearly two years after the WHO declared COVID-19 a global pandemic, researchers are still learning more about how the virus has affected clinical and pharmaceutical research.

By Emily Newton

COVID-19’s impact could have significant long-term consequences for a variety of research industries.


This is what we know now about the virus’s impact on labs and how the pandemic may be reshaping the future of research.

The Immediate Impact of COVID-19 on Labs


Coronavirus Disease 2019 (COVID-19) was formally characterized as a pandemic by the WHO on March 11, 2020. Almost immediately, many non-medical labs were forced to shutter, while medical labs found themselves facing a wave of “unprecedented demand” for healthcare resources, including medical testing.


At the same time, however, non-COVID testing dropped precipitously. In the second quarter of 2020, smaller labs reported a 40 to 90% reduction in testing volumes, and some in vitro fertilization labs shuttered entirely.


Larger labs, in general, tended to fare better — but did not escape COVID’s impact. Big box labs reported a 40% drop in testing volumes.


The drop in demand was not evenly distributed across different types of testing not related to COVID-19. Pathology and toxicology testing volume, for example, dropped by 50%, while non-invasive prenatal screening for fetal chromosome conditions dropped by only 20%.


The only tests that saw volume increase during the early days of the pandemic were related to COVID-19 — like testing for interleukin-6, a cytokine that appears to serve as a predictor of severe disease in COVID patients. Demand for these tests sometimes surged well above pre-pandemic levels.


Many medical laboratories also secured additional testing equipment to meet these new demands. In some cases, laboratories began using molecular testing tools for the first time.


According to data from the Association of Public Health Laboratories, a small-but-significant portion of public health labs (PHLs) struggled to keep up with demand for COVID-19 testing. It was only in mid-2021 that 100% of PHLs were able to consistently meet this testing demand.


A minority of PHLs also struggled (and continue to struggle) with reagent shortages and supply chain disruptions.

How COVID-19 May Change Lab Design and Management


After the WHO’s declaration of the COVID-19 pandemic, and in the months that followed, laboratories of all kinds adopted new policies — like mandatory PPE and social distancing — intended to combat the spread of COVID in their facilities without fully shutting down their facilities.


New lab habits and protocols emerged as lab managers looked to limit the spread of COVID while grappling with labor shortages and supply shocks that made effective safety protocols harder to implement.


For example, many hospitals “set up methods for reprocessing and disinfecting gowns and N95 respirators for reuse using ultraviolet lighting or a hydrogen peroxide vapor treatment,” according to lab safety expert Dan Scungio writing for Lab Manager Magazine.


Many laboratories switched from using disposal lab gowns and coverings to reusable ones. These same labs also quickly developed new protocols for COVID-19 testing and had discussions about room ventilation, safety equipment, and specimen transport.


Scungio concluded that a year after the pandemic began, “fear among lab workers appears to be diminished. Proper procedures are in place, and adequate protection measures have been implemented.”


In addition to mitigating the spread of COVID-19, changes to lab practices could also help to make labs safer and more efficient in general.


For example, safety policies, reusable PPE, and improved ventilation can all help to prevent the spread of other infectious diseases, as well as limit worker exposure to toxic fumes and dangerous chemicals that can be a major safety risk in lab environments.


Ongoing PPE shortages and supply chain disruptions will continue to make certain safety practices challenging to implement — and experts believe that it may be years before supply chain experts are able to expand production capacity and leverage technology like AI to resolve current supply chain issues.


However, in the long term, the pandemic could help to make medical labs much safer work environments.

As the Pandemic Continues, What’s Next for Laboratories?


Right now, COVID-19 case rates are declining, and Omicron — a variant that is much more transmissible than previous variants but appears to cause less severe disease — remains the dominant COVID variant.


Some disease experts and pharmaceutical industry leaders believe that the pandemic could be close to over — though others remain wary of future variants that could be more transmissible, more virulent, and better at escaping vaccine immunity.


In the short term, demand for COVID-19 testing will remain high while other types of testing could remain below expected levels. Essential laboratory resources, like reagents and PPE, may remain more expensive or more challenging to source than they were before the pandemic.


Over the next few years, the long-term impact of the pandemic will become more clear. It’s likely that COVID-19 could change how lab managers approach safety and lab design.


Lab managers and staff may also use their experience with COVID-19 to prepare for future crises. Future PPE shortages could have less of an impact on the industry now that many laboratories have adopted reusable personal protective equipment.


Pharmaceutical Microbiology Resources (

Tuesday 29 March 2022

Stigma and Discrimination are Some of the Leading Barriers to Accessing TB Services



Ahead of International Day of Social Justice, the Stop TB Partnership today called on high burden countries for tuberculosis (TB) to invest in interventions that overcome the prevalent human rights barriers that currently diminish the effectiveness of national TB control efforts and ensure social justice equality for all. This call comes as new evidence, published in a recent peer-reviewed publication, showing that stigma and discrimination against people affected by TB are the leading human rights barriers impeding access to TB prevention, diagnosis, treatment, care and support. The paper, published in the Health and Human Rights Journal, summarizes the findings of Community, Rights and Gender (CRG) assessments carried out in 20 countries.

“At the 2018 UN High-Level Meeting on TB, world leaders made pioneering commitments to prioritize communities, human rights and gender in the TB response,” said Dr. Lucica Ditiu, Executive Director, Stop TB Partnership. “The review of recent Community, Rights and Gender assessment findings from 20 countries mean that we now, for the first time, have the evidence needed to show that we must have a TB response centered on social justice and human rights.”

Between 2018 and 2021, 20 countries across four regions—Africa, South Asia, Southeast Asia, and Eastern Europe and Central Asia—carried out CRG assessments, and these reports were reviewed, analyzed and summarized in a paper published in late December 2021. The paper, developed with the support of the Stop TB Partnership and with funding from USAID and the Global Fund to Fight AIDS, Tuberculosis and Malaria, analyzed the assessment findings using seven dimensions of the normative right to health framework: availability, accessibility, and quality; nondiscrimination and equal treatment; health-related freedoms; gender perspective; vulnerable and marginalized groups; participation; and remedies and accountability.

The CRG assessment is a community-based participatory research tool that assesses and highlights the significance of human rights, law and gender in the TB response. It aims to establish recommendations to overcome the barriers and challenges on the journey to accessing TB services and completing treatment.

“Forty years after AIDS was first identified, the links between human rights and the spread and impact of HIV are widely acknowledged and recognized,” added Dr. Ditiu. “Yet, nearly 140 years after the discovery of the bacteria that causes TB, attention to the rights of people affected by TB, as well as the funding needed to protect those rights, remain inadequate.”

“The TB response between 1990 and 2000 was composed of packages of interventions based on the level of income of countries, failing to address the actual needs of people affected by TB. This is completely unacceptable, and I am happy this is changing now,” Dr Ditiu continued. “Today, we have unprecedented evidence of the often-overlooked challenges faced by people affected by TB, which we hope will serve as a wake-up call to everyone invested in the fight to end this disease.”

Despite considerable diversity among the issues identified across the 20 countries that carried out CRG assessments, there is a significant overlap of shared challenges, namely: 

  • In 18 countries surveyed (90%), people affected by TB experience stigmatizing and discriminatory treatment in health care, both for TB care and primary healthcare settings.
  • In 15 countries (75%), people affected by TB experience employment discrimination. Yet, 19 of these countries (95%) fail to explicitly prohibit such discrimination in law.
  • Findings in 18 of the countries (90%) highlight various privacy concerns, including breaches in confidentiality, that deter the use of TB health services.
  • In most countries, patriarchal norms negatively impact women’s access to TB health services and increase their vulnerability to TB infection and disease.
  • Women affected by TB also experience more frequent or more intense stigma and discrimination than men in their families and communities, sometimes leading to emotional and physical abuse, divorce or abandonment. The CRG assessments, as summarized in this figure, also exposed the critical need to ensure that people affected by TB meaningfully participate in all parts of the TB response, from the design and delivery of services through to their monitoring and review. The assessment findings also highlighted the low number of civil society and community groups working on TB, their limited influence, and the lack of financial and other support available to them.

“We need to do for TB what strident activists did for HIV more than 30 years ago,” added Maurine Murenga, Global Fund Communities Delegation. “It’s time to get angry and noisy to ensure that the voices of communities affected by TB are heard loud and clear by policymakers, governments, donors and drug manufacturers around the world.”

To focus the TB response on communities, rights and gender, the Stop TB Partnership recently launched round 11 of its Challenge Facility for Civil Society (CFCS). With US$9 million available for grants, it is the largest round yet. Over the past 15 years, the CFCS has grown from $700,000 to $9 million in yearly funding to help TB-affected communities and civil society organizations promote and protect human rights and gender equality. Despite the steady increase in funding still, only a quarter of the funding needs are met.

Out of the 90 countries with either high burdens of TB, TB/HIV coinfection or multidrug/rifampicin-resistant TB, more than 30 have yet to conduct a CRG assessment. The Stop TB Partnership calls on all countries to complete such assessments and then develop and fund national Action Plans to mitigate, overcome and eliminate human rights and gender-related barriers to TB services—including stigma and discrimination. In 2020, the Stop TB Partnership even recommended that completed such assessments and action plans be prerequisites for countries to obtain grants from donors like the Global Fund.

“Too often, people with TB are forgotten and neglected, and so are their rights,” added Ani Herna Sari, TB Survivor and Executive Director, Rekat Indonesia. “Attention to TB and human rights, including stigma and discrimination, is essential. But beyond attention, we need elevated financial resources. Without a fully funded TB response, this airborne disease will continue to kill more than 4100 people every day—and everyone should feel accountable for this.” `

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