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Antibiotic Resistance: Obama White House Today Convenes First Antibiotic Summit

SUMMARY:  This is an incredibly timely followup to my last post, ANTIBIOTIC RESISTANCE AND MICROBIOME COMPETITIVE CROWDING OUT CONCEPTS.  Copied below is the press coverage, issued just minutes ago, of:

 Today: Obama White House Convenes (one day) First Antibiotic Summit focusing on “Forum on Antibiotic Stewardship” .

I can’t say enough about the real risk for acquiring an antibiotic resistant infection as explained in my last post,  ANTIBIOTIC RESISTANCE AND MICROBIOME COMPETITIVE CROWDING OUT CONCEPTS, especially given that the average American has lost 1/3 of their diversity.  Another study estimates 1 in 4 have 40% less bacteria (see prior post link for references).   This post also provided maps that showed individual state antibiotic use and resistance risk:

Antibiotic resistance is an issue that you need to be aware of as antibacterials do not necessarily neutralize these strains.  CDiff is one such example, as a virulent, antibiotic-resistant strain of CDiff now causes close to 500,000 new cases and 30,000 deaths a year in the United States alone. –Wide Use of Antibiotics Allows C. Diff to Flourish.

The only cure at the moment is Fecal microbiota transplantation [which] has >90 percent cure for antibiotic resistant CDiff.  In the US, only after repeated antibiotic failure (thus confirming that the CDiff strain is in fact antibiotic resistant) is FMT allowed to be administered in order to implant a new donor microbiome.  More details can be found in PRESERVE & RESTORE LOSS OF MICROBIOME DIVERSITY IS AGGRESSIVE PREVENTATIVE MEDICINE.

CDiff infections had mainly been thought to be hospital acquired, however,  Wide Use of Antibiotics Allows C. Diff to Flourish, and CDC investigates deadly bacteria’s link to doctors’ offices revealed the increased prevalence of infection from  “a 2013 study, where researchers found C. diff present in six out of seven outpatient clinics tested in Ohio,including on patients’ chairs and examining tables... patients should wash their hands after visiting the doctor’s office — with soap and water, because alcohol-based gels don’t get rid of C.diff.”

Antibioitics associated with CDiff includes:  Ampicillin, amoxicillin, cephalosporins, clindamycin and fluoroquinolones are the antibiotics that are most frequently associated with the disease, but almost all antibiotics have been associated with infection.” Wide Use of Antibiotics Allows C. Diff to Flourish

Maja Rupnik wrote in The New England Journal of Medicine:

“The healthy gut microbiota has three features: a large number of micro-organisms, a large number of different species, and an increased representation of certain bacterial phyla and a decreased representation of other phyla.  The disruption of any of these features can result in increased susceptibility to the growth of C. difficile… Even after infected individuals recover, about 5 percent continue to harbor the toxic strain in their stool for six months, and if they take another antibiotic during that time, the illness can recur.”

No mention of Microbiome Connection to Antibiotic Resistant Infections

Sadly, the White House has left off the Antibiotic Summit table mention of microbiome, as well as of how individuals can best protect themselves from antibiotic resistant infections, which likely is through shoring up a diverse healthy microbiome (see OPTIMAL MICROBIOME DIET FROM AMERICAN GUT DATA for the eleven point punch list from key 16SrRNA researcher Dr. Rob Knight.)  I am sincerely glad you understand and appreciate THE SCIENCE BEHIND FOOD, DISEASE, MICROBIOME and it’s impact on health and wellness.

 Now for the copy of the press coverage:

Today: Obama White House Convenes First Antibiotic Summit, by Maryn McKenna

Representatives of more than 150 health care organizations, medical schools, pharmaceutical companies federal health agencies and food-production interests will meet at the White House today for a day-long “Forum on Antibiotic Stewardship,” the first of its kind. The Forum is a day-long meeting, to be held mostly out of the public eye,  in which the Obama Administration plans to press the companies and organizations to commit to plans to reduce and conserve antibiotic use, in order to slow down the advance of antibiotic resistance.

Putting its own marker on the table, the White House announced this morning that it is directing federal departments to begin purchasing meat and poultry raised with what they called “responsible antibiotic use,” a term that is going to take some unpacking but that probably means in accordance with the reduced-antibiotic use policies that the Food and Drug Administration has been pushing forward since last year. In an announcement posted this morning, the White House said the purchasing plan would have work on a five-year timeline, ending up in 2020 with “applying a preference” for antibiotic-free meats.

The summit follows on a suite of other actions the administration has taken to combat resistance, which according to data from the Centers for Disease Control and Prevention kills 23,000 American each year and sickens more than 2 million. (The UK-based Review on Antimicrobial Resistance estimates that the worldwide toll is 750,000 deaths a year, and predicts it will rise as high as 10 million.) Last year, the administration issued a national strategy for combatting resistance, along with an executive order signed by Obama, and a lengthy report by the President’s Council of Advisors on Science and Technology that set forth explicit steps each agency and the private sector should take.

In a press briefing Monday evening, Amy Pope, the deputy Homeland Security advisor, said the summit today is intended to push those efforts along further, by bringing to the table the entire range of entities involved with any aspect of resistance, and getting them to make explicit (though voluntary) commitments to taking action.

Here are a few of the commitments, according to a White House fact sheet released this morning:

  • Hospital Corporation of America: agrees to develop computerized decision-making tools for tracking lab results, highlighting the emergence of resistance in patients, and choosing the best prescriptions;
  • Intermountain Healthcare: commits to reducing inappropriate outpatient antibiotic use by half;
  • Pediatric Infectious Disease Society: will ensure that hospitals that usually cater to adult patients will have stewardship education tools that address the different care and prescription needs of kid patients;
  • BD Diagnostics: will develop rapid tests for CREs, the almost completely resistant superbugs that have been spreading through hospitals across the US for 15 years.

There is likely to be a lot of attention paid to the commitments being made by food-production and food-service companies, because in the push to reduce resistance, agriculture and veterinary pharma have resisted change. On the summit invitation list are a number of food companies that have recently made striking commitments to change their practices, including McDonald’s, Tyson, Walmart, and Smithfield, along with Foster Farms, which just yesterday announced antibiotic reduction policies.

Speaking during the briefing last night, Dr. Thomas Frieden, director of the CDC, said: “Tomorrow is a really important day, because antibiotic resistance is a really important problem.”

I’ll update with ongoing coverage and links throughout the day.

Increased health through your awareness,


4 thoughts on “Antibiotic Resistance: Obama White House Today Convenes First Antibiotic Summit”

  1. Biofilm for antibiotic resistant Pseudomonas aeruginosa bacteria.

    Oxylipins produced by Pseudomonas aeruginosa promote biofilm formation and virulence, full text, Dec 2016, http://www.nature.com/articles/ncomms13823 ScienceDaily article, Researchers’ findings offer clue on how to block biofilm shields of bacterial infections, https://www.sciencedaily.com/releases/2016/12/161212152525.htm

    Bacteria Pseudomonas aeruginosa is an antibiotic resistant bacteria. “Oxylipins produced by P. aeruginosa promote biofilm formation and virulence. When P. aeruginosa produces oxylipins the biofilm is stronger.

    Oxylipins act to promote the organization of bacterial colonies into a more complex organization known as biofilm, where the bacteria are embedded inside a matrix that protect them from antibiotics.

    Their findings show that oxylipin production essentially changes the bacteria from a free-swimming state to what amounts to a fixed state, allowing for the formation of a colony.

    “We think oxylipins are signaling molecules that probably trigger other known or unknown pathways responsible for the biofilm production,” Campos-Gomez said.

    New meds/therapy of an oxylipin blocker could make a formerly antibiotic-resistant bacterial infection once again treatable.

    This was in vitro and in vivo (Drosophila flies) studies. They demonstrated that the oxylipins produced by the bacterium promoted virulence in the flies and in lettuce leaves.

  2. CDiff, is epidemic and it isn’t easy to treat—it lives for months on surfaces, and several strains are antibiotic resistant. It’s on doorsteps, on the bottom of shoes, and in doctor and dental offices which helps to explain how 35% of infections are not hospital acquired. CDiff is epidemic now and it’s debilitating; many repeat rounds of antibiotics are used to treat it and when those fail, poop transplants, called FMT, is used to treat it; FMT has a 90+% cure for those.

    Here’s what you need to know to protect yourself:

    1. Make it habit that you always take your shoes off at your door (39% of shoe soles have CDiff as do 40%of doorway doorsteps),
    2. Patients should wash their hands after visiting the doctor’s office — with soap and water, because alcohol-based gels don’t get rid of C.diff,
    3. Upon returning from dentist, doctor or other medical facility or a hospital, bleach wipe the bottoms of your shoes,
    4. If prescribed an antibiotic: Powerful broad-spectrum antibiotics wipe away good bacteria in your gut that fight off the bad bacteria, which leads the way to C. diff. You should question your doctor whenever you’re prescribed an antibiotic. Johns Hopkins safety expert Dr. Peter Pronovost recommends asking your doctor:
    a. If you really need an antibiotic,
    b. If there’s a less powerful one that will treat your infection, and
    c. If you’re being prescribed the antibiotic for the shortest time possible.

    Information for this note comes from:
    CDC investigates deadly C. diff bacteria’s link to doctors’ offices

    The Disgusting Disease That’s On The Bottom Of Your Shoes summary https://www.yahoo.com/health/the-disgusting-disease-thats-on-the-bottom-of-122466202628.html
    1. 35% of CDiff is not hospital acquired. http://www.cnn.com/2015/02/25/health/deadly-bacteria-doctors-offices/ 150,000 people who had not been in the hospital came down with C. diff in 2011. Of those, 82% had visited a doctor’s or dentist’s office in the 12 weeks before their diagnosis.
    2. CDff is on the bottoms of shoes: 40% of doorsteps samples were contaminated with CDiff, so were 39% of shoe soles!
    3. Great ideas…..
    a. Take shoes off at your door, and upon returning from dentist, doctor or other medical facility or a hospital,
    b. Bleach wipe the bottoms of your shoes.

  3. 41 percent of people hadn’t even heard of antibiotic resistance.

    “Almost half of Americans don’t understand threat of antibiotic resistance.” Published: July 05, 2015 http://www.consumerreports.org/cro/news/2015/07/what-is-antibiotic-resistance-and-why-should-i-care/index.htm

    While a majority of Americans strongly agreed that taking an antibiotic unnecessarily can make that drug less effective for you in the future, fewer people appear to understand the bigger picture. Roughly just half (52 percent) strongly agreed that bacteria that are resistant to multiple antibiotics, so-called “superbugs,” are a major public health problem today. Forty-nine percent strongly agreed that taking an antibiotic you don’t need makes that drug less effective at treating illnesses in other members of the community in the future. Overall, less than half (45 percent) said they’re somewhat or very concerned that this problem might affect their family.

    Americans are being prescribed antibiotics inappropriately for illnesses against which the drugs either don’t work or may not be the best treatment, such as sinus infections (12 percent), as a precaution after medical or dental surgery (11 percent), coughs or colds (8 percent), and abnormal urinary symptoms (7 percent).

    Steps you can take to help keep you, your family, and everyone else safe from superbugs include:

    Don’t take antibiotics for viral infections. And even when you do have a bacterial infection, if it’s mild, ask your doctor about fighting it off on your own without resorting to the use of an antibiotic. Case in point: sinusitis and bronchitis are usually viral. And even when bacteria are the cause, mild sinus and bronchial infections often clear up in about a week on their own. Also many older people are routinely given antibiotics for findings of urinary bacteria, even though they are lacking symptoms of a urinary tract infection. Such inappropriate use of antibiotics can do more harm than good.

    Requesting targeted drugs. If your doctor determines you need an antibiotic, ask for a culture to be done to identify which bacteria is causing the infection. That should lead to prescription of an antibiotic that can specifically treat the identified bacteria, rather than a broad spectrum drug that kills more types of bacterial, unnecessarily, as well.

    Avoiding antibiotic topical creams, unless advised by your doctor. Even antibiotics applied to the skin can lead to resistant bacteria. So use over-the-counter ointments containing bacitracin and neomycin only if dirt remains after cleaning with soap and water.

    Preventing infections in the first place. That means staying up to date on vaccinations. And it means washing your hands thoroughly and regularly, especially before preparing or eating food, before and after treating a cut or wound, and after using the bathroom, sneezing, coughing, and handling garbage. Plain soap and water are best. Avoid antibacterial hand soaps and cleaners, which may promote resistance.

    Getting rid of leftover antibiotics. More than one out of four people (28 percent) in our poll this past June said they have leftover antibiotics at home. To avoid misuse, dispose of unused antibiotics safely, either by returning them to the pharmacy or mixing them with coffee grounds or cat litter and tossing the mixture in the trash.

Now I'd like to hear your thoughts... comments are always welcome!