Cocktail Of Common Antibiotics Can Fight Resistant E Coli
- Technical University of Denmark
- Scientists have discovered that a combination of two common antibiotics is able to eliminate multi-drug resistant E. coli causing urinary tract infections. This combination treatment could become an effective measure against clinically relevant antibiotic resistant urinary tract infections.
A group of scientists in Denmark is trying to get one step ahead in the battle against antibiotic resistance.
Today, many disease-causing bacteria acquire resistance genes, which make antibiotic treatment ineffective. Especially, one gene, CTX-M-15, encoding an extended spectrum beta-lactamase can lead to resistance in E. coli causing urinary tract infections.
The team of researchers at DTU have shown that a cocktail of two common antibiotics, mecillinam and cefotaxime, can make these specific multi-resistant E. coli sensitive to treatment again.
The development of resistance towards either mecillinam or cefotaxime leads to concurrent sensitivity to the other drug — a phenomenon called collateral sensitivity. The study has been published in Nature Communications.
The CTX-M-15 gene is widely distributed globally and limits doctors’ ability to effectively treat urinary tract infections.
Another advantage using mecillinam and cefotaxime as a drug combination is that both drugs can be administered orally — as pills. Thereby doctors could use these two already approved drugs to treat multi-drug resistant E. coli infections.
What If I Have Frequent Recurring Utis
Within a year of havig a UTI infection, roughy one-quarter to one-half of women will have another UTI. For these women antibiotic prophylaxis may be recommended by her health care provider. With a recurrent course of UTIs, a urine culture or imaging tests may be required for further analysis.
For recurrent UTIs, there are several antibiotic options for prevention:
- A shorter course of antibiotics at the first sign of UTI symptoms a prescription may be given to you to keep at home.
- A longer course of low-dose antibiotic therapy.
- Take a single dose of an antibiotic after sexual intercourse.
The choice of antibiotic is based on previous UTIs, effectiveness, and patient-specific factors such as allergies and cost. Antibiotics commonly used for recurrent UTIs can include sulfamethoxazole-trimethoprim, nitrofurantoin, cefaclor, or cephalexin.
In postmenopausal women with vaginal dryness that may be leading to recurrent UTIs, vaginal estrogen may be an effective treatment. Treatment options your doctor might recommend include: Estring, Vagifem , or vaginal estrogen creams .
Effects Of Different Antibiotics On Ecoli Growth
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The effects of antibiotics on the growth of Escherichia coli have been found in several studies and some recent studies have also focused on the tolerance and reduced growth levels in bacteria to examine the molecular changes that allow such as change. E. Coli and anti-microbial agents: In a study by Dixon et al , the antibacterial effects of microcystin, which is, a cyanotoxin produced by Microcystis aeruginosa have been discussed. In the presence of microcystin, the inhibitory values for a range of hydrophobic inhibitors were significantly reduced. Dixon and his colleagues studied the direct effects of appropriate concentrations of microcystin on the integrity of bacterial inner and outer membranes and found that the presence of microcystin affects the permeability levels of entero-bacterial outer membranes.
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Escherichia coli was found in cattle faeces and novobiocin was used in the isolation method when samples of E coli were separated in different occasions. This study by Tutenel et al effectively links the isolation of E. coli O157 samples using the antibiotic novobiocin suggesting the adverse effects of antibiotics on bacterial growth or survival.
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How Do You Get Infected
You can become infected when you swallow even a small amount of E. coli bacteria. Among the ways this can happen:
- Ground meat: You eat ground meat that carries E. coli, and the meat wasnât cooked enough to kill the bacteria. When meat is processed, sometimes bacteria from the animalsâ intestines make their way into the meat. This happens more with ground meat because it comes from more than one animal.
- Untreated milk: You drink unpasteurized milk, which hasnât been heated to kill bacteria. E. coli can get into the milk from the cowâs udder or from milking equipment.
- Vegetables and fruit: You might eat fresh vegetables or fruit thatâs been tainted by water that has the bacteria. This happens most often when manure from nearby animals mixes with the water supply.
- Other foods and beverages: You might also get E. coli from unpasteurized fruit juices and yogurt and cheese made from raw milk.
- Water: You swallow water that contains E. coli, perhaps while swimming in a pool, lake, or pond.
- Other people: You might get E. coli from another person who has it, such as a child. The bacteria can be passed to you if you clean up after an infected person and then donât wash your hands really well before you touch your mouth.
- Animals: It can be found at petting zoos or animal exhibits at fairs.
You can also contaminate food in your own kitchen if you allow a knife or cutting board that has touched uncooked meat to come into contact with food that will be eaten raw .
Can E Coli Be Prevented
You can reduce your chance of E. coli infection by avoiding risky foods and practising good hygiene. Always wash your hands after going to the toilet or changing a nappy.
It is important to prepare, cook and store your food safely.
Safe food handling will avoid transmitting the infection from one food item to another for example, from infected raw meat to fresh food. Washing fruits and vegetables that youll be eating raw in clean water will also reduce any E. coli contamination.
If you have been sick due to E. coli infection, you can also take steps to avoid infecting others.
- Wash any bedding, clothing or household surfaces that have been dirtied by diarrhoea or vomit.
- Avoid preparing food for others in your household for 24 hours after any symptoms disappear.
- Stay away from work, or keep your child home from childcare or school, until at least 24 hours after any symptoms disappear .
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Treatment Of Infections Due To Multi
The presence of ESBLs and AmpC b-lactamases complicates antibiotic selection especially in patients with serious infections such as bacteraemia. The reason for this is that these bacteria are often multiresistant to various antibiotics and an interesting feature of CTX-M-producing isolates is the co-resistance to the fluoroquinolones . Antibiotics that are regularly used for empiric therapy of serious community-onset infections, such as the third generation cephalosporins or fluoroquinolones are often not effective against ESBL and or AmpC-producing bacteria . This multiple drug resistance has major implications for selection of adequate empiric therapy regimens. Empiric therapy is prescribed at the time when an infection is clinically diagnosed while awaiting the results of cultures and anti-microbial susceptibility profiles. Multiple studies in a wide range of settings, clinical syndromes, and organisms have shown that failure or delay in adequate therapy results in an adverse mortality outcome. This is also true of infections caused by ESBL-producing bacteria . A major challenge when selecting an empiric regimen is to choose an agent that has adequate activity against the infecting organism. Empirical antibiotic choices should be individualized based on institutional antibiograms that tend to be quite different from hospital to hospital, city to city and country to country.
What Is A Urinary Tract Infection
If you have ever experienced the frequent urge to go the bathroom with painful and burning urination, you have probably experienced a urinary tract infection . UTIs are one of the most common types of infections, accounting for over 10 million visits to health care providers each year. Roughly 40% of women experience a UTI at some time, and in women, it is the most common infection. Healthcare costs related to UTIs exceed $1.6 billion per year.
A urinary tract infection can happen anywhere along your urinary tract, which includes the kidneys , the ureters , the bladder , or the urethra . Most UTIs occur in the bladder and urethra. Common symptoms include frequent need to urinate, burning while urinating, and pain in lower abdomen area.
There are different types of UTIs based on where the bacteria goes. A lower urinary tract infection occurs when bacteria gets into the urethra and is deposited up into the bladder — this is called cystitis. Infections that get past the bladder and up into the kidneys are called pyelonephritis.
Urinary tract infection symptoms may include:
- Pain or burning upon urination
- A frequent or urgent need to urinate
- Passing small amounts of urine
- Blood in the urine or or pink-stained urine
- Urines that looks cloudy
- Strong-smelling urine
- Pain, cramping in the pelvis or pubic bone area, especially in women
Upper UTIs which include the kidney may also present with symptoms of fever, chills, back or side pain, and nausea or vomiting.
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When Should I See My Doctor
See your doctor if:
- you have diarrhoea that is severe or has blood in it
- you have a high fever with your diarrhoea
- you have symptoms of haemolytic uraemic syndrome
- the diarrhoea lasts for more than 2 days in an adult, or for more than 24 hours in a baby
- you get dehydrated
- you have severe pain in your abdomen or rectum
- you have signs of a urinary tract infection
- you are worried that you might have pneumonia
- you are concerned that your baby is unwell
How Could I Get Infected
You can pick up E. coli infections in many different ways. You can get it from:
- contact with contaminated food such as meat , unpasteurised dairy products and fruit juices, and unwashed raw fruit and vegetables
- contact with contaminated water, especially in rural areas or in swimming pools
- personal contact with people who are sick or from direct contact with animals who carry the bacteria
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Microbiology Laboratory Diagnosis And Typing
The organism is Gram-negative bacillus from the family Enterobacteriaceae that grows readily on simple culture media with minimal nutrients glucose or glycerol is often sufficient. E. coli is typically first identified in the microbiology laboratory as a lactose-fermenting gram-negative rod that can grow both aerobically and anaerobically, preferably at 37ºC, and can be either non motile oo motile. It is oxidase negative, produces indole, does not ferment citrate, and demonstrates a positive methyl red test and a negative Voges-Proskauer reaction. The adoption of several molecular techniques has allowed for more rapid detection and identification of the different pathotypes .
E. coli can be typed according to their somatic lipopolysaccharide , capsular , and flagellar antigens. Classic serotyping is based on the Kauffman classification scheme where E. coli is typed using the O and H antigens. The O:H combination is referred to as a serotype. At least 174 O and 53 H antigen types have been described however only a small subset of subset of O H combinations are associated with human disease . Most notable among these is E. coli O15 H7, one of the major serotypes seen in enterohemorrhagic E. coli infections. K1 encapsulated isolates constitute approximately 80% of E. coli causing neonatal meningitis .
What Causes A Bacteria To Mutate
Bacteria are increasingly becoming resistant to antibiotics. Research shows that environmental challenges produce mutations, as bacteria struggle to survive. Many bacteria, for example, mutate to become resistant to antibiotics. In the case of food manufacturing process, producers use various sanitation methods, including ethanol, chlorine and various antibacterial soaps. All of these can cause bacteria strains to grow stronger.
Bacteria, like any other living being, adapt to challenges. They become resistant to challenges, and become stronger. This is apparently the case for EHEC O104.
One of the characteristics of EHEC O104 is their adherence to the intestinal walls, where they release endotoxins, which infect the kidneys and other organs. According to research, this strain has become resistant to multiple antibiotics, and likely various sanitation methods. EHEC O104 was in fact, one of 41 E. coli strains that were part of a study published in Zoonoses Public Health that measured antibiotic resistance among E. coli.
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How To Treat Intestinal E Coli Infections
For intestinal E. coli infections, what a person doesnt do to treat symptoms is as important as what that person does do. For instance, intestinal E. coli infections caused by Shiga toxinproducing E. coli, or STEC which spurs an estimated 265,000 foodborne infections each year in the United States does not require antibiotic treatment.
In fact, treating these cases with antibiotics can triple your risk of developing hemolytic uremic syndrome , a complication in which toxins destroy red blood cells, disrupting the kidneys filtering system and possibly causing kidney failure, according to a report published in November 2012 in the journal Toxins.
Its also important not to treat STEC infections with over-the-counter antidiarrheal medication. These, too, can increase your risk of developing HUS, according to a study published in Clinical Infectious Diseases. Antidiarrheal medication slows down the digestive system, which prevents the body from getting rid of the toxins swiftly.
But that doesnt mean theres nothing a person can do to help ease symptoms and feel better. Experts recommend the following supportive therapies that can be done at home to aid recovery from a STEC infection:
Does Cranberry Juice Prevent A Uti
Some patients may want to use cranberry or cranberry juice as a home remedy to treat a UTI. Cranberry juice has not been shown to cure an ongoing bacterial infection in the bladder or kidney.
Cranberry has been studied as a preventive maintenance agent for UTIs. Studies are mixed on whether cranberry can really prevent a UTI. Cranberry may work by preventing bacteria from sticking to the inside of the bladder however, it would take a large amount of cranberry juice to prevent bacterial adhesion. More recent research suggests cranberries may have no effect on preventing a UTI
- According to one expert, the active ingredient in cranberries — A-type proanthocyanidins — are effective against UTI-causing bacteria, but is only in highly concentrated cranberry capsules, not in cranberry juice.
- However, cranberry was not proven to prevent recurrent UTIs in several well-controlled studies, as seen in a 2012 meta-analysis of 24 trials published by the Cochrane group.
- While studies are not conclusive, there is no harm in drinking cranberry juice. However, if you develop symptoms, see your doctor. Some people find large quantities of cranberry juice upsetting to the stomach.
Increasing fluid intake like water, avoiding use of spermicides, and urinating after intercourse may be helpful in preventing UTIs, although limited data is available.
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Latest Antibiotics For Utis
- Vabomere is a combination carbapenem antibiotic and beta-lactamase inhibitor. Vabomere was first approved in August of 2017.
- Vabomere is used for the treatment of adult patients with complicated urinary tract infections due to susceptible Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae species complex.
- Vabomere is given as an intravenous infusion every 8 hours. Dosage adjustments are required in patients with varying degrees of kidney impairment.
- Zemdri is an aminoglycoside antibacterial for the treatment of complicated urinary tract infections, including pyelonephritis. Zemdri was first approved in February of 2015.
- Zemdri is used against certain Enterobacteriaceae in patients who have limited or no alternative treatment options. Zemdri is an intravenous infusion, administered once daily.
See also: Treatment Options for UTIs
What Happens If E Coli Goes Untreated
In nearly all cases, an untreated E. coli gut infection will resolve in seven to 10 days. In the most severe E. coli infection, called enterohemorrhagic E. coli infection, approximately 15% of patients will develop a severe complication called hemolytic uremic syndrome that can result in kidney damage or death. There is no specific treatment to prevent enterohemorrhagic E. coli infection from progressing to HUS.
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What Is E Coli
Escherichia coli, or E. coli, is a bacteria that lives harmlessly in the human gut along with other bacteria. Certain strains of E. coli, however, are invasive, toxic, or both, and can cause a severe infection called E. coli infection. Characterized by watery diarrhea, abdominal cramps, and vomiting, E. coli gut infections are one of the most common causes offood poisoning. The more toxic E. coli strains, however, can be life-threatening.
Besides gut infections, E. coli can cause several other types of infections. The human body has evolved to live with E. coli colonies in the intestines, but not other organs. If normally harmless E. coli bacteria travel to other parts of the body, they can cause serious infections. For instance, 80% to 90% ofurinary tract infections are caused by E. coli from the gut traveling up the urethra and infecting the urethra, bladder, or kidneys. Peritonitis , bacteremia , meningitis , and cholangitis can all be caused by E. coli bacteria finding their way to other parts of the body.
Many E. coli infections strike newborns, such as neonatal meningitis, neonatalpneumonia, or neonatal. All of these opportunistic E. coli infections are distinct conditions with different complications and treatments. This article will focus on intestinal infections caused by infectious E. coli that normally live in animals.
For more information about E. coli urinary tract infections, read our article onUTI Treatments and Medications.
Antibiotics In Combination Can Kill Highly Resistant E Coli Strain
University at Buffalo researchers found three antibiotics used together can destroy the deadly strain of E. coli carrying mcr-1 and ndm-5.
Typically, presence of the mcr-1 and ndm-5 genes makes the E. coli bacterium immune to last-resort antibiotics. However, the combination of aztreonam, amikacin and polymyxin B can kill the strain within 24 hours. The combination also prevented any regrowth.
Researchers examined dozens of combinations of more than 15 antibiotics paired with polymyxin B. A combination of polymyxin B and either aztreonam or amikacin eliminated the E. coli strain, but researchers saw regrowth to initial levels after 96 hours. Only the combination of all three antibiotics both eliminated the strain and stopped it from growing again.
“The threat of gram-negative bacteria, including E. coli carrying mcr-1, is worrisome,” says Zackery Bulman, PharmD, study author and a former postdoctoral fellow at the UB School of Pharmacy and Pharmaceutical Sciences, who is now an assistant professor at the University of Illinois at Chicago College of Pharmacy. “We believe that the appearance of mcr-1 and ndm-5 in patients may be a harbinger for what is to come. The golden era of antibiotics isnt over yet, but we wanted to help clinicians prepare therapeutically for the occurrence of these strains.”
The researchers published their findings in mBio, a journal for the American Society of Microbiology.
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