Antibiotic Side Effects and How to Manage Them
A New Approach Can Address Antibiotic Resistance To Mycobacterium Abscessus
Scientists at St. Jude Children's Research Hospital are tackling Mycobacterium abscessus (Mab) antibiotic resistance. This naturally antibiotic-resistant pathogen is becoming more prevalent, highlighting the urgent need for novel therapeutics. To address this, the scientists designed new versions of the drug spectinomycin that overcome efflux, the main mechanism driving resistance. The work was published today in Proceedings of the National Academy of Science.
Mab infections are increasingly found in health care settings. Such infections can be hazardous for patients with compromised lung function, such as in cystic fibrosis, or who are immunologically compromised, such as in childhood cancer. These infections are treated with long courses of antibiotics and can result in poor outcomes. The emergence of Mab and other similar pathogens presents a growing and deeply concerning public health threat because there are few effective therapeutic options and a limited drug development pipeline.
"We chemists are in a race against the pathogens. We make stronger antibiotics, and the pathogens become more resistant," said corresponding author Richard Lee, PhD, St. Jude Department of Chemical Biology and Therapeutics.
Scientists at St. Jude modified the naturally occurring antibiotic spectinomycin to create analogs, comparable but structurally distinct N-ethylene linked aminomethyl spectinomycins (eAmSPCs). These synthetically created eAmSPCs are up to 64 times more potent against Mab than standard spectinomycin.
"By re-engineering the molecule through structure-based drug design, we and our collaborators have adapted the antibiotic to increase its activity," Lee added.
Overcoming efflux to make a more effective antibiotic
Through their work, the scientists unraveled the mechanism of action by which eAmSPCs are more effective: they circumvent efflux. Efflux is the process that cells use to get rid of a drug -- imagine pumping water out of a flooded basement -- and is a significant mechanism by which cells become resistant to therapy.
The N-ethylene linkage structure of the eAmSPCs plays a critical role in how the compounds avoid efflux, suggesting that longer linkages modify how the compound is pumped out of the cell. This ultimately shifts the balance toward higher concentrations of eAmSPC within the cell and thus enhances antimicrobial efficacy.
"Over the past two decades, we've seen a massive increase in the number of infections caused by non-tuberculous mycobacteria like Mab," said co-first author Gregory Phelps, PharmD, St. Jude Graduate School of Biomedical Sciences. "We had a place to start with this naturally occurring antibiotic, which, through modification, we've made much more efficacious against this clinically relevant pathogen."
The researchers also found that eAmSPCs work well with various classes of antibiotics used to treat Mab and retain their activity against other mycobacterial strains. Collectively, this work demonstrates that eAmSPCs should be further studied and developed because once issues of tolerability and safety are addressed, these compounds could become next-generation therapeutics.
"It is challenging to attract pharmaceutical companies to develop new antibiotics for several economic reasons," said Phelps. "If we can boost the drug pipeline against this hard-to-treat bacteria, we can potentially make a difference for patients like the ones we have here at St. Jude who are increasingly faced with limited or no therapeutic options."
Trendy, Celeb-loved IV Drip Treatments Could Be Dangerous, Experts Warn — Even Deadly
You need-le to hear this.
Intravenous, or IV drip treatments to boost wellness and cure hangovers — favored by celebs like Chrissy Teigen, Lorde and Miley Cyrus — have skyrocketed in popularity during the last decade.
But now, infectious disease experts and ER doctors are warning of an increase in severe infections and other injuries connected to the trendy treatments.
The restorative infusions release cocktails of vitamins, minerals, electrolytes and antioxidants such as selenium, vitamin C and B-complex directly into patients' veins, which many claim provide an almost immediate boost.
When administered properly, the treatments "help flush out toxic metabolites and serve as a vehicle through which to deliver medications and antioxidants that alleviate symptoms associated with hangovers and help reduce damaging free radicals," Dr. Johnny Parvani, REVIV founder & chief medical officer, told The Post.
In response to incredible demand, IV bars have opened around the country, IV companies make house calls, with some even setting up shop inside luxury apartment buildings.
The restorative infusions release cocktails of vitamins, minerals, electrolytes and antioxidants such as selenium, vitamin C and B-complex directly into patients' veins which many claim provide an almost immediate boost. Viacheslav Yakobchuk – stock.Adobe.ComBut as accessibility to the treatments has increased, so has the number of patients reporting adverse reactions.
Dr. Richina Bicette-McCain, an emergency medicine physician at Baylor College of Medicine, reported that she's treated a growing number of patients experiencing bad reactions after undergoing these kinds of treatments at med spas or hydration clinics.
In response to the increase in bad reactions, the Food and Drug Administration (FDA) issued a warning last month about unregulated fat-dissolving injections and improper injection techniques.
In response to the increase in bad reactions, the Food and Drug Administration (FDA) issued a warning last month about unregulated fat-dissolving injections and improper injection techniques. FDA"One of the most common complications that we see is infection, usually at the site of the IV placement," Bicette-McCain told NBC News.
Unfortunately, Bea Amma, 26, can speak from experience. The fitness influencer was infected with an aggressive bacterium called Mycobacterium abscessus in 2021 after spending $800 on IV infusions at a luxury spa in Los Angeles.
Amma paid to receive dozens of shots of vitamins B1 and C mixed with "fast dissolving" deoxycholic acid, injected in each arm, her back and stomach, which soon became covered with festering and painful skin lesions.
Bea Amma, 26, was infected with an aggressive bacterium called Mycobacterium abscessus in 2021 after spending $800 on IV infusions at a luxury spa in Los Angeles. Nstagram.Com/beatriz.Amma"I had all these welts on my skin," Amma told Kennedy News. "They just started popping up in the places it had been injected … My entire body started eating itself alive."
"My body had lost the fight. I remember just being in so much pain that I thought I was going to die that night. I couldn't fight anymore."
Doctors believe she contracted the infection as a result of the deoxycholic acid being injected improperly.
"My body had lost the fight. I remember just being in so much pain that I thought I was going to die that night. I couldn't fight anymore," Amma recounted. Instagram.Com/beatriz.AmmaThe bacterium is often connected to cosmetic procedures that involve injections if the equipment is not sterilized properly, said Dr. Claire Brown, an infectious disease expert at UCLA, told NBC News.
"Everything about my life has changed because of this," Amma, who's still recovering three years later, told NBC News. "Who knows if I'll ever be cured?"
The owner of the spa where Amma went did not respond to NBC News's request for comment and the Los Angeles County Public Health Department's investigation into her case was "inconclusive."
An unsafe experience at a med spa is also suspected to have forever changed the lives of Jenifer Cleveland's family and friends.
Jenifer Cleveland died after going into cardiac arrest following an IV Infusion at a med spa in Texas. FacebookThe 47-year-old woman received an IV infusion at The Luxe Medspa in Wortham, Texas on July 10 when she said she was struggling to breathe and felt her chest tightening, according to attorneys for The Luxe Medspa.
She then passed out and was rushed to the hospital where she was reported dead, the Texas Medical Board reported. Doctors said she suffered a cardiac arrest.
Although the autopsy could not determine whether or not the IV therapy caused Cleveland's death, the Texas Medical Board suspended the spa medical director's license for a failure "to properly supervise an unlicensed individual performing intravenous treatments" that resulted in death.
Cleveland's family is calling for increased regulations and oversight for med spas along with experts in the field.
Alex Thiersch, the chief executive of the American Med Spa Association, explained that there are currently no federal health regulations or national standard procedures for med spas, with each state left to set their own rules.
"There is a bit of an underbelly to this industry, where you've got folks who should not be doing the treatment that they're doing," Thiersch said to NBC News noting that some states "don't have the resources or time" to guarantee each med spa is doing everything properly.
"This is a very safe industry," Thiersch said. "But what's missing is that baseline level of consistency across all states."
Royal Papworth Hospital: Widow Seeks Answers Over Infection
By Alastair FeeBBC South Today
The couple, pictured after his successful transplant, were looking forward to a bright future togetherA widow whose husband contracted an infection following a pioneering heart-lung transplant said she wanted answers from the hospital that cared for him.
Aaron Green, of Arundel, West Sussex, had the world-first surgery at Royal Papworth Hospital in Cambridge in 2019.
It was a success, but an infection may have led to his body rejecting the organs. He died in July, aged 26.
Royal Papworth said its thoughts were with the family and it had never recorded an outbreak of the bacteria.
Reverted back to wheelchairMr Green was the first person to have a heart and lung transplant from a donor whose heart had stopped beating, which the hospital said was a major breakthrough.
After his recovery, he was back playing cricket and riding his bike, and things were "really positive", his widow Julie said.
The couple married in September 2020, but he then became ill, having contracted the bacterial infection mycobacterium chelonae.
"Every time we caught it [the infection], it came back; every time we thought we had beaten it, it came back," said Mrs Green.
"He just got more ill and more ill, he lost so much weight.
"He reverted back to being in a wheelchair and on oxygen, and eventually we were told he would have two to four months to live."
'Don't drink the water'She and her husband suspected his decline could be linked to an outbreak of another bacteria at Royal Papworth, which was believed to have been contracted by patients through the hospital's water supply.
Mycobacterium abscessus was contracted by 32 other hospital patients and led to a serious incident report at the trust.
A joint inquest is to be held to consider whether it contributed to the deaths of two patients.
Aaron Green told BBC Inside Out in 2020 he "couldn't believe" how quickly his new heart and lungs "kicked in" The team at Royal Papworth Hospital had been keeping check on Aaron Green's new organs following his transplant"We think it [mycobacterium chelonae] came from the water supply at the hospital," said Mrs Green.
"There were a few other patients that came in at the same time that had caught similar bacteria and we received a letter one day, when we were in clinic, saying 'don't drink the water here'.
"He had been drinking the water, he had been showered in the water, he had washed his nebuliser - which is like a medicine machine - in that water, and all of a sudden they were saying people were picking stuff up."
'Aaron deserves answers'She has instructed lawyers to help establish what happened to her husband and five other patients who also became ill following surgery.
"Hopefully the investigation will find out for sure if the two are connected," she said.
"I have a strong inkling that the two would be; it's too suspicious and Aaron really wanted to know the answers and he deserves the answers to come to light."
A review into Mr Green's death, ahead of an inquest, is due to take place in Cambridgeshire later this month.
A spokesperson for Royal Papworth Hospital NHS Trust said: "Our thoughts are with Aaron's family at this difficult time.
"There has never been a recorded outbreak of mycobacterium chelonae at Royal Papworth Hospital and we are fully supporting the coroner's inquiries.
"In 2019, we did identify cases of mycobacterium abscessus, a different organism, and as part of our extensive investigations we have put multiple measures in place to maintain safety, including treatment of the water supply and installing specialist filters on taps and showers."
Find BBC News: East of England on Facebook, Instagram and Twitter. If you have a story suggestion email eastofenglandnews@bbc.Co.Uk
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