Development of new antibiotics cannot keep pace with speed of drug resistance. Hospitals especially risky places.
Photo above of the contaminated surfaces in hospitals that increase cross-transmission of disease (Source: Wikipedia)
Photo below of Acinebacter baumannii, a disease-causing (pathogenic) bacteria resistant to most antibiotics.
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HEALTH: Super bacteria crisis on the way by Apiradee Treerutkuarkul
Thailand is facing a health crisis from antimicrobial resistance which could lead to a more complicated healthcare situation and higher costs in treating bacterial infections, health experts have warned.
The National Antimicrobial Resistance Surveillance Centre monitored the situation at 28 hospitals nationwide during 2000-2010 and found worrying signs of antibiotic resistance among several bacteria strains.
An antimicrobial kills or inhibits the growth of microorganisms such as bacteria, fungi or protozoans.
Carbapenems and Cefoperazone-Sulbactam are considered the antibiotics of last resort for many bacterial infections. However, Carbapenem resistance among Acinebacter baumannii, a superbug which causes hospital-acquired infections among in- and out-patients, rose dramatically from 1-2% in 2000 to 60-62% in 2010, according to the report.
The report on anti-microbial resistance in Thailand also identified up to 80% ampicillin resistance among the Escherichia coli bacterium, one of the most frequent causes of urinary tract infections and blood poisoning.
Penicillin and erythromycin resistance in children aged below five years was at 47% and 57%, respectively. ''Such data reflects the increasing problem of antimicrobial resistance,'' the report says.
''The issue can become so severe that we may not be able to discover new antibiotics to keep pace with widespread drug resistance.''
Each antibiotic takes between 10 and 20 years of research and development to produce. However, bacterial resistance to an antibiotic can develop within just three or four years of use.
Rajesh Bhatia, World Health Organization Southeast Asia regional adviser on blood safety and laboratory technology, said only two new antibiotics - Glycylcycline and Oxazolidinone - had been developed in the last 10 years.
Antimicrobial resistance has a huge impact on health. It requires longer duration treatment as well as more expensive drugs. Inappropriate prescriptions, poor compliance among patients, lack of access to essential antimicrobials and antibiotic use in animals all lead to resistance in humans, he said.
Niyada Kiatyingangsulee, manager of the Thai Drug System Watch, was concerned about the high amount of antibiotics imports, improper use of drugs and lack of proper data collection.
(Source: Bangkok Post, HEALTH, Super bacteria crisis on way, 6/08/2011, Apiradee Treerutkuarkul, link)
Health and Medical Vocabulary
bacteria - a very small single cell living thing with no nucleus (prokaryote), reproduces by cell division (meitosis), along with viruses the cause of many diseases, typically a few micrometres in length, have a wide range of shapes, ranging from spheres to rods and spirals, the oldest and most numerous living thing on earth (See Wikipedia)
bacterial infection - (See Wikipedia)
on the way - will arrive in the near future (currently travelling from one place to another place, or here: situation developing and getting worse)
microbe (noun) - very small living thing such as a bacteria, protozoa, fungi, algae, viruses and some worms that cause injury to other living things (organisms)
organism - a living thing
microorganism - very small living thing such as a bacteria, protozoa, fungi, algae, viruses and some worms, roughly the same as "microbe" (See Wikipedia and Google Definitions)
microbial (adjective) - related to microbes and microorganisms
antimicrobial (adjective) - acting to destroy microbes (as drugs and medicine do)
antimicrobials (noun) - a drug that kills or inhibits the growth of microorganisms such as bacteria, fungi, or protozoans, as well as destroying viruses, an "antibiotic" is an example of a "antimicrobial" (See Wikipedia)
antibiotics - a drug that kills or inhibits the growth of bacteria (See Wikipedia)
fungi - a plant like a mushroom that has no green clouring and no leaves or flowers, living as a parasite on humans, animals or plants fungi are the source of some infectious diseases (See Wikipedia)
protozoan - very small one cell living things, often live in water, less than 5 - 1000 µm in size, composed of a gelatinous material, and show scarcely any trace of distinct organs "Some protozoa cause diseases in people with weakened immune systems, such as people with HIV or AIDS. Protozoa are responsible for some of the AIDS-defining opportunistic infections, notably toxoplasmosis and cryptosporidiosis" (See Wikipedia and Google Definitions)
resistant (adjective) - not harmed or affected by something
resistance (noun) - การต่อต้าน, การขัดขืน การต่อต้าน, การขัดขืน
drug resistance (noun) - when the living things that cause a disease (pathogens) learn to resist or defend themselves against the drug taken to destroy them (See Wikipedia)
antimicrobial resistance - microorganisms that have developed drug resistance to antimicrobials such as antibiotics
super bacteria - same as "antibiotic resistance"
superbug - same as "antibiotic resistance"
antibiotic resistance - (See Wikipedia)
multiple drug resistance - (See Wikipedia)
crisis - a situation that has reached and extremely difficult or dangerous point วิกฤต, วิกฤตการณ์ ช่วงวิกฤต
complicated - has so many parts connected in different ways that it is difficult to understand (for example, a complicated machine or a city with a complicated system of streets) ที่ซับซ้อน
monitored - watch carefully what is happening, to make sure everything goes well เฝ้าระวัง
monitor the situation - carefully watch a situation as things change (to take action if a problem occurs)
National Antimicrobial Resistance Surveillance Centre - the government agency that monitors the drug resistance situation in Thailand (See website)
surveillance - the careful watching of the activities of people such as criminal suspects (or some thing such as a disease) (examples: criminal suspects under police surveillance, electronic surveillance)
nationwide - throughout a whole country ทั่วทั้งประเทศ ทั่วประเทศ
last resort - the last thing you do, when nothing else works (example: A country's central bank is the lender of last resort, because it will lend to a bank when no one else will.)
antibiotics of last resort - antibiotics that are used when all other antibiotics have failed due to drug resistance
Carbapenem - "one of the antibiotics of last resort for many bacterial infections, such as Escherichia coli (E. coli) and Klebsiella pneumoniae. Recently, alarm has been raised over the spread of drug resistance to carbapenem antibiotics among these coliforms, due to production of an enzyme named NDM-1. There are currently no new antibiotics in the pipeline to combat bacteria resistant to carbapenems, and worldwide spread of the resistance gene is considered a potential nightmare scenario" (See Wikipedia)
Acinebacter baumannii - a disease-causing (pathogenic) bacteria resistant to most antibiotics, "As a result of its resistance to drug treatment, some estimates state the disease is killing tens of thousands of U.S. hospital patients each year" (See Wikipedia)
Cefoperazone-Sulbactam - another anti-biotic of last resort, "one of few cephalosporin antibiotics effective in treating Pseudomonas bacterial infections which are otherwise resistant to these antibiotics" (See Wikipedia)
hospital-acquired infections - infections that people get while staying in the hospital," In the United States, the Centers for Disease Control and Prevention estimate that roughly 1.7 million hospital-associated infections, from all types of microorganisms, including bacteria, combined, cause or contribute to 99,000 deaths each year... can cause severe pneumonia and infections of the urinary tract, bloodstream and other parts of the body. Many types are difficult to attack with antibiotics," also called "nosocomial infections" (See Wikipedia)
X acquired at Y - get X at place Y
Y-acquired X - X which you get at place Y
in-patients - patients staying in the hospital (receiving treatment in the hospital)
out-patients - patients receiving treatment outside of the hospital
dramatically - in a big way อย่างใหญ่หลวง
identified - found or named something ระบุชื่อ
ampicillin - used extensively to treat bacterial infections since 1961, an early broad spectrum penicillin that can be used to fight infections with many different kinds of bacteria (See Wikipedia)
broad spectrum antibiotic - an antibiotic that acts against a wide range of disease-causing bacteria (against both Gram-positive and Gram-negative bacteria) (See Wikipedia)
Escherichia coli - E coli, a species of rod-shaped bacteria with many varieties commonly found in the lower intestine of warm-blooded organisms such as humans, most E. coli strains are harmless, but some types can cause serious food poisoning in humans, one the the harmless kinds of bacteria typically found in the human gut (See Wikipedia)
frequent - happening often เกิดขึ้นบ่อย
urine - yellow coloured fluid waste passing out of the front of the body น้ำปัสสาวะ (See Wikipedia)
urination - "the passing of urine from the urinary bladder through the urethra to the outside of the body ... In males urine is ejected through the penis, and in females through the urethral opening", also known as micturition, voiding, peeing, weeing, pissing (See Wikipedia)
urinary tract - the tubes and sacks in the body from the kidney to the outside used to dispose urine produced by the kidney: two ureters from kidneys to bladder then one urethra to outside (See Wikipedia)
Urinary Tract Infection (UTI) - a bacterial infection that affects any part of the urinary tract, "symptoms include frequent feeling and/or need to urinate, pain during urination, and cloudy urine. The main causal agent is Escherichia coli. Although urine contains a variety of fluids, salts, and waste products, it does not usually have bacteria in it... The most common type of UTI is acute cystitis often referred to as a bladder infection. An infection of the upper urinary tract or kidney is known as pyelonephritis, and is potentially more serious. Although they cause discomfort, urinary tract infections can usually be easily treated with a short course of antibiotics ... In young sexually active women, sex is the cause of 75–90% of bladder infections, with the risk of infection related to the frequency of sex. The term "honeymoon cystitis" has been applied to this phenomenon of frequent UTIs during early marriage ... Women are more prone to UTIs than men because, in females, the urethra is much closer to the anus and is shorter than in males; furthermore, women lack the bacteriostatic properties of prostatic secretions" (See Wikipedia)
blood poisoning - "sepsis" (See Wikipedia and Pubmed)
penicillin - the first kind of "antibiotic" that scientists discovered: "a group of antibiotics derived from Penicillium fungi. ... Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and infections caused by staphylococci and streptococci. Penicillins are still widely used today, though many types of bacteria are now resistant ... used in the treatment of bacterial infections caused by ... usually Gram-positive, organisms," kills bacteria by preventing the building of bacterial cell walls (See Wikipedia)
erythromycin - an early antibiotic slightly broader spectrum than penicillin (See Wikipedia)
aged - very old สูงอายุ
data - facts or information used for making calculations or decisions ข้อมูล
issue - a problem that needs to be considered, a subject that people discuss or argue about ประเด็น
severe - very serious and worrying ที่รุนแรง ที่น่าเป็นห่วง
pace - the speed at which something happens ท่างทำนอง ย่างก้าว จังหวะ ที่สิ่งต่างๆ ดำเนินไป the speed and rhythm of something (See glossary)
to keep pace with - to go at the same speed as (not fall behind and lose the race)
widespread - happening or existing in many places, or affecting many people อย่างแพร่หลาย
Research and Development (R&D) - the process of research that leads to new products or improving ones that already exist (See Wikipedia)
Glycylcycline - a new class of antibiotics derived from tetracycline. These tetracycline analogues are specifically designed to overcome two common mechanisms of tetracycline resistance, namely resistance mediated by acquired efflux pumps and/or ribosomal protection. Presently, there is only one glycylcycline antibiotic for clinical use: tigecycline (See Wikipedia and List)
Oxazolidinone - "developed during the nineties when several bacterial strains were becoming resistant against such antibiotics as vancomycin. These antibiotics are considered as a choice of last resort where every other antibiotic therapy has failed. Linezolid (Zyvox) [was] the first approved agent in the class" (See Wikipedia)
impact - the effect some event has, the good or harm that an event does ผลกระทบ
duration - length of time it exists
treatment - the process of providing medical care การรักษา
prescription - medical prescription, an official order for medicine given by a medical doctor (the patient takes to the pharmacy which prepares the medicine for the patient) (See Wikipedia)
appropriate - right and suitable for a certain situation
inappropriate - not appropriate, not right or suitable for a certain situation
inappropriate prescriptions - a prescription that is not right or suitable for a certain situation
compliance - following a rule or law
poor compliance among patients - patients who do not follow the doctor's directions for taking a medicine (example: stop taking an antibiotic before the full amount prescribed is finished)
lack - does not have ขาดแคลน
access - the right or opportunity to have or use something ได้รับสิทธิ์หรือโอกาสในการใช้
lack of access - not being able to get something
essential - necessary and important ที่จำเป็น ที่สำคัญ
concerned - worried about something มีความกังวล
proper - doing an activity or task the right way (example: If you do not take proper care of your pet turtle, it will die.)
lack of proper data collection - not collecting or gathering data in the right way (not accurate, sample not representative, etc)
Thai Drug System Watch - (See Wikipedia)