76% of Swiss tourists return with multi-resistant germs from India

#1 Jul 22nd, 2016, 15:42
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The authors of a study examined stool-samples before and after an India trip (on average 18-days-long) of 38 Swiss people. After their return the researchers found bacteria resistant to common types of antibiotics in 26 people.

15 of them suffered from diarrhea and other additional symptoms. What is worse is that in 4 of them bacterias were found which are also resistant to Colistin. It is at the moment the only antibiotic which can be used for multi-resistant bugs.

One of these colistin-resistant strains of bacteria carried a gene which boosts the colistin-resistance in other bacteria in the intestines of people and animals, and spreads it. Results of molecular analysis showed that the people got infected through the food chain as well as from environmental sources.

This is my translation of an excerpt from an article in the Science supplement of Neue Zürcher Zeitung.http://www.nzz.ch/wissenschaft/mediz...dien-ld.106494 The study was published under this title: Travelers Can Import Colistin-Resistant Enterobacteriaceae Including Those Possessing the Plasmid-Mediated mcr-1 Gene in the Journal of the American Society for Microbiology.

It was done at the University of Berne, Switzerland. The microbiologists recommend a monitoring program in order to minimise the chances of spreading of diseases from that colistin-resistant gene.
#2 Jul 22nd, 2016, 15:44
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Being Swiss short-term travelers, they probably were not budget travelers, or at least not all of them. Of course, we don't know what they ate and where they stayed, which class of hotels, but more likely in upper class establishments. Chances are they ate food in those hotels, that they ate raw uncooked food, or drank Lassi.

There is also no indication of how experienced these people were with travelling in microbiologically diverse environments/countries, and the kind of precautions required in such countries.

One of the main misconceptions in the field is that the higher-class one travels and eats, the safer the places are in terms of chances of infection. The best places IMO are normally places where local customers are the majority, or even the only clientele (excluding the places at railway stations, because those places serve food of the lowest quality as they do not have to rely on repeat-customers).

One worrying aspect of the study is that we all may be carriers of multi-resistant germs without knowing it, since not all people infected actually got diarrhea. In fact there is an estimate that 95% of the population in India carries such germs.

The monitoring program recommended by the researchers might affect us Asia-travelers in the future. Some sort of surveillance, maybe with a special app to come soon? Or already in place...
#3 Jul 22nd, 2016, 15:53
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On the positive side, 12 people, one third of them, did not get any infection, which says, it is avoidable with proper precautions. Again, unfortunately we don't know what they did differently, but perhaps they read Indiamike , or at least research their choices well, before acting.
#4 Jul 22nd, 2016, 16:11
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Did the 24% tourist starve themselves

We are over a billion people, with least regards to cleanliness and food hygiene, I am surprised the figure is not 100%.
If you find my posts confrontationist, please bear, I am an old frustrated guy who has nothing better to do than sit on rocking chair and curse the world whole day
#6 Jul 22nd, 2016, 17:58
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Quote:
Originally Posted by atala View Post On the positive side, 12 people, one third of them, did not get any infection, which says, it is avoidable with proper precautions. Again, unfortunately we don't know what they did differently ... ...
Quote:
Originally Posted by atala View Post I wonder what those 5 or so % did right for not getting infected during a lifetime?
Perfectly possible, if not likely, that it was pure chance.
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#7 Jul 22nd, 2016, 21:18
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Indian doctors are too free with prescribing antibiotics. Now we can see the sad results.
#8 Jul 22nd, 2016, 23:29
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Originally Posted by Matka View Post Indian doctors are too free with prescribing antibiotics. Now we can see the sad results.
Prescription is less of the evil, the main problem is not completing the course.

And India is not a unique case, antibiotics are becoming useless everywhere, US has its own homegrown superbugs. Lets us face it, bacteria are much better at adapting than us making new antibiotics.
#9 Jul 22nd, 2016, 23:42
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The majority of antibiotics are manufactured for farm animal use (and abuse) across the world, especially in developed countries. Meat eaters in whatever country get their dose automatically, I guess.
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#10 Jul 23rd, 2016, 00:24
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Quote:
Originally Posted by jituyadav View Post Prescription is less of the evil, the main problem is not completing the course.

And India is not a unique case, antibiotics are becoming useless everywhere, US has its own homegrown superbugs. Lets us face it, bacteria are much better at adapting than us making new antibiotics.
Yes, I've seen first-hand how doctors prescribe antibiotics very freely as well as my Indian friends who didn't know you're supposed to take the full course of antibiotics. They've always stopped taking them when they felt better. In my Indian experiences you go to the doctor, they write a prescription, you take it next door to the pharmacy, they give you your medicine & you take it home. No one explains WHAT the medicine is, what it's for, how to properly take it (except for 3x/day or whatever) or potential side effects to look out for. And many Indians don't care or know to ask. After one of my friends was prescribed something I asked what it was & what it was for & he didn't know. I told him to go back to the doctor & ask. (And he actually did, haha!) The doctor told him "don't worry about it", refusing to tell him what is was or what it was for! My GUESS is that the doctor is rarely asked that question & figured the information would be useless to him. Also, I've seen where one of my friends had cold symptoms & went on their own to a pharmacy, getting just a couple antibiotic pills without a prescription. Ugh. I was pretty frustrated with it all.
#11 Jul 23rd, 2016, 02:05
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As mentioned above, the issue is not India-centric. There is a global crisis and with ever increasing global travel, this will only get worse over the years.

There is a very interesting report on the issue for those that want to read further:

Review on Antimicrobial Resistance: The O’Neill Report - Tackling drug-resistant infections globally

It's available as a pdf download here:
May 19, 2016 – Tackling Drug-Resistant Infections Globally: final report and recommendations

Quote:
Translations of the introduction and executive summary are available in the following languages; Arabic, Chinese, French, Japanese, Portugese and Spanish.



Also, for anyone interested, there have been two fabulous radio programmes recently on the topic. I will link to them below as they may be available to listen to again where you are. If you have difficulty listening to them and still want to, then contact me.


1. Health Check - Fighting Antimicrobrial Resistance (sic) (27 minutes)

BBC World Service Radio - Sun 24 Jul 2016 - 20:32 (first Broadcast Wed 20 Jul 2016 - 22:32)

(Photo: A pharmacist looking at a bottle of medicine. Credit: Getty Images) source

Quote:
Claudia Hammond focusses on the attempts to discover new antibiotics, and alternative therapies for combating bacterial infection.

Most of the antibiotics we use were discovered in the mid-20th century, but as the threat of drug resistant infections increases, the race is on to find new organisms that make novel medicines. We have only identified a tiny fraction of the microbes living on Earth and are "bioprospecting" for useful ones in wildly different locations. Microbiologist Matt Hutchings has been looking to the oldest farmers in the world - leaf cutter ants.

From exotic locations to under your fridge: Dr Adam Roberts runs a scheme called Swab and Send. It's a citizen science project that asks members of the public to swab a surface and send the sample to him – he'll analyse them to look for the presence of new antibiotic-producing bacteria. We joined in the hunt by swabbing spots around the BBC: Adam's microphone, our tea kitchen's sponge, the revolving entryway doormat, and lastly, the Dalek standing on guard outside the BBC Radio Theatre.

Antibiotics are not the only weapon in the war against bacteria. A hundred years ago, a class of virus that infect and destroy bacteria were discovered. They're called bacteriophages. Phage therapies were used throughout the era of Soviet Russia, and still are in some countries, including Georgia. Phage researcher Prof Martha Clokie told us whether phage therapy might be coming to the UK.

With expert comment from James Gallagher, BBC News health reporter.



2. More or Less - Antibiotics and the Problem of the Broken Market (9 minutes)

BBC World Service Radio - Last on: Mon 29 Feb 2016 - 14:50 (first Broadcast Fri 26 Feb 2016 -20:50)

(Image: Computer artwork of bacteria. Credit: Science Photo Library) source

Quote:
It is a life and death situation – the world is at its last line of defence against some pretty nasty bacteria and there are no new antibiotics. But it is not the science that’s the big problem, it is the economics. Despite the $40 billion market worldwide there is no money to be made in antibiotics so big pharmaceuticals have all but stopped their research. Why is this and how do we entice them back in? Wesley Stephenson finds out.
#12 Jul 23rd, 2016, 03:18
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Quote:
Dr Adam Roberts runs a scheme called Swab and Send. It's a citizen science project that asks members of the public to swab a surface and send the sample to him – he'll analyse them to look for the presence of new antibiotic-producing bacteria.
Fantastic!

I had a botany teacher who, in a former research lifetime, was engaged in the long hard slog of putting soil samples in dishes with bacteria and seeing if anything happened to the bacteria. They received samples from all over the world. She and her team did discover one important antibiotic... in a soil sample from her own garden.
#13 Jul 23rd, 2016, 03:39
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In that programme, the Dalek from Dr. Who got the most hits, chiefly I guess, because all people passing it want to touch it. Ants have been using antibiotics in their nests but they don't get resistant ones because apparently they rotate the use. Try and listen to the programmes; they are very good.
#14 Jul 23rd, 2016, 10:39
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Along the lines of what cap'n said - that's true. NYtimes quoted an FDA study here on the same - http://www.nytimes.com/2013/03/28/op...at-we-eat.html

The Independent (UK) is more direct, exhorting meat eaters to stop. http://www.independent.co.uk/voices/...-a6742031.html
#15 Jul 23rd, 2016, 10:46
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Not just meat. Cows are pumped full of antibiotics, so milk products too. A vegan diet is the healthiest.
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