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  • Lancet Infect Dis. Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study

    The Lancet Infectious Diseases, Early Online Publication, 11 August 2010
    doi:10.1016/S1473-3099(10)70143-2Cite or Link Using DOI
    Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study


    Original Text
    Karthikeyan K Kumarasamy MPhil a, Mark A Toleman PhD b, Prof Timothy R Walsh PhD b Corresponding AuthorEmail Address, Jay Bagaria MD c, Fafhana Butt MD d, Ravikumar Balakrishnan MD c, Uma Chaudhary MD e, Michel Doumith PhD c, Christian G Giske MD f, Seema Irfan MD g, Padma Krishnan PhD a, Anil V Kumar MD h, Sunil Maharjan MD c, Shazad Mushtaq MD c, Tabassum Noorie MD c, David L Paterson MD i, Andrew Pearson PhD c, Claire Perry PhD c, Rachel Pike PhD c, Bhargavi Rao MD c, Ujjwayini Ray MD j, Jayanta B Sarma MD k, Madhu Sharma MD e, Elizabeth Sheridan PhD c, Mandayam A Thirunarayan MD l, Jane Turton PhD c, Supriya Upadhyay PhD m, Marina Warner PhD c, William Welfare PhD c, David M Livermore PhD c, Neil Woodford PhD c


    Summary
    Background
    Gram-negative Enterobacteriaceae with resistance to carbapenem conferred by New Delhi metallo-β-lactamase 1 (NDM-1) are potentially a major global health problem. We investigated the prevalence of NDM-1, in multidrug-resistant Enterobacteriaceae in India, Pakistan, and the UK.
    Methods
    Enterobacteriaceae isolates were studied from two major centres in India?Chennai (south India), Haryana (north India)?and those referred to the UK's national reference laboratory. Antibiotic susceptibilities were assessed, and the presence of the carbapenem resistance gene blaNDM-1 was established by PCR. Isolates were typed by pulsed-field gel electrophoresis of XbaI-restricted genomic DNA. Plasmids were analysed by S1 nuclease digestion and PCR typing. Case data for UK patients were reviewed for evidence of travel and recent admission to hospitals in India or Pakistan.
    Findings
    We identified 44 isolates with NDM-1 in Chennai, 26 in Haryana, 37 in the UK, and 73 in other sites in India and Pakistan. NDM-1 was mostly found among Escherichia coli (36) and Klebsiella pneumoniae (111), which were highly resistant to all antibiotics except to tigecycline and colistin. K pneumoniae isolates from Haryana were clonal but NDM-1 producers from the UK and Chennai were clonally diverse. Most isolates carried the NDM-1 gene on plasmids: those from UK and Chennai were readily transferable whereas those from Haryana were not conjugative. Many of the UK NDM-1 positive patients had travelled to India or Pakistan within the past year, or had links with these countries.
    Interpretation
    The potential of NDM-1 to be a worldwide public health problem is great, and co-ordinated international surveillance is needed.
    Funding
    European Union, Wellcome Trust, and Wyeth.


  • #2
    Re: Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study

    British doctors warn new superbug could spread

    august 11, 2010

    LONDON ? British scientists have found a superbug that is resistant to most antibiotics and are warning that it is widespread in India and could soon appear worldwide.

    The superbug has so far been identified in 37 people who returned to the U.K. after undergoing surgery in India or Pakistan.

    In an article published online Wednesday in the journal Lancet Infectious Diseases, doctors reported finding a new gene, called NDM-1. The gene alters bacteria, allowing them to become resistant to nearly all known antibiotics. It has been seen largely in E. coli bacteria, the most common cause of urinary tract infections, and on DNA structures that can be easily copied and passed onto other types of bacteria.

    The researchers said the superbug appeared to be already circulating widely in India, where the health system is much less likely to identify its presence or have adequate antibiotics to treat patients.

    More: http://www.google.com/hostednews/ap/...VwwoAD9HH7DO00
    ?Addressing chronic disease is an issue of human rights ? that must be our call to arms"
    Richard Horton, Editor-in-Chief The Lancet

    ~~~~ Twitter:@GertvanderHoek ~~~ GertvanderHoek@gmail.com ~~~

    Comment


    • #3
      Re: Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study

      See also this thread: http://www.flutrackers.com/forum/sho...148#post366148
      ?Addressing chronic disease is an issue of human rights ? that must be our call to arms"
      Richard Horton, Editor-in-Chief The Lancet

      ~~~~ Twitter:@GertvanderHoek ~~~ GertvanderHoek@gmail.com ~~~

      Comment


      • #4
        Re: Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study

        Detection of Enterobacteriaceae Isolates Carrying Metallo-Beta-Lactamase --- United States, 2010

        Weekly
        June 25, 2010 / 59(24);750

        During January--June 2010, three Enterobacteriaceae isolates carrying a newly described resistance mechanism, the New Delhi metallo-beta-lactamase (NDM-1) (1), were identified from three U.S. states at the CDC antimicrobial susceptibility laboratory.

        This is the first report of NDM-1 in the United States, and the first report of metallo-beta-lactamase carriage among Enterobacteriaceae in the United States.

        These isolates, which include an Escherichia coli, Klebsiella pneumoniae, and Enterobacter cloacae, carry blaNDM-1, which confers resistance to all beta-lactam agents except aztreonam (a monobactam antimicrobial) (1); all three isolates were aztreonam resistant, presumably by a different mechanism.

        In the United Kingdom, where these organisms are increasingly common, carriage of Enterobacteriaceae containing blaNDM-1 has been closely linked to receipt of medical care in India and Pakistan (2). All three U.S. isolates were from patients who received recent medical care in India.

        Carbapenem resistance and carbapenemase production conferred by blaNDM-1 is detected reliably with phenotypic testing methods currently recommended by the Clinical and Laboratory Standards Institute (3), including disk diffusion testing and the modified Hodge test (4).

        Carbapenem resistance in all three of these isolates was detected in the course of routine testing. Current CDC infection control guidance for carbapenem-resistant Enterobacteriaceae also is appropriate for NDM-1--producing isolates (5).

        This includes recognizing carbapenem-resistant Enterobacteriaceae when cultured from clinical specimens, placing patients colonized or infected with these isolates in contact precautions, and in some circumstances, conducting point prevalence surveys or active-surveillance testing among other high-risk patients.

        Laboratory identification of the carbapenem- resistance mechanism is not necessary to guide treatment or infection control practices but should instead be used for surveillance and epidemiologic purposes.

        Clinicians should be aware of the possibility of NDM-1--producing Enterobacteriaceae in patients who have received medical care in India and Pakistan, and should specifically inquire about this risk factor when carbapenem-resistant Enterobacteriaceae are identified.

        CDC asks that carbapenem-resistant isolates from patients who have received medical care within 6 months in India or Pakistan be forwarded through state public health laboratories to CDC for further characterization.

        Infection control interventions aimed at preventing transmission, as outlined in current guidance (5), should be implemented when NDM-1--producing isolates are identified, even in areas where other carbapenem-resistance mechanisms are common among Enterobacteriaceae. Additional information is available by contacting Brandi Limbago or Alex Kallen at search@cdc.gov.

        ?Addressing chronic disease is an issue of human rights ? that must be our call to arms"
        Richard Horton, Editor-in-Chief The Lancet

        ~~~~ Twitter:@GertvanderHoek ~~~ GertvanderHoek@gmail.com ~~~

        Comment


        • #5
          Lancet Infect Dis. Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study

          Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study (The Lancet Infectious Diseases, abstract, edited)

          [Source: Lancet, <cite cite="http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(10)70143-2/abstract">Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study : The Lancet Infectious Diseases</cite>. Abstract, edited.]

          The Lancet Infectious Diseases, Early Online Publication, 11 August 2010
          doi:10.1016/S1473-3099(10)70143-2

          Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study

          Karthikeyan K Kumarasamy MPhil a, Mark A Toleman PhD b, Prof Timothy R Walsh PhD b, Jay Bagaria MD c, Fafhana Butt MD d, Ravikumar Balakrishnan MD c, Uma Chaudhary MD e, Michel Doumith PhD c, Christian G Giske MD f, Seema Irfan MD g, Padma Krishnan PhD a, Anil V Kumar MD h, Sunil Maharjan MD c, Shazad Mushtaq MD c, Tabassum Noorie MD c, David L Paterson MD i, Andrew Pearson PhD c, Claire Perry PhD c, Rachel Pike PhD c, Bhargavi Rao MD c, Ujjwayini Ray MD j, Jayanta B Sarma MD k, Madhu Sharma MD e, Elizabeth Sheridan PhD c, Mandayam A Thirunarayan MD l, Jane Turton PhD c, Supriya Upadhyay PhD m, Marina Warner PhD c, William Welfare PhD c, David M Livermore PhD c, Neil Woodford PhD c


          Summary

          Background
          Gram-negative Enterobacteriaceae with resistance to carbapenem conferred by New Delhi metallo-β-lactamase 1 (NDM-1) are potentially a major global health problem. We investigated the prevalence of NDM-1, in multidrug-resistant Enterobacteriaceae in India, Pakistan, and the UK.

          Methods
          Enterobacteriaceae isolates were studied from two major centres in India?Chennai (south India), Haryana (north India)?and those referred to the UK's national reference laboratory. Antibiotic susceptibilities were assessed, and the presence of the carbapenem resistance gene blaNDM-1 was established by PCR. Isolates were typed by pulsed-field gel electrophoresis of XbaI-restricted genomic DNA. Plasmids were analysed by S1 nuclease digestion and PCR typing. Case data for UK patients were reviewed for evidence of travel and recent admission to hospitals in India or Pakistan.

          Findings
          We identified 44 isolates with NDM-1 in Chennai, 26 in Haryana, 37 in the UK, and 73 in other sites in India and Pakistan. NDM-1 was mostly found among Escherichia coli (36) and Klebsiella pneumoniae (111), which were highly resistant to all antibiotics except to tigecycline and colistin. K pneumoniae isolates from Haryana were clonal but NDM-1 producers from the UK and Chennai were clonally diverse. Most isolates carried the NDM-1 gene on plasmids: those from UK and Chennai were readily transferable whereas those from Haryana were not conjugative. Many of the UK NDM-1 positive patients had travelled to India or Pakistan within the past year, or had links with these countries.

          Interpretation
          The potential of NDM-1 to be a worldwide public health problem is great, and co-ordinated international surveillance is needed.


          Funding
          European Union, Wellcome Trust, and Wyeth.

          a Department of Microbiology, Dr ALM PG IBMS, University of Madras, Chennai, India
          b Department of Infection, Immunity and Biochemistry, School of Medicine, Cardiff University, Cardiff, UK
          c Health Protection Agency Centre for Infections, London, UK
          d Department of Microbiology, Shaukat Khanum Cancer Hospital, Lahore, Pakistan
          e Department of Microbiology, Pandit B D Sharma PG Institute of Medical Sciences, Haryana, India
          f Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
          g Department of Pathology and Microbiology, The Aga Khan University, Karachi, Pakistan
          h Department of Microbiology, Amrita Institute of Medical Sciences, Kerala, India
          i University of Queensland Centre for Clinical Research, University of Brisbane, Herston, QLD, Australia
          j Department of Microbiology, Apollo Gleneagles Hospital, Kolkata, India
          k Department of Medical Microbiology, Northumbria Healthcare NHS Foundation Trust, Tyne and Wear, UK
          l Department of Microbiology, Apollo Hospitals, Chennai, India
          m Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India

          Corresponding Author Information
          Correspondence to: Prof Timothy R Walsh, Professor of Medical Microbiology and Antimicrobial Resistance, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN, UK

          -
          ------

          Comment


          • #6
            Re: Lancet Infect Dis. Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study

            CORRESPONDENCE

            Year : 2010 | Volume : 28 | Issue : 3 | Page : 265-266


            New Delhi metallo-beta-lactamases: A wake-up call for microbiologists

            BVS Krishna
            Department of Clinical Microbiology, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom



            Date of Submission 24-Sep-2009
            Date of Acceptance 05-Apr-2010
            Date of Web Publication 17-Jul-2010


            Correspondence Address:
            BVS Krishna
            Department of Clinical Microbiology, Royal Infirmary of Edinburgh, Edinburgh
            United Kingdom


            Source of Support: None, Conflict of Interest: None

            DOI: 10.4103/0255-0857.66477

            PMID: 20644324







            How to cite this article:
            Krishna B. New Delhi metallo-beta-lactamases: A wake-up call for microbiologists. Indian J Med Microbiol 2010;28:265-6

            How to cite this URL:
            Krishna B. New Delhi metallo-beta-lactamases: A wake-up call for microbiologists. Indian J Med Microbiol [serial online] 2010 [cited 2010 Aug 12];28:265-6. Available from: http://www.ijmm.org/text.asp?2010/28/3/265/66477


            Dear Editor,

            New Delhi metallo-beta-lactamases (NDM) is a nomenclature that Indians cannot be proud of, NDM-1 is the designation for carbapenemases found in enterobacteriaceae isolated from patients in the United Kingdom and elsewhere who have had healthcare contact in India or Pakistan. [1],[2]

            Carbapenems (imipenem, ertapenem, meropenem, doripenem) are a class of beta-lactam antibiotics with a broad spectrum of activity against gram-positive, gram-negative, and anaerobic bacteria.

            Carbapenemase enzymes belonging to Ambler molecular classes A to D have been detected in various clinical isolates. Of these the class B enzymes are clinically the most significant. They are the metallo-beta-lactamase (MBL) enzymes of the IMP or VIM series that have been reported worldwide. MBL enzymes, whose genes are plasmid and integron located, hydrolyze virtually all beta-lactams except aztreonam. [3] Many of the carbapenemase producers are frequently resistant to fluroquinolones and aminoglycosides.

            NDM-1 was first detected in a Klebsiella pneumoniae isolate from a Swedish patient of Indian origin in 2008. The gene coding for this unique enzyme blaNDM-1 was found in one of the three resistance-carrying regions of an integron. NDM-1 shares very little identity with other MBLs. As well as possessing unique residues near the active site, NDM-1 also has an additional insert between positions 162 and 166, which is not present in other MBLs. NDM-1 has a molecular mass of 28 kD and is monomeric. [4]

            NDM-1 have been isolated from K pneumoniae, Escherichia More Details coli, Citrobacter freundii, Enterobacter cloacae, and Morganella morganii. [2] Other classes of carbapenemases have already been found in K pneumoniae, E cloacae, Pseudomonas aeruginosa, and Acinetobacter baumannii. [5]

            The first clue to the presence of a carbapenemase comes from the increased minimum inhibitory concentration (MIC) values or frank resistance of the enterobacteriaceae to ertapenem, imipenem, or meropenem. NDM-1 is inhibited by EDTA like other MBL enzymes; this has been demonstrated by the EDTA-disc synergy test. The carbapenemase activity can be screened for by the modified Hodge test. [6] Further characterization and identification of the enzyme can be done only by molecular methods.

            Treatment of infections caused by pathogens producing carbapenemases, including NDM-1, poses a serious challenge as these infections are resistant to all commonly used antibiotics. [5] Treatment of patients should be guided by the susceptibilities of the individual pathogens, and clinical laboratories must test for a wide range of antibiotics, including tigecycline, colistin, polymyxin, and aztreonam. The use of antibiotic combinations may have to be considered in desperate cases.

            Carbapenems are the only reliably active antibiotics against many multiresistant gram-negative pathogens, particularly those with extended-spectrum beta-lactamases (ESBLs) and AmpC enzymes. [7] The emergence and diversity of carbapenemase-producing strains is therefore a major concern and one that Indian microbiologists cannot afford to ignore.

            The virtual nonexistence of antibiotic policies and guidelines in India to help doctors make rational choices with regard to antibiotic treatment is a major driver of the emergence and spread of multidrug resistance in India. This is augmented by the unethical and irresponsible marketing practices of the pharmaceutical industry, and encouraged by the silence and apathy of the regulating authorities. Poor microbiology services in most parts of the country add to the problem.

            Microbiologists in India have a very important role in the prevention of spread of these dreaded multiresistant pathogens across the world. They should actively participate in the clinical decision making with regard to the treatment of infections, influence the policies and approach to infections and antimicrobials by the government, develop guidelines for antibiotic therapy in their local hospitals, become infection-control doctors, set up surveillance systems for drug-resistant organisms, and educate healthcare workers and the general public about the dangers of multidrug resistant organisms, including hospital-acquired infections.

            ~ References

            1. Yong D, Giske CG, Toleman M, Walsh TR. A novel subgroup metallo-beta-lactamase (MBL), NDM-1 emerges in Klebsiella pneumoniae (KPN) from India. 48th Annual ICAAC/IDSA 46th Annual Meeting, Washington DC, October 25-28, 2008. 2009;C1-105:87.
            2. Health Protection Agency. National Resistance Alert: Carbapenemases in Enterobacteriaceae. Health Protection Report 2009;3:news.
            3. Nordmann P, Poirel L. Emerging carbapenemases in Gram-negative aerobes. Clin Microbiol Infect 2002;8:321-31. [PUBMED] [FULLTEXT]
            4. Yong D, Toleman MA, Giske CG, Cho HS, Sundman K, Lee K, et al. Characterization of a new metallo-beta-lactamase gene, bla(NDM-1), and a novel erythromycin esterase gene carried on a unique genetic structure in Klebsiella pneumoniae sequence type 14 from India. Antimirob Agents Chemother 2009;53:5046-54.
            5. Walsh TR. Clinically significant carbapenemases: An update. Curr Opin Infect Dis 2008;21:367-71. [PUBMED] [FULLTEXT]
            6. Lee K, Chong Y, Shin HB, Kim YA, Yong D, Yum JH. Modified Hodge and EDTA-disk synergy tests to screen metallo-beta-lactamase-producing strains of Pseudomonas and Acinetobacter species. Clin Microbiol Infect 2001;7:88-91. [PUBMED] [FULLTEXT]
            7. Pitout JD, Laupland KB. Extended-spectrum beta-lactamase-producing Enterobacteriaceae: An emerging public-health concern. Lancet Infect Dis 2008;8 :159-66. [PUBMED] [FULLTEXT]

            Twitter: @RonanKelly13
            The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

            Comment


            • #7
              Re: Lancet Infect Dis. Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study

              Superbug more hype than substance?
              HT Correspondent, Hindustan Times

              New Delhi, August 14, 2010First Published: 01:07 IST(14/8/2010)
              Last Updated: 01:09 IST(14/8/2010)
              India superbug study author Karthikeyan Kumarasamy has backtracked and said the threat to the world was not as big as it was being made out to be. ?It?s all hype and not as bad as it sounds. The threat of the NDM-1 is not that big as, say, H1NI (swine flu),? said the 32-year-old research student at
              Chennai?s Dr A.L. Mudaliar Postgraduate Institute of Basic Medical Sciences.

              He also said the study?s conclusion that the superbug came from India was speculative at best, underscoring the health ministry?s claim that the study was motivated and prejudiced.

              ?The conclusion that the bacteria was transmitted from India is hypothetical. Unless we analyse samples from across the globe to trace its origin, we can only speculate,? said Kumarasamy.

              The study alleged that people travelling from Britain to India ? largely because of medical tourism ? were taking back a drug-resistant superbug called New Delhi metallo-beta-lactamase (NDM-1). Existing antibiotics used to treat other superbugs such as methicillin-resistant Staphyloccus aureus (MRSA), are ineffective.

              Since superbugs such as NDM-1 and MRSA are difficult to treat, the infection spreads easily within the body, especially people who are ill or recuperating from an illness. Its fatal if the infection enters the bloodstream, heart, lungs, bones or joints.

              Experts in India insist the design and conclusion are flawed, not just because researchers admit they ?could not prove statistically significant strain relatedness between Indian and UK isolates? but also because none of the samples was clonally related.

              ?This means there was no clear link tracing infections in the UK back to India. Any infection is anyway present in the US, Canada, Australia and the Netherlands,? said Dr VM Katoch, director general, Indian Council Of Medical Research.


              New Delhi: Hitting out at the superbug controversy, the government said there was a need to find out whether some ?ulterior motives? were behind the claim as there was inadequate proof to prove that it had originated from this country. ?The reasoning that has been given, that the patients went from India and Pakistan to London... but this has not been mentioned that whether the patient who was in London was tested for having it before coming ...,? health minister Ghulam Nabi Azad (in pic) said. PTI
              Twitter: @RonanKelly13
              The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

              Comment


              • #8
                Re: Lancet Infect Dis. Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study

                We do not take any position on "Pharma". We do not know enough about the issues to make a comment.

                The A/H1N1 pandemic was real, not withstanding the claims that it was a creation of WHO in conjunction with "Big Pharma".

                We are 100% against naming any disease for a location, which denotes a certain population.

                Comment


                • #9
                  Re: Lancet Infect Dis. Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study

                  We are placing these threads in:

                  Antibiotic Resistant Bacteria including: MRSA, metallo-beta-lactamase


                  MBL is an acceptable name.

                  Comment


                  • #10
                    Re: Lancet Infect Dis. Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study

                    We can use gs's method of naming it:

                    *** *****M-1
                    The salvage of human life ought to be placed above barter and exchange ~ Louis Harris, 1918

                    Comment


                    • #11
                      Re: Lancet Infect Dis. Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study

                      Originally posted by sharon sanders View Post
                      We are placing these threads in:

                      Antibiotic Resistant Bacteria including: MRSA, metallo-beta-lactamase


                      MBL is an acceptable name.
                      I don't think that Lancet would have used a name without weighting the impact on Indian populations sensitivity.

                      NDM-1 is the 'label' for an enzyme, not an identifier for blaming.

                      The fact that a paper cites the name of a novel antibiotic (tigecycline) and at the bottom of the abstract one reader discovers that among the study funders there is the manufacturer of the agent (Wyeth), this may be disturbing for some.

                      Comment


                      • #12
                        Re: Lancet Infect Dis. Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study

                        Originally posted by Snowy Owl

                        Three objectives are realised by this Pharmaceutical PR.

                        - Generating fears on a bug present in India and others countries discrideting India Hospitals.

                        - Prompting the generation and the sale of the new Wyett Pharma to sell more of its adapted antibiotic for this superbug.

                        -Maintaining and hyper the fears.

                        -Redirecting surgeries back to western hospitals.
                        Looking for a Superbug Killer

                        Published: Saturday, November 6, 2010 at 6:01 a.m.
                        Last Modified: Saturday, November 6, 2010 at 5:09 a.m.
                        ( page of 5 )


                        Worried about an impending public health crisis, government officials are considering offering financial incentives to the pharmaceutical industry, like tax breaks and patent extensions, to spur the development of vitally needed antibiotics.
                        <style>.art_main_pic { width: 250px; float: left; clear: left; }</style>
                        While the proposals are still nascent, they have taken on more urgency as bacteria steadily become resistant to virtually all existing drugs at the same time that a considerable number of pharmaceutical giants have abandoned this field in search of more lucrative medicines. The number of new antibiotics in development is ?distressingly low,? Dr. Margaret A. Hamburg, commissioner of the Food and Drug Administration, said at a news conference last month. The world?s weakening arsenal against ?superbugs? has prompted scientists to warn that everyday infections could again become a major cause of death just as they were before the advent of penicillin around 1940.

                        Full text: http://www.gainesville.com/article/2...NYT01/11063008

                        Comment

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