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Susceptibility & Antibiotic Resistance

As part of the 2010 Conference on Antimicrobial Resistance, Symposium 2 brought together experts in the area of Susceptibility Issues.

Dr. George M. Eliopoulous, of Beth Isreael Deaconess Medical Center (Boston, MA) moderated talks given by Dr. Ronald N. Jones, of JMI Laboratories (North Liberty, IA), Michael N. Dudley, PharmD, FIDSA, of Mpex Pharmaceuticals, Inc. (San Diego, CA), and Dr. David G. White, of the United States Food & Drug Administration (Laurel, MD).

Jones presented “What’s ‘Hot’ in Antimicrobial Resistance and the Challenges in Resource-Limited Settings”.  He noted statistics that the somewhat successful initiative “Bad Bugs, No Drugs” by the Infectious Diseases Society of America released on declining research investments in antimicrobial development.

According to Dr. Jones, between 2003-2008 there was an 86 percent increase in Carbapenem drug usage, in response to rapidly spreading resistant strains which he said indicates, “that without stewardship, we’re in trouble.”

Strains_spread_rapidly.gif 

Carbapenems are a class of beta-lactam classes of drugs which include penicillins, cephalosporins,

cephamycins and carbapenems. These antibiotics have a common element in

their molecular structure: a four-atom ring known as a beta-lactam. The

lactamase enzyme breaks that ring open, deactivating the molecule’s

antibacterial properties.

Jones also noted that current susceptibility patterns of newer antimicrobial drugs goes up every year, especially with drugs such as Vancomycin and Daptomycin MIC, a glycopeptide antibiotic and a novel lipopeptide antibiotic respectively, used in the prophylaxis and treatment of infections caused by Gram-positive bacteria.

Speaker Dudley presented a technical talk on pharmaceutical breakpoints and antimicrobial resistance called “Towards Improved Susceptibility Tests: Getting the Right Answer”. 

White’s presentation entitled “Paper or Plastic? Bringing Resistance Home” touched on the current crossroads of food safety and antimicrobial resistance.  He cited the differences in growing, packaging, storage, and cooking in different regions and countries as catalysts for foodborne illnesses and food safety issues.

White gave a brief history of food illness outbreaks over the past 4 years.  Instances of illness outbreaks included Salmonella in chocolate in 2006, Samonella in Veggie Booty in 2007, Salmonella in peppers in 2009, and Salmonella in peanut butter in 2008-2009.

White also noted difficulties in regulating imported food as the United States trades with over 150 countries and territories that are not susceptible to the same regulations as food within the U.S.  Today, 75 percent of seafood and 60 percent of vegetables and fruits sold in the U.S. are imported. 

According to White, the National Antimicrobial Resistance Monitoring System (NARMS), which monitors domestic meat and other retail foods has been effective.  NARMS was established in 1996 as a collaborative

effort between the U.S. Food and Drug Administration’s Center for Veterinary

Medicine, U.S. Department of Agriculture, and the

Centers for Disease Control and Prevention. The NARMS program

monitors changes in antimicrobial drug susceptibilities of selected

enteric bacterial organisms in humans, animals, and retail meats to a

panel of antimicrobial drugs important in human and animal medicine.   

Read more about the conference here.

Abstracts from the Susceptibility Symposium or the rest of the conference are also available here (pdf).

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