A research team led by scientists at the University of Texas at Austin has developed chemical “probes” to help identify an enzyme produced by certain types of E. coli and Streptococcus pneumoniae that is known to break down several common types of antibiotics, making the bacteria dangerous resistant to treatment.

“In response to antibiotic treatment, bacteria have evolved various mechanisms to resist that treatment, and one of those mechanisms is to make enzymes that basically ‘chew up’ the antibiotic before it can do its job,” said Emily Que, an associate professor of chemistry at the University of Texas at Austin and one of the team’s lead researchers.
The tool we developed gives us critical information that can keep us one step ahead of the deadly bacteria.”

In a paper published online May 26 in the Journal of the American Chemical Society, researchers focused on the threat posed by a bacterial enzyme called New Delhi metal-beta-lactamase (NDM).
They set out to create a molecule that glows when it comes in contact with the NDM enzyme.
When these chemical “probes” are added to a test tube, they bind to enzymes and glow.
Such tools could be used to alert doctors to what bacterial threats are affecting their patients and to tell them which antibiotics to use.

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NDM breaks down antibiotics such as penicillin, cephalosporins and carbapenems, which are some of the safest and most effective treatments for bacterial infections.
Other classes of antibiotics also exist, but they may have more side effects, have more drug interactions, and may not be as readily available in some parts of the world.

 
In addition to showing the presence of the NDM enzyme, fluorescence chemistry “probes” developed by Que and Walt Fast (Professor of Chemical Biology and Pharmaceutical Chemistry) may help to find a different approach to combat these resistant bacteria.
One treatment that doctors use against resistant bacteria is a combination of a common antibiotic and an inhibitor.
Although there are currently no known clinically effective inhibitors against NDM producing bacteria, Que’s probe can help find one.

Once the probe binds to the enzyme and starts to glow, if an effective inhibitor is introduced, it will loosen the “probe” and the glow will stop.
This allows scientists to test a large number of potential drugs very quickly — a research that Que and FAST hope to continue in the future.

“This allows us to work towards developing treatments and ultimately to understand the evolutionary characteristics of this protein,” said Radhika Mehta, a PhD graduate student at the University of Texas at Austin and lead author of the paper.
Mehta is currently a postdoctoral fellow in the Mawson Lab at the University of California, Berkeley.

The study also looked at a process called vegetative immunity, which comes from the production of proteins in the body in response to infection.
These proteins rob the body of all available metals, such as zinc, needed to make NDM, making the bacteria more vulnerable.

“The evolution of this bacterium since it was discovered in 2008 suggests that it is not only developing antibiotic resistance, but also trying to fight this natural human immune process.
It was particularly scary, “Que said.

The “probe” developed by Que can also be used to study nutritional immunity and NDM because it only glow-up when the zinc needed to form enzymes is present.

When it comes to osteoporosis, many people will associate it with the elderly. It is true that osteoporosis mostly occurs in people over 50 years old, but with the development of economy and society, osteoporosis tends to develop at a young age, and more and more young people will suffer from osteoporosis to different degrees.
It can be seen that osteoporosis will become a popular disease, so the prevention of osteoporosis is urgent.

Real examples:

Ms. Zhu, who just turned 35 years old this year, is a designer of an advertising company. As the company belongs to Party B, Ms. Zhu suffers from double pressure. Not only does the leader of the company put pressure on her assessment, but the company connected with Party A also puts pressure on her work.
Busy all day dizzy, stay up late to work overtime has become a common, in order to work in the daytime have spirit, a day almost to drink 4 cups of coffee to refresh.
Ms. Zhu has been working in such a high-intensity and high-pressure environment for nearly four years. Although her ability has been greatly improved, her body is exhausted.

Some time ago, Ms. Zhu felt a pain in the waist, especially the pain will be increased by sitting for a long time, feel tired to the hospital to take painkillers, then eat still work, but after a period of time and pain;
Not long ago, Ms. Zhu on the way home from work, accidentally stepped on a step, directly fell to the ground, the waist to break, sitting on the ground ouch ouch ouch call, passers-by sent her to the hospital, examination found that Ms. Zhu’s twelfth and thirteenth ribs fracture;
After a detailed examination, it turned out that the fracture was caused by osteoporosis.

When Ms. Zhu heard the word osteoporosis, she was very surprised. How could I suffer from osteoporosis when I was so young?
The doctor is also a little puzzled, later the doctor through understanding, inquiry just know, originally with zhu Ms. Usually bad diet habit and lifestyle have a relationship.

A 35-year-old woman suffered a sudden fracture and was diagnosed with osteoporosis. Osteopath: 3 daily habits may be related

1. Too much coffee

Coffee contains caffeine, and caffeine will increase diuresis, urine in the excretion process will increase the excretion of calcium, when calcium can not meet the bone needs, so it will lead to osteopenia, bone microstructure is also damaged, and in the long run, will induce osteoporosis.

Ms Zhu drinks at least four cups of coffee a day, which is far more than the national limit. Besides, Ms Zhu works too hard, which could lead to osteoporosis.

2. Lack of weight-bearing exercise

With the development of economic society and the acceleration of the pace of life, many people are more sitting in the office, the pressure and intensity of work, resulting in they can not afford to walk, almost little exercise;
When people lack a certain weight-bearing exercise, it will lead to bone reduction, and it is not conducive to bone calcium precipitation and absorption, and increase bone loss, so it will induce osteoporosis.

Ms. Zhu’s daily life is a two-point line, the company and home, work rarely get up to do some activities, always staring at the computer work, home after work tired paralysis in bed, such a lifestyle is not conducive to the growth and development of bones.

3. Stay out of the sun

Ultraviolet light from the sun is the skin contact, synthesis of vitamin D, which can promote the absorption of calcium, vitamin D for bone formation, but now people are away for the sun, afraid of being uv black, sunburn, aging, and there are some people in stay indoors all day, rarely have the opportunity to contact with sunshine, so vitamin D reduce relatively,
Therefore, the utilization of calcium will be reduced, which is not conducive to bone growth.

Ms. Zhu rarely had the opportunity to take it outside during the day, plus her usual poor diet and vitamin D supplements.

It is the above three kinds of bad lifestyle and diet habits, led to Zhu’s young age induced osteoporosis, and also complicated with a more harmful fracture.

Osteoporosis is preventable and treatable. There are two things you can do to prevent and improve osteoporosis

First, tonic food — psoralein

At present, many patients with osteoporosis in the treatment, most did not find the correct way to maintain bone, think that osteoporosis will be caused by calcium deficiency, usually eat calcium tablets and drink bone soup can be, in fact, this approach is far from the effect of Pangu bone;
Therefore, in order to better stabilize bone and prevent osteoporosis, it is suggested that we can supplement some psoralein on a daily basis. This substance is a dietary nutrient for bone, which can promote the precipitation and absorption of bone calcium, assist the normal growth of bone and delay the rapid loss of bone.

This is mainly due to the fact that psoraletin contains a variety of nutrients, namely psoraletin, chondroitin sulfate, Eucommia ulmoides leaf and Epimedium, which interact and cooperate with each other to have multiple effects on the body and bone as follows:

(1) Liver and kidney tonify, strengthen muscles and bones, and effectively promote blood activity, and pure Chinese medicine preparation, safe and effective.

(2) It has the function of treating both the symptoms and root causes. It can supplement calcium and phosphorus at the same time to maintain the balanced development of calcium and phosphorus and promote bone health, aiming at the loss of calcium and phosphorus caused by osteoporosis.

(3) Psoralein also has a relieving effect on fractures, bone pain and arthritis, and has the effect of removing blood stasis and relieving pain.

(4) in the treatment of osteoporosis, but also anti-bacterial anti-inflammatory, improve the body immunity.

Second, strengthen exercise

The risk of osteoporosis is higher for those who are sedentary and do not exercise.
Adhere to the exercise helps to exercise the muscles and bones, strong body, secondly can also enhance the bone, to avoid falling fracture.

I believe that many Bao Bao parents have such experience, children because of bacterial infection to the hospital after antibiotic treatment, some babies take antibiotics after a period of time will appear diarrhea and other symptoms, then if the exclusion of food or other external reasons, Bao Bao parents need to be alert to antibiotic-related diarrhea.
Antibiotic Associated Diarrhea (ADD) is refers to after the use of antibiotics can not be explained by other reasons for Diarrhea, is the most common adverse reaction of antibiotics, especially in children, 10% of children will have Diarrhea after taking antibiotics,
The incidence is up to 18 percent in children under 2 years of age.
Figure 1 The incidence of antibiotic-associated diarrhea in children
What are the specific causes of ADD
At present, the etiology and specific pathogenesis of ADD have not been clearly studied, which is usually believed to be related to intestinal flora disorder.
Under normal circumstances, probiotics and opportunistic pathogens in the human gut are in a balanced state. Probiotics can improve the intestinal environment, regulate the intestinal flora, inhibit the growth of harmful bacteria, and also help with normal digestion and absorption.
Contingent pathogens are too few in number to cause disease.
After the use of antibiotics, on the one hand, the number of probiotics is significantly reduced, and the digestion and absorption function supported by the probiotics is impaired, resulting in insufficient metabolism of some sugars, which stay in the intestines, increase osmotic pressure and change pH value, and stimulate the increase of substances secreted by the intestines, leading to diarrhea.
On the other hand, antibiotics disrupt the balance of flora, allowing opportunistic pathogens, such as Clostridium difficile, to flourish, leading to intestinal inflammation and diarrhea.
Because the bacterium is well studied, ADD is sometimes referred to specifically as diarrhea caused by Clostridium difficile.
Of course, there are also studies that the allergic reaction and toxic effect caused by antibiotics can directly cause intestinal mucosa damage, leading to absorptive diarrhea;
Some antibiotics, such as erythromycin, can stimulate the contraction of the gastric antrum and duodenum, causing symptoms such as diarrhea and vomiting.
Common antibiotics that cause ADD
In general, broad-spectrum antibiotics are more likely to induce ADD than narrow-spectrum antibiotics.
It has been reported that the incidence of ADD caused by broad-spectrum antibiotics is 10-70 times that of narrow-spectrum antibiotics.
The most common include: lincomycin, second and third generation cephalosporins, broad-spectrum penicillins (amoxicillin and potassium clavulanate);
Less relevant ones include first-generation cephalosporins, other penicillins, macrolides;
Few associated drugs include aminoglycosides, rifampicin, and sulfonamides.
Current treatments

1. Antibiotics
   Discontinuation and adjustment of antibiotics are recommended.
   For most ADD, stopping the use of antibiotics is effective, even if Clostridium difficile infection, some patients only stopping the use of antibiotics is effective.
   Therefore, for all ADD patients, if it does not affect the recovery of the primary disease, antibiotics should be considered to stop immediately.
   In clinical practice, if it is mild to moderate diarrhea that does not lead to abdominal pain, dehydration and other problems of the child, there is no need to stop using antibiotics temporarily, or to use the full course of treatment;
   In general, diarrhea can be relieved automatically a few days after the antibiotics are stopped after the full course of treatment.
   If during the course of antibiotic treatment, diarrhea gradually gets worse, or the symptoms are serious, such as fever, obvious abdominal pain, bloody stool, dehydration or even shock, antibiotics should be stopped immediately and corresponding symptomatic treatment should be given.
   2, supplement probiotics
   Probiotic supplements are recommended to restore the balance of normal intestinal flora.
   At present, it is believed that probiotics may have a moderate protective effect on the prevention of ADD and can shorten the duration of diarrhea by 1 day.
   There are no specific recommendations for specific strains, preparations and dosages. Lactobacillus rhamnosus or Saccharomyces braglii are commonly used in clinical practice, with a daily frequency of 10-20 billion CFUs.

Misfortunes never come singly!
Recently, there has been a rapid increase in cases of mycosis infection among COVID-19 patients in India.
As of May 22, 8,848 cases of Mucor infection had been reported across India and 212 people had died, according to figures cited by Indian media.
Just two weeks ago (9 May), only about 300 people in India had been infected with the disease.

According to reports by India Today, NDTV and other Indian media, the medical community in India has yet to reach a final conclusion on the cause of the infection. However, doctors who collected patient data found that most of the infected patients were male, had used steroids during Coronavirus treatment, and most of them had underlying diabetes.

Dr. Vinod Kumar Paul, a medical expert and member of the Indian think tank NITI Aayog, said today (May 22) that the surge in cases of mycormyosis can be attributed to the disproportionate use of steroids in the treatment of COVID-19 patients.

Earlier, India’s Ministry of Health reiterated the importance of “strict adherence” to infection prevention and control practices and urged all regions to strictly control the spread of trichomycosis in hospitals.
Several Indian states, including Rajasthan, Uttar Pradesh, Orissa and Gujarat, have declared Mucormycosis a statutory epidemic.

Screenshot of the report showing more than 8,800 cases of mycosis in India

Immunity low population, easy to infect mycosis

According to Indian doctors and specialists, mucormycosis (Black Fungus) as the “epidemic” of epidemic, by “hairy mould fungi that exist in the natural environment, its symptoms as headache, nasal bleeding, coughing up blood, facial numbness and swelling, blurred vision, breathing difficulties, severe cases may also cause maxilla damage and even blindness.

Experts said Mucormycosis usually “does not pose a significant threat” to people with normal immune systems, but some people are more vulnerable because they have been taking immunosuppressant drugs for a long time for health problems and are less able to fight pathogens in the environment.

Mucormycosis mainly affects arteries and blood vessels, causing thrombosis and necrosis, vision problems, chest pain and breathing difficulties.
In severe cases, the mortality rate of Mucormycosis exceeds 50%.

The treatment of trichomycosis needs to race against time and adopt a multi-pronged approach.
Once a fungal lesion is diagnosed, surgical volume reduction, such as orbital resection or intracranial decompression, must be performed immediately to remove all fungus and necrotic tissue;
In the meantime, patients are given daily intravenous injections of anti-fungal drugs for eight weeks.

“It (Mucormycosis) is everywhere, in the soil and air, even in the noses and mucus of healthy people.
Dr. Akshay Nair, an ophthalmologist in Mumbai, said the body’s defenses keep Mucor out, but when the immune system is weakened, the fungus can take advantage.

The Indian Express counted several conditions that lower a person’s immune system: diabetes, steroid use, hematological malignancies, immunosuppressant use, excessive iron or ferriamine use, trauma, burns and malnutrition.

A patient with Mucormycosis after surgery, pictured from India

There were 8,848 cases of Mucormycosis infection and there was a shortage of drugs

The total number of cases has reached 8,848 and 212 people have died, with 2,281 cases in Gujarat, the worst-hit state, the minister said Monday.
Just two weeks ago (9 May), only about 300 people in India had been infected with the disease.

Guda added on Twitter that the government had sent more than 23,000 vials of key drugs for treatment to the affected states “following a detailed review of the rising number of infections everywhere” in light of the rapid increase in cases of Mucormycosis.

Earlier, the Ministry of Health reiterated the importance of “strict adherence” to infection prevention and control practices, requiring all regions to strictly control the spread of the disease in hospitals and declare it a statutory epidemic.
Indian Prime Minister Narendra Modi also stressed that Mucormycosis is a life-threatening fungal infection and all measures must be taken to prevent it during an online meeting with some of the frontline health care workers on Tuesday.

As of now, Rajasthan, Uttar Pradesh, Orissa, Gujarat and many other states have declared Mucormycosis a statutory epidemic.

Tweets screenshots

Separately, the BBC (BBC) reported on the 23rd that the emergence of cases of Mucor infection has added to the overcrowding of medical resources across India due to the COVID-19.

At a 1,100-bed state hospital in the central Indian city of Indore, the number of patients infected with Mucor had jumped from eight a week earlier to 185 on Tuesday evening.
Dr VP Pandey, the hospital’s medical director, told the BBC that more than 80 per cent of these patients required immediate surgery.

Dr. Pandey said the hospital has set up 11 wards with a total of 200 beds to treat patients with Mucor.
He said: “The spike in the number of patients was absolutely unexpected.
We’ve only seen one or two cases in the past year.”

He estimates that Indore alone has at least 400 patients.
“Currently, Mucor infections are more challenging than Novel Coronavirus.
If patients do not receive prompt and proper treatment, the mortality rate can be as high as 94 percent.
Treatment is expensive and medicines are in short supply.”

The Times of India reported on Wednesday that hospitals across India were experiencing shortages of the antifungal drug amphotericin B.

Screenshots of a shortage of mycosis drugs in India

Use of steroids to treat coronavirus may cause increase in cases, Indian expert says

At present, the medical community in India has not reached a conclusion about the cause of the infection.
But some doctors say the use of steroid drugs to treat patients with severe COVID-19 may be one reason for the surge in cases of mycosis, as the drugs can reduce immunity.

Dr Pandey, from the Indian city of Indore, told the BBC he had collected data from 201 patients at four hospitals in the city.

The patients, mostly men, appear to have developed symptoms of infection within 12 to 18 days of recovering from COVID-19, Dr. Pandey said.
Most of them had used steroids during Coronavirus treatment and all had underlying medical conditions, mainly diabetes.

The BBC cited two other studies by doctors in India: one that looked at more than 100 patients with Mucormycosis, 79 of whom were men, and 83 with diabetes;
Another study looked at 45 patients with mycosis, all of whom had diabetes.
“None of the patients with Mucormycosis have normal blood sugar.”
“Akshay Nayar, an Indian ophthalmologist, told the BBC.

Dr. Vinod Kumar Paul, a medical expert, said the spike in Mucor cases can be attributed to the disproportionate use of steroids in the treatment of COVID-19 patients at a press conference held by NITI Aayog, an Indian think tank, on Wednesday.

A doctor is diagnosing a patient with mycosis. Photo taken in print

Meanwhile, medical experts in India have also suggested that the government should look into other reasons behind the surge in cases of Mucor in parts of the country.

Professor Giridhar Babu, head of life process epidemiology at the Public Health Foundation of India, said: “There are several hypotheses, but the most likely is that it is multifactorial in nature: perhaps the availability of medical oxygen, or the presence of comorbid diseases.”

Two weeks ago, Professor K. Srinath Reddy, chairman of the Public Health Foundation of India, said in an interview that the recent spike in cases of the disease could be caused by inhalation of contaminated water.
“More patients need oxygen this time,” he said at the time.
Many patients use oxygen concentrators at home, and if the water is slightly contaminated, there is a risk of fungal infection, especially for those with weakened immune systems.”

In addition, Mucor exists on wet surfaces, so “patients should make sure the humidifier is waterproof when receiving oxygen support (to prevent the growth of the fungus),” Maffat, head of the department of otolaryngology at a public hospital in Mumbai, warned.