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Health Talk Recommends: How a superbug traveled the world

At Health Talk, we’re big fans of infographics.  We thought the one above, from Trevor Lawley and Nature Genetics was great.

The graphic (and it’s accompanying story) appeared this weekend on NPR’s Shots Blog and helps illustrate how a powerful infection, clostridium difficile (or C-diff. for short), traveled the world.

According to author Michaeleen Doucleff, around 10 years ago a particularly nasty and antibiotic-resistant strain of C-diff. appeared in the United States. Researchers started to wonder where it came from and how it had become so effective at combating our arsenal of antibiotics.

Well, after sequencing the DNA of more than 150 C-diff. strains found in patients between 1985 and 2010, scientists at the Wellcome Trust Sanger Institute might have found an answer.

According to Doucleff:

“From the DNA sequences, they calculated that the highly virulent form of C. difficile first appeared in Pittsburgh around 2001. From there, it spread to Oregon, New Jersey, Arizona and Maryland, where it caused major hospital outbreaks in each state. Since 2007, the drug-resistant bacteria have also made appearances in South Korea and Switzerland. The genomic data also showed that another superbug of C. difficile cropped up independently in the U.S. around the same time.”

As for how these strains became resistant to our antibiotics?  Researchers at Wellcome think they found the answer to that too.  Evidently both aforementioned strains of C-diff. underwent a single mutation – independently – that allowed them to fight off antibiotics commonly prescribed a decade prior.  Scary stuff.

Check out Doucleff’s story at NPR for more.

P.S., if Doucleff’s story leaves you wanting to learn more about treatment options for C-diff. infections, be sure to check out our earlier post on the concept of fecal transplants.

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In the News: Fecal transplant offers rare hope against deadly colon disease

Yesterday, Minnesota Public Radio’s Lorna Benson highlighted a unique procedure that’s been gaining attention over the past few years: fecal transplantation.

And yes, the procedure is exactly what it sounds like.

According to Benson’s report, University of Minnesota physicians are transplanting human feces into the colons of patients battling clostridium difficile.  What’s more – the procedure isn’t just working, but it’s providing hope to patients battling severe illness that can result from the infection, which is often resistant to antibiotics.

Benson reports:

“Doctors say fecal transplants could allow patients to more quickly develop their own natural defenses against clostridium difficile, an infection that kills 14,000 people in the United States each year, according to the U.S. Centers for Disease Control and Prevention.

The antibiotic-resistant bacteria, which many contract in hospitals, typically are treated with strong drugs. But using the antibiotics can be a double-edged sword, as the drugs also destroy good bacteria that normally keep harmful bacteria in check. If too much good bacteria are lost, the disease can flare up again soon after antibiotic treatment is stopped.”

Since the University of Minnesota started its program in 2009, gastroenterologist Alexander Khoruts, M.D., has performed more than 100 fecal transplants.  The Mayo Clinic has also started offering the procedure, though Benson points out their program is in the early stages.

For more, visit MPR’s web site.

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In the News: Do most GERD sufferers really need an endoscopy?

If you’re a patient suffering from gastroesophageal reflux disease (GERD) wondering whether or not an endoscopy is in your future to screen for esophageal cancer, the answer may actually be no.

According to new guidelines published in Annals of Internal Medicine, the journal of the American College of Physicians, only GERD patients who have failed to respond to treatment and who display severe symptoms associated with esophageal cancer may need to undergo an upper endoscopy.

Furthermore, as Susan Perry of MinnPost points out, there isn’t sufficient evidence that routine use of an upper endoscopy can lower the risk of GERD patients dying from esophageal cancer.  But there is evidence that overuse of the procedure may be contributing to rising health care costs.

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