Rise of the Superbugs

Name: Nia Angeline R.Migue

1. Antibiotics have allowed us to do things that nobody could have dreamed of doing
historically. These feats include:
a. They've allowed us to transplant organs
b. They've allowed us to undergo chemotherapy, -
c. They've allowed us to receive therapy in intensive care units when we're critically
ill.
2. According to one of the speakers, prior to antibiotics era, these diseases that had the
following % mortality: meningitis (100%),appendicitis/ruptured bowel(30%), bad
pneumonia (100%). Sometimes the only cure then was surgical intervention to cut the
infection out.
3. Its the Indian subcontinent which is proving to be the superbugs birthing petri dish
because of antibiotic abuse.
4. Cite specific reasons why India is a fertile ground for antibiotic resistance.
a. There's no antibiotic policy in the country.
b. India mass produces antibiotics and sells them cheaply. The drugs are available
over the counter without prescription.
c. Waterways and even the soil are contaminated by waste from antibiotic
manufacture.
d. On top of poor sanitation and chronic overcrowding.
5. Indian 1 or New Delhi metallo-beta-lactamase or NDM-1. is one of the worlds most
dangerous superbugs. Briefly explain how it unleashes its antibiotic resistance.
Indian 1 or New Delhi metallo-beta-lactamase or NDM-1 is a gene that can
turn bacteria once easily destroyed into untreatable killers. Just like Professor
Lindsay Grayson said, The NDM bug is really scary because when you only have to
drink one or two of those bugs. And they don't have to multiply in themselves, they
just have to spit out the little bits of genetic material that make them superbugs
and then they convert all your healthy bacteria into superbugs.So it's a bit like
putting a red t-shirt into the washing machine of white shirts. And the t-shirt itself
doesn't have to multiply, it just has to leach out this stain and it changes all your
white shirts into red shirts and converts them into you know, a superbug.
6. What were specific solutions proposed by one Indian medical practitioner regarding this
superbug menace in their country?
a. Government should take initiative and ask the medical community to use the
antibiotics very sensibly.
b. The government should bring in strict laws to rationalise the antibiotics in
countries, there must be strict antibiotic policies on one end.
c. On the other end, governments should talk to pharma industries to stimulate the
research on antibiotics.
7. David Riccis experience with Indian 1 intaction:
a. What was the last antibiotic standing that saved his life? The last antibiotic
standing that saved his life was Collistin.
b. What was the downside of this drug that led to its abandonment years ago? The
downside of this drug that led to its abandonment years ago was it was too toxic.
c. Given his current condition and his five past operations, what was that risk that he
was facing? His kidneys and white blood cell count and everything started dropping
and they had to they had to pull him off right before you know most of his organs
were unretainable.
8. TB Story in Papua New Guinea: Extensively Drug Resistant TB or XDR TB. Describe the
conditions that could have possibly led to the emergence of XDR in this part of the world
(paragraph form).

The conditions that possibly led to the emergence of XDR in this part of the world is
that when we have close contact for a prolonged period of time with known TB patients in
crowded, enclosed environments like clinics, hospitals, prisons, or homeless shelters
because its an airborne disease. TB bacteria are put into the air when a person with TB
disease of the lungs or throat coughs, sneezes, shouts, or sings. These bacteria can float
in the air for several hours, depending on the environment. Persons who breathe in the air
containing these TB bacteria can become infected. So everyone must wear masks to
prevent this.

9. What is the TB DOTS Program of the Philippine Government? Describe the antibiotic
regimen.
For new patients, they are to take ISONIAZID (300mg), ETHAMBUTOL (800 mg),
RIFAMPICIN (450 mg), and PYRAZINAMIDE (1 g) for the 2 months of the intensive phase
then follow up with ISONIAZID (300 mg) and RIFAMPICIN (450 mg) for the next four months
for maintenance. The dosages can be changed depending on the patients weight.
10.Research on the treatment schedule of XDR TB so you can compare it with our regular TB
DOTS program.
For patients of XDR TB, they are to take CAPREOMYCIN (1000 mg), MOXIFLOXACIN
(400 mg), ETHIONAMIDE (750 mg), ETHAMBUTOL (1200-1600 mg)or TERIZIDONE (750
mg)or CYCLOSERINE (750 mg), PYRAZINAMIDE (1750-2000 mg) and PAS (8000 mg) daily
for the first 6 months or the injectable phase then follow it up with MOXIFLOXACIN (400
mg), ETHIONAMIDE (750 mg), ETHAMBUTOL (1200-1600 mg) or TERIZIDONE (750 mg)or
CYCLOSERINE (750 mg), PYRAZINAMIDE (1750-2000 mg) and PAS (8000 mg) taken daily
for at least 18 months for the continuation phase. Like the medication for normal TB, the
dosages can be changed depending on the patients weight. But unlike normal TB, this
type of medication includes more drugs for longer periods of time.
11.Katrina was diagnosed with Multi-Drug Resistant TB in Saibai and flew to Australia for
treatment. However this transition led to her case developing into an XDR TB form. What
was the purported cause? Check out online or ask key DOH personnel if we have cases of
MDR or XDR TB here in the Philippines.
The purported cause of her MDR TB becoming an XDR TB is the 3 month break that
she took from taking her medicine. One MDR TB patient in the Philippines is Mildred
Fernando. Her battle against MDR TB lasted for almost 12 years resulting in her losing half
of her right lung. Now, she works as an accountant at Management Sciences for Health.
12.Prof. David Paterson stated that the antibiotic Drug Resistant strains from countries
geographically close to Australia pose a grave threat to Australia. This may imply that in
the near future we may have no antibiotics at all to treat some patients. But together with
Prof Lindsay Grayson, they suggested the following measures:
a. Improve the hand hygiene.
b. Use bleach as a cleaning product. It kills HIV, it kills all viruses, it kills everything.
c. We need to improve the hospital designs.
d. We need a set of national guidelines for invasive procedures to stop those
superbugs getting into our bloodstream.
e. If all else fails, eradicate the source or area of infection, and that means radical
surgery, and clearly that's going to impact many people's lives creating more
amputees.
Sources:

http://www.abc.net.au/4corners/stories/2012/10/29/3618608.htm
http://dev.tbsouthafrica.org/Documents/ACSM/TB_job_aids_10_08.pdf
https://www.philhealth.gov.ph/partners/providers/pdf/ComprehensiveUnifiedPolicy_TB.pdf