Maryn McKenna

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Does Foodborne Illness Trigger Lifelong Health Problems?

March 30, 2012 By Maryn Leave a Comment

I have a new column up at Scientific American about a health issue that is really just starting to be discussed: Whether foodborne illness causes long-term health problems, and therefore whether it should be a higher medical and public-health priority than it is now.

Quick summary: The few studies that have followed victims of foodborne illness for years afterward show that later in life, they suffer higher-than-usual rates not only of digestive trouble, but of arthritis and kidney problems, as well as greater risk of heart attack and stroke.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: CDC, food, food policy, foodborne, SciAm, Science Blogs

Why Is Type 1 Diabetes Rising Worldwide?

January 26, 2012 By Maryn Leave a Comment

We’ve gotten sadly accustomed by now to warnings about obesity and its effect on health: joint damage, heart disease, stroke, diabetes and its complications such as blindness and amputation. We almost take for granted that as obesity increases worldwide, diabetes will also, and it is. That is, type 2 diabetes — the kind that is linked to obesity and used to be called adult-onset diabetes — is rising as obesity does.

But here’s a puzzle: Type 1 diabetes — the autoimmune disease that begins in childhood and used to be called juvenile-onset diabetes — is rising too, around the globe, at 3 percent to 5 percent per year. And at this point, no one can quite say why.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: diabetes, food, food policy, SciAm, Science Blogs

Fecal Transplants: They Work, the Regulations Don't

December 9, 2011 By Maryn Leave a Comment

Lara Thompson was 26 when her life fell apart.

She was living in Rhode Island and working in HIV prevention research when she unexpectedly developed nausea and diarrhea. It was early 2008, a few weeks after New Year’s, and she thought she might have picked up a stomach virus at a holiday gathering, or stressed her system with overindulgence. She expected the symptoms would pass after a few days. They didn’t.

“In three weeks, I dropped 15-20 pounds,” she says now. “I couldn’t keep anything in; I would have to run to the bathroom at a moment’s notice. I was so lethargic I had to stay home from work.”

When she consulted her doctor, she found out what was bothering her was more complex than a virus. Somehow, her intestinal lining had become infected with Clostridium difficile, or C. diff, a tough and persistent bacterium that has been rising in incidence and gaining antibiotic resistance, becoming increasingly difficult to treat.

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Filed Under: Science, Science Blogs, Superbug Tagged With: C.diff, FDA, microbiome, SciAm, Science Blogs

The Enemy Within: A new superbug, KPC/CRKP

March 28, 2011 By Maryn Leave a Comment

Remember NDM-1, the “Indian supergene” that created a media furor last fall and then fell below the news horizon? This is worse.

I have a story in the April Scientific American (“The Enemy Within,” just previewed online) about a new and very troubling form of antibiotic resistance: Carbapenem resistance, spreading through Gram-negative bacteria such as Klebsiella (above, from the CDC) and E. coli.

Carbapenems are drugs of last resort for Gram-negatives, which include many of the bacteria that cause potentially deadly infections in debilitated ICU patients and frail elderly in nursing homes. Gram-negatives have been becoming ever-more resistant to antibiotics, but the carbapenems remained reliable drugs of last resort for even the most serious cases. Then, in 1996, researchers at the Centers for Disease Control and Prevention spotted the first signal that carbapenems were under threat: A single bacterial sample, found in a patient in a North Carolina hospital, that was resistant to the carbapenems and could only be treated by a few remaining drugs that were much less effective or so toxic that medicine had put them on the shelf years ago.

By 2000, that same resistance pattern surfaced in hospitals in Manhattan: first one, then another, then a third and fourth. Then it began to spread to cities where New Yorkers vacation, and then to countries where they travel. Now, more than a decade later, it has reached at least 37 states and at least a dozen countries around the world.

It is spreading much faster than drugs to combat it could be developed — if there were such drugs. One of the difficulties, indeed tragedies, of carbapenem resistance is that there are very few such drugs left — because, for reasons I’ve explored before, drug development in the United States has ground to a halt. For resistant Gram-negatives, there are almost no drugs left, and none on the immediate horizon. If that scares you, well, it should.

Here’s a quick snip from the article:

The end of the antibiotic miracle is not a new theme. For as long as there have been antibiotics, there has been antibiotic resistance: The first penicillin-resistant bacteria surfaced before penicillin was even released to the marketplace in the 1940s. And for almost that long, doctors have raised the alarm over running out of drugs, sparked by the global spread of penicillin-resistant organisms in the 1950s and followed by methicillin resistance in the 1980s and vancomycin resistance in the 1990s.

This time, though, the prediction of post-antibiotic doom comes from a different part of the microbial world. The genes that confer carbapenem resistance have appeared over the past decade or so in a particularly challenging grouping of bacteria called gram-negatives.

Gram-negative bacteria are promiscuous: They facilely exchange bits of DNA, so that a resistance gene that arises in Klebsiella, for example, quickly migrates to E. coli, Acinetobacter and other gram-negative species. Gram-negative germs are also harder to dispatch with antibiotics because they have a double-layered membrane that even powerful drugs struggle to penetrate, and possess certain internal cellular defenses as well. In addition, fewer options exist for treating them. Pharmaceutical firms are making few new antibiotics of any type these days. For the protean, stubborn gram-negatives, they have no new compounds in the pipeline at all.

Carbapenem resistance has already brought hospital-acquired infections to the brink of untreatable. The imagined future that keeps health authorities awake at night is the undetected dissemination of carbapenem resistance genes into organisms that cause everyday maladies—such as E. coli, which is responsible for most of the millions of urinary tract infections in the U.S. every year.

Carbapenem resistance in Klebsiella — which is sometimes called KPC or CRKP for short — got a spike of attention last week just as my piece hit the web. Coincidentally, the article posted just as the Los Angeles County Department of Public Health released results of a survey showing 356 cases just between June and December 2010 just in LA County medical facilities.

This SciAm piece is the first that we know of to tell the whole tangled, troubling story. I hope you’ll take a look.

And while you’re there, please read SciAm’s brave and cogent editorial against antibiotic overuse in industrial-scale agriculture. It’s marvelous.

CDC Public Health Image Library

Filed Under: Science, Science Blogs, Superbug Tagged With: agriculture, antibiotics, CDC, CRKP, KPC, Resistance, SciAm, Science Blogs

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