Difference between revisions of "Team:XJTLU-CHINA/HP/Gold Integrated"
m |
|||
| Line 136: | Line 136: | ||
<i>Staphylococcus aureus</i> (MRSA) for example, that can turn into a global health issue. Hence, to figure | <i>Staphylococcus aureus</i> (MRSA) for example, that can turn into a global health issue. Hence, to figure | ||
out the real situation of antibiotic use in clinical practices and to better understand gastrointestinal | out the real situation of antibiotic use in clinical practices and to better understand gastrointestinal | ||
| − | diseases and their treatments, on the 28th of June, we invited an expert | + | diseases and their treatments, on the 28th of June, we invited an expert Ms. Hui Shi from the |
Department of Gastroenterology & Hepatology in Nanjing General Hospital to conduct a field investigation | Department of Gastroenterology & Hepatology in Nanjing General Hospital to conduct a field investigation | ||
on the situation of antibiotic abuse, colonization of bacteria in the intestine and the universal treatment | on the situation of antibiotic abuse, colonization of bacteria in the intestine and the universal treatment | ||
Revision as of 07:06, 28 October 2017
HP Gold
Activity: Questionnaire Survey
In China, overuse of antibiotics is a severe problem. The alarming data shows that China has become one of the world’s top antibiotics consuming countries, with an annual per-capita consumption of antibiotics at 138 grams, or 10 times that of an average American (The Nation, 2013). The overuse of antibiotics is not only driven by physicians, but also by patients themselves. Patients frequently ask for prescribing antibiotics for some common conditions, for example, diarrhea, and sometimes even fall out with their physicians over the use of antibiotics. Patients who like to self-medicate purchase inappropriate antibiotics over the counter in pharmacies easily.
Therefore, with an aim to figure out patients’ perception of medical treatment and to improve our project design by making it more applicable so that it can handle real life problems, we conducted a public survey to better understand how bacterial enteritis are treated in daily life as well as the current situations of antibiotic overuse.
150 people had participated in the public survey, and their age ranges from 16 to 50 and the gender of the participants is relatively equal, making the statistical data relatively effective and reliable. According to the survey (Figure 1), only 25% of the patients with serious diarrhea caused by Staphylococcus aureus infection choose to go to hospital while the others just take some medicine by themselves.
For patients who take medicine by themselves, over 50% of them will take antibiotics as their first choice, Smecta being the second. This phenomenon revealed a widespread use of antibiotics in daily enteritis treatment, which may not be a wise option due to a series of side effects and the well-known existence of antibiotic resistance.
In addition to investigating the current condition of antibiotic overuse, we also asked what other measures people will take to prevent such diseases. For the majority of people, suggested by the data above, they tend to take yogurts as a preventive solution rather than Chinese medicine, giving us some clues to our project design. It is likely for us to insert the gene of antimicrobial peptides into a certain kind of probiotics. Thereafter, the genetically modified probiotics can be made into a daily yogurt product that can later be manufactured, which is likely to benefit thousands of patients who suffer from serious bacterial enteritis.
Activity: Visit to Nanjing General Hospital
China has a higher rate of antibiotic use and abuse than many western countries. One of the most dangerous potential consequences of rampant antibiotic abuse is the rapid rise of antibiotic-resistant “superbugs”, methicillin-resistant Staphylococcus aureus (MRSA) for example, that can turn into a global health issue. Hence, to figure out the real situation of antibiotic use in clinical practices and to better understand gastrointestinal diseases and their treatments, on the 28th of June, we invited an expert Ms. Hui Shi from the Department of Gastroenterology & Hepatology in Nanjing General Hospital to conduct a field investigation on the situation of antibiotic abuse, colonization of bacteria in the intestine and the universal treatment of gastrointestinal diseases.
In accordance with Ms. Shi’s words, the abuse of antibiotics in China, though has been improved a lot, yet still not negligible. Just in the case of Nanjing General Hospital, the patients can be treated with antibiotics only after getting doctors’ prescription. Fortunately, we got the data concerning the use of antibiotics from the survey and showed below:
From the survey, the most common intervention was rehydration therapy (62%) and the most common drugs are antibiotics (61%), which is followed by dioctahedral smectite (59%), probiotics (48%) and herbal medicine (32%). Therefore, this shows that there exists an extreme misuse of antibiotics in the clinic and this data also serves as a reminder that nationwide education in the rational use of antibiotics is essential.
In addition, Ms. Shi shared with us the stories about the antibiotic resistant Staphylococcus aureus. In the early 1940s, the introduction of penicillin in staphylococcal infection dramatically improved the cure of patients. However, a few years later, penicillin-resistant staphylococci were recognized, first in hospitals and subsequently in the community. By the end of 1960s, more than 80% of both community and hospital-acquired staphylococcal isolates were resistant to penicillin. Thereafter, methicillin, a penicillinase-resistant semisynthetic penicillin, was introduced. However, in less than 1 year later, methicillin-resistant S. aureus (MRSA) was reported and subsequently spread to the other parts of the world. In the 1980s, quinolones represented a significant therapeutic advancement in the treatment of patient with infection caused by S. aureus. However, quinolone resistance among S. aureus emerged quickly, more prominently than the MRSA, and became a serious clinical problem. “Therefore, if you can really use antimicrobial peptides to replace antibiotics,” said Ms. Shi, “I think it sheds light on relieving the trend that Staphylococcus aureus develops resistance to the last therapeutic resorts for fighting S. aureus infection.”
Ms. Shi also mentioned that beside the abuse of antibiotics, acute watery diarrhea, or even with blood for up to dozens of times during one day, is a very serious symptom of S. aureus infection. Diarrhea may persist for more than 14 days. And if it is MRSA infection, it may lead to pseudomembranous colitis and becomes lethal if the patients are untreated. Despite of the improvements in public health and economic wealth, the incidence of S. aureus intestinal infection still remains high and continues to be an important clinical problem.
The doctor additionally mentioned other regular methods of diagnosis of enteric infection and treatment. Initially, doctors should incubate a little sample from patients’ defecation into multiple media to identify the strain of the pathogenic bacteria that makes the patients ill. The whole diagnosis process may take a week, or if fortunately, four days at least. Therefore, it is a considerably high risk for patients who have acute diarrhea. For the treatment part, doctors usually test the tolerance of morbigenous bacteria to distinct antibiotics. At last, they prescribe the most effective antibiotic or a combination of several antibiotics to cure the illness. After this, due to the killing effects on the enteric microbial flora, post-treatment recovery is to let the patients ingest pills which are full of dry bacteria such as Bifidobacteria. In sum, the whole therapy costs more than one week. Hence, safer and effective biological therapy manifests to be in strong demand.
Finally, Ms. Shi also offered suggestions for us to protect the engineered bacteria in order to make the bacteria specifically release only in the proper intestinal environment. Acrylic resin should be used as the enteric coating. Based on different of pH, diverse materials can be chosen. In addition, although many researchers support the view that probiotics can shorten the duration of acute diarrhea illness, more experiments are needed to provide a definitive answer to the question on whether the engineered Lactococcus lactis can really regulate the micro-ecological balance in the intestine.
Collaborators and Supporters
