Latest news with #Streptococcuspneumoniae
The Star
20 hours ago
- Health
- The Star
Wrong treatment of sore throats is fuelling antimicrobial resistance
In Malaysia, as in many other countries worldwide, there is a growing concern over a silent, yet widespread epidemic caused by the excessive and often inappropriate use of antibiotics. This issue is particularly evident in the treatment of sore throats, which are usually the result of viral infections and do not require antibiotics. Despite this, overprescription remains alarmingly high, especially in primary care settings. Over the past decade, Malaysia has witnessed persistent and concerning patterns in the misuse of antibiotics for sore throats. A 2022 study in public primary care clinics found that only 2.8% of sore throat cases were caused by group A Streptococcus – the only common bacterial cause warranting antibiotics. Yet, antibiotics were prescribed to 22.3% of patients, with over 90% of those prescriptions being unnecessary. In private clinics, the situation is even more pronounced: only 42.9% of prescriptions for sore throats were appropriate, while 58.5% were excessive. On the rise again The Health Ministry has consistently raised alarms about the escalating issue of antimicrobial resistance (AMR), yet the trend of overprescribing antibiotics remains prevalent due to several key factors: Patient misconceptions A 2021 study in the journal Patient Preference and Adherence showed that 79.1% of Malaysians mistakenly believe antibiotics can cure viral infections, and 77% mistakenly believe they can cure coughs and colds. Doctor practices Many physicians in both public and private primary care settings are often influenced by patient expectations and diagnostic uncertainty, leading to the prescription of antibiotics even when they are not clinically indicated. Although antibiotic use temporarily declined during the Covid-19 pandemic due to heightened public health awareness, usage rates have since rebounded, particularly in the private sector. In 2021, antibiotic utilisation in private primary care was nearly ten times higher than in public clinics. The misuse of antibiotics contributes directly to the rise of antibiotic-resistant superbugs, which pose a significant threat to public health. A 2021 study from a Malaysian tertiary hospital, published in the journal Pathogens , identified high rates of beta-lactam resistance among common respiratory pathogens such as Streptococcus pneumoniae and Haemophilus influenzae . These pathogens, once easily treatable, now present serious challenges to effective treatment due to resistance. Community-acquired infections with methicillin-resistant Staphylococcus aureus (MRSA) are also becoming more common. ALSO READ: New antibiotics desperately needed as germs become more resistant A clinical consensus Group A Streptococcus bacteria (orange), seen here in a colourised scanning electron microscope image, are the only common cause of sore throats that warrant the use of antibiotics. — NIAID The World Health Organization's Global Antimicrobial Resistance and Use Surveillance System (GLASS) has categorised Malaysia as a high-alert nation due to the increasing threat of AMR. In comparison to other Asian countries, Malaysia is among the leading nations in terms of antibiotic overuse. To address this, the 2024 Malaysian Sore Throat Consensus – formulated and finalised in 2023 – is set to be officially launched on July 22 (2025). Developed through collaboration by a multidisciplinary panel of Malaysian experts, the consensus reflects updated evidence and local context, offering a unified, evidence-based approach to managing sore throats. Contributors included representatives from primary care, otorhinolaryngology (ear, nose and throat, or ENT), paediatrics, microbiology and infectious diseases, respiratory medicine, pharmacy, and general practice, spanning both public and private sectors. The consensus outlines several key clinical criteria and tools to guide appropriate diagnosis and management, including: Antibiotics should not be the first-line treatment unless group A Streptococcus infection is confirmed. Overprescription drives AMR. > Use of the McIsaac Score (Modified Centor Score) This is a validated scoring system assessing bacterial likelihood based on symptoms such as fever, lymph node swelling and absence of cough. A score of two or less suggests viral infection, while a score of three or less increases the likelihood of group A Streptococcus infection. Rapid antigen detection tests for group A Streptococcus improve diagnostic certainty and reduce unnecessary antibiotic prescriptions. Non-steroidal anti-inflammatory drugs (NSAIDs) like flurbiprofen lozenges or sprays, are recommended for pain relief, addressing patient needs without resorting to antibiotics. > Multidisciplinary approach Developed by a panel with broad clinical representation, the consensus ensures relevance and applicability across Malaysia's diverse healthcare settings. A stubborn problem Despite ongoing awareness efforts, misconceptions and behavioural gaps remain entrenched. Many patients continue to pressure clinicians into prescribing antibiotics and incomplete courses of antibiotics are still common. National surveys confirm that public understanding remains low, highlighting the urgent need for continuous education campaigns and for healthcare professionals to serve as active educators. AMR also brings severe economic and environmental consequences. By 2050, the World Bank estimates that AMR could shrink the global economy by up to 3.8% and push 28 million people into poverty. Treating resistant infections is up to three times more expensive than treating non-resistant ones. Overprescribed antibiotics frequently end up in wastewater, contaminating soil and rivers, and accelerating the spread of resistance in the environment. ALSO READ: Study: Superbugs expected to kill 39 million by 2050 Malaysia has already made significant strides, such as implementing stewardship programmes and launching public campaigns, but urgent, bolder steps are needed. One practical and meaningful move within the next one to three years would be to strengthen antibiotic stewardship policies in primary care, particularly for upper respiratory tract infections. This could include making clinical scoring tools or rapid antigen tests mandatory before antibiotics are prescribed and encouraging voluntary benchmarking of prescribing rates in clinics. This approach promotes accountability without public shaming, while supporting clinicians in prescribing more wisely. Looking ahead, the launch of the Malaysian Sore Throat Consensus represents a timely and critical step forward. Grounded in local data and international best practices, this national initiative, supported by British multinational health and hygiene consumer goods company Reckitt, aims to empower frontline providers with the tools, clarity and confidence to combat antibiotic misuse effectively. With firm, but supportive policies, cross-sector collaboration and consistent public education, Malaysia has the potential not only to safeguard public health domestically, but to also lead Asean in combating AMR on a regional scale. Professor Dr Baharudin Abdullah is a senior consultant otorhinolaryngologist and head and neck surgeon at Universiti Sains Malaysia. For more information, email starhealth@ The information provided is for educational and communication purposes only, and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
Hindustan Times
3 days ago
- Health
- Hindustan Times
The impact and driving force behind India's National Sickle Cell Anaemia Elimination mission
In just over a year since its launch, India's National Sickle Cell Elimination Mission (NSCEM) is already demonstrating a notable impact in the nation's fight against Sickle Cell Disease (SCD). This public health initiative, active in 278 districts across the country, has rapidly transformed the approach to both diagnosis and management of SCD. With a focus on tribal populations which are more susceptible to the disease and an ambitious target to eliminate SCD as a public health problem by 2047, the mission has achieved unprecedented reach, which is evident in its screening numbers. The initiative aims to eliminate Sickle Cell Disease by 2047. According to government statistics, more than 42 million people were screened for SCD in the first year. This figure, in comparison, is over 10 times the annual number of babies screened in the universal new born screening program in the United States (approximately 3.6 million) and 70 times more. This daily identification rate is roughly equivalent to the total number of new births affected over an entire year in the United Kingdom. Furthermore, approximately 2,500 carriers of the sickle cell trait are identified daily. While these individuals do not present immediate clinical concerns, their identification is critical for future prevention. These carriers are informed about the disease and offered premarital screening and genetic counselling to help prevent the transmission of SCD to future generations. All screened individuals are given a standardised, color-coded identity card that visually indicates their sickle cell status and reproductive risk in an accessible format. The mission's multi-pronged approach extends beyond screening to encompass comprehensive care and counselling and also future research. This includes: Prevention strategies Prevention of serious infections has played a key role in SCD management. Immunisations against Streptococcus pneumoniae and Haemophilus influenzae have improved survival rates and brought down deaths caused by the pneumococcal disease. The government is also carrying out mass screenings and those at high-risk are being counsel Prenatal screening For couples at risk, prenatal screening for SCD using advanced techniques like chorionic villus sampling and amniocentesis, is made available at Government of India's expense. This empowers families to make informed decisions. Efforts are being made to improve access to these services in geographically remote areas also. Social support and legal protection Recognising the challenges faced by individuals with SCD, the Rights of Persons with Disabilities (RPWD) Act of 2016 includes thalassemia, haemophilia, and SCD among the three haematological disorders covered. This act provides vital protections and entitlements for those with 40 per cent or more disability, including: · Accommodations at school and work, such as flexible timings and extra leave to allow for medical care · Relaxation in attendance requirements and additional time for timed examinations · Financial assistance for medical expenses · Consideration for employment opportunities in proximity to comprehensive care facilities The Act also mandates non-discrimination, upholds the right to equality and life with dignity, offers incentives for employers to hire individuals with disabilities, and provides preferences in admission to higher education courses. Advancements in disease-modifying therapies Hydroxyurea: A widely used disease-modifying therapy, Hydroxyurea (HU) has been used in patients with SCD in India since 2008. HU is dispensed free of charge through government health systems and is commercially available at low cost. It is manufactured domestically by several pharmaceutical companies, ensuring ready availability. An oral liquid formulation, stable at room temperature is also being manufactured in India, offering a significant advantage for treating children in remote, tropical regions. HU has proven effective in reducing painful episodes, blood transfusion needs, and hospitalisation rates. It is currently being given to all patients with sickle cell disease starting at two years of age. Research is ongoing to assess the efficacy of different dosages and dose escalation strategies. Advancements in curative therapies Hematopoietic Cell Transplantation: Hematopoietic Cell Transplantation (HCT), often referred to as bone marrow transplant, has been gaining popularity in India over the past four decades. The country now has 114 HCT centres, with 89 reporting results to a bone marrow transplant registry. Clinical research India is emerging as a hub for SCD clinical trials, with approximately 47 trials registered in the Clinical Trial Registry India for SCD. These trials encompass a range of interventions, including HU, haploidentical transplant conditioning regimens, and novel drug candidates pyruvate kinase activator, fetal haemoglobin (HbF) inducers. With large numbers of patients with SCD and medical services in private and academic hospitals, India has the potential to serve as a source for conducting interventional clinical trials. Looking into the future Announced by PM Narendra Modi in 2023, NSCEM is a comprehensive effort to improve the care of all SCD patients and lower disease prevalence. Some of its core pillars include: · Increasing awareness for SCD and pre-marital genetic counselling · Prevention via universal screening and early detection · Providing continuous care across primary, secondary, and tertiary healthcare levels · Strengthening tertiary and quaternary healthcare facilities · Encouraging community adoption and providing support systems The progress of the mission is meticulously tracked and updated in real-time on a public online portal, guiding resource allocation at district, state, and national levels. Furthermore, recognising the potential of transformative therapies, the Government of India has made significant investments in research to develop gene therapies for SCD domestically. While concerns about feasibility and cost in low and middle-income countries remain, India's proactive research support comes as a glimmer of hope for future curative solutions. Note to the Reader: This article has been produced on behalf of the brand by HT Brand Studio and does not have the journalistic/editorial involvement of Hindustan Times. The information provided does not constitute medical advice. Please consult a registered medical practitioner for health-related concerns.
The Print
25-06-2025
- Health
- The Print
Lancet report highlights gaps in immunisation—no routine vaccine for 14.4 lakh Indian kids in 2023
The report—published in The Lancet Wednesday—said that in 2023, more than half of the 1.57 crore unvaccinated children worldwide were living in just eight countries, primarily in sub-Saharan Africa (53 percent) and South Asia (13 percent). New Delhi: Nearly 14.4 lakh children in India did not receive a single shot of any routine vaccine in 2023, with the country recording the second-highest 'zero dose' kids, according to a new and significant analysis by the Global Burden of Disease Study Vaccine Coverage Collaborators. The lack of immunisation against deadly diseases puts children at risk of life-threatening diseases, says the World Health Organisation (WHO). 'The challenge now is how to improve vaccine delivery and uptake in areas of low coverage,' said lead author Dr Emily Haeuser. She added that the world would miss the immunisation goals for 2030 without targeted, equitable immunisation strategies, alongside the strengthening of primary healthcare and efforts to tackle vaccine misinformation and hesitancy. The World Health Organisation recommends a range of eleven three-vaccine combinations for all children globally, targeting polio, diphtheria, tetanus, pertussis, measles, mumps, rubella, tuberculosis, hepatitis B, Haemophilus influenzae type b (Hib), Streptococcus pneumoniae, rotavirus, varicella, etc. Vaccine coverage between 1980 and 2023 has globally doubled against diphtheria, tetanus, whooping cough (pertussis), measles, polio, and tuberculosis, according to the report funded by the global vaccine alliance GAVI and The Gates Foundation. Additionally, the number of children who never received a routine childhood vaccine—known as zero-dose children—declined globally by 75 percent between 1980 and 2019. Their number dropped from 5.68 crore to 1.47 crore just before the COVID-19 pandemic. But since 2010, progress has stalled or reversed in many countries, with measles vaccination declining in 100 of 204 countries between 2010 and 2019. In 2023, an estimated 1.57 crore million zero-dose children had not received any doses of the diphtheria, tetanus, and pertussis vaccines in their first year of life, the report pointed out. In India, under the Centre-run Universal Immunisation Programme, vaccines against 12 diseases are offered free of cost to all children, and in some cases, pregnant women at a specified age, via government hospitals. In a rebuttal to a United Nations Children's Fund, which had shown a high number of zero-dose children in India last year, the Union health ministry had said the 'reports depict an incomplete picture of the country's immunisation data as they do not factor in the population base and immunisation coverage of the countries compared'. ThePrint has reached out to Union Health Secretary Punya Salila Srivastava over email for a response to the report. This copy will be updated if and when a reply is received. Independent experts ThePrint spoke with pointed at the disruption in routine immunisation services during the pandemic across health systems that prioritised COVID-19 care mainly. Traditionally, misinformation and vaccine hesitancy among some population groups have constantly remained barriers. 'The number of zero-dose children has been low in some tribal and other religious minority communities due to a reluctance to accept routine vaccines over the fear of serious side effects,' infectious disease specialist Dr Ishwar Gilada said. India now needs to prioritise providing vaccination coverage to such groups, Gilada said, adding that it was paramount that people saw these figures in context, such as considering the population of India. Also Read: Don't scratch mosquito bites. Here is how to deal with itching, redness Countries with a huge vaccination gap India has consistently featured among the countries with the highest numbers of zero-dose children. According to the report, 53·5 percent of zero-dose children lived in five countries—India, China, Indonesia, Pakistan, and Bangladesh—in 1980. By 2019, most of them—52.8 percent of zero-dose children—still lived in only seven countries, which are Nigeria, India, Ethiopia, the Democratic Republic of the Congo, Brazil, Somalia, and Pakistan. The COVID-19 pandemic, which, in many areas, resulted in declining trust in public health institutions and polarised opinions on the necessity, as well as safety, of COVID-19 vaccines, has had varying effects on public perceptions regarding the importance of routine childhood vaccination and willingness to vaccinate, according to the report. Substantial increases in coverage are necessary in many countries and territories, and those in sub-Saharan Africa and South Asia face the toughest challenges, the report noted. (Edited by Madhurita Goswami) Also Read: Eli Lilly announces trial results for world's 2nd weekly insulin, aims for launch by year-end
USA Today
25-05-2025
- Health
- USA Today
Yes, pneumonia can be contagious. But here's why it depends on the form.
Yes, pneumonia can be contagious. But here's why it depends on the form. Show Caption Hide Caption Medications can add to heat related illnesses Extreme heatwaves can trigger heat exhaustion and heat stroke, but health experts say some people on specific medications can be more prone to these types of risks. Fox - Seattle For the second half of the 19th century and the early part of the 20th, pneumonia was a leading cause of death that killed hundreds of thousands of people. Sir William Osler – usually considered the father of modern medicine – described pneumonia at the time as "the most fatal of all acute diseases" because it killed about one in four of the people it infected during the Civil War. Thanks to advancements in modern medicine, though, pneumonia in the U.S. is not as fatal as it once was. Still, some 41,000 people in the country die from the disease every year – and more than 1.4 million people still visit an emergency room because of it, according to the U.S. Centers for Disease Control and Prevention. Here's what pneumonia is, what causes it and how the disease is usually treated once it has been diagnosed. What is pneumonia? Pneumonia is a serious respiratory infection that exists inside of the lungs, says Dr. Jillian Diuguid-Gerber, an internal medicine specialist at NYC Health + Hospitals/Woodhull. She explains that it's what happens when the tiny air sacs inside of the lungs (called alveoli) fill with fluid or pus. This can lead to clogged airways or inflammation that can make it difficult to breathe. Telltale shortness of breath, rapid breathing or other breathing difficulties are the most worrisome symptoms of pneumonia, as they "can be a sign of low oxygen levels," says Diuguid-Gerber. But breathing difficulties are not the only symptom of the disease. Other symptoms include chest pain, fatigue, loss of appetite, sweating "and fever and cough are especially common," says Dr. David Levine, pediatrician and the Chief of Ambulatory Pediatrics at the Atlantic Health System's Goryeb Children's Hospital in New Jersey. Symptoms of pneumonia can be concerning in anyone but are especially problematic in children as their lungs are still developing; they have smaller airways than adults. "Pneumonia can also be very worrisome in people with weakened immune systems and with existing lung problems," adds Diuguid-Gerber. Did you see? COPD can be debilitating. What exactly is it? What causes pneumonia? Pneumonia is caused by bacteria, viruses or fungi, "but usually when people are thinking of pneumonia, they are thinking of the kind caused by bacteria," says Diuguid-Gerber. She explains that the most common bacteria to cause the disease is called Streptococcus pneumoniae, but other bacteria can also cause it. These include Haemophilus influenzae, Mycoplasma pneumoniae and Staphylococcus aureus. Beyond bacteria, "viruses are also common causes of pneumonia," says Diuguid-Gerber. These include any virus that can affect the respiratory system, including influenza (flu) viruses, the adenovirus (similar to the common cold), RSV, human metapneumovirus and the coronavirus (COVID-19). While bacteria and viruses are behind most pneumonia cases, Levine says that fungi can also cause pneumonia. Pneumocystis jirovecii and Histoplasma capsulatum are the types of fungi most commonly responsible. The cause of the disease also determines whether pneumonia is contagious or not. The viral forms of it that are most contagious are transmitted "through respiratory droplets being released into the air when a person coughs, sneezes or even talks," says Levine. Heads up: RSV is common and sometimes dangerous. Here's what to know. How is pneumonia treated? Regardless of what has caused the disease to develop, symptoms of pneumonia are often targeted through everyday remedies like getting plenty of rest, staying hydrated with plenty of fluids using a humidifier to soothe irritated airways and taking over-the-counter pain relievers like ibuprofen and acetaminophen to treat discomfort. Hospitalization may be needed in order to provide oxygen support or intravenous hydration. Treating the cause of the disease can often be done with nothing more than "at-home care," says Levine, "but some cases of the disease require antibiotics." Antibiotics only treat bacterial forms of pneumonia, however, and antiviral medications are used to treat viral forms for the disease, Diuguid-Gerber explains. Antifungal medications are usually needed to treat fungal pneumonia. The discomfort of pneumonia and associated treatment can often be altogether avoided through vaccination. "Getting the pneumonia vaccine, flu vaccine or COVID vaccine could all help prevent pneumonia," says Diuguid-Gerber. Indeed, pneumonia vaccines have been shown to be between 45% and 75% effective in preventing the disease, depending on what type of pneumonia you're dealing with. And even if you're among the people who get pneumonia despite having gotten the vaccine, Levine adds, "vaccines can prevent many of the worst outcomes of the disease."
Indian Express
22-05-2025
- Health
- Indian Express
Can hospital superbugs chew up stents and implants? Here's what a new study says
A dangerous hospital-acquired bacteria can digest and live on plastics present in sutures, stents, wound dressings and implants in your body. Researchers from UK's Brunel University also found that when the bacteria used plastics as its food source, it led to the formation of more biofilms — barriers that can protect the pathogen from attacks by the immune system and antibiotics. The finding means that bacteria, such as the one they studied, could degrade medical implants, lead to infections at the site of the implant and cause infections that are harder to treat. What did the researchers find? There are bacteria in the environment that have developed the capacity to break down different types of plastics. So researchers wanted to see whether bacteria that cause infections in humans could also lead to such degradation within the body. For the study, scientists looked for different pathogens with genes that could potentially produce enzymes similar to the ones that environmental bacteria use to degrade plastics. While they found several hits, they selected a Pseudomonas aeruginosa sample that came from a patient's wound. They isolated an enzyme — which they named Pap1— that could digest a type of bio-degradable plastic frequently used in medical devices called polycaprolactone (PCL) plastic. The researchers found that the enzyme degraded 78 per cent of the plastic sample in just seven days. Importantly, the researchers found that the bacteria were not only degrading the plastic, they were also using it as their carbon source — effectively eating it. 'This means we need to reconsider how pathogens exist in the hospital environment. Plastics, including plastic surfaces, could potentially be food for these bacteria. Pathogens with this ability could survive for longer in hospitals,' Dr Ronan McCarthy, author and professor of biomedical sciences at Brunel University, said in a release. Why is this concerning? This is concerning for several reasons: One, bacteria could live on in hospitals or within a patient even when there aren't any other nutrients present. Two, they could degrade medical devices that use plastics, leading to their failure. This could lead to a rethink of materials that should be used for medical devices. Three, researchers found that the plastic-digesting bacteria could cause more severe infections. The researchers further found that the bacteria were using the broken down plastic molecules to create biofilms (a matrix made of sugars, proteins, fats and DNA) that make pathogens more resistant and difficult to treat. Four, degrading medical devices would also mean that the pathogens would be able to create pits and niches within the human body, where it could be shielded from the immune system and antibiotics, again causing difficult-to-treat infections. Are there other pathogens that could have this ability? Researchers found that other pathogens like Streptococcus pneumoniae, Klebsiella pneumoniae and Acinetobacter baumannii, too, carried genes that could potentially create plastic-digesting enzymes. More studies are needed. Importantly, the researchers found that Pap1 enzyme was structurally similar to known enzymes that can degrade even more hardy plastics such as PET bottles.
