The Levy CIMAR's Dr. Bree Aldridge Explains Combination Drug Therapies, DiaMOND, and How Researchers are Working to Improve Patient Outcomes
Using two or more drugs together as treatment is a simple idea with a complicated underpinning. In order to combine drugs to treat complex infections such as tuberculosis, HIV, and most cancers, we have to understand how their mechanisms work together first. One drug may target one pathway, another drug another pathway. If infected cells grow at different rates, some classes of antibiotics kill the fast-growing cells better, while others are better at killing the slow ones. There can be thousands of combinations to measure. If the right combinations are found, such multidrug therapy may increase treatment efficacy and prevent the development of drug resistance, both important long-term goals.
The Levy CIMAR’s Alysse G. Wurcel, M.D., from Tufts Medical Center in Boston, and colleagues assessed disparities in SSTI treatment using data from the national survey of Acute Care Hospital Groups within Vizient Inc. (Oct.16, 2018, to Jan. 13, 2019). The researchers found that Cefazolin was more commonly used in White inpatients versus Black inpatients (13 versus 5 percent), while clindamycin was more frequently used in Black inpatients than White inpatients (12 versus 7 percent). Cefazolin is one of the first-line SSTI treatments. Clindamycin is not recommended given frequent dosing and high potential for adverse effects including Clostridioides difficile infection.
The discovery of drugs appears to obey a rule christened Eroom’s Law. In a nutshell, the number of drugs approved for every billion dollars’ worth of research and development (R&D) halves every nine years. This pattern has remained largely consistent for over 70 years. Since 1950, the cost of developing a new drug has risen at least 80-fold. A Tufts University study suggests that the cost of developing a drug approved by the U.S. Food and Drug Administration (FDA) rose at least 13 times between 1975 and 2009. By the mid-2000s it was $1.3 billion. In the 1960s, by contrast, costs per drug developed were around $5 million. Timelines, at least pre-Covid, are likewise extended. Eroom’s Law shows that it takes more and more effort and money to develop new drugs. Achieving a pharmaceutical breakthrough is on a trend of increasing difficulty.
Drug-Resistant Infections in the US Have Risen Sharply During the Pandemic, and Experts Warn it's Getting Worse as COVID Patients Overwhelm Hospital Resources
Drug-resistant “superbugs” pose a dire threat in hospitals, where an antibiotic-resistant germ like MRSA could leave an already sick patient without any treatment options. Superbugs were a topic of concern in the medical community long before COVID-19 was in our vocabulary, says the Levy CIMAR’s Helen Boucher, MD, an infectious disease physician at Tufts Medical Center and interim dean of Tufts University School of Medicine. “It’s a growing problem, and many of us call it a silent pandemic, because it is, ever, ever so much still with us, despite our very appropriate focus on COVID,” she says.
Bacteriophage Therapy Market 2021 Share Leaders, Current Status, Industry Size By Major Key Vendors, Trends
Coherent Market Insights recently published an in depth study of Bacteriophages Therapy Market covering interesting aspects of the market with supporting development scenarios starting from 2021-2027. The report delivers the clean elaborated structure of the Market comprising each and each business-related information of the market at a worldwide level. the entire range of data associated with the worldwide Market is obtained through various sources. PhagePro, Inc., co-founded by the Levy CIMAR’s Andrew Camilli, PhD, is listed among key players focusing on bacteriophage therapies.
As COVID-19 cases rise once again, and as variants continue to spread, the Centers for Disease Control and Prevention are recommending that vaccinated people start wearing masks indoors, in many situations. The recommendation applies to areas considered to have a “high and substantial transmission” of COVID-19, and in K-12 schools. The Levy CIMAR’s Dr. Shira Doron, an infectious disease physician and hospital epidemiologist at Tufts Medical Center, joined WBUR’s Morning Edition to discuss what this means for Americanas and how this affects Massachusetts residents in particular.
“Before antibiotics, a simple skin infection had a 10% chance of killing you. People never think about that today, because we have antibiotics that cure all bacterial skin infections. We don’t think about skin infections as being a problem at all,” says Dr. Helen W. Boucher of the Levy CIMAR and interim Dean of the Tufts University School of Medicine in Boston. But now, she warns, time for many of these drugs is running out. Antimicrobial resistance is turning back nearly a century of work to prevent deaths from bacterial and fungal infections. In the U.S. alone, nearly 3 million people annually are believed to fall ill to antibiotic-resistant bacterial infections, and more than 35,000 of the patients die.
Dozens of studies show that for many bacterial infections, a short course of antibiotics, measured in days, performs as well as the traditional course, measured in weeks. Shorter courses also carry a lower risk of side effects. In April the strength of this research persuaded the American College of Physicians to issue new “best practice advice” for four kinds of infections: pneumonia (the kind acquired in the community rather than in a hospital), “uncomplicated” urinary tract infections (UTIs), skin infections known as cellulitis (provided there is no pus) and acute bronchitis in people with chronic obstructive pulmonary disease.
Many people are worried that the rise of the delta variant of the coronavirus, which is more contagious than the earlier variants and has become the dominant strain in the U.S., as well as in Massachusetts. Among the questions people have been wondering is whether they need to wear masks inside again indoors, even if they’ve been vaccinated. The World Health Organization recently said they should, but the U.S. Centers for Disease Control and Prevention says that’s unnecessary.Experts including the Levy CIMAR’s Dr. Shira Doron, an infectious disease physician and epidemiologist at Tufts Medical Center, weigh in.
Thanks to vaccines, the number of COVID-19 cases has plummeted in the U.S. and restrictions are being lifted across the country. But as we return to our normal activities, we face a more familiar summertime scourge. We’re in the thick of Lyme disease season, the two-month run from early June to the end of July when 85 percent of infections take place. Surprisingly, vaccines may have allowed us to avoid this epidemic, too. A vaccine called LYMErix has existed for decades, but it’s no longer available. In this article, you will learn why LYMErix is no longer available and discover where the research stands today.
Helen Boucher, MD, chief of the Division of Geographic Medicine and Infectious Diseases at Tufts Medical Center, professor of medicine at Tufts University School of Medicine, and a director of the Stuart B. Levy Center for Integrated Management of Antimicrobial Resistance (Levy CIMAR), has been named to a new, joint position as interim dean for Tufts University School of Medicine and chief academic officer for Wellforce, beginning July 1. Dr. Boucher will be the first woman to lead the School of Medicine in its 128-year history. Cheleste Thorpe, MD, will step in as Interim Director to lead the Levy CIMAR alongside Director Ralph Isberg, PhD.
Plotting the End of Lyme Disease: Tufts Researchers Lead the Cutting Edge of Fighting this Mysterious Illness
As people weary of being cooped up during a pandemic winter look forward to a summer outside, residents across the northeastern United States are once again confronted with a familiar virulent pathogen lurking in the woods and fields. Unlike coronavirus, however, this dangerous microorganism doesn’t float through the air—it enters the body through the bite of a tick. Lyme disease has been a constant scourge since it was identified five decades ago on the Connecticut coastline, before spreading across the New England and Mid-Atlantic states. Several Levy CIMAR are involved in the fight against Lyme including Senior Leadership Members Drs. David Snydman and John Leong.
Last week, the College of the Holy Cross presented seven alumni with Sanctae Crucis Awards for their extraordinary commitment and leadership in critical fields throughout the COVID-19 pandemic. The Sanctae Crucis Award is the highest non-degree accolade that the College bestows on alumni. The awards have been presented annually since 1998 to alumni who have distinguished themselves professionally and in the service of their community. Among the awardees is Levy CIMAR Director Dr. Helen Boucher, Chief of Infectious Diseases at Tufts Medical Center. She graduated from Holy Cross in 1986 prior to attending the University of Texas Medical School in Houston.
The pandemic isn’t over yet, but with more and more Americans getting vaccinated against COVID-19 and the light at the end of the pandemic tunnel becoming a little brighter every day—at least in the United States—many clinicians, scientists, and public health advocates are calling for renewed attention to an infectious disease threat that was in the spotlight before the pandemic arrived. Prior to the pandemic, antimicrobial resistance (AMR) was considered one of the major looming health threats facing the world, if not the looming threat. But over the past year, COVID-19, and its multifaceted impact on society, has pushed AMR further back on the agenda, both for the public and policy makers.
In this guest column, Levy CIMAR Director Dr. Helen Boucher says, “The Biden administration’s plan to defeat the coronavirus is underway – and notably includes intentions to ‘build better preparedness for future threats.’ This detailed guidance could not have come at a better time. While we are making progress against the current pandemic, we remain in the midst of a worsening health crisis posed by antibiotic resistance. Deadly bacteria, commonly known as ‘superbugs,’ are evolving to resist even our strongest antibiotics, and we’re not even close to developing enough new treatments to keep pace.”
Millions of Americans have at some point in their lives gotten a long course of antibiotics to treat a bacterial infection. But according to new recommendations from a major U.S. doctors’ group, some of the most common bacterial infections can now be treated with shorter courses of the drugs. The advice, from the American College of Physicians (ACP), says that for several types of infections, shorter courses of antibiotics do the job — and even do it more safely. “Antibiotics can be lifesaving, but like any medication, they have side effects,” says Levy CIMAR Director Dr. Helen Boucher.
The NIH has awarded $2.5 million in grants to 12 institutes around the world to support research on bacteriophage therapy. Boston-based PhagePro, Inc. and Principal Investigators Minmin Yen and the Levy CIMAR’s Andrew Camilli were among the recipients named. These awards represent NIAID’s first series of grants focused exclusively on research on this therapy, an emerging field that could yield new ways to fight antimicrobial-resistant bacteria. A 2019 report from CDC found that antibiotic-resistant pathogens cause more than 2.8 million infections in the U.S. each year and more than 35,000 people die.
Levy CIMAR Joins Forces with Filmmakers for 'Beating Superbugs' Documentary and Panel World Premiere
“The pandemic has forced keen awareness of a topic that most people would rather not talk about,” says Beating Superbugs: How Can We Win? filmmaker Bill Mudge. “Most importantly, we emphasize real solutions rather than feeding an all too pervasive crisis fatigue. Regardless, there’s nothing quick, cheap, or easy about containing superbugs but it definitely can be done.” You can now watch this timely film and panel event, featuring several experts including our own Dr. Helen Boucher, as well asa our affiliate member Dr. Muhammad Zaman, from your mobile devices, computers, or TVs on Vimeo.
Tufts Medical Center in Boston began administering the Johnson & Johnson COVID-19 vaccine Thursday, giving Massachusetts a third vaccination option in its push to get more shots in arms. The Levy CIMAR’s Helen Boucher, Chief of Infectious Diseases at Tufts Medical Center, urged vaccinated residents to continue to keep their guard up to protect themselves and others.“I encourage people as good citizens and good Americans to continue to wear their masks,” she said. Watch the full story on WHDH online.
The COVID-19 pandemic has shown what happens when we let our guard down against infectious disease, despite years of increasingly loud warnings. So it’s time to be even more worried about antibiotic-resistant germs. What policy steps can fight this growing problem? Recently STAT convened policymakers, researchers, and corporate executives to chart a path to progress. Levy CIMAR Director Helen W. Boucher M.D., Chief of Division of Geographic Medicine and Infectious Diseases at Tufts Medical Center, joined the discussion.
The COVID-19 pandemic has revealed the deadly impacts of structural racism and systemic health inequalities on racial and ethnic minorities in the USA. Black and Hispanic/Latinx populations have been disproportionately impacted by COVID-19, accounting for nearly half of the cases and 37% of the deaths so far, despite making up less than a third of the US population. This stark imbalance has highlighted the need to examine the role of racial and ethnic disparities in shaping health outcomes, particularly with respect to Antimicrobial Resistance, say Levy CIMAR’s Drs. Maya Nadimpalli and Shira Doron.
With Ticks Spreading Across the Country, the CDC Says There May Be Nearly Half a Million Cases of Lyme Annually
Between 2010 and 2018, the U.S. had approximately 476,000 cases of Lyme disease every year, according to the CDC. That number is substantially higher than the CDC’s previous estimates, of about 300,000 annual Lyme cases. Linden Hu, MD, of the Tufts Lyme Disease Initiative, notes that the true number of cases of Lyme disease probably varies widely from one year to the next based on changes in tick density in different areas, weather patterns, and more. Still, he says, “there certainly are a lot of cases, and based on the spread of tick range, and things like that, we do anticipate that there’s an upward trend.”
Amy Pickering, PhD, has joined the faculty at UC Berkeley as Assistant Professor in Development Engineering, a joint Blum Center-College of Engineering appointment made possible through a generous gift from Richard C. Blum and an anonymous donor. There, she is also the Blum Center Distinguished Chair in Global Poverty and Practice. Pickering, formerly a Tiampo Family Assistant Professor in Civil and Environmental Engineering at Tufts University and a distinguished member of the Levy CIMAR, is now a Levy CIMAR Affiliate Member as of January 2021.
The proportion of infections among young children that are antimicrobial-resistant is increasing across the globe. Newborns may be colonized with enteric antimicrobial-resistant pathogens early in life, which is a risk factor for infection-related morbidity and mortality. Levy CIMAR Core Faculty Members, Maya Nadimpalli, PhD, Amy Pickering, PhD, and colleagues say that breastfeeding and human milk supplements deserve greater attention as potential preventive measures in the global effort to combat AMR, particularly in low- and middle-income settings. Recent evidence supports the role of breastfeeding in preventing the acquisition, establishment, and proliferation of enteric pathogens, including AMR bacteria.
“My career as a hospital epidemiologist has been based on science and evidence, which I believed to be the touchstones of my work,” says Levy CIMAR Core Faculty member Shira Doron, MD. “But COVID-19 has taught me that fear — gut-wrenching, all-consuming fear, like the fear of dying from a horrific respiratory virus — can be much more powerful than science. We can’t conquer this fear unless we acknowledge and respect it. I’m no stranger to my work keeping me awake at night. In pre-pandemic times, I sometimes lost sleep over issues like a spike in staph infections in a particular intensive care unit. Now I lie awake worrying about keeping patients safe from COVID-19.”
Massachusetts could receive enough doses of Pfizer’s vaccine by Christmas to vaccinate 300,000 people. How significant is that number? And how quickly could it slow our rate of new cases? According to Levy CIMAR Director Helen Boucher, MD, Chief of Infectious Diseases at Tufts Medical Center: “That is a significant number. It is a larger number than we had expected, so this is good news. I do think we have to temper that with understanding it is going to take weeks to months before we reach the levels of immunity that will stop the spread of the virus. I think our estimates of some time to the spring and summer next year before we reach that 60-70% to allow us to get back to everyday activities is still reasonable.”
Over the past decade, the world has witnessed unprecedented scale-up of antiretroviral therapy (ART) which has saved the lives of tens of millions of people. As of December 2019, 25.4 million people out of an estimated 38 million people living with HIV were receiving ART globally. Increased use of ART has, not unexpectedly, been accompanied by the emergence of some degree of HIV drug resistance, the levels of which have steadily increased in recent years. Join the WHO and experts in the field including the Levy CIMAR’s Michael Jordan, MD, for a webinar on “Addressing HIV drug resistance to protect the effectiveness of HIV treatment” in celebration of World Antimicrobial Awareness Week.
If you’re planning on relying on a COVID-19 test as the go-ahead before spending Thanksgiving with people from other households, experts say that doesn’t necessarily ensure the virus won’t spread. “A test is just one point in time,” said Levy CIMAR Director Dr. Helen Boucher, chief of infectious diseases at Tufts Medical Center. “The incubation period for this virus is 14 days. Just because someone tests negative today doesn’t mean they won’t be positive tomorrow or in the next 13 days.” A large dinner in which people from different households sit closely together indoors, maskless, could create a “perfect storm” for COVID19 spread, she said.
The global COVID-19 pandemic has been raging on for months, but some experts warn another health crisis is looming: Antibiotic-resistant bacteria or so-called “superbugs.” Levy CIMAR Director Dr. Helen Boucher said drug-resistant infections have grown significantly in the past 10 years due to antibiotic overuse and misuse. She said some doctors are overprescribing drugs and some patients are not taking them properly. “We shouldn’t ask for antibiotics for things like colds which are caused by viruses and for which antibiotics won’t help,” Boucher said. “We should really take them, these precious medicines, exactly as prescribed so we can do our part to prevent more resistance.”
According to the Center for Infectious Disease Research and Policy, caring for COVID-19 patients is causing shortages of that drug and several others, including heart medication norepinephrine, albuterol inhalers which are often used by asthma patients, certain antibiotics and propofol, a sedative used to calm patients while they are intubated. “Just like testing materials, medical equipment and PPE, drugs — even the ones we commonly use for everyday medical conditions and hospitalized patients — are in short supply since the pandemic began, and all of those shortages have the potential to negatively impact the care of patients in Boston,” said Levy CIMAR’s Dr. Shira Doron, an epidemiologist with Tufts Medical Center.
Tufts Medical Center Hospital Epidemiologist and Levy CIMAR Core Faculty Member Dr. Shira Doron discusses the increase in COVID-19 cases in Massachusetts, the role of social gatherings in spreading the virus, coronavirus in wastewater, and shortages of critical drugs in her weekly appearance on WCVB. ‘The data suggests that right now, every infected person is on average transmitting the infection to more than one other person,” says Doron. ” Therefore, if we change nothing at all, we can expect to see the numbers continue to rise faster and faster. The time is now to double down on those efforts to avoid situations.”
There’s a long road from discovering a potential drug to getting it approved for human use. Levy CIMAR’s Bree Aldridge, Ph.D., thinks the process could be speeded up by using a computerized imaging system that looks at how bacterial cells are deformed by a drug. Such changes can give hints as to what part of a cell’s biology the drug is acting on. “We think we know what a drug does, but then if you look at how it actually destroys the cells, we can sometimes see that it’s a little bit different,” Aldridge says. “This sort of method allows us to rapidly determine whether a drug is acting like known drugs or whether a drug is doing something that’s novel.” If it’s novel, it might be a class that bacteria are not yet resistant to.
The U.S. government released an update to its National Action Plan for Combating Antibiotic-Resistant Bacteria (NAP CARB), which aims to combat antibiotic-resistant bacteria and subsequent infections. There are more than 2.8 million antibiotic-resistant infections—and 35,000 deaths—in the U.S. each year. Among other things, the Plan aims to slow the growth of resistant bacteria and prevent infections from spreading, strengthen surveillance efforts, and advance development and use of rapid diagnostic tests.
“Regardless of the role wet markets will play in future respiratory virus epidemics, wet markets pose additional zoonotic health risks that must be prioritised by global health researchers and policy makers. Specifically, wet markets could be hotspots for enteric pathogen transmission because of poor and unregulated hygiene conditions. … Building improved wet market infrastructure is urgently needed, particularly in low-resource settings.” — Levy CIMAR Core Faculty members Drs. Maya Nadimpalli and Amy Pickering
The Center for Integrated Management of Antimicrobial Resistance, a collaborative effort supported by Tufts University and Tufts Medical Center, has been renamed the Stuart B. Levy Center for Integrated Management of Antimicrobial Resistance (Levy CIMAR) at Tufts, in honor of the pioneering antibiotic-resistance researcher. Levy, a professor emeritus of molecular biology and microbiology at Tufts University School of Medicine and a staff physician at Tufts Medical Center, passed away in September 2019 at the age of 80. He retired in 2018 after 47 years at Tufts.
COVID-19 can be accompanied by secondary bacterial infections with deadly consequences. But the industry that researches and produces antibiotics to fight such illnesses has been upended — and the pandemic is only making things worse. Now, medical experts worry about the long-term health implications of not having cutting-edge antibiotics in the pharmaceutical pipeline. Per CIMAR Dir. Dr. Helen Boucher: “This need to have a robust and renewable pipeline of antibiotics has really never been greater.
A letter sent by the leadership of the Infectious Disease Society of America (IDSA) including board member, CIMAR Dir. Dr. Helen Boucher, as well as those from dozens of other organizations calls on the Trump administration to reverse its decision to bypass the US Centers for Disease Control and Prevention (CDC) in “the collection and analysis of COVID-19 patient data.”
A new technology that combines high throughput imaging and machine learning could speed discovery of drugs to fight tuberculosis, which for generations has killed more people worldwide than any other disease caused by a single agent—4,000 people every day. “We urgently need shorter, more effective TB therapies, and MorphEUS enables us to screen through drug candidates, see how they actually affect the cell, and learn which drugs have unique ways to kill the M. tb,” says CIMAR’s Dr.Bree Aldridge.
Nearly 20,000 people have now tested positive for the novel coronavirus in Massachusetts. Well over 500 have died. With the surge in COVID-19 hospitalizations fast approaching in Massachusetts, WBUR’s Weekend Edition joined Dr. Helen Boucher, chief of the Division of Geographic Medicine and Infectious Diseases at Tufts Medical Center, to discuss where we are now on the infection curve and what to expect in the coming weeks.
CIMAR and Tufts Medical Center's Dr. Shira Doron Discusses What SARS-CoV2 Antibody Tests Might Reveal
Dr. Shira Doron, Core Faculty Member of CIMAR and hospital epidemiologist at Tufts Medical Center, answers questions about what the hospital is seeing in patients and what antibody tests available may show. She also discusses the anticipated surge in COVID-19 hospitalizations in Massachusetts and more.
Antibiotics make procedures including joint replacement, transplantation, cancer chemotherapy, and premature newborn care possible. Recent reports have warned of the dangerously failing antibiotic pipeline; on January 18, the World Health Organization issued an unprecedented warning, declaring that “only government intervention can fix the broken market for antimicrobial drugs.”
One surprising trait: Patients who seem to be recovering can suddenly crash. CIMAR’s Dr. Gabriela Andujar Vazquez, an infectious disease physician at Tufts Medical Center in Boston, said patients should also watch for chest pain, and advised anyone experiencing chest pain or breathing difficulty to head to the emergency room. “People need to really monitor themselves for the first week. After the first week, you’ll either get better or worse,” she says.
Most of the time, we can count on our clothes to offer us protection from the outside world. In the midst of the novel coronavirus pandemic, however, it’s easy to see them as a potential threat — particularly if you’re not sure how you should be washing them. If you’ve arrived home from errands concerned about how long coronavirus live on your clothes, it may offer comfort that by staying vigilant, you can safely re-wear favorite pieces and dress how you please.
Calculations, Concerns, & Crisis: The struggle to find masks and gowns spurs local hospitals to make drastic decisions
CIMAR’s Dr. Shira Doron, an infectious disease physician and epidemiologist at Tufts Medical Center, was exhausted. Minute by minute, the supply numbers changed, donations came in, patient predictions soared. At this rate, if patient numbers doubled daily, staff would run out of masks in a matter of days. If the health system could go through fewer supplies each day, a slower burn rate, maybe they could last a few weeks.
CIMAR Director Dr. Helen Boucher discusses the training that goes into being an infectious diseases specialist, as well as what ID clinicians such as herself are doing to diagnose, treat, educate, and protect the public in the face of the COVID-19 pandemic.
"Continue What We’re Doing as Long as Possible:" CIMAR's Dr. Shira Doron Says Social Distancing Must Continue
While some politicians, including the President, are looking to ease restrictions keeping people from work, CIMAR’s Dr. Shira Doron (an Attending Physician, Hospital Epidemiologist, and Antimicrobial Steward at Tufts Medical Center) says distancing needs to continue during the COVID-19 pandemic while medical professionals deal with a shortage of supplies.
CIMAR featured trainee, Dr. Gabriela Andujar Vazquez, has several tips including calling up any restaurant you plan on ordering from and asking specific questions about what they’re doing to deter the spread of coronavirus at all stages of the cooking and handling process.
With schools shut down across the Bay State for the next three weeks in an attempt to stop the spread of the coronavirus, parents are faced with the tough question of whether or not to let their kids socialize. CIMAR’s Dr. Helen Boucher is urging families to think small when it comes to playdates.
CIMAR Director Dr. Helen Boucher, Chief of Geographic Medicine and Infectious Diseases at Tufts Medical Center, and Dr. Joshua Barocas of Boston Medical Center and the Boston University School of Medicine joined WBUR to answer listener questions about COVID-19/Novel Coronavirus.
The number of coronavirus cases in Massachusetts is climbing. CIMAR Director Dr. Helen Boucher, Chief of Geographic Medicines and Infectious Disease at Tufts Medical Center, joined WBUR’s Morning Edition host Bob Oakes to help put the numbers in perspective.
In two new reports, the global health agency says only government intervention can fix the broken market for new antimicrobial drugs. “We can’t have more companies going bankrupt,” said CIMAR Director Dr. Helen Boucher, an infectious disease specialist at Tufts Medical Center and a member of the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria. “If the pipeline remains this anemic, that’s going to have real implications for our patients.”
All manner of fancy ideas have been floated to kill the superbug, when what we’ve needed is a hero willing to go toe-to-toe with these pitiless, heavily-armored bacteria. And here it is: a seek-and-destroy motorized molecular drill that is activated by light to “spin at three million rotations per second” – and ruthlessly disembowel the enemy outright. Notably, the world’s first single molecule electric motor was developed at Tufts University’s School of Arts and Sciences in 2011.
One of America’s biggest antibiotics specialists, Melinta Therapeutics Inc., filed for bankruptcy in late December, citing slow sales growth and high costs. Other makers might soon face a similar fate, saying their cash will run out before the end of 2020. “We don’t know the fate of those drugs for our patients,” said CIMAR Director Helen Boucher, chief of infectious diseases at Tufts Medical Center in Boston. “As a physician, that’s my biggest concern.”
Drug-resistant germs sicken about 3 million people every year in the United States and kill about 35,000, representing a much larger public health threat than previously understood, according to a long-awaited report released Wednesday by the Centers for Disease Control and Prevention. The new estimates show that, on average, someone in the United States gets an antibiotic-resistant infection every 11 seconds, and every 15 minutes, someone dies.
“We see people from everyday life, who are young and otherwise healthy, who get a MRSA [methicillin-resistant Staphylococcus aureus] infection on their skin,” says CIMAR Director Dr. Helen Boucher. “We want to have diagnostic tools and medical treatments for problems we know we’re going to have,” she said. “But we also need to prepare for the kind of resistance that we could never predict. We know from history that bacteria and mother nature are smarter than we are.”
When Roxana Sudderth’s son, Trey, a healthy high school freshman, developed a sore on his foot after playing basketball, “it just looked like a small blister.” Doctors gave him antibiotics, but the pain persisted. Sudderth took him to the hospital where they told her he had a life-threatening infection, MRSA, a bacterium resistant to antibiotics. Over 19 days, his condition deteriorated until finally doctors told Sudderth it was time to take Trey off life support.
Researchers at Tufts’ Laboratory for Living Devices (L2D) link materials like silk and paper with technology, medicine, and diagnostics. CIMAR and L2D faculty member, Dr. Bree Aldridge, and her team are using biomaterials made of silk to engineer programmable diagnostic platforms—or “petri dishes of the future”—to fight antimicrobial resistance by gathering more detailed information about susceptibility to multiple drugs.
A new report suggests clinicians, public health professionals, and journalists need to rethink the way they talk about antimicrobial resistance to increase public understanding and promote action by policy makers. In this article, CIMAR Director Dr. Helen Boucher acknowledges that while it is challenging issue to explain to the public, stakeholders haven’t done a great job of communicating the immediacy and severity of antimicrobial resistance.
Desperate to find new medicines against pathogenic microorganisms, scientists are turning to Crispr, which has typically been considered for macroscopic tasks: altering mosquitoes so they can’t spread malaria, editing tomatoes so they are more flavorful and curing certain genetic diseases in humans. Now researchers are harnessing Crispr to turn a bacterium’s machinery against itself, or against viruses that infect human cells.
Dr. Gabriela Andujar Vazquez presented groundbreaking findings from her antimicrobial stewardship pilot study at IDWeek in Washington, D.C. earlier this month. The study showed a 20% decrease in antibiotic start rate in patients, potentially demonstrating the benefit of enhanced stewardship support by an expert on antibiotic use in long term care.
Experts say the problem of AMR is compounded by improper use of antibiotics by doctors, hospitals and patients, as well as by farmers and others in the agricultural sector (the drugs are commonly administered to livestock, as well as to humans). Check out this eye-opening panel discussion from CIMAR’s Dr. Helen Boucher and others.
The TWiM holobionts pay tribute to Stuart Levy, and reveal the remarkably diverse array of cyclic nucleotides synthesized by bacteria that likely mediate interactions with animal and plant hosts. Dr. Levy’s friends and colleagues, Drs. Elio Schaechter and Michele Swanson, join the discussion.
Stuart B. Levy, a key inspiration for CIMAR and an Emeritus Professor of Molecular Biology and Microbiology at the Tufts University School of Medicine, died following an extended illness on September 4th. Dr. Levy’s pioneering research and impassioned advocacy raised awareness of the danger of antibiotic resistance, He was 80. Colleagues, friends and family remember Dr. Levy in this piece from TuftsNow.
Actually, there is a human vaccine for eastern equine encephalitis (EEE), but it has never been approved for public use. The U.S. Army Medical Research Institute of Infectious Diseases—the military medical research institute at Fort Detrick in Maryland—developed a human EEE vaccine in the mid-1980s. Tufts Cummings School Professor Sam Telford, an expert on infections spread by mosquitoes and ticks, explains.
Tufts Cummings Vet School Hosts Symposium on "Engaging Veterinarians to Advance Human and Animal Health"
Nearly 600 veterinary students from the U.S., Canada, and beyond attended the 30th National Veterinary Scholars Symposium, hosted by the Cummings School of Veterinary Medicine at Tufts University. The meeting featured topics on critical care, antimicrobial resistance, regenerative medicine, cancer biology, infectious diseases, and pathways to research career development.
The Food and Drug Administration has approved a new drug for highly drug-resistant tuberculosis, the world’s leading infectious cause of death. The antibiotic, called pretomanid, was developed by a nonprofit group called TB Alliance at a time when few companies are investing in the expensive and unprofitable endeavor of creating next-generation antibiotics. CIMAR Director Dr. Helen Boucher shares her insights.
New England has some of the highest rates of Lyme disease in the country. In 2017, there were more than 400 confirmed and probable cases in Massachusetts. In Maine, the number of confirmed and probable cases was more than 1,800. Now, a unique project aims to stop the disease in its tracks by going straight to the source.
“This novel, low-cost technology requires no behavior change or effort by users–safe water comes straight out of the tap,” says CIMAR’s Dr Amy Pickering, who led the research. “This point-of-collection approach to water treatment could be a transformative strategy for reducing gastrointestinal disease burden in low-income urban communities.”
According to CIMAR Director Dr. Helen Boucher and others, the U.S. should have had a nationwide network to monitor for the next viral outbreak or biological threat a decade ago. Instead, public health leaders make do with a patchwork system while waiting for the Department of Health and Human Services races to get its integrated network in service.
Shortly after the FDA directive mandating that any antibiotics for honeybees be prescribed by veterinarians, Tufts Cummings School offered a sold-out continuing-education bee medicine workshop for practicing veterinarians. Tufts hopes to offer more training for veterinarians in the near future.
Not long ago, Achaogen Inc. was flying high. In early 2017, the drugmaker’s market capitalization soared above $1 billion on high hopes for its new medicine, an antibiotic targeting complicated urinary-tract infections. But in April—less than a year after the drug was approved by the Food and Drug Administration—Achaogen filed for bankruptcy.
The Infectious Diseases Society of America (IDSA) treasurer Dr. Helen Boucher, FIDSA, has urged lawmakers to support and expand federal efforts to stabilize the antibiotic market, spur the development of new infection-fighting drugs and protect existing ones in testimony before House Oversight and Reform Subcommittee on National Security.
The House Oversight subcommittee on national security convened experts last week to discuss biodefense — and the focus was on the threat of antimicrobial resistance. A bug doesn’t have to be a weapon to be deadly. “We have the sad duty of sending people to hospice because we don’t know how to treat their infections,” CIMAR’s Dr. Helen Boucher told the panel.
“Antibiotic infections pose serious threats to our national security,” said Dr. Helen Boucher, director of the Tufts Center for Integrated Management of Antimicrobial Resistance at Tufts University. “Resistant pathogens complicate our soldiers’ combat wounds, increasing risk of limb loss and death, and compromise our military combat readiness and effectiveness.”
CIMAR Epidemiologist Maya Nadimpalli, PhD, Describes Efforts to Document Antibiotic Resistance in Developing Countries
As an epidemiology postdoc at the Pasteur Institute in Paris, Maya Nadimpalli became interested in antibiotic resistance among young children in low-income countries. Now at Tufts University in Boston, Massachusetts, Nadimpalli shares the opportunities and challenges of studying public health in developing nations in this Nature Careers Q&A.
The FDA has approved a new indication for Merck’s ceftolozane/tazobactam (Zerbaxa), allowing for the drug to be used to treat hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia. Contagion® spoke with CIMAR’s Yoav Golan, MD, attending physician and associate professor of medicine at Tufts University School of Medicine, about what this could mean for patients.
In the latest of a string of high-profile cases in the U.S., a cocktail of bacteria-killing viruses successfully treated a cystic fibrosis patient suffering from a deadly infection caused by a pathogen that was resistant to multiple forms of antibiotics. Curing infections is great, of course. But what about using these bacteria-killing viruses to prevent infections in the first place?
Joining Forces for Good: Tufts CIMAR and the Tufts Clinical and Translational Science Institute Encourage Multidisciplinary Collaboration.
CIMAR and CTSI are just two of the exciting initiatives that embody Tufts’ commitment to enhancing multi-disciplinary collaboration. Each brings together investigators and clinicians from across the medical school, the university, and Tufts Medical Center to solve pressing real-world problems with a One Health approach.
“We’re seeing healthy young people with urinary tract and skin infections that we don’t have a pill for,” says Helen Boucher, an infectious disease specialist at Tufts Medical Center in Boston. “And we may not be able to perform organ transplants, and even routine surgeries like joint replacements. We should all be scared.”
Predicting TB's Course: CIMAR's Gillian Beamer Hopes to Unlock Why the Bacterium Affects Individuals Differently
Beamer plans to identify and test both proteins in blood and lung tissue that accurately determine disease categories and DNA sequences on chromosomes that accurately correlate with these disease outcomes. “Our goal is to generate testable models that can predict the outcome of infection before disease occurs,” Beamer said.
Medical researchers have known for decades that the pipeline for new drugs to stave off bacterial infections would one day run dry. That day is now at hand. “The crisis has already arrived. We are in an era now when doctors like me have no effective antibiotics for some of their patients,” says CIMAR Director Dr. Helen Boucher.
Public health experts are calling for new incentives to reward companies for bringing drugs that are effective against resistant strains to market. Achaogen Inc. spent 15 years racing to develop antibiotics against resistant superbugs such as carbapenem-resistant Enterobacteriaceae, or CRE, a strain that can kill up to half the people it attacks. But as a business, it’s a failure. The drug, Zemdri, lacked sales in its first six months on the market == less than $1 million. Achaogen filed for bankruptcy in April.
Late last year, a retirement community in Vermont was quarantined after an outbreak of antibiotic-resistant bacteria swept through the facility, sickening 70 seniors. In pediatric oncology wards, children beating cancer are increasingly felled by drug-resistant bacteria and fungal infections. Every week, we hear more stories of infections that have become untreatable due to resistance. Such alarms, once rare, are becoming more commonplace. The time to fix the problem is now, before it’s too late.
Drug-resistant diseases are hospitalizing and killing people across the world. To fight this crisis, researchers and physicians from Tufts University and Tufts Medical Center are bringing together their unique skillsets under one umbrella: The Tufts Center for Integrated Management of Antimicrobial Resistance.
“We’re worried that Achaogen is not alone, and that we will see the fall of other small antibiotic manufacturers,” said Helen Boucher, MD, director of the Tufts Center for Integrated Management of Antimicrobial Resistance and treasurer of the Infectious Diseases Society of America (IDSA). “And we’re worried about the danger this could present for our patients.”
Over the past year we’ve watched two troubling trends escalate. First, patients increasingly face — and their doctors struggle to treat — infections that do not respond to existing antibiotics. Second, major pharmaceutical companies are backing away from developing new antibiotics.
Stopping Cholera in Its Tracks: Testing Bacteriophages as a Way to Halt the Spread of the Deadly Disease
Cholera strikes almost 3 million people each year worldwide. Tufts/CIMAR researchers are developing a treatment to prevent its spread, using viruses to attack the bacterium that causes the disease.
Antimicrobial Resistance Fighters: CIMAR is cracking down on one of the biggest global health concerns
Antimicrobial resistance is a global catastrophe, leading to 700,000 deaths annually around the world. Tufts University and Tufts Medical Center are heeding the call with the new Tufts Center for Integrated Management of Antimicrobial Resistance (CIMAR)…
Tufts-Led Study Compares Gender-Specific Expression of Antibiotic Resistance Genes During Active Gonorrhea Infection
The World Health Organization estimates that 78 million people worldwide are infected with gonorrhea each year…
Given an increasingly difficult funding climate, finding the research strengths of the university and focusing resources on those areas is a priority for Tufts. After a year-and-a-half consultative process involving researchers from across the university, five thematic priority areas emerged. …
The Tufts Center for Integrated Management of Antimicrobial Resistance (CIMAR) hosted its first event last month to introduce the Center to the local scientific community and to offer a platform for investigators and clinicians to showcase their research and promote collaborations.
Tufts prides itself on being a distinguished research university, providing students with opportunities to apply what they have learned in the classroom to the real world. …
IDSA announces Tufts Medical Center Among Recipients of Antimicrobial Stewardship Centers of Excellence Designation
The Infectious Diseases Society of America (IDSA) announced today the recipients of its Antimicrobial Stewardship Centers of Excellence (CoE) designation. …