Day: June 8, 2021

UTI Bacteria Traced to Meat Production

A Portuguese study has found that bacteria in urinary tract infections (UTI) can be traced back to meat through the production chain where it was prepared.

UTIs are caused by both Gram-negative and Gram-positive bacteria, as well as by certain fungi. Staphylococcus saprophyticus is a major cause of UTI in young women, reaching 20% prevalence. Understanding the epidemiology of this microorganism can help identify its origin, distribution, causes, and risk factors. Researchers from ITQB NOVA led by Maria Miragaia showed that Staphylococcus saprophyticus can originate in food, specifically in the meat-production chain. Their findings were published in the journal Emerging Infectious Diseases.

Pork is the most popular meat type in Europe. S. saprophyticus can be a contaminant of that meat, and it is also found in the environment, the gut and rectal flora of pigs, and in the human gastrointestinal tract, vagina, and perineum.

The researchers used a combination of phenotypic, genomic, and pan-genome wide association approaches, which enabled them to identify two different lineages (G and S) of S. saprophyticus. Lineage G is of food origin and transmitted to humans by contact with food products, and lineage S is of human origin. Both cause disease and may be transmitted directly or indirectly between persons within the community, with an extensive geographic distribution possible.

To find out if these bacteria causing UTIs could be related to the ones found in pork, the research group looked at S. saprophyticus from a slaughterhouse and compared them to those causing human UTIs. The team analysed bacteria collected from UTIs worldwide over two decades, and from UTIs and pork meat production chain in Portugal.

The results showed that bacteria found in the slaughterhouse (equipment, meat, colonisation of workers) were similar to human UTI bacteria and had the same antibiotic resistance profile.

Although S. saprophyticus colonisation rate in pigs was extremely low (1%), 35% of slaughterhouse samples were contaminated. The presence of an antiseptic resistance gene (qacA) by all the lineage G bacteria could be part of the explanation for the ineffective cleaning procedures that were used. 
S. saprophyticus strains of animal origin (lineage G) enters the slaughterhouse through food animals, persist on the equipment, disseminate and contaminate the meat processing chain and humans. Human colonisation is a crucial step for the later occurrence of UTI,” explained first author Opeyemi Lawal.

The researchers also studied genomic data of bacteria collected from patients attending three hospitals in the Lisbon area, and found that the transmission of these pathogenic bacteria from both lineages (G and S) occurs between persons within the community. Making use of this deep-structured analysis, researchers were also able to identify putative new virulence factors for this unexplored bacterium. The team will continue to search for reservoirs of this bacterium in humans and animals, and to study the mechanisms of S. saprophyticus dissemination and disease to inform strategies against  this pathogen. 

“This a clear example of how food manipulation can impact in human health, and how important it is to educate consumers regarding good individual hygiene practices to avoid spreading of infectious diseases“, said Maria Miragaia, head of the Bacterial Evolution and Molecular Epidemiology Lab. 

“This adds to the list of bacteria that are transmitted to humans through contact with animals and animal-derived food. But the exact mechanisms associated to the conversion from a coloniser to an infectious agent remains to be clarified”, added Henrik Westh from the Copenhagen University Hospital – Amager and Hvidovre, University of Copenhagen (Denmark).

Source: ITQB NOVA

Meet the Two Women in the Running for SA’s Top Medical Job

Photo by Markus Winkler on Unsplash

Health Minister Dr Zweli Mkhize is in hot water over alleged procurement fraud for a R150 million COVID contract, and is widely expected to step down shortly.

President Cyril Ramaphosa is reportedly weighing up two candidates to replace Dr Mkhize as health minister.

The candidates are the former Gauteng health MEC Dr Gwen Ramokgopa, (who took over following the Life Esidimeni tragedy) and Dr Nkosazana Dlamini-Zuma, who, as Health Minister saw the overhaul of the country’s apartheid-era healthcare systems.

As an anti-Apartheid activist, Dr Ramokgopa held various leadership positions. She qualified as a medical doctor (MBChB) in 1989 and obtained her Master’s in Public Health (MPH) in 2007. She worked as a Medical Officer at the Dr George Mukhari (then Ga-Rankuwa) Hospital until 1992.

Having served once as the Gauteng health MEC in 1999,  Dr Ramokgopa took on the role deputy health minister from 2010 to 2014. She succeeded Qedani Mahlangu as Gauteng health MEC following the shameful Life Esidimeni tragedy involving the deaths of at least 94 mental health patients released from private mental healthcare facilities to 27 unlicensed facilities. In a  statement, she vowed to tackle waste and corruption.

Dr Nkosazana Dlamini-Zuma completed her MBChB at the University of Bristol in 1978, and took part in underground ANC activities. During Mandela’s presidency, she was appointed Minister of Health, and courted controversy by voicing support for Virodene, an ‘HIV cure’ which attracted heavy criticism and which was never approved.

She then served as Minister of Foreign Affairs from 1999 to 2009, and then Minister of Home Affairs to 2012, where she turned around a department mired by mismanagement. Despite stubborn resistance from French-speaking nations, she was elected the African Union’s (AU) Chairperson from 2012 to 2017 and was praised for focusing on gender issues. After this, she began vying for the ANC presidency as an MP. In 2019, she was appointed Minister of Cooperative Governance and Traditional Affairs.

During South Africa’s lockdown, she memorably rose to internet fame for using “zol” to refer to cannabis when giving reasons for the tobacco ban.

New Insights into How Kidney Cancer Cells Respond to Treatment

Photo by National Cancer Institute on Unsplash

Researchers from the University of Michigan Rogel Cancer Center have uncovered clues as to why kidney cancers respond so differently to treatment, opening up new tailored treatment options.

Not all kidney cancers behave the same, and some have wildly differing responses to immunotherapy or other treatments – resulting in wildly different outcomes for patients.

By sequencing the RNA of individual cells within multiple benign and cancerous kidney tumors, the researchers have identified the cells from which different subtypes of kidney cancer originate, the pathways involved and how the tumor microenvironment impacts cancer development and response to treatment.

The findings, published in PNAS, could help researchers better understand renal cell carcinoma development and guide oncologists in optimising therapies for each patient.

“Single cell RNA sequencing was key to allowing us to monitor gene expression patterns in each individual cell, revealing the mechanisms at play within the tumour microenvironment that can predict overall survival,” says study author Arul Chinnaiyan, MD, PhD, director of the Michigan Center for Translational Pathology and SP Hicks Professor of Pathology at Michigan Medicine.

Researchers produced gene expression atlases for normal kidney and renal cell carcinoma samples. They predicted the putative cell of origin for more than 10 subtypes of renal cell cancer. Their analysis also uncovered pathways and interactions within the tumour microenvironment that predicted if the tumour would respond to immunotherapy. These findings could help develop biomarkers to guide kidney cancer treatment.

“By understanding the cell type where a cancer originates, it may allow us to target more precise treatments for that cancer type as well as better understand response to therapy,” Dr Chinnaiyan said.

Source: University of Michigan

Journal information: “Single-cell analyses of renal cell cancers reveal insights into tumor microenvironment, cell of origin, and therapy response,” PNAS. DOI: 10.1073/pnas.2103240118

New Measurement of Heart Function Could Benefit High-risk Heart Patients

A new measurement of heart function developed at UVA Health could improve survival for people with heart failure by identifying high-risk patients who require tailored treatments, according to a new study.

The study is the first to show a survival benefit from wireless pressure monitoring sensors implanted in the pulmonary arteries. Pulmonary artery proportional pulse pressure, or PAPP, is a new measure of heart function that can identify patients at very high risk of hospitalisation or death from systolic heart failure or pulmonary hypertension (high blood pressure in the heart and lungs).

Previous work showed that patients with low PAPPs were at much higher risk than those with higher PAPPs, so the researchers tested whether these benefits were maintained in patients undergoing implantation of pressure sensors that continuously monitor pressure in the pulmonary artery.

“We found that PAPP is a very good measure of how stiff or compliant the pulmonary arteries are. The stiffness of the pulmonary arteries determines how much resistance the right side of the heart has overcome to pump blood effectively to the lungs,” said Sula Mazimba, MD, MPH, a heart failure expert at UVA Health and the School of Medicine. “The importance of this simple measure is that it can identify patients that are at greatest risk of dying or being hospitalised. This allows us to tailor more aggressive treatments.”

Heart failure causes more than 1 million hospital admissions each year, and approximately half of patients die within five years of diagnosis.

The new study evaluated the benefits of PAPP monitoring in patients with systolic heart failure, where the left ventricle is weak, as well as those with pulmonary hypertension.

To find out if PAPP monitoring could predict outcomes in these patients, Dr Mazimba and colleagues analysed data from 550 participants in the CHAMPION clinical trial, whose participants were randomised to receive an implantable, wireless heart monitor called the CardioMEMS HF System.

They found that participants with a below-average PAPP had a significantly higher risk of hospitalisation or death compared with those with higher PAPPs. Furthermore, the monitoring  reduced the risk of death for those with low PAPPs by 46% annually during two to three years of follow-up.

“The implications of this study are highly significant,” said co-investigator Kenneth Bilchick, MD, MS, a cardiologist at UVA Health. “We now have identified a specific group of patients who appear to have a marked improvement in survival with implantation of these pulmonary artery wireless monitors. As a result, the findings of the study could maximise the impact of this technology for a large number of potential candidate patients. This is an excellent example of how secondary analyses of clinical databases maintained by the National Institutes of Health can result in novel and personalised approaches to patient care.”

The researchers say further study is necessary to gauge the full potential of PAPP monitoring to improve care for patients with heart failure, but early results were encouraging.

“In the past, the function of the right chamber of the heart was often ignored and considered to be inconsequential to the overall performance of the heart, but we are now learning that this is not the case,” Dr Mazimba said. “Having tools that signal when the right side of the heart is under strain may aid clinicians to adopt timely tailored treatments for heart-failure patients.”

Source: UVA Health

Zinc’s Surprising Role in Blood Pressure

Source: Wikimedia CC0

Researchers have discovered that a trace element, zinc, plays a previously unknown role in the regulation of blood pressure.

While the role of metals like potassium and calcium have been long known in this process, a new discovery about zinc’s critical and underappreciated role offers a potential new pathway for therapies to treat hypertension. While hypertension had been known to be associated with low zinc levels, it was not clear as to why.

The findings were published recently in Nature Communications.

The smooth muscle cells lining blood vessels regulate the speed at which the blood travels around the body. As smooth muscles contract, they narrow the artery, increasing blood pressure, and as the muscle relaxes, the artery expands and blood pressure falls. Too low a blood pressure, and the blood flow will be insufficient to sustain body tissues. If blood pressure is too high, the blood vessels risk being damaged or even ruptured.

“Fundamental discoveries going back more than 60 years have established that the levels of the calcium and potassium in the muscle surrounding blood vessels control how they expand and contract,” said lead author Ashenafi Betrie, PhD, and senior authors Scott Ayton, PhD, and Christine Wright, PhD, of the Florey Institute of Neuroscience and Mental Health and The University of Melbourne in Australia.

Specifically, the researchers explained, potassium regulates calcium in the muscle, and calcium is known to induce the narrowing of the arteries and veins that elevate blood pressure and restrict blood flow. Other cells surrounding the blood vessel, including endothelial cells and sensory nerves, also regulate the calcium and potassium within the muscle of the artery, and are themselves regulated by the levels of these metals contained within them.

“Our discovery that zinc is also important was serendipitous because we’d been researching the brain, not blood pressure,” said Dr Betrie. “We were investigating the impact of zinc-based drugs on brain function in Alzheimer’s disease when we noticed a pronounced and unexpected decrease in blood pressure in mouse models treated with the drugs.”

The investigators discovered that coordinated action by zinc within sensory nerves, endothelial cells and the muscle of arteries triggers lower calcium levels in the muscle of the blood vessel. This causes the vessel to relax, decreasing blood pressure and increasing blood flow. The scientists found that the brain and heart’s blood vessels were more sensitive to zinc than blood vessels in other areas of the body, warranting further research.

“Essentially, zinc has the opposite effect to calcium on blood flow and pressure,” said Dr Ayton. “Zinc is an important metal ion in biology and, given that calcium and potassium are famous for controlling blood flow and pressure, it’s surprising that the role of zinc hasn’t previously been appreciated.”

This research also explains the fact that the genes that control intracellular zinc levels are known to be associated with cardiovascular diseases including hypertension, and hypertension is also a known side effect of zinc deficiency.

“While there are a range of existing drugs that are available to lower blood pressure, many people develop resistance to them,” said Dr Wright, who added that a number of cardiovascular diseases, including pulmonary hypertension, are poorly treated by currently available therapies. “New zinc-based blood pressure drugs would be a huge outcome for an accidental discovery, reminding us that in research, it isn’t just about looking for something specific, but also about just looking.”

Source: Medical Xpress

South African Woman Gives Birth to 10 Babies in World First

Photo by William Fortunato from Pexels

In a world first, a Gauteng woman has given birth to 10 babies. It was only last month when Malian woman Halima Cissé had set the record when she gave birth to nine children in Morocco.

Gosiame Thamara Sithole, 37, delivered her seven boys and three girls by Caesarean section at 29 weeks along last night at a Pretoria hospital, according to her husband Teboho Tsotetsi. 

While such large numbers are usually a result of fertility treatment, Sithole had told the Pretoria News that her pregnancy was natural. She already has a pair of six-year-old twins.

Sithole said in an interview that she was shocked and fascinated by the pregnancy.

The retail store manager was told she had sextuplets, before that was revised to octuplets and finally decuplets because two foetuses were hidden in the fallopian tubes.

“I am shocked by my pregnancy. It was tough at the beginning. I was sick. It was hard for me. It’s still tough but I am used to it now. I don’t feel the pain anymore, but it’s still a bit tough. I just pray for God to help me deliver all my children in a healthy condition, and for me and my children to come out alive. I would be pleased about it,” Sithole said.

At first, she was dubious when the doctors informed her she was pregnant with octuplets.

“I didn’t believe it. I doubted it. I was convinced that if it was more, it would be twins or triplets, not more than that. When the doctor told me, I took time to believe it. Even when I saw the scans I didn’t believe it. But, as time went by, I realised it was indeed true. I battled to sleep at night though.”

Sithole had worried a great deal about her unborn children.

“How would they fit in the womb? Would they survive? What if they came out conjoined at the head, in the stomachs or hands? Like, what would happen? I asked myself all these questions until the doctor assured me that my womb was starting to expand inside. God made a miracle and my children stayed in the womb without any complications.”

Tsotetsi, who is unemployed, also said he was shocked when he heard the news.

“I could not believe it. I felt like one of God’s chosen children. I felt blessed to be given these kinds of blessings when many people out there need children. It’s a miracle which I appreciate. I had to go do my own research on whether a person could really conceive eight children. It was a new thing. I knew about twins, triplets and even quadruplets,” Tsotetsi said.

“But after I found out that these things do happen, and saw my wife’s medical records, I got even more excited. I can’t wait to have them in my arms.”

Professor Dini Mawela, deputy head of the school of medicine at the Sefako Makgatho Health Sciences University, said Sithole’s case was rare and usually the result of fertility treatments. Because it was a “high risk” situation, the children will spend the next few months in an incubator, she said. Termed ‘grand multiparity‘, such pregnancies can be risky, and a pregnancy with 10 babies is of course unprecedented.  

“It’s quite a unique situation. I don’t know how often it happens. It’s extremely high risk (pregnancy). It’s a highly complex and high-risk situation. The danger is that, because there is not enough space in the womb for the children, the tendency is that they will be small. What would happen is that they would take them out pre-term because there is a risk if they keep them longer in there. The babies will come out small, chances of survival compromised. But all this depends on how long she carried them for.”

Source: IOL