TIME Research

Here’s What You Use to Fight Antibiotic Resistant Bacteria

Researchers say a tough form of fungus may hold the key to battling the bacteria that are resistant to the strongest antibiotics

There’s a war going on, and most of us can’t even see it. Man has been battling microbes for millennia, and despite their microscopic size, the bugs have been winning. But man may finally have a leg up, scientists from Canada and the U.K. say—and it’s all thanks to a humble fungus.

While antibiotics have been a powerful weapon against bacteria that can cause serious and even fatal infections, the microbes have been just as busy as drug makers in finding ways to evade the medications. What’s more, the man-made compounds also appear to pose little challenge to bacteria, which are surrounded by such molecules, made by their neighbors, other microbes or other organisms in their environments. “Bacteria seem to laugh in their face,” says Gerard Wright, director of the Michael G. DeGroote Institute for Infectious Disease Research at McMaster University and the new study’s senior author. The result? Most antibiotics, including penicillin and the carbapenems that have been introduced more recently, contain a chemical ring that bacteria have been remarkably adept at breaking. Once compromised, the ring and the antibiotic are neutralized.

MORE: Antibiotic-Resistant Bacteria Are Now In Every Part of the World

So most drug companies have tried to develop stronger, or slightly different chemical rings, but Wright and his colleagues decided to tackle the problem from a different tack. Why not disrupt the enzyme that the bacteria were using to disable the antibiotics instead?

It’s an old approach that most pharmaceutical companies have abandoned, since the strategy requires combining an antibiotic with something that disables the bacteria’s ability to resist the drug±two drugs means twice the potential complications and side effects, so most large-scale efforts have focused on building better solo antibiotics.

MORE: Antibiotic Resistant Genes Are Everywhere, Even in Arctic Ice

But aware that nature is a rich resource of organisms that naturally make compounds that can interfere with bacterial enzymes, Andrew King in Wright’s lab screened 500 such molecules and found one, from Aspergillus versicolor, that worked remarkably well in inhibiting New Delhi Metallobeta-Lactamase-1 (NDM-1), an antibiotic resistant gene that the World Health Organization recently called a global public health threat. (He also tested 30,000 synthetic compounds and none inhibited NDM-1.)

“Natural products, and especially natural products that come from microbes like bacteria and fungi, are privileged molecules, in the sense that they are products of evolution themselves, so they are much better at interacting with bacteria,” says Wright, who published his results in the journal Nature. Rather than being relatively simple and flat, like the compounds created in labs, these agents are three-dimensional with structures and functions that are difficult to recreate in a petri dish. “If we want to look for inhibitors of antibiotic resistance on a significant scale, we need to go back to these sources,” he says.

MORE: Why You Need to Worry About NDM-1: Not a ‘Superbug,’ But Still a Threat

The fungus turns out to be one of the most resilient organisms on the planet, able to survive in the harsh climates of the arctic, the salty Dead Sea and even the International Space Station. That hardiness also makes it among the most common molds in damp or water-damaged buildings and moist air ducts.

When Wright and his team tested the fungus in mice infected with lethal doses of K. pneumoniae that carried the NDM-1 resistance to antibiotics, the mice shrugged off the infection. In fact, the fungus allowed the antibiotic to work effectively again, essentially circumventing the bacteria’s attempt at resisting the drug.

“The idea of rescuing our old antibiotics, is something that folks are starting to realize is not only a good idea, but doable,” he says. He and his team hope to find similar inhibitors to neutralize resistance against the other major classes of antibiotics, but as optimistic as Wright is about the strategy, he admits that ultimately the bacteria may find ways to resist even these agents. “Resistance is a natural phenomenon’ it’s just natural selection. There’s no way to get around it.” Except perhaps to stay one step ahead of the microbes and find compounds that can thwart them…again and again.

TIME Breast Cancer

High-Tech 3D Mammograms Probably Saved This Woman’s Life

A large study shows the latest screening tool can detect more cancers with fewer false positives

Lori Safer is a convert. The 55 year old occupational therapist had been told by many mammogram technicians that her breasts were hard to image. Her fibrocystic tissue meant that every mammography report was somewhat less than reassuring. “They would say, ‘It doesn’t’ look like anything is there, but just come back in a year, and we’ll keep an eye on it,’” the New Jersey resident says.

Worried that the mammograms were not picking up on possible cancers, Safer went to University of Pennsylvania, where the breast imaging center was testing a 3D mammogram, which is the subject of a new study published in JAMA. Building on the 2D technology, the 3D version simply slices the images of the breast and reconstructs them on a computer in 3D form, allowing doctors to get a better view of the entire breast and any potential tumors growing within.

Sure enough, the 3D test picked up a suspicious lump. She got a biopsy, and even that was negative, but because the 3D mammogram had detected a potential tumor, doctors recommended she have a lumpectomy to remove the growth. It turned out to be malignant. But because the cancer was picked up in its earliest stages, before any cancer cells could spread to the lymph nodes, Safer is now cancer-free. “If I had waited a year, like I would have if I had been getting the regular mammogram, it could be a totally different story,” she says.

MORE: What Now? 4 Takeaways From the Newest Mammogram Study

The latest research on the 3D mammograms, or tomosynthesis, backs her up. Led by Dr. Sarah Friedewald, chief of breast imaging at Advocate Lutheran General Hospital in Illinois, researchers report that 3D mammograms can pick up more breast cancers and lead to fewer callbacks for repeat testing than 2D mammography. It’s the data that many breast cancer physicians have been waiting for.

Since the Food and Drug Administration approved the first 3D mammogram machine in 2011, doctors have been documenting whether the technology can outperform existing mammography by improving detection of breast cancer while cutting back on false positives. In the JAMA study, the researchers collected data from more than 454,000 mammograms done at 13 sites; nearly a quarter included both the traditional 2D mammogram as well as an additional 3D image. Compared to the 2D mammograms alone, the tomosynthesis improved detection of invasive cancers by 41%, while not increasing rates of picking up DCIS cancers, which don’t spread from the milk ducts and have higher survival rates. That’s important because other technologies, including ultrasound and MRI, led to higher rates of detecting all types of growths, but it’s more important to identify early-stage invasive cancers because treating them can lead to higher remission rates and longer survival.

MORE: The Mammogram Melee: How Much Screening Is Best?

“In my long career, this is the biggest improvement in screening I have seen,” says Dr. Emily Conant, professor or radiology and chief of breast imaging at the University of Pennsylvania Perelman School of Medicine and one of the study’s co-authors. “This is much bigger than the improvement in going from analogue or film to digital; I don’t think there’s a doubt about that.”

The study is the largest to show that 3D mammograms can increase the detection of invasive cancers while lowering the rate of recall testing. “That’s a critical point of 3D,” says Friedewald. “Other screening modalities [such as ultrasound and MRI] have shown that they can pick up additional cancers but none have simultaneously reduced the number of recalls.” Fewer recalls can lead to fewer risks, and costs, for women. Safer, for example, says that she has been called back after a mammogram at least six or seven times for additional testing, which contributed to more time and costs for her, not to mention psychological stress about whether she had cancer.

MORE: Higher Risk for Women With False-Positive Mammogram Results

With these findings, the focus will now shift to figuring out how often women need to be screened using the 3D technology, and how to phase in the machines, which cost $500,000. Not all insurers cover the cost of the 3D screening, which is slightly more expensive than traditional mammography. That could also mean that women requesting it will pay more out-of-pocket as well.

The 3D machines used in the study required women to get double the dose of radiation of a regular mammogram, which was still below the safe levels established. But newer versions of the technology will bring that exposure down to levels similar to those of current mammography machines.

Should every hospital switch to imaging? “I think it’s premature to replace 2D mammography, since we are still trying to understand the utility and limitations of the technology,” says Dr. Therese Bevers, medical director of the cancer prevention center at the University of Texas MD Anderson Cancer Center. “But a test that weighs more favorably toward benefits—and fewer callbacks—is a win-win.”

MORE: Breast Cancer Screening Isn’t Going Away—At Least Not Yet

The researchers hope that that results will convince more insurers to cover 3D imaging on the premise that despite its higher upfront cost, the test’s sensitivity in detecting invasive cancers would lead to cost savings by avoiding costly follow ups and additional testing.

For Safer, there’s no question about what type of mammogram she will be getting from now on. “I called all my friends and relatives, and told them you can’t just go for a regular mammogram,” she says. “I told them they have to go online to find places that have 3D.”

If these results hold up, then those facilities won’t be so hard to find in the near future.

TIME

Too Much of a Good Thing: Kids Get Too Many Vitamins and Minerals

Foods fortified with extra vitamins and minerals may be doing more harm than good

Not only are many popular kids’ foods high in calories and sugar—here are 12 cereals of them that are more than 50% sugar by weight—but they may be packing too many vitamins and minerals, says the Environmental Working Group (EWG).

Manufacturers have been using nutrient fortification as a marketing tool to appeal to parents who want healthier foods for their families, but more isn’t necessarily better when it comes to certain nutrients. The advocacy organization studied 1,556 breakfast cereals and 1,025 snack bars and found that many contained substantially higher amounts of three nutrients—vitamin A, niacin and zinc—than is considered safe by the Institute of Medicine (IOM).

While nutrients are important for health, too much of certain nutrients can have harmful effects. Among the products the EWG tested, 114 cereals contained 30% or more of the Food and Drug Administration’s (FDA) recommended daily values for vitamin A, niacin or zinc, and 27 of the snack bars have more than 50% of the recommended values.

MORE: 12 Breakfast Cereals That Are More Than 50% Sugar

The fortification is especially concerning among children, since the values are set for adults, who are physically larger and need more of the nutrients. Children also typically eat more than one serving of cereal or snack bars in a day, and many also take vitamin supplements, further pushing them toward dangerously high levels of vitamin A, niacin and zinc.

Studies have shown that too much vitamin A can contribute to liver damage, brittle nails and hair loss. Overdoing it with zinc can interfere with normal immune functions, while niacin overages can cause rashes and vomiting.

MORE: Study Finds Folic Acid May Decrease Risk For Autism

The authors say that such excess isn’t as much a problem for children who eat more fresh and unprocessed foods. But in the average U.S. diet, earlier studies documented that 45% of children under 8 years old get too much zinc, 13% eat too much vitamin A and 8% get excessive amounts of niacin from their food alone.

To address the “over-nutrient-izing” of the American public, the IOM established upper limits of daily intake for common vitamins and nutrients, calculated for specific age groups and for pregnant women.

The EWG authors are calling for the FDA to adopt similar age specific guidelines for nutrient intake, and to revise its daily values, which were created before many manufacturers began fortifying their products with extra nutrients. And to avoid overdosing their kids on certain vitamins, parents should stay away from products that contain more than 20% to 25% of daily values for vitamin A, niacin and zinc.

TIME social anxiety

This Is the Brain Circuit That Makes You Shy

Using a new light-based technique, scientists trace the nerve network that lights up when mammals meet

What do you do when you want to study something as complicated as what happens deep in the brain when two strangers meet? You develop a completely new way of tracking nerve connections, and then you test it in mice.

That’s what Dr. Karl Deisseroth, a professor of psychiatry and bioengineering at Stanford University, and his colleagues did. “We know social behavior is complicated, but to be able to delve into the brain of freely behaving mammals and to see the signal in real time predicting their social interaction was very exciting,” says Deisseroth, who published his results in the journal Cell.

Brain researchers have long known that certain chemicals known as neurotransmitters soar or drop depending on what we’re doing and how we feel. Based on these observations, drug companies have developed an armada of medications aimed at mimicking these changes to treat everything from depression, hyperactivity and even social anxiety or shyness. But there’s a difference between observing hormone levels rising or falling and identifying a specific circuit — among the millions that occur in the brain — responsible for how we feel and whether we are friendly at a first meeting, say, or a little more reserved. Studying those circuits has been challenging because scientists simply couldn’t get real-time information about which nerves were firing, and where, when certain behaviors, such as a meet and greet, occurred.

(MORE: The Upside of Being an Introvert (and Why Extroverts Are Overrated))

Deisseroth solved that problem. Using optogenetics and fiber photometry, he was able to tag specific nerves in the brain with light-receptor molecules and connect them to ultra-thin fibers that were tied to a switch. Flip the switch on, and the cells were stimulated; turn it off and they quieted down.

Deisseroth and his team hooked up their show to cells that operated on the brain chemical dopamine. When they turned the system on, the cells would release dopamine, and when that happened, the mice showed more interest in investigating newcomers dropped into their cage — they sniffed, they explored and they engaged. When the dopamine activation was turned off, however, the mice made little effort to acknowledge or investigate the intruder.

(MORE: Study: Nearly 1 in 8 Shy Teens May Have Social Phobia)

While manipulating the social interactions of mice is fascinating in itself, Deisseroth sees his findings as being potentially helpful in treating mental illnesses. The fact that he was able to isolate a single circuit that affected something as complex as social behavior suggests that manipulation of deep brain circuits might be a promising way to treat, or modulate behavior in people as well. What if, for example, it became possible to dampen the social aversion that affects some children with autism? If they could interact with people more comfortably, it might be possible to modulate the other symptoms of their developmental disorder. Or what if hyperactivity could be dialed down? Or depression’s darkest moods lightened in the same way?

Deisseroth stresses that we’re far from even speculating how such therapies might be used, but the possibility that deep brain circuits might be tapped to affect behavior is promising. In the meantime, says Deisseroth, “We know these things are complex. The brain is so mysterious, and psychiatry is so mysterious, so our job for a long time will be to deepen understanding of these complex circuits. If that’s the only thing that comes out of this, that would still be great.”

TIME Autism

Pesticide Exposure During Pregnancy Strongly Linked to Autism

Prenatal exposure to commercial pest spraying can boost risk of autism by up to 60%

Autism cannot be attributed to any one risk factor—genes play a role, as does an expectant mom’s diet, some medications and exposure to environmental pollutants. While previous studies have connected autism to prenatal exposure to agricultural chemicals, it wasn’t clear whether other factors could account for the higher rates of autism among their children. A new study gets closer to the answer.

California laws require that commercial pesticide spraying be recorded. So Irva Hertz-Picciotto, professor of epidemiology at the Mind Institute at University of California, Davis, took advantage of the data showing where pesticides had been sprayed and matched it against pregnant women’s home addresses. About one-third of the mothers-to-be lived under a mile from at least one pesticide application during their pregnancy. If the pesticide was an organophosphate, a class of compounds that has largely been phased out of home bug and lawn sprays but remain in commercial applications, the women showed a 60% higher risk of having a child with an autism spectrum disorder (ASD). Living near a spraying of pyrethroids, which are commonly found in home insect sprays, just before conception or during the third trimester of pregnancy increased by up to two-fold the risk of both ASDs and developmental delays.

Insecticides are known to be toxic to nerves, and developing babies may be especially vulnerable, says Hertz-Picciotto, since their brains are just forming important brain structures and connections that can be disrupted by the chemicals. “Many pesticides operate through affecting the nervous system of lower organisms,” she says. “So they should be taken seriously, because they are by design neurotoxic. The question is at what dose.”

Still, while the study involved more than 1,000 participants, Hertz-Picciotto says it’s not definitive proof that pesticides cause autism. They adjusted for potential factors that could also contribute to higher risk of autism, such as parental age, mother’s health, and distance of the residences from freeways. But they did not have information on how many hours the pregnant women typically spent at home, or on whether they were actually at home during the sprayings. The scientists also did not have information on the mothers’ diets, which could introduce pesticide residue from foods, or their occupations, including whether their workplace exposures might have also played a role in their children’s autism risk.

The association does add to growing data that connects pesticide exposure to potential developmental problems in fetuses, however. The fact that the rates of autism were highest among women who lived closest to the pesticide applications, and lower among those who lived further away, suggests that the chemicals are worth studying further for what role, if any, they play in contributing to autism.

TIME CDC

Here’s What You Need to Know About the Anthrax Accident

A microscopic picture of spores and vegetative cells of Bacillus anthracis which causes the disease anthrax.
A microscopic picture of spores and vegetative cells of Bacillus anthracis which causes the disease anthrax. Reuters

Researchers handling the deadly bacteria may have been exposed when the bugs were not deactivated properly

The Centers for Disease Control and Prevention announced on Thursday that 86 of its staff members in Atlanta are being monitored for possible anthrax exposure.

Scientists at the facility routinely study the bioterror agent, which is classified at “Biosafety Level 3,” meaning it can cause fatal infections and is transmitted easily by inhalation.

Bacillus anthracis occurs naturally in soil and can infect wild and domestic animals, who can transmit the bacteria to humans. In the U.S., livestock are routinely vaccinated against anthrax, which keeps the number of domestic outbreaks low. Once inside the body, anthrax produces toxins that can be fatal if left untreated. Because the spores are microscopic and can be mixed into powders or liquids and into the food supply, the biggest threat of anthrax infection may come from bioterrorists. In 2001, spores were sent in the mail to political leaders and members of media, and five of the 22 people who were exposed, including postal service workers, died.

The CDC’s Level 3 facility can only be accessed through a set of double, self-locking doors that prevent air from escaping the lab into the outside environment. All workers must wear gowns, gloves, protective eye equipment and, often, respirators. Any work with the bacteria is done under a “hood,” which protects workers with a clear shield. So how did the workers get exposed?

MORE: Anthrax: A Medical Guide

According to the CDC, proper procedures to “deactivate” the anthrax when leaving the lab were not followed. The workers handling anthrax were properly protected, but they passed the bacteria on to other labs that had lower safety requirements. Several days after the transfer, when the original plates of bacteria were thrown out, technicians noticed that anthrax was still growing on some of them. The building was closed and decontaminated, and officials continue to test air samples for presence of the bacteria.

“CDC believes that other CDC staff, family members and the general public are not at risk of exposure and do not need to take any protective action,” the agency said in a statement.

Intravenous antibiotics can counteract the bacteria, and antitoxins can neutralize the poison. The CDC staff who might have been exposed are currently taking antibiotics and being monitored for symptoms of infection.

CDC leadership is investigating the incident to determine why proper deactivation procedures for the anthrax were not followed.

TIME fitness

Here’s How Kids Can Get Better Grades

It’s not the brain but the heart that may matter more when it comes to excelling at school

Just like other organs, the brain needs to be used regularly to be at its best. And new research suggests physical exercise is correlated with improved mental functions, too.

Researchers in Spain followed more than 2,000 children aged 6 to 18 for three years and looked at how physical fitness, motor skills and muscle strength related to academic performance. Fitness levels were assessed based on how efficiently people’s hearts and lungs respond during exercise—and when they compared the students’ fitness to their grades in math and language classes, as well as their overall GPA, the researchers found that the more fit kids had higher grades.

The scientists say theirs is the first study to look at the independent role that fitness can have on academic performance, and suggests that efforts to improve students’ grades may include not just intellectual but physical programs as well. Other studies have linked strong heart and lung function, for example, to better blood flow in the brain, which can help cognitive functions. Other benefits include the release of nerve growth factors that keep neural connections healthy and functioning properly.

“Promoting physical activity that involves aerobic exercise and motor tasks during the school years … may be important not only for health, but also for successful academic development,” the authors write in the Journal of Pediatrics. Another reason to keep gym class in school.

TIME

80% of People Think Alzheimer’s Is A Normal Part of Aging

Confusion around the neurodegenerative disease

Despite estimates that more than one billion people will be affected by Alzheimer’s disease by 2050, many around the world still don’t understand the disease.

In a survey of more than 6000 people from 12 countries, the Alzheimer’s Association says nearly a quarter of responders list Alzheimer’s disease as the condition they most fear getting, behind cancer. Yet in some countries, including India, China and Saudi Arabia, more than 80% believe that the neurodegenerative condition is a normal part of aging, and not an abnormal state of the brain in which plaques of proteins build up and break down nerve connections. At the same time, nearly 40% of people believed that only those with a family history of the disease could be affected.

And while the disease is often associated with symptoms of memory loss and cognitive decline, it can eventually affect physical functions as well and be fatal in those affected. “Alzheimer’s disease knows no bounds,” Harry Johns, president and CEO of the Alzheimer’s Association said in a written statement about the survey. “Anyone with a brain is at risk for Alzheimer’s disease, so everyone with a brain should join the fight against it.”

TIME Depression

No, Antidepressants During Pregnancy Don’t Harm Babies’ Hearts

Silhouette of Pregnancy
Getty Images

The latest study finds no significant increase in heart malformations in babies whose moms used antidepressants during pregnancy

That should reassure the 8% to 13% of women who take antidepressants while expecting. Concerns about the risks of the drugs, primarily selective serotonin reuptake inhibitors (SSRIs), on the developing fetus prompted the Food and Drug Administration in 2005 to add warnings about the risk of heart defects in babies born to moms taking antidepressants. While studies have shown up to a three-fold increase risk in some congenital heart abnormalities associated with antidepressants, doctors couldn’t be entirely sure the higher risk wasn’t due purely to chance. Now, the New England Journal of Medicine reports that may indeed be the case, thank to the work of Krista Huybrechts, in the division of pharmacoepidemiology at Brigham and Women’s Hospital and Harvard Medical School, and her colleagues.

In their analysis involving 949,504 pregnant women, 64,389 of whom used antidepressants during the first trimester, the rate of heart defects in newborns was similar between the groups. “Based on our study, there is no evidence to support a substantial increased risk of cardiac malformations overall,” she says.

She and her team specifically focused on adjusting for potential confounding factors that could explain the heart malformations, such as age, how many children the women had had, diabetes, hypertension and use of psychotropic medications. Even after accounting for these effects, they found no strong association between antidepressant use and heart defects.

While the findings should be reassuring for expectant mothers who take antidepressants, Huybrechts says that “heart defects are one factor in a whole range of potential risks” associated with the drugs. Some studies hint, for example, that the medications may contribute to hypertension in newborns, as well as other adverse health conditions. “The study provides quite solid evidence of the low risk in terms of cardiac malformations, but the treatment decision should consider the whole range of other potential adverse outcomes,” Huybrechts says. “[Decisions also need to consider] potential risk of not treating women who are severely depressed and required pharmacologic interventions. It’s one piece of the puzzle but definitely not the whole answer.”

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