Latest news with #AbdulGhafur
The Hindu
27-05-2025
- Health
- The Hindu
The pleasing whiff of good bugs - where microbiology and perfumes meet
For someone who has been battling bad bugs for his entire professional life, life has produced an interesting deviation for Abdul Ghafur, infectious diseases expert. He has now begun engaging with the good bugs too, in particular looking at the skin microbiome to see what perfume is right for you. That's right. The perfume type has to be at ease with your skin microbiome, for it to actually work. Otherwise, multiple applications and overexposure to the chemicals in the perfumes might turn sour, at the least, and at the extreme, even turn harmful for humans. Microbiome bugs and perfume chemistry 'We think of bugs as being all 'bad', but that is not true at all. About 99.999 % of bugs are either neutral or good for us. It's only 0.001 % of bugs that are 'bad', rather, disease causing,' Dr. Ghafur hastens to clarify. While his profession hitherto has set him up arms akimbo, against the disease-causing critters, his passion has more recently set him on the side of the good ones! 'I am a connoisseur of perfume. And I've always wondered why some perfumes work for some people, but not for others. No two people have the same skin microbiome, and that's why a perfume that smells divine on one person may not work the same on another. The secret lies not just in the perfume, but in how your skin's bacteria interact with its ingredients,' he explains. If a certain perfume does not work, 'people just keep changing their brands frequently, or they think they have to apply more, spray liberally, or use the perfume multiple times. All of which cannot be good, because these perfumes are essentially a cocktail of chemicals that can impact the skin, cardiac health and may also be carconigenic,' he adds. That is what led him to studying what determines why perfumes work or not. 'It's skin chemistry, basically. The human skin is home to millions of bacteria that control the pH level, dryness, oil content etc. And we have plenty of data on these skin microbiome,' he explains. Sweat itself has no odour, it's just salt and water, it is the skin bacteria that lend the smell to sweat. Key players in body odour As far as body odour goes, there are three key groups of enabler bugs: Propionibacterium acnes that is found in areas with the lubricating sebaceous glands (face, back, chest, arm pit, groin), they contribute to a stronger body odour with a musky smell. The second is Micrococcus, which is found on various parts of the body, and its main role is to convert the sweat into ammonia and sulfur compounds, giving body odour a stronger and sharper scent. Finally, there is the Lactobacillus, which is found in the face, scalp, armpits, and groin. While it does not significantly contribute to body odour, instead does the opposite - helps prevent overgrowth of odour-producing bacteria. The concentration of skin microbiome is influenced by food, the enviroment and weather changes, but the percentage composition of the main bacterial group remains the same for an individual for a long while. There are specifications on where certain types could be used, for instance, floral notes should be used on the wrist, which is a dru area, musky scents on the neck, which is comparitively moist. Integrating skin microbiome analysis into fragrance science There is a lot of information available about the skin microbiome from a health perspective, but literally none of that has been adopted by the fragrance industry. 'But we have information, so we need to extrapolate our insights and findings to understand the personalisation of perfumes for individuals,' Dr. Gafur says. He has now taken up skin micobiome metagenomic testing for other connoisseurs of perfumes. 'We are not recommending testing for everyone. There is no viable business model for routine, expensive metagenomic testing before choosing a perfume. Our goal is to share valuable insights from microbiome and VOC ( Volatile Organic Compound) research and how they can be applied conceptually to fragrance use,' he says. Some people do spend lakhs on perfumes, and knowing what works for them will be helpful. All they need is a gentle skin swab—rubbing a cotton bud softly on the skin, and this swab is then used for skin microbiome metagenomic analysis to identify the unique bacterial profile of your skin. Recent consumer surveys, he adds, have shown an increased interest in safe and microbiome-friendly products. 'Several deodorants are already microbiome friendly, but that kind of orientation for perfumes is missing. We must remember, if deodorants are a song, them perfume is like a symphony,' Dr. Ghafur says. Clearly, we need to take care of the symphony as well.
Indian Express
01-05-2025
- Health
- Indian Express
Lancet study shows drug resistance three times higher in cancer patients: What are risk factors?
Infections caused by drug-resistant bacteria are the second leading cause of death in cancer patients, according to a new study published in The Lancet Oncology. Researchers analysed over 1.5 million pathogens (including over 50,000 from patients with cancer) and found that counts of different antimicrobial-resistant bacteria were between 1.2 and three times greater in outpatients with cancer. The study is significant because it is the first large multi-centre study to quantify AMR bacteria in outpatients with cancer in the US. The bacteria was isolated from adults aged 18 and older, with and without cancer, at 198 outpatient facilities. The authors have highlighted that the higher counts of AMR bacteria in outpatients with cancer may be due to the use of antibiotics they received during chemotherapy. Study co-author and Fellow of the Infectious Diseases Society of America (FIDSA) Vikas Gupta, says AMR is a growing global health crisis. 'Given the rising rates of AMR globally, more specifically in India, and the increasing drug resistance in vulnerable cancer populations, there should be careful consideration about antibiotic stewardship. This means optimising the use of antibiotics, maximising their efficacy while minimising their harm. Additionally, surveillance efforts to quantify AMR among the cancer-affected population must be undertaken because cancer incidence is projected to increase,' he says. What the study says Data was collected between April 1, 2018, and Dec 31, 2022. Across all evaluated pathogens, outpatients with cancer had significantly higher AMR rates per 1,000 pathogen isolates for P aeruginosa and Enterococcus spp compared to non-cancer outpatients. Why cancer patients are at a higher risk The results are not unexpected for Dr Abdul Ghafur, consultant in infectious diseases, Apollo Hospital, Chennai and coordinator of the Chennai Declaration on AMR (not attached with the study). 'Cancer patients are at a higher risk because they visit hospitals and healthcare facilities much more frequently than non-cancer patients — before the diagnosis, during the diagnostic process, and later for chemotherapy, radiotherapy, outpatient visits and multiple admissions. With each hospital visit, each admission, and each infection episode, the exposure to antibiotics increases. Naturally, more infections require a higher antibiotic exposure, which means a higher risk of developing drug-resistant bacterial infections,' he says. Not only a cancer patient's problem, AMR needs global strategy In cancer patients, the AMR crisis is not a 'silent pandemic' but a very visible, overt pandemic. Since patients are immune-compromised, infections have more severe consequences. 'At our cancer centre, approximately 20% of E. coli and 40–50% of Klebsiella isolates are carbapenem-resistant. Mortality is notably higher in cancer patients infected with drug-resistant bacteria compared to those infected with drug-susceptible strains. This trend holds true in both cancer and non-cancer patients,' says Dr Ghafur, arguing for a well-designed antibiotic policy at the hospital level to reduce mortality. He also argues for a detailed data collection from patients to formulate an antibiotic use policy. 'In cancer patients, antibiotic therapy must begin without delay — there is no time to wait. 'With the right data, one can make an informed choice to improve patient outcomes,' he adds.
The Hindu
30-04-2025
- Health
- The Hindu
Study highlights lack of access to right antibiotics in eight countries
Only 7.8% of patients with drug-resistant infections in India received an appropriate antibiotic, a study of eight nations published in The Lancet Infectious Diseases journal has revealed. Lack of access to appropriate treatment for such serious infections increases morbidity and mortality, besides driving up health care costs and prolonging hospitalisation. Research carried out by Global Antibiotic Research and Development Partnership (GARDP), a non-profit health organisation, has revealed that a significant number of multidrug-resistant infections in low- and middle-income countries (LMICs), including India, are not being treated appropriately, because of large gaps in access. The study looked at which antibiotics were available to treat nearly 1.5 million cases of carbapenem-resistant Gram-negative (CRGN) infections across eight geographically diverse and populous LMICs — Bangladesh, Brazil, Egypt, India, Kenya, Mexico, Pakistan and South Africa. India's 7.8% measures are against an average of 6.9% across all eight countries. The study was undertaken to establish the barriers along the treatment pathway from initial presentation at the health facility to laboratory diagnostic testing to antibiotic access. Two key parameters The researchers defined and estimated two key parameters — the need for treatment or total number of resistant bacterial infections; the number of individuals potentially initiated on appropriate treatment, specifically focusing on CRGN infections. Researchers used The Lancet's 'Global Burden of Antimicrobial Resistance' (GRAM) study and IQVIA data for 2019 to arrive at the numbers. 'We were looking at three aspects,' explains Jennifer Cohn, GARDP's Global Access Director and senior author of the study. 'These were: To evaluate the access to antibiotics gap; create better data that will be an imperative to better define the cascade of care; and look at strong programmes or innovations that enabled better antibiotics stewardship in nations.' While the study only focused on eight countries, including India, she said there was a good reason to believe that the findings from this study also apply to other LMICs. 'We all know that high-end antibiotics are extensively overused and misused in countries like India, contributing significantly to resistance against these life-saving drugs. But this paper reminds us of an equally alarming issue — lack of access to these same antibiotics,' says Abdul Ghafur, infectious diseases specialist and founder, AMR Declaration Trust. 'In 2019, India had nearly 10 lakh carbapenem-resistant gram-negative infections, yet less than 1 lakh patients received appropriate treatment. The modelling suggests that around 3.5 lakh deaths occurred due to these infections. So we are caught in a paradox — irrational overuse on one end, and insufficient access on the other,' he added. 'To address this dual crisis, we must act on both fronts: preserve existing antibiotics through responsible use and ensure access to those who genuinely need them,' Dr. Ghafur further suggested. In the paper, authored by Anant Mishra et al, the recommendations are to set in place regulatory guardrails that will not only control antibiotics use, but also make sure that the access gap is bridged by nations and institutions. They also call for more research to better understand the barriers in accessing care, diagnoses and appropriate treatment.
The Hindu
24-04-2025
- Health
- The Hindu
Experts warn against overuse of last line antibiotics
Infectious diseases experts have flagged the overuse of a potent antibiotic leading to it losing its efficacy, and drug resistance. The Drugs Controller General of India has been urged to lay down strict pathways for these newer antibiotics, so that they are not misused by practitioners. Abdul Ghafur, infectious diseases specialist, and founder of the AMR Declaration Trust, has written to Rajeev Singh Raghuvanshi, DCGI, about ceftazidime-avibactam. 'One of the most potent antibiotics currently available in our armamentarium is rapidly losing its efficacy due to extensive, irrational, and uncontrolled use.' The drug which was initially registered with the U.S. FDA in 2015 and after three years it was approved in India, is a last-line antibiotic. It is to be used as targeted therapy for certain carbapenem-resistant gram-negative infections and not prescribed as a general antibiotic. Dr. Ghafur however claims it is already being misused in the community. 'To overcome this resistance, aztreonam is often added to ceftazidime-avibactam, unfortunately, resistance has now emerged even to this combination, due to irrational use.' The problem, he explains, is that while the DCGI has licenced the drug, it has only provided indications for use. There are no clear-cut pathways laid out, and nothing to deter mis-prescriptions. This trend could erode the huge gains secured in India primarily with the ban on use of colistin as a growth promotion drug amongst poultry, in recent times. This 'bold and meaningful action' from the government resulted in a significant drop in prevalence of colistin-resistant bacteria in hospitals in India, he adds. Rational use There are two new very powerful antibiotics that are about to enter the Indian market, Cefierocol and Cefepime-zidebactam. Dr. Ghafur urges the DCGI to kick in with antibiotics stewardship: 'We need these drugs in India. However, their use must be restricted strictly to infections where no other effective alternatives exist. Education alone is not enough; we need a clear regulatory pathway to ensure the rational use of these molecules from the moment they are licensed.' 'If we do not act now, we risk losing the few therapeutic options left. Antimicrobial resistance (AMR)is already a serious crisis in our country. Without urgent and strong action, it may escalate to an unmanageable level. We cannot change the past — but we still have time to act for the immediate future,' he says.
