Latest news with #Buil
NBC News
09-07-2025
- Health
- NBC News
Fungal infections are getting harder to treat
Fungal infections are getting harder to treat as they grow more resistant to available drugs, according to research published Wednesday in The Lancet Microbe. The study focused on infections caused by Aspergillus fumigatus, a fungus that is ubiquitous in soil and decaying matter around the world. Aspergillus spores are inhaled all the time, usually without causing any problems. But in people who are immunocompromised or who have underlying lung conditions, Aspergillus can be dangerous. The fungus is one of the World Health Organization's top concerns on its list of priority fungi, which notes that death rates for people with drug-resistant Aspergillus infections range from 47%-88%. The new study found that the fungus's drug resistance is increasing. On top of that, patients are typically infected with multiple strains of the fungus, sometimes with different resistance genes. 'This presents treatment issues,' said the study's co-author, Jochem Buil, a microbiologist at Radboud University Medical Centre in the Netherlands. Buil and his team analyzed more than 12,600 samples of Aspergillus fumigatus taken from the lungs of patients in Dutch hospitals over the last 30 years. Of these, about 2,000 harbored mutations associated with resistance to azoles, the class of antifungals used to treat the infections. Most of them had one of two well-known mutations, but 17% had variations of these mutations. Nearly 60 people had invasive infections — meaning the fungi spread from the lungs to other parts of the body — 13 of which were azole-resistant. In these people, nearly 86% were infected with multiple strains of the fungi, making treatment even more complicated. 'It is an increasingly complicated story and physicians may have trouble identifying whether or not they are dealing with a drug-resistant fungal infection,' said Dr. Arturo Casadevall, chair of molecular microbiology and immunology at the Johns Hopkins Bloomberg School of Public Health who wasn't involved with the research. Before treating an Aspergillus fungal infection, doctors look for resistance genes that can give them clues about which drugs will work best. If someone is infected with multiple strains of the same type of fungus, this becomes much less clear-cut. Oftentimes, different strains will respond to different drugs. 'Azoles are the first line of treatment for azole-susceptible strains, but they do not work when a strain is resistant. For those, we need to use different drugs that don't work as well and have worse side effects,' Buil said, adding that some people will require treatment with multiple antifungal drugs at the same time. The findings illustrate a larger trend of growing pressure on the few drugs available to treat fungal infections — there are only three major classes of antifungal drugs, including azoles, that treat invasive infections, compared with several dozen classes of antibiotics. Resistance to these drugs is growing, and new ones are uniquely difficult to develop. Humans and fungi share about half of their DNA, meaning we're much more closely related to fungi than we are to bacteria and viruses. Many of the proteins that are essential for fungi to survive are also essential for human cells, leaving fewer safe targets for antifungal drugs to attack. 'The big problem for all of these fungal species is that we don't have a lot of antifungals,' said Jarrod Fortwendel, a professor of clinical pharmacy at the University of Tennessee Health Science Center, who was not involved with the research. 'Typically the genetic mutations that cause resistance don't cause resistance to one of the drugs, it's all of them, so you lose the entire class of drugs.' Further complicating matters, the vast majority of azole resistance in Aspergillus fumigatus stems from agriculture, where fungicides are widely used. These fungicides typically have the same molecular targets as antifungal drugs. Farmers spray them on crops, including wheat and barley in the U.S., to prevent or treat fungal disease. (The first instance of azole resistance was documented in the Netherlands, where antifungals are widely used on tulips.) Aspergillus fungi aren't the target, but exposure to these fungicides gives them a head start developing genes that are resistant to these targets, sometimes before an antifungal drug with the same target even hits the market. This was the source of the vast majority of the drug resistance analyzed in the study. Fortwendel noted that fungal resistance is increasingly found around the world. 'Basically everywhere we look for drug-resistant isotopes, we find them,' he said. 'We are seeing this azole drug-resistance happening throughout the U.S. Those rates will likely climb.' Any individual person's risk of having an azole-resistant Aspergillus fumigatus is low, Casadevall said. Infections typically affect people who are immunocompromised and amount to around a few thousand cases per year in the U.S., Casadevall estimated. While relatively uncommon, the bigger risk is the broader trend of drug-resistant fungal infections. 'The organisms that cause disease are getting more resistant to drugs,' he said. 'Even though it's not like Covid, we don't wake up to a fungal pandemic, this is a problem that is worse today than it was five, 10 or 20 years ago.'
Yahoo
04-02-2025
- Politics
- Yahoo
Could US criminals be sent to El Salvador's mega-jail?
US Secretary of State Marco Rubio could not have been more complimentary about the deal he struck with the president of El Salvador on Monday. The Trump administration's top diplomat appeared delighted yet stunned by the fact that President Nayib Bukele should have "agreed to the most unprecedented, extraordinary, extraordinary migratory agreement anywhere in the world". Bukele had offered to take in people deported from the US, regardless of their nationality, and house them in El Salvador's mega-jail. "We can send them and he will put them in his jails," Rubio said. While that was already a win for President Donald Trump, whose priority has been to speed up the removal of undocumented migrants from the US, the real surprise came in the part of the deal Rubio mentioned next. "He [Bukele] has also offered to do the same for dangerous criminals currently in custody and serving their sentences in the United States even though they're US citizens or legal residents," Rubio said. The Salvadorean leader confirmed that he had "offered the United States of America the opportunity to outsource part of its prison system". He clarified that El Salvador would be "willing to take in only convicted criminals" and that his government would do so "in exchange for a fee". Bukele also revealed where he would house those deported from the US: "our mega-prison". The mega-jail, also known as Cecot (short for Terrorism Confinement Centre), has become emblematic of Bukele's iron-fist approach to crime and punishment. The maximum-security prison, one of the largest in Latin America, opened in January 2023 and can house 40,000 inmates, according to government figures. Inmates are confined to windowless cells, sleep on bare metal bunks and are constantly monitored by armed guards - some of whom watch over them from atop the lattice ceiling. BBC News Mundo's Leire Ventas, who was allowed to take an official tour of the facility last year after the BBC had repeatedly asked for access, described how temperatures in the cells would reach 35C. Take a look at graphics and maps of the mega-jail With access to the prison severely restricted and journalists only allowed on occasional and carefully choreographed official tours, the number of inmates per cell is not clear. Some rights groups put it at 80 prisoners while others say it can go up to more than 150. Asked by our journalist what the maximum capacity was, the prison's director responded "where you can fit 10 people, you can fit 20". Face to face with inmates in El Salvador's mega-jail Prisoners are locked up inside their cells 24 hours a day - except for 30 minutes of group exercise in a windowless corridor. The layout of the jail is no coincidence. Following a particularly bloody weekend in 2022, when more than 70 people were killed in the small Central American nation, President Bukele wrote on social media: "Message for the gangs: because of your actions, your "homeboys" will not be able to see a ray of sunshine". Building of the Cecot mega-jail was started shortly afterwards. Conditions at the jail and the treatment of inmates has come under severe criticism from human rights groups. Miguel Sarre, a former member of the United Nations Subcommittee for the Prevention of Torture, has described it as a "concrete and steel pit". So could the Trump administration send US citizens there? On Tuesday, Trump told reporters he would embrace the idea but questioned its legality. "If we had the legal right to do it, I would do it in a heartbeat," he said during an executive order signing ceremony in the Oval Office. "I don't know if we do or not. We're looking at that right now, but we could make deals where we'd get these animals out of our country." But any attempt to deport US citizens or people lawfully resident in the US to a foreign jail is bound to face legal challenges. US citizens who were born in the United States enjoy legal protection from deportation. There are some cases, however, in which naturalised citizens - those who were not born in the US and who obtained US citizenship after birth through a legal process - can have their citizenship revoked. This tends occur when the person in question used fraud to obtain the citizenship in the first place. Alex Cuic, an immigration lawyer and professor at Case Western Reserve University in Ohio, told the BBC that naturalised US citizens suspected of ties to criminal gangs or terrorist organisations -- such as the Tren de Aragua criminal gang or the Mara Salvatrucha, known as MS-13 - could also, in theory, be stripped of US citizenship. "If they find out you were a member of any group that persecuted or threatened to persecute others, they can try to denaturalise you," Mr Cuic added. "So, if you had gang ties and never disclosed them, they could use that as a reason to denaturalise you." Once a person has been "denaturalised", they are at risk of deportation. Mr Cuic pointed out that any such move would have to be preceded by a "formal court process" conducted in a federal court. But the lawyer warned that "citizenship is not something that is definitively forever if you are naturalised". He stressed though that he had "never heard" of cases of natural-born US citizens being sent abroad for imprisonment for crimes committed and prosecuted in the US. Shev Dalal-Dheini, the director of government relations for the American Immigration Lawyers Association, similarly said that she had "never heard of such a suggestion" as sending US citizens to serve US prison sentences overseas. While she acknowledged that there were various scenarios in which naturalised US citizens could lose their citizenship, she said that "you can't denaturalise a natural-born citizen". The status of lawful permanent residents in the US, however, is more precarious than that of US citizens. They can be deported if they violate certain provisions of the Immigration and Nationality Act, which include committing drug offences, violent crimes or crimes such as theft, fraud or assault. Like naturalised citizens, they can also be deported if they obtained their residency through fraud. Permanent lawful residents who are involved in terrorism, espionage or any activity threatening US national interest could also be at risk of deportation. This last point is important in light of the executive order President Trump issued on his inauguration day in which he designated drug cartels as "foreign terrorist organisations". Two criminal organisations named in the executive order, Tren de Aragua and MS-13, were also mentioned last week by Trump's special envoy for Latin America, Mauricio Claver-Carone. Speaking at a briefing about Marco Rubio's trip to El Salvador, Claver-Carone not only praised Bukele's handling of the MS-13 - a gang which is deeply rooted in El Salvador and has long terrorised its citizens - but also said that Bukele could offer the answer on how to deal with the Venezuelan gang Tren de Aragua. Claver-Carone also appeared to argue that the mere prospect of being sent to a Salvadorean jail could drive Venezuelan gang members back to their homeland. "I bet they're going to want to go back to Venezuela instead of dealing with the Mara prisons in El Salvador," he said of members of the Tren de Aragua gang. Marco Rubio, too, seemed to stress that the Trump administration would first and foremost want to send members of these two notorious gangs to El Salvador's prisons. "Any unlawful immigrant and illegal immigrant in the United States who is a dangerous criminal -- MS-13, Tren de Aragua, whatever it may be -- he has offered his jails," Rubio said after his talks with Bukele. While it is by no means clear who - if anyone - will being sent from the US to El Salvador's mega-prison, what is certain is that with his "unprecedented offer of friendship", Bukele has landed firmly in the Trump's favour at a time when relations between the US and its neighbours have been rocked by the US president's threats to impose tariffs on their goods. With additional reporting by the BBC's Bernd Debusmann Jr in Washington, DC. Mass arrests bring calm to El Salvador but at what price? El Salvador voters focus on security ahead of poll In pictures: A rare glimpse into Salvadorean jails
