Ondine Biomedical, Inc

Although hospitals are centers of refuge for those who need care, an unfortunate reality is that the number of people coming in and leaving these facilities inevitably results with the spread of disease and infections between patients, doctors, and other health care workers. These unintentionally transmitted diseases, born in hospital settings, are collectively known as Hospital Acquired Infections (nosocomial infections in medical literature). This class of disease results in over  99,000 deaths each year in the United States alone.

One significant form of nosocomial infection is Ventilator Acquired Pneumonia (VAP) which, as the name suggests, is pneumonia (an inflammatory condition of the lung) transmitted to patients while they are on mechanical ventilator breathing support. The incidence of this disease is between 8% and 20%, and mortality rates are between 20% and 50%. As a result, VAP has a critical impact on morbidity, length of stay, and cost of ICU care.

A significant contributor to such high rates of incidence and morbidity is the fact that patients on mechanical ventilation systems are often sedated and are rarely able to communicate or cough up the biofilm that grows in the tubes and drains down into the lungs. Typical symptoms of pneumonia may be absent or unobservable, leading to delays in detection and therefore treatment.  Under these conditions, the medical signs that a patient has acquired pneumonia are increased number of white blood cells on blood testing and new shadows (infiltrates) on chest x-rays. Other important signs are fever, low body temperature, purulent sputum, and hypoxemia (decreasing amount of oxygen in the blood).

If any of these symptoms are suspected by care takers, two conventional methods of diagnosis are deployed. The first is to collect cultures from the trachea while also scanning the chest with an x-ray to detect new or enlarging infiltrates. The other method is more invasive and involves a bronchoalveolar (where fluid is squired out small areas of the lung and recollected for examination), as well as a chest x ray.

Treatment regimens depend on the specific bacteria causing the inflammation, although a widely used first step is the prescription of empiric therapy (broad spectrum antibiotics) until the particular bacterium and its sensitivities are determined. Once the specific microorganisms implicated in generating pneumonia are known, more antibiotics are prescribed. The use of antibiotics raises the issue of resistance from the bacteria, and the related decrease of efficacy of the antibiotic in the years to come.

Photodisinfection is a non antibiotic approach under development by the research and development teams at Ondine Biomedical Inc., for the decolonization of the tubes of long term intubated patients. Pre-clinical studies have demonstrated proven effects of Photodisinfection directed toward the inner surface of the endotracheal tubes. The Exelume™ Photodisinfection system is currently being tested in NIH funded clinical trials in the US. Other Photodisinfection applications under development by Ondine include:  periodontitis, chronic sinusitis, burns & wounds, UTI, vertical transmission of HIV, nasal decolonization to reduce SSI, GI infection protection, etc.

By the time we are 18, we have received 10-20 courses of antibiotics. This antibiotic usage has enabled us to live longer and healthier lives, by overcoming bouts of infections. But there are, of course, drawbacks to this antibiotic consumption. The most obvious and most worrying of these drawbacks, is the development of drug resistant bacteria (superbugs) such as MRSA. However, antibiotics also kill the normal microflora, the ‘good bacteria’ that we need to maintain good overall health. The long term implications of repetitive disruption of our microflora by antibiotics, unfortunately, are not understood and not being adequately investigated.

When in the right concentrations and when the body’s natural immune system is healthy, bacteria are an important part of us. In fact, there are 10 times more bacteria cells in us than there are human cells.⁵ Human cells and bacteria have developed a symbiotic relationship over time. In order to answer the question of whether harming the good bacteria is harmful to us in the long run, we need to understand more about bacteria.  So how are bacteria beneficial to us?

Firstly, in our stomach, intestines and colon, we have “good” bacteria that play a major role in breaking down our food into nutrients to be absorbed by our body and into waste material that is eventually eliminated.  Along the way, these good bacteria take up colonization sites thereby preventing harmful bacteria, and other pathogens, from taking residence where they do not belong.

Secondly, bacteria can also play a major role in the production of key elements in our body. For example, Bacteroides species of bacteria live in our colon and help us produce Vitamin K, needed for blood clotting. Helicobacter pylori (H. pylori) is another example of the body needing a bacteria to function properly. H. Pylori, while responsible for stomach ulcers in some people when in overabundance, seem to play a major role in the generation of key hormones that control our appetites. H. Pylori appears to affect the regulation of the two hormones, ghrelin and leptin, involved in human energy homeostasis and implicated in the control of food intake such as controlling hunger. Leptin signals to your body it is full while ghrelin stimulates appetite. In one study, it was determined that fewer than 6% of children’s stomachs in the United States, Sweden, and Germany now carry H. Pylori. The lack of Helicobacter pylori has been thought to be linked to the increase in gastroesophageal reflux, Barrett’s esophagus, and esophageal cancer. Interestingly, those lacking H. pylori are also more likely to develop asthma, hay fever or skin allergies.1 Dr. Martin Blaser, a professor of microbiology at New York University Langone Medical Center, suggests ‘that antibiotics may permanently alter your gut bacteria and interfere with important hunger hormones secreted by your stomach, leading to increased appetite and body mass index (BMI)’.³

Our bodies have been living in balance with our bacteria for thousands of years. It is a symbiotic relationship that is now being permanently altered by the use, overuse and misuse of antibiotics. No one knows at this point how seriously antibiotics are harming our long term health prospects. It will take decades worth of research and the resolve of governmental forces to undertake this large scale investigation. However, for today, it is worth asking the question; “By harming our good bacteria, are we not also harming ourselves in the long run?”

^{References: 1} http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2435636/

² http://articles.mercola.com/sites/articles/archive/2011/11/24/antibiotics-promote-obesity.aspx

³ http://www.jpp.krakow.pl/journal/archive/11_06_s5/articles/05_article.html

⁴ http://en.wikipedia.org/wiki/Bacteria

The expression “food for thought” is often used proverbially more than literally, although results from FDA reports make it necessary to consider how our food and livestock are processed and put serious thought into the food we eat. To make the case immediately apparent, consider that four fifths of all antibiotic consumption in the USA is not human consumption; it’s consumed by farm animals. To quantify this statement, in 2011, 7.7 million pounds of antibiotics were consumed by American people, while 29.9 million pounds went into meat and poultry production.

Antibiotics Sold to Livestock Industry vs. Sold for Human Consumption.

The proportion of antibiotics fed to livestock is not a recent issue, it has been growing and the problems that arise from it have accumulated for over 50 years. An alarming development of bacteria that had grown drug resistant due to antibiotics in the livestock industry is MRSA (short for methicillin-resistant Staphylococcus aureus) which is a persistent threat to human health. Estimates indicate that MRSA kills 19,000 Americans each year, hospitalizes 370,000, and results in billions of dollars of additional health care spending. The intent of these statistics is not to frighten, but to raise awareness concerning administering millions of pounds of antibiotics annually to artificially boost animal growth. Maryn McKenna wrote a book chronicling the rise and danger of these superbugs (http://superbugthebook.com/).

What is important to note is that a vast majority of the provided antibiotics is not to target infections or better animal health. It is administered at a herd or flock wide basis through the animals water source or feed to promote growth and weight gain, as well as to preventatively help livestock survive harsh farm and living conditions. This is one reason why antibiotics are used, another is for therapy. Therapy is used when farm animals exhibit clinical diseases, and drugs can be an effective way to prevent catastrophic health risks that could be detrimental to the agricultural sector.

Administering antibiotics to animals is not an inherently bad thing to do, although it can become detrimental if done without caution and concern. The FDA’s report on the application of antimicrobial drugs in industry warns that “the development of resistance to this important class of drugs, and the resulting loss of their effectiveness as antimicrobial therapies, poses a serious public health threat”. In this article, the main point is not to suggest entirely eliminating antibiotic consumption in the livestock industry, but to manage it judiciously by targeting specific diseases. Another significant argument is that farmers and food corporations should “voluntarily” withdraw from using drugs which have a functional similarity to drugs used in humans, since this would reduce the concern for transmitting resistive bacteria on to humans through our food. Use of antibiotics for livestock growth promotion has been banned by many European countries, as they have determined that similar investment in more food resulted in the same growth yields without the additional antibiotic resistance generation.

It is evident that we can no longer take how our food is produced for granted. The expression food for thought is no longer some overused metaphor, it is a reality.

This week, the 1st Scientific Meeting of the PanAmerican Photodynamic Therapy Association (PAPDT) will be held in Boston, Massachusetts on Saturday, April 6, 2013, from 8:30am-5:30pm. For the first time the Annual Scientific Meeting will be held in association with the American Society for Laser Medicine and Surgery (ASLMS) to enhance the basic science and clinical interdisciplinary aspects of photodynamic therapy, bringing together scientists, clinicians and engineers with an interest in both photonics and medicine to share their experiences from bench to bedside.

The main theme of this Scientific Meeting will be to discuss the basic science and clinical advances in cancer, antimicrobial and other photodynamic therapeutic applications with the declared focus of improving the scientist/clinician interface.  The PanAmerican Photodynamic  Therapy Association is soliciting abstracts for oral presentations and posters.  Please submit your abstract using the ASLMS online system for submission.  You will need to select “Photodynamic Therapy” as the presentation category.  Important to note, you must either email Michelle directly at michelle@aslms.org so that she knows the abstract is for the PanAmerican Photodynamic Therapy Association.  Students and young researchers are especially welcome.

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It takes a certain kind of person to be a great clinician and caregiver. In a world full of opportunities for education, talent and hard work, it takes a special kind of person to dedicate their lives to the pursuit of better patient outcomes.

It is a life of service, long hours, and often, lack of appreciation.

The personal sacrifice is always greater than anyone truly understands, and yet doing more for people in their hour of need is the greatest reward.

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We couldn’t be any more excited by this! After announcing the results of our Vancouver General Hospital project, we were featured on national canadian news.  In this year-long quality improvement project, patients entering major select surgeries were treated with MRSAid Photodisinfection System and chlorhexidine body wipes. This was done to reduce their risk of developing surgical site infections. Here are highlights of the data:

• Surgical site infections were reduced by 39%
• Vancouver General Hospital saved ~$1.9 million
• Readmissions due to surgical site infections decreased from 4 to 1.25 cases/month
• 553 patient bed days were freed up
• 138 more surgeries could be performed

We are grateful for the amazing work Dr. Elizabeth Bryce and her team at Vancouver General Hospital team has done to integrate MRSAid into their workflow. Check out these videos:

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It takes a certain kind of person to work for a small Canadian Medical Devices R&D company…not just anyone can make the cut. First of all you need raw talent and horsepower to make the team. Then, you need a lot of heart, stamina and a great deal of dedication to the mission. You need to feel the passion. Combining passion with talent creates the makings of success….and we aim to succeed. Our goal is to save lives and improve patient outcomes around the world. Our people are our greatest assets, and we continue to battle a world of resistance. As this year draws to a close, it is natural to look back on the year and its triumphs and its frustrations. 2012 was a challenging year for Ondine as I struggled to get myself back together again. I am so very proud of this amazing team that did their very best and wish to sincerely thank each individual for their extraordinary contributions made over this past year. They both motivate and inspire me to fight the good fight.

As the old saying goes, ‘Christmas is a time for giving’—a time to share gifts and reconnect with friends, family, and loved ones.  It’s also the time of year that many of us get sick and unintentionally spread illness to all those around us— whether it’s a cold, flu, or bacterial infection.  While receiving socks and underwear under the tree may be disappointing— or downright depressing—coughing or vomiting through the holiday season doesn’t exactly make for fond yuletide memories or warm Christmas cheer.

In fact, lining up for the bathroom after eating a partially cooked turkey has been known to scar even the most diehard Santa fans.  So, in the true spirit of Christmas prevention, we’ve come up with a short list of health tips, so you and your loved ones can avoid a less than ideal holiday experience.

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Laziness, disillusionment, anger— these are just a few words that come to mind when considering the problem of antibiotic resistance.   From the deliberate misuse of antibiotics in animal feeds, to wide-spread, inappropriate prescriptions for viral infections, the sheer scale of the problem lends itself to feelings of powerlessness and frustration.  For many of us, it’s simply easier to ignore the warning signs and shrug off the future consequences of doing nothing.  Unfortunately, the reality is that people are dying every day—in hospitals, nursing homes and long-term care facilities—from bacteria that were once treated with antibiotic therapy. What were once miracle drugs just a few decades ago—able to eradicate any bacterial infection in the blink of an eye— are now no longer working for a number of infections.  With a lack of good treatment options against resistant strains such as MRSA, enterococci, and c. difficile, frontline health professionals are becoming increasingly alarmed and frightened for future patients.

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Topping some 29-million pounds per year, antibiotics given to livestock have reached record numbers with no hints of slowing down.  With superbugs and antibiotic resistance on the rise, everywhere, the implications for public health are staggering.  Primary used as a growth enhancing agent in factory farming, antibiotics help to offset the risk of disease among livestock living in cramped and squalid conditions.  While increasing profitability for farmers, this practice also streamlines the creation of resistant strains of bacteria—or superbugs—that ultimately infect human beings and threaten our ability to treat bacterial infections as a whole.  At the current rate of resistance, it’s not impossible to conceive of a future where some infections become untreatable and result in death.

In the agricultural world, most major classes of human antibiotics are well represented—that is everything from penicillins, cephalosporins, macrolides, to aminoglycosides are available for animal use.  These drugs, in their human forms, are used to treat the majority of bacterial illnesses—from strep throat to C. difficile infections.  Considering bacteria’s handy-dandy ability to swap resistance factors, it’s hardly surprising that antibiotics are beginning to lose potency among human patients.  As a 2003 Danish study put it, ‘humans and animals share overlapping reservoirs of resistance [to antibiotics]’.  The same study demonstrated the idea that resistant strains could jump from animals fed antibiotics to humans.  The bacterial strain of choice, an enterococci, which was isolated from human beings was able to demonstrate resistance to one of the strongest, last line antibiotics available to medicine: vancomycin.  Interestingly, after the EU banned the offending feed product, levels of resistance in animals, food, and people began to decrease.  Read More