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The Most Dangerous Bacteria
An anonymous reader writes "Forbes has a story listing the six most dangerous bacteria (one's actually a fungus, but it kills people who get it half the time) that have afflicted athletes, soldiers, and hospital patients. Some scientists worry that even with a bunch of new antibiotics hitting the market, there still aren't enough and they want legislation to make it easier for companies to develop them."
As I am a ICU doctor, I see these guys more often that I want.
The problem is that the drug companies don't make much money from antibotics. They have high production costs and are used infrequently...
While hypertension and anti-cholesterol medicines are used by almost everyone if they live long enough.
At least that's the theory why drug companies spend so much less money creating antibotics than other meds.
See the problem is, you can develop 20 different types of medicine to combat different types of bacteria / germs / viruses but they will simply continue to evolve. It's life, all these things have to find some way to keep on going, just like we do.
Syphilis is neither that dangerous nor a bacteria.
The title of the article is very misleading. These 6 are the bacteria/fungus that have been become the highest resistant to antibotics.
Pneumococcus pneumonia, neisseria meningitis, and strep soft tissue infections typically kill patients much quicker than the organisms listed above.... we have good antibotics for these; however, they can just overwealm the system before the antibotics have time to work.
Recently, the British version of the American Medical Association (AMA) recommended that Doctors stop wearing ties and those spiffy white lab coats.
:major: image thing and that patients respond much more favorably to it than normal clothes.
They said that since guys rarely wash their ties, they end up carrying around bugs, ditto for labcoats. The article I read specifically mentioned MRSA*, which is one of the 6 "scary" bugs TFA mentions.
I told this to my doctor and they said that the white lab coats is a
*Methicillin-resistant Staphylococcus aureus
AKA 'Staph'
[Fuck Beta]
o0t!
He spells out how bacteria acquire their antibiotic resistance: The runoff of tainted feedlot manure, containing millions of pounds of diluted antibiotics, enters rivers and watersheds where the world's free bacteria dwell. In cities, municipal sewage systems are giant petri-dishes of diluted antibiotics and human-dwelling bacteria. Bacteria are restless. They will try again, every twenty minutes. And they never sleep.
If you haven't read it already, click the link - it is well worth it. It still scares the hell out of me, and it looks like his dark vision is coming true...
"I will take the Ring," he said, "though I do not know the way."
I'm a mycologist and study fungi that infect plants (not animals). I, however, am extremely familiar with Aspergillus. People don't realize that fungi such as this Aspergillus, and the less harmful and closely related Penecillium, are extremely common in our environment. You breath in spores of these things by the thousands each day! They are also the scurge of introductory plant pathology and microbiology courses everywhere because they contaminate everything.
Fungal infections in people are nasty. They can progress quickly and have awful symptoms. The problem with these infections, in comparison to bacteria, is that our two Kingdoms are relatively closely related. The chemicals that affect fungal growth, for example, often negatively us as well and have multiple side effects.
Ooh, ooh, I know! Let's patent their DNA. That way, if any bacteria decides to multiply, we just drag them through court!
Out of spite for Forbes, here's the list (yeah yeah, you can click slower/faster/stop)...
Methicillin-resistant Staphylococcus aureus (MRSA)
Drug-resistant "staph" causes 102,000 hospital infections a year, more than any other. For sick patients, it can be a killer. Recently, S. aureus has escaped the hospital. The number of children infected jumped 28% in three years. Now, athletes are being infected. In 2003, five football players on the St. Louis Rams suffered staph-infected turf burns that resisted multiple antibiotics.
Escheria coli and Klebsiella
These bacteria, a major cause of urinary tract, gastrointestinal and wound infections, are quickly becoming resistant to existing drugs. Half of Klebsiella, for instance, were found to be resistant to Cipro in a recent study. More worrisome, two experimental drugs being tested against these bacteria are in the same class as drugs to which the bugs are already resistant.
Acinetobacter baumannii
This drug is perhaps most well known for its presence in troops returning from Iraq, where it has infected dozens of patients and spread to others inside hospitals. It is also an increasingly common cause of pneumonia, now accounting for 7% of hospital-acquired cases. There are few existing drugs to treat it, and no medicines in development targeted at this bug.
Aspergillis
Cancer patients, transplant patients and others with weak immune systems are at risk of being infected with this fungus. Once it gets loose in the bloodstream, aspergillis kills 50% of the time or more--and that's with the best new antifungal drugs that have been developed in recent years. Experts complain that drug companies are choosing to test their medicines on other, easier-to-treat fungal infections.
Vancomycin-resistant Enterococcus faecium (VRE)
VRE is a major cause of infection of the heart, brain and the abdomen. A recent survey of 494 U.S. hospitals found infections of 10% across all patient groups. Current drugs do not rapidly kill the bug, and only one is available as a pill.
Pseudomonas aeruginosa
This bug is better than most other bacteria at becoming resistant to new antibiotics. A third of P. aeruginosa were found to be resistant to drugs like Cipro and Levaquin in 2002. Patients with cystic fibrosis are at particular risk; antibiotics can keep them healthy, but once bacteria become resistant, they may need lung transplants.
Bacterial resistance? It's an exercise in futility: doctors are very careful in prescripting antibiotics unnecessarily, but as far as I know, animal feed is laced with antibiotics (makes them grow faster, and you get less disease in crowded conditions). The antibiotics used are related to the ones used in humans. All this resistance came not from antibiotics we use on ourselves, since it is dwarfed by those use for feeding pigs and chickens... Who to blame though? This is a classic case of the "tragedy of the commons" - if one doesn't use antibiotics for his/her farm, one's competitor will.
I acquired it while I was in the hospital in 2004 to have some more of my leg cut off (although the doctors said I might have colonised me outside of the hospital and gone active once they did the surgery, yeah right). The treatment for MRSA was eight weeks of IV Vancomycin and 1000mg of Cipro every day. Now Vancomycin is nasty, nasty stuff, it's pH is so low that it will kill any veins you have it injected into, so you have to deliver it through a central line. It can also cause liver and hearing damage, so if you're on it for any length of time you have to get your liver enzymes tested and your hearing check. It's the next best thing to being on chemo. Cipro is no fun either and it's really fucking scary that there are bacteria that are resistant to these because these drugs, due to their side effects, are the anti-biotics of last resort, anything stronger would probably kill you outright instead of just damaging your liver and hearing.
cheap labor conservatives - they want to keep you hungry enough to be thankful for minimum wage.
More antibiotics is what is getting us into this mess in the first place. Seriously, people get a simple cold and run to their doctor to get a prescription; Mothers run around their house disinfecting everything with wipes and sprays. Parents medicate their children every chance they get. How long until our immune systems aren't worth sh*t anymore because we never get exposed to the little bugs in the first place until it's too late, and how long until we have a pandemic of a human-transmittable infection that has grown immune to all known antibiotics because everybody is pumped full of them all the time?
What about the people who get it all the time? Do they die too?
"Empathise with stupidity, and you're halfway to thinking like an idiot." - Iain M. Banks
when bacteria fail to understand that evolution is only a theory!
"Seven Deadly Sins? I thought it was a to-do list!"
But the main point isn't what Forbes says, to develop more drugs to treat Drug Resistance.
A better point would be to take A Giant Rubber Mallet and Hit Up Side The Head anyone using anti-bacterial soaps, kleenex, sprays, cleaners, etc.
Just
Use
Soap
Seriously, this fad to use anti-bacterial soaps and cleansers:
a. does not work - many studies show that soap, by itself, works as well or better, and not even fancy soap at that, just basic soap
b. builds resistance to antibiotics
c. creates havoc in our streams and rivers as we flush them down our toilets, sinks, and shower/bathtubs
Now, if you want to talk Drug Resistance, I heard a fascinating seminar yesterday at the UW from Christopher Lee, on Mapping Evolutionary Pathways of HIV-1 Drug Resistance, presented by the Center for Computational Biology. He's got a website that has links to at least one of his papers. There he uses evolutionary pathways predictions of Ka/Ks to manipulate viral evolution in ways that you can either slow the drug resistance evolution or force it to evolve into a the equivalent of low-energy traps they have a hard time evolving out of.
-- Tigger warning: This post may contain tiggers! --
unless you call it a bacterium, then it goes on a killing rampage!
Engineering is the art of compromise.
I think that when antibiotics are given, multiple types must ALWAYS be given.
I am not sure if this is the situation today, but assuming multiple anti-biotics require multiple mutations for the bacteria to survive, then multiple antibiotic types should be used to make the antibiotics last longer.
If an antibiotics A requires a mutation with chance P(A) and an antibiotics B requires a mutation with chance P(B), then the combination requires a mutation with chance P(A)*P(B). Giving the antibiotic types separately results in a: MIN(P(A), P(B)) chance of the mutations occuring.
In other words, if we give people "the next" antibiotic type every time, we are "burning" the antibiotics much faster than if we give as many antibiotic types at the same time.
All this assuming different mutations are required to survive multiple antibiotic types.
Since I thought about this in a few minutes of my spare time, I assume that doctors/biology experts know this. My question is: Is this applied? Or is there something I am missing?
We have the expertise! We just need the equipment and salaries. I am, of course, an academic researcher in biology. I don't personally have interest in anti-microbial research, but there are plenty of us Ph.Ds who do. The problem is, the only choices we have are to stay in academia, where product devlopment is nil, or go to industry, where the bottom line takes precedence over all else. I propose more funding to academic labs (and even national labs) specifically to develop antibiotics (and eventually many other pharmaceuticals). Currently, the big Pharmas take research that began at academic labs based on public funds and privatize it by taking some small step forward. I think this is a big scam for the public, who then has to pay up the wazoo to get any of the tangible benefits. If there were a program specifically to help academics take products to market via non-profits, I think real progress in healthcare could be made, even for these difficult-to-make-profitable antibiotics. But, it is difficult to overcome the Pharma lobby.
The rules for dairy cattle and beef cattle are very different. Most people aren't aware of the ban on antibiotics for dairy cattle or that it goes so far that companies that sell milk can't advertise the lack of antibiotics as a feature since everyone else has to do it too.
Beef cattle are very different. Farmers use antibiotics in them because it causes them to grow larger. This is widely considered to be a potential problem for helping to spread immunity to bacteria that can infect humans, but there aren't any good studies proving it one way or another that I'm aware of. If any studies did show up, expect a hard industry push for studies to "disprove" it and hard lobbying to stop any bills to restrict the practice.
For those who are willing to pay, organic beef does not have this problem. Most beef, though, does possess this problem.
If it's for-profit but free, you're not the customer -- you're the product (e.g., the Slashdot Beta's "audience").
Developing new antibiotics is very costly and can be dangerous. Recently, courts have punished drugs manufacturers with incredibly high damage awards. Take for instance the COX-2 inhibitors Vioxx. Granted, there were two (2) victims, but there is no proof that the drug actually killed them. It was simply an added risk.
A lot of antibiotics have the potential to expose their manufacturers to that kind of 8-figure lawsuits. Some of them can create kidney or liver damage and are used as "last chance" drugs. Hospitals and doctors cover their arses by requesting waivers to be signed when this kind of dangerous treatment has to be attempted, but the waivers don't include drug manufacturers, which then become the logical target.
I am the first one to think that drug companies are business, not humanitarian angels, but this is getting ridiculous. There are currently almost 10,000 (10^4) lawsuits against Merck alone. If only 10% of these lead to the multimillion damage payola that's becoming the norm, the company will default and its research labs will be closed down. One less avenue for new drugs, at a time where new diseases are propagating fast and old one are reappearing. Good going.
On top of that, antibiotics are extremely expensive to develop, because of the test protocols involved. There were 10 new molecules brought to the market last year. Ten. The development cost for each was several billions.
So you have a product that has ruinous R&D and makes ambulance chasers drool so much they trip over their own tongue. Is it worth it?
The answer is clear: drug companies now prefer to devote their resources to creating new lawsuit-free products such as dinosaur-shaped kid vitamins. The margins are high, the risks are low, and the lawyers are kept at bay.
So next time you hear someone diss drug companies, remind them that thanks to this kind of attitude, the next generation will have to fight deadly infections with grapefruit flavored, T-rex shaped multivitamins. That ought to cure them all right.
Disclaimer: I don't work for a drug company. But I am not getting younger, and I'd like my generation not to have to back to chewing tree bark when we're sick.
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Mad science! Robots! Underwear! Cute girls! Full comic online! http://www.girlgeniusonline.com/
Wrong on both counts.
1. Syphilis is a spirochete, which is a bacteria. There are other bacteria in this class as well, such as the bacteria that causes 'yaws'
2. Syphilis ravaged Europe and North America among other parts of the world for centuries causing large amounts of morbidity and mortality in newborns and people in late stages of the disease. I'd say that counts as dangerous. Of course, it remains excuisitly sensitive to penicillin and we regularly screen for it now in some populations so its not as common as it once was fortunatly.
The human body is a veritable petri dish, perfectly incubated and full of nutrients. Most antibiotic courses are prescribed in a dosage that will kill the majority of infections of that type, plus a little for safety's sake. If the course of antibiotics is stopped or if the medication is taken over too lengthy a period of time in too small a dosage, then the bacteria take advantage of the wonderful petri dish that is your body. Because they have had an innoculation of antibiotic (just like we give viral innoculations to prevent disease) their tiny cells evolve and can survive the next antibiotic onslaught, keeping the bacteria able to reproduce and people more ill than before.
You may counter and ask why don't we give everyone wide spectrum or cocktails of antibiotic treatments on a regular basis since they are normally more effective against the treatment of bacterial infection? It goes right back to people not following their course of treatment. If medical professionals begin to prescribe these more hard-hitting treatments as a matter of course, then those treatments will quickly become obsolete for the same reason as mentioned above. This is of course ignoring the effect of very strong antibiotics on the helpful bacteria living in our systems which assist said systems in functioning.
Moral of the story: Do like you did in Kindergarten and follow directions (even if you start to feel better after the first day or two of treatment).
The ones mentioned in the article, however, are really all over the place and quite prevalent in the environment (yes, even MRSA—at least where I practice medicine, the prevalence rate of community-acquired MRSA is somewhere between 30-50% of all Staph infections. They are no longer exclusive to the hospital.) They generally don't cause problems in people who have intact immune systems and have intact normal flora. The reason you run into trouble is that patients who have these bugs growing in their bloodstream or eating their lungs are usually already very sick, which automatically means their immune systems are shot out. And if they've been sitting in the hospital for a while, chances are they've had their share of powerful antibiotics which have wiped out all their friendly, benign bacteria that often keep these bad actors in check.
The Gram-positive cocci that get resistant—Staph. aureus and the Enterococci—are still pretty much killable. If you get MRSA, the community-acquired variants still tend to be sensitive to other drug classes like clindamycin, the sulfas, and the tetracyclines. The hospital-acquired variant tends to be tougher, but there's always vancomycin. There have been a few reported cases of vancomycin-resistant Staph. aureus but there haven't been massive outbreaks—yet. Vancomycin-intermediate forms are more common, however. Then there's VRE (vancomycin-resistant Enterococcus). For these, you can use linezolid, and so far this works pretty well, although there have been isolated cases of resistance as well (though much less common than vancomycin resistance.) What freaks me out, though, is that we're starting to use this stuff like candy, especially since it's available as a pill.
The nastiest bugs, though, are the Gram negative rods, which include E. coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumanii. We tend to treat Pseudomonas with a lot of respect because it becomes rapidly resistant to antibiotics, and if we find it, or even just suspect it, we start off with two agents at least off the bat. Acinetobacter, on the other hand, is pervasive in the environment, and usually only starts causing problems when it has overgrown, usually in chronically-ill patients who have been in and out of the hospital a lot and who have gotten frequent antibiotics or, as mentioned, in ICU patients who have gotten multiple courses of antibiotics. The problem is that it is very hard to kill, since it is frequently multi-drug resistant and we often have to start out with big guns like meropenem. The abuse of penicillins and cephalosporins has caused an ncreasing prevalence of bacteria with extended-spectrum beta-lactamase activity, and even these big guns don't always do the trick against these puppies.
What scares me the most is the fact that there are really no new drug classes in the pipeline targetting Gram negative rods. The newest classes—fluoroquinolones, carbapenems, and monobactams—really haven't seen much development since the 1980s, and fluoroquinolones at least have already become
If a doctor has the option of giving a patient one medication which works, with few side effects, or several in combination that are marginally effective, may not work, and have severe side effects, the doctor would presumably want to go with option A.
In the case of resistant bacteria, they no longer have that option.
So to answer your question, yes it's the SCIENTISTS who are asking for more tools in their toolbox. That's not to say their bosses aren't happy about it, but your rush to assume the worst is unwarranted.
How pathetic are you that you follow me from topic to topic and waste all your mod points at once modding me down?
It's implied. Obviously, an intelligent designer created these diseases to kill humans. I mean, what intelligent designer _wouldn't_ look at the current state of humanity & not design such a thing?