Slashdot Mirror
New Wave of Antibiotic-Resistant Bacteria
reporter writes "New strains of 'Gram-negative' bacteria have become resistant to all safe antibiotics. Though methicillin-resistant Staphylococcus aureus (MRSA) is the best-known antibiotic-resistant germ, the new class of resistant bacteria could be more dangerous still. 'The bacteria, classified as Gram-negative because of their reaction to the so-called Gram stain test, can cause severe pneumonia and infections of the urinary tract, bloodstream, and other parts of the body. Their cell structure makes them more difficult to attack with antibiotics than Gram-positive organisms like MRSA.' The only antibiotics — colistin and polymyxin B — that still have efficacy against Gram-negative bacteria produce dangerous side effects: kidney damage and nerve damage. Patients who are infected with Gram-negative bacteria must make the unsavory choice between life with kidney damage or death with intact kidneys. Recently, some new strains of Gram-negative bacteria have shown resistance against even colistin and polymyxin B. Infection with these new strains typically means death for the patient."
MRSA bugs immunity to hospital disinfectants and antiseptics
And this, children, is why you always, always complete the full course of antibiotic treatment, even if you think the problem's cleared up half-way through. If you stop early you leave the small subset of bugs, not enough to cause a visible problem, that are the most resistant to the antibiotics. Lather rinse repeat a few times and you end up with bugs that laugh at antibiotics and proceed to run rampant.
The language of the slashdot post seems to suggest that the presence of gram negative bacteria is recent. It also suggests that the gram negative characteristic of the bacteria is the definitive characteristic of its virulence. Also, the Gram test isn't a 'so called' test, which somehow suggests or implies doubt.
The test has been done for decades; our knowledge of the two major types of bacteria (gram positive and gram negative) has been around for decades as well. And while gram negativity is characteristic of bacteria that must be approached with different antibiotic means than gram positive, due to their extracellular topology/materials, it does not mean that being gram negative makes the microbes virulent or specifically dangerous.
And to debunk the loose implication that gram negativity might have evolved from human antibiotic applications I will say this: it didn't.
General Bacteriology ftmfw.
They wouldn't need to use antibiotics on our cattle if we just fed them grasses instead of corn feed.
Unfortunately corn feed and antibiotics is cheaper than feeding them grasses.
Not really. The method of damage here is due to filtration of the active antibiotic from the blood at the glomerulus. In order to spare the kidneys here, you'd need to bypass the renal arteries, which receive about 20% of the body's blood flow. Thats not even getting into the fact that you need kidney perfusion to maintain proper blood volume. I am a med student studying on renal physiology (test on friday...)
"Only" lab experiments, but this shows the problem is not as simple.
I guess, like samurphy21 says, the only way to be sure is to nuke them from^W^W^W use a high-ethanol concentration.
It wasn't the Mayo Clinic and they have this to say: "Oil of oregano has received a great deal of attention, with proponents claiming it can treat a variety of illnesses, including sinus disorders. Like many spices, oregano does have some antibacterial and antifungal properties — making it at least plausible that it might help or prevent some sinus problems caused by bacteria and fungi. Unfortunately, there have been no published trials that have looked at oil of oregano specifically for this use. For this reason, it isn't known what role, if any, oil of oregano plays in treating or preventing sinusitis." Or at least that's James T. Li, M.D., Mayo clinic asthma and allergy specialist has to say on the Clinic's webpage. Current as of Aug 29, 2009.
As for the crack about big pharma, bullshit. Traditional treatments have attracted a lot of investigation for the last couple of decades. If (if!) you find out that the traditional treatment works, then you can isolated the active compound(s) and patent and sell that.
Theoretically yes. It would just take rerouting the incoming kidney blood supply into a loop to bypass it into dialysis. However, you would likely have to filter the drugs out, pass it back to the kidney, reroute it out again and restore the drug. Wouldn't help if your kidneys died from lack of blood supply. Last case scenario stuff probably though.
While the idea sounds like a good idea on paper, I have to tell you, as a practicing surgeon, it really sucks.
First let me clear up, the antibiotics themselves are either directly nephrotoxic (damage the kidneys) or their breakdown products are. Its not a matter of taking the kidneys “off-line”. And in addition not all drugs are removed with dialysis.
To access both renal arteries and veins (assuming normal anatomy many people have duplicated renal vascular systems) is not an benign undertaking. The vessels are in the retroperitoneum (behind all the structures in the "classic" abdominal cavity. So it is not a "trivial" procedure. Next to totally bypass the kidneys is not a great idea...extended bypass systems tend to cause a lot of damage to the blood, they can speed up the drestructiong of red cells (oxygen carrying) and platelets (clotting cells). The circuit also tends to active the clotting system and you get a paradoxical, hyper/hypo-coagulable state. This is similar to DIC (Disseminated intravascular coagulation) [http://en.wikipedia.org/wiki/Disseminated_intravascular_coagulation]
Also the bypass circuit itself is made of synthetic material with acts to harbor bacteria. Given large scale infections, we as surgeon, routinely remove all sorts of prosthetics (AV graft material used for dialysis, artificially heart valves, pacemakers, rods and screws from orthopedic procedures)
The information in the article itself is not new. When I did a rotation in a burn unit in 2004, we had a standing problem with the unit harboring several species of Acinetobacter, and these organisms were resistant to all the antibiotics that the lab routinely tested. We routinely had to use Imipenem(tm) [http://en.wikipedia.org/wiki/Imipenem]. And it was not unusual to have bugs start to build resistance to that drug. We usually had to resort to poly-pharmacy as opposed to mono-therapy as we usually prefer.
Again as I posted a few weeks ago: As physicians we need to be vigilant in our use of antibiotics, but patients need to be respectful of them as well and to stop asking for an antibiotic (that is useless for viral infections) for every little sniffle when you have the common cold or flu (both caused by viruses).
Forgive me for quoting wikipedia, but I felt some footnotes were warrented. I usually yell at my students and residents when they quote it to me, but for the level of discussion here, it is adequate.
Actually, a few weeks/months is enough.
Give it a year without prescribing antibiotics for anything but the most severe cases, and all the nice little antibiotics are effective again.
Google for 'norway antibiotics' .. ( http://www.fftimes.com/node/229972 )
"Rune Kristian Viken" - http://www.nwo.no - arca
My family raises cattle on a farm in Iowa. Speaking from our experience, I'll tell you that putting a pound of meat on a steer takes in the neighborhood of ten pounds of feed -- and much more than that, if you're feeding them exclusively grasses (including hay).
So. Take a hundred head of cattle and turn them loose on a hundred acres of land. These animals are still growing (since, when they're ready for the slaughterhouse, well... they get taken to the slaughterhouse). If we want to put a hundred pounds on each steer, then that means each steer needs half a ton of feed.
Good luck getting 50 tons of grass from a hundred acres of land. It's not going to happen. The farmer has two choices at this point: raise fewer cattle (and thus raise meat prices for the consumer), or convert some of the cornfields into pasture (and thus raise grain prices for the consumer).
Either way you're talking about raising the prices of basic foodstuffs. You won't inconvenience the rich: the rich will still be able to afford filet mignon and Kobe beef. After all, they're rich.
But the elderly, who live on fixed incomes... poor families who depend on food stamps... or just a college student burdened with debt who wants to be able to take his girlfriend to a steakhouse for a special occasion... all of these people are seriously impacted.
The name of the game in modern farming is efficiency. Reducing prices is the overall goal.
I don't know about the new organisms, but the older resistant strains DO spend considerable metabolic energy on their resistance, either producing enzymes that have no other purpose or supporting active pumps on their membranes to remove the antibiotics that get in. In either case, in an environment free of the antibiotics, the resistant strains waste energy for no benefit.
"The programme revealed that we - ie humankind - had discovered a superior cure (to antibiotics) for bacterial infections around the same time that penicillin was being discovered. The research programme on bacteriophages (phages for short) began in Stalin's Georgia in the 1930s. To this day, our knowledge of each of the many thousands of phage viruses remains concentrated in a now rundown laboratory in Tbilisi, Georgia. The arrival of capitalism in the Caucuses threatens a repository of knowledge, built up over 50 years, that could prevent the superbug pandemic that threatens us all next century. ...
While there are some genuine reasons why phage treatments of bacterial diseases were overlooked in the 1930s and 1940s, the failure to develop a western research program into bacteriophage treatment in the 1980s and 1990s represents an inexcusable failure of western capitalism. By the 1980s, ther e could be no denial that antibiotic resistance was going to be a major problem in (if not before) the twentyfirst century. Yet, we just didn't want to know about what will probably turn out to be the most important medical breakthrough in the twentieth century; a breakthrough made in communist G eorgia, in Stalin's Soviet Union.
It is embarrassing when western science is out-trumped, especially by the "communists". Usually, when out-trumped, we don't tell anyone. That's what happened here. Not only did we not have the nous to start a western programme in bacteriophage research; we looked the other way when the files of phials threatened to be destroyed following the breakup of the Soviet Union, and during the little reported civil war that engulfed Georgia a few years ago. So much for the knowledge economies of the west. How can such valuable knowledge be so cheap?
It's not too late for western medicine to enter the post-antibiotic bacteriophage era. Our grandchildren will hardly thank us if we persevere with our corporate-profit-motivated conservatism.
The Soviets were able, eventually, to admit that they were wrong to follow Lysenko. Will we in the west be equally able to admit that we were wrong to put all our medical eggs into the one antibiotic basket, in the process ignoring the most basic tenets of the theory of evolution?
"""
From:
http://www.scoop.co.nz/stories/HL9910/S00096.htm
(I'm glad to see several people have posted links to phage therapy information.)
A 21st century issue: the irony of technologies of abundance in the hands of those still thinking in terms of scarcity.
[hemo] dialysis is using a counter current "dialysate" to effect a net removal of solvent and solute from the blood...aka accomplishing a filtration the way a kidney works by using a semi-permeable membrane. Can also be done via a process of peritoneal dialysis using a catheter inserted into the abdominal cavity.
plasmaphoresis is the process of removing the plasma from the body and replacing it with albumin or other colloid solution (fresh frozen plasma). This is used to reduce the immune components of the blood e.g. antibodies. Most commonly used for auto-immune disorders.
lukopheresis is selectively removing the white cells from blood. This is mostly commonly used in packed red cells used in transfusions.
The latter two procedures would be contraindicated in the face of a bacterial infection as they would severely inhibit the immune function of the body.