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."
Stop wasting all those antibiotics on beefing up our cattle and giving a bunch of supergerms a tolerance for the stuff?
Great. A big thank-you to all the knee-jerk antibiotics prescribers and disinfectant abusers.
And the soccer moms as well who scream for antibiotics for everything from the common cold to a skinned knee.
These prescriptions are thrown around like candy whether they are warranted or not.
There's plenty of blame to go around, but of course the trick is what we do moving forward. Some of the simple techniques, such as ensuring hospital staff wash their hands, are very useful in terms of preventing the contraction of bacterial infections and should be something where we encourage, expect, and ultimately demand a 100% success rate (i.e. always wash your hands), without blaming people for not having done it in the past. Nurses at the hospitals with poor discipline stopped washing their hands once disposable gloves started being commonly used in medicine. At this point, for many of them, they have been told or taught to always wash hands or put on new gloves before touching a patient after touching nonsterile surfaces, but they're not part of a hospital culture where that is the unbreakable rule, so they get sloppy.
It's not everyone, nor every hospital, but it's common enough that it's not even frowned on at some hospitals. Simply attacking someone about doing it wrong isn't enough, nor helpful, and our goal isn't to blame, it's to move forward and say, "all right. No more! Let's get this right! Let's cut down on staph infections by twenty percent in the next year." There should be intense competition for objectively defineable metrics of success, where the higher the number the better the patient care (so no race conditions), with conservative results and massive penalties for failing to report properly (so it's in everyone's interest to do well but nobody's interest to cheat), and each year the hospital should be able to report, "we saved X lives this year, and Y of those are lives we saved because of these particular programs and improvements we've achieved since last year."
The goal isn't to blame, it's to achieve. It's to save lives. And ultimately, of course, to save the world. *Flash Gordon Theme plays*
-- IANAL, this isn't legal advice, and definitely isn't legal advice for you. Also, Squee!
Welcome back to the world before antibiotics were discovered.
However, a few decades of not using antibiotics at all and the bacteria around the world will again mostly be susceptible to the more common, low-risk ones. The mutations that make for antibiotic resistance have negative effects on bacteria's ability to reproduce... except in an environment with significant antibiotic use.
Terrorist, bomb, al Qaeda, nuclear, yellowcake, kill, assassinate. Carnivore is dead... long live Echelon.
Kinda hard to shunt the circulatory system around them when they need oxygenated blood to survive as well. Neat idea though, there should be a further way to get around that problem, like a miniature dialysis loop just for the kidneys while you run the treatment.
Of course that's assuming the bacteria isn't in your kidneys...
Slashdot needs a "-1, Wrong" moderation option.
The Urban Hippie
In general, pharma companies benefit from heavy use of antibiotics: immediately because they can sell more, but also in the long run because it makes their old products (for which they no longer hold a government-issued monopoly) obsolete faster, improving the market for newly developed drugs that fix old problems.
On the other hand, when it comes to these gram-negative bacteria the above idea does not hold true. They can't benefit from it if they don't have a product to sell that fixes the problem.
That is innovative thinking, however, after a moment I realized that the kidneys would be infected also and as a result would reinfect the person when reconnected.
When antibiotics and antiviral research was first being used, they used methods of stimulating the immune system to a better response. But when chemicals proved easier, research switched to that. If we can get the immune system to fight them off itself, we won't have these problems.
Yes but then large pharm companies will have no money.
Stop suggesting things useful and life saving at the expense of profit!
So, what you're saying is that if you drive to the farm yourself, cut out all the middlemen who are involved in distributing food to grocery stores and coops, etc., then you can buy beef that's reasonably priced (but still above market rates). And if for some reason you can't, then you have to buy from a co-op and pay substantially above-market rates.
You apparently live close enough to a small farm that you can cut out the middleman like this. Most Americans don't. Most Americans live in metropolitan areas and are dozens of miles away from the nearest small family farm. To someone living in a metro area like D.C., going out to a family farm is easily a two- or three-hour round trip. The opportunity costs there jack the $4.75 price up substantially more. You aren't just paying $4.75 per pound at that rate -- you're giving up a substantial chunk of your weekend, too.
Don't make the mistake of thinking that just because something works for you, that it will scale up to work for a nation of millions.
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.
Americans who can't afford beef can do the same thing the rest of the world does (at least those parts of the world that aren't starving). Eat something else.
Chicken is cheaper than beef, eggs are cheaper than chicken, and rice and beans is cheaper still. The cost of one dinner at a steakhouse for two will buy a huge sack of rice and huge sack of beans, including a bunch of stuff to make it taste good. This will easily last a month, even for a family.
If we want to put a hundred pounds on each steer, then that means each steer needs half a ton of feed.
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.
This is why you just eat some vegetarian food. I love a good steak as much as the next guy, but at this point, it seems that the economic/ecological arguments win out. What a waste of societies' resources to turn 1.5 tons of food into 100 pounds of food.
Computers are useless. They can only give you answers.
-- Pablo Picasso
It is true that endotoxin A, which is presented to the human body upon cell lysis is heavily immunogenic and can cause disease and/or death. And it is true that it is found as the intracellular component of the gram negative lipopolysaccharides.
But what isn't true is that gram negative = virulent. Virulence is a measure of an organisms ability to cause disease. Many gram negative bacteria simply cannot survive in the human body, so it is false to state or imply that being gram negative is clearly a threat to human health.
Gram negative bacteria that can colonize in the body are dangerous and may cause disease. The point I was trying to clarify was that the characteristic of being gram negative does not mean the bacteria will cause human disease/death. There are various attributes among species of bacteria that will determine if they can grow in the human body.
I hope my point is more clear.
Gram negative != dangerous to human
gram negative + able to colonize in humans = dangerous to human.
Furthermore, there are many bacteria that are gram negative that exist as symbiotic bacteria in the intestinal flora. Need an example? Escherichia Coli is gram negative. If the simple characteristic of being 'gram negative' made a microbe dangerous, we would all be in danger right now.
I was raised in rural Saskatchewan and worked on a farm many times. While what you say about field yields is true, overuse of antibiotics in farming harms all of us. Those people you identify: elderly, poor families or college students now have to face even higher medical bills when they catch antibiotic resistant bacteria. There was a story a couple of years ago about the FDA clearing some of the last chance antibiotics for agricultural use. This story may or may not be related, but the quantities used when treating farm animals and the discharge of the antibiotics into the environment only put the rest of us at risk.
Atlas stands on the earth and carries the celestial sphere on his shoulders.
I am amazed at how many people are reading what I said as a defense of antibiotic-fed beef.
I am not in favor of antibiotic-fed beef. I am opposed to it on humanitarian grounds. Generally, you only need massive amounts of antibiotics if you're raising cattle in such confined conditions that any infection will spread like wildfire. I don't endorse this style of agriculture. I think it's ethical to eat meat -- but I also think we have an obligation to our animals to make their lives at least somewhat comfortable. They give us their lives: the least we can do is give them a few acres to walk around. In the process of treating animals humanely, we also reduce our dependence on antibiotic-fed beef.
The original poster presented grass-fed beef as the solution to our woes. The idea that we can meet current meat demand while feeding animals grass and hay is absolutely ridiculous. That's what I'm pointing out. We raise animals on grain because there are no other economically feasible options, and whether an animal is fed grain has nothing to do with whether it is also fed antibiotics.
Nice idea, but phage are also very good at facilitating horizontal gene transfer, so there's a chance they could make the problem worse by conferring resistance to other strains of related bacteria.
Yeah, and in various "green" stories, the masses are asked to live in high density cities rather than further away because it makes it cheaper to build public transport, uses less petroleum.
Ever been to Mexico? Brazil? Ecuador? Thailand? Vietnam? India?
Walk into any pharmacy. Tell them you've got a little bit of a sore throat. 30 seconds later you're walking out of the pharmacy with a package of antibiotics.
What's worse, is that you get none of the precautionary questions/warnings regarding side effects, possible allergies to antibiotics, instructions to take the whole package, etc.
*This* is where the problem lies. My experience with US and European antibiotics prescriptions has been that there actually is a decent amount of responsibility on the part of prescribers. In other places however, antibiotics are uncontrolled, very cheap, and very very easy to get.
------ The best brain training is now totally free : )
The article is incorrect in many points. Firstly it is not just the two antibiotics mentioned that are effective against gram negatives, but quite a large range of Aminoglycosides, Quinolones, and even some Cephalosporines for example. Resistance against these happns too, of course.
Furthermore, damage to the kidneys (or hearing nerve) and other severe adverse effetcs can happen, but are rather the exception than the rule. The patient's choice is thus not "to lose his kidneys or die with intact kidneys" but to accept a reasonably small risk of potentially serious adverse effects in exchange for a treatment that is most likely life saving.
Of course it is sad if we gradually lose more and more powerful antibiotics because some reckless idiots overuse them in clinical practice (the USA is one of the worst offenders in that aspect within the "ciilized" realm, especially when it comes to misuse and overuse of Fluoroquinolones) or, even worse, just in order to make cruel intensive meat farming viable.
In some ways this is one of the unintended consequences of patient choice.
If a Doctor wants to keep his patients, he/she not only has to provide high quality-medical care, but also the perception of high-quality medical care. Are you going to tell your friends about the doctor who sent you home telling you to drink plenty of fluids and tough it out, or the one that prescribed you a bottle of pills and sent you out for additional tests "just to be on the safe side".
Plus, no Doctor ever got sued for prescribing antibiotics that wern't needed.The converse isn't true.