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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."
Anyone remember Phage Therapy?
Would it be possible to at least take one (or both) Kidneys offline? Basically, run your body through a dialysis machine during the antibiotic procedure. Of course, this would have to be an extreme life or death situation to consider the possibility.
Life is not for the lazy.
I've always thought that doctors should use shots to deliver antibiotics whenever possible. For many of the most common things like ear infections it is 1 shot or 2 weeks of pills. It also applies disincentive for idiots who ask for antibiotics for problems that don't need them(based on the fact that many people that I know hate getting shots).
Assuming they delay the process by a decade, 200,000-300,000 in the U.S., but that is assuming that all of those people are otherwise healthy.
That's more than AIDs but less than car accidents (and a hilarious footnote compared to heart disease and cancer).
Nerd rage is the funniest rage.
Me and all my friends do shots at least once per week.
"His name was James Damore."
Most medical antibiotics are based on naturally-occuring antibiotics found in soil organisms. Of course, as these organisms evolved the antibiotics the bacteria around them co-evolved defenses. This means that for most antibiotics there are bacteria around that have genes that make them resistant. Since bacteria trade their genes around it's only a matter of time until the resistance genes find their way into disease organisms. Hospitals contain concentrations of people being treated with antibiotics and so that is where the resistant disease organisms tend to appear.
We need antibiotics based on novel modes of action not found in nature, but these are hard to develop. The ability to sequence the genes of bacteria as well as the ability to synthesize proteins with predictable characteristics will help.
Warning: this article may contain humor, sarcasm, parody, and perhaps even irony. Read at your own risk.
A common form of resistance is to build a molecular pump that pushes the antibiotic out of the cell. That definitely takes energy to grow and run.
Nerd rage is the funniest rage.
You don't have any idea what you're talking about. Many industrial scale cattle, swine and chicken operations use subtherapeutic doses of antibiotics in feed as a growth enhancing technique. Over 70% of all antibiotics used in teh US are used in agriculture, and the vast majority of those are used in feed, and subtherapeutic doses are the problem. The ag CAFOs are where many of these bugs get a toehold.
Tyson chicken, Smithfield pork, all the big operators use antibiotics in feed. Look it up. http://www.alternet.org/health/145272/the_overuse_of_antibiotics_in_livestock_feed_is_killing_us
In fact, more than 60% of the Gram negative isolates in our hospital (in-patients) appear to be producing an enzyme called extended spectrum beta lactamases (ESBL). These ESBL-strains are often resistant to other classes of antibiotics as well, narrowing therapeutic options. In a subset of cases, these bugs turn up as resistant to almost all the antibiotics we test.
But, I am yet to come across a case where the isolate was resistant to colistin and polymyxin B. No clinician would even think of using these drugs if other options are available. But, if, as the article reports, these organisms turn out to be resistant to even these last-resort drug... we can safely assume that we are in deep shit.
When visiting a doctor for a sinus infection, he said that in India they would take a swab from my nose, determine in a few minutes with a microscope what bacteria was bothering me, and give me a specific antibiotic that was known to work well.
In the USA, he said insurance tells them to just proscribe an antibiotic and if it doesn't work, they'll come back. The ten minutes of lab work isn't covered by insurance, so they don't do it. I asked if I could pay cash for the test with the microscope, but he refused and said he'd get in trouble.
Most doctors follow insurance rules, worry about liability, and treat symptoms, in that order.
I just read somewhere that Norway is taking this approach. Unless you're going to die without them, antibiotics are not prescribed. Antibiotic resistance has plummeted as a result. Between this and banning their addition to farm feed I'd bet things turn around inside of 10 years, except it will take a major catastrophe in the US to overcome the political resistance to farm use.
I have mod points. The reign of terror begins now.
You will be free to continue using expensive antibiotics on your farm...
We raise antibiotic-free beef. Grain-fed, but no chemicals. You generally don't need antibiotics for free-range beef. Antibiotics are needed when you're doing large-scale industrial farming where the cattle are packed together like sardines and an infection in one animal quickly spreads throughout the barn like wildfire.
We give our animals room to roam. We do it for humane reasons -- we think it's inhumane to put an animal in a pen and never allow it to leave. I don't know any family-run farm operations that raise cattle in pens: free-ranging is almost an article of faith among us.
You are not the first person to assume that I'm in favor of putting antibiotics in beef. I'm not. I'm in favor of free-ranging them because I think it's required by the decency standards of animal husbandry.
I am also in favor of grain-fed animals, because we simply cannot produce beef in the amount demanded by the market without it.
If you dropped the regulations, the new class of designer antimicrobials that my company is developing would be on the market right now. They are designed such that immunity to them would make the resultant bug non-pathogenic.
Sadly, government regulations and the money that it takes to over come them have forced us to shift our attention to other applications for our technology.
Considering that the old new class of designer antimicrobials that your company developed for the handsoap market .. contributed to creation of this new designer bug strain ... your optimism isn't giving me a warm fuzzy feeling right now
"Suppose you were an idiot...and suppose you were a member of Congress...but I repeat myself." Mark Twain
To be honest, I'm caught in the middle of this "Big pharma? Good or evil?" debate.... On one hand, sure, I agree with you that many people employed in the pharmaceutical industry want to do good, and aren't part of some agenda to kill people and boost stock prices But let's face the facts. That's almost a universal truth, when you start talking about individuals you've singled out in ANY company. It also holds true for the military. (Talk to a U.S. solider who was deployed to Iraq, sometime. Chances are, he signed up for the service NOT because he had some agenda in his head, but simply because it paid pretty well in a bad economy - and he's trying to take care of a family.)
What you always have to examine is what direction the company is headed, on the whole. That's where I start to see the other side of the debate. It's pretty easy (and common) to hire thousands or even millions of employees who practically ALL believe they're doing "good", while the end result is decidedly "evil". Some of the big pharmaceutical firms come from fairly "tainted" backgrounds, too.
Take, for example, Bayer Corp. Today, you think of them mainly as providers of aspirin ... but in WWII, they were cranking out mustard gas, military grade chlorine and phosgene for Germany. In fact, they were stripped of their right to trademark aspirin after WWII in many nations due to their direct involvement in the war.
Big Pharma is pretty much like any Corporation: Intelligence without conscience. And it's not even because corporations are "evil". They're not. Nobody shoots down cheap cures because they want people to die. Nobody pumps oil into the sea because they enjoy to poison the planet. Nobody uses spoiled food in burgers because they enjoy making their customers sick. It's simply the way to make more money. And they don't even do that because they're greedy. They are just doing what is necessary. Actually, they are doing it in their best conscience. No matter at what level you work in a corporation, your conscience actually tells you that you have to be more profitable, and that minor little "evils" are ok for the greater good.
Profit is to be made, not because you want more but because it's your duty to be profitable, because other people placed trust into you. If you're a researcher, you have to come up with a cure because, well, that's what you do. If you're a manager, you have to patent it and make it profitable because your investors put their money into your hands and you have to honor their trust and make the most out of it. If you're their lawyer, you have to defend those patents, for the same reasons. It's all for the "greater good". Yes, that means that some people die because they can't afford the cure, but curing these people would mean you betray the trust of your investors.
The same is true wherever else you see corporations do "evil". Everyone has someone else to shift the blame to. You can shift it on your superior (because if you don't do it, you'll be fired), he can shift it upwards to his, that works 'til we reach management, who can shift the blame to investors who want revenue for their money, investors who in turn don't even know what they invest in because they just handed money to some guy at a bank who, in turn, has to take the most profitable route for his customer because he, again, has been entrusted with money... So, in a way, if you lose your job in the next layoff, it could well be you that fires you if you happen to have stock in the company you work for.
Big Pharma doesn't want to kill me. They want to treat me. They want to profit off me. Just like everyone else. And while the sales rep might be a human being with human feelings who tells the doctor about a cheaper treatment, this is not the most profitable route. If there is a sociopath that does not tell the doc about the cheap cure, which means that 3-4 kids out of 10 will die because they can't afford the cure, and he's competing for the sales rep slot, he will be the one succeeding in the end because the 6 that survived and bought the cure will make him look more successful at selling and that's what counts in the quarter report.
Yes, sociopaths do come out on top. Unfortunately, life is not a prisoner's dilemma game. Mostly because too many people play it. It just doesn't bite you in the ass when you keep cheating, you don't play too often against the same people again, you have plenty of people to choose from...
We used to have a Bill of Rights. Now, with the rights gone, all we have left is the bill.
> "If you dropped the regulations, "
>> "If the US had a nickle for every time a businessman said that about regulations..."
Try your hand at operating a small manufacturing business at some point, then come back and provide your revised commentary. That was what my family TRIED to do when I was growing up. On the days you weren't dealing with OSHA and EPA, it was planning and zoning, DOT, dept. of weights and measures, etc. Then let's not forget the bloody IRS. Seemed like there was a full time bureaucrat in the Federal, State and local government for every one of the 8-10 people my family employed, and their job was to make our lives miserable and our business inoperable by enforcing the most obscure and idiotic regulations imaginable. That experience forever shaped MY worldview when it comes to the government and their useless bureaucracts.