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A Post-Antibiotic Future Is Looming (www.cbc.ca)
New submitter radaos writes: A gene enabling resistance to polymyxins, the antibiotics of last resort, has been found to be widespread in pigs and already present in some hospital patients. The research, from South China Agricultural University, has been published in The Lancet. According to research Jian-Hua Liu, "Our results reveal the emergence of the first polymyxin resistance gene that is readily passed between common bacteria such as Escherichia coli and Klesbsiella pneumoniae, suggesting that the progression from extensive drug resistance to pandrug resistance is inevitable."
Work on alternatives is progressing — Dr. Richard James, former director of the University of Nottingham's center for healthcare associated infections, writes, "Until last month I was still pessimistic about our chances of avoiding the antibiotics nightmare. But that changed when I attended a workshop in Beijing on a new approach to antibiotic development based on bacteriocins – protein antibiotics produced by bacteria to kill closely related species, and exquisitely narrow-spectrum."
when I attended a workshop in Beijing on a new approach to antibiotic development based on bacteriocins â" protein antibiotics produced by bacteria to kill closely related species, and exquisitely narrow-spectrum."
While we've been working on making the better antibiotic, Russia has been working on phage therapy. Of course, we are the ones with the resources to develop it, not them. It should arguably be the other way around. The problem with this idea though, which is also the same reason we have antibiotic resistance today, is that you have to identify the problem before you can use it. We have an inadequate number of medical personnel pretty much everywhere in the world, and they already can't keep up with illness even using broad-spectrum antibiotics that historically have enabled them to help people without identifying a specific pathogen. They certainly don't have the time or training to do any better. We need more medical personnel, or nothing we do to try to fight these resistant illnesses is going to make a difference because we won't have the manpower to implement it.
"You're right," Fisheye says. "I should have set it on 'whip' or 'chop.'"
A gene enabling resistance to polymyxins, the antibiotics of last resort, has been found to be widespread in pigs and already present in some hospital patients.
Is that a roundabout way of saying that some complete and utter moron has been feeding the antibiotic of last resort to pigs in order to boost his profit margins and the resulting resistant bacteria are now spreading to humans? I could be wrong about that of course since I am not a bacteriologist, so for what other reason would polymyxins resistance be widespread in Chinese pigs and now spreading to humans?
The reason why antibiotic-resistant strains have been forming and allowed to be a problem is that people have been misusing antibiotics.
A small scale problem is that antibiotics have been used by human patients that would not benefit from them. Other patients have stopped or cut down on using antibiotics when they have started to feel well - but before the strain has been fully eradicated. In some countries, antibiotics have even been available over the counter without prescription.
A large scale problem is the over-used of antibiotics in agriculture. Livestock are given antibiotics in their feed as a precaution, and this is still going on on a large scale in most Western countries.
Antibiotics-resistant strains are widespread, even the norm in many parts of the world.
Seriously, this has to stop! We need to treat this problem seriously. If a resistant strain of bacteria is found on a farm then that farm should be put in quarantine and the stock of animals should be destroyed, like what happened when Mad Cow Disease - but instead this is seen as normal. Diseased eggs and meat are the norm, and I am not talking about third-world countries. I am talking about Western Europe and the USA.
"We mustn't be caught by surprise by our own advancing technology" -- Aldous Huxley
Antibiotics are not fed to animals solely as a precaution. Animals that are fed antibiotics gain more weight, faster. This works on people too. Feed people antibiotics and they gain weight.
California, in the USA, recently banned such agricultural use of antibiotics and so have some countries in Europe.
It really is as someone said, greed/lust for profits/need to compete with others using antibiotics is the real reason why resistance is showing up.
-PM
Dead from antibiotics resistant bacterial infections. 3,000 people died in 9/11 in one particular year.
USA spent $2T on subsequent wars.
So it seems that $100T is "justified" in spending to combat antibiotic resistance, right? (Frankly, I'd be happy to see $20B increase.)
And it pretty much has to be Government supported investment, the market case just isn't there for a drug company to develop new antibiotics. How do you make your billions back from a drug which people just take for a little while, while they are sick?
Drug companies just want to develop drugs that make them lots of money, drugs that people will take every day or will take in huge quantities. So if a drug company DOES develop an antibiotic, they'll soon sell it for agricultural use to help animals gain weight--that's the only way they can ever make money.
Free market economics pretty much dictate that antibiotics will be misused if developed at all, that is why we have to have PUBLIC investment in new antibiotics.
-PeterM
Replacing antibiotics with proteins and possibly phage is a doomed proposition if done as a simple substitution. The advantage that antibiotics have that proteins can never match is they are low molecular weight chemicals. thus you don't have to give someone a high mass dose, it can be absorbed in the gut or membranes, and it can get into cells. Furthermore proteins are relatively easy to decompose without inventing any custom hardware, they are also easy to recognize specifically (which is also why they can provoke an immune response if not properly humanized). Thus proteins are not substitutes and start out with many many orders of magnitude handicap in molecular weight and accessibility. Therefore to overcome that one needs to exploit protein therapies in different ways. proteins are good at things like catalysis. The intital activity of a chemical is stochiometric in which one chemical binds one receptor. But an enzyme can turn over many many reactions, so one can, if used right, have a manyfold activity. (on the otherhand, this advanage is not clear cut, since the receptors bound by standard chemicals may amplify the signal as well, and many desired targets medical for proteins will be stochiometric binders not catalytic enzymes). A big big advantage of proteins is their potential for specificity which will both diminish their side effects and could concentrate them into a specific target area. Imagine for instance protein therapeutic which only affected a certain pathogen and left the other bacteria in your gut alone. Finally, if the protein is large enough then it can remain in the circulatory system longer before the body removes it. But that also means higher molecular weight which can be bad.
Phage are even higher molecular weight. But they can reproduce. And presumably they might be tailored to only infect the bad bacteria as their host for reproduction. But they also might become antigens and your own body would clear them.
Both of these therapies have killer applications and are not to be dismissed. Their extreme specificty will completely change medicine even more than antibiotics did. But they are not in the near future any sort of replacement for antibiotics.
Some drink at the fountain of knowledge. Others just gargle.
Sorry to say it, but "most industrialized countries" feed antibiotics to animals routinely.
There are only a FEW industrialized countries which ban this, notably in Europe, notably NOT in North America (though the Republic of California just enacted a ban.)
It's NOT just a third world practice! Routine feeding of antibiotics to animals makes them gain weight faster. Market win! Industrial farmers LOVE using antibiotics.
Your mistake was underestimating the force of greed-induced stupid.
--PM
Phage therapy is essentially the use of viruses against bacteria. This seems like a wonderful idea and quite specific against specific bacteria.
For antibiotics we often want something broad-spectrum, because it takes time and a lab test to determine what germ is causing the problem. Precious time and uncertain results from the lab test.
So right off the bat phage therapy is less useful.
I wonder right also if the human host would mount an immune response to the phages used, effectively defending the very bacteria that the phages were intended to attack. It's a foreign antigen, after all, even a virus, why WOULDN'T your immune system attack it?
So might it be the case that phage therapy would only work once on a given person, for a particular phage?
So I'm not sure phage therapy really would be an effective replacement for the antibiotics we used to have. Helpful, certainly, but of limited use, maybe?
--PeterM
Maintaining antibiotic resistance is costly, and populations of bacteria which are not exposed to antibiotics will drop the capability after a while or be out-competed by competitors without the baggage.
So maybe a world-wide complete ban on use of some of the older antibiotics that are now mostly useless would help? Bacteria resistant to those old antibiotics might become rare due to lack of selection pressure.
Then, after 20 years of rest, maybe those antibiotics could be rotated back into use, because they've again become useful?
--PeterM
Remember how it was being villified by certain luminaries as leading to "Death Panels"? And when certain folks tried to kill it for being "unconstitutional"? That's the level of sanity of the political environment it was conceived in.
And even now we get posts from people who somehow don't like it (for whatever reason) but who still shy away yanking collective health insurance from a couple of milion people. Couldn't be their sense of ethics getting in the way. They're not like that. Something to do with political fallout I guess.
For better or worse, the insurance companies are simply the privatised face of national health insurance. And privatised means "for-profit". Which in turn means "maximise revenue and minimise expense". Bad news for anyone taking out or trying to claim on insurance. Fair enough. So what's your alternative? Want to set up an NHS-style system in the US? Perhaps sen. Bernie Sanders will look on that idea with favour, but absolutely no-one else will. Also be prepared to be branded a Communist, Socialist, Atheist, Satanist, Jihadist, Terrorist or simply all-round Un-American. Just a warning.
You might want to think about imposing more regulation on those insurance companies. Such as more financial transparency. Or some sort of nation-wide re-insurance. Well, good luck with either idea.
Sorry but in the mean time the ACA is what we've got. Lets try to smooth out its rough edges while we mull over what to replace it with, shall we?