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Person carrying bacteria resistant to antibiotics of last resort found in U.S.
- Practicality 10y agoIt might be time to start editing our (DNA) code to fight the bacteria. It seems like the only thing that will be fast enough to keep up with the mutations.
- Quanticles 10y agoOr make little robots to fight the bacteria
- searine 10y ago>It might be time to start editing our (DNA) code to fight the bacteria. This will just create the same selection pressure chemotheraputics did, except now you have the additional burden of fucking with your DNA (and probably risking cancer).
- coryrc 10y agoThere already is a method, decades old: bacteriophages [1] in phage therapy [2]. Put them with bacteria that have resistance and they'll evolve along with them. It's cheap and will always be effective. [1] https://en.wikipedia.org/wiki/Bacteriophage https://en.wikipedia.org/wiki/Bacteriophage [2] https://en.wikipedia.org/wiki/Phage_therapy https://en.wikipedia.org/wiki/Phage_therapy
- Terr_ 10y agoApparently we (and other animals) have evolved some mucus-strategies for capturing bacteriophages for our own use. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3696810/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3696810/
- dctoedt 10y agoTime for Congress to authorize a very big monetary prize for the company that comes up with a better solution, with that solution then being licensed for free to all U.S. manufacturers (or something like that to make it politically acceptable to the xenophobic elements in the GOP).
- coryrc 10y agoThere already is a free and better solution: https://en.wikipedia.org/wiki/Phage_therapy https://en.wikipedia.org/wiki/Phage_therapy Sorry for the redundant comments, but it's important for people to hear this. More people die from MRSA than AIDS in the US, and the FDA is structurally against adaptive therapies.
- Fomite 10y agoAs much as I love phage therapy, there are some very real problems with it. And characterizing it as "free" is...flawed, at best.
- coryrc 10y agoThe parent comment mentioned "licensing", so I used free as in libre, not beer.
- Fomite 10y agoEven then, generalized, FDA-approved "Phage Kits" that don't require bespoke lab solutions for each and every patient likely won't be free as in libre.
- coryrc 10y agoRequiring there not be bespoke lab solutions for any patient is the problem -- it's why people are suffering and dying from MRSA now in the USA, but some can travel to poor areas of the former USSR and get cured. We can already take bacterial cultures and breed them in an automated fashion, breeding effective bacteriophages is the next step. We need to be funding R&D into doing this safely and in an automated way. It's already possible to do with 1930s technology so we should only be able to do better now.
- searine 10y agoThe are three solutions needed here : 1. Stricter regulation of antibiotics, particularly in farming. 2. Better government funding of antibiotic discovery. 3. Stricter regulation of antibiotic use. No solo-drugs, all antibiotics used in stacks of 3 or more. Better monitoring of complete antibiotic use cycles. Biologic resistance can be managed, HIV is more than enough evidence of it working. We have to get serious about it, the age of reckless antibiotic use needs to end, now.
- semi-extrinsic 10y agoI'm going to go out on a limb here, and say antibiotics overuse in third world countries is a big part of the problem, and the hardest one to fix. This is purely from anecdotes, but I've heard from several friends who were exchange students from Pakistan/China/India that we have such a ridiculous system here, that back home they can just buy random antibiotics from the pharmacy whenever they catch a cold.
- spoofball 10y agoBiggest problem is animal agriculture. The use of extremely aggressive antibiotics increases muscle growth, improves health and eventually leads to larger profit. 150 billion land animals raised yearly are a big evolutionary pool of bacteria. To become resistant to antibiotics takes much less time when you run the experiment in parallel 150 billion times per year, than a couple hundred million in humans. One strain, isolated in one of the 150 billion animals can become resistant and spread around the farm. If it goes unnoticed it can quickly spread over the country.
- deleted 10y ago[deleted]
- janvidar 10y agoThe problem is that antibiotics is simply too cheap. The next generations will be a lot more expensive due to the cost of developing it. Sadly, this means that many will die not affording the medicine.
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- ams6110 10y agoMeta: something about washingtonpost.com locks my browser every time.
- MrTolkinghorn 10y agoOpen the link in incognito mode, should bypass their monthly article limit.
- readams 10y agofirefox self-destructing cookies extension. Greatest thing since adblock.
- tjohns 10y agoRelevant story: As a kid, one of my friends would frequently get strep throat. So his mom would give him amoxicillin until he appeared better... and then save the rest of the bottle for the next time he'd (invariably) get strep throat. And that's how antibiotic resistance happens.
- dijit 10y agoThe biggest issue for antibiotic resistance is farming. Farmers use antibiotics basically by default and in large doses to avoid bacterial problems with their cattle. I remember reading a stat that said 93% of all anti-biotics use is in agriculture.
- smellf 10y agoReasons for agricultural antibiotic use are twofold. On the one had it is as you said, as a preventative measure to head off infection (which is obviously very bad), but it's worse than that - industrial farmers use antibiotics so they don't have to inspect and treat each animal. Just dump antibiotics into their food and if they are injured somewhere along the way it will hopefully heal on its own. Inspecting and treating each animal individually would be a lot more expensive. The other reason antibiotics are given to livestock is to cause weight gain. If the antibiotics cost less than the value of the extra meat produced, then you make more money. It's a fucked up practice that we'll be all pay for in a few decades. Note the wiki page is an ok source, but is in need of some attention from someone outside the industry. https://en.wikipedia.org/wiki/Antibiotic_use_in_livestock https://en.wikipedia.org/wiki/Antibiotic_use_in_livestock
- bflesch 10y agoHow about a startup that uses image recognition from video feeds to identify and track individual anmials, and then tags those to be medicated once symptoms pop up? Or will the continuing dosage of antibiotics in the food prevent symptoms from appearing at all? I see some great opportunities in technology for streamlining processes behind fair and high-quality agricultural products.
- adrusi 10y agoLook, this is scary and a big problem, but can we please stop talking about the "end of the road" for antibiotics? The worry here isn't that antibiotics will suddenly become useless and whenever anyone gets a bacterial infection they'll have no hope. The worry is that there will be a number of prevalent bacterial illnesses which can't be treated with antibiotics. Currently antibiotics work for an overwhelming majority of bacterial illnesses, that's not going to change overnight. What will change is the idea that bacterial illnesses are trifles because they can be cured every time by antibiotics. A few diseases will emerge, more and more over time, that have much worse consequences than we are used to thinking about right now, but the rest will be the same. I don't mean to underplay the threat, but if we keep pushing this rhetoric, people will discredit the threat when it turns out that 50 years later we're still using antibiotics for most illnesses that people actually get (because antibiotic-resistant strains are effectively quarantined). People will compare it with the "we're going to run out of oil" scare.
- refurb 10y agoYou raise a really good point. Antibiotic resistance doesn't always go up. For example, the rates of MDR gonorrhea have dropped substantially.[1] There are other examples as well. Is it a problem that needs to be addressed? Yes. Is it the end of the world? Unlikely. [1]https://www.poz.com/article/drug-resistant-gonorrhea-25776-2772 https://www.poz.com/article/drug-resistant-gonorrhea-25776-2...
- ogig 10y agoEven the article implies your point. Some fear here and there it's good for the clicks tho. >The strain found in the woman is treatable with some other antibiotics.
- HillaryBriss 10y agosurgery becomes more risky with these antibiotic resistant bacteria circulating in hospitals. so any medical condition that might be improved or even cured by surgery becomes more difficult to handle. surgery may not be such an easy choice to make.
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- jwatte 10y agoIf we can't kill these infections after they happen: Can we develop vaccines against them to prevent occurrence?
- gph 10y agoThere are pneumonia vaccines[1], but they mostly cover the main bacterial strains that cause it. A lot of diseases like pneumonia can be caused by multiple strains of bacteria. It's hard to vaccinate against all of them. [1]http://www.cdc.gov/vaccines/vpd-vac/pneumo/default.htm http://www.cdc.gov/vaccines/vpd-vac/pneumo/default.htm
- slg 10y agoThe article doesn't touch on it, but the obvious followup question from the laymen is why can't we develop new antibiotics? I was curious and according to Wikipedia we haven't developed a new class of antibiotics in 30+ years. Can someone with knowledge on the subject explain why we seemingly can't discover/develop new forms of antibiotics to combat these resistant bugs?
- jinfiesto 10y agoAFAIK, the main issue is that we don't know how to cultivate very many kinds of bacteria (relative to the number of species there are.) Since antibiotics are a by-product of bacteria, the number of antibiotics we can effectively produce are limited to the antibiotics produced by species of bacteria that we can effectively cultivate.
- crimsonalucard 10y agoI thought the main issue was that it wasn't profitable enough.
- fleitz 10y agoThat's vaccines and there are regulatory issues in the US with them, antibiotics are perfectly profitable. Also, only in the US does profitability seem to affect making basic medicines. Bacterial resistance is a global issue, not just one like vaccines that is largely a US issue.
- refurb 10y agoAntibiotics aren't generally that profitable in the US. The first reason is antibiotic stewardship: make a really great antibiotic and nobody wants to use it unless they have to. The other reason is that the way antibiotics are reimbursed in the hospital setting prevents charging a price that makes it all that profitable.
- TeMPOraL 10y agoThis is a tricky thing. "Not being profitable enough" isn't always a petty reasoning. With today's technology and science levels, you can do almost anything you can imagine - if you can get enough minds, hands and resources into the project, which is equivalent to throwing enough money at it. Technological advance today is really less about discovering new things and more about making everything easier and cheaper - so that projects that were previously too expensive become cheap enough to tackle.
- c3534l 10y ago> Health officials said the case in Pennsylvania, by itself, is not cause for panic. The strain found in the woman is treatable with some other antibiotics. Thanks for completely ignoring that advice with a headline and three paragraphs of misleading information designed specifically to cause panic.
- Zelmor 10y agoThis is what happens when you raise livestock on antibiotics as the de facto standard. You are what you eat.
- deleted 10y ago[deleted]
- af16090 10y agoThe cover story for this past week's Economist was about antibiotic resistance: http://www.economist.com/news/briefing/21699115-evolution-pathogens-making-many-medical-problems-worse-time-take-drug-resistance http://www.economist.com/news/briefing/21699115-evolution-pa... And from that story, it talked about Colistin (the drug this patient's E. coli is resistant to): "Some of the antibiotics farmers use are those that doctors hold in reserve for the most difficult cases. Colistin is not much used in people because it can damage their kidneys, but it is a vital last line of defence against Acinetobacter, Pseudomonas aeruginosa, Klebsiella and Enterobacter, two of which are specifically mentioned on the CDC watch list. Last year bacteria with plasmids bearing colistin-resistant genes were discovered, to general horror, in hospital patients in China. Agricultural use of colistin is thought to be the culprit." Considering the same article says that "In America 70% of [antibiotics] sold end up in beasts and fowl" it seems that an easy thing to do would be to stop giving antibiotics to animals
- fleitz 10y ago70% of what is produced by pound, live stock do not receive on a regular basis 70% of the different antibiotics available. eg. If all animals are given penicillin that does not explain why we see resistance to cipro.
- refurb 10y agoExactly. Agricultural antibiotics are often very different from the ones humans take. Yes, they might be in the same class as human antibiotics (which would explain resistance) but some aren't.
- LeifCarrotson 10y agoIt would be easy, if the agricultural industry was concerned about antibiotic resistance. Unfortunately, like most markets, externalities like that are hard to price in. If Farmer Bob takes the high road and stops using so many antibiotics, he'll lose some stock and get outcompeted by Farmer Bill. If the turkey farmers band together heroically and agree to reduce their use of antibiotics, uninformed consumers will choose chicken instead. And there's not enough governmental desire for them to regulate it - and local government would be outcompeted by imported goods that use antibiotics.
- rdtsc 10y agoWonder if we'll see a resurgence of phage therapy due to this. Phage therapy is using viruses which will infect and attack the bacteria. Viruses can mutate and adapt just as well as bacteria (while say antibiotics are static in a way). So they can keep up with the mutations. It is a pretty crazy but also ingenious approach. https://en.wikipedia.org/wiki/Phage_therapy https://en.wikipedia.org/wiki/Phage_therapy
- ralfruns 10y agoA start-up from Boston called Sample6 is using phages in diagnostics, currently only for food but it is start. I would be very afraid it ends up like the introduction of Mongoose to Hawaii to control rats in the 19th century.
- bhickey 10y ago> I would be very afraid it ends up like the introduction of Mongoose to Hawaii to control rats in the 19th century. There's no way for them to jump domains prokaryotes to eukaryotes. It's just biologically implausible. Phage are very narrow spectrum and coevolve with their hosts. They're all over our environment and have been since just about the dawn of life. Hypothetically, I guess you could accidentally sterilize your gut flora, but again: they aren't broad spectrum.
- Fomite 10y agoThe biggest risk for phage therapy is an adverse reaction to bacterial endotoxins as the phages cause them to lyse.
- reasonattlm 10y agoPerhaps: http://www.the-scientist.com/?articles.view/articleNo/44785/title/Viral-Soldiers/ http://www.the-scientist.com/?articles.view/articleNo/44785/... It does seem to be undergoing a growth in interest in the research and development communities. I suspect that this might get squashed by the newfound ability to discover new classes of antibiotics pretty much as needed, however: http://www.popsci.com/ichip-new-way-find-antibiotics-and-other-key-drugs http://www.popsci.com/ichip-new-way-find-antibiotics-and-oth...
- leot 10y agoRelevant: http://www.foodsafetynews.com/2015/02/study-e-coli-vaccines-are-effective-but-economic-incentive-needed/ http://www.foodsafetynews.com/2015/02/study-e-coli-vaccines-...
- GigabyteCoin 10y agoI wonder if antibiotic resistance will be the reason that people move out of the cities back to rural areas. You can't get sick if you're not near anyone else.
- gonzo41 10y agoMore likely that we'll start seeing bleach and ozone being used in hospitals to clean again. Probably radiation too. I know that bleach is used, but hospitals used to smell of the stuff. Amputations are going to make a comeback big time. Its going to be interesting if you can't go into surgury for fear of getting post op infection. This will be interesting to watch.
- jrapdx3 10y agoIt's already a huge problem. Post-op infection is common and hard to treat. There are new approaches in use to reduce risk. I recently needed to have surgery. A preventative measure was a gown with ventilation ports. I was told circulating warm air over the body surface has been shown to reduce post-surgical infections. As well, in the hospital IV antibiotics were administered as a further precaution. Fortunately for me I escaped infections, but a number of people I know did not have as favorable an outcome. As you point out, using disinfectants is not a new idea. Readily available materials other than bleach are effective and not as malodorous or irritating as bleach. Hospitals are usually pretty careful about that, there are always mishaps, chance of carelessness, infections are hardly rare. By all means avoid surgery if that's feasible. If not avoidable, may we find an excellent hospital with great, dedicated staff and be blessed with generous insurance benefits. And of course, one can never have too much good luck.
- nwmcsween 10y agoHospitals generally don't use bleach as a multipurpose germicide/virucide/fungicide as it is really bad at doing that, they use an specialty chemical solution that can kill things that bleach won't.
- Fomite 10y ago
- jrk 10y ago"Colistin is widely used in Chinese livestock" oh for fuck's sake…
- ifdefdebug 10y agoTwo lines in the article: > Colistin is the antibiotic of last resort for particularly dangerous types of superbugs and further down: > Colistin is widely used in Chinese livestock ... This is absurd. Preventive use of antibiotics on livestock works just like a giant training camp for hostile bacteria, and horizontal gene transfer will spread the necessarily created resistances to human microbes rendering them useless sooner or later.
- tedd4u 10y agoThere is an interesting RadioLab episode that covers antibiotic resistance and an unlikely source of new antibiotics. Staph Retreat - Nov 2015 http://www.radiolab.org/story/best-medicine/ http://www.radiolab.org/story/best-medicine/ Or load it up in your favorite mobile podcast app.
- rtpg 10y agoI don't get the deal here. >Health officials said the case in Pennsylvania, by itself, is not cause for panic. The strain found in the woman is treatable with some other antibiotics. So the last resort doesn't work, but other stuff works. It's totally reasonable to assume that if bacteria becomes resistant to more common antibiotics, that some other kind of antibiotic could do the trick. Though I guess it would be nicer to have some sort of "proof" that the bacteria _does_ get weaker to stuff it's less exposed to. Actually, side note but wouldn't mass feeding of antibiotics for certain kinds of bacteria let us completely wipe it out, a la smallpox?
- URSpider94 10y agoIn a word, no. Here's why: -- Viruses can't reproduce outside their host. They have a limited lifetime in the environment before they degrade. -- Immunity lasts a long time, even a lifetime. -- So, if you successfully immunize everyone in the population against a virus (like smallpox), and keep doing it for a few years, then eventually that virus will die out This is not true for bacteria. Many bacteria can live in the wild, and in fact only opportunistically infect humans. Also, antibiotics are only effective while you are taking them, and many of them have negative consequences if taken for long times in therapeutic doses (stomach upset, light sensitivity, yeast infections, just to name a few). Next, 60% to 90% of a dose of penicillin is excreted into the urine fully intact, so our sewers, which are teeming with bacteria, would also be flooded with sub-therapeutic doses of antibiotics. Finally, bacteria can exchange DNA with each other, even inter-species, so if we train the sewer germs to survive an antibiotic dose, then they can transfer that capability to other more virulent bacteria that can infect humans. This is, in fact, probably the mechanism for formation of some of these multi-drug resistant strains.
- rdl 10y agoI wonder if you could create a new antibiotic and restrict it to supervised inpatient use only, to preserve efficacy for as long as possible.
- tokenadult 10y agoAnother Hacker News user submitted a better story yesterday http://arstechnica.com/science/2016/05/everybody-be-cool-a-nightmare-superbug-has-not-heralded-the-apocalypse-yet/ http://arstechnica.com/science/2016/05/everybody-be-cool-a-n... but I see that this story with the alarmist headline got more traction on the main page of HN. That's unfortunate for understanding the underlying issues.
- umanwizard 10y agoPlease submit this.
- ChrisArgyle 10y agoTL;DR Modern medicine is over! Get to the zombie apocalypse shelter! Not really though; everything scary in this article is either wrong, exaggerated or both. Ars Technica explains it expertly: http://arstechnica.com/science/2016/05/everybody-be-cool-a-nightmare-superbug-has-not-heralded-the-apocalypse-yet/ http://arstechnica.com/science/2016/05/everybody-be-cool-a-n...
- JSoet 10y agoYes, but although the arstechnica article points out a lot of problems with the original article's claims about this specific bacteria and points out the fear mongering about this specific case, even the ars article admits that the overlying problem of antibiotic resistance is still a bigger issue: "For now, the case serves mostly to highlight the ongoing crisis of rising antibiotic resistance and furthers the need for better stewardship of old antibiotics and development of new ones."
- chris_va 10y agoAgreed, but the level of research in novel antibiotics is really quite limited, mostly due to a lack of return on investment. This actually means there is almost certainly a lot of unexplored potential, but getting drug makers interested is quite difficult (though in the last 5 years the field has been 10x more popular). Most antibiotics on the market are just penicillin variants (well, β-lactam variants), mostly because that was one of the first things to blow onto a petri dish, was non-toxic, easy to manufacture, small molecular weight, and it happened to work quite broadly. Most bacteria share β-lactamase encoding plasmids with each other, so resistance is conferred within years (I think the original penicillin made it 4 years). Honestly we have done very little outside of this space. β-lactamase inhibitors (basically blocking the method of resistance with a separate drug) have a lot of potential, as do many other combination therapy techniques. There are also many other non-β-lactam templates we could play around with. With modern sequencing, you can actually identify the exact resistance mechanism of each strain you encounter. If we move to rapid diagnostic sequencing, we can tailor the treatment to avoid any existing resistance for the specific infection.
- PythonicAlpha 10y agoAnd still, the (mis-)use of antibiotics in meat production carries on (at least in Europe) -- even using last-resort antibiotics.