8 ms·
Antibiotic resistance: The grim prospect
- ucaetano 10y agoLink points to a piece from The Economist, from a month and a half ago, not to current news. Please change the title.
- known 10y agoI'll do. Thank you...
- JPKab 10y agoAt what point do they just move the outdoor water events to the ocean? I understand it's a hit to national pride to move them, but won't the publicity be far worse if a bunch of athletes get sick?
- i_live_there 10y agoThere are lots of other beaches in Rio that could've been chosen to host the water events. However, Rio wanted to have some sort of legacy after the olympic games, something to be proud of after spending so much money while people are suffering without health and security. So the governors chose Baía de Guanabara! It's poluted as fuck, but the intent was to cleanse it before the games and have it as the Olympic legacy. As always, Brazil screwed it and the bay still is a shit hole. Hell, 2 days ago they found in the bay the body of a college student that was murdered nearby. Source: Live in Brazil. Send help
- brianwawok 10y agoFinding a body seems unrelated. Even a clean river can get a body now and then...
- elros 10y agoPublicity? What publicity? From the perspective of the politicians in charge, who cares? If athletes don't get sick, the politicians get political capital. If athletes do get sick, the politicians will be nowhere to be found. Either way, they already made their money in bribes. Welcome to Brazil.
- radiorental 10y agoDrug resistant bacteria found in ocean off Rio http://www.bbc.com/news/world-latin-america-30490396 http://www.bbc.com/news/world-latin-america-30490396
- opium_tea 10y agoI'm confused. What's the relevance of this to the posted story - "Antibiotic resistance: The grim prospect"?
- outworlder 10y agoSuperbugs were found in the waterways of Rio de Janeiros, which is hosting the Olympic Games.
- dluan 10y agoThis is such a clickbait title. It's like saying "Dogs that can learn tricks discovered in NYC".
- sctb 10y agoThanks, we've updated the title to that of the article.
- jkot 10y ago> Hospital hygiene is another focus; there is some evidence that staff are more careless about cleanliness than they were in pre-antibiotic days, when they saw deaths like Albert Alexander’s on a more regular basis.
- elros 10y agoI wouldn't say the staff (as in, doctors and nurses) are careless. It's just that in many hospitals the state hasn't been paying for cleaning services. There have been multiple instances of rats being found in hospitals, for example. Here's a source from a few months back. This one was in the pediatric ICU! http://rederecord.r7.com/video/rato-e-encontrado-em-uti-do-hospital-estadual-albert-schweitzer-no-rj-55f2dc086c4db2770500c1e9/ http://rederecord.r7.com/video/rato-e-encontrado-em-uti-do-h...
- copperx 10y agoI spent a month at one of the top US hospitals and I witnessed crazy unhygienic practices. The most common one is when the nurse assistant puts on gloves to clean the toilet and other items touched by bodily fluids and then proceeds to clean the food tray with the same gloves and often even adjust the IV lines. I got a lot of nurses angry by pointing this out (it must suck to hear someone else tell you that you're doing your job badly, but still). My mother caught a C diff infection. After that, I carried a clorhexidine bottle with me to the hospital and cleaned all surfaces that contacted food with it.
- Smudge 10y agoHospital-acquired infections have become incredibly common. My grandmother caught a C diff infection after what had already been a very arduous treatment and recovery, and she received basically no support from the hospital that had effectively given her the infection.
- Fomite 10y agoWhile she likely got it in the hospital, it should be noted that a fair portion of the population carried C. difficile in their guts, and could develop a symptomatic infection purely as the result of a disruption of the less hardy elements of their gut flora.
- reasonattlm 10y agoDisaster stories sell papers, but the situation is not a disaster story. Rather it is the standard plot for development of new things. People see possible scarcity and react accordingly, far in advance of the non-specialists of the press figuring it out. The scientific community is and has been responding well to the threat of running out of antibiotics. In particular, new advances in mining the bacterial world - a 100-fold enhancement in that mining - mean that we'll be flooded with many new antibiotic drug candidates in the years ahead. For example, see: https://www.edge.org/response-detail/26701 https://www.edge.org/response-detail/26701 http://www.popsci.com/ichip-new-way-find-antibiotics-and-other-key-drugs http://www.popsci.com/ichip-new-way-find-antibiotics-and-oth... Antibiotics Malthusianism has the same problem as all other forms of Malthusianism, which is that people work to fix the problems they see arising in the future, and resources are far from static as a result.
- linkregister 10y agoThanks for adding this comment. I do think the facts you presented temper the "doom and gloom" sentiment of the article, though the new advancement in bacterial growth has not yet yielded new antibiotic candidates.
- chadclan 10y agoCan you say clickbait? We've been on the cusp of an antibiotic resistance epidemic (according to the media and select physicians) for decades. 1979 - http://www.ncbi.nlm.nih.gov/pubmed/45521 http://www.ncbi.nlm.nih.gov/pubmed/45521 1992 - http://science.sciencemag.org/content/257/5073/1064 http://science.sciencemag.org/content/257/5073/1064 But, as @reasonattlm said far more eloquently than I: humans seem need these stories to provide the motivation to use existing antibiotics less and to get moving on creating new antibiotics.
- daveguy 10y ago> ...to provide the motivation to use existing antibiotics less... But always complete your antibiotic prescription.
- astazangasta 10y agoThis bit of folk/medical wisdom has been around for a few decades, but for the life of me I can't understand the logic - beyond the notion that merely being asymptomatic doesn't mean you've killed all the bugs. How this can possibly contribute to the spread of antibiotic resistance is mystifying to me, as is the basis of this advice - is there ANY evidence that patients not completing their drug courses causes resistance?
- hga 10y agoAbsolutely! As I learned as a rule of thumb while doing microbiological research in a NSSF Summer Science Training Program in 1977, most random antibiotics would fail to kill E. Coli at a rate of 1 in a million, and it went up to 1 in a billion with streptomycin (this is with random mutations, no plasmid acquisition involved, which is another story). However, these surviving bugs are generally not as fit as wild type, they've probably survived by sacrificing something, or doing something that consumes more energy. This helps your immune system mop them up, and note if antibodies are involved (don't know about that) it takes a while to come up with new ones, plus if there's any sort of bacteria ecology in the target area that survives the antibiotic they'll out-compete them. It shouldn't take much research on your part to confirm the basics of what I've related above, it's a tremendous problem, especially with TB, who's defenses require long and obnoxious drug schedules, resulting in more and more MDR and XDR (multi- and extensively-drug resistant) strains. If you get XDR, you're probably going to die, in a era where that's squalid instead of romantic. And I just came across "Totally drug-resistant tuberculosis" https://en.wikipedia.org/wiki/Totally_drug-resistant_tuberculosis https://en.wikipedia.org/wiki/Totally_drug-resistant_tubercu... Not official yet, but....
- teh_klev 10y agoI think the article above was written off the back of, or at the same time as, some fairly shoddy reporting about antibiotic resistant strains back around March to May this year, because who doesn't want to get in on a decent untreatable rampant killer bug story. It's worthwhile having a read of this: 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...
- uptown 10y agoMedical professions risk losing a patient or being sued if hey misdiagnose a condition, so the understandable reaction is to throw antibiotics at the problem rather than waiting for test results to come-back to determine whether a specific course of care is appropriate. The good news is that some test times are decreasing dramatically ... from days to minutes in many cases: http://nanologix.com/test_results.html http://nanologix.com/test_results.html * tuberculosis from 21+ days to 1.5 hours. * e.coli from 18 - 24 hours to 30 minutes * salmonella from 24 hours to 30 minutes * group b streptococcus from 48 - 72 hours to under an hour My hope is that faster results leads to fewer unnecessary prescriptions being administered, and better overall care for the patients.
- akiselev 10y agoAre the false positive rates comparable between the older slow tests and the new fast ones?
- Fomite 10y agoDepends very much on the test. The study I did for rapid influenza tests showed that their accuracy was pretty bad. Very sensitive, not at all specific.
- atmosx 10y ago> Medical professions risk losing a patient or being sued if hey misdiagnose a condition, so the understandable reaction is to throw antibiotics at the problem rather than waiting for test results to come-back to determine whether a specific course of care is appropriate. As a pharmacist, my experience says otherwise. I think the following are the main reasons for bacterial resistance: a) Patient doesn't respect doctor's/pharmacist's guidelines. He feels much better after day 3, so he stops his class X ATB in day 4 instead of day 7. If bacteria survives, might very well be class X ATB-resistant. b) Patient has a relative who when was feeling sick took ATB XYZ and got better. The main reason for this is poverty: A visit to the doctor might cost 25-120 EUR. c) Hospitals. MRSA became "MR" in hospitals, where bacteria conjugation takes place. That said, at some in point, we should expect bacterial organisms to evolve some kind of resistance. That's how evolution works.
- tomkinstinch 10y agoChemical antibiotics are currently the best and most developed tool we have for bacterial infection, but other options are being explored, including defensins[1,2,3] (antimicrobial peptides) and—as mentioned in the article—phage therapy[4,5,6,7] (viruses that infect and replicate within a bacterium). Like many of our current antibiotics, they have their origins in nature. As therapeutics, they're far off, and would have to be characterized and go through the usual clinical trial process to be evaluated for efficacy and safety. Specificity is an issue for phages, and delivery is a challenges for both. One novel application is a defensin-based chewing gum being developed by the US military to combat the bacteria responsible for dental plaque[8,9]. 1. http://www.nature.com/nri/journal/v3/n9/full/nri1180.html http://www.nature.com/nri/journal/v3/n9/full/nri1180.html 2. https://en.wikipedia.org/wiki/Defensin https://en.wikipedia.org/wiki/Defensin 3. http://onlinelibrary.wiley.com/doi/10.1002/biot.200700148/abstract;jsessionid=502B8ABC8A1924B726025B62168619BE.f03t01 http://onlinelibrary.wiley.com/doi/10.1002/biot.200700148/ab... 4. http://www.nature.com/news/phage-therapy-gets-revitalized-1.15348 http://www.nature.com/news/phage-therapy-gets-revitalized-1.... 5. https://www.amazon.com/Forgotten-Cure-Future-Phage-Therapy/dp/1461402506 https://www.amazon.com/Forgotten-Cure-Future-Phage-Therapy/d... 7. https://en.wikipedia.org/wiki/Phage_therapy https://en.wikipedia.org/wiki/Phage_therapy 8. http://www.newyorker.com/tech/elements/zero-dark-cavity http://www.newyorker.com/tech/elements/zero-dark-cavity 9. http://www.usaisr.amedd.army.mil/news/news_stories/2014_FEB/DTRD_developing_anti_plaque_chewing_gum.html http://www.usaisr.amedd.army.mil/news/news_stories/2014_FEB/...
- Retric 10y agoPhages are not universal in nature like Antibiotics which limits their value.
- Fomite 10y agoAs much as I love phage therapy (and have loved it for more than a decade now), it's miles away from being as useful as antibiotics, or as functional.
- dredmorbius 10y agoI just want to say thank you for a hugely informative, referenced, and brief comment. You've pointed me at more information on a concept I'm familiar with (bacteriophages), and taught me two new terms -- defensins and antimicrobial peptides. Clipped & saved.
- 55acdda48ab5 10y agoEverybody likes to harp on feeding antibiotics to livestock as a huge problem but I'm not actually aware of any resistant bacteria spread to humans from livestock. Sodomy and promiscuity are absolutely definitively tied to resistant infections that are killing people. But apparently legal sodomy is now sacred.
- paulgerhardt 10y agoSee also the May article in Nature in how we can now create endless supplies of slight variations on antibiotics through semisynthesis to circumvent resistance: http://www.nature.com/nature/journal/v533/n7603/full/nature17967.html http://www.nature.com/nature/journal/v533/n7603/full/nature1... Previous discussion: https://news.ycombinator.com/item?id=11740340 https://news.ycombinator.com/item?id=11740340
- pklausler 10y agoI wonder if there's any correlation between anti-vaxxers and those folks who insist on getting antibiotics that they don't need.
- supercarrot 10y agoThere isn't. Because most of the antibiotics are given to non-human animals which then provide billions of evolutionary pools for resistance development every year. Nothing can beat that. Humans as pools of evolution for bacteria, aren't causing this problem. Recent AMA https://reddit.com/r/askscience/comments/4q920m/askscience_ama_series_we_are_sarah_fortune_and/?st=iqa2ipvh&sh=1f8c46f2 https://reddit.com/r/askscience/comments/4q920m/askscience_a... points out that animal agriculture is a huge problem. Not pseudoscientific idiots.