8 ms·

...for most superbugs, health departments and the US Centers for Disease Control and Prevention (CDC) don’t track who acquires them, nor do they know how many r

...for most superbugs, health departments and the US Centers for Disease Control and Prevention (CDC) don’t track who acquires them, nor do they know how many recovered or died. The most recent CDC report estimates that 23,000 people die in the U.S. each year from superbug infections, based on data from 2010. But a recent report estimated that at least 153,000 people died from superbug infections the same year, an estimate that is nearly seven-fold higher. We are allowing most superbugs to maintain their invisibility under the radar, where they are spreading quietly. Unreported. Undetected. And, increasingly, untreatable. this isn't really scary at all. i'm not scared. are you scared? why be scared?

Analemma_ 7y ago
To me, the really scary thing about antibiotic resistance is not necessarily random infections in the hospital (as bad as that is) but the fact that antibiotics are what made surgery possible, and if they don’t work, all these medical procedures we’ve gotten used to as harmless suddenly carry a very serious risk-reward tradeoff. Imagine C-sections, biopsies, hip replacements, etc. all having a one-in-four chance of death. That’s what we’re heading back to.
- est31 7y ago
  For operations, sterilizations are carried out with a mixture of means like chemical disinfectants, subjecting instruments to extreme heat (Autoclaving), etc. but they don't rely on antibiotics. Instruments can be put into environments toxic to both human and bacterial cells. The big difference of antibiotics is that they are toxic to bacteria but not to human cells so they can be put directly into the system. Some bacteria are also developing resistance against chemical disinfectants but here we have a much larger choice.
  - wl 7y ago
    It's defense in depth. Yes, sterile technique is used to minimize the occurrence of surgical site infections. Sterile technique, when performed 100% correctly, isn't perfect and prophylactic antibiotics are standard to help mitigate any remaining risk.
    - est31 7y ago
      Oh, TIL. Thanks for the info! It won't throw us back to the pre-semmelweis era though only to the pre-fleming area.
    - Fomite 7y ago
      The field uses "Swiss cheese" as a term for a reason - you can have holes in each layer (and will), but if you have enough layers you'll be okay.
- HillaryBriss 7y ago
  agree. and my next fear is that all of the medical establishment, suppliers, and practitioners who depend upon surgical procedures for their profitability downplay the additional risks and continue to encourage all of us to undergo surgery
  - Fomite 7y ago
    Surgeons are already the bane of many infection control specialists.
sithadmin 7y ago
Extremely scared, especially in light of barriers to drug approval killing off interest in antibiotics development. Just take a look at what happened to Achaogen: http://www.bioworld.com/perspectives/2019/04/24/a-decade-of-incentives-to-promote-antibiotic-development-and-still-no-viable-route-to-commercial-success/ http://www.bioworld.com/perspectives/2019/04/24/a-decade-of-... The FDA granted Fast Track designation for their antibiotic, only later refuse to approve it for use in bloodstream infections due to quibbling over study size (which was admittedly smaller than it could have been, largely in part due to the Fast Track designation). The antibiotic has been relegated to on-label use for complicated UTIs. Though it can still be used off-label, this isn't enough to attract further investment or keep sales strong enough to sustain ongoing operations. Achaogen was forced to lay off nearly all staff, and is now entering bankruptcy. Unfortunately, this sort of thing is hardly unique among early stage pharma companies focusing on antibiotics, and it's steering investors away from such companies. It's also driving pharma professionals away.
- pkaye 7y ago
  But they could still get approval in other countries.
  - sithadmin 7y ago
    Wouldn't have mattered previously, won't matter going forward. The USA is the most important and lucrative market, whether we like it or not.
  - BurningFrog 7y ago
    As I understand it, other countries are not very profitable as pharmaceutical markets, so they probably won't get developed in the first place there.
jen_h 7y ago
The point of her article wasn’t to push despair, but rather to urge the Western medical establishment to get moving on phage research. Bacteriophages as a solution to our antibiotic resistance crisis have been largely ignored in the West due to unpatentability, research mainly performed in Eastern Europe, etc — but her story is that a bacteriophage cocktail saved her husband’s life where antibiotics failed...and the only reason they even were able to go that route was because she’s an epidemiologist who pulled some strings, pulled research teams together, got approvals, and managed the project herself.
- Mirioron 7y ago
  So, why isn't government funded research being done on it then? I often hear about how the government funds a lot of medical research, so this seems like the perfect thing for them to fund.
  - Fomite 7y ago
    What makes you think they're not?
- DoreenMichele 7y ago
  From the article: Alternatives to antibiotics are desperately needed. She's not pushing phage research per se, just research into alternatives generally.
  - jen_h 7y ago
    Did you stop reading there, by chance?
    - deleted 7y ago
      [deleted]
    - throwaway5752 7y ago
      Shame on whoever downvoted you. The full last 5 paragraphs are devoted to bacteriophages, which are what ultimately saved the author's husband. The author is "Co-Director of the Center for Innovative Phage Applications and Therapeutics" at UCSD (https://profiles.ucsd.edu/steffanie.strathdee https://profiles.ucsd.edu/steffanie.strathdee) It closes on "The possibility of living in a post-antibiotic era where simple surgeries or scrapes could lead to an infection that requires limb amputation or results in death means we need to improve AMR surveillance, diagnosis and treatment. This includes antibiotics, but should also include phage therapy. We can’t afford to bury a promising alternative to antibiotics for another hundred years." She is absolutely pushing phage research. Not exclusive to any alternatives, but that is basically the point of the article.
rossenberg79 7y ago
Not scary at all. This is just life, and we must endure it. Keep in mind at the same time this is happening we also have to deal with climate change and not blowing ourselves up in all out Nuclear War. And even if we avoid all that you could still step outside and be shot or stabbed by a ruffian who leaves you dead all the same.

Analemma_ 7y ago

To me, the really scary thing about antibiotic resistance is not necessarily random infections in the hospital (as bad as that is) but the fact that antibiotics are what made surgery possible, and if they don’t work, all these medical procedures we’ve gotten used to as harmless suddenly carry a very serious risk-reward tradeoff. Imagine C-sections, biopsies, hip replacements, etc. all having a one-in-four chance of death. That’s what we’re heading back to.

est31 7y ago
For operations, sterilizations are carried out with a mixture of means like chemical disinfectants, subjecting instruments to extreme heat (Autoclaving), etc. but they don't rely on antibiotics. Instruments can be put into environments toxic to both human and bacterial cells. The big difference of antibiotics is that they are toxic to bacteria but not to human cells so they can be put directly into the system. Some bacteria are also developing resistance against chemical disinfectants but here we have a much larger choice.
- wl 7y ago
  It's defense in depth. Yes, sterile technique is used to minimize the occurrence of surgical site infections. Sterile technique, when performed 100% correctly, isn't perfect and prophylactic antibiotics are standard to help mitigate any remaining risk.
  - est31 7y ago
    Oh, TIL. Thanks for the info! It won't throw us back to the pre-semmelweis era though only to the pre-fleming area.
  - Fomite 7y ago
    The field uses "Swiss cheese" as a term for a reason - you can have holes in each layer (and will), but if you have enough layers you'll be okay.
HillaryBriss 7y ago
agree. and my next fear is that all of the medical establishment, suppliers, and practitioners who depend upon surgical procedures for their profitability downplay the additional risks and continue to encourage all of us to undergo surgery
- Fomite 7y ago
  Surgeons are already the bane of many infection control specialists.

sithadmin 7y ago

Extremely scared, especially in light of barriers to drug approval killing off interest in antibiotics development. Just take a look at what happened to Achaogen: http://www.bioworld.com/perspectives/2019/04/24/a-decade-of-incentives-to-promote-antibiotic-development-and-still-no-viable-route-to-commercial-success/ http://www.bioworld.com/perspectives/2019/04/24/a-decade-of-... The FDA granted Fast Track designation for their antibiotic, only later refuse to approve it for use in bloodstream infections due to quibbling over study size (which was admittedly smaller than it could have been, largely in part due to the Fast Track designation). The antibiotic has been relegated to on-label use for complicated UTIs. Though it can still be used off-label, this isn't enough to attract further investment or keep sales strong enough to sustain ongoing operations. Achaogen was forced to lay off nearly all staff, and is now entering bankruptcy. Unfortunately, this sort of thing is hardly unique among early stage pharma companies focusing on antibiotics, and it's steering investors away from such companies. It's also driving pharma professionals away.

pkaye 7y ago
But they could still get approval in other countries.
- sithadmin 7y ago
  Wouldn't have mattered previously, won't matter going forward. The USA is the most important and lucrative market, whether we like it or not.
- BurningFrog 7y ago
  As I understand it, other countries are not very profitable as pharmaceutical markets, so they probably won't get developed in the first place there.

jen_h 7y ago

The point of her article wasn’t to push despair, but rather to urge the Western medical establishment to get moving on phage research. Bacteriophages as a solution to our antibiotic resistance crisis have been largely ignored in the West due to unpatentability, research mainly performed in Eastern Europe, etc — but her story is that a bacteriophage cocktail saved her husband’s life where antibiotics failed...and the only reason they even were able to go that route was because she’s an epidemiologist who pulled some strings, pulled research teams together, got approvals, and managed the project herself.

Mirioron 7y ago
So, why isn't government funded research being done on it then? I often hear about how the government funds a lot of medical research, so this seems like the perfect thing for them to fund.
- Fomite 7y ago
  What makes you think they're not?
DoreenMichele 7y ago
From the article: Alternatives to antibiotics are desperately needed. She's not pushing phage research per se, just research into alternatives generally.
- jen_h 7y ago
  Did you stop reading there, by chance?
  - deleted 7y ago
    [deleted]
  - throwaway5752 7y ago
    Shame on whoever downvoted you. The full last 5 paragraphs are devoted to bacteriophages, which are what ultimately saved the author's husband. The author is "Co-Director of the Center for Innovative Phage Applications and Therapeutics" at UCSD (https://profiles.ucsd.edu/steffanie.strathdee https://profiles.ucsd.edu/steffanie.strathdee) It closes on "The possibility of living in a post-antibiotic era where simple surgeries or scrapes could lead to an infection that requires limb amputation or results in death means we need to improve AMR surveillance, diagnosis and treatment. This includes antibiotics, but should also include phage therapy. We can’t afford to bury a promising alternative to antibiotics for another hundred years." She is absolutely pushing phage research. Not exclusive to any alternatives, but that is basically the point of the article.

rossenberg79 7y ago

Not scary at all. This is just life, and we must endure it. Keep in mind at the same time this is happening we also have to deal with climate change and not blowing ourselves up in all out Nuclear War. And even if we avoid all that you could still step outside and be shot or stabbed by a ruffian who leaves you dead all the same.