Losing the war on bacteria

Started by Vekseid, February 28, 2010, 05:00:10 PM

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Vekseid

Seriously : /

Quote
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“For Gram-positives we need better drugs; for Gram-negatives we need any drugs,” said Dr. Brad Spellberg, an infectious-disease specialist at Harbor-U.C.L.A. Medical Center in Torrance, Calif., and the author of “Rising Plague,” a book about drug-resistant pathogens. Dr. Spellberg is a consultant to some antibiotics companies and has co-founded two companies working on other anti-infective approaches. Dr. Rice of Cleveland has also been a consultant to some pharmaceutical companies.

Doctors treating resistant strains of Gram-negative bacteria are often forced to rely on two similar antibiotics developed in the 1940s — colistin and polymyxin B. These drugs were largely abandoned decades ago because they can cause kidney and nerve damage, but because they have not been used much, bacteria have not had much chance to evolve resistance to them yet.

“You don’t really have much choice,” said Dr. Azza Elemam, an infectious-disease specialist in Louisville, Ky. “If a person has a life-threatening infection, you have to take a risk of causing damage to the kidney.”

Such a tradeoff confronted Kimberly Dozier, a CBS News correspondent who developed an Acinetobacter infection after being injured by a car bomb in 2006 while on assignment in Iraq. After two weeks on colistin, Ms. Dozier’s kidneys began to fail, she recounted in her book, “Breathing the Fire.”

Rejecting one doctor’s advice to go on dialysis and seek a kidney transplant, Ms. Dozier stopped taking the antibiotic to save her kidneys. She eventually recovered from the infection.

Even that dire tradeoff might not be available to some patients. Last year doctors at St. Vincent’s Hospital in Manhattan published a paper describing two cases of “pan-resistant” Klebsiella, untreatable by even the kidney-damaging older antibiotics. One of the patients died and the other eventually recovered on her own, after the antibiotics were stopped.

“It is a rarity for a physician in the developed world to have a patient die of an overwhelming infection for which there are no therapeutic options,” the authors wrote in the journal Clinical Infectious Diseases.
...

We're breeding killer bacteria through ignorance, apathy and poverty, imagine what a significantly pissed off group of people could do.

Oniya

I honestly think that a co-contributor to this is the big hype on sanitizing everything that I've seen of late.  Clean is good, but the world outside is not sterile.  We're stunting our own immune systems by not getting exposed to the common, everyday stuff. 

Antibiotics should be used to take care of what we can't handle - and should be taken according to directions - but I'd love to see a study on how well human antibodies to S. aureus work against MRSA (one of the drug-resistant strains of S. aureus.
"Language was invented for one reason, boys - to woo women.~*~*~Don't think it's all been done before
And in that endeavor, laziness will not do." ~*~*~*~*~*~*~*~*~*~*~Don't think we're never gonna win this war
Robin Williams-Dead Poets Society ~*~*~*~*~*~*~*~*~*~*~*~*~*~Don't think your world's gonna fall apart
I do have a cause, though.  It's obscenity.  I'm for it.  - Tom Lehrer~*~All you need is your beautiful heart
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Trieste

Gram-negs are beastly little buggies; they're the single-celled version of little tanks. That's how they got their name - they have a dual layer that protects them, whereas Gram-pos bacteria only has one layer of lipids. It acts like armor, making it difficult for anything to interfere with their biological processes.

Poor Mr. Armbruster. :(

RubySlippers

What choice do many poor in the US have? I have an option by human grade pills labeled for Fish Tank use that costs $35.00 for 100 x 500mg pills of Amoxcillin or pay $75 for a doctor, get tests done even if I'm 99% sure its a UTI that may cost over $250+. I choose the cheap option and pray it works. The drug bought at a pharmacy goes for $4 but I need a damned prescription so that means alot more money.


Oniya

I believe that's why Veks included poverty on the list of culprits.
"Language was invented for one reason, boys - to woo women.~*~*~Don't think it's all been done before
And in that endeavor, laziness will not do." ~*~*~*~*~*~*~*~*~*~*~Don't think we're never gonna win this war
Robin Williams-Dead Poets Society ~*~*~*~*~*~*~*~*~*~*~*~*~*~Don't think your world's gonna fall apart
I do have a cause, though.  It's obscenity.  I'm for it.  - Tom Lehrer~*~All you need is your beautiful heart
O/O's Updated 5/11/21 - A/A's - Current Status! - Writing a novel - all draws for Fool of Fire up!
Requests updated March 17

Serephino

Yeah, turning people into germaphobes definitely didn't help.  Those commercials for Lysol and Clorox and other cleaning products pray on a parent's fear by saying that all these germs are on common household things.  Yes, germs are everywhere!  Our ancestors survived them, I would think we could too. 

If I get sick I usually try home remedies first.  Again, they worked for our ancestors, and science is starting to figure out why.  And you aren't in danger from nasty side effects and having your kidneys damaged by a cup of chamomile tea and a bowl of chicken soup.....  But if that doesn't work, if it's something I've had before like a sinus infection or pink eye I can just call up my doctor's office and they'll fax a prescription for me to the local Wal Mart pharmacy. 

DarklingAlice

This is why we need more than two clinics in this country doing phage therapy trials! There are viruses that specifically target certain bacteria (e.g. phage lambda targeting E. Coli). These viruses are capable of evolving along with the bacteria, making it less likely that bacteria can effectively generate a resistance to them (especially if given in conjunction with antibiotics). Let's treat with viruses. It seems pretty straight forward. If evolution gives you lemons...

Quote from: Oniya on February 28, 2010, 06:21:43 PM
I honestly think that a co-contributor to this is the big hype on sanitizing everything that I've seen of late.  Clean is good, but the world outside is not sterile.  We're stunting our own immune systems by not getting exposed to the common, everyday stuff.

We may be doing more than just stunting our immune systems. There is a theory that our hygiene is partially responsible for the higher levels of auto-immune disease in developed countries. Of course there could just be a higher incidence of diagnosis/reports in countries with more advanced medicine. Still, worth looking into.
For every complex problem there is a solution that is simple, elegant, and wrong.


Oniya

Quote from: DarklingAlice on March 01, 2010, 01:49:56 AM
This is why we need more than two clinics in this country doing phage therapy trials! There are viruses that specifically target certain bacteria (e.g. phage lambda targeting E. Coli). These viruses are capable of evolving along with the bacteria, making it less likely that bacteria can effectively generate a resistance to them (especially if given in conjunction with antibiotics). Let's treat with viruses. It seems pretty straight forward. If evolution gives you lemons...

This is so incredibly amazing...  I'm going to have to poke more at it when I'm fully awake.
"Language was invented for one reason, boys - to woo women.~*~*~Don't think it's all been done before
And in that endeavor, laziness will not do." ~*~*~*~*~*~*~*~*~*~*~Don't think we're never gonna win this war
Robin Williams-Dead Poets Society ~*~*~*~*~*~*~*~*~*~*~*~*~*~Don't think your world's gonna fall apart
I do have a cause, though.  It's obscenity.  I'm for it.  - Tom Lehrer~*~All you need is your beautiful heart
O/O's Updated 5/11/21 - A/A's - Current Status! - Writing a novel - all draws for Fool of Fire up!
Requests updated March 17

DrFier

Quote from: DarklingAlice on March 01, 2010, 01:49:56 AM(e.g. phage lambda targeting E. Coli)

That sounds like it could cause it's own set of problems though.
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Trieste

It depends. It's not exactly biologically happy for a pathogen to kill off its host, and there are plenty of microbes that help rather than heal. While movies like Frankenstein are fun, the public conscious also has deveeloped this science-as-bogeyman mentality that really can make it easy to scare people away from alternative therapies.

@Alice: I read somewhere that they're working on a way to keep our immune systems occupied to try and reduce the incidences of allergies and the like. It was interesting.

DarklingAlice

Quote from: Trieste on March 01, 2010, 08:01:53 AM
While movies like Frankenstein are fun, the public conscious also has deveeloped this science-as-bogeyman mentality that really can make it easy to scare people away from alternative therapies.

This has got to be one of my biggest pet peeves >_< Especially when trying to promote viral treatment. Everyone's first response seems to be: "Germs are scary! It will mutate! OMG!" We need new therapies, and viruses offer numerous interesting antibacterial, antiviral, and anticancer treatment options. Retroviral gene therapy could cure retinoblastoma. Bacteriophages targeted against staphylococcus could cure MRSA. Flossie Wong-Staal (one of the top virologists in the world, famous for mapping HIV) has even been working on an HIV cure, using HIV itself as the vector. Every change in medicine generally seems new and frightening (e.g. "You want to inject me with a live attenuated virus to keep me from getting sick!?! OMG!"), but we can't shy away from new developments.

Quote from: Trieste on March 01, 2010, 08:01:53 AM
@Alice: I read somewhere that they're working on a way to keep our immune systems occupied to try and reduce the incidences of allergies and the like. It was interesting.

Ooh! Cool, I will start hunting for articles on this.
For every complex problem there is a solution that is simple, elegant, and wrong.


Trieste

Quote from: DarklingAlice on March 01, 2010, 03:28:28 PM
This has got to be one of my biggest pet peeves >_< Especially when trying to promote viral treatment. Everyone's first response seems to be: "Germs are scary! It will mutate! OMG!" We need new therapies, and viruses offer numerous interesting antibacterial, antiviral, and anticancer treatment options. Retroviral gene therapy could cure retinoblastoma. Bacteriophages targeted against staphylococcus could cure MRSA. Flossie Wong-Staal (one of the top virologists in the world, famous for mapping HIV) has even been working on an HIV cure, using HIV itself as the vector. Every change in medicine generally seems new and frightening (e.g. "You want to inject me with a live attenuated virus to keep me from getting sick!?! OMG!"), but we can't shy away from new developments.

You articulated my point in a way that I couldn't (mostly because I was on my phone and pressed for time). So, thank you. It's a pet peeve of mine, too.

DrFier

I guess it's kind of the science is the boogieman thing from the movies, but more Jurassic Park than Frankenstein. Conventional thought says that viruses like to mutate, and what would stop a mutated virus from, say, killing the wrong strain of E. Coli?

The best method we could possibly have would be having something along the lines of nanites in our blood, to stop the pathogens from interacting with our cells, and /or ideally engulf them and digest them with some sort of acid. But that's just science fiction, now isn't it? :D
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Trieste

With the holes in Asimov's Three Laws (assuming your nanites followed them), wouldn't nanites be just as bad as a mutated virus?

"I'm sorry, Dave, but I'm afraid I can't let you digest that." *hork*

DrFier

I guess they would, but I was making a reference to leukocytes.

Sorry, I'd be more coherent but I haven't slept in a few days.
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The Dark Raven

Quote from: Trieste on March 01, 2010, 04:31:07 PM
<snip>

"I'm sorry, Dave, but I'm afraid I can't let you digest that." *hork*

...I think I'm going to have to take that quote to my microbiology teacher....  Yay for nanobots and bacteriophages!

Now if we can get people to take all their antibiotics when they have a bacterial infection and NOT take them when they have a viral infection... *steams*

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DrFier

Quote from: Daylily on March 07, 2010, 07:01:01 PM
Now if we can get people to take all their antibiotics when they have a bacterial infection and NOT take them when they have a viral infection... *steams*

Now why on earth would they want to do that? XD
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RubySlippers

There are other issue antibiotics are not normally big moneymakers for major drug makers in the US, while treating trendy conditions like blood pressure is especially chronic care drugs that people must take forever.

You created a new cholesterol drug it can make you ample money for years as people take it every day. If you make a antibiotic its a case by case drug.

WhiteyChan

Quote from: Trieste on March 01, 2010, 04:31:07 PM
With the holes in Asimov's Three Laws (assuming your nanites followed them), wouldn't nanites be just as bad as a mutated virus?

"I'm sorry, Dave, but I'm afraid I can't let you digest that." *hork*

*ahem - enters physics mode*

Nanotechnology hasn't yet evolved to the point where you can have nano-robots in one's bloodstream, doing something they were "programmed" to do. What you can have, though, are specifically designed molecules or structures (eg carbon nano-tubes) that react in a certain way when presented with a certain stimulus. Thus, if one could find a combination of elements in a specific structure that reacted with a virus to make the virus harmless, it would be perfect, as it would do that and only that - no thinking or programming or whatever involved. Definitely none of Asimov's Laws of Robotics.

To make a robot on the scale of viruses, that is fully functional and indeed, super-computer scale in processing ability, which is what would be needed for something like this, we would first have to perfect quantum computing, and that stuff is waaaaay off at the minute.

Trieste

Physics degree makes sense of humor fail. :(

Torch

Quote from: Daylily on March 07, 2010, 07:01:01 PM


Now if we can get people to take all their antibiotics when they have a bacterial infection and NOT take them when they have a viral infection... *steams*

Tell that to the hordes of parents stampeding the local pediatrician's office every time "widdle snookums" so much as sneezes.

And listen to them scream like banshees and demand an antibiotic scrip for everything from a cold to a broken leg. *eyeroll*

[/sarcasm]
"Every morning in Africa, a gazelle wakes up. It knows it must outrun the fastest lion or it will be killed. Every morning in Africa, a lion wakes up. It knows it must run faster than the slowest gazelle, or it will starve. It doesn't matter whether you're a lion or a gazelle, when the sun comes up, you'd better be running."  Sir Roger Bannister


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RubySlippers

Then doctors are not doing their jobs. Mine will give drugs prescribed to help relieve symptoms if bad enough for that over common things in the drug store. But they need to explain an antibiotic won't help a cold since its a virus and 99.99% of the time a child if given time to rest will blow off the illness if otherwise healthy.

Torch

Quote from: RubySlippers on March 11, 2010, 11:20:53 AM
Then doctors are not doing their jobs. Mine will give drugs prescribed to help relieve symptoms if bad enough for that over common things in the drug store. But they need to explain an antibiotic won't help a cold since its a virus and 99.99% of the time a child if given time to rest will blow off the illness if otherwise healthy.

Doctors do explain, and parents are quite aware of this. The parents demand an antibiotic anyway ("Just in case" is the usual argument), and for many physicians, it's easier to give out a scrip than a lecture.
"Every morning in Africa, a gazelle wakes up. It knows it must outrun the fastest lion or it will be killed. Every morning in Africa, a lion wakes up. It knows it must run faster than the slowest gazelle, or it will starve. It doesn't matter whether you're a lion or a gazelle, when the sun comes up, you'd better be running."  Sir Roger Bannister


Erotic is using a feather. Kinky is using the whole chicken.

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Oniya

You know, I'd like to sit those doctors down and replace 'antibiotic' with 'pain pills' in the parent's demand.  How many of them would prescribe in that case?   >:(

Parent:  These are the symptoms.  I think we need some antibiotics pain pills.
Doctor:  The condition isn't serious, and should go away on its own in a few days.  Antibiotics Pain pills won't really help anything.
Parent:  But what if it doesn't?  Can't you just give me some antibiotics pain pills just in case?

Try doing that at your average emergency room, and see how fast they assume you're an addict.
"Language was invented for one reason, boys - to woo women.~*~*~Don't think it's all been done before
And in that endeavor, laziness will not do." ~*~*~*~*~*~*~*~*~*~*~Don't think we're never gonna win this war
Robin Williams-Dead Poets Society ~*~*~*~*~*~*~*~*~*~*~*~*~*~Don't think your world's gonna fall apart
I do have a cause, though.  It's obscenity.  I'm for it.  - Tom Lehrer~*~All you need is your beautiful heart
O/O's Updated 5/11/21 - A/A's - Current Status! - Writing a novel - all draws for Fool of Fire up!
Requests updated March 17

Serephino

Sadly, there are doctors who could lecture till they turn blue in the face, the parents/patient won't stop demanding antibiotics until they get them.  And if they can't get them from one doctor, they'll keep going to different doctors until they find one who will give it to them.