Announcement

Collapse
No announcement yet.

The rapid emergence of pan-antibiotic-resistant bacteria - a global crisis

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

  • The rapid emergence of pan-antibiotic-resistant bacteria - a global crisis

    Threat Report 2013 | Antimicrobial Resistance | CDC



    Hunting the Nightmare Bacteria | FRONTLINE | PBS

    https://medium.com/p/892b57499e77

    As a scientist who works in bioscience (but not antimicrobial drug development) I have to say that the trends are dire. Multiple outbreaks have occurred in hospital settings, the bugs are impossible to eradicate and the mortality rate is extremely high for those infected. Several of the emerging resistance genes are encoded by snippets of DNA that can be passed freely between even different species of bacteria as if they are simply upgrading their software. If something is not done soon (as in immediately), we may be looking at dramatic increases in the risks of operations and child birth within a decade, and possible entry into a post-antibiotic era in medicine (meaning pre-1940 levels of mortality due to infections) soon after.

    Regulation will not suffice. The sources of this problem are global and the genes are already out there. However, the economics of drug development cannot support large scale privately funded efforts because what we need are new drugs to be developed (~$1 billion per drug) and then held in reserve, meaning not sold, until they are truly needed. By the time there is an economical market for these drugs we will already be in a world of hurt, and if we start only then, then it might take another decade or more before drugs come to market.

    This is one area where the federal government needs to step in immediately with massive support specifically for development of new antibiotics by pharmaceutical companies. Some thing to the tune of $1 billion per year would be a start.
    Last edited by citanon; 25 Nov 13,, 01:01.

  • #2
    It is difficult to directly compare the amount of drugs used in food animals with the amount used in humans, but
    there is evidence that more antibiotics are used in food production.
    Pulled this straight from the pdf you posted. We need to regulate the food industry quickly on this regard, surely that should be the easier side of the coin.

    Comment


    • #3
      Originally posted by tantalus View Post
      Pulled this straight from the pdf you posted. We need to regulate the food industry quickly on this regard, surely that should be the easier side of the coin.
      The moment I saw that you had posted on this thread I knew you were going to say something like that. An issue, but only one & not the most pressing.
      sigpic

      Win nervously lose tragically - Reds C C

      Comment


      • #4
        Originally posted by Bigfella View Post
        The moment I saw that you had posted on this thread I knew you were going to say something like that. An issue, but only one & not the most pressing.
        Well since I made the point yesterday on another thread, its hardly a prediction worthy of the bold emphasis. Its unclear how significant but the above quote should serve as a warning to the possibilities. Everyone is aware of the misuse of antibiotics in the human population and the potential for resistance to evolve, the food industry dynamic is lesser known, therefore its informative to highlight it.

        Comment


        • #5
          Originally posted by Bigfella View Post
          The moment I saw that you had posted on this thread I knew you were going to say something like that. An issue, but only one & not the most pressing.
          Actually Consumer Reports came out with an article called "Is your Chicken safe to eat?" Most chicken in the U.S. comes from the big producers like Tyson and Foster Farms. All use antibiotics in their chickens. All samples showed over 80% of all brands had staph contamination. Next was E. coli between 56-78%. Campylobacter at 20-56%. Of course, the way the meat is processed guarantees that it will be contaminated much more than beef. Still the use of antibiotics is questionable especially since I need to prescribe them to people.

          Testing for superbugs found 38% of salmonella, 40% of e. coli, 26% of enterococcus, 13% of campylobacter, 8.5% of klebsiella and 3.6% of s. aureus.

          Still whether or not you run into a chicken with a superbug one can still get pretty sick from the non-superbugs. I enjoy chicken and so I am a fanatic when it comes to handling this meat correctly. It all goes back to my microbiology classes long ago and we would plate samples out from meat. It was enough to curdle your milk and then some.

          Comment


          • #6
            I agree the widespread use of antibiotics in industrialized meat production is a big problem. The bacteria doesn't care whether the resistance gene came from, it will still use it to make your body a nice home.

            Unfortunately I'm afraid the genie may already out of the bottle on this one. The genes are out there and it's just a matter of time now. Regulating the food industry might slow things down but it's not going to hold off the inevitable. We need new drugs and these drugs need to be developed and not made easily available, and they need to be administered in strictly controlled settings that ensure patient compliance with the regimen. Normally you just make a dose cost $50K and that solves the problem right there, but a lot of these cases are going to be occurring in developing nations where it seems they are seeing more of these cases in hospital settings. If you make the drug too expensive they are going to break the patents to make the drug available, then the cost plummets and you can't hold back the flood of people demanding to get these things first.

            Maybe what you need is an intergovernmental agreement to regulate availability but limit cost. But that means the payments have to be front loaded to make sure the drug maker can recoup the billion dollar development cost. This makes me think that a government funding model may be needed. Thus, the new classes of new antibiotics need to be developed and held under patent and under government control for human use as a third or fourth line drug. We'd need to negotiate with other governments to make sure they contribute what they can so we don't have to pay for everything.

            On the other hand, the shear horror of going back to 1920s hospital conditions, means to me at least, that we need to get this done even if the US has to go it alone and pay out an extra billion dollars per year. Yes tax me please. This is money I'm actually willing to spend.

            Comment


            • #7
              Speaking about the availability of drugs here is one for you. Did you know that you can walk into any pharmacy in the Philippines and ask for the antibiotic of your choice. From penicillin to azithromycin to cephalosporins all without a Rx. On the other hand walk into the Pharmacy and look for a nasal decongestant, like sudafed, you won't find it on the shelf. You need to ask the pharmacist for it and you are then informed you can only obtain it with a prescription. I'd say go figure but the "Philippines" makes it self explanatory.

              Comment


              • #8
                I saw this Frontline video and an idea came to my mind. Instead of creating permanent hospitals, why don't we create a honeycomb type of structure where after a patient finishes his/her stay in the patient room, that room gets disposed and a new room is brought in. All ventilation and water systems would be strictly controlled to prevent any airborne or waterborne bacteria or virus from spreading. And it would be easy to dispose the materials in the disposable room and replace it with a new room that has no bacteria and has been sterilized under conditions that would kill any bacteria no matter what their resistance may be.

                Would that be feasible under an economy that can mass produce units efficiently?

                Comment


                • #9
                  Originally posted by tbm3fan View Post
                  Speaking about the availability of drugs here is one for you. Did you know that you can walk into any pharmacy in the Philippines and ask for the antibiotic of your choice. From penicillin to azithromycin to cephalosporins all without a Rx. On the other hand walk into the Pharmacy and look for a nasal decongestant, like sudafed, you won't find it on the shelf. You need to ask the pharmacist for it and you are then informed you can only obtain it with a prescription. I'd say go figure but the "Philippines" makes it self explanatory.
                  Yes I'm more than aware. My grandfather used to run a large hospital in Shanghai. Our fridge at home was "well stocked" so to speak. We had more access stuff than the average family, but really if you ask and can afford the doc will give it to you. At one point, at my other grandparents' house we were giving the strong stuff to my gold fish when it was looking a little ill. :)
                  Last edited by citanon; 31 Dec 13,, 09:40.

                  Comment


                  • #10
                    Originally posted by citanon View Post
                    Yes I'm more than aware. My grandfather used to run a large hospital in Shanghai. Our fridge at home was "well stocked" so to speak. We had more access stuff than the average family, but really if you ask and can afford the doc will give it to you. At one point, at my other grandparents' house we were giving the strong stuff to my gold fish when it was looking a little ill. :)
                    Ugh! You see patients can't be trusted to use antibiotics correctly. One has to ride herd on them to make sure the correct dosage and duration are adhered to. Have been even known to show patients ugly photos of what can happen if they don't. That usually does the trick. In the meantime I'm very judicious about who gets an antibiotic to start with and the lecture they get.

                    I remember once having an elderly man in my chair in his late 70's. While sitting there he pulls out a bottle and puts a drop in each eye. I ask if I can see the bottle and turns out it is Pred Forte a strong steroid eye drop. He uses it like others used Visine. My problem now was 1) he is strong headed, 2) a multi-millionaire, 3) he made his fortune starting one of the oldest West Coast drug stores with his brother long ago - Long's Drugs, so 4) he can get whatever he wants whenever he wants.

                    Comment


                    • #11
                      You can't protect everyone from themselves. Ask politely what he was proscribed that for and if he seems receptive to advice, advise. If not, document and help those you can.
                      I'm just an EMT, so I don't diagnose or prescribe but I'll tell you, I see so many elderly people that have more drugs than they can possibly track or be taking properly. I write them all down, ask a few questions about where they get them, what they take, what they've stopped or just started and pass it along at the ER. If there is time during transport, I look up interactions and ask about it at the ER. It's frightening how easily some things are prescribed.

                      Comment


                      • #12
                        Originally posted by Bigfella View Post
                        The moment I saw that you had posted on this thread I knew you were going to say something like that. An issue, but only one & not the most pressing.
                        Disagree, in the US we massively over medicate animals and this provides a lot of opportunity for zoonotic bacteria to develop counters.

                        Comment


                        • #13
                          A few things here. This is a global problem so it has to be treated globally. Secondly it does not cost a billion to find a new antibiotic. The research isn't even close to that. The biggest fees are administration, advertising, and regulations and those can be lowered. There are natural things that work well but the pharmaceutical companies can't make money so people are kept in the dark.That is costing lives and that needs to stop. Third, We also need to expand our research on compounds and other methods to combat bacterial infections. Fourth we need to be smarter with the use of future antibiotics and improve our own immune systems. Immunizations for specific strains of bacteria should be looked at in more detail. Remember, generally speaking, what doesn't kill you makes you stronger. Fifth, When bacteria get resistance to something new they have to give up something in return. With advances in DNA research we will soon be able to more quickly find holes in the offending bacterias defenses so there is hope. Lastly, hospitals are going to have to make some wholesale changes as far as cleanliness and general routines. Hospitals are filthy and filled with people with compromised immune systems and thus are perfect breading grounds.
                          Removing a single turd from the cesspool doesn't make any difference.

                          Comment


                          • #14
                            Originally posted by zraver View Post
                            Disagree, in the US we massively over medicate animals and this provides a lot of opportunity for zoonotic bacteria to develop counters.
                            Didn't say it wasn't an issue, just not the only one or most pressing. As has already been discussed, the biggest issues in the creation of resistant bacteria are the over-prescription/over-use of antibiotics and hospitals themselves. There was also an issue with drug companies not putting research into new antibiotics because they weren't profitable, though I'm not sure if they have done something about that more recently. In terms of importance these currently rank higher, though all the issues - dosing of food animals included - need to be seriously addressed.

                            My point was about the way people tend to ride their hobby horses.
                            sigpic

                            Win nervously lose tragically - Reds C C

                            Comment


                            • #15
                              Originally posted by bonehead View Post
                              A few things here. This is a global problem so it has to be treated globally. Secondly it does not cost a billion to find a new antibiotic. The research isn't even close to that. The biggest fees are administration, advertising, and regulations and those can be lowered.
                              Bonehead,

                              It literally costs about a billion dollars and ten years in research today to take the drug from the lab to the clinic here in the US. You have to go through three stages of clinical trials. The costs at each stage go up exponentially. You also have a very high rate of failures considering the amount of investments you have to make. Many drugs fail at stage 3. It's an incredibly expensive business to be in. The major pharmas are trying to move research out of house by buying or teaming with smaller companies, but for antibiotics, they probably still have the best efforts around. They might be able to spin off those units with enough support or veterans of that area might start a new company, but it's going to literally take billions.

                              Comment

                              Working...
                              X