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Science

Strep Bacteria Resistant to New Antibiotic 58

Posted by michael from the living-in-a-bubble dept.
Aaron Rowe writes "MSNBC and The Lancet medical journal have reported that the new oxazolidinone antibiotic Zyvox is ineffective against some forms of Staphylococcus aureus."
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Strep Bacteria Resistant to New Antibiotic More

Strep Bacteria Resistant to New Antibiotic

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  • Strep != Staph (Score:2, Informative)

    by ntr0py ( 205472 )
    Much like Streptococcus != Staphylococcus.

    • strep & staph (Score:4, Informative)

      by tid242 ( 540756 ) on Tuesday July 02, 2002 @06:13PM (#3810923) Homepage
      morphologically staph & strep are virtually indistinguishable, they are both gram positive cocci (circular) and are generally differentiated only by their colony morphology (they can also be differentiated by their lysing ability of RBC's, salt tolerability, celluar metabolism etc): strep grows in strings, staph in clusters (as their latin names would imply). but clinically they cause very different infections.

      staph is mostly known for surgical infections, staph is the major cause of post-surgical infections and deaths in the US, particularly Staph. areus. oft you may hear of Methicillin-Resistant Staph. Areus (MRSA) in which vanco/zyvox are considered the only therapeutic alternatives (to nafcillin & broad-spectrum B-lactams), although there are always exceptions to the rule Staph is known primarily for wound-infections...

      Strep. Streptococcus is the cause of some wound infections such as the infamous necrotizing fascitis ('flesh-eating bacteria'), but it is mostly known for pneumonia (henceforth the name 'strep pneumo'), and 'strep throat' (group B beta-hemolytic strep (if memory serves me correctly)).

      there are generally more alternatives for treating strep than there are for staph, clinically. strep is more sensitive to almost all cephalosporins (or at least used to be), macrolides, and a plethora of other abx that staph is not.

      (since i saw this on another post, but am too lazy to make another reply, i'll just add) contrary to some peoples' beliefs most of these infections do not resolve very well on their own, which is much the reason infectious disease was the #1 killer 100 years ago, but is near the bottom of the list today. sure strep throat might eventually be 'fought off' but your chances of phyelonephritis or glomereulonephritis (renal infection) are high enough that you'd probably opt for the abx instead of risking it. if you have a Staph. A infection chances are it's from getting knifed, operated on, or otherwise had your skin broken and your tissue innoculated with its resident bacteria. if this is the case you will _not_ get better by yourself, nor are your chances of 'fighting it off' good enough for anyone to expect you to survive. while it is shown that your body requires immune challenge to maintain its ability to ward off disease, you don't seem me opting for an Ebola innoculation to keep my immunity robust.

      -tid242

      • It's great to see a post by someone who knows what they're talking about, but a few minor comments: clinically, I think staph and strep are usually differentiated by enzymatic assays, not by how they cluster (though you can do that too). As far as strep pyogenes, which causes strep throat, that does not cause pyelonephritis, which is infection of the kidney. Glomerulonephritis, an inflammatory kidney disease which is not due to infection, arises from an incompletely understood mechanism believed to involve antigenic mimicry. Antigens are things that your immune system reacts against--the "M antigen," IIRC, of strep pyogenes mimics, or "looks like," components of your kidneys and heart on a molecular level, so untreated strep throat can actually cause you to mount an autoimmune response against your heart (rheumatic fever) and kidneys (glomerulonephritis). That is the reason that doctors are so aggressive in terms of treating strep throat with antibiotics, not because strep throat itself is a dangerous condition.
  • The subject says Strep, but the summary mentions Staph.
  • When the first antibiotics (penicillin) were made, it took a lot of time for bacteria to evolve and become imune. If they now have suceeded in becoming imune soon after its discovery, normal antibiotics (chemicals) are likely not to be effective much longer. The whole way of thinking antibiotics... bacterias always adapt after some time.

    We need to think of a new way to fight bacterias or we're all going to die!! cool...

    And I don't feel a little sorry for the great farmaceutical industries
    • We need to think of a new way to fight bacterias or we're all going to die!!

      1. Nanotechnology
      2. Genetic Engineering
      • I wouldn't think of genetic engineering. Bacterias evolve faster than we can make experiments... they're millions and billions in a small place. They're a mutation factory, that's why they evolve. Short life-time, huge population, natural selection for adaptation to some enviroment.

        Now nanotech would be something. We could make some nano-probes which would identify bacterias (in some biochemical way, membrane receptors, for example) and destroy them somehow (a violent method, nano-laser or some other cool killing machine). That would rock!!!
        • Now nanotech would be something. We could make some nano-probes which would identify bacterias (in some biochemical way, membrane receptors, for example) and destroy them somehow

          I'm way ahead of you. I have, in my possession, a two part nanotechnological design for exactly this. The first nanite is relatively simple, it's a "Y"-shaped machine with "grabbers" tuned to match parts of bacteria and viruses, and one end that's recognized by a larger, more complex nanite that spots the first nanite, and is triggered to destroy the invader by surrounding it and attacking it with a burst of oxidizing chemicals.

          I'm not kidding - I've been testing this system for years, and I can report that it works very well...

          (see any "Immunology" textbook for further details)...

      • 3. Teenage mutant ninja microbes.
    • Whatever happened to Bacteriophage research?

      Some Russian prof was growing them from sewage, and claimed that there was a phage for every nasty bug, they eat them all, then die off. A US company started to work with him to develop them, but the MoneyFuckers withdrew funding because (they they were too thick to see where they could line their own pockets I suppose, and) there was/is more profit in treatments than cures.

      May they all catch flesh eating bugs on their nads. And then die.

      (the scroogeoids, not the scientists...)

  • This is their more optimistic response: (and actually, their site is currently down... http://pharmacia.com/News/PressReleases.asp)

    Pharmacia Comments on Lancet Research Letter

    PEAPACK, NJ (July 19, 2001) Pharmacia Corporation (NYSE: PHA) commented today on a letter* being published in the July 21 issue of The Lancet that reports the development of linezolid-resistant Staphylococcus aureus bacteria in one patient.

    Pharmacia in vitro studies and laboratory studies conducted by other researchers have shown that linezolid-resistant S. aureus would develop infrequently. As a result of this research, it is presumed that resistance would likely only occur in the most extreme clinical conditions. These data have already been reported to the global medical community. No other cases of linezolid-resistant S. aureus have been reported, despite the fact that more than 80,000 patients have been treated worldwide with linezolid, marketed by Pharmacia as ZYVOX(tm) (linezolid injection, tablets and for oral suspension) in the US and 15 other countries.

    One of the authors of the research letter, Robert Moellering, M.D., Chairman of the Department of Medicine, Beth Israel Deaconess Medical Center, and Professor of Medicine, Harvard Medical School, provided additional perspective to the case reported in the research letter. "Despite the discovery of this single report of resistant S. aureus, linezolid remains an important part of the physician's armamentarium for the treatment of infections, including those due to resistant bacteria and one that may allow patients to leave the hospital earlier."

    "At each stage of the development and market introduction of ZYVOX, we have proactively shared our research and knowledge with physicians and regulatory officials around the globe," said Cameron Durrant, M.D., Vice President, Infectious Diseases, Global Prescription Business, Pharmacia Corporation. "We are interested in the experience of all patients treated with ZYVOX, including this specific patient, and are confident that the unmatched efficacy and convenient formulations of ZYVOX will continue to provide great potential benefit to patients."

    Pharmacia's preclinical and clinical experience to date has defined the risk factors for development of resistance. These are:

    • Indwelling prosthetic device
    • Long-term therapy
    • Inadequate dose
    • Undrained abscess
    The patient history described in the letter to The Lancet is generally consistent with these findings. Pharmacia continues to actively monitor for potential emerging resistance.

    ZYVOX comes from the first completely new class of antibiotics to reach hospitals in 35 years. ZYVOX attacks bacteria in a way unlike any existing therapies. ZYVOX attacks bacteria by stopping protein production at a very early point in the process that is different from any other antibiotic. Studies have shown that ZYVOX is effective against a broad range of Gram-positive bacteria including those that are resistant to other antibiotics.

    ZYVOX is approved for adults in the treatment of nosocomial (i.e. hospital-acquired) pneumonia, community-acquired pneumonia, complicated and uncomplicated skin and skin structure infections caused by susceptible strains of designated organisms. ZYVOX is also approved for use in complicated skin infections and nosocomial pneumonia caused by certain sensitive and resistant pathogens, including methicillin-resistant Staphylococcus aureus (MRSA).

    ZYVOX is generally well tolerated. The adverse events reported for patients receiving ZYVOX and comparators in clinical trials were similar. The most common adverse events for patients treated with ZYVOX were diarrhea, nausea, headache and vomiting. Myelosuppression has been reported in patients receiving ZYVOX. Therefore, complete blood counts should be monitored weekly. Discontinuation of ZYVOX should be considered in patients who develop or have worsening myelosuppression.

    Pharmacia (NYSE: PHA) is a top-tier global pharmaceutical company with a leading agricultural subsidiary. Pharmacia's innovative medicines and other products save lives and enhance health and wellness. Pharmacia's 59,000 people work together with many diverse stakeholders to bring these benefits to people around the world, and to create new health solutions for the future.

    *Tsiodras S, Gold H, Sakoulas G, et al. Linezolid resistance in a clinical isolate of Staphylococcus aureus. The Lancet 358 (July 21, 2001):207-208. Certain statements contained in these comments are "forward-looking statements" provided under the "safe harbor" protection of the Private Securities Litigation Reform Act of 1995. Examples of forward-looking statements are anticipated financial results, financial projections, business prospects, future product performance, future research and development results, Expected regulatory actions and other matters that are not historical facts. These forward-looking statements are based on the information available, and the expectations and assumptions deemed reasonable by the Company, at the time when the statements are made. However, because these forward-looking statements are subject to many risks, uncertainties and changes over time, actual results may differ materially from those expressed or implied by such forward-looking statements. Among the many factors that may cause or contribute to actual results being materially different from those expressed or implied by such forward-looking statements are acquisitions, divestitures, mergers, licenses or strategic initiatives that change the Company' structure or business; competitive effects from current and new products, including generic products, sold by other companies; price constraints imposed by managed care groups, institutions and government agencies; governmental actions to provide lower cost pharmaceutical products; the Company' ability to continue to discover and license new compounds, develop product candidates, obtain regulatory approvals and market new products; the Company' ability to secure and defend its intellectual property rights; the Company' ability to attract and retain management and other key employees; product developments, including adverse reactions or regulatory actions; social, legal and political developments, especially those relating to health care reform, pharmaceutical pricing and governmental and public acceptance of biotechnology; unusual seasonal conditions in agricultural markets; new product, antitrust, intellectual property or environmental liabilities; changes in foreign currency exchange rates or general economic or business conditions; changes in applicable laws and regulations; changes in accounting standards or practices; and such other factors that may be described in Companies' filings with the U.S. Securities and Exchange Commission.

    • So what they are saying is "Well, we've only seen one case, so we won't worry about it." Is no-one worried by the fact that after only one year and fewer than 100,000 patients treated, the first case of resistance has already been found? This worries me, and leads me to believe that within a few more years, Zyvox will have followed in the path of many other antibiotics and be almost completely ineffective. And by the way, what the heck is an "armamentarium"?! Wasn't the word armament good enough?
      • Believe me, even after one treated patient, there are already resistent bacteria to be found. It's only because of the small numbers those bacteria will not survive.. The immunodeficiency system will take care of them. Prokaryotic drug resistancy is inevitable in the end: the only way to avoid resistance is not by attacking vulnerable molecules or metabolic pathways the microbes use, but by enhancing the human immunodeficiency system in a certain way. Using cocktails of antibiotics can help as well, but you'll have a more dangerous strain in the end if it goes wrong.. Armamentarium: the collection of treatments available for a particular condition. An armament would be one of these treatments.

  • Evolving Patterns (Score:3, Insightful)

    by captainktainer ( 588167 ) <captainktainerNO@SPAMyahoo.com> on Tuesday July 02, 2002 @01:51PM (#3808711)

    One should not take this development as a sign that bacteria are doing things they shouldn't be doing. It's a matter of natural selection- antibiotic applied to colony, most members die, some with resistance to the drug survive. It's the same process, simplified, that most likely gave rise to multicellular organisms, worms, fish, amphibians, corals, mammals, and ultimately humans. While it's certainly worth noting, it's not like it isn't expected. Life changes. Life evolves. Life moves on to new forms.

    That said, it does disturb me. One would think that with multibillion dollar budgets pharmaceutical company researchers could have found a drug effective enough to delay this sort of resistance. It is essential that we find a way to control staphylococcus infections. This disease and others cause many deaths, and can make entering a hospital hazardous. I myself lost a good family friend when staph germs entered her body during heart surgery and simply overwhelmed her body. One of my friends has lost a good deal of his kidney function due to extensive scarring of his kidneys from a staph infection. (It would be wise to point out that recent examinations have revealed the presence of a new growing kidney, complete with ureter, that is forming from the cortex of one of his kidneys- possibly due to healing processes gone amuck).

    Staph is a scourge of humanity, and it must be fought. Otherwise, what other suffering will take place?


    • One should not take this development as a sign that bacteria are doing things they shouldn't be doing. It's a matter of natural selection- antibiotic applied to colony, most members die, some with resistance to the drug survive. It's the same process, simplified, that most likely gave rise to multicellular organisms, worms, fish, amphibians, corals, mammals, and ultimately humans. While it's certainly worth noting, it's not like it isn't expected. Life changes. Life evolves. Life moves on to new forms.

      And we're now here because the dinosaurs used antibacterial soaps. Then an early pre-mammal sneezed..

    • I find the regenerating kidney far more interesting than the anti-biotic resistant bacteria. The implications of being able to duplicate the cause of the regeneration would be staggering.

  • Clean envorinment? (Score:4, Insightful)

    by zulux ( 112259 ) on Tuesday July 02, 2002 @01:55PM (#3808749) Homepage Journal
    There was a study of rats that were raised in anaseptically clean environments, and lo and behold, their immune systems bairly developed. Perhaps it would be wise to let your children overcome an infection or two on their own, rather than attempt to fix it via antibiotics every time.

    here [sciencenews.org] for more info

    • Re:Clean envorinment? (Score:1)

      by Anonymous Coward
      Except that untreated strep can kill you. Who modded this jackass up?

  • Not a surprise (Score:2, Insightful)

    by RevAaron ( 125240 )
    How many of you use anti-bacterial products? Until we start using anti-bacterial agents judiciously, bacteria will continue evolving to this new environment.

    I choose to know use any anti-bacterial agents, with the exception of bleach, which kills by a different type of pathway than anti-biotics.

    Unforunately, this isn't a case of something where one person can make a difference. As long a huge percentage of the people in this world (mostly Americans and Canadians, I imagine) continue overusing and over perscribing anti-biotics, we will just be making the bacteria populations stronger and better adapted to whatever drugs we throw at them.

    For starters, try to get everyone in your household to stop using anti-bacterial products unless they need them. The people with whom you interact the most are the ones you live with, and swap the most bacteria.

    No, this isn't just one of those things that "environmentalists" talk about. The possible danger is very real. That's evolution for you.

    Looking through my roomate's things, I find:

    * Anti-bacterial deoderant
    * Anti-bacterial shower soap bar
    * Anti-bacterial toothpaste
    * Anti-bacterial mouthwash
    * Anti-bacterial liquid hand soap
    * Anti-bacterial hand lotion (why?!)

    There are probably more around here, stashed somewhere.

    Yes, it'll even happen if you're a x-ian who "doesn't believe" in evolution. Unless you know something we don't- perhaps god is the anti-bacterial agent to which bacterial population cannot adapt! :P

    • Re:Not a surprise (Score:3, Interesting)

      by dschuetz ( 10924 )
      Looking through my roomate's things, I find:

      * Anti-bacterial deoderant
      * Anti-bacterial shower soap bar
      * Anti-bacterial toothpaste
      * Anti-bacterial mouthwash
      * Anti-bacterial liquid hand soap
      * Anti-bacterial hand lotion (why?!)

      Of course, what exactly is the anti-bacterial agent in these products? Is it a true antibiotic, or simply some kind of cell-killing agent like bleach?

      I doubt that the super-expensive "magic bullet" antibiotics that we're afraid of germs getting immune to aren't in these products, so they're really contributing to adapted bacteria. Or so I'd guess.

      • Re:Not a surprise (Score:3, Informative)

        by AnalogBoy ( 51094 )
        Usually, it is triclosan.

      • Is it a true antibiotic, or simply some kind of cell-killing agent like bleach?

        You know, I'd always thought it was similar to phenols (Remember Dr. Lister's "carbolic acid" [Phenol] antiseptic?), but it appears that triclosan interferes with an enzyme that bacteria use to form their cell walls. I don't know if it's the same thing that Penicillin-related compounds interfere with for the same purpose, though it does imply that bacteria may become resistant to it. It appears that triclosan, like a lot of antibiotics, can activate a "pump" that expels antibiotics from bacteria before they can do damage.

        Poking around on Google also brought up an interesting article [nature.com] however, which pointed out that the "resistance" that triclosan induces is ALSO triggered by an awful lot of off the shelf foods from grocery stores...though on the other hand, I don't recall rubbing cinnamon or mustard on my hands like antibacterial soap, either...

      • what exactly is the anti-bacterial agent in these products? [...] bleach?

        Is it possible that some bacteria gets resistant even to bleach and similar? I suppose they're harder to resist than antibiotic, as the latter should be safe enough to be used inside a living being without much damage, but I seem to remember that there are some bacteria able to resist unfriendly environments like boiling water for a while.

        If this is the case, even anti-bacterial stuff may become "dangerous", given enough time.

        • I imagine that an organism could become resistant to something like bleach or alcohol. I imagine it would take a long time for such a trait (or a series of traits compounding to end up with that phenotype) to evolve.

          Yes, some bacteria thrive in boiling water, super-high levels of sulfer, and extremely high saline levels.
      • As Analog Boy said, I think most the ones I listed are triclosan. I'm at work now though. I didn't list the non-drug-anti-bacterial agents. My roomate also has an alcohol-based no-water hand cleaner, but since it it has alcohol, I didn't think it really counted.
    • I do use antibacterial soap in events where im touching or may have touched something EXTREMELY contaminated - such as the cat box. However, usually, just soap & water..

      But i've traveled on two assumptions here, that most AB external use products are pretty much absolutely bacteriocidal:

      1: Anti-bacterial soap is more or less un-neccesary, as, supposively, soap washes away may contaminants, AND, the drastic change in ph should kill much of whats left?

      2: Some antibacterial products simply kill through simple chemical properties. Drop alcohol on something and dehydrate it... i think it would die.

      [Warning: The above are assumptions based on observations. I haven't the time nor the will to look it up right now. I don't know much about triclosan, except that it may contain dioxin, and that it can take up to two minutes to do its job]

      I'd say the greater danger is the use of antibacterial drugs.
    • Looking through my roomate's things, I find:

      * Anti-bacterial deoderant
      * Anti-bacterial shower soap bar
      * Anti-bacterial toothpaste
      * Anti-bacterial mouthwash
      * Anti-bacterial liquid hand soap
      * Anti-bacterial hand lotion (why?!)

      I agree to some extent with your point but it has to be said that otc anti-bacterial products such as these are unlikely to confer resistance to to different classes of antibiotics such as this one. All antibiotics are not the same.

      The possible danger is very real. That's evolution for you.

      The real danger is over prescribing of effective antibiotics in unnecessary cases. How many times have you taken antibiotics for a cold? for the flu? Doctors even think it may be unnecessary for bronchitis. [philly.com]

      That said the original poster is correct, use of those products is really unnecessary.

      -Sean

      • Re:Not a surprise (Score:3, Interesting)

        by RevAaron ( 125240 )
        No, not all antibiotics are the same, and I hope I didn't sound like I was saying that resistence to one particular drug or class of drugs meant resistance to all of them. However, as the effectiveness of the drug used in these products declines, it will be replaced by one that still works.

        Yes, over-prescribing is a huge deal. I realize I made it sound like it's largely antibiotic deoderant, my bad. I was just trying to get across that it's up to *us* to turn down antibiotics unless neccesary.

        The real danger is over prescribing of effective antibiotics in unnecessary cases. How many times have you taken antibiotics for a cold? for the flu? ...bronchitis.

        My mom is one of those people are generally try to avoid prescriptions, antibiotics and generally any drug unless the doc says that it's quite needed. It's a somewhat irrational fear, but grounded in fact. I've personally never taken antibiotics for a cold, flu, or brochitis (only had it once).

    • Re:Not a surprise (Score:5, Informative)

      by !splut ( 512711 ) <sputNO@SPAMalum.rpi.edu> on Tuesday July 02, 2002 @03:04PM (#3809405) Journal
      I'm afraid you are confusing the terms "anti-bacterial" and "antibiotic." Anti-bacterial is a very broad, vague term that can be applied to any substance or product that exhibits the ability to kill bacteria. It is a marketing buzzword, used to play on the consumer's fear of microbes and misunderstanding of microbiology. Rubbing alcohol, vinegar, and boiling water would all easily fit under the anti-bacterial label.

      The products that you list - anti-bacterial cosmetics and soaps - kill microbes due to very high or low pH, alcohol content, the presence of detergents that lyse cell walls/membranes, and the presence of other toxic chemicals that kill a broad spectrum of organisms in a very general way - the same way bleach kills just about anything you dump it on.

      But bleach, alcohol, detergents, etc, are NOT antibiotics. Antibiotics are drug-like compounds that kill bacteria in a targeted fashion, by interfering with growth, cell wall development, and/or metabolic pathways. Antibiotics bind to specific enzymes, proteins, or other structural molecules. Bacteria are able to gain resistance to antibiotics by accumulating changes in the structure of these molecules (via mutations).

      So, nonspecific general anti-bacterial compounds, and NOT antibiotics, are present in these cosmetics and soaps. Microbes CANNOT easily develop resistance to nonspecific anti-bacterials. Thus, use of these anti-bacterial products has no effect on the evolution of antibiotic resistant strains of pathogens.

      Interestingly, it should be noted that the formulation of many of these household anti-bacterial products is essentially identical to the forerunning "non-anti-bacterial" versions. All liquid hand soaps, for instance, are anti-bacterial to begin with. So the addition of the "anti-bacterial" buzzword on the bottle is just a marketing ploy.
      • Of the ones I listed, triclosan or another drug-sounding active ingredient was listed. While pH may play a role in these products, there is no doubt that triclosan's presence must have a purpose. I tried to avoid listing the products that seemed to rely on alcohol as the bacteria terminating agent.

        He also has an erythromycin-based acne medication which was prescribed to him. He has close to no acne (one zit every couple months), and has been like that for a long time. Doctor keeps giving him scripts for it, just in case.

        Thanks for pointing out the ambiguity in my use of the terms, though. :)

        • Re:Not a surprise (Score:1)

          by Anonymous Coward
          Last time I went to buy liquid hand-soap I literally could not find a bottle that was not "anti-bacterial." I was not looking specifically for triclosan, I just assumed that the buzzword meant they were using that agent. I was disappointed as I really wanted to avoid contributing to the problem, but given the choice between anti-bacterial soap or no soap at all, I had to go with anti-bacterial soap.

          BTW, this was at a k-mart with about 10 different varietys of liquid hand-soap.
          • Yeah, I've noticed a similar thing. Not neccesarily because of this, I do most of my pertinent shopping at a locally owned organic co-op a block away. If it's really important to you, stop by if you have one in the area, they have plenty of "clean" soap. :)

            I've also not had problems finding non-anti-bacterial SoftSoap, which is a brand of liquid soap, in grocery or Target stores. :)
    • Actually, I suspect Americans and Canadians may well be #2 and #2, after the Japanese. I've heard news items before about how the Japanese are more culturally clean than we are, and may well be using technology to take it too far. Whereas Americans and Canadians are merely victims of Katzian corporatism because we have so blasted many antibiotic products thrown at us.

      As for routine use of antibiotics, there appears to be another downside... The immune system appears to require some level of regular/constant challenge for proper development and maintenance. The news article I heard/saw this one in specifically mentioned the Japanese, and that they were having bad immunological side-effects as a result of being too clean.

      As my mother-in-law used to day (in reference to my kids) and appears to be more sensible than might otherwise have been credited, "You'll eat dirt before you die." My wife looks hard to avoid antibiotic handsoaps and other households.
      • Yeah, I've heard similar things about Japanese culture, but I don't feel well versed enough to make any statements.

        Indeed, the immune system needs to work up immunity. We have evolved to be the species we are over millions upon millions of years to live with bacteria.

        Similarily, kids need to get sick when they're young, to be exposed to a community of people and thus a community for microbes for which they built resistance. Without that exposure, the immune system is an atrophied muscle with very few immunities.

        Kudos to you and your wife.


    • Let's not overlook the most common use of anitbiotics in the US: Feed supplements for live stock. To get an idea of exactly why, look into the system of feedlots as described in _Fast_Food_Nation_. There's some other recent works in the NY Times critical of the beef industry worth reading. The short of it is that because we're raising cattle so contrary to how they evolved, the majority of cattle are susecptible to infections that they never used to get. To control this feedlot operators mix fairly alarming amounts of antibiotics into the feed they give the animals. Although no one's proven a conclusive link to livestock being fed antibiotics and the emergence of resistant bacteria, outfits like the CDC are very worried about the situation. Now I'm not a PETA type, but this alone makes me revaluate my eating habits in terms their long range affects. BTW, I picked up some free range beef recently, and man was that some good stuff. Alternatives exist even if they are more expensive.
    • As long a huge percentage of the people in this world (mostly Americans and Canadians, I imagine)

      since when does less than 5% of earth's population constitute a "huge percentage?" but all joking aside: 3rd world countries use a HUGE amount of antibiotics inappropriately, most major metropolitan arenas feature a plethora of street vendors selling antibiotics by the tablet, can we say 'inappropriate and subtherapeutic abx administration?' developing countries do not have the necessary barriers to entry for there to exist a system to properly & systematically screen for appropriate usage. not to mention the infeasibility of someone who pays 2-weeks worth of pay for 1 day's worth of treatment self-treating for the normal 7-14 days of standard therapy...

      hell, look at the united states; over a billion abx 'scripts were written in the latter half of the 90's for the common cold, uh... does Amoxil kill rhinoviruses? - just think this, but on a magnitude 20+ times greater...

      abx usage in agriculture is another story entirely, but of greater weight, especially considering its worldwide breadth.

      point being that abx mis-use (or antibacterial misuse) is NOT an american/canadian problem, it is a global problem with the biggest contributors beyond the borders of biosphere I's first world countrys' borders...

      it's amazing that this Zyvox/linezolid story made it to /. what about the vanco resistance cropping up for the past few years? if you think linezolid resistance is a bad bad thing, think about vancomycin, its usage, its mainstay, then imagine it wasn't there. i shudder to think about it...

      granted, the linezolid-resistance is somewhat amazing, tho not unexpected, given the fact that it was supposed to be used only within the strictest of circumstances, but it's not as if institutions usually follow these sorts of guidelines, unless it costs$10,000+ like Xigris (drogecogen alpha (sp?))

      -tid242

  • Brute Force... (Score:2, Interesting)

    by Steve Mitchell ( 3457 )
    According to my Russian wife, she claims most hospitals in Russia control Staph and other nasties using UV lamps placed in hallways and rooms. If the room or hallway is vacated and the doors are shut, the lamps automatically go on killing most of the bacteria without the risk of developing resistance. Other than potential risk of exposure which probably could be kept under control, I think it's a great idea and I'm wondering why aren't US hospitals using it.

    -Steve
    • I don't know the technical aspects of this unfortunately, but before I went out the country last year I went to get tuberculosis and some other shots at a local public clinic--they had special lights there in the waiting room (up on the ceiling and always on) that were designed to get rid of bacteria like you say.
    • UV light, in the grand scheme of things, does have properties that allow it to kill bacteria, but it is largely ineffective except in strongly controlled situations. First off, it only kills bacteria that are exposed to the light. Bacteria "hiding out" underneath, inside, or between things won't be affected. Second, not all species or strains of bacteria are susceptible (esp. those that produce spores, as someone previously mentioned). Third, in general UV light is fairly weak when it comes to killing microbes. It works by causing mutations (pyrimidine dimers) in bacterial cells that essentially cause the cell to shut down (same reason we get sunburned from too much UV exposure). However, a large number of these dimers have to form and pile up in the cell's DNA before it will die, because cells have their own DNA repair systems working overtime to make sure such a thing doesn't happen. Therefore, while some bacteria will die, some will survive. That being said, I also must add that I think the UV lamp idea is great. Again, it won't exactly sterilize a room like pressurizing it with hot, steamy air would (a'la an autoclave), but it would still decrease the number of buggers floating around in hallways and such, which is definitely not a bad thing.
  • The discussion came up around the office that if the antibiotics are working against the bacteria, how do they survive to mutate? The answer that we came up with, not being biologists, is that the ones that are mutants and therefore different from the norm, are not affected by the antibiotics. Since they stay around, they propogate their mutation and soon the mutants outnumber the "normal" bacteria. Is that pretty much how it works?

    • Re:How do they mutate? (Score:4, Informative)

      by Valdrax ( 32670 ) on Tuesday July 02, 2002 @06:50PM (#3811123)

      That's pretty much how it works. However, many species of bacteria can exchange DNA with other species of bacteria. This means that many strains of bacteria get their first resistant variant without having to go through all the trouble of random mutation by swapping with other kinds of bacteria and then surviving while their peers die.

      Both are slightly technical, but can be skimmed over without missing too much detail.

  • Another problem for standard antibiotics (and antibacterials) is biofilms. These are formed by bacteria as a protective film, that antibiotics and other compounds, such as bleach, cannot easily penetrate. Here's two articles:

    http://instruct1.cit.cornell.edu/Courses/biomi29 0/ Horror/Biof.tutorial.HTML

    http://www.edstrom.com/Lab/WaterQualityBulletins /b iofilm/biofilm01.htm

    What's even worse is that separate colonies of bacteria, each in their own biofilms, appear to be able to communicate to each other regarding threats. Across small distances of course, I'm not saying they've got mobile phones or anything...

    • What's even worse is that separate colonies of bacteria, each in their own biofilms, appear to be able to communicate to each other regarding threats. Across small distances of course, I'm not saying they've got mobile phones or anything...

      Well, in a few years they probably _will_ have mobile phones considering the pace of bacterial evolution (induced by our overuse of antibiotics) and the evolution of mobile phones...

      ;-)

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