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Biotech Medicine Bug Science

New Wave of Antibiotic-Resistant Bacteria 404

Posted by kdawson
from the gram-of-prevention dept.
reporter writes "New strains of 'Gram-negative' bacteria have become resistant to all safe antibiotics. Though methicillin-resistant Staphylococcus aureus (MRSA) is the best-known antibiotic-resistant germ, the new class of resistant bacteria could be more dangerous still. 'The bacteria, classified as Gram-negative because of their reaction to the so-called Gram stain test, can cause severe pneumonia and infections of the urinary tract, bloodstream, and other parts of the body. Their cell structure makes them more difficult to attack with antibiotics than Gram-positive organisms like MRSA.' The only antibiotics — colistin and polymyxin B — that still have efficacy against Gram-negative bacteria produce dangerous side effects: kidney damage and nerve damage. Patients who are infected with Gram-negative bacteria must make the unsavory choice between life with kidney damage or death with intact kidneys. Recently, some new strains of Gram-negative bacteria have shown resistance against even colistin and polymyxin B. Infection with these new strains typically means death for the patient."
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New Wave of Antibiotic-Resistant Bacteria

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  • Idea (Score:5, Insightful)

    by shentino (1139071) on Sunday February 28, 2010 @05:00PM (#31309200)

    Stop wasting all those antibiotics on beefing up our cattle and giving a bunch of supergerms a tolerance for the stuff?

    • Re:Idea (Score:5, Insightful)

      by ObsessiveMathsFreak (773371) <obsessivemathsfreak@ei r c o m .net> on Sunday February 28, 2010 @05:22PM (#31309378) Homepage Journal

      No, it's obvious that we need even less government regulation so that the free market can allow doctors and sick patients to reach stable equilibrium with the bacterial hordes! There's a basic game theory model that proves my position!!!

      • Re:Idea (Score:5, Insightful)

        by Anonymous Coward on Sunday February 28, 2010 @07:26PM (#31310424)

        I'm horrified that you achieved +4 insightful instead of the +5 funny that you were going for.

        • Re: (Score:3, Informative)

          by frieko (855745)
          Facetious and insightful aren't mutually exclusive. In fact, there's a word for it [wikipedia.org].
      • Re:Idea (Score:4, Interesting)

        by tmosley (996283) on Sunday February 28, 2010 @09:40PM (#31311344)
        If you dropped the regulations, the new class of designer antimicrobials that my company is developing would be on the market right now. They are designed such that immunity to them would make the resultant bug non-pathogenic.

        Sadly, government regulations and the money that it takes to over come them have forced us to shift our attention to other applications for our technology.
        • Re:Idea (Score:5, Interesting)

          by tuxgeek (872962) on Sunday February 28, 2010 @09:55PM (#31311422)
          Considering that the old new class of designer antimicrobials that your company developed for the handsoap market .. contributed to creation of this new designer bug strain ... your optimism isn't giving me a warm fuzzy feeling right now
          • Re: (Score:3, Insightful)

            by eskayp (597995)

            Business Plan:
            1: design new class of antimicrobials
            2: patent and market new antimicrobial for widespread use
            3: virulent microbes quickly evolve resistance to misapplied product at no cost to corporation
            4: repeat steps 1 thru 3 repeatedly to maximize profits at customers' expense
            ( Hey, it worked for Microsoft, why not biomeds? )

          • Re: (Score:3, Insightful)

            by tmosley (996283)
            This class is different, because it is designed to specifically attack those structures on the surface of the bacterium that make them pathogenic. Their evolution is guided toward one in which they do not harm people.

            We can also target basic proteins on the surface that can't be changed at all (motifs that are found in ALL strains of a given species). "immunity" in this case would force them to literally evolve into a new species.
        • Re:Idea (Score:5, Insightful)

          by mspohr (589790) on Monday March 01, 2010 @03:07AM (#31313036)
          I think you are missing the point. The problem is not a lack of new fancy antibiotics. The problem is the overuse and misuse of the antibiotics that we already have.

          Antibiotic resistance develops when you have widespread use of antibiotics. Currently antibiotics are used widely by corporate farms (chickens are commonly fed antibiotics, etc.). This creates resistant bacteria. Basic evolution. (You can also reverse this by stopping the use of antibiotics and the bacteria will usually lose their resistance.) Antibiotics are also overprescribed for viral respiratory infections where they have no effect.

          Fix these problems and we won't need your expensive designer antibiotics (which will become useless in a few years anyway).

    • Re:Idea (Score:5, Informative)

      by Xenkar (580240) on Sunday February 28, 2010 @05:27PM (#31309418)

      They wouldn't need to use antibiotics on our cattle if we just fed them grasses instead of corn feed.

      Unfortunately corn feed and antibiotics is cheaper than feeding them grasses.

      • Ever been on a farm? (Score:5, Informative)

        by rjh (40933) <rjh@sixdemonbag.org> on Sunday February 28, 2010 @07:34PM (#31310496)

        My family raises cattle on a farm in Iowa. Speaking from our experience, I'll tell you that putting a pound of meat on a steer takes in the neighborhood of ten pounds of feed -- and much more than that, if you're feeding them exclusively grasses (including hay).

        So. Take a hundred head of cattle and turn them loose on a hundred acres of land. These animals are still growing (since, when they're ready for the slaughterhouse, well... they get taken to the slaughterhouse). If we want to put a hundred pounds on each steer, then that means each steer needs half a ton of feed.

        Good luck getting 50 tons of grass from a hundred acres of land. It's not going to happen. The farmer has two choices at this point: raise fewer cattle (and thus raise meat prices for the consumer), or convert some of the cornfields into pasture (and thus raise grain prices for the consumer).

        Either way you're talking about raising the prices of basic foodstuffs. You won't inconvenience the rich: the rich will still be able to afford filet mignon and Kobe beef. After all, they're rich.

        But the elderly, who live on fixed incomes... poor families who depend on food stamps... or just a college student burdened with debt who wants to be able to take his girlfriend to a steakhouse for a special occasion... all of these people are seriously impacted.

        The name of the game in modern farming is efficiency. Reducing prices is the overall goal.

        • by pushf popf (741049) on Sunday February 28, 2010 @08:41PM (#31310914)
          But the elderly, who live on fixed incomes... poor families who depend on food stamps... or just a college student burdened with debt who wants to be able to take his girlfriend to a steakhouse for a special occasion... all of these people are seriously impacted.

          Americans who can't afford beef can do the same thing the rest of the world does (at least those parts of the world that aren't starving). Eat something else.

          Chicken is cheaper than beef, eggs are cheaper than chicken, and rice and beans is cheaper still. The cost of one dinner at a steakhouse for two will buy a huge sack of rice and huge sack of beans, including a bunch of stuff to make it taste good. This will easily last a month, even for a family.
        • by lawpoop (604919) on Sunday February 28, 2010 @08:50PM (#31310984) Homepage Journal

          If we want to put a hundred pounds on each steer, then that means each steer needs half a ton of feed.

          But the elderly, who live on fixed incomes... poor families who depend on food stamps... or just a college student burdened with debt who wants to be able to take his girlfriend to a steakhouse for a special occasion... all of these people are seriously impacted.

          This is why you just eat some vegetarian food. I love a good steak as much as the next guy, but at this point, it seems that the economic/ecological arguments win out. What a waste of societies' resources to turn 1.5 tons of food into 100 pounds of food.

        • by codegen (103601) on Sunday February 28, 2010 @09:29PM (#31311282) Journal
          I was raised in rural Saskatchewan and worked on a farm many times. While what you say about field yields is true, overuse of antibiotics in farming harms all of us. Those people you identify: elderly, poor families or college students now have to face even higher medical bills when they catch antibiotic resistant bacteria. There was a story a couple of years ago about the FDA clearing some of the last chance antibiotics for agricultural use. This story may or may not be related, but the quantities used when treating farm animals and the discharge of the antibiotics into the environment only put the rest of us at risk.
          • Re: (Score:3, Insightful)

            by rjh (40933)

            I am amazed at how many people are reading what I said as a defense of antibiotic-fed beef.

            I am not in favor of antibiotic-fed beef. I am opposed to it on humanitarian grounds. Generally, you only need massive amounts of antibiotics if you're raising cattle in such confined conditions that any infection will spread like wildfire. I don't endorse this style of agriculture. I think it's ethical to eat meat -- but I also think we have an obligation to our animals to make their lives at least somewhat comfo

        • by TubeSteak (669689) on Sunday February 28, 2010 @10:56PM (#31311762) Journal

          My family raises cattle on a farm in Iowa. Speaking from our experience, I'll tell you that putting a pound of meat on a steer takes in the neighborhood of ten pounds of feed -- and much more than that, if you're feeding them exclusively grasses (including hay). ...

          Either way you're talking about raising the prices of basic foodstuffs. You won't inconvenience the rich: the rich will still be able to afford filet mignon and Kobe beef. After all, they're rich.

          If your family raises cattle, then you should know that farmers have been culling cattle herds like crazy for the last ~5 years or so. Beef prices have gone through the floor because the recession seriously dampened demand and caused a glut in the market. At the same time, corn prices have been zooming up because of the ethanol push. This isn't just limited to cattle, as the pork and chicken industries have been cutting production too.

          Just so no one things I'm pulling this out of my ass, here's the first relevant google result for "culling cattle herds"
          http://www.businessweek.com/news/2010-01-27/u-s-cattle-herd-falls-to-1958-low-as-losses-climb-survey-says.html [businessweek.com]

          Here's another article, this time from April 2009, talking about 2008 herd numbers for the various industries:
          http://www.avma.org/onlnews/javma/apr09/090415a.asp [avma.org]

          Moving to grass fed beef would resolve the market price problem (grass fed commands a premium) and the cost problem (grass is free, more land is cheap, corn feed is not).

    • Re: (Score:3, Informative)

      by Baron_Yam (643147)

      The nice thing is, if we stopped RIGHT NOW, Darwin's invisible dead hand would be on our side... if there is no reason for the germs to have a resistance to antibiotics because they're everywhere, those germs lacking the resistance become more 'fit' since they use less energy supporting the requirements of that resistance. Instead they put their energy to reproduction or getting by on less sustenance, and will breed out the resistant bugs in fairly short order.

    • Re: (Score:3, Insightful)

      by jeff4747 (256583)

      The problem with your comment is it is highly relevant WHICH antibiotic is given to the cattle.

      Resistance to one antibiotic does not confer resistance to other antibiotics, since each antibiotic works in a slightly different way.

      The original variant of Penicillin is useless today medically. You might get a newer variant (Penicillin G, for example) but you'll never be prescribed the original because it just doesn't work that well any more for treating disease because too many bugs are resistant to it.

      So fee

  • Thanks (Score:5, Insightful)

    by complacence (214847) on Sunday February 28, 2010 @05:01PM (#31309208)
    Great. A big thank-you to all the knee-jerk antibiotics prescribers and disinfectant abusers.
    • Re:Thanks (Score:4, Funny)

      by ColdWetDog (752185) on Sunday February 28, 2010 @05:15PM (#31309344) Homepage

      disinfectant abusers

      Wow. Never heard of that one. I guess I'll just have to hide in the bathroom to wash my hands.

    • Re:Thanks (Score:5, Insightful)

      by samurphy21 (193736) on Sunday February 28, 2010 @05:16PM (#31309352) Homepage

      Sanitizers that lyse microbes with high doses of ethanol don't contribute to these antibiotic resistant critters, but over prescribing antibiotics definitely does.

      However, a major player is also the improper use of properly prescribed antibiotics. People who stop taking their medicine for strep as soon as they feel better instead of completing the course, as is required.

      This isn't entirely upon the doctors, but also upon those of us who don't follow doctors' directions.

    • by Oxford_Comma_Lover (1679530) on Sunday February 28, 2010 @05:25PM (#31309408)

      There's plenty of blame to go around, but of course the trick is what we do moving forward. Some of the simple techniques, such as ensuring hospital staff wash their hands, are very useful in terms of preventing the contraction of bacterial infections and should be something where we encourage, expect, and ultimately demand a 100% success rate (i.e. always wash your hands), without blaming people for not having done it in the past. Nurses at the hospitals with poor discipline stopped washing their hands once disposable gloves started being commonly used in medicine. At this point, for many of them, they have been told or taught to always wash hands or put on new gloves before touching a patient after touching nonsterile surfaces, but they're not part of a hospital culture where that is the unbreakable rule, so they get sloppy.

      It's not everyone, nor every hospital, but it's common enough that it's not even frowned on at some hospitals. Simply attacking someone about doing it wrong isn't enough, nor helpful, and our goal isn't to blame, it's to move forward and say, "all right. No more! Let's get this right! Let's cut down on staph infections by twenty percent in the next year." There should be intense competition for objectively defineable metrics of success, where the higher the number the better the patient care (so no race conditions), with conservative results and massive penalties for failing to report properly (so it's in everyone's interest to do well but nobody's interest to cheat), and each year the hospital should be able to report, "we saved X lives this year, and Y of those are lives we saved because of these particular programs and improvements we've achieved since last year."

      The goal isn't to blame, it's to achieve. It's to save lives. And ultimately, of course, to save the world. *Flash Gordon Theme plays*

    • Re:Thanks (Score:4, Informative)

      by localman (111171) on Sunday February 28, 2010 @10:49PM (#31311726) Homepage

      Reading this article earlier today, about conquering resistant infections in Norway [miamiherald.com]. Sounds like they've basically figured it out. What are the chances that we can get that kind of smarts imported into the US?

      Cheers.

  • Am I the only one? (Score:2, Interesting)

    by Servaas (1050156)
    Sometimes I gets this weird feeling that for every medicine discovered nature pushes back with one that is more effective and deadly. Is the idea of world without diseases (never mind getting the medicine to all people) a utopia that will never get reached?
    • by John Hasler (414242) on Sunday February 28, 2010 @06:11PM (#31309746) Homepage

      Most medical antibiotics are based on naturally-occuring antibiotics found in soil organisms. Of course, as these organisms evolved the antibiotics the bacteria around them co-evolved defenses. This means that for most antibiotics there are bacteria around that have genes that make them resistant. Since bacteria trade their genes around it's only a matter of time until the resistance genes find their way into disease organisms. Hospitals contain concentrations of people being treated with antibiotics and so that is where the resistant disease organisms tend to appear.

      We need antibiotics based on novel modes of action not found in nature, but these are hard to develop. The ability to sequence the genes of bacteria as well as the ability to synthesize proteins with predictable characteristics will help.

  • by Anonymous Coward on Sunday February 28, 2010 @05:04PM (#31309244)

    And the soccer moms as well who scream for antibiotics for everything from the common cold to a skinned knee.

    These prescriptions are thrown around like candy whether they are warranted or not.

  • by Anonymous Coward on Sunday February 28, 2010 @05:05PM (#31309254)

    I'd really be pissed if that happened to me.

  • Life lesson (Score:5, Informative)

    by Todd Knarr (15451) on Sunday February 28, 2010 @05:18PM (#31309354) Homepage

    And this, children, is why you always, always complete the full course of antibiotic treatment, even if you think the problem's cleared up half-way through. If you stop early you leave the small subset of bugs, not enough to cause a visible problem, that are the most resistant to the antibiotics. Lather rinse repeat a few times and you end up with bugs that laugh at antibiotics and proceed to run rampant.

    • Re: (Score:3, Interesting)

      by MadShark (50912)

      I've always thought that doctors should use shots to deliver antibiotics whenever possible. For many of the most common things like ear infections it is 1 shot or 2 weeks of pills. It also applies disincentive for idiots who ask for antibiotics for problems that don't need them(based on the fact that many people that I know hate getting shots).

    • Ever been to Mexico? Brazil? Ecuador? Thailand? Vietnam? India?

      Walk into any pharmacy. Tell them you've got a little bit of a sore throat. 30 seconds later you're walking out of the pharmacy with a package of antibiotics.

      What's worse, is that you get none of the precautionary questions/warnings regarding side effects, possible allergies to antibiotics, instructions to take the whole package, etc.

      *This* is where the problem lies. My experience with US and European antibiotics prescriptions has been t

  • by insitus (250638) on Sunday February 28, 2010 @05:19PM (#31309364)

    Anyone remember Phage Therapy [wikipedia.org]?

    • by morty_vikka (1112597) on Sunday February 28, 2010 @10:57PM (#31311764)
      Nice idea, but phage are also very good at facilitating horizontal gene transfer [wikipedia.org], so there's a chance they could make the problem worse by conferring resistance to other strains of related bacteria.
  • by joocemann (1273720) on Sunday February 28, 2010 @05:27PM (#31309414)

    The language of the slashdot post seems to suggest that the presence of gram negative bacteria is recent. It also suggests that the gram negative characteristic of the bacteria is the definitive characteristic of its virulence. Also, the Gram test isn't a 'so called' test, which somehow suggests or implies doubt.

    The test has been done for decades; our knowledge of the two major types of bacteria (gram positive and gram negative) has been around for decades as well. And while gram negativity is characteristic of bacteria that must be approached with different antibiotic means than gram positive, due to their extracellular topology/materials, it does not mean that being gram negative makes the microbes virulent or specifically dangerous.

    And to debunk the loose implication that gram negativity might have evolved from human antibiotic applications I will say this: it didn't.

    General Bacteriology ftmfw.

    • by BigDukeSix (832501) on Sunday February 28, 2010 @06:54PM (#31310164)
      While TFS is indeed inflammatory, your post is factually incorrect. Specifically, gram negative bacteria are very much more virulent than gram positive bacteria (or, for that matter, organisms that don't gram stain at all). The gram negatives are the only class of bacteria that express lipopolysaccharide endotoxin. The human immune system has specific receptors (like CD14) for this toxin, resulting in an extreme inflammatory response which is the pre-death phenomenon called 'sepsis'.

      We saw these pathogens emerge in our ICU three years ago and have been using colistin. The side effects are real but not nearly as common with modern supportive care as they were 40 years ago. Which is good, because when the colistin quits working, well, your patient is dead. Currently these pathogens only emerge after many weeks of critical illness and multiple runs of strong intravenous antibiotics.

      We go through fairly draconian measures to limit any spread of these organisms, which so far seem to work. Negative pressure rooms, isolation gowns and masks for simply entering the room, disposable stethoscopes, etc. all help. Rooms and gear are disinfected by two different individuals so that personal tendencies don't allow transmission. And we wash our hands. A lot.
      • Re: (Score:3, Informative)

        by morty_vikka (1112597)
        Despite not having read TFA, the synopsis seems to imply that all Gram negative bugs are potentially superbugs because their cell walls are different to Gram +ve bacteriia. In fact, most Gram -ves are susceptible to penicillin (and other beta-lactams), just like their Gram +ve cousins, because their cell walls still contain peptidoglycans, albeit less than the average Gram +ve organism.

        Sure LPS might be inflammatory but that doesn't make all (e.g.) E.coli pathogenic - it's the aquired attachment/invasi
      • by joocemann (1273720) on Sunday February 28, 2010 @09:10PM (#31311152)

        It is true that endotoxin A, which is presented to the human body upon cell lysis is heavily immunogenic and can cause disease and/or death. And it is true that it is found as the intracellular component of the gram negative lipopolysaccharides.

        But what isn't true is that gram negative = virulent. Virulence is a measure of an organisms ability to cause disease. Many gram negative bacteria simply cannot survive in the human body, so it is false to state or imply that being gram negative is clearly a threat to human health.

        Gram negative bacteria that can colonize in the body are dangerous and may cause disease. The point I was trying to clarify was that the characteristic of being gram negative does not mean the bacteria will cause human disease/death. There are various attributes among species of bacteria that will determine if they can grow in the human body.

        I hope my point is more clear.

        Gram negative != dangerous to human

        gram negative + able to colonize in humans = dangerous to human.

        Furthermore, there are many bacteria that are gram negative that exist as symbiotic bacteria in the intestinal flora. Need an example? Escherichia Coli is gram negative. If the simple characteristic of being 'gram negative' made a microbe dangerous, we would all be in danger right now.

  • by mdf356 (774923) <mdf356@g[ ]l.com ['mai' in gap]> on Sunday February 28, 2010 @05:29PM (#31309436) Homepage

    Welcome back to the world before antibiotics were discovered.

    However, a few decades of not using antibiotics at all and the bacteria around the world will again mostly be susceptible to the more common, low-risk ones. The mutations that make for antibiotic resistance have negative effects on bacteria's ability to reproduce... except in an environment with significant antibiotic use.

    • by Fëanáro (130986) on Sunday February 28, 2010 @05:55PM (#31309608)

      However, a few decades of not using antibiotics at all and the bacteria around the world will again mostly be susceptible to the more common, low-risk ones. The mutations that make for antibiotic resistance have negative effects on bacteria's ability to reproduce... except in an environment with significant antibiotic use.

      Immunity to antibiotics would diminish, but I imagine in many cases the neccessary genes would be only supressed or disabled, not completely removed. Plasmids integrated in an inactive part of the genome, point mutations in the promoters and stuff like that.
      If we started using antibiotics again, immunities might quickly return.

      • by aurispector (530273) on Sunday February 28, 2010 @07:53PM (#31310612)

        I just read somewhere that Norway is taking this approach. Unless you're going to die without them, antibiotics are not prescribed. Antibiotic resistance has plummeted as a result. Between this and banning their addition to farm feed I'd bet things turn around inside of 10 years, except it will take a major catastrophe in the US to overcome the political resistance to farm use.

    • by arcade (16638) on Sunday February 28, 2010 @07:12PM (#31310324) Homepage

      Actually, a few weeks/months is enough.

      Give it a year without prescribing antibiotics for anything but the most severe cases, and all the nice little antibiotics are effective again.

      Google for 'norway antibiotics' .. ( http://www.fftimes.com/node/229972 [fftimes.com] )

  • by DigiShaman (671371) on Sunday February 28, 2010 @05:30PM (#31309438) Homepage

    Would it be possible to at least take one (or both) Kidneys offline? Basically, run your body through a dialysis machine during the antibiotic procedure. Of course, this would have to be an extreme life or death situation to consider the possibility.

    • by Skreems (598317) on Sunday February 28, 2010 @05:43PM (#31309520) Homepage
      Kinda hard to shunt the circulatory system around them when they need oxygenated blood to survive as well. Neat idea though, there should be a further way to get around that problem, like a miniature dialysis loop just for the kidneys while you run the treatment.

      Of course that's assuming the bacteria isn't in your kidneys...
    • Re: (Score:3, Insightful)

      by moteyalpha (1228680)
      That is innovative thinking, however, after a moment I realized that the kidneys would be infected also and as a result would reinfect the person when reconnected.
    • by tpjunkie (911544) on Sunday February 28, 2010 @05:47PM (#31309540) Journal
      Not really. The method of damage here is due to filtration of the active antibiotic from the blood at the glomerulus. In order to spare the kidneys here, you'd need to bypass the renal arteries, which receive about 20% of the body's blood flow. Thats not even getting into the fact that you need kidney perfusion to maintain proper blood volume. I am a med student studying on renal physiology (test on friday...)
    • by Nadaka (224565) on Sunday February 28, 2010 @06:11PM (#31309738)

      Congratulations, you just wrote the next episode of House.

  • by urusan (1755332) on Sunday February 28, 2010 @05:46PM (#31309534)

    In general, pharma companies benefit from heavy use of antibiotics: immediately because they can sell more, but also in the long run because it makes their old products (for which they no longer hold a government-issued monopoly) obsolete faster, improving the market for newly developed drugs that fix old problems.

    On the other hand, when it comes to these gram-negative bacteria the above idea does not hold true. They can't benefit from it if they don't have a product to sell that fixes the problem.

    • Re: (Score:3, Insightful)

      by CodeBuster (516420)
      Many of the available antibiotics, with the exception of relatively new ones such as linezolid [wikipedia.org], are actually no longer protected by patents; so I doubt that substantial patent portfolios in antibiotic drugs and the desire to preserve "profitable" antibiotics have much, if any, effect on the pace of new development. Most drug companies would love to have a new antibiotic, provided that it could be developed for the right price and that, IMHO, is the real problem. Antibiotics, like all new drugs, are expensiv
  • by T Murphy (1054674) on Sunday February 28, 2010 @05:57PM (#31309624) Journal
    I don't know much about this part of science, but does it work to target whatever the bacteria is taking in to produce the next generation, or to produce their toxin (as opposed to targeting the bacteria directly)? I suppose it entirely depends on what the bacteria does that causes the problem, but for example an article linked in another comment mentioned MRSA developing a pump mechanism to deal with disinfectants- if you tricked it into pumping out its 'food', you would kill it and hopefully cause a drug-resisting trait to go out of favor.
  • by RichardJenkins (1362463) on Sunday February 28, 2010 @05:59PM (#31309642)

    If it's possible to donate a kidney, and possible to remove a kidney intact, and possible to keep someone going with dialysis for a while, can they not develop a procedure to temporarily remove kidneys if the patient is going to have treatment that would damage them?

    Prohibitive code? Difficulty keeping the organ alive outside of the body? Risks of surgery whilst infected?

  • by blind biker (1066130) on Sunday February 28, 2010 @07:12PM (#31310320) Journal

    Extensively-drug-resistant tuberculosis (XDR-TB) is already a nearly-unstoppable killer. In fact, it could very well be a doomsday bacterium. It is deadly, practically untreatable, survives well outside of the human body (as long as it's away from direct sunlight), rather long incubation period.... Finally, to diagnose XDR-TB you'll currently need anywhere between 2 to 4 MONTHS! All that time you might be curing a person with drugs that are ineffective.

  • by anoopsinha (685380) on Sunday February 28, 2010 @07:18PM (#31310364)
    I'm a clinical microbiologist working in a teaching hospital in India. We've been seeing multi-drug resistant strains of hospital bugs (Gram negative) for quite some time now.

    In fact, more than 60% of the Gram negative isolates in our hospital (in-patients) appear to be producing an enzyme called extended spectrum beta lactamases (ESBL). These ESBL-strains are often resistant to other classes of antibiotics as well, narrowing therapeutic options. In a subset of cases, these bugs turn up as resistant to almost all the antibiotics we test.

    But, I am yet to come across a case where the isolate was resistant to colistin and polymyxin B. No clinician would even think of using these drugs if other options are available. But, if, as the article reports, these organisms turn out to be resistant to even these last-resort drug... we can safely assume that we are in deep shit.

  • by Bhrian (531263) on Sunday February 28, 2010 @07:36PM (#31310502) Journal
    When visiting a doctor for a sinus infection, he said that in India they would take a swab from my nose, determine in a few minutes with a microscope what bacteria was bothering me, and give me a specific antibiotic that was known to work well.

    In the USA, he said insurance tells them to just proscribe an antibiotic and if it doesn't work, they'll come back. The ten minutes of lab work isn't covered by insurance, so they don't do it. I asked if I could pay cash for the test with the microscope, but he refused and said he'd get in trouble.

    Most doctors follow insurance rules, worry about liability, and treat symptoms, in that order.
  • Probiotics (Score:3, Interesting)

    by Akaihiryuu (786040) on Sunday February 28, 2010 @08:07PM (#31310690)
    Probiotics are going to start being a LOT more useful than antibiotics. If you have a deadly bacteria, the best way to kill it is not to actually kill it with antibiotics (which generally kill everything that's not resistant to it), but kill it by flooding the system with beneficial bacteria that will compete with the harmful ones for resources and eventually starve them out. Antibiotics should only be reserved for cases where they are absolutely necessary, and a probiotic regimin should be prescribed after the antibiotics are done. Antibiotics also tend to kill a lot of beneficial bacteria, leaving a power vacuum where ANYTHING can take over very quickly after the antibiotics are done. Filling the hole with beneficial bacteria before anything else can get in is the best thing to do.
    • Re: (Score:3, Informative)

      by Dunbal (464142) *

      by flooding the system with beneficial bacteria that will compete with the harmful ones for resources and eventually starve them out.

            That's all very well in the lab. However in a patient those "resources" also happen to be things the patient's cells need. Guess who also is going to be "starved out". Just my 2 cents worth but don't mind me, I'm just a physician.

  • by Junior J. Junior III (192702) on Sunday February 28, 2010 @08:09PM (#31310704) Homepage

    The question I have is, how quickly can we either build nanobots that can be programmed to attack these infections, or else develop custom tailored viruses that target them? In other words, are antibiotics the only way to attack infection, or might we be able to develop other weapons to use against them?

  • by geekmux (1040042) on Sunday February 28, 2010 @08:19PM (#31310778)

    Story A - Every pharm company wanting to make a buck has pushed antibiotics into every nook and cranny, eventually creating strains of resistant bacteria.

    Story B - An secret organization, funded by __________ has developed resistant strains to maintain and control ___________, and in some cases even __________.

    Nope, I really don't want to know the real story.

  • Bitter Resistance (Score:4, Informative)

    by jonabbey (2498) * <jonabbey@ganymeta.org> on Monday March 01, 2010 @03:10AM (#31313048) Homepage

    Bruce Sterling wrote what is still probably the best article for the layman about the inevitability and dangers of bacteriological antibiotic resistance.

    Bitter Resistance [eff.org]

    Check it out, peeps.

  • by hherb (229558) <horst AT dorrigomedical DOT com> on Monday March 01, 2010 @04:30AM (#31313464) Homepage

    The article is incorrect in many points. Firstly it is not just the two antibiotics mentioned that are effective against gram negatives, but quite a large range of Aminoglycosides, Quinolones, and even some Cephalosporines for example. Resistance against these happns too, of course.
    Furthermore, damage to the kidneys (or hearing nerve) and other severe adverse effetcs can happen, but are rather the exception than the rule. The patient's choice is thus not "to lose his kidneys or die with intact kidneys" but to accept a reasonably small risk of potentially serious adverse effects in exchange for a treatment that is most likely life saving.

    Of course it is sad if we gradually lose more and more powerful antibiotics because some reckless idiots overuse them in clinical practice (the USA is one of the worst offenders in that aspect within the "ciilized" realm, especially when it comes to misuse and overuse of Fluoroquinolones) or, even worse, just in order to make cruel intensive meat farming viable.

Mediocrity finds safety in standardization. -- Frederick Crane

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