Drug-Resistant Superbugs Sweeping Across Europe 433
Pierre Bezukhov writes "Klebsiella pneumoniae is a common cause of pneumonia, urinary tract, and bloodstream infections in hospital patients. The superbug form is resistant even to a class of medicines called carbapenems, the most powerful known antibiotics, which are usually reserved by doctors as a last line of defense. The ECDC said several EU member states were now reporting that between 15 and up to 50 percent of K. pneumoniae from bloodstream infections were resistant to carbapenems. To a large extent, antibiotic resistance is driven by the misuse and overuse of antibiotics, which encourages bacteria to develop new ways of overcoming them. Experts say primary care doctors are partly to blame for prescribing antibiotics for patients who demand them unnecessarily, and hospitals are also guilty of overuse."
...and patients who don't complete the course (Score:5, Informative)
The same whiny hypochondriacal medieval idiots who demand antibiotics to fight a virus.
I often think that 19th century physicians had it figured out. Blue pill (placebo), slime draught (nasty tasting placebo) and let some blood. Treat the root cause, i.e. the hypochondria.
Re:I wonder (Score:5, Informative)
Of course it does. The fact that these soaps haven't been banned yet shows how serious the EU takes this problem.
All true but (Score:5, Informative)
Re:I wonder (Score:5, Informative)
I wonder if such a common thing as antibiotic soap can increase resistance over a period of time.
Probably. It's very unlikely to kill every bacterium, and the ones it doesn't kill may go on to breed stronger strains.
Re:VS (Score:5, Informative)
It is the case in the US.
Farmers feed cattle with 12000 tons of antibiotics (Score:5, Informative)
The concern centers on farmers' routine use of antibiotics. Its use on livestock accounts for roughly half of the 25,000 tons produced in the United States each year. - link - [purefood.org]
The question of whether we are creating ‘resistances' in zoomatic organisms (that affect both species) out in the feedlot and pastures and passing this on to humans with veterinary use of drugs, however, is still a very up-in-the air question. - link - [cattletoday.com]
Re:"K"? (Score:5, Informative)
Klebsiella pneumoniae. [wikipedia.org] But you're right, /. editors should know how to write a blurp.
Re:I wonder (Score:5, Informative)
Alchohol based and similar antibiotics don't have a drug to build a resistance to. It is just deadly in a high enough dose. Those that live are through dumb luck. So these products are safe to use without fear of adding to drug resistance.
I think our etiology of antibiotic resistance is.. (Score:5, Informative)
oversimplified.
It's based on the idea, seen in insects with pesticide use, that if you kill x percentage of insects, some may survive and their offspring may have a much higher level of tolerance, meaning more pesticides are needed to kill the insects. No doubt this happens with bacteria too and is *a* cause of antibiotic resistance.
Consider that livestock may be given antibiotics, and they may have bacteria, like E. coli or Salmonella sps which can make humans ill. This represents an additional vector not generally covered in analysis.
However there may be several other big issues that are not currently included in the analysis. Many species of bacteria are known to assimilate genetic material from other bacteria even from other genuses. This means that there is a possibility that antibiotic resistance can spread between bacterial species as a result of hospital waste, causing a form of genetic pollution.
Nature is fundamentally more complex than we can model. Any sufficiently complex model would be nature itself.
However, the rise of superbugs is fascinating to watch.
Re:VS (Score:4, Informative)
Re:I wonder (Score:5, Informative)
Giving antibiotics to farm animals also doesn't help and genetically mutilated crops is an other example of the same problem of making bacteria drug resistant.
There is enough talk about reducing antibiotics for humans and animals though, but the pharmaceutical industry is lobbying against this kind of regulation for obvious reasons. The more they sell, the better. For them that is. Go free economy where only money rules and common sense comes last...
Making antibiotics ridiculously expensive and inaccessible for people who really need them is indeed one way to "regulate" the use of antibiotics instead of simply not prescribing it for a simple cough.
But also for over consumption. Everybody knows this will become a huge problem sooner or later, but everybody also decides to look the other way and hope it will go away. It's human nature I think. But nature will definitely find a new balance. It's like a nuclear reactor. If you don't regulate, things will get out of hand. We might like the outcome. We might not. :)
Re:Farmers feed cattle with 12000 tons of antibiot (Score:5, Informative)
People who think our ingestion of antibiotics from animals is a factor in antibiotic resistance are crackpots who don't pay attention to the fact that we've been eating trace amounts of penicillin for tens of thousands of years. That's not a serious concern. There are however a few serious concerns:
1) Some bugs like E coli and Salmonella sps can be hosted in animals or humans. Antibiotic resistance they pick up in animals will be a factor when the human gets sick.
2) Some bugs are known to swap DNA. This means that antibiotic resistance in a harmless bug could turn up in a harmful one later.
3) Bugs which are harmless today could jump species and become harmful tomorrow.
4) Environmental pollution around concentrated animal feeding operations could lead to antibiotic resistance in soil-borne bacteria.
Now, in the US, there is supposed to be a clear separation between classes of antibiotics used on animals and those used on people, although this is more porous than we might like to think. There are however no guarantees that other countries have the exact same divisions. Moreover even assuming that this is the case, it deprives us humans of the effectiveness of certain classes of antibiotics which might prove useful in the future.
Re:I wonder (Score:5, Informative)
Sorry to nitpick. but a virus does not react to antibiotics at all - those are for bacteria. For a virus you need completely other classes of substances like tetracyclines or interferone.
Re:I wonder (Score:5, Informative)
cattle are fed corn, because it is heavily subsidized
Obvious solution: end farming subsidies. If meat gets more expensive, import it from third world countries, where cattle is raised on the range. Use import duties and quotas to enforce good environmental practices in the producing countries.
Everybody wins, including the corn farmers who will end the monoculture that damages their soil. By rotating crops like alfalfa and soybeans they will need much less fertilizer.
Re:I wonder (Score:5, Informative)
There is a *slight* difference in the function of alcohol and penicillin in how they serve as antiseptics: Penicillin interferes with cell wall construction, whereas alcohol flat-out denatures all the proteins. Random mutations that use completely different protein structures that aren't attacked by alcohol are a fair bit rarer, to say the least.
Re:I wonder (Score:2, Informative)
Wow. No.
The problem is killing bacteria in internal infections. A bacterial strain could arise that better tolerates these special soaps but it wouldn't make them immunte to internal antibiotics. For external bacteria we can pull out the heavy guns and kill them in all sorts of awesome ways - soap and hot water, hydrogen peroxide, alcohol, iodine, dilluted immonia, any disinfectant really. Internal infections are a different problem because you can't injest all those great disinfectants (at least not in concentrations that wouldn't also kill you). You have to have a drug that's balanced in potency between killing the bacteria and being safe inside the body. There are few such drugs. Selective breeding of super bugs is an issue only if you're selecting for resistance against those few medicines. If anything, use more soap, because you're only hope is to kill the superbugs while you can - ie. before you get infected.
ps. antibacterial soap is for lazy people. You can acheive the same results by washing your hands properly - which would also kill off anything with selective immunity to the special soaps.
Re:Farmers feed cattle with 12000 tons of antibiot (Score:5, Informative)
And farmers pretty much feed all of their animals antibiotics because it's easier? cheaper? than only feeding it to animals once they're sick (in general it's a lot harder to tell when an animal is sick than a human). Or at least that's my understanding, I could be wrong.
Modern industrial cattle operations feed cows corn because calorie-for-calorie it is the cheapest food available for cows. The problem is that cows evolved to eat grass, not grains, so their stomachs aren't suited to it. They come down with stomach acidosis, and they will only live about six months once the corn diet begins.
While they are alive, they get infections via the stomach ulcers. So antibiotics are mixed into the corn to somewhat protect the stomach at least long enough for the cows to get obese for market.
I didn't choose the word 'obese' lightly. Industrial cows are literally obese, which is why their meat is so fatty. Fatty meat is easier to cook, and us dumb Westerners have been trained to prefer fatty meat ("nicely marbled").
Re:All true but (Score:5, Informative)
Do you have a source for this? I'm not saying you're wrong, just wondering about the basis for the claim. It strikes me as possibly being one of those "common sense" ideas that turns out not to be true when you actually crunch the numbers.
I can't find comparative figures but this BMJ article [nih.gov] highlights the issue
Re:I wonder (Score:5, Informative)
Yes, you're the fourth person to say that, I get it, I fucked up.
I was prompted to go to Wikipedia [wikipedia.org] and it turns out my preconceptions were in left field. The main point though is this: Livestock consume 70% of the antibiotics in the United States. (Albeit for different reasons than I stated) They are also injected with synthetic growth hormones.
I'm Canadian, and the article suggests that we haven't deregulated the cattle industry yet. i.e. it's still illegal to sell meat contaminated with antibiotics and hormones in this country. Comforting.
Re:I wonder (Score:5, Informative)
The banana story has absolutely nothing to do with drug resistant bacteria. The reason an entire species of banana can be wiped out by a single pathogen is because farmed bananas, as they are produced today, are all genetic clones. (They are not necessarily even GMO; they are just clones.) Thus, cultivated bananas do not have the same genetic diversity that other species do; you're unlikely to find a single banana that has resistance to something that another banana does not. And that's why when one plant goes, they can all go. But this is a completely separate issue from how bacteria evolve resistance to antibiotics.
Re:I wonder (Score:5, Informative)
This is one of the problems, people go to their doctor for anti-biotics for a cold or other Viral infection, and complain when the doctor (quite correctly) says it won't help ...
The other issue is that people are given a course of anti-biotics (e.g. 3 weeks) and stop after 2 "because they are feeling better" .. and so the remaining bacteria are the most resistant, and most likely to be treated by the same doctor with the same anti-biotic ...
That's a popular theme but I would point out that it doesn't make a whole like of sense and has never been demonstrated to be true.
Firstly, antibiotics never kill all of the bacteria. You need an intact immune system to help. That's one of the big issues with AIDS and cancer patients. You need to kill off enough bugs to let the immune system get the upper hand. So there will always be survivors and so there will always be relatively resistant drugs. The absolute magnitude of the effect is open to conjecture.
Even if you do take all of your antibiotics, the treatment length for the vast majority of infections is perfectly arbitrary. We really don't know how long to appropriately treat.
Then there is the issue of resident bacteria. You simply cannot and should not clear the body of useful bacteria such as staphylococcus and E.coli. Remember, most of "you" is bacteria. The pathogenic (disease causing) strains have this annoying habit of transferring genetic data to other strains and even other species with quite a degree of alacrity. In fact, the concept of 'species' in bacteria is getting strained because of rampant horizontal gene transfer. So Mr. Antibiotic resistant organism can send little packets of DNA glee to all of his friends and relatives, even at low numbers.
And, of course, then there is the problem of antibiotics in animal feed, antibiotics in soap, antibiotics in bog-knows-what-all.
It's a good idea to complete your course of antibiotics, or at least discuss stopping early with your provider, but it is not nearly as cut and dried as that.