Totally Drug-Resistant TB Emerges In India

ananyo writes "Physicians in India have identified a form of incurable tuberculosis there, raising further concerns over increasing drug resistance to the disease (abstract). Although reports call this latest form a 'new entity,' researchers suggest that it is instead another development in a long-standing problem. The discovery makes India the third country in which a completely drug-resistant form of the disease has emerged, following cases documented in Italy in 2007 and Iran in 2009."

Cough...

[wbr1]

And yet the food industry and the pharmaceutical industry would have us believe that the overuse of antibiotics is harmless ...cough.

Watch out Indonesia

[Toe, The]

Isn't the real story that it's in three countries, and that they are geographically disparate?

Or... does the disease only affect countries that start with the letter I?

Re:Not *totally* drug resistant

[tb()ne]

And yet for a Google search on "anti-antibiotics", the first page of results contains almost all links for mis/overuse of antibiotics in humans.

Re:This would be a bad time for a "Madagascar" jok

[shadowrat]

Also each evolution that allows a bacteria to become resistant to a drug weakens the bacteria in all other cases.

I had not understood this to be true. I keep hearing that strains of bacteria become resistant to all antibiotics. not just a queue of 3, then the next strain is resistant to a 4th antibiotic, but no longer resistant to the first. Evolution does seem to favor specialization, but traits are only lost if they hinder. I don't know exactly what the mechanism of resistance is, but i don't know that each kind of antibiotic requires some new organ to exist resulting in lumpy slow bacteria.

Re:Not *totally* drug resistant

[Anonymous Coward]

Except that new antibiotics aren't really being developed anymore. The last one in wide use, I forget which, was brought out some 20 years ago. The reason: high development cost, combined with fast bacterial adaptation mean that pharmaceutical companies aren't even able to recoup their investment before a drug falls out of use. Source: my infectology professor.
Two possible solutions to this problem I see is raising the price of antibiotics or introducing government subsidies for development.

Re:Not *totally* drug resistant

[LWATCDR]

True enough.
Actually there are a couple of means to attack this strain.
1. We should sequence those strains and see if we can identify any weakness to exploit.
2. Discover how their resistance works. For example strains that are resistant to say penicillin tend to make an enzyme that breaks down penicillin. So possibly one could make a drug that binds that enzyme and combine it with the antibiotic or change the antibiotic that the enzyme has no effect or even have the drug activated by the enzyme.
3. Bacteriophages are an interesting but really under researched treatment in the West. The old USSR did a lot of research in to them and frankly we should start as well.

Of course what is really scary are the folks that are no in "raw" milk. They are making claims that it can cure everything from cancer to Autism all the while providing an excellent vector for TB.

Re:Not *totally* drug resistant

[timeOday]

Universal healthcare and education would have innumerable benefits, but it would not halt the evolution of pathogens. I did find a source claiming perhaps 50% of antibiotics are used incorrectly, which is not good. But the economic rise of several populous nations, and the growing world population, will increase antibiotics use by much more than that, as well it should, saving millions of lives in the process. The more people, the more pathogens, and the more medical researchers, and the faster the arms race evolves.

Don't get me wrong, we should do what we can, but it's wrong to assume drug-resistant pathogens are "caused by" antibiotic misuse. It's one contributor to the problem.

Additional Note: 1 patient ran away

[Saishuuheiki]

It was also mentioned on NPR that one of the patients with the drug-immune TB in India actually checked themselves out of the hospital and they can't find them.

Here's to you our new "Patient Zero"

Re:Not *totally* drug resistant

[SydShamino]

I was attacked in mid-December by a cat, which bit my left hand harder than I knew cats could - twice. (It was an indoor feral cat we care for, and we were moving, and I had to get him in a cage. And yes, eventually we both calmed down and got him moved.)

Initially my hand swelled to twice its normal size, and then the wounds started to fester. This was within a day. Fortunately I went to the doctor the morning after it occurred, and by the time the wounds were filling with pus I was already ramping up 10 days of antibiotics. The infection was gone within three days (but of course I dutifully took the entire 10 day regimen). My hand still hurt a little but it's usable.

In retrospect, I've been thinking that just 100 years ago I very well could have either lost my hand or died. Now my biggest concern was a few weeks of pain and inability to use my hand, and maybe one or two small scars.

I am very grateful for the discovery and medical application of antibiotics, and I very much support restrictions with antibiotics to cases where they are mandatory. Doctors and patients abuse painkillers, so we restrict access to them and control their use closely so as to prevent the patients from hurting themselves. Doctors and patients abuse antibiotics, so why don't we restrict access to them and control their use closely so as to prevent patients from hurting all of humanity?

Re:Not *totally* drug resistant

[wolfsdaughter]

I definitely agree that we should do massive researching into phages. http://en.wikipedia.org/wiki/Bacteriophage [wikipedia.org]

problem is that big pharma won't do much with phages because they're naturally occurring which i think means no patents - so as soon as one has FDA approval, anyone can produce it,

I wish the government should give out grants to research phages - but big pharma would cry "unfair"

Re:Watch out Indonesia

[level_headed_midwest]

The BCG vaccine screws up using the skin test; your body has "seen" the TB antigen in the BCG vaccine and will react to the TB antigen in the skin test. It does NOT screw up the antibody test (Quantiferon), so people who received the BCG vaccine should get the antibody test instead of the skin test. Also, there is a direct test for M. tuberculosis bacteria- it's called a sputum culture. However you won't be able to grow any unless the patient has active TB as latent TB by definition has a negative culture. The skin test and Quantiferon test for latent TB, in the hopes that you catch latent TB, treat it, and kill it before it becomes active (and actively contagious) TB.