"Health authorities have been struggling to convince the public that the threat of totally drug-resistant bacteria is a crisis. Earlier this year, British chief medical officer Sally Davies described resistance to antibiotics as a 'catastrophic global threat' that should be ranked alongside terrorism. In September, Dr. Thomas Frieden, the director of the U.S. Centers for Disease Control and Prevention, issued a blunt warning: 'If we're not careful, we will soon be in a post-antibiotic era. For some patients and some microbes, we are already there.' Now Maryn McKenna writes that we are on the verge of entering a new era in history and asks us to imagine what our lives would be like if we really lost antibiotics to advancing drug resistance. We'll not just lose the ability to treat infectious disease; that's obvious. But also: The ability to treat cancer, and to transplant organs, because doing those successfully relies on suppressing the immune system and willingly making ourselves vulnerable to infection. We'll lose any treatment that relies on a permanent port into the bloodstream — for instance, kidney dialysis. We'd lose any major open-cavity surgery, on the heart, the lungs, the abdomen. We'd lose implantable devices: new hips, new knees, new heart valves. We'd lose the ability to treat people after traumatic accidents, as major as crashing your car and as minor as your kid falling out of a tree. We'd lose the safety of modern childbirth. We'd lose a good portion of our cheap modern food supply because most of the meat we eat in the industrialized world is raised with the routine use of antibiotics, to fatten livestock and protect them from the conditions in which the animals are raised. 'And it wouldn't be just meat. Antibiotics are used in plant agriculture as well, especially on fruit. Right now, a drug-resistant version of the bacterial disease fire blight is attacking American apple crops,' writes McKenna. 'There's currently one drug left to fight it.'"
Hugh Pickens in his introduction to Maryn McKenna's article:
We've had an article on this not long ago, but Search has let me down, plus I though this excellent article made it worth repeating this critical message. With our already compromised immune system, we more than most are reliant of antibiotics to save us from bacterial infections. Please use antibiotics responsibly, in accordance with your prescription and encourage others to do what they can to slow the development of antibiotic resistance so that antibiotics can still help us when we absolutely need them.
Further key points from McKenna's article
Sir Alexander Fleming, the Scottish biologist, pharmacologist and botanist who is best known for his discovery of penicillin, warned, when accepting his Nobel Prize in 1945 for Medicine “It is not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them… There is the danger that the ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant.”
" 3 out of 10 people who contracted pneumonia before antibiotics were used in treatment, died"
"23,000 people die each year from antibiotic resistant infections in the USA"
“Sitting with a family, trying to explain that you have nothing left to treat their dying relative — that leaves an indelible mark on you,” he says. “This is not cancer; it’s infectious disease, treatable for decades.”
Some relevant comments from Slashdotters:
"Most of the deaths (14,000 out of 23,000 deaths caused by antibiotic-resistant bacteria in the US) aren't due to skin infections, they are due to C. difficile intestinal infections acquired in hospitals. Starts out as colitis and then you shit yourself to death, infecting lots of other people in the hospital along the way."
"An earlier poster asked if the lack of corporate investment to find new antibiotics is a market failure, and the answer is yes. Besides the enormous dysfunction that permeates big pharma in general, the reality is that antibiotics are generally not nearly as profitable as once-a-day drugs that last a lifetime. Either provide regulatory incentives for antibiotic development or do more of the research at the government level or both."
Neil
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New Scientist (free registration required) has an interesting article on the extremes scientists are going to in order to bioprospect for new antibiotics that will be effective against bacteria that have developed antibiotic resistance.
Antibiotic abyss - The extreme quest for new medicines:
Check out the 'Antibiotic apocalypse' graphic to the top right of the article for a quick appreciation of why we need to quickly find new antibiotics...
"Smart bomb" puts antibiotic resistant bacteria in its sights
"A new antibiotic "smart bomb" that can target specific strains of bacteria could provide the next-generation antibiotic drugs needed to stave off the threat of antibiotic-resistant bacteria."
Fascinating info Neil....I'm 'new' to the site so I hadn't seen this before but your last paragraph, regarding C-Diff.....Believe Me....I've been suffering with it (C-diff) since late November! (in and out of Hospital 3 times, in for 're-hydration' twice; on the second course of Vancomycn...trying to get 'cleared up' so I can plan for Chemo.....what a PAIN in the A** (literally)...so, this morning I woke up with Pink Eye!! it never ends!!!!
Don't dump unused antibiotics in drains or toilets. "Even very low antibiotic concentrations have significant biological and evolutionary effects. Low, “sub-clinical” concentrations of antibiotics fall well below the concentrations used in antibiotic therapy. These concentrations do not kill bacteria. But they do induce bacteria to increase their rates of mutation, DNA recombination, and the rate at which genes hop from cell to cell.
Each of these changes at the DNA level can give advantages to bacteria, such as survival in the presence of heavy metals, disinfectants or antibiotics. So antibiotic pollution makes it vastly more likely that bacteria will become resistant or colonise new hosts, including humans." Michael Gillings, Professor of Molecular Evolution at Macquarie University, Australia, on how the125,000 tonnes of antibiotics released into the environment each year helps breed superbugs:
Thanks for reminding us of this, Neil. It seems such a dire situation, that isn't being taken seriously enough by the people who SHOULD be taking it seriously - ie doctors and drug companies.
Well I guess it's not just them- we may all be guilty, by wanting to be prescribed antibiotics too quickly sometimes. But of course with CLL, we often NEED the antibiotics more quickly than other people... No easy answers.. (though we can certainly stop throwing unused drugs in drains or toilets)
Paula
P.S. I'm practicing the font enhancing skills that you explained earlier, Neil...
"Hospitals themselves are one of the biggest sources of antibiotic-resistant diarrhoea and wound infections. In the UK, some 9 per cent of hospital patients catch a new infection during their stay.
:
Simply getting staff to wash their hands more is proving effective against the spread of superbugs MRSA and Clostridium difficile in the UK. MRSA rates in UK hospitals, for instance, have fallen by about 80 per cent since their peak in 2004. Hand-washing is not the only factor, but it seems an important one: the more alcohol hand rub a hospital uses, the lower its rates of MRSA.
:
(In Lima, Peru) "The majority of TB transmission occurs where undiagnosed people mingle with susceptible ones," says epidemiologist Rod Escombe. "Crowded waiting rooms are a hotspot, as are outpatient clinics and emergency wards.""
More in a most interesting article "A Breath of Fresh Air" from New Scientist, which explores the benefits of fresh air and sunshine in reducing infections (free registration required to read the article). Seems Florence Nightingale was right "Clinics built to her light, airy design became known as Nightingale wards: long, narrow rooms with sash windows reaching up to the ceiling that allowed fresh air to flow through."
Yes Neil, and again it shows that those who should be MOST careful about spread of infections (hospital designers and medics), are the ones who are NOT always doing all they can.
Some simple changes in handwashing habits and hospital design could make so much difference to people like us, but the message doesn't seem to get through.
At the hospital where I go for my haemo clinic, ALL the Medical Out Patients' clinics share the same big, crowded waiting room. There are about 10 different clinics going on at once - haematology, gastric, diabetic, chest problems (and more that I can't remember). The receptionists are usually stressed, overworked and often confused. On more than one occasion I have sat there waiting for hours, because my notes never got passed on to the relevant doctor, so he never knew I had arrived!
The last time that happened, when I did get to see the doctor and told him how long I'd been waiting, he looked at me in amazement! "I've been sitting here with no patients to see", he exclaimed! (It was snowy so some had not turned up!)
In a smaller clinic, the receptionist would probably have known who I'd come to see, and noticed that I'd been waiting there too long. It wouldn't be so bad if clinics weren't always in afternoons, when I usually sleep because I am SO tired then. Also, I know that the longer I sit in a crowded space with people's germs all around me, the more likely I am to pick up some bug.
Apologies for the cynical rant. I have my next clinic appointment in 4 days time and am not looking forward to it!.
Paula
P.S. I realise that many people have far more serious stuff to rant about, but what you said here really hit a chord with me. With increase in resistance to antibiotics, infections will get much harder to treat. So the system really does need to change, to improve infection control where it can!
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