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Antibiotic resistance: The last resort

200 点作者 dn2k将近 12 年前

18 条评论

timr将近 12 年前
Things like this make me increasingly sad for our priorities as a society.<p>I realize that not everyone can be a biochemist and do antibiotics research, but we&#x27;ve reached a place where our most technologically savvy people are frittering their talents on food delivery services and cat videos. I have an advanced degree in biochemistry, and it&#x27;s still basically impossible to get work doing antibiotics development. There&#x27;s no money in it. I work on websites, because that&#x27;s where I need to be to earn a living. If I could get venture capital to do speculative work developing new classes of antibiotics, I&#x27;d do that in a heartbeat.<p>What&#x27;s the point? I don&#x27;t really know. Rome is burning, I guess. Bring on the bread and the circuses.<p>(Postscript: $200M is considered a big initiative in this space. We spend BILLIONS on niche diseases: <a href="http://online.wsj.com/article/SB10001424127887323975004578499324161473326.html" rel="nofollow">http:&#x2F;&#x2F;online.wsj.com&#x2F;article&#x2F;SB1000142412788732397500457849...</a>)
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fragsworth将近 12 年前
&gt; Davies, the United Kingdom&#x27;s chief medical officer, described CREs as a risk as serious as terrorism<p>This is a descriptive strategy people need to use more often to put things into perspective for the average person and taxpayer. Many diseases pose risks vastly more serious than terrorism, but receive far less attention.<p>However, if you&#x27;re aware of the actual risk of terrorism, something that is &quot;as serious&quot; as terrorism is really not very threatening.
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DanBC将近 12 年前
Something else that&#x27;s scary is drug-resistant gonorrhea, which has been found in Japan. (<a href="http://www.reuters.com/article/2011/07/11/us-gonorrhoea-superbug-idUSTRE76A0YO20110711" rel="nofollow">http:&#x2F;&#x2F;www.reuters.com&#x2F;article&#x2F;2011&#x2F;07&#x2F;11&#x2F;us-gonorrhoea-supe...</a>)<p>I&#x27;ve posted this clip before, but in case you missed it:<p>(<a href="http://v6.tinypic.com/player.swf?file=24goih4&amp;s=6" rel="nofollow">http:&#x2F;&#x2F;v6.tinypic.com&#x2F;player.swf?file=24goih4&amp;s=6</a>)<p>Here&#x27;s a short snippet from a BBC Television programme (Horizon - &#x27;defeating the superbugs&#x27;) (<a href="http://www.bbc.co.uk/programmes/b01ms5c6" rel="nofollow">http:&#x2F;&#x2F;www.bbc.co.uk&#x2F;programmes&#x2F;b01ms5c6</a>).<p>It shows E.Coli developing anti-biotic resistance. There&#x27;s a tray of nutrient jelly. The jelly is divided into sections. It starts with no antibiotic. Then there&#x27;s a normal dose. Then there&#x27;s a 10x dose, followed by 100x dose, followed by 1000x dose. The limits of solubility are reached - they cannot dissolve any more antibiotic into the jelly.<p>Then they drop E.Coli onto the normal jelly, and use a time lapse camera to show the growth.<p>After just two weeks the bacteria is able to live on the 1000x dosed jelly.<p>It&#x27;s pretty impressive demonstration.<p>(Apologies for the suboptimal hosting site. YouTube&#x27;s contentID blocks this video worldwide.)
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scythe将近 12 年前
&gt;That means, say infectious-disease experts, that their best tools for defending patients remain those that depend on the performance of health personnel: handwashing, the use of gloves and gowns, and aggressive environmental cleaning. Yet even research that could improve best practices has been short-changed, says Eli Perencevich, an infectious-diseases physician and epidemiologist at the University of Iowa in Iowa City who studies how resistant bacteria move around hospitals. <i>“We haven&#x27;t invested in research in how to optimize even standard infection-control practices. We just blame the health-care workers when they go wrong.”</i><p>It seems that a possible positive outcome of this could be cleaner hospitals. No infection is better than a treatable infection. Even if CREs are controlled, even if new antibiotics are developed, these outbreaks will keep happening and resistance will keep developing. Developing effective yet practical hygiene procedures is the only way to solve the problem once and for all.
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w1ntermute将近 12 年前
&gt; Initially, most individuals carrying bacteria with the new resistance factor had some link to clinics in India<p>One big problem is that in India, lack (or poor enforcement) of regulations results in abuse of antibiotics, which leads to the development of resistance. People are also much more susceptible to infectious disease, due to poor public health policy (lack of clean water, etc.).
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chestnut-tree将近 12 年前
Many years ago, I remember seeing a BBC documentary about phages that were (and are) used in Russia and former Soviet states in place of antibiotics.<p>What are phages? <i>&quot;Phages are naturally occurring viruses that kill bacteria. Once they get into bacterial cells the phages&#x27; DNA replicates until it kills the host.<p>Doctors in Georgia, and in other countries that were in the former USSR, have been using this therapy for 90 years. But medics and drug regulatory bodies in most places in the developed world have been reluctant to accept that it works.&quot;</i><p>From: <a href="http://www.bbc.co.uk/news/health-21799534" rel="nofollow">http:&#x2F;&#x2F;www.bbc.co.uk&#x2F;news&#x2F;health-21799534</a>
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jivatmanx将近 12 年前
The lack of advancement in antibiotics is a stark contrast to the recent improvements in treatments for so many chronic diseases.<p>Whatever the reason the free-market pressures here are so weak, antibiotic development should consequently be a priority in government grants. I wonder if there could even be intergovernmental cooperation here?
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jechmu将近 12 年前
Another reason (which I wish I had known) to treat antibiotics as a last resort is Clostridium difficile (C. diff). In addition to killing the bad bacteria in your body, antibiotics will also kill the good bacteria in your gut. This in combination with exposure to C. Diff (rampant in US hospitals) is a very bad thing.<p>When the good bacteria in your gut is killed, it frees up real estate giving any present C. diff an opportunity to overgrow and wreak havoc. If this happens, the road to recovery can be very long. And to add insult injury it takes bleach to kill any C. Diff you happen to spread to surfaces in your home and this often results in patients re-infecting themselves repeatedly.
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zw123456将近 12 年前
My Mom was I guess sort of a hippie ahead of her time but she used to always rail against anti-bacterial soaps and etc. She used to resist using the dishwasher and anything anti-bacterial, and would say that it was good for your immune system to be exposed to germs once in awhile. The joke in the family was that she just did not want to have to do too much housework, But actually, she may have been on to something.
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plg将近 12 年前
As laypeople we seem to think about this issue much like programmers think about algorithmic efficiency ... who cares if my code is messy, slow and non-optimal, all I need to do is wait a few years for CPU speed to double and nobody will notice.<p>i.e. most people think, just wait a few years until the scientists develop a better antibiotic. Cat and mouse.
joshuak将近 12 年前
Just out of curiosity does anyone know of research proving or disproving the viability of using &#x27;safe&#x27; bacteria to defend against dangerous bacteria?<p>I&#x27;ve often wondered since we&#x27;ve selected for super bugs buy killing off the easy to kill ones with antibiotics, couldn&#x27;t we intentionally reintroduce the easy to kill ones (or something similar but benign) so that the super bugs have no population advantage? Instead of being the only guys on the playing filed they&#x27;d have to compete with the benign bacteria which would, in my thinking, limit their growth potential.
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tmoertel将近 12 年前
What seems surprisingly ignored by most of the medical community is that many microorganisms harmful to humans can thrive only in environments that have been artificially stripped of the normally dominant microorganisms that humans are mostly well adapted to. Instead of fighting an ever-escalating arms race against resistant microorganisms in some imaginary “war on germs,” maybe we ought to stop screwing with the normal microbial environment and start learning from it instead.<p>I mean, is it really so surprising that when you salt sliced cabbage and let it sit in a crock for a few weeks – no preservatives, no antibiotics – that what you end up with, after the ambient microorganisms have had their way, is not only perfectly preserved cabbage but also <i>delicious</i>? That fermented foods naturally arise when you let traditional foods “go bad” and that they taste so good ought to suggest something. It’s almost as if millions of years of natural selection in an environment devoid of modern preservatives and antimicrobial agents has made humans well adapted to (and even crave) the microbiota that naturally dominate the places where humans have traditionally lived and the foods that humans have traditionally eaten.<p>Taking us out of those environments makes our bodies and foods and hospitals competiton-free zones for modern “superbugs.” Seems like a really bad idea.
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emeerson将近 12 年前
This looks like a viable research route? New pathway for eliminating bacteria thats viral instead of antibiotic (fungal?) based:<p><a href="http://www.sciencedaily.com/releases/2012/07/120724104640.htm" rel="nofollow">http:&#x2F;&#x2F;www.sciencedaily.com&#x2F;releases&#x2F;2012&#x2F;07&#x2F;120724104640.ht...</a><p>Can anyone speak to the validity or promise of such research?
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balsam将近 12 年前
I was relieved the map showed Israel as a hub instead of India (which was cited as the &quot;source&quot;). if you think Asiana scored it for &quot;culturalism&quot; then this here could win the whole game. First disclosure: not an Indian.Second disclosure: before clicking on the link I was expecting India or Africa. You know, some tropical third way place? Maybe I just have the wrong kind of paranoias. Bill Gates really needs to use his stature in India for this. If anything is hard object versus immovable force, this is it.
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meta-coder将近 12 年前
&quot;The [Indian] Union Health Ministry is considering a new National Antibiotics Policy for the country to handle increasing antibiotics resistance in the country.&quot;<p>News Article dated 27 July, 2013: <a href="http://www.thehindu.com/sci-tech/health/policy-and-issues/new-national-anitbiotics-policy-on-anvil/article4958425.ece" rel="nofollow">http:&#x2F;&#x2F;www.thehindu.com&#x2F;sci-tech&#x2F;health&#x2F;policy-and-issues&#x2F;ne...</a>
coldcode将近 12 年前
Once people start to die in droves the obstacles to a cure will vanish. Hopefully the people who can discover and manufacture the cure won&#x27;t vanish first.
saosebastiao将近 12 年前
I have come across several doctors that have tried prescribing antibiotics for preventative reasons to either myself or my family. How sad that it is the people who understand this threat the most are the ones causing it.<p>I rarely resort to finger wagging and shaming for anything, but for antibiotics misuse, not only do I feel it is appropriate, but I encourage others to do the same. Veterinarians should get the same treatment, IMO.
derleth将近 12 年前
If it gets bad enough, outpatient antibiotic use will be a thing of the past: If you need antibiotics, you will be confined somewhere and your compliance will be monitored. Laws will be passed to make non-compliance not simply a crime, but effectively impossible. If worst comes to worst, the facilities will be quarantined. There will be incinerators on site.<p>So, no, I don&#x27;t worry about &#x27;society&#x27;. Society has ways of defending itself. However, when the notion of individual rights above all starts to bring about an existential threat, something has to give.