Nevada Woman Dies of "Superbug" Resistant to All Antibiotics Available In The United StatessteemCreated with Sketch.

in #science7 years ago (edited)

So I was reading articles today and I came across this one. I think its time for another brief discussion/rant on antibiotics, antibiotic resistance and the pharmaceutical industry.


Source

Let Us Begin With The Title Article

Briefly, A Nevada woman in her 70's contracted an infection of Klebsiella pneumoniae, which you may be surprised to know is a normal constituent of the bacteria that live on your skin and in your intestines. However it causes problems when it finds itself in other places:

Figure 1: Klebsiella pneumoniae


So innocent looking and pink

It can lead to the development of pneumonia if it infects the respiratory tract (pneumonia is just the accumulation of fluid in the lungs, so it can be caused by a variety of things), blood infections, and even meningitis.

Now we know, and have known for quite some time that Klebsiella have been gaining resistance to a wide variety of antibiotics, and the strain of bacteria that infected this woman was discovered to be a carbapenem-resistant enterobacteriacae. Thats a fancy name which is given to a bacteria that is commonly found in our digestive tract (thats the enterobacteriacae part), and carbapenem is the class of antibiotics that are given when all other antibiotics have failed to work.

In this woman's case, the hospital screened the Klebsiella that infected her against all 14 classes of antibiotics they had available and found it was resistant to EVERYTHING. As a result, the doctors were powerless to stop the infection. She was placed into isolation and treated as best they could but succumbed to her infection.

You can read more about this woman here:

https://www.statnews.com/2017/01/12/nevada-woman-superbug-resistant/

It's Just This One Type of Bacteria... That's The Real Problem Right?....RIGHT?

WRONG

See bacteria can share their genetic material, they of course rapidly share genes among members of the same species, but also can (and readily DO) share genetic material across species (Source). They do this through two processes, one called conjugation (Source For Additional Reading) and another called homologous recombination (Primary Source For Additional Reading, also I have discussed homologous recombination in a previous post Here).

These processes, which are EXTREMELY common provide a mechanism by which these antibiotic resistant bacteria can spread very advantageous genes to other bacteria. What sort of genes just might be advantageous to a bacteria? Maybe ones which stops it from dying when in the presence of an antibiotic.


Thanks for that kanamycin resistance gene Lary!

Often times genes for antibiotic resistance are encoded on small circular pieces of DNA called plasmids, that bacteria can readily share. These plasmids are energetically costly for the bacteria to maintain (they don't want to replicate a bunch of extra DNA for no reason mind you.. thats a waste of food). If they are maintained for a long time or there is complementarity to their own genome, they can then incorporate genes more permanently into their own genome. In order to keep these energy hogging plasmids around the bacteria require some sort of reason to do so... like living in an environment with antibiotics around. It's a good thing we take so much care to use antibiotics sparingly... OH WAIT... shit.

As a side comment, plasmid sharing isn't the only mechanism by which genes can be shared, through conjugation (meaning direct contact) cells can share genomic DNA directly. Resesrch has shown that large pieces of a genome were able to be transferred from one cell to a different one and recombined into the new cells genometransfered.

Antibiotics Are Everywhere... but why?

Doctors Have Been Over-prescribing Them For DECADES

For many decades doctors just chucked antibiotics around like they were candy, oh you have the sniffles? Here take some amoxicillin. They gave that shit out even when they knew the issue was caused by a virus (which can't be treated by an antibiotic... they don't do shit against viruses, most interfere with specific parts of the bacterial cell cycle... which viruses do not have since they are not cells!).

However Doctor's over prescribing antibiotics is just the tip of the ice berg of issues.

They are All Over the Damn Place in Consumer Products

Did you ever wash your hands with antibacterial hand soap? It likely had one of two compounds in it triclocan or triclocarban in it. These two compounds while they are not directly classified as antibiotics (they are a bit different) do place bacterial organisms under selective stress. This makes them more susceptible to picking up antibiotic resistance genes through the mechanisms we discussed above. So glad we were including this in our damn tooth paste.


Dammit

On the plus side the United States Food and Drug Administration banned the marketing of antibacterial soaps containing these compounds over health concerns (and hopefully concerns over the increasing prevalence of antibiotic resistant microbes....)(Source).

So yes we were filling our water supply with trace quantities of antimicrobial compounds from all our antibacterial consumer products, but even that is not the major cause of concern. What is you ask?

Antibiotic Use In Agriculture

Yes, this is the real source that should concern every one of us. We are pumping livestock full of antibiotics to allow them to grow larger, leading to them excreting mass quantities of these antibiotics which then enter our water supplies. Sure there are human health concerns due to the exposure of trace quantities of the antibiotics but that should not be concern numero uno. Rather we are exposing a wide variety of bacteria to these antibiotics, providing them ample time to crack the code and develop resistances to them.

You only have to look so far as the Nevada woman from the article I began with and the bacteria she was infected with resistant to 14 different classes of antibiotics. To realize that providing bacteria with the necessary continuous selective pressure to learn to evade death by antibiotics is a terrible idea. Are fatter cows really worth it?


This cow may tell you it's worth it, but its a cow, its not too bright, don't listen to a cow

Okay Antibiotics Abuse is Bad... Why Don't We Just Make New Ones?

Pharma Doesn't Want To Spend The Money On The Necessary Research!

The large pharmaceuticals companies are at the end of the day profit driven entities. Why spend tens of millions working on a new antibiotic which people would only need sporadically when they can work on the latest and greatest penis pill, that people will buy up like candy? A little foresight would tell any rational person that if everyone is dying off from incurable infections there won't BE too many people to buy those damn sex pills... but hey what do I know right!?

We are Not With Out Hope: Academic Researchers

I wrote an article a while back about a new antibiotic that was discovered from studying the human microbiome (HERE), so we are not only reliant on work being done at the large pharma companies for potential new antibiotic avenues. However even if the antibiotics are found, someone has to make them and get them into doctors hands... which comes back down to pharma...

Conclusions

Antibiotic resistant bacteria are becoming a bigger issue with each passing year. The ability of bacteria to transfer these resistances to other currently non-resistant bacteria is a property that should cause us all at least a mild bit of concern. Reducing the rampant abuse of antibiotics should be something we are all demanding RIGHT NOW, as that is the easiest way to slow the development of more resistant strains (remember no environmental pressure, no reason to keep the resistance genes around for the bacteria).

We should also be demanding that the large pharma companies invest in new antibiotics, not every aspect of those companies functions should be about maximizing profits. At some point there needs to be someone willing to do something for the good of everyone, even if doing so may only generate a small (rather than a huge) profit.



# Additional Sources

1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC372703/
2 http://mbe.oxfordjournals.org/content/15/4/385.full.pdf
3 http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm378393.htm
4 http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm517478.htm
5 http://www.ucsusa.org/food_and_agriculture/our-failing-food-system/industrial-agriculture/prescription-for-trouble.html#.WHmMVPkrJPY
6 http://www.pharmaceutical-journal.com/news-and-analysis/features/why-are-there-so-few-antibiotics-in-the-research-and-development-pipeline/11130209.article

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Thanks, @justtryme90, for bringing this issue to light. I see this is an old article, but it was apparently just re-steemed...

I'm about to mention a product that I designed and fabricate as an agorist enterprise. It is directly relevant here because it has a track record of helping people with MRSA-type "superbugs" resistant to the pharmaceutical antibiotics.

DISCLAIMER: If you buy this product from me, it will generate a small (rather than a huge) profit for my family.

IF you are concerned about "superbug" infections, then you will want to read how my product has made a life-changing, and in at least one case, a life-saving difference for the people who bought it. You can read some of their stories here:

http://SILVERengines.com/steemit/

At that link, you will also find a "sweet deal" for Steemians. :)

And if you are unaware of the research that has been done related to the use of silver ions against "superbugs," you can begin reading about that here:

http://SILVERengines.com/the-science-behind-nano-silver/

Of course, I would be more than glad to answer any specific questions you may have about this, if I am able to. ;)

😄😇😄

@creatr

I've yet to see an actual study done on even an animal model showing that the doses required to achieve bacterial death, are not toxic to humans. There is data showing that leaching of silver ions from the surface of colloidal nanoparticulate silver can occur and that ionic silver can have a variety of negative effects on body biochemistry.

I have seen studies where researchers have exposed cell cultures and seen no issues however this is not even the first stage in dealing with a potential drug candidate and proving it's safety. Many compounds seem perfectly safe against cellular cultures, but given to model organisms, can lead to disastrous effects, some not seen in the short term.

I remain skeptical.

Thanks, @justtryme90, for your thoughtful reply.

I don't immediately have a complete response to the issues you've raised here. However, here are a couple of items that address the toxicity issue FYI:
  https://www.atsdr.cdc.gov/ToxProfiles/tp146.pdf
  http://www.info-archive.com/colsil%20silvertox.htm
Most of the issues reported therein are related to extreme dosages, and/or to silver compounds (in contrast to elemental and / or ionic silver).

Of course, toxicity is a major issue for "conventional," thoroughly studied antibiotics:
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3175508/
  https://www.drugs.com/article/antibiotic-sideeffects-allergies-reactions.html
And if the alternative is "death," (as in your headline), is it unreasonable to use something "unstudied" but with no reported serious adverse affects (other than, in some cases, cosmetic)?

If I locate any studies more responsive to your concerns, I'll be sure to pass them along. ;)

Shared in facebook. Want my nurses and doctors friends to listen to your rants :))

I am sure they agree with me to be honest, we made a lot of mistakes in the past with antibiotics and physicians of today have to deal with the repercussions of those past mistakes.

Thank you very much for reading, and for sharing. I very much appreciate it!

We don't just start AB now when our patients are febrile. Though we do blood culture when temp is above 38 degrees. More often, post heart attack patients develop high temp but it's normal so the legendary paracetamol still works.

You make very good points in this article. Simple ear infections are a great example when a virus is much more likely and an antibiotic should not be used initially. If a patient is still concerned you can always write a prescription and say to take if the ear does not feel better in 2-3 days. The other problems you addressed in agriculture and hand soaps I had not thought about much. Interesting.

I always appreciate hearing your thoughts on topics of medical relevance! Thank you for taking the time to read the article, it makes me happy that I am able to contribute a little bit more to your knowledge base. :)

Very interesting stuffs, thanks for sharing @justtryme90!

Thank you for taking the time to read it @rea! I very much appreciate it. Glad you found it interesting. :)

I read about that and it is real scary

Thanks for reading @billykeed I very much appreciate it.

Nice work, lots of detail.
I wrote on antibiotic resistance here, but as an analogy for government regulation.
https://steemit.com/anarchism/@mattclarke/my-enemy-s-enemy

Yikes. These bugs are getting smarter. I need a drink a shot of hand sanitizer.

Well hand sanitizer is usually 120-130 proof ;)

My wife and I were just discussing some of this late night!

THANKS!

It's something that is concerning me more and more. Thanks for reading @papa-pepper!

Another example of this BS system at the end of it's rope.

Thank you for taking the time to read!

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