A post-antibiotic era


You know what’s really scary? Antibiotic resistance. The CDC says how scary.

The agency’s overall — and, it stressed, conservative — assessment of the problem:

  • Each year, in the U.S., 2,049,442 illnesses caused by bacteria and fungi that are resistant to at least some classes of antibiotics;
  • Each year, out of those illnesses, 23,000 deaths;
  • Because of those illnesses and deaths, $20 billion each year in additional healthcare spending;
  • And beyond the direct healthcare costs, an additional $35 billion lost to society in foregone productivity.

“If we are not careful, we will soon be in a post-antibiotic era,” Dr. Tom Frieden, the CDC’s director, said in a media briefing. “And for some patients and for some microbes, we are already there.”

Bacteria evolve. Resistance to antibiotics is selected. Problem.

In an interview before the report became public, Frieden said that some of these actions are already happening. “My biggest frustration is the pace of change,” he told me. “Hospitals are making progress, but it’s single digits in terms of the number of hospitals that are being very proactive.  The challenge is scaling up what we know works, and doing that fast enough so that we can close the door on drug resistance before it’s too late.”

Yes but the people in charge have more important things to do, like…uh…

I got nothin.

 

Comments

  1. Al Dente says

    In my lifetime Staphylococcus aureus has gone from being easily treatable with penicillin to some strains being penicillin resistant, methicillin resistant, streptomycin resistant and even vancomycin resistant. That proves the creationists are talking out of their asses when they deny evolution. However it means that staph infections are getting harder to treat. Remember that S. aureus causes not just acne and sinusitis but also pneumonia, meningitis and sepsis. It’s one nasty bug.

  2. says

    Recipe for fucking over humanity: (not recommended)

    Go to Mexico and buy as many of the extreme antibiotics as you can get (Cipro, etc) on the grey market. Get a swab of MRSA (any hospital has lots!!) then start culturing it. Once you have happy cultures start gradually introducing the antibiotics in small doses. Wait for the cultures to resume growth. Discard the ones that die. Do this for about a year and you’ll have a version of staph that humans can’t handle. Then go swab it all over the place at your nearest airport.

  3. iknklast says

    It isn’t enough to work with the hospitals. As long as antibiotics are being put in animal feed to be fed to healthy animals to keep them from getting sick, we will have plenty of bacteria exposed to antibiotics. And as long as we are crowding cattle into tiny spaces, shoved together with all the other cattle, we will continue putting antibiotics in their feed. And getting farmers/ranchers to change their habits is even harder than getting hospitals to change their habits. Trust me. I know.

  4. beardymcviking says

    Marcus, you’re scary. Iknklast, you’re depressing. Worst thing is you’re both right, and that’s scary and depressing :-/

    I don’t see this ending well.

  5. Markita Lynda—threadrupt says

    We’ve been spoiled by living in the golden era of antibiotics, which changed life from a gamble against death to a triumph of modern medicine. If we don’t start using them safely and developing new ones, we’ll be back to praying and watching while our children die.

  6. left0ver1under says

    So, in two centuries we’ve gone from:

    “Some are going to die, there’s nothing we can do.”

    to:

    “Nobody needs to die anymore!”

    and now to:

    “Some are going to die, there’s nothing we can do.”

    The only things that have really changed are (a) now we know what’s killing us, and (b) we made them incurable. The cure truly is worse than the disease.

  7. carlie says

    steveboen – It makes me furious that we haven’t investigated phage therapy more. Maybe this will finally knock them into doing so? It’s so stupid not to.

    As for the antibiotics themselves, we need to stop using them for damned cattle, which means not housing them in slums, and we need to stop using them ourselves for every little thing and use clean techniques in hospitals and doctor’s offices, all of which take actual work and money going to pay people to be able to do their jobs, so I’m guessing that won’t ever happen. Gaaa. Makes me so mad.

    There is a site on medical history that has a game on not spreading disease, in which you are a nurse who has to deal with things that happen in the hospital and each decision has effects, but darned if I can’t find it now. It’s really enlightening, though – you have to make decisions between “clean thoroughly with bleach, or give it a quick wipedown”, and if you give it a wipedown the patients all get sick, but if you clean thoroughly you get written up by your supervisor for not getting all your work done in time…

  8. unbound says

    @stevebowen & carlie – I think the answer to phage therapy is found in the question: How much money is there to be made?

    This isn’t a conspiracy theory, but a simple fact of how the large corporations / pseudo-corporations (like the Catholics and 7th Day Adventists that control many hospital and clinic systems around the country) view everything. They will simply not invest money unless there is at least a good return (some won’t even invest unless there is a great return), or the losses from not investing will be more than the investment cost. With the war on tort largely won and a continuing aggressive campaign against regulations, the losses are now tiny, so there is seldom reason to invest for fear of losses.

    The only hope for investment in phage therapy is if the healthcare industry can use it to reduce costs while maintaining at least the same level of income.

  9. Pieter B, FCD says

    I understand there’s a fair amount of phage-therapy research being done, but the results thus far have been disappointing, and there appears to be a non-trivial risk of unintended consequences.

    Human generations are measured in decades. Bacterial generations are measured in hours. The race is not always to the swift nor the battle to the strong, but that’s the way to bet.

    Back in the early ’70s I took a job at a major metropolitan med school. One of the Professors Emeriti was a man who told me that the hardest thing for him to endure as a young physician was watching dozens of otherwise healthy young people die from bacterial pneumonia every winter. I really hope we don’t go back to those days.

  10. quixote says

    Re phage therapy, what’s so good about it is its specificity. What Big Pharma hates about it is its specificity. Phages are viruses that attack bacteria, and they’re very specific. So you can’t just put phages in a pill and have them work on everything, like you could (past tense) with antibiotics.

    As soon as you have to tailor drugs individually, expenses go way up and profits go way down.

    That’s Big Pharma’s main beef, as far as I know, but phages are also more complicated to use for a number of technical reasons. You’d need to maintain active libraries of hundreds and thousands of phages at major hospitals, all of which needs to be curated and maintained.

    Plus, viruses mutate very fast — which is why they can stay ahead of the bacteria — but it’s also why phage libraries are very hard to maintain to a uniform standard level of effectiveness.

    But all of that will come to look like a small price to pay for happiness if antibiotic resistance gets totally out of hand.

  11. Dunc says

    As for the antibiotics themselves, we need to stop using them for damned cattle

    Damn straight. If you were to set out to design the optimum system for developing novel antibiotic-resistant pathogens, it would look almost exactly like a modern factory “farm”.

  12. Francisco Bacopa says

    I think our last best hope is botflies. Cutaribra imasculata is pretty common in rescue kittens around here. Their burrows are clean and uninfected. An infection would cause the hole to seal up and kill the larva . What antibacterial compounds to the larvae secrete to prevent death?

    The human botfly is an occasional invader down here. How does this botfly both suppress the human immune system and prevent a bacterial infection that would make the human kill it? These are the antibiotics of the future.

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