CDC Threat Report: ‘We Will Soon Be in a Post-Antibiotic Era’ • Hacker News Board

Re: CDC Threat Report: ‘We Will Soon Be in a Post-Antibiotic Era’

#91

Post by DerpObvious » Tue, Sep 17, 2013, 5:45 PM UTC

bbatchelder wrote: post #85

snowwrestler wrote: post #80

Earlier quoted context omitted.

As I understand it, the problem is more fundamental than that. Antibiotics were originally discovered accidentally, and a lot of subsequent antibiotics were discovered/created by investigating and extending the mechanisms of the original discoveries. We're now running out of those implications to chase down. To get the "next breakthrough" in antibiotics will require another surprise discovery, or some other fundament…

Last I heard, the next breakthrough is expected to be the exploitation of quorum sensing. Tricking the bacteria into thinking there are already more than enough of them so they at least stop reproducing.

Another use of interfering with quorum sensing is keeping bacteria docile, even when they've multiplied to levels where they could be threatening to the host.

Re: CDC Threat Report: ‘We Will Soon Be in a Post-Antibiotic Era’

#92

Post by protomyth » Tue, Sep 17, 2013, 5:46 PM UTC

aluhut wrote: post #33

I grew up in a former East Block country. Back then we had medical centers. If you were sick, you went there and they gave you something. Most of the time the solution was: Antibiotics. Because I was sick quite often, I can say I grew up on Antibiotics. When we moved to West Europe my mother made the mistake of chosing a doctor from our country (so she could uderstand what she says). So I continued to get antibiotics…

IHS (Indian Health Service) would give you anti-biotics when it suspected strep throat (or any other sickness) they would prescribe anti-biotics even though their tests would take 3 days[1]. If it wasn't strep, they wouldn't tell you to stop taking the anti-biotics. Glad to see we followed the practices of East Block countries.

1) send to government contracted lab, get sample test, send back result - gotta love government contracts. I'm told someone got an even bigger contract to speed up the testing or allow onsite tests.

Re: CDC Threat Report: ‘We Will Soon Be in a Post-Antibiotic Era’

#93

Post by protomyth » Tue, Sep 17, 2013, 5:50 PM UTC

cantankerous wrote: post #78

Since new anti-biotic development is so critical, I don't get why the feds don't in-source it to the CDC or provide massive incentives already. This is an infuriating problem that should've been dealt with decades ago on the R&D-funding front.

At one point[1], I heard that there were 3 new anti-biotics in development at various drug companies. It was my understanding that, like the lyme disease vaccine, they would probably not bring them to production given the current regulatory environment. I would imagine if it all goes to heck, then they would probably move forward.

1) its been a number of years so this might not be accurate anymore if it once was

Re: CDC Threat Report: ‘We Will Soon Be in a Post-Antibiotic Era’

#94

Post by haldujai » Tue, Sep 17, 2013, 5:55 PM UTC

j_baker wrote: post #87

Blahah wrote: post #46

Earlier quoted context omitted.

That's not the only reason no-one uses phage therapy - there's also a strong cultural resistance in the west. I've worked on phage targeting various Salmonella serovars, and while you do require cocktails for the most effective treatment, but phage evolve along with the pathogen. There's no inherent limit on the availability of phage like there is with our current suite of antibiotics. With extensive sequencing-based…

but phage evolve along with the pathogen. How do you prevent the phage from evolving to target the human cells?

(Bacterio)phages target bacteria only by nature, there are several mechanisms that prevent them from targeting human cells. They recognize bacterial membranes and not human, their replication mechanisms don't work in human cells and our cells have defenses against them. In short it would take a great amount of evolution to make them target human cells in the order of thousands of years at least due to the several existing barriers.

See: https://en.wikipedia.org/wiki/Bacteriophage

Edit: Just in case someone calls me out on this 'thousands of years' is an educated guess on my part from studying evolution not something I've actually read.

Re: CDC Threat Report: ‘We Will Soon Be in a Post-Antibiotic Era’

#95

Post by gtaylor » Tue, Sep 17, 2013, 5:56 PM UTC

rdtsc wrote: post #53

r0h1n wrote: post #34

Earlier quoted context omitted.

> Norwegians are sanguine about their coughs and colds, toughing it out through low-grade infections. > "We don't throw antibiotics at every person with a fever. We tell them to hang on, wait and see, and we give them a Tylenol to feel better," says Haug. I wish more of us would follow this approach and learn to accept being 'sick' for a few days (or even a week) every now and then.

What I noticed in US is that people are very touchy about being uncomfortable. Doctors are supposed to "fix" problems and make things "comfortable". This usually means "give me antibiotics to kill this infections as fast as possible" and "give me more pain pills, I don't want to feel any slight discomfort". If doctor tells them to drink some hot tea and lay in bed instead they might just switch doctors who will give…

Yeah, that's a pretty broad brush. I don't even like to take Aspirin or Ibuprofen unless I have to, and I'm not the only one like that.

Also, I've noticed that some of my fellow Generation Y'ers have arrived at similar opinions by observing the issues that come with the over-medication of their parents/grand parents into old age. Doctors love to prescribe stuff, and sometimes the interactions between drugs is so bad that it can be pretty scary. Observing this as a third party can be enough to make you wary about over-using medication. It's also expensive and our health insurance situation over here is awful.

tl;dr, Yes, that's a huge generalization. I think a lot of younger Americans are starting to bend back the other way towards only medicating when necessary after seeing how much a can of worms it can be when used as a crutch.

Re: CDC Threat Report: ‘We Will Soon Be in a Post-Antibiotic Era’

#96

Post by MartinCron » Tue, Sep 17, 2013, 6:09 PM UTC

jessriedel wrote: post #88

jacquesm wrote: post #21

Antibiotics are now so widespread in use that you can detect them in the ground water and in the oceans. http://sustainability.formas.se/en/Issues/Issue-3-November-2... http://www.sciencedaily.com/releases/2007/08/070821153926.ht... MRSA is just one small example of what the future holds if we don't manage this carefully, we're actually exerting evolutionary pressure on the one adversary that holds a serious trump ca…

> Antibiotics are now so widespread in use that you can detect them in the ground water and in the oceans. "Detectability" is a silly metric which tells you nothing about this issue. Molecules are really, really, ridiculously small. Most of the breaths you take contain atoms from Caesar's last gasp, but that doesn't tell you anything useful about the prevalence of Caesar.

It's the same kind if silly metric that is sticky, resonant, and evocative. If you want people to care about what you have to say, it's a smart strategy, especially if you back it up with meaningful analysis.

Re: CDC Threat Report: ‘We Will Soon Be in a Post-Antibiotic Era’

#97

Post by sagarm » Tue, Sep 17, 2013, 6:13 PM UTC

protomyth wrote: post #92

aluhut wrote: post #33

I grew up in a former East Block country. Back then we had medical centers. If you were sick, you went there and they gave you something. Most of the time the solution was: Antibiotics. Because I was sick quite often, I can say I grew up on Antibiotics. When we moved to West Europe my mother made the mistake of chosing a doctor from our country (so she could uderstand what she says). So I continued to get antibiotics…

IHS (Indian Health Service) would give you anti-biotics when it suspected strep throat (or any other sickness) they would prescribe anti-biotics even though their tests would take 3 days[1]. If it wasn't strep, they wouldn't tell you to stop taking the anti-biotics. Glad to see we followed the practices of East Block countries. 1) send to government contracted lab, get sample test, send back result - gotta love gover…

If you start an antibiotic course, it's important to finish it. Otherwise you will have exerted some selective pressure on bacteria in your body without making sure you killed them all, leaving only the resistant bacteria to flourish.

Re: CDC Threat Report: ‘We Will Soon Be in a Post-Antibiotic Era’

#98

Post by MartinCron » Tue, Sep 17, 2013, 6:17 PM UTC

VikingCoder wrote: post #82

stingraycharles wrote: post #10

Earlier quoted context omitted.

People aren't the problem; it's the food industry that abuses antibiotics the most. When a pig gets ill, it's way cheaper to give her a dose of antibiotics instead of getting a vet.

You just (unintentionally) said that capitalism is the problem. If people were willing to pay for antibiotic-free meat, then farmers would produce it. They would call the vet, and maybe destroy the pig rather than treat it with antibiotics. By the way, you're naively presuming they're using antibiotics when the pig gets sick. Nope, they're using them prophylactically.

Antibiotic resistance should be seen as a negative externality of our food system, just like pollution.

In the meantime, I will keep buying antibiotic-free meats whenever I can.

Re: CDC Threat Report: ‘We Will Soon Be in a Post-Antibiotic Era’

#99

Post by j_baker » Tue, Sep 17, 2013, 6:53 PM UTC

haldujai wrote: post #94

j_baker wrote: post #87

Earlier quoted context omitted.

but phage evolve along with the pathogen. How do you prevent the phage from evolving to target the human cells?

(Bacterio)phages target bacteria only by nature, there are several mechanisms that prevent them from targeting human cells. They recognize bacterial membranes and not human, their replication mechanisms don't work in human cells and our cells have defenses against them. In short it would take a great amount of evolution to make them target human cells in the order of thousands of years at least due to the several exi…

Fair enough, but I suspect "thousands of years" of evolution may come very quickly if phages were to be used half as widely as antibiotics are.

Besides that, not all of the cells bacteriophages could harmfully target are human cells. What about the billions of gut bacteria in our digestive tract?

Re: CDC Threat Report: ‘We Will Soon Be in a Post-Antibiotic Era’

#100

Post by freshhawk » Tue, Sep 17, 2013, 7:06 PM UTC

smackay wrote: post #9

rurounijones wrote: post #7

while post anti-biotic sucks for humans directly. What about post-antibiotic for livestock which forms our food sources. If we can no longer raise as many cattle, pigs, sheep etc. then what are the global implications.

Quite simple: healthier humans and more sustainable agriculture. From Yahoo Answers: it takes 17 kilos of corn, beans, grains, etc, to produce one kilo of beef in feedlot cattle. Having a large proportion of meat in one's diet is not the most efficient use of the available (limited) resources we have.

> Quite simple: healthier humans and more sustainable agriculture

After a significant number of humans die, quite probably yes.