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

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

#101

Post by tedunangst »

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…

How long did bacteria and penicillin coexist? Thousands of years? Then practically overnight the bacteria decided they needed to evolve...

I don't think evolution always works according to the popular "and then the next giraffe's neck was 1mm longer than its parents'" gradual change model.

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

#102

Post by [deleted] »

gknoy wrote: post #77
vidarh wrote: post #71

Earlier quoted context omitted.

I'm Norwegian. Norwegian doctors at least used to be extremely careful about anti-biotics. I now live in the UK, and the doctors here often prescribe anti-biotics after telling us we most likely have a viral infection. I think the main thing is to challenge them to explain why. If they can't give a coherent explanation, ask them to explain to you what they think the risks are of waiting. Most of the time when doctors…

Thank you for outlining the basics of how we can ask questions of our doctors without feeling (or sounding) like we are saying "I don't trust you to know what you're doing". As you point out, often the doctors DO have reasons, but sometimes they might do it because if they don't, other patients will complain that the doctor "didn't do anything". When we're sick or worried, it's easy to forget to ask these questions.…

[deleted]

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

#103

Post by rdtsc »

astrodust wrote: post #73
rdtsc wrote: post #53

Earlier quoted context omitted.

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…

It's ironic this attitude comes from the same country that tells you to "man up and walk it off" for just about anything.

"man up and walk it off" is what we tell others

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

#104

Post by lutusp »

tedunangst wrote: post #101
haldujai wrote: post #94

Earlier quoted context omitted.

(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…

How long did bacteria and penicillin coexist? Thousands of years? Then practically overnight the bacteria decided they needed to evolve... I don't think evolution always works according to the popular "and then the next giraffe's neck was 1mm longer than its parents'" gradual change model.

> How long did bacteria and penicillin coexist?

In different places, not an issue. It's only when penicillin is directly applied to a bacterial colony is there any chance for bacterial evolution to take place.

> Then practically overnight the bacteria decided they needed to evolve

You mean, when humans applied penicillin to bacteria on a large scale for the first time? That changed the bacteria's environment, most died, except those naturally resistant. It's classic natural selection.

> I don't think evolution always works according to the popular "and then the next giraffe's neck was 1mm longer than its parents'" gradual change model.

But one can argue that evolution almost never works, on the ground that the vast majority of mutations aren't adaptive. But the argument misses the point that some tiny fraction of the mutations become the entire future species because of increased reproductive fitness.

Also, the "gradual change" you describe normally arises because of the odd beneficial mutation, which, apart from being very improbable, might require many thousands of years to manifest itself.

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

#105

Post by gtaylor »

astrodust wrote: post #73
rdtsc wrote: post #53

Earlier quoted context omitted.

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…

It's ironic this attitude comes from the same country that tells you to "man up and walk it off" for just about anything.

I think this is probably more of a TV/movie thing than much based in reality. We're no tougher than anyone else, but I could see how you may think we see ourselves as such if you just watch our movies/shows.

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

#107

Post by coryrc »

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?

You don't take phages back out of the person, so the source is not under evolutionary pressure to affect humans -- each batch is "seeing" humans for the first time.

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

#108

Post by protomyth »

sagarm wrote: post #97
protomyth wrote: post #92

Earlier quoted context omitted.

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.

Didn't know that - wouldn't have mattered much, they never really followed up. I do wonder how many people took anti-biotics for no good reason.

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

#109

Post by astrodust »

gtaylor wrote: post #105
astrodust wrote: post #73

Earlier quoted context omitted.

It's ironic this attitude comes from the same country that tells you to "man up and walk it off" for just about anything.

I think this is probably more of a TV/movie thing than much based in reality. We're no tougher than anyone else, but I could see how you may think we see ourselves as such if you just watch our movies/shows.

You'd think that's true, but then again, look at how badly veterans are treated, especially those with deep psychological problems like PTSD.

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

#110

Post by astrodust »

jtheory wrote: post #61

Evolution is such an important concept for people in general to understand. Bacteria evolve based on environmental factors (like varying levels of antibiotics), and that's eventually a very bad thing. Viruses evolve as well, and the nasty viruses that we could eradicate entirely if we had good global vaccination coverage instead -- for a host of often-silly reasons -- get to explode in numbers in various outbreaks. E…

What we need is more research into bacteriophages, viruses that prey exclusively on bacteria, to combat the bacteria we don't want.

The enemy of our enemy is our friend.

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