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More people died of superbacteria in 2019 than HIV or malaria, study suggests

edition.cnn.com

11–20 of 32 posts

Re: More people died of superbacteria in 2019 than HIV or malaria, study suggests

#11
post #3

My hope is that phage therapy can solve the issue of drug-resistant bacteria. Also we really need to get our things together and work against misuse of antibiotics.

I did a pharmacy degree circa 1983-87 in the UK.

Antibiotic resistance was already a pressing problem. Penicillin-V was little more use than a placebo as of 1984; Amoxicillin was in danger, MRSA was already out there. The big short-term hope was Augmentin (Amoxicillin/clavulanic acid) -- clavulanic acid was a beta-lactamase inhibitor, beta-lactamase being the primary pathway for penicillin resistance in bacteria, so it was somewhat effective against penicillin-resistant infections. But resistance was already showing up for almost every antibiotic on the market except vancomycin (which is pretty nasty stuff, toxicity-wise). Today, resistance to vancomycin and other antibiotics of last resort is a thing. So there are infections out there that will kill you gruesomely, just as there were in the 19th century and earlier, because we collectively dropped the ball.

As with anthropogenic climate change, the writing has been on the wall for decades -- and has been systematically ignored by policy-makers. Adding antibiotics to animal feed improves weight gain in farm animals so farmers still shovel the stuff by the bucketload. But it also applies a selection pressure for antibiotic resistance to the bacteria infesting those animals, and when they go to the slaughterhouse the resistant strains migrate into the human reservoir.

And this says nothing about the structural incentives to discount antibiotic R&D in the commercial pharmaceutical industry. (Bluntly: they're not profitable enough to bother with, because bacterial infections are acute disease -- you cure it in a few days or weeks, your customer goes away satisfied. Unlike antidepressants or anti-hypertensives or diabetes meds, which the patient is typically on for years to life.)

We should have restricted access to antibiotics the way we (try) to restrict opiates. Failing that we should have government funded R&D via non-profits. Only now it's too late and corrective action won't take effect for years.

Re: More people died of superbacteria in 2019 than HIV or malaria, study suggests

#12
Well. There are two old St.Aureus vaccines which, in combination, allowed me to eradicate MRSA which I got during a hospital stay. One these vaccines was created long time ago in USSR for veterinary workers, another one - to treat skin infections in babies. Both are still produced and available though most of the doctors are not aware of them. Both, of course, were never tested in proper trials.

Not like anyone cares.

https://www.rlsnet.ru/tn_index_id_5850.htm

https://www.vidal.ru/drugs/therapeutic_staphylococcal_vaccin...

Re: More people died of superbacteria in 2019 than HIV or malaria, study suggests

#13
post #8
post #3

My hope is that phage therapy can solve the issue of drug-resistant bacteria. Also we really need to get our things together and work against misuse of antibiotics.

Why a phage therapy is not widespread?

complex. it is made per bacteria type as far as I know and it does not scale like a chemical compound.

Re: More people died of superbacteria in 2019 than HIV or malaria, study suggests

#14
post #8
post #3

My hope is that phage therapy can solve the issue of drug-resistant bacteria. Also we really need to get our things together and work against misuse of antibiotics.

Why a phage therapy is not widespread?

1. "Not invented here" (western medical practice largely ignored the USSR, where phage treatments were a big thing: journals didn't get translated, treatments didn't get picked up).

2. Not profitable. They were developed in the Soviet bloc hence not patented but it would have invalidated any patent in the west, so there was no lucrative monopoly to pursue.

After the collapse of the USSR western antibiotics flooded in; the home-grown technique (which was somewhat time-consuming and expensive: matching a phage to an infection requires lab work and specialist facilities) was undermined and fell into disuse.

Re: More people died of superbacteria in 2019 than HIV or malaria, study suggests

#15

Well. There are two old St.Aureus vaccines which, in combination, allowed me to eradicate MRSA which I got during a hospital stay. One these vaccines was created long time ago in USSR for veterinary workers, another one - to treat skin infections in babies. Both are still produced and available though most of the doctors are not aware of them. Both, of course, were never tested in proper trials. Not like anyone cares…

Interesting. I wonder on the issues, efficacy, etc.

TB vaccine is troublesome and not that effective, to the point that some debate it should not be used, tetanus seems wildly successful.

(These are the only other bacteria vaccines I know of)

Re: More people died of superbacteria in 2019 than HIV or malaria, study suggests

#16
post #14
post #8

Earlier quoted context omitted.

Why a phage therapy is not widespread?

1. "Not invented here" (western medical practice largely ignored the USSR, where phage treatments were a big thing: journals didn't get translated, treatments didn't get picked up). 2. Not profitable. They were developed in the Soviet bloc hence not patented but it would have invalidated any patent in the west, so there was no lucrative monopoly to pursue. After the collapse of the USSR western antibiotics flooded in…

How can a technique that requires lab work not be profitable?

Re: More people died of superbacteria in 2019 than HIV or malaria, study suggests

#17
post #9

All the health agencies in the world know this is a problem, but are there any actual changes being made to prevent the worst-case scenario? I worry this is the same situation as Covid, where health agencies knew for years hospital capacity was stretched thin, and lo-and-behold, thousands of people die unnecessarily when a new virus arrives because hospital capacity was overwhelmed.

Afaik, one problem is that the health agencies can only do so much. Most antibiotics and antibiotics misuse happens in agriculture where a totally different agency is responsible. Yes, they should foster more research into new drugs, but the main challenge remains prophylactic animal treatment.

It seems like a situation where hospitals could be designed in such a way to reduce the likelihood of creating 'superbacteria.' Certainly some must be better than others?

They could also address society generally having poor health - If the CDC pounded the table about unhealthy foods/the obesity epidemic I'm sure it could move the needle in some way. Addressing the obesity epidemic would be killing 100+ birds with one stone.

Re: More people died of superbacteria in 2019 than HIV or malaria, study suggests

#18
post #5

> Our approach can be divided into five broad components: number of deaths where infection played a role, proportion of infectious deaths attributable to a given infectious syndrome, proportion of infectious syndrome deaths attributable to a given pathogen, the percentage of a given pathogen resistant to an antibiotic of interest, and the excess risk of death or duration of an infection associated with this resistanc…

[deleted]

Re: More people died of superbacteria in 2019 than HIV or malaria, study suggests

#20

By "superbacteria" I mean "drug-resistant bacteria". I linked the original study, but I saw it Spanish national media, and then here: https://edition.cnn.com/2022/01/19/health/bacterial-antimicr...

The HN guidelines ask submissions not to edit the title except for certain narrow exceptions. Also, here's a BBC article on the topic: https://www.bbc.co.uk/news/health-60058120

The title was from the cnn.com article. I've changed to that now from https://www.thelancet.com/journals/lancet/article/PIIS0140-6... - usually the best choice for studies like this is to link to the best third-party article and link to the paper in the thread.
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