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Dr. Arjun Srinivasan: We’ve Reached “The End of Antibiotics, Period”

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Re: Dr. Arjun Srinivasan: We’ve Reached “The End of Antibiotics, Period”

#291

Post by marcosdumay »

snake_plissken wrote: post #98
erichurkman wrote: post #11

Earlier quoted context omitted.

> Now we have no weapons; we're helpless and the world is again going to be a scary place where a cut or a scrape can land you in a hospital or in a mortuary. Perhaps most terrifying is that the mere act of hospitalization will likely be the highest vector of transmission of nearly untreatable infections. Go in for a routine procedure and end up in the isolation ward due to some highly infectious, deadly disease.

This is what I don't completely understand. Why has no one developed a disinfectant spray that hospitals can apply ad-nauseum (pun intended, the smell ideally wouldn't make people nauseous) all over the hospital? Or, do I not understand the vectors properly? The way I perceive these stories is that hospitals are actually extremely dirty on a microbial level (as is most of the world), it's just counter-intuitive becau…

That kind of solution is part of the problem. Resistent bacteria are normaly outcompeted by non-resistant ones, except when there is antibiotics on the enviroment. As a consequence, the mere act of keeping something always sterilized (as well as possible) helps the resitent bacteria growth.

But, of course, you can't avoid keeping a hospital sterilized.

Re: Dr. Arjun Srinivasan: We’ve Reached “The End of Antibiotics, Period”

#292

Post by marcosdumay »

erichurkman wrote: post #11
AaronFriel wrote: post #6

For the past half century, we should have been treating our antibiotics like weapons of mass destruction - tools of last resort only to be used in emergencies, with great hesitation, and only when absolutely necessary. The industry and the doctors responded: antibiotics were too profitable and the risk seemed too distant. Now we have no weapons; we're helpless and the world is again going to be a scary place where a…

> Now we have no weapons; we're helpless and the world is again going to be a scary place where a cut or a scrape can land you in a hospital or in a mortuary. Perhaps most terrifying is that the mere act of hospitalization will likely be the highest vector of transmission of nearly untreatable infections. Go in for a routine procedure and end up in the isolation ward due to some highly infectious, deadly disease.

Maybe the solution is to have the procedure in a place that is a hospital. You'd want some environemnt that isn't shared by other sic people, and is only sporadically sterilized.

Yep, I have no idea how to actualy do that. There are all kinds of issues, but I'd guess that you can solve nearly all of them with tech.

Re: Dr. Arjun Srinivasan: We’ve Reached “The End of Antibiotics, Period”

#293

Post by mistercow »

resu_nimda wrote: post #197
mistercow wrote: post #138

Earlier quoted context omitted.

I'm slightly bugged by "desire" type language because it does actually cause problems in how laymen think about evolution. It's not uncommon to hear them make the mistake of thinking evolution will "think ahead". But the bigger problem I have with it is the "anything we do ... bacteria will eventually discover". Some problems are just very difficult to evolve around, and it's hard to predict what they'll be even if y…

Evolution is actually a really crappy optimization algorithm. The reason it has worked so well is not that it is so effective, but because it's the only game in town. It took evolution billions of years to make machines that can run 60 miles per hour. You come off as being dismissive of the power and beauty of evolution, although I don't think that's your intent. Evolution assembled the most complex system known to e…

Sure, but the main power and beauty of evolution is a direct result of the fact that it is an optimization algorithm. The fact that such an algorithm could just happen is astounding (although possibly inevitable, if universes are common and varied).

If I come across as cynical about this, it's a response to the way evolution as a process has been fetishized by people who don't understand it. People look at the application of evolutionary algorithms to solving difficult problems and conclude that evolution is smarter than humans. But evolution's power really comes from its dumbness. It works without understanding the problem, and so it can be used to solve problems we don't understand very well. But when we learn how to model a problem intelligently, we're generally able to crush the results of evolution.

Re: Dr. Arjun Srinivasan: We’ve Reached “The End of Antibiotics, Period”

#294

Post by Fomite »

uptownJimmy wrote: post #278
waps wrote: post #270

Earlier quoted context omitted.

So much wrong with this post: > There is a testable prediction here of course: either bacteria outrun human antibiotic development or they do not. I'm confident that more bacterial lineages will be wiped out before human medicine is seriously compromised by natural selection of bacteria that are resistant to most antibiotics used in human medicine. Do a dumb test. Walk into your nearest hospital, I don't even want to…

Much of this is nonsense. This, for instance: "If you get infected with a deadly viral disease, like rabies, it's curtains. There's nothing any hospital can do for you except sedate you until you're dead."

Umm...rabies pretty much is curtains. If we miss the postexposure prophylaxis window, the fatality rate for rabies is indistinguishable from 100%

Re: Dr. Arjun Srinivasan: We’ve Reached “The End of Antibiotics, Period”

#295

Post by Fomite »

ceol wrote: post #281
waps wrote: post #270

Earlier quoted context omitted.

So much wrong with this post: > There is a testable prediction here of course: either bacteria outrun human antibiotic development or they do not. I'm confident that more bacterial lineages will be wiped out before human medicine is seriously compromised by natural selection of bacteria that are resistant to most antibiotics used in human medicine. Do a dumb test. Walk into your nearest hospital, I don't even want to…

While you're in that hospital, ask what their procedure is if you've been infected with rabies within the past week. It's most certainly not "curtains and sedation." Just that bit of factual nonsense leads me to believe you are speaking far out of your area of expertise.

Yeah, but after that window closes, our treatment options for rabies are essentially Hail Mary, "Well, it's not like it can get any worse..." level treatments.

That's not a big deal in the U.S. because rabies is quite rare, but in the developing world it's still a thing.

Re: Dr. Arjun Srinivasan: We’ve Reached “The End of Antibiotics, Period”

#296

Post by VladRussian2 »

Fomite wrote: post #236
snake_plissken wrote: post #98

Earlier quoted context omitted.

This is what I don't completely understand. Why has no one developed a disinfectant spray that hospitals can apply ad-nauseum (pun intended, the smell ideally wouldn't make people nauseous) all over the hospital? Or, do I not understand the vectors properly? The way I perceive these stories is that hospitals are actually extremely dirty on a microbial level (as is most of the world), it's just counter-intuitive becau…

We do. We have disinfectant sprays, chlorhexidine, bleach, UV radiation shot by Cylon looking robots, and surfaces made of copper and patterned after shark skin. Bacteria are just bloody durable, and people are shedding new bacteria into the environment at really absurd rates.

>We have disinfectant sprays, chlorhexidine, bleach, UV radiation shot by Cylon looking robots, and surfaces made of copper and patterned after shark skin.

And the bacteria which survives all of this, i think it should look something like this:

http://www.imdb.com/media/rm617979392/tt0088944?ref_=ttmi_mi...

Re: Dr. Arjun Srinivasan: We’ve Reached “The End of Antibiotics, Period”

#297

Post by meepmorp »

kintamanimatt wrote: post #274
meepmorp wrote: post #218

Earlier quoted context omitted.

It's your basic (American, right-) libertarian argument against the state doing anything that limits business. I think its application in a case like this nicely encapsulates the flaws in the philosophy, or at least the ability of its adherents to apply it sensibly. Edit for clarity.

What? How did you make that leap from "nobody's gonna beat a vet with a rubber hose" to assuming I'm a hardcore libertarian? I'm for the reduction of antibiotics through government regulation. I think business should be restricted when it comes to doing harm to society. With such a leap, I can only logically assume you replied to the wrong comment.

No, I was responding to you with an observation about the comment above yours. There's nothing about your post that indicates adherence to libertarianism.

Re: Dr. Arjun Srinivasan: We’ve Reached “The End of Antibiotics, Period”

#298

Post by craigyk »

toufka wrote: post #210
jmsduran wrote: post #126

Earlier quoted context omitted.

I have never heard of bacteriophages before. Doing some light research, I found their protein/body structures to look almost machine-like. Very fascinating stuff. From Wikipedia's Bacteriophage page: "Medical trials were carried out, but a basic lack of understanding of phages made these invalid". I seriously hope alternatives like bacteriophages are being revisited and reconsidered within the medical community, as i…

Bacteriophages are very much the answer to the titular problem. Instead of finding tiny little lethal molecules, we will likely end up actually designing machine-like phages to kill the causes of our illnesses. They're easy to select for, quite good at what they do, and are some of the most approachable objects in synthetic biology, currently. And they are much more amenable to continued use than the 3 or 4 scaffoldi…

The biggest problem with phages is they can be quite specific. Antibiotics put phage research out to pasture because a single, easy to mass produce small molecules were capable of wiping out enormous varieties of bacteria.

With phages you'd need a large library to counter different bacteria, you'd have to successfully identify the bacteria which is causing the problem which may require culturing. If you wanted to maintain phage effectiveness in a heavily selected environment you'd also need to design phage "reactors" where the phages can be continually evolved against current bacterial populations.

Re: Dr. Arjun Srinivasan: We’ve Reached “The End of Antibiotics, Period”

#299

Post by SiVal »

thenomad wrote: post #285
waps wrote: post #270

Earlier quoted context omitted.

So much wrong with this post: > There is a testable prediction here of course: either bacteria outrun human antibiotic development or they do not. I'm confident that more bacterial lineages will be wiped out before human medicine is seriously compromised by natural selection of bacteria that are resistant to most antibiotics used in human medicine. Do a dumb test. Walk into your nearest hospital, I don't even want to…

As others have mentioned, in fact the incidence of MRSA has declined significantly over the last few years, down 50%: http://www.cdc.gov/mrsa/statistics/ (Center for Disease Control) And the numbers of infections were far lower than you're claiming here - rather than approximately 20,000 in 100,000 as claimed above, the numbers (in 2011) were 4.5 in 100,000. http://uk.reuters.com/article/2013/09/16/us-hospital-mrsa-i…

Yes, MRSA has declined, but not because of improved treatments. Now that we can no longer kill these bugs after they invade the body, hospitals have significantly ramped up their efforts to kill them before they invade.

Hurray for these protocols, but that won't do all that we need. It won't be possible to scrub the whole world with poisons the way we have begun scrubbing hospital rooms. We need ways to stop infections that we can't prevent.

Re: Dr. Arjun Srinivasan: We’ve Reached “The End of Antibiotics, Period”

#300

Post by amerika_blog »

tokenadult wrote: post #70

The interviewed expert has very good credentials and clinical experience to be talking about what he is talking about, and his warnings should be taken seriously. But even at that, the fallacious teleological language he uses about biological evolution by natural selection suggests a way out of this problem. When he says, "Bacteria, like any living organism, want to survive," and "So anything that we do to try and ki…

You've confused a figure of speech with a point of argument.

cf. "Information wants to be free."

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