Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

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

pbs.org

Post reply on HN
Print view View original

401–410 of 414 posts

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

#401

Post by ctdonath »

vacri wrote: post #348
ctdonath wrote: post #148

Earlier quoted context omitted.

It's the threat thereof that persuades compliance. If you try hard enough to do & keep doing something illegal, there is no limit which the state is unwilling to go to in coercing compliance.

Nonsense. Jaywalking is illegal, I do it every day, and have done for most of my 40 years on this planet. The state hasn't yet seen fit to bother coercing my legal compliance in this matter. It's hardly going to unlimited lengths to stop this illegal activity.

I didn't say it would go that far, I said there was no limit to how far it might should it choose to. There are plenty of horror stories regarding jaywalking prohibition enforcement. In some places, the state does indeed go to remarkable lengths to stop that activity.

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

#402

Post by waps »

Fomite wrote: post #389
robbiep wrote: post #358

Earlier quoted context omitted.

Firstly, there's a real difference between rates of MRSA colonisation and rates of MRSA infection, which implies a pathological process at work. Secondly, what on earth do you mean when you say we lost the fight against viruses a decade ago' ? We have only got better at treating viruses; we had almost no treatment for viruses a decade ago and we have some treatments now; for example we are now much better at treating…

I'm also curious as to how any period where we "Lost the fight against viruses" also includes the elimination of Rinderpest.

All the generic virus drugs we had have been eliminted : pretty much all existing viruses are eliminated and we have lost the ability to heal, for example, heal elderly or children infected with the flue (the groups at risk of dying from the disease).

We do not have any drug against any retrovirus (ie. a family of viruses) to which viruses do not show at least partial resistance.

As for the AIDS case, prevention of AIDS has pretty much failed in Africa and the middle east, as well as in significant parts of Asia. It is a matter of a decade or so until ~80% of those populations are HIV positive and the rest of the world will follow in the next few decades. All currently know anti-AIDS drugs will cease being effective in 5 years or less, and the rate of adaptation that the virus exhibits is still accelerating (we wouldn't be able to keep up with the current rate, so sadly, that doesn't even matter).

This is of course assuming we don't have another pandemic like the Spanish flue. We have had several near-pandemic panics in the past decade and all incidents have one thing in common : we failed spectacularly at containment. If, for example, bird flue had been ~6% more infectious than it was, it would have killed ~20% of the world's population (at least), and would have reaped >90% of it's death toll before a vaccine would become available. Absolutely nothing would have stopped it. Bird flue itself was only one of 5 incidents that could have exploded into a pandemic. The big message of these incidents: yes, they stopped, hurray. Sadly it wasn't us who stopped it (but rather small flaws in the virus' design).

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

#403

Post by dsizzle »

mtdewcmu wrote: post #227
vidarh wrote: post #152

Earlier quoted context omitted.

Killing bacteria is easy. The trick is killing bacteria without harming ourselves. Soaps can be massively more "brutal" in terms of the mechanisms that destroy bacteria than what antibiotics can, and so the evolutionary steps that would have to occur for resistance are vastly larger, and would mean changing them in many different directions. E.g. it does not help if a bacteria can survive a soap if it is still physic…

Handwashing with soap doesn't actually kill bacteria, it mechanically dislodges the oils and debris that bacteria are embedded in on your skin and rinses them down the drain. So bacteria have no defense.

The ability to burrow in between cells and to have more adhesive surfaces seem like two possible defenses bacteria already vary in and could evolve better. (Surely handwashing doesn't remove 100% of bacteria.) One reason this doesn't pose problems similar to antibiotic resistance is that this defense doesn't become a useful strategy inside the body, where infections are problematic for humans.

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

#404

Post by dsizzle »

Fomite wrote: post #229
dsizzle wrote: post #169

Earlier quoted context omitted.

Ignoring the snark (of the parent comment), I've often wondered why it was bad to use anti-bacterial soap (and antibiotics in general), but not regular soap, since both leave some amount of bacteria behind, which presumably have genetics making them more resistant to the pressure. I think part of the answer is that its just not possible to evolve resistance to any amount of soap and hand washing, unlike resistance to…

I'll take a stab at this - I'm an infectious disease epidemiologist that works on hospital infections mostly. The thing with anti-bacterial soaps is not that the use of the soap is bad. The problem is the anti-bacterial part. It puts amounts of a broad spectrum antibiotic into the environment (be it your hands, your countertop, or the water system) in concentrations that aren't enough to do much, but are enough to pu…

Bacteria evolving to secrete a soap-resistant compound doesn't sound far-fetched at all. Such compounds clearly exist already (e.g. pigments that don't wash off).

Thinking about this more, I suspect there already has been some selection in this direction, but that it has little to no public health impact, as this defense is not useful in places where infections are typically a problem. Indeed, our body is teeming with bacteria (mainly in the guy) that are in fact beneficial, and they've presumably managed some resistance to shear stress and extreme chemical environments (e.g. high acid).

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

#405

Post by Fomite »

waps wrote: post #402
Fomite wrote: post #389

Earlier quoted context omitted.

I'm also curious as to how any period where we "Lost the fight against viruses" also includes the elimination of Rinderpest.

All the generic virus drugs we had have been eliminted : pretty much all existing viruses are eliminated and we have lost the ability to heal, for example, heal elderly or children infected with the flue (the groups at risk of dying from the disease). We do not have any drug against any retrovirus (ie. a family of viruses) to which viruses do not show at least partial resistance. As for the AIDS case, prevention of A…

There is a staggering amount wrong with this statement. Staggering.

- The prevention of HIV in developing countries is hampered not by the ineffectiveness of drugs, but the expense and difficulty administering them. HIV in the developed world is, in many cases, now essentially a chronic disease. Indeed, it is the use of HAART drugs to prevent transmission in discordant couples that is providing a glimmer of hope for reducing the burden of HIV without a vaccine.

- While serious, prevalence of HIV is nowhere near 80%. Also, increasing prevalence is a function of disease duration, so better treatments will, mathematically, cause prevalence to rise.

- I'd contest rather strongly that we failed spectacularly at containment for several recent outbreaks.

- Antiviral drugs are not our only means of fighting viruses. If "Anti-X drugs" were the solution, we'd have eliminated many bacterial diseases - we haven't. The key to fighting viruses is vaccination, and we've wiped two viruses off the face of the earth, and are largely facing political/social problems, rather than scientific ones, with adding two more to that tally.

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

#406

Post by quasque »

vacri wrote: post #303
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…

Also, most "life" functions of a human body, like breathing, metabolism, ... are actually performed by symbiotic bacteria on our behalf. Human cells can't actually do it themselves Breathing? Where are the bacteria in the gas-exchange process? And 'metabolism' is a catch-all term that refers to so many different chemical reactions, plenty of which are conducted within the human cells themselves.

He probably confused cellular respiration with physiological respiration, and thus incorrectly conflated the primary purpose of the mitochondria with the physical act of breathing.

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

#407

Post by alan_cx »

alan_cx wrote: post #110

This is not my thing at all, so this might be a really silly question, but... Are people who have avoided prescribed antibiotics in a better position than those who haven't? Then, what is the effect on such people of the antibiotics taken in by eating meat from animals which have been give antibiotics? Have the people who have been avoiding completely wasted their time?

Just to say thanks for the replies. Im now a fair bit less clueless than I was !!!

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

#408

Post by einhverfr »

gnaritas wrote: post #400
einhverfr wrote: post #375

Earlier quoted context omitted.

It's far worse than that. Not on;y is it not possible to have semantic communication without a general agreement on the meaning of words, but at the same time perfect agreement is impossible. This is generally understood (and has been understood for a hundred years) to be one of the causes of linguistic drift. Humans aren't computers.

No they aren't, which is why it's even more important to make sure we're actually talking about the same things. Semantics matter. I tire of people insisting that I know what they mean when what it's not what they said. I don't read minds, I hear words; the words you choose have meanings and those meanings matter if you want to convey your ideas to me.

> which is why it's even more important to make sure we're actually talking about the same things.

To some extent, but it is also impossible to do so perfectly.

> Semantics matter.

Semantic agreement is limited to the actual parties to the communication, and by location, place, time, and social context. You wouldn't explain something to a 5 year old the way you would a 25 year old and the same basic problems occur when you cross cultural or temporal boundaries.

When linguists discuss language, they usually start by pointing out that human language is defined by usage, not by prescriptions regarding definitions or grammar. This is a critical difference between natural languages and computer languages. Computer languages rigidly conform to specifications. Natural languages only approximate the rules we use to describe them.

So I think you are expecting too much from human communications.

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

#409

Post by rodw »

dylandrop wrote: post #154
rodw wrote: post #121

Earlier quoted context omitted.

The function of antibiotics in agriculture isn't to prevent infection (or at least, not primarily to prevent infection) but to fatten the animals up for slaughter.

I still don't think that justifies the use of them.

Nor do I.

I'm just pointing out that the antibiotics aren't strictly being used for disease-prevention (hence better hygiene alone might not eliminate their use).

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

#410

Post by rodw »

aestra wrote: post #256
rodw wrote: post #121

Earlier quoted context omitted.

The function of antibiotics in agriculture isn't to prevent infection (or at least, not primarily to prevent infection) but to fatten the animals up for slaughter.

How exactly does antibiotics fatten animals up for slaughter?

To be honest, I have no idea.

User shabble has some ideas (in a sibling comment to this one), but reading that gives me the impression that this is a little bit of a theoretical concept. It's not. It's very widely practiced, with the explicit intent of "promoting growth".

E.g., a search like [1] calls up a large number of references to it.

[1] https://www.google.com/search?q=how+do+antibiotics+fatten+an...

Post reply on HN