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New antibiotic kills off persistent infections

phenomena.nationalgeographic.com

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Re: New antibiotic kills off persistent infections

#71

Post by ImprovedSilence »

_Adam wrote: post #29
AaronFriel wrote: post #11

The most understated portion of the article is that there is a method discovered that can kill biofilms. The discovery of new antibiotics and delivery techniques leaves me less optimistic for long-term change in the availability of life-saving antibiotics. I suspect bacteria can, and will, evolve around almost any mitigating technique we develop. Yet I'm optimistic, because tools that crack biofilms are a new are of…

>I suspect bacteria can, and will, evolve around almost any mitigating technique we develop. That's a baseless suspicion. Bacteria are ultimately bound by physical laws, and while they've proven resilient, there's no reason to suggest we will be unable to develop the means to annihilate them at will. Humans are creative - bacteria just evolve fast. I agree about the importance of the biofilm claim, but what they don'…

killing bacteria alone isnt a problem. Killing bacteria while keeping a human alive starts to complicate the problem. Killing certain bacteria while keeping a human and the rest of said humans helpful bacteria alive but not resistant to anti-bodies, is a whole different ballgame...

Re: New antibiotic kills off persistent infections

#72

Post by brandoncarl »

evacuationdrill wrote: post #61
brandoncarl wrote: post #45

Earlier quoted context omitted.

That's actually a bit of a dated response: See recent study on Rhesus monkeys: http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjourna... The "no bacteria" perspective is usually based off of IDSA guidelines. Unfortunately, they've been successfully litigated against for providing incorrect information that appear to be linked to financial interests: "My office uncovered undisclosed financial interests held by s…

"Pursuant to their agreement with Blumenthal the IDSA guidelines were reviewed by an independent panel subject to strict conflict-of-interest guidelines and vetted by a medical ethicist. The panel supported the original IDSA guidelines, finding that "chronic Lyme disease" and "post Lyme syndrome" lack clear definitions and convincing biological evidence. Further, the report emphasized that several prospective clinica…

I've watched my mother suffer from this for 20+ years. She initially had a doctor that treated her for 3 years with very strong antibiotics. She made remarkable progress. The doctor left practicing for personal reasons and subsequently she couldn't find good medical help. Her condition deteriorated over the years.

While the CDC doesn't seem to dismiss symptoms, I've watched dozens of doctors dismiss her. I've received calls from dozens of people who all have the same set of symptoms. I've also seen people get better only after years of antibiotic treatment, and slowly at that. My friends in medical school have indicated that they receive about two hours of Lyme-related training during their education.

The issue that you have is three-fold:

1. Ticks often carry multiple infections (Borrelia Burgdoferi, Bartonella, Mycoplasma, and Babesiosis). Each of these infections can leave the immune system in a dysfunctional state. Most studies only focus on treatment of BB, leaving the other infections untouched.

2. Given that, for the toughest cases, years of antibiotics may be needed, it is extremely difficult to keep studies "controlled". i.e. a week long study may not have much variability, but over a two-year study, a lot happens. The noise increases relative to the signal.

3. BB has very high genetic variability. This leads to the potential for larger numbers of strains, with over 200 thought to be in existence.

I'm not contesting that this isn't well-understood. In fact, I fully agree with that. But statements like there is little to no evidence that Chronic Lyme exists are inappropriate. This is an area that has historically been underfunded, and it has a pretty rich history of controversy. We can fight over nomenclature all day long, but that doesn't change the fact that a lot of people are suffering, and the broader medical community is woefully uninformed.

Re: New antibiotic kills off persistent infections

#73

Post by brandoncarl »

Fomite wrote: post #47
brandoncarl wrote: post #45

Earlier quoted context omitted.

That's actually a bit of a dated response: See recent study on Rhesus monkeys: http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjourna... The "no bacteria" perspective is usually based off of IDSA guidelines. Unfortunately, they've been successfully litigated against for providing incorrect information that appear to be linked to financial interests: "My office uncovered undisclosed financial interests held by s…

Your "Good summary" is in a journal that's pretty far from what I'd call reputable. The PLOS One article on Rhesus monkeys isn't terribly definitive either - it's a big step between persisting in a host and capable of producing disease without manifesting any laboratory detectable presence. To jump from "This might be a cause" to "Lets treat people with long term courses of antibiotics, which have known and often sev…

Would you agree that a medical journal's impact factor is more important for new research than a summary? I would think that for a summary the quantity and quality of the references is a bigger factor.

As far as the clinicians, having a lot of family experience with the disease, I've seen things far differently. This in addition to support groups, phone calls, etc. We're not going to get anywhere debating experience, just letting you know that it happens a lot.

Re: New antibiotic kills off persistent infections

#74

Post by brandoncarl »

evacuationdrill wrote: post #60
Fomite wrote: post #30

Earlier quoted context omitted.

Doubtful, as there's little to no scientific evidence that Chronic Lyme Disease is actually a bacterial infection.

Hm, that's interesting. "Approximately 10 to 20% of patients treated for Lyme disease with a recommended 2–4 week course of antibiotics will have lingering symptoms of fatigue, pain, or joint and muscle aches. In some cases, these can last for more than 6 months. Although often called 'chronic Lyme disease,' this condition is properly known as 'Post-treatment Lyme Disease Syndrome' (PTLDS). The exact cause of PTLDS i…

That's fair, but keep in mind that the CDC this year revised their estimates of people with Lyme 10x. This suggests that they've had a strained understanding of the problem.

http://www.pbs.org/newshour/bb/health/july-dec13/lyme_08-20....

Re: New antibiotic kills off persistent infections

#75

Post by coldtea »

ImprovedSilence wrote: post #71
_Adam wrote: post #29

Earlier quoted context omitted.

>I suspect bacteria can, and will, evolve around almost any mitigating technique we develop. That's a baseless suspicion. Bacteria are ultimately bound by physical laws, and while they've proven resilient, there's no reason to suggest we will be unable to develop the means to annihilate them at will. Humans are creative - bacteria just evolve fast. I agree about the importance of the biofilm claim, but what they don'…

killing bacteria alone isnt a problem. Killing bacteria while keeping a human alive starts to complicate the problem. Killing certain bacteria while keeping a human and the rest of said humans helpful bacteria alive but not resistant to anti-bodies, is a whole different ballgame...

>killing bacteria alone isnt a problem. Killing bacteria while keeping a human alive starts to complicate the problem.

Thank you Captain Obvious.

Re: New antibiotic kills off persistent infections

#76

Post by vxNsr »

JunkDNA wrote: post #18
giarc wrote: post #10

Earlier quoted context omitted.

This won't completely replace traditional antibiotics. As the article states this acts on Gram positive persister cells (a very specific group). The coming storm is from Gram negative bacteria such as Klebsiella, Actinetobacter and Pseudomonas. There is actually very little activity occurring in the field of antibiotic drug discovery and you identified the issue; no money in drugs that someone takes for 14 days and s…

You're right that it's about profits when pharma is involved, but you are wrong about the reason (otherwise vaccines would not exist). I can tell you from firsthand experience that the length of time someone is on a drug makes almost no difference in where research priorities are. The primary issue with antibiotics is that since the late 1990's, if you succeed, and you develop the best antibiotic the world has ever s…

As a citizen of earth and a member of humanity it hurts to hear that people who's very business is saving lives are largely driven by profits for their company and not the goal of the company: saving lives. While I know this naive I wish it weren't.

Re: New antibiotic kills off persistent infections

#77

Post by malandrew »

joe_the_user wrote: post #62
rsync wrote: post #53

Earlier quoted context omitted.

"You can't treat a hospital room with an autoclave" Hmmm... that sounds like an awfully good idea, actually... Build the hospital room with the ability to be airtight, make sure all materials can withstand 134 C (or remove things that can't for their own cleaning) ... and autoclave the room ...

There are simpler things. Like not having mega-hospitals that are impossible to keep entirely clean. Growing up near the UCLA Medical Center, a vast, vast complex, I heard tales that there were diseases that existed there and nowhere else in the world. Most patients derive little benefit from the scale of the hospital and the fact that in a huge hospital getting all rooms clean at once is logistically very difficult…

I'm honestly surprised we don't take a quarantine approach in hospitals. i.e The first sign of an infection gets you shipped out to a specialized hospital building (air gap) designed specifically to be able to keep patients in "solitary confinement" and able to be completely disinfected afterwards.

Re: New antibiotic kills off persistent infections

#78

Post by Fomite »

malandrew wrote: post #77
joe_the_user wrote: post #62

Earlier quoted context omitted.

There are simpler things. Like not having mega-hospitals that are impossible to keep entirely clean. Growing up near the UCLA Medical Center, a vast, vast complex, I heard tales that there were diseases that existed there and nowhere else in the world. Most patients derive little benefit from the scale of the hospital and the fact that in a huge hospital getting all rooms clean at once is logistically very difficult…

I'm honestly surprised we don't take a quarantine approach in hospitals. i.e The first sign of an infection gets you shipped out to a specialized hospital building (air gap) designed specifically to be able to keep patients in "solitary confinement" and able to be completely disinfected afterwards.

...this is what many infectious disease and isolation wards effectively do.

Re: New antibiotic kills off persistent infections

#79

Post by Fomite »

joe_the_user wrote: post #62
rsync wrote: post #53

Earlier quoted context omitted.

"You can't treat a hospital room with an autoclave" Hmmm... that sounds like an awfully good idea, actually... Build the hospital room with the ability to be airtight, make sure all materials can withstand 134 C (or remove things that can't for their own cleaning) ... and autoclave the room ...

There are simpler things. Like not having mega-hospitals that are impossible to keep entirely clean. Growing up near the UCLA Medical Center, a vast, vast complex, I heard tales that there were diseases that existed there and nowhere else in the world. Most patients derive little benefit from the scale of the hospital and the fact that in a huge hospital getting all rooms clean at once is logistically very difficult…

I'm...not sure I agree with most of this.

First of all, the size and scope of the hospital has very little to do with whether or not any particular room can be cleaned. The things that are "hard" to clean in rooms are features of the rooms themselves, not the number of them. For example, even small hospitals have TV remotes, soft and absorbent surfaces like mattresses, toilets, etc.

For that matter, small hospitals can't benefit from the economies of scale that allow large hospitals to have dedicated specialist cleaning teams for high risk rooms, or for that matter dedicated infection prevention staff.

Re: New antibiotic kills off persistent infections

#80

Post by Fomite »

AaronFriel wrote: post #11

The most understated portion of the article is that there is a method discovered that can kill biofilms. The discovery of new antibiotics and delivery techniques leaves me less optimistic for long-term change in the availability of life-saving antibiotics. I suspect bacteria can, and will, evolve around almost any mitigating technique we develop. Yet I'm optimistic, because tools that crack biofilms are a new are of…

There's also some research into surfaces that combat the formation of biofilms.
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