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Thread: The Post Antibiotic Era

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    Persona Oblongata OrionzRevenge's Avatar
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    The Post Antibiotic Era

    on 10/22/13 Frontline (US Public TV's Flagship of In-Depth Reporting) aired a documentary about the ominous threat looming, or rather loose, in the form of Highly Antibiotic Resistant Bacterial pathogens.

    Hunting The Nightmare Bacteria

    Most of us are aware of the issues concerning the Gram Positive Staph strain MRSA, but the emerging issues with Gram Negative pathogens make those issues seem inconsequential.

    An acronym that will almost surely become a household expression is: NDM-1

    http://www.medicalnewstoday.com/articles/197616.php

    NDM-1, which stands for New Delhi metallo-beta-lactamase-1 is a gene (DNA code) carried by some bacteria. If a bacteria strain carries the NDM-1 gene it is resistant to nearly all antibiotics, including carbapenem antibiotics - also known as antibiotics of last resort.

    Carbepenems are the most powerful antibiotics, used as a last resort for many bacterial infections, such as E. coli and Klebsiella. The NDM-1 gene makes the bacterium produce an enzyme which neutralizes the activity of carbepenem antibiotics.

    A bacterium carrying the NDM-1 gene is the most powerful superbug around.

    Put simply:

    NDM-1(New Delhi metallo-ß-lactamase-1) is the gene (the DNA code) found in some types of bacteria
    This gene makes the bacteria produce an enzyme called a carbapenemase - making carbepenem antibiotics ineffective (as well as virtually all other antibiotics).
    Carbepenem antibiotics are extremely powerful and used to fight highly resistant bacteria (when other antibiotics have not worked).
    There are no current antibiotics to combat NDM-1
    There is no research in the pipeline on drugs to combat NDM-1
    A bacterium with the NDM-1 DNA code has the potential to be resistant to all our current antibiotics, as well as new antibiotics which may come into the market in the near future.
    Bacteria sometimes have this nasty habit of open-sourcing their genetic discoveries and distributing them into the surrounding medium for any bacteria, irrespective of strain, to take in and use.

    The Frontline Doc featured a dude having his leg slowly eaten away by 10 different bacterial strains exploiting the NDM-1 resistance. Of course, each of these various strains have different genetics too, and each represents a complication to treatment.

    Benign Gram Negatives make up a goodly amount of our normal flora and you have Godzillions of them on you and in your G.I. track right now. Thus, the chances of any infection containing a rainbow coalition of bugs is extremely high.
    --------------------------------------------------------------------------------

    Dr. Arjun Srinivasan is an associate director at the Centers for Disease Control and Prevention.



    Q: What are [the bacteria] doing? Are they hiding? Are they destroying? What are the weapons that bacteria have to fight the miracle drugs?

    Bacteria have a lot of weapons that they can use to fight off antibiotics. One of the most common ways that they fight off antibiotics is actually just destroying them. They develop what we call enzymes, which is a fancy word for saying something that can chew up, so we put the antibiotic in, and the bacteria produces a chemical that chews it up. It destroys the antibiotic. The antibiotic becomes ineffective.

    The bacteria are surrounded by a wall. They can change that wall in different ways to even prevent the antibiotics from ever getting in in the first place.

    Bacteria also have ways that they can pump the antibiotics out, so even if we can get them past the wall and get them past the chemicals that would chew them up, the bacteria then turns around and just pumps them right back out again.

    And many bacteria have more than one of these weapons simultaneously.

    …Gram negatives have all of these weapons at their disposal, and many of the highly resistant Gram negatives that we see have all of these weapons at once that they’re using.

    …What’s concerning is that what we also see with Gram negatives is that they are able to pick up weapons from their neighbors, if you will.

    I don’t understand

    Resistance, some of these weapons, are carried, if you will, by genes, so the gene is what tells the bacteria how to make the weapon. Some of these genes are now carried on little pieces of DNA that are very movable between one bacteria and another.

    What we’ve seen is that one particular bacteria will develop resistance. It will put that resistance gene onto a little piece of DNA, and it might put a whole bunch of different weapons onto a little piece of DNA. So now you’ve got one piece of DNA that has the code for several of these resistance weapons, these genes, and that can be moved to a different bacteria. …
    Exponentially magnifying the threat is the fact that the Pharmaceutical Companies have pulled out of Antibiotic Research because it might cost a $Billion to bring a new Antibiotic to a Market where the Attitude will be "Great, thanks for giving us a new nuclear option. We'll buy a few units and hope we never have to use it." And even though this situation is well understood, the government never to any significant steps to underwrite Pharmaceutical R&D.

    Pfizer was the last big horse to pull out of the race.

    Dr. Charles Knirsch: Pfizer’s vice president of clinical research.



    Q: In our discussion today, I get the sense that you have to make some very ruthless decisions about where to put the company’s capital, about where to invest, about where to put your emphasis. And there are whole areas where you don’t invest, and I guess the question we’re asking is, do you learn lessons about that? When you pulled out of Gram-negative research like that and shifted to vaccines, do you look back on that and say, “We learned something about this”?

    These are not ruthless decisions. These are portfolio decisions about how we can serve medical need in the best way. …We want to stay in the business of providing new therapeutics for the future. Our investors require that of us, I think society wants a Pfizer to be doing what we do in 20 years. We make portfolio management decisions.
    Frontline requested that United States Secretary of Health and Human Services: Kathleen Sebelius, comment about these issues and...she declined.



    I know she has the hot poker up her ass over ObamaCareless right now, but this is simply inexcusable IMO.

    There are certain things that government can do best, and underwriting this desperately needed research is one of them. I think we should all insure that it is part of the national conversation in the run-up to the 2014 mid-terms.

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    Persona Oblongata OrionzRevenge's Avatar
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    Quote Originally Posted by OrionzRevenge View Post
    ...

    An acronym that will almost surely become a household expression is: NDM-1

    ...[/URL].

    Ok, so the actual household expression has morphed to CRE Superbug.

    Carbapenem resistant enterobacteriaceae

    It's big news currently in LA but it has been reported in 46 states in the US.



    A new British study claims it will be a bigger problem than Global warming by 2050 with 10 million deaths.
    They also estimate that the cost by that date will be $100 Trillion in a world with only $70 Trillion total GDP annually.

    CRE kills about 50% of the infected persons and estimates are that 90% of the victims will be in Africa & Asia.

    http://www.cnn.com/2015/02/19/health...bug-explainer/

    The problem has so much potential for ill because it is not just one species of bacteria but an entire category of Gram-Negative bacteria (many of these species thrive in our guts and on our skin by the billions) that expel this super-resistance-to-antibiotics DNA strand into the surroundings for any other of this group of bugs to take-up and incorporate into its own genes.

    So an infection by one superbug can very easily lead to an infection by ten different superbugs at one time.
    Creativity is the residue of time wasted. ~ Albert Einstein

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    a cantori Perdix's Avatar
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    You're quite the alarmist Ozzy, these things happen! New antibiotics are being developed to combat antibiotic-resistant strains.

    http://www.nature.com/nature/journal...ture14098.html
    http://www.newsweek.com/new-antibiot...nd-dirt-298216

    The world is overpopulated anyways...

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    Persona Oblongata OrionzRevenge's Avatar
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    Quote Originally Posted by prometheus View Post
    You're quite the alarmist Ozzy, these things happen! New antibiotics are being developed to combat antibiotic-resistant strains.

    http://www.nature.com/nature/journal...ture14098.html
    http://www.newsweek.com/new-antibiot...nd-dirt-298216

    The world is overpopulated anyways...
    A promising new Antibiotic is truly good news no doubt.

    But we have yet to learn how not to over use antibiotics and cause this new wonder weapon to go the same way as dozens before it.

    And I didn't write the Frontline program that details how most of the antibiotic research has completely dried up. (This latest Antibiotic was serendipitously discovered in a soil sample)

    And I didn't write the recent UK Government study saying that CRE will kill more than cancer by 2050 and cost $100 Trillion to treat.

    So I think I'm in good company looking upward in the noted company of chickens.
    Creativity is the residue of time wasted. ~ Albert Einstein

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    Mens bona regnum possidet ferrus's Avatar
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    Quote Originally Posted by OrionzRevenge View Post
    But we have yet to learn how not to over use antibiotics and cause this new wonder weapon to go the same way as dozens before it.
    It's the same as properly husbanding the resources such as oil - it just isn't in our genetic make up to think long term.
    Die Logik ist keine Lehre, sondern ein Spiegelbild der Welt. Die Logik ist transcendental. - Wittgenstein

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    a cantori Perdix's Avatar
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    Quote Originally Posted by OrionzRevenge View Post
    A promising new Antibiotic is truly good news no doubt.

    But we have yet to learn how not to over use antibiotics and cause this new wonder weapon to go the same way as dozens before it.

    And I didn't write the Frontline program that details how most of the antibiotic research has completely dried up. (This latest Antibiotic was serendipitously discovered in a soil sample)

    And I didn't write the recent UK Government study saying that CRE will kill more than cancer by 2050 and cost $100 Trillion to treat.

    So I think I'm in good company looking upward in the noted company of chickens.
    I agree that antibiotics shouldn't be overused. $100 Trillion? I doubt it. More than cancer? Good. I'm looking forward to mass population reductions.

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    Senior Member Spartan26's Avatar
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    Quote Originally Posted by OrionzRevenge View Post
    But we have yet to learn how not to over use antibiotics and cause this new wonder weapon to go the same way as dozens before it.
    Yeah, I'm wondering when we'll be able to buy a low-grade antibiotic OTC. It'd be helpful when I get a sinus infection to just go straight to the pharmacy and not have to deal with the added hassle of seeing an E.N.T. Yes, maybe not the safest thing but I've dealt w/it five times over the past decade and feel like I was just paying a 600% premium to get a legal drug dealer to write me a script.

    What we need is a home cold test. If you've got something antibiotics would help, it turns green. If not, brown. I seriously wonder when this'll be challenged. Maybe never but it seems like it's gotta be up for review, either by the FDA or Supreme Court

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    Persona Oblongata OrionzRevenge's Avatar
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    Quote Originally Posted by Spartan26 View Post
    Yeah, I'm wondering when we'll be able to buy a low-grade antibiotic OTC. It'd be helpful when I get a sinus infection to just go straight to the pharmacy and not have to deal with the added hassle of seeing an E.N.T. Yes, maybe not the safest thing but I've dealt w/it five times over the past decade and feel like I was just paying a 600% premium to get a legal drug dealer to write me a script.

    What we need is a home cold test. If you've got something antibiotics would help, it turns green. If not, brown. I seriously wonder when this'll be challenged. Maybe never but it seems like it's gotta be up for review, either by the FDA or Supreme Court
    They're working on this sort of thing
    Not a lot of trouble detecting the presence of Gram Negative or Gram Positive Bacterial markers, but I can't imagine they'll ever take the medical consultation out of the loop. Not with antibiotics. The problem is people don't stay the full course even when the doctor screams at them to do so.

    Then they pop a few months later when they get a chill or bad cut. And Doctors have blood on their hands as well for too often giving in to an over the phone consultation etc.

    LOL, I once managed this. Albeit I think I was righteous in doing so.

    I had visited the Doctor for a sore throat and he said looks like a virus (tough fucking luck).
    But I called back the next day and said "Look, I work in a Microbiology Lab and the back of my mouth has that same taste/smell you get when pulling a stack of cultures out of the incubator."

    He phoned in to the Rx a prescription of antibiotics.
    Creativity is the residue of time wasted. ~ Albert Einstein

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    Senior Member Spartan26's Avatar
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    Besides the liability, which would be huge, drs visits are too big of a revenue generator to take out of the system. But, with everyone now needing health coverage, it may be cost effective to reduce those kind of visits from the doc's schedule. I'm sure there are some insurance actuaries crunching $15 co-pay vs big pharma kickback on scripts per drug written as we write.

    I wonder if greater access would mean people completing cycles through to completion. If I've got a PPO, and looking at anywhere between $60-$115, I literally have no idea what it'll be until a bill comes, and then another $25 lab fees and then $5 for my meds themselves, how does anyone NOT shave two-three tablets from the cycle to prevent that type of experience the next time around?? I worry less, though, about a super virus wiping us out and more about the added costs to insurance for covering about 5 million more people on dialysis every year cuz people think hot scotch and amoxicillin will be the best treatment for their recovery the moment they get the sniffles for the next 30 years.

    I wonder about access and violence at sporting events. If beers didn't cost $10 a pop inside the stadium people wouldn't feel as big a need to get completely wasted outside in the parking lot. Yes, people would buy more inside at $6-$7 a glass but I'm not so concerned about the guy who had three over the course of a 3 1/2 hour game as I am the guy who had 3-4 in the hour from when he got to the parking lot and then staggered into his seats and want to fight the 2nd time his team goes 3 & out.

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    Persona Oblongata OrionzRevenge's Avatar
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    Quote Originally Posted by Spartan26 View Post
    Besides the liability, which would be huge, drs visits are too big of a revenue generator to take out of the system. But, with everyone now needing health coverage, it may be cost effective to reduce those kind of visits from the doc's schedule. I'm sure there are some insurance actuaries crunching $15 co-pay vs big pharma kickback on scripts per drug written as we write.

    I wonder if greater access would mean people completing cycles through to completion. If I've got a PPO, and looking at anywhere between $60-$115, I literally have no idea what it'll be until a bill comes, and then another $25 lab fees and then $5 for my meds themselves, how does anyone NOT shave two-three tablets from the cycle to prevent that type of experience the next time around?? I worry less, though, about a super virus wiping us out and more about the added costs to insurance for covering about 5 million more people on dialysis every year cuz people think hot scotch and amoxicillin will be the best treatment for their recovery the moment they get the sniffles for the next 30 years.

    I wonder about access and violence at sporting events. If beers didn't cost $10 a pop inside the stadium people wouldn't feel as big a need to get completely wasted outside in the parking lot. Yes, people would buy more inside at $6-$7 a glass but I'm not so concerned about the guy who had three over the course of a 3 1/2 hour game as I am the guy who had 3-4 in the hour from when he got to the parking lot and then staggered into his seats and want to fight the 2nd time his team goes 3 & out.
    I agree that many if not most of our problems result from human nature.

    If I were in R&D, I'd be trying to take a page from Whole Foods and develop Phage Therapy to treat bacterial infections.
    Give your fucking bug a bug that can adapt along with it, and is completely harmless to humans.
    And if you do have a bug, it only takes one small dose to do the trick.
    How fucking sweet is that????
    Creativity is the residue of time wasted. ~ Albert Einstein

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