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Drug-Resistant Superbugs Sweeping Across Europe

samzenpus posted more than 2 years ago | from the and-you-thought-the-old-nuclear-reactors-were-bad dept.

Medicine 433

Pierre Bezukhov writes "Klebsiella pneumoniae is a common cause of pneumonia, urinary tract, and bloodstream infections in hospital patients. The superbug form is resistant even to a class of medicines called carbapenems, the most powerful known antibiotics, which are usually reserved by doctors as a last line of defense. The ECDC said several EU member states were now reporting that between 15 and up to 50 percent of K. pneumoniae from bloodstream infections were resistant to carbapenems. To a large extent, antibiotic resistance is driven by the misuse and overuse of antibiotics, which encourages bacteria to develop new ways of overcoming them. Experts say primary care doctors are partly to blame for prescribing antibiotics for patients who demand them unnecessarily, and hospitals are also guilty of overuse."

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VS (5, Interesting)

Anonymous Coward | more than 2 years ago | (#38096206)

Any reason why this would not be the case in the US?

Re:VS (-1)

Anonymous Coward | more than 2 years ago | (#38096230)

USians pay for their medicine so they most likely are not prescribed as many by their doctors.

Re:VS (1)

Gideon Wells (1412675) | more than 2 years ago | (#38096252)

Only the cheap/poor timid ones or ones with stubborn doctors. You can be surprised how far "samples" can be stretched and how often handed out.

Re:VS (5, Insightful)

Chrisq (894406) | more than 2 years ago | (#38096260)

USians pay for their medicine so they most likely are not prescribed as many by their doctors.

I don't think that is the case. Doctors might find it harder to say "just go home and take asprin" if someone is paying for the consultation. I can't find figures but my feeling is that its just as bad - the European report was issued because most emphasis up to now has been in the USA [eurosurveillance.org] . I know that multi-resistant TB occurred in the USA and then spread to Europe, not that one example shows much. In all likelihood it actually occurred first in a third-world country with endemic TB and antibiotics available over the counter but tests found it first in te USA.

Re:VS (2)

pahles (701275) | more than 2 years ago | (#38096310)

Excuse me? Are you saying Europeans don't pay for their medicine?

Re:VS (4, Informative)

Going_Digital (1485615) | more than 2 years ago | (#38096336)

Well in the UK at least there are no charges for medical treatment and people who are retired or unemployed get free drugs where as the rest pay a flat fee for a prescription that could be $1000's worth of drugs for the equivalent of $10.

Re:VS (0, Troll)

Anonymous Coward | more than 2 years ago | (#38096570)

Nope. Not really. At least in Germany. Public insuranced patients only pay a little fee, co-payment. 5-10 Euro. In case they pay more than 2% (1% for pensioners/workless) of their income during a year, they won't pay anything at all for the rest of the year.

For tea-bagger idiots : The state cares about you (europeans). That's socialism, right?.... scary stuff. Where is the army? Pray, hole Europe has been invaded and converted to reds. Let's nuke them.....

(yeah, I do really, really despise tea-baggers...all idiots...no exception)

Re:VS (2)

Qzukk (229616) | more than 2 years ago | (#38096818)

USians pay for their medicine so they most likely are not prescribed as many by their doctors.

"USians" pay for their doctors, and if the doctor won't prescribe them what they want, they'll take their money to one that will.

Re:VS (4, Informative)

WillKemp (1338605) | more than 2 years ago | (#38096254)

It is the case in the US.

Progress! (5, Funny)

Gaygirlie (1657131) | more than 2 years ago | (#38096208)

So now we can train bugs to say no to drugs, next step is to move to animals and then finally humans!

Re:Progress! (2)

jimmetry (1801872) | more than 2 years ago | (#38096728)

The plan being to promote drugs extensively until we achieve a generation of humans that are just like "eh... it doesn't really do anything for me anyway"? Now why didn't I think of that...

I wonder (5, Insightful)

HerrWolfe (1829238) | more than 2 years ago | (#38096210)

I wonder if such a common thing as antibiotic soap can increase resistance over a period of time.

Re:I wonder (4, Informative)

tsa (15680) | more than 2 years ago | (#38096232)

Of course it does. The fact that these soaps haven't been banned yet shows how serious the EU takes this problem.

Re:I wonder (5, Informative)

Fuzzums (250400) | more than 2 years ago | (#38096414)

Giving antibiotics to farm animals also doesn't help and genetically mutilated crops is an other example of the same problem of making bacteria drug resistant.

There is enough talk about reducing antibiotics for humans and animals though, but the pharmaceutical industry is lobbying against this kind of regulation for obvious reasons. The more they sell, the better. For them that is. Go free economy where only money rules and common sense comes last...

Making antibiotics ridiculously expensive and inaccessible for people who really need them is indeed one way to "regulate" the use of antibiotics instead of simply not prescribing it for a simple cough.

But also for over consumption. Everybody knows this will become a huge problem sooner or later, but everybody also decides to look the other way and hope it will go away. It's human nature I think. But nature will definitely find a new balance. It's like a nuclear reactor. If you don't regulate, things will get out of hand. We might like the outcome. We might not. :)

Re:I wonder (1, Insightful)

Tsingi (870990) | more than 2 years ago | (#38096624)

Giving antibiotics to farm animals also doesn't help and genetically mutilated crops is an other example of the same problem of making bacteria drug resistant

Yes, cattle are fed corn, because it is heavily subsidized, and this makes them ill. So cattle are raised on a diet of corn and antibiotics. Then we eat the meat, laced with antibiotics, and the viruses in our bloodstream mutate to brush off this rather mild onslaught.

Not buying beef that was raised on corn is a possible solution, but that just means you won't be raising superbugs, everyone else will still be doing it.

Re:I wonder (4, Informative)

Sique (173459) | more than 2 years ago | (#38096660)

Sorry to nitpick. but a virus does not react to antibiotics at all - those are for bacteria. For a virus you need completely other classes of substances like tetracyclines or interferone.

Re:I wonder (0)

Anonymous Coward | more than 2 years ago | (#38096706)

Speaking for which country exactly?

Here in the UK such use of antibiotics is much more heavily regulated.

Re:I wonder (4, Informative)

mangu (126918) | more than 2 years ago | (#38096760)

cattle are fed corn, because it is heavily subsidized

Obvious solution: end farming subsidies. If meat gets more expensive, import it from third world countries, where cattle is raised on the range. Use import duties and quotas to enforce good environmental practices in the producing countries.

Everybody wins, including the corn farmers who will end the monoculture that damages their soil. By rotating crops like alfalfa and soybeans they will need much less fertilizer.

Re:I wonder (5, Interesting)

hairyfeet (841228) | more than 2 years ago | (#38096716)

Don't forget the sewer systems and water supplies. I remember reading in a magazine how many drugs could be found in your average river because the sewer systems end up one way or another into the rivers, be it leaking pipes, floods, etc and you end up with all these drugs from antibiotics to painkillers to hormones in the water supply. Then of course fish absorb the drugs, animals and people absorb the fish, and around it goes.

And finally let us not forget the massive bribes...err I mean "incentives" the drug companies give out to doctors. I could always tell which drug my local doc was getting a nice vacation package from because that is what he is pushing for EVERYTHING, funnily enough the current one fits right into TFA because his handout drug ATM is an antibiotic called Z-Pac.

Re:I wonder (4, Informative)

WillKemp (1338605) | more than 2 years ago | (#38096246)

I wonder if such a common thing as antibiotic soap can increase resistance over a period of time.

Probably. It's very unlikely to kill every bacterium, and the ones it doesn't kill may go on to breed stronger strains.

Re:I wonder (5, Informative)

Gideon Wells (1412675) | more than 2 years ago | (#38096276)

Alchohol based and similar antibiotics don't have a drug to build a resistance to. It is just deadly in a high enough dose. Those that live are through dumb luck. So these products are safe to use without fear of adding to drug resistance.

Re:I wonder (5, Funny)

Fuzzums (250400) | more than 2 years ago | (#38096326)

It will just train bacteria to become alcoholics :)

Re:I wonder (4, Interesting)

captainpanic (1173915) | more than 2 years ago | (#38096538)

The smiley suggests you think you're making a joke... but it's actually true: it will train the bacteria to become alcoholics, and build up a tolerance.
But there are good reasons to expect the bugs to need a lot longer to develop a resistance against alcohol. They will need to reinvent their cell walls for example, which is quite a dramatic change.

Re:I wonder (1)

Sique (173459) | more than 2 years ago | (#38096678)

But the same is valid for the beta-lactames like penicilline too - penicilline attacs the cell walls and supresses the building of new ones. Thus bacteria can't multiply anymore, and the normal immune system can kill off the remaining ones.

Re:I wonder (5, Informative)

Phydeaux314 (866996) | more than 2 years ago | (#38096764)

There is a *slight* difference in the function of alcohol and penicillin in how they serve as antiseptics: Penicillin interferes with cell wall construction, whereas alcohol flat-out denatures all the proteins. Random mutations that use completely different protein structures that aren't attacked by alcohol are a fair bit rarer, to say the least.

Re:I wonder (0)

Anonymous Coward | more than 2 years ago | (#38096440)

Unless some mutant has a way to survive during the presence of it.

Re:I wonder (2)

Trepidity (597) | more than 2 years ago | (#38096844)

It's not really that they don't have a drug, as that the gap between a given current bacterium, an a super-bacterium version of it that can live in alcohol-rich environments, is large enough that it's basically a completely different organism, so less likely to appear via the usual evolutionary processes. If you had a species of bacteria that was just on the edge of being able to live in high-alcohol environments, somewhat but not highly tolerant of alcohol, it's plausible that they would actually evolve greater tolerance/resistance for alcohol.

Really anything can be a source of evolutionary pressure; given the right circumstances, organisms can even evolve resistance to physical mechanisms, like the "armor plating" that some animal species have evolved to resist physical attacks.

Absolutely! See triclosan. (1)

Baraka (35968) | more than 2 years ago | (#38096582)

There is no question at all that synthetic antibacterial substances, often added to consumer products, will directly breed resistant bacteria.

As one ubiquitous example, please research triclosan's effects on bacterial biology, as well as its environmental impact. Triclosan will degrade into dioxin and other carcinogens when exposed to sunlight. The proof is in the pudding.

Lastly, even if there were such a synthetic additive which somehow did not potentiate microbial resistance, it would still likely add to our constant daily bombardment of carcinogens.

Trading short term pathology for a longer term pathology, which costs hundreds of billions of dollars annually to deal with, is not a very wise public health strategy. There are no short cuts.

...and patients who don't complete the course (5, Informative)

Rogerborg (306625) | more than 2 years ago | (#38096216)

The same whiny hypochondriacal medieval idiots who demand antibiotics to fight a virus.

I often think that 19th century physicians had it figured out. Blue pill (placebo), slime draught (nasty tasting placebo) and let some blood. Treat the root cause, i.e. the hypochondria.

Re:...and patients who don't complete the course (5, Insightful)

tsa (15680) | more than 2 years ago | (#38096248)

They're not medieval idiots, they're ignorant fools who think they know better than the doctor, even when the doctor tells them that antibiotics will not work against viruses.

Re:...and patients who don't complete the course (4, Insightful)

einhverfr (238914) | more than 2 years ago | (#38096312)

Also consider that up until recently there were classes of illnesses where antibiotics were defensively prescribed, such as in the case of ear aches, not because they were likely to do good in any particular case, but because the doctor feared malpractice suits if it was bacterial and happened to be the rare case that lead to hearing loss.

Re:...and patients who don't complete the course (2)

bryan1945 (301828) | more than 2 years ago | (#38096618)

Don't know about you, but every ear infection I've had (many, eventually causing a burst eardrum) was nicely cleared up by antibiotics. (No, I didn't sue)

Re:...and patients who don't complete the course (1)

data2 (1382587) | more than 2 years ago | (#38096676)

I only know about the affair of otitis media in children, but there, antibiotics are reserved for the more severe cases. But this is because research has shown that the chance of side effects of antibiotics is higher than the chance of complications, which then can still be treated by antibiotics.

Re:...and patients who don't complete the course (0)

Anonymous Coward | more than 2 years ago | (#38096868)

Don't know about you, but every ear infection I've had (many, eventually causing a burst eardrum) was nicely cleared up by antibiotics. (No, I didn't sue)

No reasoning known to man can convince someone that when receiving a treatment for a certain illness intended to make him better, and he does get better, that it may not have been the treatment that made him better. (some fortune-quote)

Re:...and patients who don't complete the course (5, Interesting)

Anonymous Coward | more than 2 years ago | (#38096334)

Which makes them better (or different) from medieval idiots... how, exactly?

The root cause remains an "ignorant" (your vocabulary) assumption that illness = bacteria. Bacteria are killed by magic drugs whose formulation and mechanism(s) of action most simply lack the education to understand. Because I am ill, the patient believes, I must seek this magic medicine to make the illness go away. Thus, even when a doctor says, "This magic medicine will do nothing," the patient insists that they receive it, presupposing the evil doctor must be withholding life-saving treatment to increase return visits. Despite the absence of education, the patient knows the medicine will work, denying physics, chemistry, and biology in the process.

The critical failure occurs when the patient makes the anecdotal correlation between close friends' or relatives' medical condition(s) manifesting in a similar way - this is a fundamental flaw in human cognition, not an effect that can be solved with the assumption that "modern" fools are not medieval idiots. They are medieval idiots - just with shinier toys.

Re:...and patients who don't complete the course (0)

Anonymous Coward | more than 2 years ago | (#38096404)

The problem starts at the doctors themselves. They use diagnosing as synomym of playing "guess the disease". Consider as an example the common cold - the symptoms can be caused by a virus, by bacteria, by environmental factors (that may or may not be seasonal), or a combination of all. You could take a sample and grow cultures to confirm bacteria, but probably 90% of the time is actually a virus infection, so the doctor prescribes something to treat the symptoms. If after a week the patient is still sick, maybe it's bacteria, so the doctor prescribe some antibiotics. If after another week no improvement is made, the doctor may prescribe some allergy medication. Then, if none of this works - and only then - they will start the actual testing, instead of guessing the disease.

Re:...and patients who don't complete the course (2)

mrbester (200927) | more than 2 years ago | (#38096452)

At least it won't be lupus.

Re:...and patients who don't complete the course (1)

Sique (173459) | more than 2 years ago | (#38096812)

... which actually saves much time and trouble, because in 99.5% of all cases the first two instances (first against virus, then against bacteria) solve the problem.

Develop ? (0)

Anonymous Coward | more than 2 years ago | (#38096218)

> which encourages bacteria to develop new ways of overcoming them.

which encourages bacteria to **evolve** new ways of overcoming them.

Re:Develop ? (1)

Issarlk (1429361) | more than 2 years ago | (#38096244)

> > which encourages bacteria to develop new ways of overcoming them.

> which encourages bacteria to **evolve** new ways of overcoming them.

which encourages god to design new ways for bacteria of overcoming them.

Re:Develop ? (4, Funny)

somersault (912633) | more than 2 years ago | (#38096268)

> > > which encourages bacteria to develop new ways of overcoming them.

> > which encourages bacteria to **evolve** new ways of overcoming them.

> which encourages god to design new ways for bacteria of overcoming them.

which encourages god to increase his research and development funding to develop evolution to allow new ways for bacteria of overcoming them.

Re:Develop ? (3, Funny)

Alsee (515537) | more than 2 years ago | (#38096730)

which encourages creationists to evolve new arguments to overcome all evidence.

-

Re:Develop ? (1)

ZeroExistenZ (721849) | more than 2 years ago | (#38096304)

> > > which encourages bacteria to develop new ways of overcoming them.

> > which encourages bacteria to **evolve** new ways of overcoming them.

> which encourages god to design new ways for bacteria of overcoming them.

Which kills the weaklings and singles out the resistants to bread and progressively switch over the population (instead of allowing resistent genes to delude)

Re:Develop ? (1)

Gideon Wells (1412675) | more than 2 years ago | (#38096296)

Well, it is going to lead to evolution, but you are overlooking horizontal gene transfer among bacteria that could be accelerating the problem. This isn't pure mutation and reproduction, but the bacteria equivalent of developing their own anti-anti-biotic and spreading it among their own kind too.

It is evolution + developed.

Re:Develop ? (1)

SuricouRaven (1897204) | more than 2 years ago | (#38096378)

I've used that one on creationists before. They just declare that it isn't real evolution, because it doesn't change enough.

"K"? (2)

WillKemp (1338605) | more than 2 years ago | (#38096220)

What's the "K"? You can only abbreviate it if you've already written it in full beforehand

Re:"K"? (4, Informative)

tsa (15680) | more than 2 years ago | (#38096258)

Klebsiella pneumoniae. [wikipedia.org] But you're right, /. editors should know how to write a blurp.

Re:"K"? (1)

Anonymous Coward | more than 2 years ago | (#38096300)

"K" for Killer pneumoniae ;-)

Re:"K"? (0)

louic (1841824) | more than 2 years ago | (#38096318)

Why don't you look it up? Does every word need to be explained? Show some initiative. Do you want ECDC and EU explained as well? And maybe you also want some of the "difficult" words that are not abbreviated explained? What about pneumonia? And do you /really/ know what "infection" means exactly?

All true but (4, Informative)

Chrisq (894406) | more than 2 years ago | (#38096236)

All true but the majority of resistant strains come from countries where antibiotics are unregulated (i.e. you can buy them over the counter without prescription)

Farmers feed cattle with 12000 tons of antibiotics (5, Informative)

advid.net (595837) | more than 2 years ago | (#38096256)

Indiscriminate use of antibiotics for livestock also lead to resistance, do not only blame doctors and hospitals.

The concern centers on farmers' routine use of antibiotics. Its use on livestock accounts for roughly half of the 25,000 tons produced in the United States each year. - link - [purefood.org]

The question of whether we are creating ‘resistances' in zoomatic organisms (that affect both species) out in the feedlot and pastures and passing this on to humans with veterinary use of drugs, however, is still a very up-in-the air question. - link - [cattletoday.com]

Re:Farmers feed cattle with 12000 tons of antibiot (2)

HerrWolfe (1829238) | more than 2 years ago | (#38096270)

So if we eat meat that has been fed antibiotics, it will effect our resistances as well?

Re:Farmers feed cattle with 12000 tons of antibiot (1)

DarkTempes (822722) | more than 2 years ago | (#38096360)

While I think there are concerns that the antibiotics for livestock may get passed on to people a little bit through the meat it's more that some bacteria affect both people and livestock.

Create a resistance in the bacteria (to the antibiotics) attacking the livestock and then, maybe, the new and improved bacteria could be passed to humans (either from the animals themselves or improper handling of the raw meat).

And farmers pretty much feed all of their animals antibiotics because it's easier? cheaper? than only feeding it to animals once they're sick (in general it's a lot harder to tell when an animal is sick than a human). Or at least that's my understanding, I could be wrong.

Re:Farmers feed cattle with 12000 tons of antibiot (1)

SuricouRaven (1897204) | more than 2 years ago | (#38096390)

Antibiotics tend to be big, complex molecules. They won't last long in the organism, and they'll last even less time in the oven.

Re:Farmers feed cattle with 12000 tons of antibiot (5, Informative)

einhverfr (238914) | more than 2 years ago | (#38096444)

People who think our ingestion of antibiotics from animals is a factor in antibiotic resistance are crackpots who don't pay attention to the fact that we've been eating trace amounts of penicillin for tens of thousands of years. That's not a serious concern. There are however a few serious concerns:

1) Some bugs like E coli and Salmonella sps can be hosted in animals or humans. Antibiotic resistance they pick up in animals will be a factor when the human gets sick.

2) Some bugs are known to swap DNA. This means that antibiotic resistance in a harmless bug could turn up in a harmful one later.

3) Bugs which are harmless today could jump species and become harmful tomorrow.

4) Environmental pollution around concentrated animal feeding operations could lead to antibiotic resistance in soil-borne bacteria.

Now, in the US, there is supposed to be a clear separation between classes of antibiotics used on animals and those used on people, although this is more porous than we might like to think. There are however no guarantees that other countries have the exact same divisions. Moreover even assuming that this is the case, it deprives us humans of the effectiveness of certain classes of antibiotics which might prove useful in the future.

We're not crackpots (2)

Viol8 (599362) | more than 2 years ago | (#38096668)

"that we've been eating trace amounts of penicillin for tens of thousands of years."

Some modern antibiotics can get into the soft tissue of an animal and stay there until it is slaughtered and can then survive the cooking process. Penicillin can't.

Re:Farmers feed cattle with 12000 tons of antibiot (0)

Anonymous Coward | more than 2 years ago | (#38096696)

NO, it is a big concern, it was soil bacteria being exposed to penicillin *not* human pathogens, and this makes all the difference.
Worse bacteria under stress have a horrible habit of taking up random bits of DNA from the environment, and the non human safe antibiotics have large amounts of DNA from the resistant bacteria used to produce them. This proses of DNA uptake is bad for most members of the colony but as stress is often caused by a chemical attack from another competing bacterium it increases the chance of a subset of the colony surviving by stealing resistance from dead members of the attacking rivals.

Re:Farmers feed cattle with 12000 tons of antibiot (1)

einhverfr (238914) | more than 2 years ago | (#38096302)

Also I don't think we *know* what sorts of antibiotic resistance may be created in other countries through this practice. Consider simply that there are bugs that can use livestock and humans as hosts, and our insistence on routine feed of antibiotics to animals should be quite frightening.

Re:Farmers feed cattle with 12000 tons of antibiot (2)

stiggle (649614) | more than 2 years ago | (#38096864)

This has been banned in the EU (for the last 5 years).

Antibiotic abuse (0)

Anonymous Coward | more than 2 years ago | (#38096262)

In all cases where resistance has been traced to its source, it turns out to be agribusiness. Literally tons of the latest antibiotics are used by agribusiness in feedlots and other animal husbandry to compensate for crowding and filthy conditions. The resistant bacteria find their way into our lives via the food we eat, which is contaminated with them. Hospitals, clinics and physicians are not to blame, and denying humans the antibiotics they need to fight infection will not affect the problem. The only real solution would be to stop agribusiness from these abusive pracrtises, but this isn't going to happen because the profits being made are too high.

blame the 3rd world (-1)

Anonymous Coward | more than 2 years ago | (#38096264)

The 3rd World is largely devoid of hygine, nutrition, and preventative measures.
Instead we have ignorant pseudo-pharmacists (with the equivalent of an a.a.s. degree
at best, and unconstrained by law) doling out powerful antibotics like candy.

Couple this with a steady influx of 3rd World undesirables into Europe, and you have
what amounts to a "cold" biological warfare being waged on the indiginous people of
Europe.

n

It's the culture (4, Funny)

Nick Fel (1320709) | more than 2 years ago | (#38096272)

Bacteria on the continent are allowed a little antibiotics with meals even at a young age, so they grow up with a much more mature attitude towards it. That's why they're much better at handling antibiotics than British and American bacteria.

What a load of bullshit... (0)

Anonymous Coward | more than 2 years ago | (#38096274)

To a large extent, antibiotic resistance is driven by the misuse and overuse of antibiotics, which encourages bacteria to develop new ways of overcoming them.

Only someone who doesn't understand evolution can say such nonsense. Bacteria don't "react" to antibiotics. There are no little "scientist bacteria" wearing tiny lab coats trying to come up with ways to make themselves and other bacteria immune to some antibiotic. Antibiotic effectiveness is driven down simply by natural selection. When a colony of bacteria is exposed to some antibiotics, the ones that aren't immune die, period. The ones that already had immunity survive, and eventually reproduce (their offspring also being immune to that antibiotic). They weren't "encouraged to become resistant", they already were resistant. In fact, it's been shown that there are antibiotic-resistant bacteria even in ice cores that pre-date the existence of humans.

http://news.sciencemag.org/sciencenow/2011/08/superbugs-predate-wonder-drugs.html [sciencemag.org]

Yes, antibiotic overuse can lead to an increase in the number of resistant bacteria (by killing their non-resistant competitors), but it's not the antibiotics that create the resistance.

Re:What a load of bullshit... (1)

DavidShor (928926) | more than 2 years ago | (#38096454)

Right. The reason these traits didn't exist before hand is that they were disadvantageous. So in the absence of antibiotics, they disappear.

I think our etiology of antibiotic resistance is.. (5, Informative)

einhverfr (238914) | more than 2 years ago | (#38096288)

oversimplified.

It's based on the idea, seen in insects with pesticide use, that if you kill x percentage of insects, some may survive and their offspring may have a much higher level of tolerance, meaning more pesticides are needed to kill the insects. No doubt this happens with bacteria too and is *a* cause of antibiotic resistance.

Consider that livestock may be given antibiotics, and they may have bacteria, like E. coli or Salmonella sps which can make humans ill. This represents an additional vector not generally covered in analysis.

However there may be several other big issues that are not currently included in the analysis. Many species of bacteria are known to assimilate genetic material from other bacteria even from other genuses. This means that there is a possibility that antibiotic resistance can spread between bacterial species as a result of hospital waste, causing a form of genetic pollution.

Nature is fundamentally more complex than we can model. Any sufficiently complex model would be nature itself.

However, the rise of superbugs is fascinating to watch.

Re:I think our etiology of antibiotic resistance i (5, Insightful)

erroneus (253617) | more than 2 years ago | (#38096432)

Fascinating until some gets into a casual scrape or cut in your skin...

Another cost of our overly-medicating society is that we forget how important it is to keep our immune systems healthy. We scrub and clean and sanitize everything at every turn thinking we can limit or even eliminate those dastardly bacteria which are always bad. (Not all bacteria are bad... how is the over-use of antibiotics harming the good bacteria we depend on?)

Good practices and good hygiene, of course, are important things to maintain... foods should be cooked and handled properly. Hands and bodies kept clean as well. But "sanitized" is just going too far in most cases. And so when people get sick, they have untrained immune systems which don't react as well as it should which necessitates the use of antibiotics.

George Carlin saw this problem long, long ago when he did his "swimming in raw sewage" routine. His point was to keep the immune system operating and working well. My point is that we can't seek to eliminate all "bad things" without serious consequence which includes upsetting nature's balances. Instead we should seek to coexist with bacteria in our world and seek ways to maintain a healthy balance. Instead, people seek to dominate and eliminate "their enemies" without considering the long term consequences of such reactions.

Re:I think our etiology of antibiotic resistance i (4, Interesting)

einhverfr (238914) | more than 2 years ago | (#38096550)

I agree with your points about the immune system and sanitizing everything. I would go further and say I enjoy beef tartare, sashimi, and good old fashioned home-made eggnog, plus a few scandinavian desserts with raw eggs.

I would however like to point out that with simple care, most bacterial infections can be treated without antibiotics. The last few times I have had skin infections, I have used sterilized kitchen knives to lance the infection and hot salt water to draw fluids, etc, out, and I got better at least as fast as I would have with antibiotics. I also travel a LOT and have had E coli and possibly even a mild case of cholera. None of these need to be treated with antibiotics either (with cholera the key concern is hydration, and with any diarrhea I have found the key is to go off all foods for a while to let one's immune system get a grip on what's in the digestive tract.

We use antibiotics a lot when we don't really have to, because we believe in modern medicine and all of that, and because it's easier than teaching people to soak infected fingers in hot salt water.

Re:I think our etiology of antibiotic resistance i (4, Interesting)

einhverfr (238914) | more than 2 years ago | (#38096562)

Just adding to that last comment. One of the big issues with antibiotics is that they often target harmless bacteria as well as bad ones. This means impoverished microbial biodiversity, which means it is easier to get infected again with something else. And so one intervention leads to another.

Industrial Beef (0)

Anonymous Coward | more than 2 years ago | (#38096316)

Feedlot animals, folks. They consume more antibiotics than all the humans combined.

Often, not always (4, Insightful)

Max Romantschuk (132276) | more than 2 years ago | (#38096352)

I've had a doctor tell me that I / my kid has a bacterial infection but it's not that serious, so the best option is to rest and let the body's own immune system take care of it.

Yet, something tells me that those doctors would have prescribed antibiotics if I had cluelessly demanded that I get 'proper medicine'...

Re:Often, not always (5, Insightful)

spectrokid (660550) | more than 2 years ago | (#38096468)

This is were state-run health systems like in scandinavia have the upper hand. Doctors can just tell their patients to fuck off.

Re:Often, not always (1)

sveinb (305718) | more than 2 years ago | (#38096694)

Health systems in the (rest of) EU are also state run - so this explanation doesn't quite explain the observation, which I have heard before and therefore believe: That antibiotic use in Scandinavia is less prevalent than the (rest of the) EU.

Re:Often, not always (0)

Anonymous Coward | more than 2 years ago | (#38096862)

Yeah but in France for example the doctors still get paid by the patients, even they are in turn reimbursed later by the state run health insurance. Doctors answer to patients before the health system. The government had to run multiple ad campaign to lower antibiotics use.

Re:Often, not always (0)

Anonymous Coward | more than 2 years ago | (#38096494)

The use of antibiotics for young children's ear infections is fascinating. There has been evidence to show that it doesn't actually help to give antibiotics but these goes back and forth. Am wondering though if making the immune system fight bacteria by not give antibiotics actually leads to less infections later on in life, the body build resistance.

For example as a young child I got plenty of ear infections all treated with antibiotics, and through out my life I have been very prone to ear infections about one ever two years. I am actually going to the doctor tomorrow for an ear infection, I have had on and off for a month, it's getting cold and it is acting up all the time now. Of course I might just be prone to it for other genetic/physiological reasons. Though none of my other family members ever get ear infections. But if get kids I will not run them of to the hospital at the first sign of a little discomfort.

Re:Often, not always (1)

einhverfr (238914) | more than 2 years ago | (#38096600)

Currently they are moving away from this. The issue has not been so much the thinking that antibiotics will help any particular case but rather the fear that a bacterial ear infection if left untreated could result in hearing loss.

One serious problem with antibiotics (yeah, you need them when you need them) is that they kill harmless bacteria as well, and these harmless bacteria among other things compete with harmful ones. So it's as if you spray roundup over a field and are surprised that weeds grow back faster than crops. The weeds are, of course, pioneer species and so of course they grow back faster.

So the immune system doesn't exist in a vacuum. It's important to cultivate a healthy microbial ecosystem around us which is sufficiently diverse that the bad bugs can't overrun everything as easily.

Re:Often, not always (2)

data2 (1382587) | more than 2 years ago | (#38096720)

Nice to see there are some other people who know about it. Studies have shown (sorry, I have no link), that the expected human sick days (iirc), where higher with antibiotics than without, because the side effects were more likely to manifest than a serious infection, which could be treated anyway.
Also, there are results hinting at the possibility that treating otitis media with antibiotics results in higher recurrence rates, cause afaik unknown.

Re:Often, not always (1)

Mirvnillith (578191) | more than 2 years ago | (#38096870)

Swedish medical recommendations for ear infections are now pain killers instead of antibiotics, but as previous posts hint at I guess you can get it if you ask for it ...

Re:Often, not always (1)

einhverfr (238914) | more than 2 years ago | (#38096524)

The last few times I have had bacterial infections, I have dealt with them without antibiotics. Just lancing with a sterilized blade and soaking in hot salt water. Works a lot of the time, actually.

Re:Often, not always (5, Insightful)

Rich0 (548339) | more than 2 years ago | (#38096622)

Completely true - well, most of the time.

NPR had a good series on problems in the healthcare system (unlike most treatments they seemed to take a holistic approach and not just find one issue and make it out to be the single thing that is driving up cost). They had a story about a doctor who didn't prescribe a CT scan for a girl who had a suspected spinal fracture. They ended up getting into a fight with the girl's dad who felt like the doctor was just cutting costs at the risk of the girl's health.

However, the doctor pointed out that he had every reason to do exactly what the father wanted. He would be paid more if he ordered the test. Nobody would dispute the test since doing so would expose them to liability. He was taking on risk of liability in the event he was wrong and she had a fracture. However, the fact was that the CT scan for a girl of her age carried a significant increase in risk of cancer much later in life, and based on his physical exam that risk was much greater than the risk that she might have an undetectable fracture. Of course, if she did get cancer later in life it could never be linked to the one test, and by then the doctor would probably be retired/dead/etc. So, the doctor was sticking his neck out, and taking on lots of personal risk, and declining the opportunity to make money, and wasting his time explaining all of this stuff to a father who would have just said yes no discussion needed to a CT scan, all because he wanted the girl to be healthy. How many doctors would do otherwise?

Antibiotics are a similar situation - the doctor can argue with their patient, and maybe lose them. Or, they can just take 30 seconds to fill out a prescription that they'll never get sued over and everybody is smiling since now when the patent gets better it will be because of what the doctor did. Happy patients lead to more patients, and more repeat business as well. Even if the doctor is employed by something like the NHS they probably have metrics and sending a patient on their way without hassle means more visits per hour. Or, even if they're completely unaccountable who wants to sit and argue with somebody all day?

I'm generally in favor of eliminating the need to get a prescription to get access to drugs, but antibiotics are one area where I'd make an exception. I don't see the role of government as protecting people from themselves. However, antibiotic abuse harms everybody and it is completely legitimate to regulate their use - probably more strictly.

I'd probably require doctors to submit a written justification for every prescription of an antibiotic that is less than 20 years old, and with stricter requirements on anything less than 10 years old (either documented testing that shows resistance to the alternatives, or an assessment which will be reviewed by a board that the patient would suffer irreversible harm if they waited for the results of that testing).

Of course, if you do this the market for new antibiotics is almost worthless (compared to being low-value which it is now). Who will spend a billion dollars working on new antibiotics only to release one and have 30 people take it in 10 years? The solution here is bounties - governments will have to decide how many new antibiotics they want and offer substantial bounties for their discovery (probably hundreds of millions of dollars), and use that money to buy the patent rights (the company has already been paid for their work). The bounties can be adjusted based on the number of candidates that are being submitted vs the number desired.

You could actually apply a similar model to other drugs, but it would get expensive (probably cheaper than what we're doing now, but this is completely socializing medicine which is of course much more expensive than having most of the costs be privately borne by patients and their employers). If it were successful enough you'd see the drug patent problem go away without even having to ban them, since patented drugs would be much more expensive than the generics bought with bounties, and companies would still have incentive to do R&D (but not marketing, etc).

Bacteriophage? (0)

Anonymous Coward | more than 2 years ago | (#38096398)

It's about time some drug company raids the old Russia Bacteriophage Labs. The companies could charge almost anything to cure antibiotic resistant infections. Also, Russian researchers are looking for better pay abroad but they will still be settle for less then most 1st world researchers. Of course, maybe it's lucky we don't have a cheap supply of Bacteriophage because we would probably over use that too. Then again, the virus would mutate to adapt to the bacterias adaptations. Of course the mutations could also lead to super virus that attacks the human host. But it would be wise to develop a protocol for developing Bacteriophage to attack dangerous resistant infections. And only using it in extreme cases.

Evolution is a wonderful thing (1)

Anonymous Coward | more than 2 years ago | (#38096422)

Now if only people understood it better, so that they didn't use antibiotics in absolutely everything and expect antibiotics the moment they get a sniffle. Bacteria have been around for billions of years. They are the most successful reproduction and evolution machines on the planet. In a battle between bacterial evolution and human ingenuity we are going to lose SO bad if we are complacent.

Re:Evolution is a wonderful thing (0)

Anonymous Coward | more than 2 years ago | (#38096638)

But of course they never will because teaching evolution is the work of Satan... (fundie believer's in Ambraham's god, take a bow!)

Widespread Christian Fundamentalism in Europe? (1)

brokeninside (34168) | more than 2 years ago | (#38096804)

Most of the forms of Christianity in the EU have no qualms with the theory of evolution.

Not a bug (1)

Hentes (2461350) | more than 2 years ago | (#38096424)

Not a parasite bug but a bacteria. The human body is not a piece of software to call every problem a bug.

Tragedy of the Commons (5, Insightful)

DavidShor (928926) | more than 2 years ago | (#38096448)

I think people are oversimplifying by talking about "stupid" parents. The truth is that since antibiotics and antivirals have few side-effects and are cheap to produce, it's individually rational for people to use them. But when everyone uses them, we get lots of resistance.

Antibiotic myths don't help (0)

Anonymous Coward | more than 2 years ago | (#38096490)

This is a sobering article [bbc.co.uk] . A quarter of people think antibiotics cure colds? Most of them know about antibiotic resistance in hospitals, but apparently don't make the connection?

You know, humans have a big advantage over bacteria: we're smart. But if people don't use their brain, the bacteria are going to win eventually anyway. They've been around a lot longer than humans.

Re:Antibiotic myths don't help (3)

Chrisq (894406) | more than 2 years ago | (#38096542)

This is a sobering article [bbc.co.uk] . A quarter of people think antibiotics cure colds?

Actually given a lot of people I come across day to day I find that very reassuring. Three quarters of people know that antibiotics don't cure colds! I would have expected at least a third to say "What's an antibiotic?" and one in ten to say "what's a cold?".

Doctors presciptions my ass: Agriculture (-1)

Anonymous Coward | more than 2 years ago | (#38096502)

How about the animal factories using tons of antibiotics every single day? Yet another gift from the Big Agro, the guys who brought you Phrankenphood.

Antibiotics is pretty much the only meaningful thing that separates us from the Dark Ages. We should really, really reconsider how we use them because at the current rate we're losing antibiotics much faster than new ones are coming up.

Re:Doctors presciptions my ass: Agriculture (2)

ahaubold (1705608) | more than 2 years ago | (#38096578)

Recent inspections in Germany showed that over 90% of all chicken produced for consumption contain remains of antibiotics. So I guess you are right.
http://www.spiegel.de/wissenschaft/mensch/0,1518,797970,00.html [spiegel.de] (german),
http://de.babelfish.yahoo.com/translate_url?doit=done&tt=url&intl=1&fr=bf-home&trurl=http%3A%2F%2Fwww.spiegel.de%2Fwissenschaft%2Fmensch%2F0%2C1518%2C797970%2C00.html&lp=de_en&btnTrUrl=%C3%9Cbersetzen [yahoo.com] (Yahoo Babelfish Translation)

obvious consequence (1)

Mr_Nitro (1174707) | more than 2 years ago | (#38096512)

We keep sterilizing and over-cleaning everything in hospitals (ie some UK ones where to enter sections is like entering a military biohazard zone), plus the abuse of antibiotics of course. Proper sterlization should occour just before a surgery, the rest should be treated just like any other public space ,with the exception of case specific illnesses. Not to mention that is the nasty chemicals that will give you a cancer more likely (see the overcleaning and hodgkin lymphoma connection) not a common bio treat, to which we evolved in thousands of years in resistence. Also medical community should start to think about dropping wide spectrum antibiotics in favor of phages viruses, which are a much better specific option to treat specific bacteria at a time, with a basically 100% success rate...

Re:obvious consequence (1)

shilly (142940) | more than 2 years ago | (#38096726)

Why should a hospital "be treated just like any other public space"? A hospital is stuffed full of sick people, who
a) have compromised immune systems, and are thus much more susceptible to disease
b) are a more potent source of infection than the typical public space

Hospitals need to be cleaned more than other places.

Re:obvious consequence (2)

oobayly (1056050) | more than 2 years ago | (#38096872)

I'm not sure I entirely agree with this - my mum trained as a nurse in Germany (instead of national service), nurses then were the ones who cleaned everything (not orderlies as is now the case, who appear to liken it to cleaning a supermarket). She also remembers everything being absolutely spotless.
Also, from the memoirs of a WWII nurse in the UK, she said they were drilled by the matron that any dirt was not allowed. When preparing beds coming into new wards (due to a large influx of caualties from D-Day), they weren't allowed in from outside until they'd been scrubbed down with carbolic, and then it was done again once they were actually in the ward.
Visiting hours were also limited, so that patients were allowed to rest, and it made it a lot easier to keep conditions sanitary.

Cleanliness isn't the main problem (to a point, I had a housemate who insisted on regularly bleaching the kitchen floor), it's the fact that people don't understand the difference between bacterial and viral infections and insist on having antibiotics for everything.

What pisses me off is that I'm very rarely ill, and the last two times I've been given antibiotics I haven't taken them - I was on the mend at that stage, and I was buggered if I wasn't allowed to drink on my birthday. However, if I end up in hospital, being healthy isn't going to be of any help if I end up contracting MRSA due to a generation of hypochondriacs (I exaggerate, but the point stands).

It's not the Doctors, it's the Farmers (0)

Anonymous Coward | more than 2 years ago | (#38096526)

How come almost nobody mentions the farmers who stuff their livestock with so many antibiotics from birth to slaughter that then end up not only in the meat, but in water supplies because of runoff from the farms? I get more antibiotics from a meal at a steak house than I have ever gotten from my doctor. And it's that small steady dose that the bugs use to build up resistance.

Re:It's not the Doctors, it's the Farmers (2)

stiggle (649614) | more than 2 years ago | (#38096856)

Probably because in the EU it's been banned (since 2006 for growth promotion purposes).

But while you're blaming agriculture - don't forget the GM crops which use antibiotic resistance as a marker for the bacteria carrying the required genetic modifications.

Patients asking for drugs (1)

JAlexoi (1085785) | more than 2 years ago | (#38096608)

It should be illegal for doctors to listen to patients on drug choices and procedure selection.

Re:Patients asking for drugs (3, Insightful)

KiloByte (825081) | more than 2 years ago | (#38096772)

I'd be far more concerned about doctors listening to drug companies. They send hordes of representatives who shower doctors with incentives if they prescribe a given drug.

In America, this is because of legal system (3, Insightful)

WindBourne (631190) | more than 2 years ago | (#38096692)

I have argued here and elsewhere that there is a high costs to our legal system. Sadly, just about every liberal screams that it only costs 3%. But the issue is that due to quick ability to sue, docs have adopted protective medicine. Not protection for the patient, but protection against lawsuits. As such, they give a number of antibiotics that we would not do.

However, a big issue is that ag makes propholatic use of antibiotics. That is more true in Asia esp. china, than it is anywhere else.
That is what is about cause a massive lowering of the world population.

The sollution (1)

Skvate (2459000) | more than 2 years ago | (#38096708)

http://en.wikipedia.org/wiki/Phage_therapy [wikipedia.org] And the bacteriophages will evolve alongside the bacteria they are designed to kill. Evolution will do the work for us.

50 years from now no disease will be safe (1)

BlueCoder (223005) | more than 2 years ago | (#38096766)

Just think about it. Within 50 years all disease will be conquered. We still probably won't fully comprehend the necessary symbiotic relationship between germs, our gut flora and our bodies but we will understand profoundly better. But the big thing will be able to supplement our immune system but in a direct directed way that no germ can compensate for. We will be able to identify viruses and bacteria within hours and create artificial antibodies, aka germs that fight germs. All within hours. Cancer? A thing of the past.

But we will still get colds and the flu because we will let it happen. Since our bodies were designed to get sick and fight battles which develop the immune system naturally. But at the point of it becoming life threatening a visit to the doctor would cure it. Antibiotics will work again because we will systematically eliminate all the human caused drug resistant strains.

A hundred years from now a man will be able to be virtually immortal. Everyone will have to be artificially sterilized. To have children you would need to give up your immortality. For a hundred years after that society will be fractured into different experiments where people try to balance life with relative levels of healthcare and dying and the ability to have children. Most people will probably choose to die after 300 years. Automated manufacturing has reached the point where we really won't need very many people involved. People will have more free time and I think creativity will become the biggest commodity. And as people get older they will become more and more bored. Some people will choose to die, others will simple have their minds wiped either permanently or temporarily. Others will choose to live with the risk of a random death and or doing dangerous things. I don't think there will be only one solution.

And while it may happen that someone or some group decides to reduce the population I think the biggest problem with immortality is boredom as I have already put forward. And the solution to boredom is lots of creative minds in combination with minds to entertain.

The simple solution (0)

Anonymous Coward | more than 2 years ago | (#38096774)

I'm astounded this isn't more widely known here and in the medical community.
Bacteriophages [wikipedia.org] are a pretty effecive way of killing off just about any bacteria.
They are event targetet at a spesific bacteria, rather than the "carpet bombing" approach of normal Antibiotics.

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