antibiotics

In light of the policy mediocrity that is the Obama administration, it's refreshing to read that the Obama administration is supporting the Preservation of Antibiotics for Medical Treatment Act (PAMTA). Of course, it's early days yet, so it would be par for the courseis quite possible that Obama's support for this legislation will crumble. I've discussed the bill in greater detail elsewhere, but here's why this bill would greatly improve our antibiotic use policy: It covers all classes of antibiotics; there are no exempt classes of drugs. The definition of "non-therapeutic use" is very…
Yesterday's article by Gina Kolata about cancer research mistakes a symptom--caution due to a perceived lack of funding--for the disease, which is the symbiosis between academia and the NIH. Don't get me wrong, a lot of research should involve academics. But the priorities of NIH have become overwhelmed by the priorities of academia. I think Kolata's dead on target with this part of her article (italics mine): One major impediment, scientists agree, is the grant system itself. It has become a sort of jobs program, a way to keep research laboratories going year after year with the…
I told you this would happen. I used to give a lot of talks about antibiotic resistance, and when I did so, I would often use a cartoon as a humorous way to portray the severity of the resistance problem: Sadly, this is no longer a laugh line: Former Cleveland Browns receiver Joe Jurevicius sued the team and the Cleveland Clinic on Friday, saying the team misrepresented the cleanliness of its training facility and blaming doctors with negligence over a staph infection in his right knee that kept him from playing last year.... Jurevicius has said he contracted staph following arthroscopic…
Recently, Newsweek published an article by Sharon Begley that claimed that the conflict between high-profile publication and quick release of medically-important data has led to delays in medical advancements (ScienceBlogling Orac takes down her particular example). But Begley is confusing a symptom, publication practices, with a much larger problem: incentives. What do I mean by incentives? Last week, I described how the data release policies of large and small sequencing centers differ due to distinct funding incentives: the larger centers are paid to rapidly produce lots of high…
Tweet? (and not the internet kind). At the recent ASM meeting, I saw a poster presented by Mark Schroeder of Ohio Wesleyan University about the prevalence of methicillin-resistant staphylococci in wild song birds (the staphylococci include several potential pathogens such as Staphylococcus aureus and S. epidermis). Based on my notes (Note to wee lil' scientists: If you're presenting a poster, always bring lots of page sized copies. Always.), roughly ten percent of birds had staphylococci (I think they were isolated from the plumage, but I can't be certain). Among the mannitol-positive…
...the signal peptide? Interesting. I'll start at the beginning. One of the few bright spots regarding the problem of antibiotic resistance is that resistance typically infers a fitness cost to the bacterium, at least initially. In other words, the resistant strain usually grows slower than a nearly identical sensitive strain*. While compensatory mutations can lower or eradicate this 'cost of resistance', it is thought that resistance can't increase initially without favorable selective conditions--antibiotic use--due to the cost of resistance. We'll need a little background about…
Before I get to the substance of this post, let me state that I'm not a big fan of genetically modified food crops (GMO crops). And there are few bloggers who have spent more time blogging about antibiotic resistance (never mind spending part of his professional career addressing the problem). But this claim that GMOs have led to multi-drug resistant tuberculosis is absurd: Instead of blaming multi-drug-resistant tuberculosis on patients and their alleged non-adherence to the prescribed drug regime, it would be prudent to investigate and eradicate the underlying cause for multi-drug-…
...Oh my? The CDC is being very smart about this issue. As long time readers of this blog will know, the Mad Biologist is very concerned about the evolution of resistance to antibacterials (antibiotics) and antivirals. One such antiviral is Tamiflu which is used to treat influenza infections. The CDC has flown in experts on the evolution of antiviral resistance to advise them on when and how Tamiflu should be used, so as to limit the evolution of resistance to Tamiflu. And the CDC seems to be listening. You might have noticed that there has been very little public discussion of Tamiflu--…
I was going to let the latest Huffington Post idiocy about antibiotics causing cancer go unremarked since Orac slaughtered it, but then I read the comments and became mad. Really Mad. First, this from the book promotion masquerading as an article: And many people still believe that antibiotics are helpful; we've all heard stories of mothers and patients coming close to demanding them. But did you know that antibiotics can cause a great deal of long-term harm in the body? Let me explain... Yes, we know they can in rare circumstances. That's why they should be used only to treat bacterial…
When a small body of water, say a slow flowing creek or water in a drainage ditch, "goes septic" it starts to stink, often giving off a rotten egg odor (hydrogen sulfide, H2S). This isn't a sign that the water is polluted in the chemical sense of toxic materials. It means that so much organic matter has entered the water that the bacteria there have gone on a food orgy. The initial gluttons are aerobic bugs that need oxygen as a final electron acceptor to generate energy for their needs. When the feasting aerobes use up all the oxygen they die and are replaced by a new set of diners, the…
The Ethicurean has a superb interview with author Maryn McKenna about MRSA and agriculture. In the interview, the following question about MRSA transmission was asked: But isn't the industry saying that there's no definitive evidence linking MRSA in pigs to MRSA in humans? It depends on your standards of evidence. MRSA ST398 has been found colonizing pig farms and pig farmers in the US, Canada, and in the European Union. You can argue about how prevalent it is -- it's easy to cast doubt on whether it is common, because not very many studies have been done. But you can't argue that it is…
I recently wrote about the introduction in the House of the Preservation of Antibiotics for Medical Treatment Act (PAMTA). This is a really critical piece of legislation that could put a dent in the evolution of resistance. Now, there's more good news. Senator Kennedy, along with Republican Senator Olympia Snowe, has introduced a companion bill, S. 619. Again, I can't stress how important this legislation is. Among other things, it moves the burden of proof to drug manufacturers, forcing them to demonstrate that a drug is vital. It also redefines 'therapeutic use' in such a way that it…
A small bill could have huge implications for preventing the evolution of antibiotic resistance. Every couple of years, the Preservation of Antibiotics for Medical Treatment Act (PAMTA) is offered for consideration. Two weeks ago, Democratic Rep. Louise Slaughter proposed PAMTA again for consideration. Here are the key provisions ofthe proposed bill: The findings are very comprehensive. Given the number of times, the legislation has been proposed, you would expect this (you just keep adding more justification), but citing NARMS (the National Antimicrobial Resistance Monitoring System) and…
Always listen to the Mad Biologist. By way of Joe Windish at The Moderate Voice, we find out, just as I predicted, that the pork lobby would claim we don't know enough about the MRSA ST398 problem: Livestock scientists call the opinion piece "highly speculative", and point to the Centers for Disease Control and Prevention (CDC) statements on MRSA that say most if not all cases of MRSA come from person to person contact, not person to animal. The column also does not define this strain as one that is found on any swine farm in the vicinity of Camden, Ind. "They are making a huge leap…
Always listen to the Mad Biologist. By way of Joe Windish at The Moderate Voice, we find out, just as I predicted, that the pork lobby would claim we don't know enough about the MRSA ST398 problem: Livestock scientists call the opinion piece "highly speculative", and point to the Centers for Disease Control and Prevention (CDC) statements on MRSA that say most if not all cases of MRSA come from person to person contact, not person to animal. The column also does not define this strain as one that is found on any swine farm in the vicinity of Camden, Ind. "They are making a huge leap…
If you work in infectious diseases in a hospital -- or frankly if you work anywhere in a hospital -- the emergence of antibiotic resistant bacteria is a serious problem. You have to be constantly aware of what the right drug is to prescribe to ensure its maximum effectiveness, and -- though rare -- there are some bacterial infections for which we have no good drugs. This is why I was very intrigued about researchers trying to design antibiotics that would not create resistant bacteria: Vern L. Schramm, Ph.D., professor and Ruth Merns Chair of Biochemistry at Einstein and senior author of the…
I'm always loath to criticize mainstream discussions of the antibiotic resistance, particularly when the link between antibiotic use in agriculture and antibiotic resistance is raised. But, while NY Times columnist Nicholas Kristof meant well, he missed the mark. In his column about MRSA ST398, he describes things that might happen. Here's one example: Public health experts worry that pigs could pass on the infection by direct contact with their handlers, through their wastes leaking into ground water (one study has already found antibiotic-resistant bacteria entering ground water from hog…
Nicholas Kristof has an interesting op-ed in the NY Times about the relationship between pig farming and MRSA. I'll be curious to see what he writes about in his next column, since he says, "This is a system that may help breed virulent "superbugs" that pose a public health threat to us all. That'll be the focus of my next column, on Sunday." I feel somewhat vindicated since this is a drum I've been beating for a long time; I've also been involved in efforts to curb the use of the antibiotic cefquinome in agriculture. The other good thing is that ScienceBlogling Tara, who has published on…
A recent article that examined the relationship between antibiotic use and antibiotic resistance in Finland made me realize one very sad fact: what is easy to do in Finland is nearly impossible in the U.S. because we lack a national healthcare system (note: I'm not talking about how healthcare is paid for which is an argument about reimbursement, but a uniform system of record keeping and informatics protocols). Consider this from the introduction (italics mine; citations removed for clarity): According to current Finnish care recommendations, the first-line antimicrobial agents for the…
Patients without healthcare make bad self-diagnoses. I'm shocked. The NY Times has a heartbreaking story about people under 30 who can't afford healthcare. It's pretty horrific: juvenile diabetics who have to switch from insulin pumps to injections (which lowers blood sugar control), a woman who went to the emergency room for 46 hours and wound up owing the equivalent of a year of college tuition, and so on (that I can say "and so on", and you can probably come up with your own examples is indictment enough). But this gobsmacked me: Ms. Polec's roommate, Fara D'Aguiar, 26, treated her…