The Most Dangerous Bacteria 368
An anonymous reader writes "Forbes has a story listing the six most dangerous bacteria (one's actually a fungus, but it kills people who get it half the time) that have afflicted athletes, soldiers, and hospital patients. Some scientists worry that even with a bunch of new antibiotics hitting the market, there still aren't enough and they want legislation to make it easier for companies to develop them."
Be afraid, be very, very afraid (Score:4, Informative)
He spells out how bacteria acquire their antibiotic resistance: The runoff of tainted feedlot manure, containing millions of pounds of diluted antibiotics, enters rivers and watersheds where the world's free bacteria dwell. In cities, municipal sewage systems are giant petri-dishes of diluted antibiotics and human-dwelling bacteria. Bacteria are restless. They will try again, every twenty minutes. And they never sleep.
If you haven't read it already, click the link - it is well worth it. It still scares the hell out of me, and it looks like his dark vision is coming true...
Aspergillus. (Score:2, Informative)
Fungal infections in people are nasty. They can progress quickly and have awful symptoms. The problem with these infections, in comparison to bacteria, is that our two Kingdoms are relatively closely related. The chemicals that affect fungal growth, for example, often negatively us as well and have multiple side effects.
Don't go to the "next" page automatically, ever!! (Score:3, Informative)
Out of spite for Forbes, here's the list (yeah yeah, you can click slower/faster/stop)...
Methicillin-resistant Staphylococcus aureus (MRSA)
Drug-resistant "staph" causes 102,000 hospital infections a year, more than any other. For sick patients, it can be a killer. Recently, S. aureus has escaped the hospital. The number of children infected jumped 28% in three years. Now, athletes are being infected. In 2003, five football players on the St. Louis Rams suffered staph-infected turf burns that resisted multiple antibiotics.
Escheria coli and Klebsiella
These bacteria, a major cause of urinary tract, gastrointestinal and wound infections, are quickly becoming resistant to existing drugs. Half of Klebsiella, for instance, were found to be resistant to Cipro in a recent study. More worrisome, two experimental drugs being tested against these bacteria are in the same class as drugs to which the bugs are already resistant.
Acinetobacter baumannii
This drug is perhaps most well known for its presence in troops returning from Iraq, where it has infected dozens of patients and spread to others inside hospitals. It is also an increasingly common cause of pneumonia, now accounting for 7% of hospital-acquired cases. There are few existing drugs to treat it, and no medicines in development targeted at this bug.
Aspergillis
Cancer patients, transplant patients and others with weak immune systems are at risk of being infected with this fungus. Once it gets loose in the bloodstream, aspergillis kills 50% of the time or more--and that's with the best new antifungal drugs that have been developed in recent years. Experts complain that drug companies are choosing to test their medicines on other, easier-to-treat fungal infections.
Vancomycin-resistant Enterococcus faecium (VRE)
VRE is a major cause of infection of the heart, brain and the abdomen. A recent survey of 494 U.S. hospitals found infections of 10% across all patient groups. Current drugs do not rapidly kill the bug, and only one is available as a pill.
Pseudomonas aeruginosa
This bug is better than most other bacteria at becoming resistant to new antibiotics. A third of P. aeruginosa were found to be resistant to drugs like Cipro and Levaquin in 2002. Patients with cystic fibrosis are at particular risk; antibiotics can keep them healthy, but once bacteria become resistant, they may need lung transplants.
Bacterial resistance? It's an exercise in futility: doctors are very careful in prescripting antibiotics unnecessarily, but as far as I know, animal feed is laced with antibiotics (makes them grow faster, and you get less disease in crowded conditions). The antibiotics used are related to the ones used in humans. All this resistance came not from antibiotics we use on ourselves, since it is dwarfed by those use for feeding pigs and chickens... Who to blame though? This is a classic case of the "tragedy of the commons" - if one doesn't use antibiotics for his/her farm, one's competitor will.
Use of antibiotics (Score:2, Informative)
The human body is a veritable petri dish, perfectly incubated and full of nutrients. Most antibiotic courses are prescribed in a dosage that will kill the majority of infections of that type, plus a little for safety's sake. If the course of antibiotics is stopped or if the medication is taken over too lengthy a period of time in too small a dosage, then the bacteria take advantage of the wonderful petri dish that is your body. Because they have had an innoculation of antibiotic (just like we give viral innoculations to prevent disease) their tiny cells evolve and can survive the next antibiotic onslaught, keeping the bacteria able to reproduce and people more ill than before.
You may counter and ask why don't we give everyone wide spectrum or cocktails of antibiotic treatments on a regular basis since they are normally more effective against the treatment of bacterial infection? It goes right back to people not following their course of treatment. If medical professionals begin to prescribe these more hard-hitting treatments as a matter of course, then those treatments will quickly become obsolete for the same reason as mentioned above. This is of course ignoring the effect of very strong antibiotics on the helpful bacteria living in our systems which assist said systems in functioning.
Moral of the story: Do like you did in Kindergarten and follow directions (even if you start to feel better after the first day or two of treatment).
No new Gram negative rod coverage! (Score:3, Informative)
The ones mentioned in the article, however, are really all over the place and quite prevalent in the environment (yes, even MRSA—at least where I practice medicine, the prevalence rate of community-acquired MRSA is somewhere between 30-50% of all Staph infections. They are no longer exclusive to the hospital.) They generally don't cause problems in people who have intact immune systems and have intact normal flora. The reason you run into trouble is that patients who have these bugs growing in their bloodstream or eating their lungs are usually already very sick, which automatically means their immune systems are shot out. And if they've been sitting in the hospital for a while, chances are they've had their share of powerful antibiotics which have wiped out all their friendly, benign bacteria that often keep these bad actors in check.
The Gram-positive cocci that get resistant—Staph. aureus and the Enterococci—are still pretty much killable. If you get MRSA, the community-acquired variants still tend to be sensitive to other drug classes like clindamycin, the sulfas, and the tetracyclines. The hospital-acquired variant tends to be tougher, but there's always vancomycin. There have been a few reported cases of vancomycin-resistant Staph. aureus but there haven't been massive outbreaks—yet. Vancomycin-intermediate forms are more common, however. Then there's VRE (vancomycin-resistant Enterococcus). For these, you can use linezolid, and so far this works pretty well, although there have been isolated cases of resistance as well (though much less common than vancomycin resistance.) What freaks me out, though, is that we're starting to use this stuff like candy, especially since it's available as a pill.
The nastiest bugs, though, are the Gram negative rods, which include E. coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumanii. We tend to treat Pseudomonas with a lot of respect because it becomes rapidly resistant to antibiotics, and if we find it, or even just suspect it, we start off with two agents at least off the bat. Acinetobacter, on the other hand, is pervasive in the environment, and usually only starts causing problems when it has overgrown, usually in chronically-ill patients who have been in and out of the hospital a lot and who have gotten frequent antibiotics or, as mentioned, in ICU patients who have gotten multiple courses of antibiotics. The problem is that it is very hard to kill, since it is frequently multi-drug resistant and we often have to start out with big guns like meropenem. The abuse of penicillins and cephalosporins has caused an ncreasing prevalence of bacteria with extended-spectrum beta-lactamase activity, and even these big guns don't always do the trick against these puppies.
What scares me the most is the fact that there are really no new drug classes in the pipeline targetting Gram negative rods. The newest classes—fluoroquinolones, carbapenems, and monobactams—really haven't seen much development since the 1980s, and fluoroquinolones at least have already become
Out of your mind (Score:1, Informative)
Nothing evolves to be resistant to Lysol. The other 1% survive because it's hard to kill all the germs on a surface with *anything*. There are pits and cracks, the cloth you're using misses little bits, whatever. That's why we have autoclaves.
A "resistance" to Lysol would be, at worst, adjusting to live in Lysol. Such bugs wouldn't then be able to live out of Lysol.
Re:Costly and dangerous (Score:2, Informative)
Your answer (Score:2, Informative)
In the case of resistant bacteria, they no longer have that option.
So to answer your question, yes it's the SCIENTISTS who are asking for more tools in their toolbox. That's not to say their bosses aren't happy about it, but your rush to assume the worst is unwarranted.