The Most Dangerous Bacteria

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."

the theory

[Davak]

As I am a ICU doctor, I see these guys more often that I want.

The problem is that the drug companies don't make much money from antibotics. They have high production costs and are used infrequently...

While hypertension and anti-cholesterol medicines are used by almost everyone if they live long enough.

At least that's the theory why drug companies spend so much less money creating antibotics than other meds.

Re:the 6 most dangerous bacteria

[Davak]

Syphilis is neither that dangerous nor a bacteria.

The title of the article is very misleading. These 6 are the bacteria/fungus that have been become the highest resistant to antibotics.

Pneumococcus pneumonia, neisseria meningitis, and strep soft tissue infections typically kill patients much quicker than the organisms listed above.... we have good antibotics for these; however, they can just overwealm the system before the antibotics have time to work.

I had a MRSA infection

[multiplexo]

I acquired it while I was in the hospital in 2004 to have some more of my leg cut off (although the doctors said I might have colonised me outside of the hospital and gone active once they did the surgery, yeah right). The treatment for MRSA was eight weeks of IV Vancomycin and 1000mg of Cipro every day. Now Vancomycin is nasty, nasty stuff, it's pH is so low that it will kill any veins you have it injected into, so you have to deliver it through a central line. It can also cause liver and hearing damage, so if you're on it for any length of time you have to get your liver enzymes tested and your hearing check. It's the next best thing to being on chemo. Cipro is no fun either and it's really fucking scary that there are bacteria that are resistant to these because these drugs, due to their side effects, are the anti-biotics of last resort, anything stronger would probably kill you outright instead of just damaging your liver and hearing.

Combining antibiotics

[Peaker]

I think that when antibiotics are given, multiple types must ALWAYS be given.
I am not sure if this is the situation today, but assuming multiple anti-biotics require multiple mutations for the bacteria to survive, then multiple antibiotic types should be used to make the antibiotics last longer.

If an antibiotics A requires a mutation with chance P(A) and an antibiotics B requires a mutation with chance P(B), then the combination requires a mutation with chance P(A)*P(B). Giving the antibiotic types separately results in a: MIN(P(A), P(B)) chance of the mutations occuring.

In other words, if we give people "the next" antibiotic type every time, we are "burning" the antibiotics much faster than if we give as many antibiotic types at the same time.

All this assuming different mutations are required to survive multiple antibiotic types.

Since I thought about this in a few minutes of my spare time, I assume that doctors/biology experts know this. My question is: Is this applied? Or is there something I am missing?

Re:the theory

[Morpeth]

My g/f is a doc (Internal Medicine) and all people want are drugs, drugs, drugs. Slightly off-topic, but no one wants to hear her tell them to quit smoking, loose weight, eat better (and less), get regular exercise, sleep more. People always want magic pills -- that are also dirt cheap and side effect free, of course.

While sometimes you are simply going to need meds, a lot of people beat the hell out of their own bodies and immune system (see above) and could help themselves a lot by living better. But that takes work...

I know people like to say docs overprescribe antibiotics, and that's probably somewhat true -- though to a much lesser extent now as medicals schools really emphasize restraint. BUT my g/f will literally get into heated debates with patients (who apparently are experts even though they didn't go through med school & residency) that demand antibiotics, needed or not. She, along with many of her fellow docs, get several formal complaints a month from patients saying they aren't being properly taken care of because they didn't get the drugs they wanted. So, to a large degree, we (patients) have done this by demanding them -- and trying to kill things with a nuke when a bullet would work fine too.

Except in practice....

[Anonymous Coward]

I work in pharma.

Odd they are spending billions developing new anti-infectives......

Think about the problem for one minute. Drugs which target, say hypertension always work for hypertension. You don't suddenly get a new type of hypertension develop in man which is resistant to the old hypertension drugs.

New infective agents are developing in nature all the time. So you have to constantly develop new anti-infectives.

In addition a new infective agent can appear overnight. It takes 10 years to a get a drug approved (to prove it a) works b) doesn't hurt you). And that is once you have discovered a drug which you think works.

And drug discovery.... Ho my god. This is basically a crap shot. You get some funky new compound and test it 10000's of different ways (some automated, most manual - Animals) until you notice something interesting.

Fund the academics and non-profits instead!

[posterlogo]

We have the expertise! We just need the equipment and salaries. I am, of course, an academic researcher in biology. I don't personally have interest in anti-microbial research, but there are plenty of us Ph.Ds who do. The problem is, the only choices we have are to stay in academia, where product devlopment is nil, or go to industry, where the bottom line takes precedence over all else. I propose more funding to academic labs (and even national labs) specifically to develop antibiotics (and eventually many other pharmaceuticals). Currently, the big Pharmas take research that began at academic labs based on public funds and privatize it by taking some small step forward. I think this is a big scam for the public, who then has to pay up the wazoo to get any of the tangible benefits. If there were a program specifically to help academics take products to market via non-profits, I think real progress in healthcare could be made, even for these difficult-to-make-profitable antibiotics. But, it is difficult to overcome the Pharma lobby.

Re:the 6 most dangerous bacteria

[puck01]

Wrong on both counts.

1. Syphilis is a spirochete, which is a bacteria. There are other bacteria in this class as well, such as the bacteria that causes 'yaws'

2. Syphilis ravaged Europe and North America among other parts of the world for centuries causing large amounts of morbidity and mortality in newborns and people in late stages of the disease. I'd say that counts as dangerous. Of course, it remains excuisitly sensitive to penicillin and we regularly screen for it now in some populations so its not as common as it once was fortunatly.