Another UK Hospital Scare Story.

[Big Orange]

In this age of air travel there's going to be nasty, exotic microbes cropping up from time to time, but this story seems a bit OTT:

New 'superbug' found in UK hospitals
A new superbug that is resistant to even the most powerful antibiotics has entered UK hospitals, experts warn.

They say bacteria that make an enzyme called NDM-1 have travelled back with NHS patients who went abroad to countries like India and Pakistan for treatments such as cosmetic surgery. Although there have only been about 50 cases identified in the UK so far, scientists fear it will go global.

Tight surveillance and new drugs are needed says Lancet Infectious Diseases. NDM-1 can exist inside different bacteria, like E.coli, and it makes them resistant to one of the most powerful groups of antibiotics - carbapenems. These are generally reserved for use in emergencies and to combat hard-to-treat infections caused by other multi-resistant bacteria.

And experts fear NDM-1 could now jump to other strains of bacteria that are already resistant to many other antibiotics. Ultimately, this could produce dangerous infections that would spread rapidly from person to person and be almost impossible to treat. At least one of the NDM-1 infections the researchers analysed was resistant to all known antibiotics. Similar infections have been seen in the US, Canada, Australia and the Netherlands and international researchers say that NDM-1 could become a major global health problem. Infections have already been passed from patient to patient in UK hospitals.

Story continues in link

I like this Onion/Brass Eye style comedic take on this scare story:

NEW SUPERBUG IS FOREIGN AS WELL
THE deadly new superbug that is going kill you by Friday is not even British, it emerged last night.

Experts say NDM-1 is from Pakistan or India or one of those hot places where people live piled on top each other and share the same piece of lavatory paper for a month.

According to medical journal The Lancet the bug found its way into British hospitals via UK residents who had gone to India for medical treatment as part of a growing trend that confirms the NHS really is fucked into a tinker's bucket.

In a report that is already being photocopied by skinheads in Deptford, researchers said the foreign bug 'invades' host bacteria shortly after getting off a plane from Delhi or Islamabad.

Professor Julian Cook said: "There have only been 50 cases so far in the UK which means the country will be nothing more than a giant pile of rapidly decomposing flesh by two o'clock this afternoon."

He added: "Because I'm a fucking scientist, that's how."

Meanwhile Daily Mail editor Paul Dacre, frustrated by the total indifference to his cloned cow horseshit avalanche, is said to be running round the office like a toddler who has just been given a puppy that shits Milky Ways and ice cream.

A Mail insider said: "Hopefully the main carriers of the bug will be skanky Indian single mums who've just had abortions."

Helen Archer, some bloody woman from Doncaster, said: "I'm so relieved it's from Pakistan. My theory that they were all terrorists was starting to wear a bit thin, but now a scientist says they're going to kill me with their bugs. I'm bullet proof."

Tom Logan, a dick and two arms from Peterborough, said: "Can I just ask - who the fuck is going to India for an operation? Is there really that many people who would actively prefer to have their chest cut open in a country that still has typhoid?"

And Nikki Hollis, an empty space from Grantham, said: "Apparently India is a big centre for cosmetic surgery. Instead of a tummy tuck they inject some of the local cholera straight into your lower intestine and then you just shit yourself thin by the weekend. I'm very interested."

Logan added: "I also heard on the radio that NDM-1 can only be treated with one or two types of antibiotics.

"So maybe those are the ones they should use."

The Dailymash

[Broomstick]

This isn't really news to anyone who has been paying attention.

Antibiotic resistance started increasing in, oh, 1950 although it didn't really accelerate until the 1980's. Highly resistant strains have been around for 30 years. They've been moving into the communities at large for 15 at least. There have been reports of totally resistant infections off and on for probably 5-10 years. And it's not just the UK, it's everywhere in the industrialized world, and rapidly spreading to everywhere.

But, every now and then media breathlessly relates that We're All Gonna Die from this "new" threat that has been decades in the making.

Um... by the way, yes, it's scary as hell. Welcome to the universe, it's a hostile place.

[Big Orange]

Yes, I vaguely remember in an old 1990s documentary that the development of anti-biotics had long become pretty much like a arms race.

[Sea Skimmer]

Even in 1945 they observed more or less instantaneous increases in resistance to penicillin in patients. The big problem today is drug companies want money, and yet since all new antibiotics are reserved for special cases so they are little used. That makes it hard to justify spending 2 billion dollars on a new one. Ironically, and a bit terrifyingly we may have this problem solved in part by antibiotic resistant bacteria. That will mean even the high end anti biotic have to be used in massive quantities, so more incentive will exist to channel money into research. Course the money will take 10-20 years to pay off. An arms race is a very good analogy. Trouble is humanity got lazy, while it was life or death for the germs.

[Stark]

So you called a thread about high-school science a 'UK Hospital scare'... why? It's not specific to the UK, hospitals, and it isn't scary. Are you just paranoid or what?

[Alyrium Denryle]

There is a solution to this... Stop using anti-biotics. Very simple really. The proteins expressed by resistant bacteria are energetically expensive. If you remove the selective pressure that favors them in competition with other microbes, the other bacteria, the pure strain or wild types will be able to outcompete them because they have less metabolic baggage. Granted it really sucks to be the patient...

[Stark]

Various medical associations have tried to limit or curtail the use of various types of antibiotics a bunch of times just in my lifetime.

[Darth Nostril]

Most of the surgeries in my area now have signs at the entrances and in the waiting rooms that state "If you have a cold or the flu then antibiotics will not help. Please do not ask for them."

[LadyTevar]

So... it's a bacteriophage?

[Alyrium Denryle]

So... it's a bacteriophage?

No. Many bacteria can incorporate DNA that is found free floating in the environment. A bacteria carrying the gene necessary dies and degrades, the DNA becomes free floating in the environment, the pathogen picks it up and incorporates it into its own genome.

[Broomstick]

I thought some of it was also due to bacteria having sex with each other, which they can do. Or it's something like sex. I confess, I'm not entirely clear on what they do, but gene exchange is part of it.

[Edi]

I thought some of it was also due to bacteria having sex with each other, which they can do. Or it's something like sex. I confess, I'm not entirely clear on what they do, but gene exchange is part of it.

Exchange of plasmids. Plasmids are a sort of capsule that can contain DNA that can give a bacteria features it would not normally have and these can be exchanged between bacteria.

Plasmids are very energy intensive to maintain, however, so given the opportunity, bacteria will ditch them unless the advantages given by the plasmid are necessary for survival (such as in an antibiotics saturated environment where the immunity comes from the plasmid).

This is all from memory, based on what a biologist friend of mine told me some years ago, so any mistakes should be attributed to me. Those were the main points of it, however.

[Melchior]

I thought some of it was also due to bacteria having sex with each other, which they can do. Or it's something like sex. I confess, I'm not entirely clear on what they do, but gene exchange is part of it.

Some bacteria are able to inject plasmids (a plasmid is small DNA molecule, usually with a pretty simple regulation/expression structure that makes them handy to engineer the production of extraneous proteins in organisms) into other bacteria; the correct term is "conjugation". Keep in mind that usually "antibiotic resistence" (that can be carried by a plasmid) isn't some kind of deep metabolic change that makes the bacterium immune to having, for example, its structural proteins skewered, it's generally a LD50 increase that works often by expressing pumps capable of sending the offending molecules out of the cell, it can still be overwhelmed (the patient might like this less than the pathogens, on the other hand).

[Zaune]

Actually, LadyTevar's comment gives me an idea. What if we were to drop antibiotics altogether and focus on creating targeted bacteriophages to kill TB, MRSA and the like? Would modifying them in reaction to new strains be easier and/or cheaper than inventing new antibiotics for every situation, and would there be potential risk we couldn't keep manageable?

[Gil Hamilton]

There is a solution to this... Stop using anti-biotics. Very simple really. The proteins expressed by resistant bacteria are energetically expensive. If you remove the selective pressure that favors them in competition with other microbes, the other bacteria, the pure strain or wild types will be able to outcompete them because they have less metabolic baggage. Granted it really sucks to be the patient...

They do this with HIV treatment, I believe. "Staggered treatment", where they beat the crap out of the virus with medication until its down to nothing and when it starts showing signs that a mutant has become resistant, they simply stop treatment, let the wild type outcompete the mutant into nothing, then start the same treatment over again to beat the original. This has the advantage that you don't have to fight a losing race trying to beat down each new mutant, but can use the same medication which works best for the patient. The downside is that you've got to let the virus have its way some of the time; however, in terms of HIV treatment, I remember from that biology lecture that it is incredibly successful in keeping HIV in check for decades longer than anyone expected before they tried it.