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August 12, 2010 5:09 PM   Subscribe

New Delhi metallo-beta-lactamase has been found in India and Pakistan, Sweden, the Netherlands, Australia, Canada and the US. "Medical tourism, family travel and international migration have combined to import a potent new form of antibiotic resistance halfway around the planet—and the physician-researchers who have tracked its rapid spread say it is already on the verge of becoming untreatable." You hear that? UNTREATABLE!
posted by vidur (34 comments total) 5 users marked this as a favorite

 
SHUT.

DOWN.

EVERYTHING!

/oblig.
posted by cerulgalactus at 5:20 PM on August 12, 2010 [2 favorites]


Nuke it from orbit...
posted by Greg_Ace at 5:27 PM on August 12, 2010


New Delhi metallo-beta-lactamase

Goddamn! Music genres are so fractious these days!
posted by lumpenprole at 5:30 PM on August 12, 2010 [25 favorites]


I first heard about this yesterday, via a breathless tabloid TV promo advert. So my immediate reaction was "Western doctors upset that their lifestyle is being threatened so they are going FUD with both barrels."

Plus, I already thought there were UNTREATABLE antibiotic resistant bugs wot have been living in our hospitals for decades?
posted by uncanny hengeman at 5:33 PM on August 12, 2010 [1 favorite]


This is what happens when people on AskMe give medical advice.
posted by Blazecock Pileon at 5:33 PM on August 12, 2010 [15 favorites]


The Guardian asks: Are you ready for a world without antibiotics?

Variations of this story have been mking the rounds, I'm glad it popped up here because I know there are a lot of cool-headed Hard Science types hanging around and I'm curious to hear a less sensational spin on the whole thing.
posted by chaff at 5:34 PM on August 12, 2010 [5 favorites]


The Guardian article is certainly apocalyptic.
posted by edheil at 5:38 PM on August 12, 2010


I will survive by replacing all my bodily fluids with potent spirits to dispel the evil ghosts.
posted by The Whelk at 5:40 PM on August 12, 2010 [4 favorites]


So glad I had my bout with mostly-antibiotic-resistant-staph in late 2001 (except for trying to get Cipro for a legitimate reason during the Great Anthrax Scare). Surviving it means I have built up an immunity to everything now, right?
posted by oneswellfoop at 5:40 PM on August 12, 2010


I'm curious to hear a less sensational spin on the whole thing.

Wash your hands more often, that's a really good thing you can do now until new drugs come online. It might look grim, but medicine is progressing at a very fast rate. Ten years from now may bring discoveries and treatments we can't foresee.
posted by Blazecock Pileon at 5:42 PM on August 12, 2010 [1 favorite]


Thanks for that Guardian link, chaff. Interesting, and frightening, stuff.
posted by flapjax at midnite at 5:44 PM on August 12, 2010


WHAT
THE
FUCK
New Delhi metallo-beta-lactamase?
posted by mr_crash_davis mark II: Jazz Odyssey at 5:45 PM on August 12, 2010 [1 favorite]


I will survive by replacing all my bodily fluids with potent spirits to dispel the evil ghosts.

May I suggest some potent percussion to go along with that? You can't be too safe, you know!
posted by flapjax at midnite at 5:48 PM on August 12, 2010


Not surprisingly, there's another side to this story. Not that it makes me any more hopeful about the results.
posted by sneebler at 6:08 PM on August 12, 2010


Ten years from now may bring discoveries and treatments we can't foresee.

And at the rate medical and pharmaceutical costs are going in the US, I'm gonna guess we'll have to take out home equity loans to afford the prescription (seems like we're already there for the surgery).
posted by crapmatic at 6:11 PM on August 12, 2010




Ten years from now may bring discoveries and treatments we can't foresee.

Some of them based on things we knew about all along. (previously)
posted by jackflaps at 6:45 PM on August 12, 2010


> Goddamn! Music genres are so fractious these days!

I keep telling my little music genres at home to be in bed at 10 pm, eat their vegetables, and do their homework, but they never listen.

fractious
posted by christonabike at 7:26 PM on August 12, 2010


Phage therapy has several potential advantages over antibiotics. One of them is that phages are very specific to the bacteria they invade and do not harm the useful bacteria that live in and on the body. Most of the antibiotics we currently use also attack harmless and even beneficial bacteria that make a living on us. This can lead to severe diarrheal infections or colonization by other undesirable organisms (such as the current hospital spread of Clostridium difficile), especially in patients with a weak immune system.

What are Phages?

Still scared? Move to Georgia
posted by a non e mouse at 7:31 PM on August 12, 2010 [1 favorite]


[Madagascar joke]
posted by BeerFilter at 7:48 PM on August 12, 2010 [2 favorites]


It sounds like its just another spontaneously evolved gene that encodes an enzyme that breaks down beta lactam family of antibiotics - really common ones like penicillin and cephalosporins. There are non-beta lactam antibiotics out there, like vancomycin or daptomycin.

The biggest challenge with phase therapy is targeting the phage to specific populations of bacteria and hope that the phage doesn't manage to infect the beneficial commensal bacteria that body likes.
posted by porpoise at 7:50 PM on August 12, 2010


cerulgalactus, BeerFilter, It's finally beaten me, I've heard it referenced too many times. I'm going to have to check out what this Madagascar meme is all about.

This gif always makes me smile: http://cdn2.knowyourmeme.com/i/6911/original/madagascar.gif
posted by uncanny hengeman at 8:03 PM on August 12, 2010


It seems obvious that a naturally evolving medicine (phage) that keeps up with the bacterias' mutating cycle is going to be faster to deploy than anti-biotic for new resistant strains.

I'm wondering why it's taken so long to find its way into mainstream practise.

/there is no cabal?
posted by a non e mouse at 8:15 PM on August 12, 2010


The Soviets did a lot of phage research, while W.Eur/N.Am were into antibiotics, post WWII.

Antibiotics are the primary form of ... biotic... control around the world today. People buy boxes of 500mg cipro over the counter in much of E.Eur and other places.

Getting the phages to do exactly what we want and keep doing so is hard. However, we've got metric tons more molecular tools than back when television was black and white. I dunno, maybe make the phage express a high fidelity polymerase that's dominant negative to the endogenous primary mitogenic polymerase in addition to the normal lytic activity. Easier said than done.
posted by porpoise at 8:41 PM on August 12, 2010


Heh - might be easy for you to say, my brain just exploded!
posted by a non e mouse at 9:03 PM on August 12, 2010


Maybe ten years from now phage therapy will be dramatically more widespread.
posted by KokuRyu at 9:13 PM on August 12, 2010


Easier said than done.
You aint kiddin'!
posted by Duke999R at 10:07 PM on August 12, 2010


Maybe ten years from now phage therapy will be dramatically more widespread.

Not if we can help it.
posted by the Cabal at 10:18 PM on August 12, 2010 [4 favorites]



Easier said than done

I tried saying out loud what you wrote, and if it is indeed easier said than done, it must be very, very hard to do.
posted by DreamerFi at 12:37 AM on August 13, 2010


There are non-beta lactam antibiotics out there, like vancomycin or daptomycin.

They don't work against gram-negative bacteria, do they?
posted by mittens at 2:55 AM on August 13, 2010


They don't work against gram-negative bacteria, do they?

Indeed they do not.
posted by atrazine at 4:44 AM on August 13, 2010


Phage research was remarkably advanced in Tblisi until the USSR collapsed. There's still a group of scientists there who are trying to keep the cultures going. They were doing pretty well until Georgia got embroiled in the endless civil war these last few years and now the news is not so good. Currently, the best phage research is supposedly happening in Israel.

As far as phage research in the US goes, the way our system is set up discourages it. Any given infection (and you better hope for a one infection = one microbe scenario) could be any of a number of strains. This means that you either need to have a one phage - one strain match, meaning a library of thousands of strains, or you need to develop phage cocktails. The FDA requires you to test every individual component of a medicine. Phage cocktails might consist of 400-500 strains. To do that in the US we'd have to run 400-500 clinical trials and no drug company wants to go to that expense.

Speaking of those drug companies, why don't we have lots of new antibiotics? The bacteria can develop resistance so fast that it's not worth the time and money to do research to something that will expire faster than your patent will. There's always the risk of lawsuits about side effects and lawsuits from the family of people who died. 95% of infections are in poor countries, and people in poor countries don't have money to give you. Why go to all that effort when you could just cure impotence or acne or something that affects the nice rich people?

There's a bill introduced to encourage drug companies to research rare pediatric cancers (similar issues exist). We aren't likely to see novel antibiotic research unless we encourage the drug companies to do so.

Fortunately, the US is not the only place in the world for scientific research. Maybe we'll get lucky in the US and be able to use the science from someone else. At least two people in North America have traveled to Tblisi for successful phage therapy.
posted by arabelladragon at 7:35 AM on August 13, 2010


Heres the WHO plan from 10 years ago, seems like no-one paid it much attention:

1. Adopt WHO Strategies and Policies (immunization)
2. Educate Health Workers and the Public on the Use of Medicines
3. Contain Resistance in the Hospital
4. Reduce the Use of Antimicrobials in Livestock
5. Increase Research for new Drugs and Vaccines
6. Build Alliances and Partnerships to Increase Access to Antimicrobials
7. Increase Availability of Essential Drugs
8. Make Effective Medicines Available to Poor People
Overcoming Antimicrobial Resistance, World Health Report on Infectious Diseases 2000
posted by Lanark at 10:32 AM on August 13, 2010


Aside: Madacascar
posted by Jilder at 5:20 AM on August 14, 2010


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