A Woman Was Killed by a Superbug Resistant to All 26 American Antibiotics | Hacker News Reader

A Woman Was Killed by a Superbug Resistant to All 26 American Antibiotics

theatlantic.com

43 pointsadanto684015 comments

Can anyone comment on using phages to kill bacteria. I read the this was developed extensively in Russia during the Cold War.

Not a microbiologist nor an infectious disease specialist. However in med school I had an attending who liked to say, "The main difference between me and my patients is I know what page it's on." In that spirit, these seem like decent reviews:

Short overview: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3400130/?report...

Somewhat longer (PDF): https://www.researchgate.net/profile/Sarah_Kuhl2/publication...

I had a little bit about that in med school. Interestingly the largest phage therapy center was (is?) in Georgia. This method was often used for resistant skin infections with e.g. Staphylococcus aureus, so the application was generally topical.

There were also attempts at intravenous administration of phages, but I am not sure about safety concerns there (rapid lysis of bacteria resulting in a toxic shock, excessive antiviral response of the immune system and purification of phages all come to mind).

* https://en.wikipedia.org/wiki/Bacteriophage

* https://en.wikipedia.org/wiki/Phage_therapy

Phages are being researched. This literally comes up in every single HN thread on antibiotics, so once more, posting my "Why Phages Aren't the Answer" shortlist. Note that I love phage therapy - this is the problems as seen by someone who doesn't think it's a dead end:

Phage therapy is neat, it really is, but there are a couple major issues:

- There is no such thing as a "broad spectrum" phage. You can't do empirical treatment using phages, and there's not really "off the shelf" phage therapy - it tends to be a bespoke creation for a particular infection.

- There's some serious regulatory problems, similar to those experienced by fecal transplant treatments. We're not yet really equipped to think about handling evolving, custom microbes as a treatment. - Because of the first, it's going to require a considerable amount more lab capacity than most clinical settings currently have, and considerable delays until treatment.

- There's also some biosafety issues around phage prep, but those are easily solvable. It's a great way to treat particularly resistant or hard to treat infections, but it's not a particularly great general solution. There's a reason it was abandoned in countries with easy access to antibiotics - they're just roundly superior in basically every respect.

I find it almost impossible to take any article seriously that uses the term "superbug". Journalists, please stop using it. People can understand words like multidrug-resistant bacteria. Also shame on the reporter for not even listing the species of the bacteria. I had to click another link to see that it was Klebsiella pneumoniae.

Also the term "American Antibiotics". I didn't realize that antibiotics were citizens of specific countries.

More to the point, I wish these scare tactics would stop. Resistant bacteria is nothing new and its true that we need ongoing constant research into antibiotics and antibiotic-like substances but that's about it.

You are correct: resistant bacteria is not new. Resistance to /all/ antibiotics is.

The problem is that this was resistance can spread to even relatively unrelated bacteria via horizontal gene transfer. This means that it is not unreasonable to expect an increasing number of such fatalities.

The reason people are worried is that this literally puts us back to where we were 80 years ago, in which a cut could actually kill you. Obviously we've come a lot further in understand how contamination occurs, and how infections spread so i suspect that it won't be as bad overall (reduced amputation, faster correct response) but it won't be smooth sailing as usual.

Did you read the article? The only antibiotic that the bacteria showed sensitivity towards is not approved for use in the United States.

And how is this article "scare tactics?" Sure, we have known about increasing antibiotic resistance for years. But this is a sentinel event that absolutely deserves attention. Resistance isn't one of those things that simply disappears if everyone stops talking about it.

Drug approval agencies are country specific.

>I find it almost impossible to take any article seriously that uses the term "superbug".

see: https://scholar.google.com/scholar?q=superbug

Superbugs threaten hospital patients https://www.cdc.gov/media/releases/2016/p0303-superbugs.html

My bet is on the Chinese with their enormous pig farms which feed every pig a constant cocktail of antibiotics to ensure they grow faster to be the ground zero for an antibiotic-resistant epidemic.

Edit Source: A Chinese government official in charge of a meat-producing SOE boasted about it during a presentation seeking foreign investment

The same practice is used by meat producers in the US.

In fact the practice was invented here. https://en.m.wikipedia.org/wiki/Antibiotic_use_in_livestock

Though we're not particularly heavy users of colistin in livestock, unlike China, which is specifically called out in the article.

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