Antibiotic 'apocalypse' warning | Hacker News Reader

Antibiotic 'apocalypse' warning

bbc.co.uk

84 pointsNux108 comments

It's interesting that governments are aware of the threat, but they don't take any action against the root cause, which is inappropriate, nonmedical antibiotic uses, particularly with livestock and poultry.

http://www.nytimes.com/2012/12/17/opinion/antibiotics-in-liv...

Cramming loads of animals together and pumping them with antibiotics is probably widespread farming procedure by now. I would imagine changing this will require some effort.

Not to mention this will prolly raise the price of your favourite horse, errm.. beef burger at the local supermarket. :-)

There are always neigh-sayers

(sorry)

One of the best things about HN is the lack of idiotic pun threads. Leave that to reddit.

We vote with every purchase, we can help by not buying meat that uses antibiotics (natural/organic/etc), and by not taking antibiotics unless the doctor strongly recommends. I tell my doctor straight up that I do not want meds unless necessary for my health and safety. I do not trust the pharmaceutical industry one bit, I personally believe that they create as many problems as they solve.

My understanding is that antibiotic usage in cows is that it significantly increases their growth rate given the livestock feed we use by altering their gut flora to utilize the nutrients better. If MRSA became resistant to whatever antibiotic they use, I don't think it would alter agricultural practice since that's not what they're using it for.

I could be wrong since this is way out of my areas of interest, but AFAIK it has nothing to do with fighting off infections.

Any idea how the antibiotics make them grow faster? You'd think killing gut flora would make them grow more slowly?

Cattle don't need flora to digest grains. They never ate grain in their evolutionary past, only grass. Their flora doesn't process it- which is why E. coli takes over.

The majority of cattle which end up in a grocer, convenience store, or restaurant spent most of their life completely infested with E. coli. Right up to the point of being thrown into the grinder.

E. Coli is commonly found in the intestines of all warm-blooded animals, and it is usually harmless. There are only a few problematic strains.

They are raised in unsanitary conditions and antibiotics reduce the infections. Watch the documentary Food Inc. for a good overview of how screwed up the US meat industry is

Lobbyists.

I don't think people understand how much this matters. If you were an evil genius and wanted to destroy Earth's antibiotics, there would almost be no better way than to mass feed it to animals that can have diseases jump to humans. It's the number one reason I'm vegan.

It's even more astonishing that a reputable news organization like the BBC would do a story on it and not mention livestock. It would be like doing a story on global warming and not mentioning carbon emissions.

Apparently this practice was banned back in April of 2012?

http://www.nytimes.com/2012/04/12/us/antibiotics-for-livesto...

Tell that to my local feed store. I picked up package of Terramycin (Oxytetracycline) powder at one a few months ago.

If so, shouldn't you be reporting it to the FDA?

Why would I want to do that? No need to get a vet involved when you know what you're doing. It's not like I used it as a feed additive for growth stimulation (which is a horrible practice, in my opinion).

Sorry, I thought you just implied your feed store was illegally dispensing antibiotics without prescriptions. Maybe you know what you're doing, but that does not imply that everyone else is.

I certainly didn't have a prescription. As best as I can tell, the linked article above states the FDA wants manufacturers to voluntarily label their products as prescription-only, which will presumably reduce indiscriminate selling and use of such antibiotics. They threaten a mandatory change in regulations if the problem remains.

I know antibiotics are a public health problem, but I'd personally be pissed if I needed to pay extra for the drugs and a vet's involvement for such a simple thing. We're talking $6 or so for the meds I mentioned earlier. How much does the average farm vet house call cost? Beats me, but I'm not anxious to find out, and it might be better to put down an animal than shoulder such expense.

The FDA (or maybe that would be the USDA?) would be better off to simply ban sale of animal products with any measurable trace of antibiotics. Period. That would certainly cause a major upset in the industry as we know it, but the living conditions of commercially-raised meat animals is appalling and could use the change.

It's not quite as simple as your making it out to be. It would be reasonable to ban any and all use of antibiotics on livestock for any reason. If instead of an outright ban you dramatically increased the cost you get similar benefits and still allow for edge cases.

PS: There is a finite amount of discoverable antibiotics FOR ALL TIME. Without a long term replacement or human extinction any and all systimatic use of antibiotics on animals will lead to significant human casualties (as in millions to billions of human lives.) Granted most of these people have not been born yet but it's way more important than a lot of other hot button issues.

It has been an established medical principle since 400BC that letting people die now to save others (whether more or less) in the future would never, ever, under any circumstance, be considered valid medical practice.

Besides, many say it's too late. Resistance genes are in the wild and bacteriophages will spread them. Nothing can prevent that. Banning it's use on livestock at this point will most likely be an exercise in futility, like shooting the evil queen after eating the poisoned apple.

In order to kill the resistance of the existing bugs we'd need to start letting people die from both kinds of bacteria, resistant ones and non-resistant ones, so that the energy efficiency the non-resistant ones gain very slowly wins out over the advantage of treatment resistance that the resistant ones have. If any small subset of humans for any reason deviates from this, it negates the effects, so effectively you cannot have even a small country disagree. Nor can you get away with only treating the rich. Not for a year or two, but likely for centuries. And even when that does happen, you still have to limit usage of the drugs.

Please note that it isn't necessarily so bad. Viruses have won the resistance battle against medication decades ago, and aside from a few incidents, effects have been relatively limited. There has not been an even medium-scale pandemic. But there are quite a few viruses where getting infected means it's curtains, and no treatment is possible. One particularly scary one is rabies. Fortunately, inoculation still mostly works, with only a few exceptions (like HIV).

We've lost this battle, let's just move on.

You have no idea what your talking about. First off Antibotics have never worked on Viruses, full stop.

Second it's not an all or nothing story. We use far more antibiotics on Animals than people and that's a huge issue because it's eroding effectiveness not simply creating a single super bug that will now rule for all time.

On the other hand, the BBC did air an excellent Horizon episode last year, "Defeating the Superbugs" [1], which did cover the livestock angle in detail.

[1] http://www.bbc.co.uk/programmes/b01ms5c6/clips

The majority of human use is inappropriate also.

So I used to believe exactly this until a friend of mine (who happens to be attending the most prestigious veterinary school in the US) linked me to this post: http://www.foodsafetynews.com/2013/01/antibiotics-and-animal...

Food Safety News is a rag published by a personal injury law firm (Marler Clark). When foodborne illness outbreaks occur and people get sick, the firm profits.

I wouldn't read that article as serious journalism.

Is there a factual claim made you take issue with? I'm having trouble understanding how the sponsorship of a personal injury law firm discredits what's said in the piece. Are you implying that these lawyers actually believe antibiotic use in livestock to be harmful to humans, but publicly state otherwise to get customers?

It's not only the use of antibiotics for livestock. In Russian prisons for example TB is a big problem, but there isn't enough money to give every patient the full antibiotic treatment. This results in a patient getting antibiotics for a few days and then the treatment stops before the TB is fully healed. Those are ideal conditions for TB to become resistant against antibiotics. I am sure similar things are happening elsewhere where there is a lack of funding. I am also pretty sure tat so e patients think they are cured and decide to stop treatment premarturly, resulting in the same problem. Link to the Russian prison problem: http://microbewiki.kenyon.edu/index.php/Tuberculosis_in_Russ...

Norway does: http://www.cbsnews.com/2100-205_162-6014559.html

And it works.

EDIT: Actually, Norway's success in reducing resistant infections is due to their limiting of antibiotics use in humans.

You're generalising US practice globally. In the EU, antibiotic use in livestock is strictly regulated. Antibiotics can't be used as a feed additive and can't be used prophylactically. The parliament is currently debating a complete ban on the agricultural use of several "last resort" antibiotics that are important in the treatment of drug-resistant infections. Even China are banning the use of antibiotics as a growth promoter.

As others noted, inappropriate use in humans is at the very least, to blame too.

In many countries, antibiotics are sold over the counter and/or given as placebo to patients who visit the doctor with a virus infection.

This is a prime example of a tragedy of the commons: you can be as careful as you want in your use of antibiotics, but that will not help much if others are breeding resistant strains. For an example, look at the map at http://en.wikipedia.org/wiki/Methicillin-resistant_Staphyloc... or at the data in http://www.sante.public.lu/publications/rester-bonne-sante/m... and compare Scandinavia and, to a lesser extent, the Netherlands and Germany with other EU countries.

People who work in the goverment know about the threat but they in of themselves can not solve it.

Someone has to formulate a specific policy and then get it through the House/Senate sub-committee if they want funding. In a period where there is a strong tide against all goverment spending and some very anti-science people that are key in the process I'm not hopeful that a solution will come up soon.

Time to step up the research into the therapeutic use of bacteriophages. If the bacteria evolve, then let's create cures that evolve along with them.

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

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

The problem is you can't talk to your immune system to explain why it should leave those particular viruses alone.

They're bacterial viruses. They have zero interest in your cells.

Right, I think the point is that your immune system doesn't know that and will attack them.

Considering how often they'll be glued to the bacteria they're fighting, sounds fine to me.

I'm not even sure that they're recognized by the immune system as a threat. They won't be causing any infections that would trigger a response.

Response is triggered by any foreign protein. It does not matter it is not infecting your cells. Anything that is not known to be you is attacked. And the more and longer you have of it inside of you, the bigger the immune response gets.

This is really sad: "patent issues (specifically on living organisms) may complicate distribution for pharmaceutical companies wishing to have exclusive rights over their "invention", making it unlikely that a for-profit corporation will invest capital in the widespread application of this technology."

The biggest cause IMHO is the rampant use of antibiotics in farm feed. It's been proven NOT to be effective. And worse, it's given everyday with no infection. And the amount is multiples of human consumption!! Why focus on human consumption when antibiotics in farm food is rampant and on a much much bigger scale of consumption.

That's one of the reasons I prefer organic meat, where such behavior isn't allowed.

Really? Here's a whole list of synthetic medicines that can be used on organically raised livestock (US Law):

http://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&SID=0bc0fb14...

And if it's considered to be non-synthetic, the only restriction is strychnine.

As mentioned by tocomment in another thread, the rules are apparently changing.

http://news.ycombinator.com/item?id=5110144

This is for Organic certified livestock, not general livestock.

At least that's the KRAV rules, but that's mostly a Swedish organisation/set of rules. They explicitly forbid pre-emptive use of medication (but require swift treatment of ill animals).

Ditto. Organic milk too: http://www.news.harvard.edu/gazette/2006/12.07/11-dairy.html.

See the article linked by CreRecombinase: http://www.foodsafetynews.com/2013/01/antibiotics-and-animal...

Summary: most of the antibiotics given routinely to animals are of types that are never or rarely used in humans. The most effective antibiotics are already restricted to human use or require a prescription for animal use.

See my comment above - Food Safety News isn't a real news outlet, it's a rag published by the personal injury firm Marler Clark.

So I'm not an evolutionary biologist or a doctor, and this is a heavily studied problem, so I am not going to say "they're doing it wrong." There's probably just something I'm missing, and I want to know what it is.

But the problem with drug resistance is that these bacteria strains evolve when exposed to a drug, so that the mechanism of action for the drug stops being effective. What I want to know is: why aren't we treating new infections by giving patients a drug with every (still working) mechanism of action at once, attacking the infection on multiple fronts?

Essentially you'd be massively constraining the optimization problem that evolution has to solve, and making it way more unlikely that the bacteria in the patient could acquire all of the necessary mutations before being wiped out.

So what is it about this strategy that wouldn't work? Why are doctors still just prescribing amoxicillin alone?

In two words: side effects.

Some powerful antibiotics are very toxic (e.g. liver, etc) and thus less used.

I'm not an expert either, but combinations are apparently used. For example, you mention amoxicillin, which is often combined with something called clavulanic acid [1]. Another combination drug is Trimethoprim/sulfamethoxazole [2].

Some diseases, like resistant tuberculosis, are sometimes treated with antibiotic "cocktails".

The problem is that combinations of antibiotics may have cytotoxic effects even at doses lower than normally harmful. Those two combinations above are used because they are known to work in synergy, with few side effects.

Some antibiotics are not used except as a last resort precisely because they are so toxic to the human body that they might kill the host in the process of eradicating the target bacteria. In fact, antibiotics are found in nature all the time, but they tend to be too toxic to use.

[1] http://en.wikipedia.org/wiki/Amoxicillin/clavulanic_acid

[2] http://en.wikipedia.org/wiki/Trimethoprim/sulfamethoxazole

Precisely

There are some infections that call for combination therapy but it must always be done with an eye to side effects;

Effectively microbiologists work out what the 'MIC' or minimum inhibitOry concentration is, and then use that because hopefully that will be the least likely to cause other side effects, or I.e. totally obliterate the patients GI fauna which could open them up to attack by something worse

Surely the worst side effect would not be obliterating GI fauna but systemic cell death (apoptosis) or similar, though?

I don't think (not a doctor) that antibiotics can cause large scale apoptosis (except in unrealistic quantities).

Many antibiotics in a cocktail in significant dosages can cause kidney failure.

More unlikely is not 0, and you don't want to skip all the mid points and create the super bug in one treatment. Probably safe if you do this now and then, but not if it's the SOP for antibiotics.

No idea if that's why they don't do it. Side effects sounds plausible too.

Also, remember that medicine is all about postponing the inevitable. We put a ton of money into postponing a person's death. It makes sense that, if they don't have a better alternative, they would continue to use these antibiotics if they got local results even if the practice has an expiration date.

If a patient has a functioning immune system, it generally isn't necessary for antibiotics to clear the whole infection, especially if they're not in the hospital. The course will cull the infection long enough for the patient's body to acquire a sufficient degree of adaptive immunity to heal themselves completely. In some cases (tuberculosis), a typical patient's immune system can't be counted on to win, so cocktails are the norm. Bacterial resistance to antibiotics is not new; as Wiki notes, the genes are "ancient", and simply become more prevalent when antibiotics are used.

http://en.wikipedia.org/wiki/Tuberculosis_management#The_sta...

"The frequency of spontaneous mutations that confer resistance to an individual drug are well known: 1 in 10^7 for EMB, 1 in 10^8 for STM and INH, and 1 in 10^10 for RMP."

So resistance is basically everywhere -- it becomes deadly when it is concentrated.

I don't know much about bacteria and antibiotics, but the strategy you described is the reason HAART is so effective and HIV patients live much longer lives than they did even 20 years ago.

http://en.wikipedia.org/wiki/Management_of_HIV/AIDS

A great problem is partial treatment of disease in developing countries.

For example, India, Russia and China have a large amount of TB. Some patients start treatment regimes but do not complete them. The bacteria develops resistance and then spreads.

Allow this to happen over millions of individuals then throw in international travel, bringing the infection to areas that do not suspect it quite as often. London is having a TB boom due to immigration. (disclosure: I am a doctor, partner specialises in infectious disease)

> is partial treatment

I've never understood this, maybe you can answer me. Doesn't the immune system also kill bacteria? By using antibiotics you kill most of the bacteria, and then the immune system finishes them off.

After all, if any bacteria were left wouldn't they just get the person sick again?

An infection starts with just a few bacteria, a reinfection would be the same - unless the immune system keeps them in check, in which case there are no bacteria left to build resistance.

If a bacteria is resistant then giving the full does wouldn't help anyway, it's resistant after all. It won't do anything except remove all competition so the resistant will be the only bacteria left. It seems to me it's better to try to kill only some of the bacteria so you don't isolate the resistant one so well, and rely on the immune system to kill most of the bacteria.

'resistant' isn't the same as 'totally unaffected by' - it's a spectrum, and the duration of treatment is one of the factors which determines how much of that spectrum is killed. At the 'I feel better now' stage, there could still be quite a large population that would still be killed by completing the course of treatment.

One function of the immune system is killing bacteria, but it can also quarantine and reject (e.g: Phlegm, vomiting, etc) them, which is one source of transmission.

> there could still be quite a large population that would still be killed by completing the course of treatment.

That's perfect! That means if you stop there then what you have left is un-resistant bacteria. That's excellent, you avoided breeding resistance.

So why do you want to keep taking antibiotics that narrows down the bacteria till only resistant ones are left?

You're still breeding resistance, just slightly slower.

In the best case, the full treatment kills all of them, or enough that your immune system can eliminate them completely. Resistance doesn't develop because it doesn't get a chance. They're all dead.

Worst case, you kill enough to weed out those with no or weak resistance, and then spread the infection to others where it can continue to evolve.

So it comes down to (a) how much are you concentrating/selecting for these resistances, and (b) how likely are you to pass it on such that it propagates.

I think it's reasonable to assume that a lower bodily population makes it less likely to pass on, which would be one good reason. Another might be that, by heavily reducing the population, you may reduce the genetic diversity enough that they're susceptible to other factors (ie: when not facing antibiotics, they get starved out by the non-resistant strains because the resisting mutations come with costs attached). By leaving a larger population alive, there's more scope for hybridisation leading to overall stronger species.

I must admit I have little formal knowledge in this area, so it's possible these effects don't exist, or have only limited impact. If I had time it would be interesting to look into it further, it seems like this topic is too obvious not to have been considered before.

On the last bit, resistance isn't a binary switch. If you assume a spectrum, then day 1 kills all the really easy bacteria. By day 4 of 8, you've killed the 85% most killable bacteria, and your symptoms are gone, so you stop. Then you have leftover bacteria that your immune system may or may not be able to handle, but you can still pass it to someone else who doesn't have an immune system primed to fight it off, so their infection starts with the 85th percentile bacteria.

(all numbers arbitrary)

That just makes my question stronger! So why continue the antibiotic till you create bacteria at the 98th percentile?

Stop the antibiotic as early as possible.

It's not like you're going to wait to infect people till you're done with the antibiotic, so the "starts with the 85th percentile" scenario still happens. But by taking even more antibiotic all you do (as far as I can tell) is make even more resistant bacteria.

One reason I can think of is that most Antibiotics do not only kill bacteria, they also stall bacterial growth.

So while the most resistant bacteria are killed at last, they still might not be able to multiply.

Because now you have ten times as many resistant bacteria going out into the world. They are marginally less resistant but they are still resistant, and you have so many more of them.

I'm reaching the end of my knowledge, but I would guess that there's a good tradeoff between reducing the number down to 2% vs culling down to the "best" remainder. You also give your immune system more time to catch up and take car of the rest for you. If you can, with antibiotics, kill off 98% and prevent growth over a week, you immune system can probably handle the rest and you transfer 0 to the next person.

The body does finish them off in a way. They wall off areas of the lung for example, making "tubercles", that contain tissue and latent bacteria.

Future ill health allow these to reactivate.

Interesting you say this. I spent the last year in Bangladesh and while I loved how cheap medicines were (and they seemed legitimate), the doctor/pharmacists who would proscribe them on every street corner seemed to not follow the instructions I found online for the very same drugs.. Sometimes they didn't even follow the directions listed on the box. They'd say "take antobiotics for 4 days" when online it would say to take for 12, for example. It's as if they just sort of winged everything with the aim of doing the minimum to nuke the infection... understandable goal but risky along the lines of what you say.

We should also try to cure common illnesses with other home remedies if possible. How did people get over sinus infections 1,000 years ago? Or did everyone just die? I don't know the answer, but these days antibiotics are handed out to cure everything as a precaution.

I'd love to know the answer to that, because I get those things with some frequency, and antibiotics clear them up very quickly and effectively: after 10/15 days of feeling shitty, I get immediately better within 24 hours. It's hard to know beforehand, though, whether it's really an infection or just a draggy cold. All the 'alternative' type remedies I've tried have been completely ineffective.

Well one answer is that they didn't. Infection was a major cause of death. When you see a brutal dentist scene in a historical film it gives shivers, the missing context is that the patients life was probably being saved.

Whenever my old relatives talk about how they grandparents lived up to 120 years old in remote Russian villages without any doctors, it gives shivers. Last relative died at age 98, so much for modern civilization.

And not like they were on life support when hitting over 100, they were out in the fucking field working.

But yeah, eventually this will disappear and all we have is a book saying that 100 years ago average life span was 30 years so we are doing great increasing it to 60 :D

That's bullshit. Scientists are actively studying populations with high longevity to find exactly why they live so long. No one is trying to hide it.

I'm sure one of the causes for longevity is letting weak children die. Those that survive will naturally live longer than average in a similar population where weak children are saved and then make statistics look bad...

I guess they didn't mention the part about half their siblings dying before they hit the age of twenty, as was common in those times. Cholera. Spanish Flu. Polio. If you can survive all that you're one tough bastard.

Things I learn what not to discuss in healthy discussions :)

There are no home remedies that cure common illnesses. Our body's immune system will often beat bacterial infections on its own. Antibiotics will speed the process up or help those who's immune systems aren't strong enough on their own. Many more people died before antibiotics.

A lot of people just died. Wide-spread antibiotic use has been one of the major contributing factors in the population growth over the past century.

That's why having many children was preferable in time past: it was a foregone conclusion that several of them would probably never reach adulthood, often due to infectious disease

It makes complete sense. We are essentially exposing bacteria in the wild to extremely efficient natural selection.

Congressmen don't believe in evolution, ergo natural selection is a lie because of jesus. On the plus side, natural selection will kick in for humans as well when getting infections removes you from the gene pool, thus making humans more naturally resistant to infection.

A lot of religious folks, who do not believe in natural science, are procreating much more(and at an earlier age) than the average population. With this in mind, I don't think natural selection will be beneficial for civilization...

Was there ever a time when that was not the case?

If it were impossible for the children of anti-science fundamentalists to constitute a sufficient and sane majority to protect science, we'd have almost certainly never gotten to where we are.

That America, a country populated largely by those whose primary intent was the pursuit of religious fundamentalism, was ever the world lead in science and technology puts rather large holes in the "fundamentalists breeding will be the downfall of us all" argument.

Similarly goes the concern about "dumb people breeding more/faster" necessarily leading to the dystopic future of IDIOCRACY.

We can absolutely suffer a reversion to fundamentalism and/or a rise of proudly celebrated ignorance. There are plenty of historical examples of civilizations falling to those threats. I'm just saying that we also have plenty of data that it needn't necessarily go that way.

Evolution and natural selection only apply to the long term over many, many generations. Your short term observations mean very little.

It is, in principle, possible to change people's ideas without first changing their genes.

There's no large scale correlation between religion and procreation. On the other hand, there's a good correlation with wealth/living standards; namely, richer countries reproduce less, poorer countries reproduce more.

Source: http://www.ted.com/talks/hans_rosling_religions_and_babies.h....

Most religious people (in the USA) believe in "micro-evolution" but not "macro-evolution" (both terms have been made up by religious people).

They accept that evolution can cause variations within species (anti-biotic resistant bacteria being a very clear example) but don't accept that evolution causes speciation.

This has been one of the things that scares me the most about the future. I really don't want to end up in medieval times, i fear something like this would lead to a weird high tech medieval world.

The good news is that it is 'merely' a public health crisis. We still have hygiene and sanitation and the germ theory of disease (that latter makes the others far more effective and has only been widely accepted for ~100 years).

That may be so, but they had antisepsis, vaccination and the germ theory of disease in the 1920s and 1930s ... and it still didn't save them from losing as many people to fulminating bacterial infections as we lose to cancer today.

I'm not eager to be without antibiotics or anything. I'm glad (at least some) people are taking the problem seriously.

I guess I just think about it from the angle that the public health system has to run around drumming up popular support to get anything new done, even though all the boring old stuff they do has such a huge impact.

Here's a thought: out-sourcing hospital cleaning services to the lowest bidder is a really bad idea. Because the other term for "hospital cleaning services" is "infection control".

Similarly, elderly patients frequently end up suffering from malnutrition in hospitals because of poor food and/or not enough staff to feed people with difficulty eating. And malnutrition leads to immunological depression. Again: shaving margins on this stuff costs lives.

New drugs actually come some way down the checklist of things we need to be doing to contain infectious diseases.

>>>We still have hygiene and sanitation

Those are the first things abandoned by the homeless. Who have also been the breeding pool for resistant TB.

Somewhat slanting the topic here, but what happened to Tetracycline (non-synthetic)? One of the oldest, inexpensive treatments available – discontinued for, what appears to be, no tangible reason. It was highly effective for all sorts of infections and was involved in some groundbreaking studies that tested its use as a cancer treatment, as well, was found to slow angiogenesis, treat rheumatoid arthritis, aging, depletion of collegen, acne, prostate cancer and treatment of fibromyalgia just to name a few. It's also a pretty reliable anti-inflammatory.

For whatever reason, it is now hard to get or not available at all. Any insight into this?

I think it has lost favor versus other drugs in the same family such as doxycycline and minocycline are still available, but have less adverse effects

Thanks :) I personally found that mino/doxycycline were not as good as tetracycline for treatment of acne and I don't know why. I'm concerned that the same is true of the other potential applications.

I wonder if phage therapy will be the best future treatment of bacterial infections.

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

Saw this recently, and apparently there are people working on it: http://www.bbc.co.uk/programmes/b01ms5c6 (or on everyone's favourite torrent site)

I'm imagining a completely modular hospital composed of detachable rooms and corridors made of fabric, such that each room can be torn down, hard boiled, and replaced after every patient/procedure/day. The same for corridors every week, entire wings every month. (For example).

Is this anything approaching a workable idea?

Much better option is just to add high intensity UV lighting to sterilize the AIR and most surfaces. For deep cleaning there are plenty of more or less mechanical solutions that are next to impossible to evolve around.

I've read interesting research that suggests that subjecting surfaces to ultrasound discourages the development of biofilms. This also helps cleaning.

In some hospitals they have rolling columns of UV lights that they leave in rooms after chemically cleaning them to provide an extra cleansing effect and also reduce airborne transmission of disease.

Switching standard fixtures over to copper based alloys (which have antimicrobial properties[1]) might be a good place to start.

I'm not sure to what extent the physical plant (walls, floors, etc) is the primary source of transmission compared with the staff/patients/visitors. The stats on something as basic and fundamental as hand-washing are often quite shocking.

[1] https://en.wikipedia.org/wiki/Antimicrobial_properties_of_co...

I am not sure if this helps in any way, but it just popped up in my newsfeed http://mashable.com/2013/01/24/ibm-hydrogel/

[edit: typo]

Auggesting that "we might not ever see global warming" is a foolish way to raise awareness of this issue. To begin with -- we are seeing it just as we are seeing increasing drug reistance in bacteria.

I think the point she was trying to make was that, while global warming gets a lot of attention from governments and media, it won't matter much if we're all killed by drug resistant infections in the next 10 years. In other words, she's saying that our priorities right now are not in line with the timeframes of the threats we're facing. Of course, there's no reason we can't address both at the same time.

To claim that two threats are equal, only to then turn around and deny one of those threats, is not a very good way to argue that the other threat is a grave concern.

You want to co-exist with bacteria, not wipe them out. Diplomacy versus war.

Se probiotics.

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