
Bacteria that resist 'last antibiotic' found in UK - aftabh
http://www.bbc.com/news/health-35153795
======
mschuster91
How about the most obvious solution: Stop keeping (farm) animals in conditions
that require mass antibiotic feedings for the animals to survive?!

~~~
Betelgeuse90
Amen. Animal agriculture (innocuously referred to as "agriculture" in the
article) has to be the single biggest contributor to the existence of these
superbugs.

~~~
Houshalter
Possibly. Agriculture uses about 50% of the world's supply of antibiotics. The
rest goes to humans. That's a lot, but even without it, there are enough
humans on antibiotics to breed resistant strains. Many people take low doses
of antibiotics every day for certain conditions like acne.

~~~
Betelgeuse90
I think a factor of importance is how much selective pressure there is that
could lead to their creation. The sporadic and fairly arbitrary use in humans
doesn't create a selective pressure strong enough to create these superbugs in
meaningful amounts and have them survive.

When used en masse in large, concentrated populations, you're statistically
much more likely to bring these superbugs into existence, and have them
survive. After all, an infected human is fairly isolated. But Stick an
infected chicken in a hen and you've got some trouble on your hands.

------
perlpimp
"Alliance to Save Our Antibiotics says 837kg of colistin was sold to British
farms in 2014."

Why is this being sold to farmers in the first place, the antibiotic of last
resistance?

~~~
invaliddata
Agricultural use of colistin worldwide, and especially in China, dwarfs this:

[http://www.lancet.com/journals/laninf/article/PIIS1473-3099(...](http://www.lancet.com/journals/laninf/article/PIIS1473-3099\(15\)00424-7/fulltext)

(see cached version for the full text, standard link has full text behind
paywall)

... China is the world's largest poultry and pig producer, and in 2014
produced 17·5 million tonnes and 56·7 million tonnes, respectively.25 Most of
the production is for domestic consumption with about 10% for export.26 The
global market value of veterinary drugs increased from US$8·7 billion in 1992
to $20·1 billion in 2010, and in 2018 is anticipated to reach $43 billion.27,
28, 29 China is also one of the world's highest users of colistin in
agriculture.29 Driven largely by China, the global demand for colistin in
agriculture is expected to reach 11 942 tonnes per annum by the end of 2015
(with associated revenues of $229·5 million), rising to 16 500 tonnes by the
year 2021, at an average annual growth rate of 4·75%.29 Of the top ten largest
producers of colistin for veterinary use, one is Indian, one is Danish, and
eight are Chinese. Asia (including China) makes up 73·1% of colistin
production with 28·7% for export including to Europe.29 In 2015, the European
Union and North America imported 480 tonnes and 700 tonnes, respectively, of
colistin from China.29

------
geertj
I'm hoping new antibiotics like _Teixobactin_ get to market quickly.

That said multiple comments have been made here on HN on how there are no
incentives for the pharmaceutical industry to bring a new antibiotic to
market. It would likely be prescribed as a last effort antibiotic, with a very
low volume.

~~~
giarc
Correct, antibiotic stewardship is basically holding back prescribing rights
for last line drugs like linezolid, daptomycin etc, and rightfully so. If
you're a drug company producing the newest drug, and you know that for anyone
to use it they are going to need an pharmacy or ID consult to get it approved,
you can view this as a barrier to adoption.

------
themartorana
_Officials say the threat to human health is low, but is under ongoing
review._

I feel better?

Is my kid going to live in a post-apocalyptic world where a new Black Plague
has wiped out 2/3 of the population because it is completely antibiotic
resistant? Or will new solutions (maybe ones that attack at a molecular level)
be available first?

I'm not asking rhetorically, any input would be awesome.

~~~
mod
From what I've read, the antibiotics can be phased out, and then later, phased
back in.

Because the competition is so high, the bacteria can't afford the
energy/resources to continue resistance to antibiotics that aren't in use--
they are out-competed.

Therefore, currently ineffective antibiotics will become effective again in
the future.

That said, I did not read if this is being practiced already.

~~~
placeybordeaux
The major problem here is not that there are not ways forward, but that we
need to act together as a species to solve this problem. Development of drug
resistance can happen anywhere that antibiotics are used and best practices
are not observed everywhere.

An interesting first step might be to restrict some antibiotics to human use
only. At least then we wouldn't be breeding resistance for cheaper meat.

------
Wintamute
What is not mentioned in the article is that the bacteria in question is
treatable with a range of other antibiotics aside from Colistin ... make of
that what you will.

~~~
aftabh
From the article:

> "antibiotic of last resort - colistin"

> "The DNA that gives bacteria resistance to colistin - the mcr-1 gene - can
> spread rapidly between species.

The concern is that colistin-resistance will now find its way into other
superbugs to create infections that doctors cannot treat. "

~~~
TTPrograms
Is there reason to think that bacteria with every gene for antibiotic
resistance would be at all viable? It seems likely that these genes have other
negative effects on fitness that make them unlikely to spread significantly in
the absence of the antibiotic.

~~~
dredmorbius
The tendency, under selective pressures, is for organisms to become more fit
over time. By applying constant antibiotic-induced generalised selective
pressure, you're greatly increasing those odds

~~~
TTPrograms
"More fit" only makes sense with regards to the pressure. I.e. the bacteria
may survive antibiotics, but that may come at the expense of general
pathogenicity.

The fact that the gene is not already widespread suggests that in the absence
of the selective pressure of the antibiotic it has other effects that decrease
fitness in a typical environment.

~~~
aftabh
I agree with your statement if it was a single (or a limited number of)
species of antibiotic resistance bacteria.

But, the problem seems to be that they'll be acting more like a gang (where
each gang member is a species of bacteria) by multiplying and transferring
their weapons (in this case, antibiotic resistant MCR-1 gene) among different
bacteria species by means of _horizontal gene transfer_ [1].

Here, horizontal gene transfer means bacteria don't need to carry the "general
pathogenicity" as parts of its genome and transfer to future generations (by
sexual/asexual re-production)[2]. They only have to be good (and will be damn
good by MCR-1 gene) at whatever pathogen they carry. "Horizontal gene
transfer" will take care of the rest.

I _think_ we'll get a better idea of the problem I'm trying to explain if we
look at it from "Unix philosophy" perspective which "favors composability as
opposed to monolithic design"[3]. I hope that I'm decidedly proven wrong in
this regard. But, it's just a hope.

Note:

I don't have any formal education/background in medical sciences.

\---

[1]
[http://www.thelancet.com/journals/laninf/article/PIIS1473-30...](http://www.thelancet.com/journals/laninf/article/PIIS1473-3099\(15\)00424-7/abstract)

[2]
[https://en.wikipedia.org/wiki/Horizontal_gene_transfer](https://en.wikipedia.org/wiki/Horizontal_gene_transfer)

[3]
[https://en.wikipedia.org/wiki/Unix_philosophy](https://en.wikipedia.org/wiki/Unix_philosophy)

------
cbeach
Studies show that immigration, sadly, is linked to the spread of antibiotic-
resistant diseases.

Example:
[http://www.ncbi.nlm.nih.gov/m/pubmed/25418572/](http://www.ncbi.nlm.nih.gov/m/pubmed/25418572/)

Immigrant hotspots in London now have tuberculosis rates higher than Iraq and
Rwanda. 80% of cases are people born abroad, and some are antibiotic-
resistant. This is a disease we thought we'd erradicated:

[http://www.bbc.co.uk/news/uk-england-
london-34637968](http://www.bbc.co.uk/news/uk-england-london-34637968)

The U.K. has seen unprecedented inflows in the last year (640K immigrants),
and since then the rate has risen further - to the point where the government
has refused to publish official immigration figures because it would be
"unhelpful" to our negotiation with the EU, and upcoming referendum on EU
membership

[http://www.telegraph.co.uk/news/newstopics/eureferendum/1205...](http://www.telegraph.co.uk/news/newstopics/eureferendum/12057025/Government-
accused-of-cover-up-as-data-suggests-million-EU-migrants-unaccounted-for-in-
Britain.html)

I know how alarmist this comment sounds, and I fully expect it to be downvoted
because it contradicts the politically-correct utopian vision of immigration
that we're all expected to hold.

But I hope lefties realise that it's their suppression of debate that
frustrates people and leads them supporting reactionary leaders like Trump.

We need to start discussing immigration without the stifling constraints of
political correctness.

~~~
cup
Bringing up immigration in a conversation about antibiotic resistance, knowing
what we know about animal farming practices is ridiculous.

An analogy is like complaining about one leaking faucet in a conversation
about drought when everyone is watering their garden.

~~~
prebrov
I think his argument was that poorly supervised mass migration, specifically
from places with poor healthcare and agriculture practices spreads readily
available drug-resistant bacteria to places where otherwise there'd be none or
little of them.

And that is a fair point, imo.

We enforce strict border control to protect ourselves from Ebola, SARS and
other infectious diseases we can't treat.

I would assume poster expects to see that actions to help refugees and other
less lucky people of the world are thoroughly weighed against health risks.
Again, fair point, even if the poster is a Trump supporter.

~~~
arethuza
See, you managed to put the same point in a reasonable way without raving
about political correctness, liberals/lefties and invoking Trump. Which is the
kind of comment I expect from HN... :-)

So have an upvote.

