Drug Resistance To Antibiotics
The list of drug options via doctors is short and
New bacteria are pushing our immune system's to
month more and more drugs are failing to
And what is it with the latest threat, the
Zika Virus ...
resistance is partially our own fault for trusting
in doctors with blind faith and willingly allowing
them to happily prescribe countless drug cocktails
as fast as we demand them, especially when we are
desperate for relief from pain, stress, insomnia
article below explains what is happening today and
hopefully will prevent so many people reaching for
quick fixes with toxic synthetic drugs. Our immune
systems are shot. Detox and radical changes in
lifestyle and thinking must now take place if we
are to remain healthy and not succumb to the never
ending strains of new bacteria and viruses that
are bombarding populations worldwide.
The article below was written in 2008 but is just
as relevant today, and even more so. Turn on the
TV in the USA and watch countless ads pushing
drugs for everything under the sun. It will not
stop until people stop believing there is a magic
pill for everything that ails them and never mind
the deadly side effects.
the latest 'threat to humanity"? Oh yes, the Zika
Virus, now 'suddenly' appearing in Western
countries, thus generating a new income for
conducting routine surveillance for yellow fever
in the Zika forest of Uganda isolate the Zika
virus in samples taken from a captive, sentinel
rhesus monkey.' - www.who.int/bulletin/online_first/16-171082/en/
what ... a monkey in Africa again, wasn't
that how AIDS was first discovered?
Fast forward 68 years, to
2015: 'The Pan American Health
Organization and WHO issue an alert to the
association of Zika virus infection with
neurological syndrome and congenital malformations
in the Americas.' - www.who.int/bulletin/online_first/16-171082/en/
ahead, pop some pills, get a vaccine and be
careful who you have sex with (it can be
transmitted sexually). Good luck if your pregnant
because the 'authorities' are suggesting you abort
the fetus. In some circles this is known as
'population control', just saying. And lets not
overlook the deliberately gene altered mosquitoes
being created to combat the Zika mosquitoes, and
neighborhoods being dusted with chemicals.
everything can be genetically altered, cloned or
created for profit ... animals, crops, viruses,
bacteria, drugs ... and what else has been done
that we don't yet know about? Truth is, humanity
is doomed unless we wake up! Is it too late?
race ahead of drugs.
Deadly infections increasingly able to beat
Sabin Russell - Sunday,
January 20, 2008
busy microbiology lab in San Francisco, bad bugs
are brewing inside vials of human blood, or
sprouting inside petri dishes, all in preparation
for a battery of tests.These tests will tell
doctors at UCSF Medical Center which kinds of
bacteria are infecting their patients, and which
antibiotics have the best chance to knock those
infections down. With disturbing regularity,
the list of available options is short, and it
is getting shorter.
Brooks has been director of the UCSF lab for 29
years, and has watched with a mixture of
fascination and dread how bacteria once tamed by
antibiotics evolve rapidly into forms that
practically no drug can treat. "These organisms
are very small," he said, "but they are still
smarter than we are."
the most alarming of these is MRSA, or
methicillin-resistant Staphylococcus aureus, a bug
that used to be confined to vulnerable hospital
patients, but now is infecting otherwise healthy
people in schools, gymnasiums and the home. As
MRSA continues its natural evolution, even more
drug-resistant strains are emerging. The most
aggressive of these is one called USA300.
week, doctors at San Francisco General Hospital
reported that a variant of that strain, resistant
to six important antibiotics normally used
to treat staph, may be transmitted by sexual
contact and is spreading among gay men in San
Francisco, Boston, New York and Los Angeles.
problem goes far beyond one bug and a handful of
drugs. Entire classes of mainstay antibiotics are
being threatened with obsolescence, and bugs far
more dangerous than staph are evolving in ominous
ways. "We are on the verge of losing control of
the situation, particularly in the hospitals,"
said Dr. Chip Chambers, chief of infectious
disease at San Francisco General Hospital.
The reasons for increasing drug
are well known:
* Overuse of antibiotics, which
speeds the natural evolution of bacteria,
promoting new mutant strains resistant to those
* Careless prescribing of antibiotics that
aren't effective for the malady in question,
such as a viral infection.
* Patient demand for antibiotics when they
* Heavy use of antibiotics in poultry and
livestock feed, which can breed resistance to
similar drugs for people.
* Germ strains that interbreed at hospitals,
where infection controls as simple as
hand-washing are lax.
All this is happening while the
supply of new antibiotics
from drug company laboratories is running
commercial production of penicillin began in the
1940s, antibiotics have been the miracle drugs of
modern medicine, suppressing infectious diseases
that have afflicted human beings for thousands of
years. But today, as a generation of Baby Boomers
begins to enter a phase of life marked by the
ailments of aging, we are running out of miracles.
Top infectious disease doctors
are saying that lawmakers
and the public
at large do not realize the grave
implications of this trend.
just a few years, we could be seeing that most of
our microorganisms are resistant to most of our
antibiotics," said Dr. Jack Edwards, chief of
infectious diseases at Harbor-UCLA Medical Center.
Brooks' microbiology laboratory, the evolutionary
struggle of bacteria versus antibiotics is on
display every day. He grabbed a clear plastic dish
that grew golden-hued MRSA germs taken from a
patient a few days earlier. Inside were seven
paper dots, each impregnated with a different
drug. If the antibiotic worked, the dot had a
clear ring around it - a zone where no germs could
grow. No ring meant the drug had failed. This test
was typical. Three drugs worked, four had
strategy for nearly 70 years has been to stay a
step ahead of resistance by developing new
antibiotics. In the past decade, however, major
drugmakers have been dropping out of the field. The
number of new antibiotics in development has
plummeted. During the five-year period ended
in 1987, the FDA licensed 16 novel antibiotics. In
the most recent five-year period, only five
For drugmakers, the economics
are simple: An antibiotic can cure an infection
in a matter of days. There is much
more money in finding drugs, that must be taken
for a lifetime.
of antibiotic resistance.
antibiotic research lagging, the bugs are catching
up, and infections are taking a terrible toll. The
federal Centers for Disease Control and Prevention
estimates that each
year 99,000 Americans die of various bacterial
infections that they pick up while hospitalized
- more than double the number killed every year
in automobile accidents.
1.7 million hospital-acquired infections that
occur each year, studies show, 70 percent are
resistant to at least one antibiotic. Drug-resistant
staph is rapidly becoming a major public health
menace. Last fall, the CDC estimated that MRSA
alone has killed 19,000 Americans. Most of these
patients picked up the bug in the hospital, but it
is now spreading in urban and suburban
neighborhoods across the nation.
McQueary's struggle to survive:
killing people. It almost killed me," said Peg
McQueary, whose life was upended when she nicked
her leg with a razor three years ago. Within days,
her leg was grotesquely swollen, red from foot to
knee. Her husband wheeled her into a Kaiser
medical office, where her doctor took one look and
rushed her to an isolation room. She was placed on
intravenous vancomycin, a drug reserved for the
most serious cases of MRSA. Since that frightening
week, the 42-year-old Roseville woman has spent
much of her life in and out of hospitals, and
she's learned just how difficult these infections
can be to treat. McQueary has burned through drug
after drug, but the staph keeps coming back. She's
been hooked up at her home to bags of vancomycin
and swallowed doses of linezolid, clindamycin and
a half a dozen other antibiotics with barely
pronounceable names and limited effect.
the newest antibiotics, intravenous daptomycin -
approved by the Food and Drug Administration in
2003 - seems to work the best, but it has not
prevented recurrences. "It's just a struggle to do
everyday things," she said. "I am ready to scream
about it." Today, she moderates a Web site, MRSA
Resources Support Forum, swapping stories with
other sufferers. "Giving them a place to vent is
some sort of healing for me," she said.
travails are becoming an all-too-familiar American
experience. As bacteria evolve new ways to
sidestep antibiotics, doctors treating infections
find themselves with a dwindling list of options.
Old-line drugs are losing their punch, while the
newer ones are both costly and laden with side
Drugs' weakening grip.
Joseph Guglielmo, chairman of the Department of
Clinical Pharmacy at UCSF, closely tracks the
effectiveness of dozens of antibiotics against
different infectious bacteria. Laminated
color-coded cards called antibiograms are printed
up for hospital physicians each year. They chart
the success rate of each antibiotic against at
least 12 major pathogens. These charts show how
antibiotics, like tires slowly leaking air, are
losing strength year by year.
of the hospital pharmacy, Guglielmo oversees a
small warehouse at the medical center that stores
millions of dollars worth of prescription drugs
that are used every day to treat patients there.
Strolling down the aisles that houses bins of
antibiotics, he reached for a bottle of imipenem,
and cradled the little vial in the palm of his
hand. "This one is the last line of defense," he
was approved by the FDA in 1985. A powerful member
of the carbapenem family - the latest in a long
line of penicillin-like drugs - it is frequently
used in hospitals today because it can still
defeat a wide variety of germs that have outwitted
the earlier-generation antibiotics. But at a cost
of about $60 a day, and with a safety profile that
includes risk of seizure, it is a "Big Gun" drug
that must be used carefully. As soon as doctors
discover that a lesser antibiotic will work, they
will stop prescribing imipenem, like soldiers
conserving their last remaining stores of
there are signs of trouble.
has been the antibiotic of choice for doctors
treating Klebsiella, a vigorous microbe that
causes pneumonia in hospitalized patients. But in
June 2005, New York City doctors reported in the
journal Archives of Internal Medicine outbreaks of
imipenem-resistant Klebsiella. Fifty-nine such
cases were logged at just two hospitals. The
death rate among those whose infections entered
their bloodstreams was 47 percent. Last
year, Israeli doctors battled an outbreak of
carbapenem-resistant Klebsiella that has killed
more than 400 patients.
antibiotic Cipro, approved by the Food and Drug
Administration in 1987, is familiar to millions of
Americans because it is widely prescribed for
pneumonia, urinary tract infections and sexually
transmitted diseases. It was the drug used to
treat victims of the anthrax mailings that
followed the Sept. 11 attacks.
most antibiotics, which originated from natural
toxins produced by bacteria, Cipro came from
tinkering with a chemical compound used to fight
malaria. The German drug giant Bayer patented
Cipro's active ingredient in 1983, and it
subsequently became the most widely sold
antibiotic in the world.
hospitals across the country, however, clinicians
have witnessed a remarkable drop-off in the
utility of Cipro against more commonly encountered
germs. Antibiograms from the UCSF lab highlight
the alarming erosion: As recently as 1999, Cipro
was effective against 95 percent of specimens of
E. coli - bacteria responsible for the most common
hospital-acquired infections in the United States.
By 2006, Cipro would work against only 60 percent
of samples tested.
bacterial evolution that has so quickly sapped
Cipro has also reduced the effectiveness of the
entire family of related antibiotics called
fluoroquinolones - drugs such as Levaquin, Floxin,
and Noroxin. "If there is ever a group of drugs
that has taken a beating, it is these," said UCSF
pharmacy chief Guglielmo.
Acinetobacter - a bug responsible for rising
numbers of bloodstream and lung infections in
intensive care units, as well as among combat
casualties in Iraq - Cipro's effectiveness
fell from 80 percent in 1999 to 10 percent just
four years later. Cipro has also lost
ground against Pseudomonas aeruginosa, a common
cause of pneumonia in hospitalized patients.
Nearly 80 percent of the bugs tested were
susceptible to Cipro in 1999. That fell to 65
percent by 2004.
doctors carefully monitor the trends in drug
resistance and modify their prescribing patterns
accordingly. As a result, they have been able to
nudge some of these resistance levels down.
Cipro's effectiveness against Acinetobacter crept
up to 40 percent last year, for example, but the
overall trend remains alarming.
MRSA infections have been capturing headlines,
bugs such as Acinetobacter, Klebsiella and
Pseudomonas are keeping doctors awake at night.
They come from a class of pathogens called
Gram-negative bacteria, which typically have an
extra layer of microbial skin to ward off
antibiotics, and internal pumps that literally
drive out antibiotics that penetrate.
infections have always been difficult to treat,
and few new drugs are in development. Some
researchers believe that the pipeline for new
antibiotics is drying up because it is simply
getting more difficult to outwit the bugs. "It
may be that we've already found all the good
antibiotics," warned Chambers, San Francisco
General Hospital's infectious disease chief. "If
that is so, then we've really got to be careful
how we use the ones we have."
Hazen, senior scientist at Lawrence Berkeley
National Laboratory and director of its ecology
program, is not at all surprised by the tenacity
of our bacterial foes. "We are talking about 3.5
billion years of evolution," he said. "They are
the dominant life on Earth."
have invaded virtually every ecological niche on
the planet. Human explorers of extreme
environments such as deep wells and mines are
still finding new bacterial species. "As
you go deeper into the subsurface, thousands and
thousands of feet, you find bacteria that have
been isolated for millions of years - and you find
multiple antibiotic resistance," Hazen said.In his
view, when bacteria develop resistance to modern
antibiotics, they are merely rolling out old
tricks they mastered eons ago in their struggle to
live in harsh environments in competition with
similarly resilient species.
industry economics are also a factor. "It takes a
hell of a lot of effort to find the next really
good drug," said Steven Projan, vice president of
New Jersey pharmaceutical giant Wyeth Inc. The
costs of bringing a new drug to market are hotly
debated. A Tufts University study estimated $802
million; the consumer group Public Citizen pegs it
at $110 million. Either way, the investment is
By 1990, according to the
Infectious Diseases Society of America, half the
major drugmakers in Japan and the United States had
cut back or halted antibiotic research. Since 2000,
some of the biggest names in pharmaceutical
development - Roche, Bristol-Myers Squibb, Abbott
Laboratories, Eli Lilly, Aventis and Procter &
Gamble - had joined the exodus.
common measures used to gauge the profit potential
of new drugs, antibiotics fall way behind, Projan
explained. For every $100 million that a new
antibiotic might yield, after projected revenue
and expenses are tallied, a new cancer drug will
generate $300 million. A new drug for arthritis,
by this same analysis, brings in $1.1 billion.
Investors have been placing their bets
Wyeth had sharply curtailed its own antibiotic
drug discovery programs. "We tried to get out of
the field, but one of the reasons we did not get
out altogether is we feel we have a public
responsibility to fund more research," said
decision to keep some antibiotic research alive
eventually paid off. In June 2005, the FDA
licensed Tygacil, an intravenous antibiotic for
complicated skin diseases such as drug-resistant
staph infection. Only one new antibiotic for oral
or intravenous use has won FDA approval since.
Pointing a finger at doctors.
waning of antibiotics in the arsenal of modern
medicine has been going on for so long that some
doctors fear a kind of complacency has set in.
Increasingly, the medical profession is pointing a
finger at itself.
behaved very badly," said Dr. Louis Rice, a
Harvard-educated, Columbia-trained specialist in
infectious diseases. "We have made a lot of stupid
choices." His words brought a nervous silence to
thousands of his colleagues, as he delivered a
keynote speech in 2006 for the American Society
for Microbiology's annual conference in San
professor at Cleveland's Case Western Reserve
University, said doctors
and drug companies alike are responsible for
breeding resistance by "the indiscriminate
dumping of antibiotics into our human patients."
germs contaminate the bedrails, the catheter
lines, the blood pressure cuffs and even the
unwashed hands of doctors, nurses and orderlies.
The germs keep evolving, swapping drug-resistance
traits with other microbes. He likened American
intensive-care units - the high-tech enclaves
where the most seriously ill patients are treated
- to "toxic waste dumps."
companies, he said, have a responsibility to
refill the nation's depleted medicine chest. He
suggested that a tax - similar to a Superfund tax
placed on polluters to clean up toxic waste sites
- be imposed on companies that have dropped
antibiotic research. It would support drugmakers
that are still in the game. "Your products
that you've made billions and billions and
billions and billions of dollars on have created
this problem, and you can't just walk away," he
stressed that the existing arsenal of antibiotics
should be used wisely, and that often means
sparingly. During a half century of antibiotic
use, he said, there
is scant research on how short a course of drugs
is actually needed to cure a patient. Instead, doctors routinely
prescribe a week to 10-day course of drugs
recommended by manufacturers. If patients are
taking antibiotics after their infections are
truly gone, they are creating conditions that
breed resistance. Indeed, a Dutch study showed
that one kind of pneumonia can be treated just as
successfully with three days of amoxicillin as
with the traditional eight.
drug companies cannot be expected to spend money
on research that could trim sales of their
products, federally funded agencies such as the
National Institutes of Health should do the job,
Rice said in a recent interview.
took his own specialty to task for failing to
protect the most important weapons its arsenal.
Infectious disease experts at hospitals must find
the "backbone" to stop other doctors from
prescribing antibiotics unnecessarily, Rice said.
He argued they should assert their authority to
control antibiotic usage, just as cancer
specialists have a say in which chemotherapy drugs
are prescribed by surgeons. And all health care
professionals, he added, "have to wash their damn
hands." - www.sfgate.com
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