Monday, January 22, 2007

Antibiotic-Resistant Acinetobacter (and the Iraq War)

This piece from Wired is an absolutely fascinating (and pretty damn scary) read. I'm already fairly alarmed about antibiotic-resistant bacteria, though, so maybe my opinion is unreliable here.

There's too much in there to even start to comment on at the end of a long day, so for now I just link.

Read, read!

(HT: Canis Major, who seems to be trying to further degrade the peacefulness of my sleep.)

12 Comments:

Blogger Tom Van Dyke said...

I'm not afraid.

9:08 PM  
Blogger Winston Smith said...

I don't get it. I think this must be the wrong link.

11:21 AM  
Anonymous Anonymous said...

Yeah, that was kind of my thought as well.

11:57 AM  
Anonymous Anonymous said...

Guessing at your point, TVD (since I only have limited time to chase links chains): You're conservative and you're not afraid of nature's evolving biowarfare, thus falsifying the Psychology Today hypothesis that conservatives are fearful by nature. Is that it? (And did you send readers hopping links via Dr. Helen just so we could see probably the prettiest forensic psychologist in my hometown?)

Drilling further in, neo-neocon asks rhetorically, are fear and rationality mutually exclusive, anyway? Of course not, though I suspect that the real hypothesis is that conservatives are more prone to irrational fear. There's plenty of anecdotal support for that in the success of Duhbya's politics.

I'm not going to defend the article in Psychology Today. I'm not even going to read it; too much likelihood given the source that its sources are nonsense, even if I might agree with its conclusion. I'm not even going to try to winnow out the good studies from the inevitable bad ones.

For my part, back to the original topic, I agree that antibiotic-resistant bacteria are scary enough that we need to do something about them, but there's no point in attacking scalpels over Acinetobacter just because they're both found in hospitals. Proving I'm a damned laissez-faire-skeptic liberal, I suspect some government action is required, since there's not enough profit motive until after we're dying in sufficient numbers. Then, Big Pharma (the original BP, not Rush) will come up with an expensive maintenance drug.

By the way, the cavalier use of antibiotics, that is, their normal prescription pattern all over the world, is a generalized prisoners' dilemma where the market (choices based on individual assessments of costs and benefits) fails to deliver an efficient result. But I digress.

I'm not fearful enough of multi-drug-resistant bacteria to do a Howard Hughes, not yet anyway. I do however try to reduce my contact with pathogens by hand-washing, etc., especially during cold and flu season. The problem is mainly in hospitals anyway (at least until you start thinking about food-borne illnesses), and I try to stay out of hospitals!

So maybe we've reached the end of the golden age of antibiotics, or maybe not. TVD, you're probably right not to be so afraid of this that you quarantine yourself, but the end of effective antibiotics could push our life spans back toward three score and ten again.

There are a couple of facts that could make things worse. First, bacteria exchange genes easily. If current bacteria are more selected to exchange genes, they may exchange virulence in face of our existing immune systems as easily as virulence in face of drugs. (By the way, I'd bet less that 1% of Americans know that bacteria of different species frequently exchange genetic material, and that this permits them to gain resistance without the trouble of many intervening generations. Be honest; did y'all?)

Second, the world's a much smaller place than it used to be, both in population density and in ease of travel. Vectors are wider and faster. A major epidemic is essentially inevitable. Oh, wait, I forgot; AIDS has already happened.

Even the success of viruses, though, holds some comfort. There's very little that medical technology can do against most viruses, yet most of us survive from day to day.

There's a rational basis for fear here, though not enough to run screaming from the room. But I suspect that we'll mostly devolve here into arguing whose fears are rational. That's probably not a useful argument.

7:36 PM  
Anonymous Anonymous said...

By the way, the cavalier use of antibiotics, that is, their normal prescription pattern all over the world, is a generalized prisoners' dilemma where the market (choices based on individual assessments of costs and benefits) fails to deliver an efficient result. But I digress.

I was actually thinking about this earlier today . . . it's one thing I've never heard a good (or even really coherent) libertarian solution for.

8:47 PM  
Blogger Tom Van Dyke said...

Cheers, LL. You met me even more than halfway. I got a little chafed around here lately by the contention that lefties have a monopoly on morality and rationality, and by extension, righties are bereft of both. Posting that link was my way of saying ouch.

No, I didn't know that bacteria exchange DNA easily, and I even get Discover magazine. If you have the time, I'd be interested in reading a link or two.

As a bit of a "crunchy con" (I even own a pair of Birkenstocks), I've never sought and gobbled antibiotics routinely. Just seemed careless, what with antibiotic-resistant strains of this and that evolving and all.

1:07 AM  
Blogger Winston Smith said...

Oh, so Tom's link WAS irrelevant...

That's what I thought.

Sorry, Tom...I think I'm getting cranky about this. You seem to have to put in your $0.02 on everything, even when all you've really got is a Canadian penny and some pocket lint.

Love ya, man, but c'mon.

Few points, mostly in agreement with LL:

1. I did know that bacteria could exchange DNA sequences easily! Hooray! (For me, I mean. Boo for the damn bacteria.)

2. Consequently: goodbye, Darwin (and perhaps even: goodbye, neo-Darwinian synthesis?). Evolution is more complex than we used to think. The endosymbiotic hypothesis (re: mitochondrial DNA) showed us that already.

3. No, libertarians have no solution to the antibiotic problem. Honest libertarians even admit this.

3a. Antibiotics must be regulated by the government.

3b. Farmers must be prevented from giving their stock continuous low-level prophylactic antibiotics.

3c. R&D into antibiotics should be heavily sponsored/conducted by the government.

4. It's far more important to control antibiotic use than it is to control recreational drugs. (In fact, of course, outlawing the latter is probably immoral.)

7:37 AM  
Blogger Winston Smith said...

Well, ya know, not, like, *totally*, ya know, *goodbye* Darwin... But you know what I mean.

11:22 AM  
Anonymous Anonymous said...

The species concept is a lot fuzzier than Darwin - or most of the rest of us, even evolutionists - thought. This is true for macrofauna, too, hence the ability of closely related species to interbreed, often but not always with sterile results. There's also a bird species (would help if I could remember which one) whose range completely circles the globe. In locales from west to east, individuals can breed, but there's a range overlap where individuals are too different to mate. One species or two? Neither answer fully works.

At bottom, the genetic mechanisms don't know they're serving species X. They're just chemistry.

The bacterial case of gene exchange just exploits a natural form of recombination. If it did not exist, most of our biotech (fish genes in tomatoes, for example), even the non-chimerical kind, wouldn't work.

Viruses characteristically exploit the indiscriminate protein chemistry of cells. They inject their RNA into the cell, and it merrily builds more viruses until it explodes and they look chemically for the right binding sites on other cells.

Of course, scientists want to use this viral talent for gene therapies that change defective individual genomes, sometimes permanently, sometimes heritably. Again, this would have no chance of working without the natural mechanisms of recombination.

It's a brave new world, but it was always here under our skin, and we're just now discovering it.

9:10 AM  
Blogger Tom Van Dyke said...

Thanks, LL. Didn't know about the bird species, either. Gotta catch up...

(Would like to know the name of the species, if you ever run across it again.)

7:57 PM  
Anonymous Anonymous said...

Some sources: The bird is the greenish warbler, and it's an example of a ring species, which are rare but not unique. This is a page on ring species.

I learned about gene exchange in bacteria in Lynn Margulis's popular book, Microcosmos, written with her son Dorion Sagan and presumably titled as a take-off of ex-husband and father Carl Sagan's Cosmos. Microcosmos argues for the endosymbiotic hypothesis, though I don't recall that term from it. Is anyone still in doubt that mitochondria originated through endosymbiosis? (That is, of course, just the beginning of what Margulis asserts.)

Mother and son have another book out, as seen here. I haven't read it - yet.

9:56 PM  
Anonymous Anonymous said...

The Margulis hypothesis has been around for about 30 years or more, and I wasn't impressed by it then or now.

I have my doubts about it because it can't be tested, and the SciAm article that she wrote a few years back postulated an intermediate form between primitive cells and todays' mitochondria-carrying eukaryotic cells that to me seemed to be nothing more than a lot of arm-waving.

11:22 AM  

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