Re: Science: Vaccines Work, GMOs Are Safe, Everything is a Chemical
Doctors: does resistant to antibiotics of last resort mean forever or is it possible to discover / synthesize new ones? And if you feel like going on at greater length, why does the analysis of a bug not mean also knowing how to stop it? Are they too complicated, or is it like a code where just because you see the coded message doesn't mean you can decode it?
Fair warning, off the cuff answer and I also am not an infectious disease doc. Resistant to antibiotics of last resort means the the bacterium is resistant to the one or so antibiotics we have to treat an already resistant bug. There are a few bugs that have one or two antibiotics left that we can actually use to treat them with and in some cases, they have not seemed to develop resistance in the same pattern because it is too large of an evolutionary step to hurdle. Oddly enough, sometimes if an antibiotic falls out of favor because of resistance, a bacterium can drift back to being susceptible to the disused antibiotic depending on the mechanism of susceptibility. This is because resistance is sometimes energy taxing to the bug and if they are not pressured, they will jettison the energy intensive traits that do not provide a selective advantage. It is always possible to discover new ones but we have fully used the proverbial "low hanging fruit" of antibiotics based on our current understanding of microbiology.
We know how to stop all bugs...the problem is selectively killing the bug and saving the organism around it. Per XKCD, a handgun will kill bacteria in a petri dish.
There are a few antibiotics that require infectious disease consults to prescribe because they are the "big guns" and our last resort to a few bugs. We use them very selectively because almost without fail, the more you use a drug, the more resistance will develop. Evolution is a *****. It is helpful to have the ID docs as gate-keepers because at times a caring physician will use some antibiotics inappropriately in patients who are having a poor hospital course as a last resort. I have used these last resort antibiotics a few times and usually they did not alter the clinical course, the patient was sick enough it probably did not matter and we were trying everything we had, even though they were prescribed within the infectious disease community's guidelines.
Interestingly, I recently read a report regarding public thoughts on antibiotic resistance. The prevailing opinion of the "lay public" was antibiotic resistance was more of an individual problem as in "antibiotics wont work as well in me in the future" instead of "Everyone has the chance of getting a bug that we cannot treat." Helps explain why people still want antibiotics for a viral illness.
Personally, I'd play with the bacteria's genome to see if I could render it inert. Drugs always lead to another resistant strain.
Altering a bacteria's genome is helpful in many ways but unless you are doing it to all of the bacteria that are resistant at the same time (or have a drug to do it which is pretty improbable), they will squeak by and continue to infect people.
