The Morning News The superbugs are here.
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A human neutrophil interacting with Klebsiella pneumoniae (pink), a multidrug-resistant bacterium. Credit: NIAID.

Take us to your breeder: The superbugs have arrived.

One percent of e. coli and Kleibsella pneumoniae in China has developed resistance, mainly because of overuse of colistin to speed livestock growth. And last week we learned that a Nevada woman died last fall from a "nightmare" infection resistant to all 26 FDA-approved antibiotics. She may have picked up her strain of Kleibsella pneumoniae from India, where superbugs have clustered.

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I would like to sound one note of warning. Penicillin is to all intents and purposes non-poisonous so there is no need to worry about giving an overdose and poisoning the patient. There may be a danger, though, in underdosage. It is not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them, and the same thing has occasionally happened in the body

The scientist who discovered penicillin used his Nobel speech to warn us of antibiotic resistance.
↩︎ Nobel Prize
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The scale of the superbug problem is massive.

Ten million people could die per year by 2050 from antibiotic-resistant diseases. That’s about how many people die from heart attack every year now. And a lot of therapies like chemo and transplants may become more dangerous because they expose the body to a higher rate of infection

There will be nothing exceptional about superbugs. They will be normal, and they'll drive up meat prices, kill our forests, and make childbirth more dangerous.

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Antibiotic resistance helped scientists realize the rate of evolution is elastic to environmental factors.

Constant stress from low levels of antibiotics in water and environment probably induced a higher gear of hyper-evolution, breaking against several factors scientists previously believed would constrain the rate of evolution. 

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Convenience, laziness, perverse financial incentives and sheer bad luck have conspired to nullify almost every attempt to stop the emergence of resistance.

We never came up with a system to correct the dangerous misalignment between those who misuse drugs and those who pay the cost.
↩︎ Economist
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Overprescription is rampant in some parts of the world.

A study of Cambodian doctors found they prescribed antibiotics far too often and without evidence that the malady was even bacterial

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Antibiotics don't have to be ingested to cause bacteria to evolve. As this mini doc shows, the water near Hyderabad, India is so saturated with antibiotics from a pharmaceutical facility, it causes deathly infections to bloom. 

Despite several promising moonshots, there's no proven alternative waiting to succeed antibiotics as the miracle drug.

Modifying existing antibiotics may add a new generation of antibiotics, but bacteria will eventually evolve to resist them, too. Soap won't stop antibiotic-resistant infections, but scientists are looking to a variety of more advanced technologies that could slow their advance: 

CRISPR-based therapies could use manipulated bacteria to neuter resistance. 

Machine learning to generate novel antibiotics. (Technical paper here.)

—"Phage therapy"—which is where you get injected with viruses from pond water—can combine with antibiotics to checkmate bacteria.

Implementing any of these strategies, as well as shorter term tactics, requires more cooperation between doctors, pharmaceutical companies, and governments than has previously gathered. The only sure thing? Prescribing fewer antibiotics was found to be a key strategy to curb C. Difficile outbreaks in the United Kingdom.

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