Hacker News new | past | comments | ask | show | jobs | submit login
A novel way to stop the spread of antibiotic-resistant bacteria (economist.com)
132 points by known on Dec 4, 2018 | hide | past | favorite | 53 comments



On a sidenote, if you are thinking of visiting Tbilisi, Georgia (hotspot for phage therapy) I definitely recommend it. It's gorgeous, both day and night and so fun to walk around. There's some amazing architecture and great dramatic views from atop the surrounding hills. The city hosts people from all around the world, so it's fairly easy to get around even if you don't speak any Russian. Here's a video to get a feel for the city: https://www.youtube.com/watch?v=mWvXMGzUew4


> it's fairly easy to get around even if you don't speak any Russian

Is Russian that widespread in Georgia? That sentence strikes me as odd, it would be like going to the US and saying "it's easy to get around even if you don't speak any Spanish".


Never been but I think the assumption of the writer is that pretty much nobody who isn't from Georgia is going to speak Georgian, while my understanding is that due to history a high percentage of the Georgian population is fluent in Russian.

Given geo-politics I imagine this is probably starting to change, and that more and more Georgians are probably learning English. But that's just a hunch.


That makes sense, thank you.


It used to be that a lot of people spoke a little Russian, but nowadays you meet more people who don't (especially the younger folk, but they often speak English).

If you have some time, I'd recommend venturing outside of the capital (Tbilisi). The scenery you see in different parts of the country is breathtaking.


Hmm, I might prioritize it for a trip, thank you. It's only a (comparatively) short flight from where I live (Greece), so it might be a nice destination for a week away.


In my limited experience of being in Tbilisi just a few days, nearly everyone we encountered was able to speak Russian. Keep in mind, this was in the capital city of the country and in restaurants and other major sight-seeing locations. I was with a group of people who could speak Russian and that was more useful than English in nearly every situation we were in.

A more knowledgeable stackexchange user says:

If you know Russian, use it. Despite the political situation, Georgians are smart and open minded. They may not like the Russian government but they love Russian people and they love the Russian language.

I'm pretty convinced after seven months in Georgia that people learn Russian there for just the same reason foreigners everywhere learn English: it's cool and it's useful.

English is spoken, but I wouldn't say "widely". It's spoken by people aged in their 20s and younger, moreso if they're in a big city and moreso depending on their level of education.

Source: https://travel.stackexchange.com/questions/10640/what-langua... (the full answer is worth the short read)

---

Also, another point of interest for US citizens is that Georgia gives you a 1 year visa-free stay. Could be a great option if you're traveling Europe and need to be out of the Schengen zone when your 90 days are expired.

https://travel.state.gov/content/travel/en/international-tra...

https://www.schengenvisainfo.com/us-citizens/


Such bacteriophages are one area where Soviet research/practice outpaced the West: https://slate.com/technology/2006/05/the-soviet-method-for-a...


A very insightful and concise video on bacteriophages by Kurzgesagt: https://www.youtube.com/watch?v=YI3tsmFsrOg


That video was awesome. I really liked the animation style they used.


Maybe not so animated but I really got excited by this ted talk about phages.

https://www.ted.com/talks/alexander_belcredi_how_a_long_forg...


Bacteriophages are cool. I watched a documentary two or three years ago about western people travelling to Tbilisi, Georgia (were they use bacteriophages since the 1930s) in hope for tratment of their wounds which were infected with antibiotica resistant bacteria.

First they determined which phages to use and then they injected them into the wounds while also giving the patient a cocktail to drink multiple times of the day that also contained these phages.

At least for the patients shown this was helpful.


Any chance you remember what the documentary was called?


Unfortunately not, I tried to find it yesterday but had no luck. The only documentation I could find was a recent one in german [0] but the one I watched was in english.

In this documentation they also mentioned that there are two different types of phages and only one is usable. They also mentioned that food companies already try to use them to disinfect food by spraying phages on the food.

[0] https://translate.google.com/translate?sl=auto&tl=en&u=https... (not sure if that can even be viewed outside of germany, it's also not only about phages but multiple alternatives to antibiotics, but it seem similar -> people travel to georgia for treatment; there are two patients, one from germany and one from the netherlands)


Awesome, thanks!


Archive.is link: http://archive.is/WP9F6


Kurzgesagt has a great short video on phages: https://youtu.be/YI3tsmFsrOg


I don't see how this would be a long term solution. The bacteriophages would evolve to expand, or even switch their host selection pretty quickly if similar non-resistant strains of E. coli are available. E. coli is a pretty fast adapter itself. It'd become an evolutionary arms race, and as we've seen from the Lenski experiments, that does not result in the destruction of the pathogen's host.


"When offered various bacteria as potential prey, [the viruses] attacked only it."

Any insights on how that might work, beyond attacking every option but only succeeding in one? Viruses are presumably too simple to make a strategic choice.


Bacteriophage are quite selective for their prey.

“To enter a host cell, bacteriophages attach to specific receptors on the surface of bacteria, including lipopolysaccharides, teichoic acids, proteins, or even flagella. This specificity means a bacteriophage can infect only certain bacteria bearing receptors to which they can bind, which in turn determines the phage's host range. Host growth conditions also influence the ability of the phage to attach and invade them.” from Wikipedia


My god is this website awful, this is what I see when I first open it up: https://i.imgur.com/wcUDbhD.png


I subscribe to The Economist and I still get all that crap.


How lovely that the scientist who figured this out in Saudi is not just a foreigner but also a woman. It must be tough for her to work there.

Wonder how the local news reported it?


This is entirely off topic, but it peeves me when people use just the adjective to describe a name when the name is "<adjective> <noun>". It's like saying "He lives in South" when you mean "South Carolina". Same goes for calling "Wikipedia" "Wiki" or "cryptocurrency" "crypto".


Agreed. Calling "Saudi Arabia" just "Saudi" is like calling "British Columbia" just "British."


In case where the missing "noun" can lead to confusion it makes sense but are there multiple Saudi "noun" options ?


A Saudi is someone from the Arabian peninsula, further complicating things.


It conveys a kind of breezy familiarity, which could be intended to suggest personal experience, or could be subtle snub - you hear plenty of people call the USA "the States" to potentially both ends. In this case, people also use The Kingdom or KSA as short forms for Saudi Arabia, though the former doesn't save a lot of keystrokes...


This is exactly my point, though. They call it "the States", not "United".


Don't eat meat.


I'd suggest instead: if you're going to eat meat, be picky about its provenance. Specifically, insist on grass-fed beef (as the corn-based diet of factory cattle is a major contributor to sick cows and the "need" for antibiotics). Voting with your wallet -- thus providing signal to the marketplace that how meat is sourced matters -- is more effective than opting out altogether. Not an option for everyone, but many omnivores could take this approach. Combined with options like "impossible burger" we might be on the verge of a tipping point towards a large and positive change.


Opting out altogether is the most powerful form of voting with your wallet.


Not necessarily. By opting out, there's no signal at all that it matters how the meat is sourced.


How does the factory farmer know whether:

A) I buy my meat at the farmer's market.

B) I buy tempeh instead of meat.


It's not about one factory farmer being connected so directly to your specific choices, it's more like: restauranteers and grocers increasingly notice customers insisting on local, humanely raised, grass-fed beef, and thus they reduce their factory-meat order size and quantity. Factory farmer asks why, maybe gets an answer and thinks about improving conditions, or maybe doesn't in which case it's still a net win as the market share shifts in favor of the "good guys".


Useless advice.

I could offer something just as useless: "don't eat plants".

Meat and plants can both be infected with bacteria. And both require freezing and refrigeration to avoid spoiling.


The meat industry is a major reason for antibiotic resistant bacteria.


A major reason, but not the only major reason, and not the largest among major reasons.

Doctors constantly prescribing antibiotics for literally anything (even viruses, which would require an antiviral not an antibiotic), and then patients not taking all of their pills (giving you a double whammy of dumb) is just as bad, or even worse, than meat.

Also, the beef industry in the US has stopped the practice of subtherapeutic antibiotics used for growth. Antibiotics can only be given to beef strictly by on-label usage, thus closing one of the possible routes.

Pro-vegan propaganda does not belong on HN.


It seems a bit less cut and dry, and still unsolved.

> is just as bad, or even worse, than meat.

"By 2011, a total of 13.6 million kg (30 million lb) of antimicrobials were sold for use in food-producing animals in the United States,[53] which represented 80% of all antibiotics sold or distributed in the United States"

> Antibiotics can only be given to beef strictly by on-label usage, thus closing one of the possible routes.

"The FDA has asked drug companies to voluntarily edit its labels to exclude growth promotion as an indication for antibiotic usage."

https://en.m.wikipedia.org/wiki/Antibiotic_use_in_livestock

Even if the US comes down hard if there is are countries that still allows it, the risk remains. Resistance doesn't care about borders.

> Pro-vegan propaganda does not belong on HN.

Sure. But it seems an important issue and the facts seem to indicate it's not solved yet.


The rules changed in 2015 so references from 2011 are not worth considering.


Quote 1 describes the scale of the problem. Quote 2 shows why it's not fixed yet.


Because the virus world was put on notice at that time and changed their ways?

A lot of damage was already done.


> the virus world

The bacterial one. Virus infections are (almost?) never treated with antibiotics.


Seems to me like it was more of a poorly worded argument rather than "propaganda".

Anyway, what's interesting to me is that doctors are in an impossible position. They want to make their patients happy, not just healthy. And patients equate antibiotics with getting better, thus doctors prescribe antibiotics.


Suggestion: for colds, write a prescribe for an infusion of Camellia sinensis in heated DHMO, to be taken orally once a day with bovine mammary secretions. Call it a “traditional Chinese herbal remedy” if anyone asks.


Caffeine reduces immune response:

Caffeine, like other xanthines, also acts as a phosphodiesterase inhibitor.[141] As a competitive nonselective phosphodiesterase inhibitor,[142] caffeine raises intracellular cAMP, activates protein kinase A, inhibits TNF-alpha[143][144] and leukotriene[145] synthesis, and reduces inflammation and innate immunity.[145] Caffeine also affects the cholinergic system where it inhibits the enzyme acetylcholinesterase.

https://en.wikipedia.org/wiki/Caffeine


Huh. I’d never have guessed that, given its use in (non-prescription) cold-and-flu medicine.


It really shouldn't be to difficult to overcome. In the UK if you go in with an infection, you are quite likely to be told 'its probably viral, so there is no point prescribing antibiotics'


"Antibiotics can only be given to beef strictly by on-label usage"

That's wonderful news, if I understood it correctly. Did you mean that they completely stopped giving antibiotics to cattle unless and until said cattle is sick? Is that a regulation? Does it apply to chicken as well? Any links?


Yes, and they must complete the dosing regiment. I can't find a good link on it, but the regulation is part of the larger 2015 FDA Veterinary Feed Directive.

I'm not sure if it applies to chicken, however Perdue has been trying to save its damaged brand by removing antibiotics also used for humans entirely (about a decade ago), and semi-recently announced that only half of their chicken used any antibiotics at all and none used off-label; they also have antibiotic free sub-brands.

This is notable because Perdue is the third largest chicken product company, after Tyson (Tyson, Jimmy Dean, Hillshire Farm, Sara Lee, Ballpark, Wright's), and JBS (Pilgrim's, Swift, Plumrose), although both Tyson and JBS produce twice (each) as much chicken as Perdue does (giving Perdue 1/5th of the market).


Yes. Also:

The agriculture industry is a major reason why pesticides, herbicides, destructive monocrops cultures and such, are done. They are responsible for the destruction of the Amazon by planting soyabean monocultures, because of the rich soil.

Both are as horrible as each other.

Both can be done quite sustainably. Problem is that there's not money in doing so, because greed runs the show.


Just like the healthcare industry, evidence for that is actually quite overwhelming in contrast to agricultural use effects [0]

So should we shut down all hospitals and never visit the doctor again?

[0] https://www.niaid.nih.gov/research/antimicrobial-resistance-...


And a major reason for affordable meat for the billions of people.




Guidelines | FAQ | Lists | API | Security | Legal | Apply to YC | Contact

Search: