New Superbug in Children: Streptococcus Pneumoniae 19A

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Discussion Overview

The discussion revolves around the emergence of a new superbug, a substrain of Streptococcus pneumoniae known as 19A, particularly affecting children and exhibiting resistance to all antibiotics approved for pediatric use. Participants explore the implications of antibiotic misuse, the mutation of pathogens, and the challenges faced by healthcare providers in educating patients about appropriate antibiotic use.

Discussion Character

  • Debate/contested
  • Technical explanation
  • Conceptual clarification

Main Points Raised

  • Some participants express concern over the emergence of the 19A superbug and its resistance to antibiotics, linking it to the inappropriate use of antibiotics in treating viral infections.
  • Others argue that bacterial and viral mutations are a natural process, suggesting that adaptation will always be necessary.
  • One participant highlights the challenge physicians face in managing patient expectations and educating them about the differences between viral and bacterial infections.
  • There is a discussion about the role of patients not completing antibiotic courses, which may contribute to the development of superbugs.
  • Some participants mention the variability in flu vaccine effectiveness due to the unpredictability of viral mutations and strain selection.
  • A suggestion is made to explore Paul Ewald's work on the evolution of infectious diseases for further understanding of pathogen-human interactions.

Areas of Agreement / Disagreement

Participants generally agree on the concern regarding antibiotic misuse and its role in the development of superbugs, but there are multiple competing views on the causes of this issue and the implications of pathogen mutation. The discussion remains unresolved regarding the extent of responsibility among healthcare providers and pharmaceutical companies.

Contextual Notes

Participants note the limitations in patient understanding of antibiotic use and the complexities involved in prescribing practices, as well as the challenges in predicting flu vaccine effectiveness due to evolving strains.

scorpa
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I'm sure most of you have seen this already but it seems we have a new superbug on our hands, a substrain of streptococcus pneumoniae called 19A. Here is a link for anyone interested.

http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20071107/superbug_071107/20071107?hub=TopStories

It is occurring in childern and showing resistance to all of the antibiotics approved for use in children forcing physicians to use antibiotics only approved for use in adults. This is pretty scary stuff, and a big part of it is due to the inappropriate use of antibiotics in the first place. Doctor's seem to prescribe penicillin and other drugs like they are candy without first bothering to look deeply into the causes, most sore throats for example tend to be causes by viruses yet most of the time you will just be given a prescription for an antibiotic which of course will do you no good.

On another note I just learned that the flu shots people have been getting are now less effective because the virus has already mutated. Interesting stuff.
 
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It will always be like this. Bactaria and viruses will always mutate and we will have to adapt.
 
what said:
It will always be like this. Bactaria and viruses will always mutate and we will have to adapt.

Of course they will but that doesn't mean we have to help them do it. I just find it interesting how they do, it is pretty cool stuff.
 
what said:
It will always be like this. Bactaria and viruses will always mutate and we will have to adapt.
Except when they adapt so fast that we cannot slow them down and they remain contagious enough to cause a pandemic. Some of us will survive.
 
Yea I agree, we for sure created conditions for them to mutate, irresponsibility at that. I'm not sure at this point whether wide spread use of anti-biotics was pushed by pharmaceutical companies, good intentions or simply lack of knowledge? I think the former is more likely than the latter.
 
scorpa said:
Doctor's seem to prescribe penicillin and other drugs like they are candy without first bothering to look deeply into the causes, most sore throats for example tend to be causes by viruses yet most of the time you will just be given a prescription for an antibiotic which of course will do you no good.
This is a challenge for physicians dealing with a patient population lacking in sufficient basic knowledge about differences between viruses and bacteria. There are huge swaths of the population who expect that physicians are miracle workers...if they go in sick, they expect to be handed something to make them better, and feel like they've wasted their money if they go to a doctor and are just told to take an over-the-counter cold remedy to treat symptoms until they get over a virus on their own in a few days (not realizing the point of going to the doctor is to rule out that they have something more serious that does require treatment). And, when the waiting room is overflowing with patients who all have the flu, it's hard to take sufficient time to educate them one-by-one that there is nothing to be done for it but wait a few more days until it goes away on its own.

Keep in mind it is not only about inappropriate prescribing, but also due to those people who do not follow the instructions with their prescription completely when they DO have a bacterial infection that requires an antibiotic, and this is even more of a contributor to development of these "superbugs." When someone stops taking an antibiotic as soon as they feel better rather than following the full course, it gives the surviving bacteria a chance to "recover" and for mutations to proliferate rapidly due to the way bacteria can swap plasmids. An antibiotic given to someone who does not have a bacterial infection will not have any effect on a bacteria not present (but could affect bacteria that are non-pathological).

On another note I just learned that the flu shots people have been getting are now less effective because the virus has already mutated. Interesting stuff.
Actually, the effectiveness of flu shots varies year by year. The vaccine each year is formulated months in advance based on an educated guess about which strains of flu will hit in that year, because it takes that long to produce it, so they can't wait until they know precisely which strain will hit. Some years they get it completely right, and other years they completely miss. Most years, they get the major strains, but another unexpected strain also appears. The vaccine can usually provide some limited protection against other strains, but not always. And, yes, strains will also mutate, which will render a vaccine less effective. Most of the time, that means you'll still get the flu, but might not get it quite as severely as if you didn't have the vaccine at all.
 
If you are actually interested in how human pathogens and humans interact and evolve try
Paul Ewald's 'Evolution of Infectious Disease'
 
Moonbear said:
Keep in mind it is not only about inappropriate prescribing, but also due to those people who do not follow the instructions with their prescription completely when they DO have a bacterial infection that requires an antibiotic, and this is even more of a contributor to development of these "superbugs." When someone stops taking an antibiotic as soon as they feel better rather than following the full course, it gives the surviving bacteria a chance to "recover" and for mutations to proliferate rapidly due to the way bacteria can swap plasmids. An antibiotic given to someone who does not have a bacterial infection will not have any effect on a bacteria not present (but could affect bacteria that are non-pathological).

Very true Moonbear, I can't even count how many people I have talked to how have admitted to quitting taking their prescription when they feel better. I usually tell them why they shouldn't do that but they usually don't believe me anyway.