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View Diary: The looming antibiotic crisis can't be solved by the free market (248 comments)

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  •  Antibacterials are a bad idea too (28+ / 0-)

    I agree that we should not use antibacterial soap or other crap -- I never buy them.  They also lead to resistance, at least to themselves.  But the "hygiene hypothesis" for allergies is not getting much support from the evidence.  Allergies are getting stronger in other countries too, where they don't keep the little darlings in hermetically-sealed anti-bacterial playroom bubbles.  This story, The Allergy Buster, in Sunday's NYTimes magazine, about multi-food allergy desensitization, mentions that fact, which I've also heard elsewhere.

    •  I grew up in the 1960s. I don't remember ever (15+ / 0-)

      having a kid in my class with peanut allergies. Now it seems like there are more than just a few in any school.

    •  Here's the thing-- back in the 50s and 60s, when (22+ / 0-)

      I grew up, there weren't as many environmental complicating or triggering factors that might lead to food allergies.  It's not just some new allergen or bacteria creating more infections and allergies now; it's that now we live with so much unchecked pollution, chemical runoff, food engineering, hormones, etc. that course through our bodies in the air we breathe, the rain that falls on us, the soil we walk on, the food we eat.

      Yes, there are tons more allergies now than there were back in the day.  Hell, I never had any allergies when I was a kid, and now I have them at age 51.  But I also live in the state with the most air pollution (Ohio) and after 20 years of living here, the poor quality of our air, along with the effects of pollution in rainwater runoff, soil, etc. are, I am sure, conspiring to produce allergies.  

      We need research into antibiotics that will take into account the exacerbating and triggering effects of environmental pollutants and chemicals.

      That's one more thing to add to my long list of small problems. --my son, age 10

      by concernedamerican on Wed Mar 13, 2013 at 05:10:51 AM PDT

      [ Parent ]

      •  And even for people who would have had an allergy (4+ / 0-)

        to a food even back then, thanks to processed food factories getting larger and companies making ever greater varieties of products under the same roof, that one thing someone knows they are allergic to can end up in a LOT more stuff simply because it's in the factories so it can be used in a completely different product as an intended ingredient.

        And thanks to processed food, even intended ingredients can be awfully hard to figure out - I've got an acquired sensitivity to a not uncommon but not common cheese variety, and oh the trouble sometimes trying to figure out if a frozen pizza's 'deluxe'-ness comes from adding something that is not usually pizza cheese on there... At least in a restaurant I have a chance to try asking and "If you feed me this, I will know and feel ill before you ask me if I want to order dessert and definitely before we figure out the tip" means I have a decent chance of getting an honest answer. And when it comes to in-family cooking, we just don't keep the stuff around.

        Prayers and best wishes to those in Japan.

        by Cassandra Waites on Wed Mar 13, 2013 at 07:59:01 AM PDT

        [ Parent ]

      •  Another likely culprit (7+ / 0-)

        in increasing food allergies may be the 'extra' large proteins produced by GE food cultivars, which are ubiquitous in our food supply these days. Monsanto's GE soy was found by FDA to produce several of these large-molecule 'extras', proteins that were not intended by the genetic manipulations. Child allergies to soy in the UK more than doubled in the year following the introduction of GE soy in the UK, as documented by the UK's universal health care system.

        Soy and soy lecithin are in pretty much ALL processed foods, and soy is quite closely related to peanuts. GE corn is also ubiquitous, if not as an identified corn ingredient then as the corn used to produce the HFCS that food processors add to almost everything. Remember the Starlink corn fiasco? The FDA/USDA did not approve that cultivar for human consumption due to potentially allergenic 'extra' large-molecule proteins - it was allowed solely for animal feed. But it got into the human supply anyway (and inevitably), leading to a short-term increase in allergic reactions requiring medical intervention.

        Then, of course, there are the bacterial toxins engineered into food crops, to which humans have never been directly exposed but are now expressed in every cell of the plant cultivar. The long-term consequences of that remain unknown, as no long-term feeding trials were ever conducted for any of the toxins. Or rather, the public are the guinea pigs for the ongoing long-term feeding trials. In this country GMO foods and additives are not required to be labeled as such. So even if the trial goes very badly, the cause-effect relationship could not be traced.

        Lucky us...

        •  Where can one shop, and buy food, to minimize (1+ / 0-)
          Recommended by:
          Joieau

          one's exposure to these things?

          Any national or mail-order chains in the US?

          That's one more thing to add to my long list of small problems. --my son, age 10

          by concernedamerican on Wed Mar 13, 2013 at 10:44:13 AM PDT

          [ Parent ]

          •  I am lucky enough (3+ / 0-)

            to live in one of those "hip enclave" areas, where customer lobbying some years ago got most big area grocery chains to label their produce for country/state of origin, carry nice selections of locally grown fruits and veggies, local raw honeys, locally produced value-addeds (honey, condiments, jams and jellies, fried and dried veggie chips, etc.), and dedicate whole sections to certified organic produce. They also carry organic label canned and box goods, right there amongst the regular selections in the aisles. There are also many local and regional farmer's markets large and small, I can find one almost any day of the week for nine months a year.

            Without that, I'd advise shopping at markets that advertise organics, and seek out organic selections at your regular grocery store, quite a few are offering these days because people are willing to pay a few cents more - they fly off the shelves. There are several association labels out there for organically grown, non-GMO products from farmers who have chosen not to jump through USDA's hoops for certification. Monsanto's been busy-busy trying hard to subvert the whole enterprise since the beginning, and they've succeeded on some levels. I obtain grain from local producers in the valley who have more land than I do and a tractor to work it with. Wheat, barley, corn and oats. I can grind at home, but if I want rolled multi-grains for hot cereal and breads I buy in bulk from EarthFare or Amazing Savings (great organic collections). Also grow herbs, veggies and fruit (peaches, cherries, apples, pears and grapes - muscadine, concord and zinfandel) on my homestead, and make wine, wine and balsamic vinegars, dried fruit mixes, pickles, veggie-herb table salts, powdered soup stocks, etc.

            A trip twice a month to the regional farmer's market can be fun. Take the kids (some have enclosures with miniature horses and goats and such), maybe a couple of neighbors, friends or relatives and share the experience. If you aren't sure of something, just ask the vender point-blank. I have never had one lie to me about how the food was grown or if it's a GMO cultivar. Most keep those well separate at their spaces so they can get that premium for organics when the right customer comes along. Think about joining a local CSA [Community Supported Agriculture], usually one or several small farms that specialize in certain crops/products, for which you purchase a 'share' early in the year to help them buy seeds and do the work. You get a nice box or bag of fresh food once a week, whatever's coming in at the time.

            •  somebody gave me a grain mill a few years ago (1+ / 0-)
              Recommended by:
              Joieau

              and I have never used it.

              Perhaps I should?  I could buy bulk grain at the local organic market, and grind it into my own flour?

              How would one make the equivalent of "white flour" if one grinds grain at home?  Which grains, do you know?

              Thanks!

              That's one more thing to add to my long list of small problems. --my son, age 10

              by concernedamerican on Wed Mar 13, 2013 at 02:55:20 PM PDT

              [ Parent ]

              •  I grind red wheat (1+ / 0-)
                Recommended by:
                concernedamerican

                as I need it, haven't used white flour for years. Since the germ is removed as well as the bran from white flour, I don't know how you'd get it at home. But you can set your mill to grind coarse or fine, and if you run it through 'fine' more than once, it's good for pastry or cakes.

                Mostly I use my mill for corn. Grow Indian and blue corn. Which so far isn't GMO but any big lot may contain transgene contamination. Corn pollen can travel on the wind for miles and contaminate fields. I still can't believe they were allowed to create these and turn them loose on the world indiscriminately. Transgenes are promiscuous - are DESIGNED to be promiscuous - and do get around.

                •  Wheat, or wheat berries? How does it come at (1+ / 0-)
                  Recommended by:
                  Joieau

                  the health food store?  (No other way to get it where I live.)  I'll have to find out.

                  Thanks!!!

                  That's one more thing to add to my long list of small problems. --my son, age 10

                  by concernedamerican on Thu Mar 14, 2013 at 09:11:20 AM PDT

                  [ Parent ]

                  •  Comes already threshed, (1+ / 0-)
                    Recommended by:
                    concernedamerican

                    as berries. You'll get germ in your flour, but little to no bran. You can order whole organic grains over the internet, there are lots of dealers and a range of prices. But then you've got to pay shipping, which can make it much cheaper at the health food store in small amounts.

                    My region has several buying cooperatives for hard staple items. That's a group of people who get together and order enough bulk to get the volume discount and free shipping. Getting that volume takes awhile, so you shouldn't be in a hurry.

                    If there's a Co-Op near you, members can sometimes add a bushel to the outlet's order for grain and get it at a significant discount plus Co-Op overhead. Wheat's averaging $6 to $8+ a bushel on the commodities market, and a bushel of wheat is 60 pounds. Average price of wheat berries retail is more than a dollar a pound from organic outlets (sometimes double that), so $20-$30 for 60 pounds is a very good price.

                    But for many it's just more convenient to buy already ground grain. Bob's Red Mill and King Arthur both have certified organic lines available in most good-sized grocery stores. If you put the stuff in jars and store in the freezer, it'll keep well for as long as it lasts.

          •  It's not easy to eliminate GMO's ... (1+ / 0-)
            Recommended by:
            concernedamerican

            If you want to eliminate GMO's completely, you need to do a lot of research and hook up with your local Whole Foods staff or your local CSA.  Check out the movie "Genetic Roulette".

            Some GMO crops are corn, soy, cotton, canola, sugar (beets) and potatoes.  So, you might want to make sure you are buying organic when you buy products made with them.  Also, corn syrup is made with GMO corn and is in lots of stuff, like just about anything sweet that you drink.  I agree that I don't want to eat anything that comes from a Round Up Ready seed.  I used to use that s**t on my brick walkway because it kills just about everything.

            I was not happy to find out that billions of tons of it is going into our food supply.  This is not something that one can wash off of their produce.

    •  If you do a PubMed search on (13+ / 0-)

      "hygiene hypothesis" - which turns up something like 1589 peer reviewed papers (many of them very recent) - it is clear that

      1) it has major caveats and cannot explain everthing

      2) it has NOT been debunked / discredited

      3) remains a very active research area.

      The problem probably comes in when people try to use it to explain too much with overly broad blanket statements:  Here's typical information:

      Curr Opin Pediatr. 2012 Feb;24(1):98-102. doi: 10.1097/MOP.0b013e32834ee57c.

      The hygiene hypothesis revisited: does exposure to infectious agents protect us from allergy?

      Fishbein AB, Fuleihan RL.
      SourceDivision of Allergy and Immunology, Children's Memorial Hospital and Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

      Abstract

      PURPOSE OF REVIEW: The increase in incidence and prevalence of allergic disease remains a mystery and cannot be explained solely by genetic factors. The hygiene hypothesis provides the strongest epidemiological explanation for the rise in allergic disease. This review evaluates the recent epidemiological and mechanistic research in the role of infectious agents in the pathogenesis of or protection from allergic disease.

      RECENT FINDINGS: Recent literature has extended the epidemiological findings of the protective effect of being born and reared in a farm environment and associates an increased diversity of organisms in house-dust samples with protection from allergic disease. Furthermore, human and animal studies provide increasing evidence for the role of both the innate and adaptive immune systems, including regulatory cells, as mediators of this protective effect.

      SUMMARY: There is evidence that exposure to some infectious organisms can protect from atopy, whereas other infections appear to promote allergic diseases. The timing of exposure to infection and the properties of the infectious agent, in addition to the genetic susceptibility of the host, play an important role in the future development of allergic disease.

      PMID: 22227779 [PubMed - indexed for MEDLINE]

      Note that the "recent findings" section of this paper stresses accumulating evidence for this hypothesis.

      And that the "summary" takes care to point out that certain infectious agents actually have the opposite effect . .. .  probably a pretty big caveat for any parent who decides to purposefully expose their kid to pathogens to prevent allergies!

      •  There's a difference between food and (1+ / 0-)
        Recommended by:
        JerryNA

        environmental allergies in this - apparently food allergies are not well explained by the hygiene hypothesis, but environmental allergies are. Where people do NOT keep their children hermetically sealed through childhood, environmental allergies like ours are much lower, but they are getting food allergies.  

        We all understand that freedom isn't free. What Romney and Ryan don't understand is that neither is opportunity. We have to invest in it.
        Julian Castro, DNC 4 Sept 2012

        by pixxer on Wed Mar 13, 2013 at 07:02:09 AM PDT

        [ Parent ]

    •  It's not obvious to me why rampant sales (4+ / 0-)
      Recommended by:
      entrelac, Steve Masover, Paul1a, JerryNA

      of "antibacterial" soaps are even legal, since they increase the likelihood of antibiotic resistance developing. That ought to be something the US government has an interest in as a public health issue, and so could regulate. What on Earth department would handle it I don't know.

      We all understand that freedom isn't free. What Romney and Ryan don't understand is that neither is opportunity. We have to invest in it.
      Julian Castro, DNC 4 Sept 2012

      by pixxer on Wed Mar 13, 2013 at 06:23:06 AM PDT

      [ Parent ]

      •  Anti bacterial agents are not antibiotics (13+ / 0-)

        The use of anti bacterial soaps and other surface disinfectants should not be conflated with the use of antibiotics.  they are very different chemistry with very different biological actions.  Biological resistance to the disinfecting agents used in some soaps may well occur (indeed it is highly likely to so do) however that does not indicate any increase in the likely resistance to antibiotics.  in reality the mechanical action of washing has a greater log reduction than the anti-bacterial agent in the soap, the exception being alcohol based hand gels used in hospitals.

        Disinfectant chemistry is relatively simple with most molecules focused on disruption of the cellular membrane operation.  the antibiotic chemistry we use involves complex organic molecules that are typically derived through biological processes in fungi or plants, there multiple modes of action some very focused some broader spectrum.  The biggest problem is that as the number and type of pasmids present in the environment to be collected and incorporated by organisms is increasing and has provided resistance characteristics to species that would not otherwise exhibit those attributes.

        there is only one reality, republicans just forget at times

        by Bloke on Wed Mar 13, 2013 at 06:58:11 AM PDT

        [ Parent ]

        •  I'll admit to just parroting public health (0+ / 0-)

          organizations on the soap thing, without looking up the chemistry myself. But public health organizations have indeed decried the widespread use of "antibacterials" in soaps etc. I always assumed that the action in hand gels must be to disrupt the lipid bilayer, which would be pretty hard to develop resistance to. You're saying that the "antibacterial" soaps are also just working on the membrane? [OK, I can look this up, really :) ] Thanks.

          We all understand that freedom isn't free. What Romney and Ryan don't understand is that neither is opportunity. We have to invest in it.
          Julian Castro, DNC 4 Sept 2012

          by pixxer on Wed Mar 13, 2013 at 07:12:53 AM PDT

          [ Parent ]

        •  OK, I learned something about Triclosan (2+ / 0-)
          Recommended by:
          JerryNA, Sunspots

          and it is indeed something bacteria could easily become resistant to, given all it does is act to inhibit an enzyme involved in FA biosynthesis. Search obviously a quickie at this point, but here is something from a peer-reviewed journal (Clinical Infectious Diseases), anyway:

          Results. Soaps containing triclosan within the range of concentrations commonly used in the community setting (0.1%–0.45% wt/vol) were no more effective than plain soap at preventing infectious illness symptoms and reducing bacterial levels on the hands. Several laboratory studies demonstrated evidence of triclosan-adapted cross-resistance to antibiotics among different species of bacteria.

          Conclusions. The lack of an additional health benefit associated with the use of triclosan-containing consumer soaps over regular soap, coupled with laboratory data demonstrating a potential risk of selecting for drug resistance, warrants further evaluation by governmental regulators regarding antibacterial product claims and advertising. Further studies of this issue are encouraged.

          So, as you importantly point out, this does not have to do with resistance to the antibiotics we buy from the pharmacist. However, the potential for creating bacteria resistant to this compound that could indeed be of use in the future (and evidently is not so in hand soaps) should mean that the compound should be removed from the popular market.

          I also liked this popular article, though I read it pretty quickly. It's from the USC magazine "illumin."

          We all understand that freedom isn't free. What Romney and Ryan don't understand is that neither is opportunity. We have to invest in it.
          Julian Castro, DNC 4 Sept 2012

          by pixxer on Wed Mar 13, 2013 at 07:33:02 AM PDT

          [ Parent ]

          •  There are lots of surface disinfectants (1+ / 0-)
            Recommended by:
            pixxer

            Triclosan is not particularly effective, and many of the claims made are exaggerated.  I really do not worry about that aspect, I believe that the challenge associated with producing effective antibiotics is far greater than the challenge/cost associated with producing surface disinfectants.  
            Once we have a resistant organism eradication from the environment such as a hospital is relatively expensive but is possible, getting it out of the community is a bigger issue. eradicating those pathogens from people is a real challenge.  Many of us are colonized with MDROs but asymptomatic, a drop in immune status may change that relationship, as does the impact of certain antibiotics (check out the prime cause of Clostridium difficile associated disease)
            the whole subject is a lot more complex than simply banning a biocides in hand soaps.

            there is only one reality, republicans just forget at times

            by Bloke on Wed Mar 13, 2013 at 03:39:13 PM PDT

            [ Parent ]

    •  You're right, they're stupid. (1+ / 0-)
      Recommended by:
      mamamedusa

      All soap is anti-bacterial.  There is no need to add extra antibacterials to soap.  

    •  Most antibacterials are things that are difficult (0+ / 0-)

      to develop resistance to.

      How does a cell develop resistance to the equivalent of a human stab wound to the chest?

      We don't want our country back, we want our country FORWARD. --Eclectablog

      by Samer on Wed Mar 13, 2013 at 10:35:01 AM PDT

      [ Parent ]

      •  See comment above about Triclosan (0+ / 0-)

        Samer, you're wrong.  While bacteria may not become resistant to ethanol, they are becoming resistant to Triclosan, and cross-resistant to other antibiotics.  

        •  OK, I might be wrong about the "most," but my (0+ / 0-)

          basic point is that many of them have a mechanical basis, rather than a biochemical basis, that are difficult to evolve resistance to. Triclosan is an example of the latter.

          And I didn't say "impossible" because there are organisms that can survive in near vacuum (like Deinococcus radiodurans).

          We don't want our country back, we want our country FORWARD. --Eclectablog

          by Samer on Wed Mar 13, 2013 at 03:14:40 PM PDT

          [ Parent ]

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