Posts Tagged ‘antibiotic resistance’
“Sometimes this high-tech world calls for low-tech solutions”*…
Our human war against infectious microbes has escalated. As bioscience has produced a stream of anti-bacterial and anti-fungal treatments, the continuously-evolving micro-organisms they target evolve in ways to protect themselves… and so our antibiotics become less effective.
This antibiotic resistance is estimated to result in more than 2.8 million infections from antibiotic-resistant bacteria, and more than 35,000 people die as a result. Antibiotic resistance adds $20 billion in excess direct healthcare costs each year in the US. Additional costs to society for lost productivity could be as high as $35 billion a year. All of this is driven in some measure by over-prescription (the CDC reckons that over 25% of antibiotics prescribed in US outpatient settings are unnecessary)– but the evolutionary dynamics of our microbial “enemies” being what they are, the problem would be material in any case.
So effective non-antibiotic treatments are especially valuable. Ian Ingram reports on one of the latest..
The FDA cleared medical-grade Australian sheep blowfly (Lucilia cuprina) larvae in what maker Cuprina Holdings believes marks the first debridement product to use this particular species.
Dubbed Medifly Maggots, the product [pictured above] is indicated for removing dead or infected tissue from non-healing necrotic skin and soft tissue wounds — such as pressure or neuropathic foot ulcers — and non-healing traumatic or post-surgical wounds.
A healthcare worker is required to oversee the application of the prescription maggot product, which was cleared based on demonstration of equivalence to the previously cleared medical-grade green bottle blowfly larvae — Lucilia sericata (Medical Maggots).
“Maggot debridement therapy has earned its place in modern wound care, and adding a second FDA-cleared species strengthens the entire field,” Ronald Sherman, MD, the company’s medical and scientific director, said in a statement.
“Lucilia cuprina has a meaningful international track record,” and the new clearance “gives clinicians and their patients more flexibility in how this therapy is delivered,” added Sherman, who has worked on the development of medical-grade maggots for decades and was instrumental in getting the first product cleared by the FDA in 2004.
According to recent estimates, anywhere from 1-2% of people in developed countries have chronic wounds, which are associated with greater risks of limb amputation and mortality.
Maggots, long used for clearing dead or non-healing tissue before the invention of antibiotics, can spare antibiotics and have also been associated with a lower risk of lower-limb amputation in diabetics with non-healing lesions…
As poet A. R. Ammons wrote (in “Catalyst“): “Honor the maggot, supreme catalyst.”
“New Type of Maggot Cleared by FDA as Medical Treatment,” from @medpagetoday.com.
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As we rethink remedies, we might spare a thought for Alice Stewart; she died on this date in 2002. A physician and epidemiologist, she specialized in social medicine and the effects of radiation on health. Starting in WW II, she investigated the health effects of exposure to TNT in ammunitions factories, of carbon tetrachloride, and a prevalence of tuberculosis among shoe industry workers.
In the 1950s, Stewart led a pioneering study of x-rays (especially the pre-natal x-rays of expectant mothers) as a cause of childhood cancer. Her results were initially regarded as unsound, but were eventually accepted worldwide; the use of medical x-rays during pregnancy and early childhood was curtailed as a result– though it took around two and a half decades.
And after a visit to the U.S. in 1974, Stewart consulted on a major investigation of the health of workers in the nuclear industry there: she examined the sickness records of employees in the Hanford (WA) plutonium production plant and found a far higher incidence of radiation-induced ill health than was noted in official studies (produced by the nuclear industry).
Stewart was awarded the Right Livelihood Award in 1986 “for bringing to light in the face of official opposition the real dangers of low-level radiation.” In 1997 she was invited to become the first Chair of the European Committee on Radiation Risk.
“I do not mind if you think slowly. But I do object when you publish more quickly than you think.”*…
Each year, governments around the world pour vast sums of public money into scientific research — as much as $156 billion in the United States alone. Scientists then use that funding to further human understanding of the world, and occasionally to make compelling discoveries about everything from whale brains to dwarf stars to the genetic underpinnings of deadly cancers. But often, this research — despite being subsidized with taxpayer money — ends up being published in exclusive journals that sit behind steep paywalls with three- and four-figure subscription fees, accessible to only a tiny fraction of the public.
The power of these scientific publishers — with names even lay readers might recognize: Springer Nature, Taylor & Francis, Elsevier, among a handful of others — is substantial. According to one estimate, just four corporations now publish close to 50 percent of scientific papers. Together, they control the copyright to much of the world’s scientific literature, charging billions of dollars each year for access to that body of knowledge — and securing hefty profits in the process.
Critics have argued for decades that this system is wasteful, and that the public should have access to the scientific literature that its tax dollars support. Scientists, scholars, and public institutions, they say — and not the private sector — should control access to this trove of knowledge. “The commercial interests of publishers trying to promote their brand should not be what determines what kind of scientific discipline becomes well-funded and well populated,” said Michael Eisen, a biologist at the University of California, Berkeley and a vocal supporter of the alternative model of research distribution, broadly referred to as “open-access” publishing, which has long aimed to harness the internet to make research more widely available — at little to no cost. The current system, he said, gives a handful of publishers “a disproportionate power to shape the way that science is done.”
The ensuing decades have been, in certain respects, a triumph for supporters of open access. Research funders in the United States and Europe adopted policies to make more of the research they fund accessible to the public. Several open-access organizations now operate thriving journals, and pirating tools like Sci-Hub have made it easier than ever to sneak around publishers’ paywalls.
Meanwhile, a group of Europe’s largest scientific backers — including the funding agencies of France, Britain, and the European Union as a whole — will soon require all research they underwrite to be openly accessible to everyone. That scheme, called Plan S, may be the most ambitious government-sponsored open-access effort yet — though federal officials in the U.S. are considering a policy that would require immediate open-access publishing for all federally-funded research as well, potentially revolutionizing the publishing industry. “Open Access Is Going Mainstream,” The Chronicle of Higher Education announced in a headline last year.
These successes, though, have also revealed divisions within the open-access community over two now-familiar questions: Who should run the publishing houses? And who should pay for the whole system? Instead of an open-access commons run by scholars in the public interest, the new open-access revolution increasingly looks like it will depend on the same big commercial publishers, who, rather than charging subscription prices to readers, are now flipping the model and charging researchers a fee to publish their work. The result is a kind of commercial open-access — a model very different than what many open-access activists envisioned…
As it stands, all trends point to an open-access future. The question now is what kind of open-access model it will be — and what that future may mean for the way new science gets evaluated, published, and shared. “We don’t know why we should accept that open access is a market,” said Dominique Babini, the open-access adviser to the Latin American Council of Social Sciences and a prominent critic of commercial open-access models. “If knowledge is a human right, why can’t we manage it as a commons, in collaborative ways managed by the academic community, not by for-profit initiatives?”
Peer review, editorial prep: how should we manage–and pay for– the quality control that makes scientific discourse most effective? “A Revolution in Science Publishing, or Business as Usual?”
(Coronavirus has led to an explosion of scientific publication… and it has amplified the debate over open access and how to accomplish it.)
* Wolfgang Pauli
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As we share and share alike, we might send healing birthday greetings to Hattie Elizabeth Alexander; she was born on this date in 1901. A pediatrician, microbiologist, and educator, she won international acclaim for developing a serum to combat influenzal meningitis, a common childhood disease that is nearly always fatal to infants and young children, virtually eliminating the mortality rate.
When the advent of antibiotics made the antiserum obsolete, she quickly mastered their use against all the bacterial meningitides. Late in her career–the 1950s and 60s–she became a pioneer in microbial genetics. She pioneered the study of bacterial mutation and resistance to antibiotics, and in 1964, she became one of the first women to head a national medical association as president of the American Pediatric Society.
Over her career she published over 70 papers.
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