How Serious is Antibiotic Resistance?
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- Опубліковано 6 лип 2024
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How serious is antibiotic resistance, what causes it, and what are scientists doing to fight it? In this video I talk about some of the most promising recent developments to develop new antibiotics and fight bacteria.
The recent report in The Lancet about antibiotic resistance that I mention in the introduction is this:
www.sciencedirect.com/science...
The WHO website about antibiotic resistance is hers:
www.who.int/news-room/fact-sh...
The 2018 paper about the growth of antibiotic consumption is this:
www.pnas.org/doi/10.1073/pnas...
The paper about leaf-cutting ants that use antibiotics is here:
www.nature.com/articles/s4159...
The study which used artificial intelligence to look for new antibiotics is this:
www.sciencedirect.com/science...
The 2019 paper about the successful treatment with genetically modified phages is here:
www.nature.com/articles/s4159...
The 2019 paper about the new antibiotics which I mention at 11 mins 22 seconds is this:
journals.plos.org/plosone/art...
And finally the two papers about the peptides are those:
www.ncbi.nlm.nih.gov/pmc/arti...
pubs.acs.org/doi/abs/10.1021/...
Many thanks to Jordi Busqué for helping with this video jordibusque.com/
You can support us on Patreon: / sabine
0:00 Intro
0:48 What are antibiotics and how do they work?
2:43 What causes antibiotic resistance and how bad is it?
6:50 What are scientists doing?
13:33 Sponsor message - Наука та технологія
Joke I heard: What do you give the man who has everything? Broad spectrum antibiotics
Oh!!! Lmiao! BOOOOOOO!!! Lol. 💜
Bravo good sir :D
You are a terrible person, and I would like to attend your lecture.
LOL!
Ouch! Dad (or mom) joke alert!
I knew about the phage therapy and how promising it is but it's my first time hearing about the peptide treatment it's really interesting
Theres no cure for the phage all you can do is steal bodyparts and change for your own to prolong your life. I saw it on star trek!
Apparently Soviets did some extensive research in this field - but that was, AFAIR, research conducted by Army, so "совершенно секретно" (top secret). And anyway I read about it many, many years back ('80s? '90s?) so can't say much more about it than "Soviets researched this field extensively".
@@MrKotBonifacy yeah i watched a documentary about that i wish it was adopted by the west
@@nziom I guess they will... in a "due time". Y'see, there's this saying, "Americans are great nation and they'll always find an appropiate solution to any problem - pity, they always want to try all other 'solutions' first". ;-)
As part of my work in a microbiology lab, I did a high-throughput screen for novel anti-infectives (both antibiotics and anti-virulence compounds, which target the mechanisms that microorganisms use to hijack host cells). A terrible problem was that the chemical libraries available for this, as enormous as they are (often hundreds of thousands of compounds), have the fundamental flaw of having compounds that are easy for our chemical skills to synthesize, but leaving out major classes of compounds that would be more likely to actually do something useful. The most glaring example of this is that nearly all of the compounds (other than those in the small "known bioactives" libraries consisting of a few hundred to slightly over 10000 compounds) are planar, whereas most natural compounds including antibiotics and antivirals have a 3 dimensional structure, which is usually chiral (if you look at them in a mirror they look different from the original compound in a way that you can't undo by rotating them). Such compounds are almost completely absent from the giant compound libraries because they are much harder to synthesize, especially when trying to synthesize huge numbers of compounds in parallel.
Dear Lucius, Thank you for this wonderful contribution to this very important topic!
Thankyou Lucius. I think it was Asimov who drew on the lack of communication between all the scientific disciplines. Folk, especially, theoreticians (& esp physicists) lack the ability to compound think, & very often get polarised within their own, very specialised, fields. A biologist is unlikely to hear the math; as a chemist might dismiss both, or not, but neither will consult the other. It's a disaster, for sure, which is partly why we're in this current mess. But to address yr post.... yh, not surprising is it: that it's a human, almost Victorian trait to quote the obvious, & discard all data outside the parameters which aren't favourable to yr own subjective experiment, in research they do it all the time. This is how falsehoods become ingrained, taken as granted, and are never challenged. Fortunately the internet has allowed a freedom of speech, & expression.... and unprecedented access to information - ignorance was never an excuse, but today there really is no excuse. So right there, in your post, is a gapping hole yr aware of because yr closest to it. Perhaps it's too difficult to think of such giant molecules in 3D [yet crucial for proteins/enzymes etc]. It must be a human limitation. Folk, especially righteous ones, loathe being told they put their ladder against the wrong wall or spent their lives chasing a flawed idea, but that's folk, and quite a lot us are PhDs and still in a denial. Left-handed or right-handed? Why is it these molecules are always of one kind? Fortunately, a mathematician, or physicist can never answer that question.... but they'll always be rude in their retort, simply because it's perceived as an affront. And that is a very simple human condition.
@@tenbear5 I think it's less those things (although some of that contributes) and more what's easy to do and what would look like it would turn the quickest profit. Also remember that if someone's paycheck depends upon them not understanding something, it's very hard to get them to understand it.
@@tenbear5 I think it's less those things (although some of that contributes) and more what's easy to do and what would look like it would turn the quickest profit. Also remember that if someone's paycheck depends upon them not understanding something, it's very hard to get them to understand it.
This has been an unexpected education, much appreciated. Does any of your research or work have any relevance to the problem with phthalates?
The dangers of antibiotic-resistant bacteria were shown clearly to me when my best man for my wedding died 2 days beforehand, due to a methicillin-resistant staphylococcus aureus infection he had got a few days earlier that week.
I'm truly sorry to hear that. It's a massive shock anything like that, it's a very dangerous infection for sure.
@@therealkellyiom thank you! Yes, indeed it is.
do you know how he got infected?
@@narrator89 no, I don’t. He went golfing the Saturday before my wedding, and Sunday went to Church as usual, but I don’t know any details of how or way he was admitted to the hospital, or what had happened beforehand that might explain the infection. 🤷♂️
I think Phage Therapy deserves its own whole video. It's a fascinating subject.
Phagio therapy Its quite standard treatment in Georgia. In Tbilisi, You can get phage prescribed by doctor since about 100 years ago.
Also need treatment of a problem with phage therapy -- your immune system will think the phage is another enemy and try to clear it out.
@@Lucius_Chiaraviglio I think they go unnoticed by Immune system. (Not 100% sure thou)
@@DeePPurPleLemoN If you're lucky, yes. If you're not so lucky, at best you get to use that phage one time but never again, and at worst it quits being effective before the bacteria are gone the first time.
@@Lucius_Chiaraviglio I think, like the many bacteria and other particles moving throughout the body all your life, they are left alone.
Probably somebody else already said it, but the Halicin thing might refer to AI killing life, as explained anti-biotic technically being "anti-life"
That hadn't occurred to me, thanks!
This comment despite being brief and to the point was way more chilling than I thought any ~21 word could be. Must be a new record.
Right. Horrifying concept. Almost as horrific as Sabine saying she might be too dumb to get it. She can’t possibly know everything but she would have no problems getting this.
About that "overprescription" of antibiotic "in some countries" (which tend to be the very same countries with a lot of "unfinished antibiotic courses") - back in mid-90s my friend, who back then lived in Asia, tripped nad fell while playing basketball with his friends (a leisure afternoon game "just to kill some time"), landed on his right hand sprained his wrist. And since he was a quite heavy fellow (120 kg) he decided to see a doctor "just in case", just to make sure there's nothing seriously wrong with his hand. There was no wound, just pain and a swell - so he's expected some X-ray and some topical medicine (like Burow's solution used in situations like that), and maybe some painkiller - but no, he got just a painkiller and, guess what? (Oh, how did you guessed...?)
Yep, he walked away from doctor's office with antibiotic prescription. Like, Whisky Tango Foxtrot? What for? And that wasn't some Philippine or Indonesian remote village, that was in Singapore. In a very "upscale" polyclinic, in an affluent neighbourhood. Makes you scratch your head...
Perhaps it’s a prestige thing; they want to seem western? Similar to why Brazil had a huge amount of elective c sections.
@@wplants9793 TBH I have no idea WHY the antibiotics, although I don't think it was about "wanting to look like westerners". Many of their doctors ARE in fact western-educated, for instance "my" dentist (a VERY good one!) was a local fellow, ethnic Malay, who was London-trained.
Few years latter he emigrated to Australia (I was told) and started his practice there, so no inferiority complex here I think...
For my best friend, antibiotic resistance was literally a life or death situation. He passed away in December 2021, from a medication-resistant infection.
He died for America.
You never cease to surprise me. I would have hardly expected a physicist to speak on antibiotics and alternatives. Many thanks for this instructive video.👌
Hmm I just had a thought: not finishing an antibiotics course is akin to vaccinating the bacteria against the antibiotic.
Sabine mentions this at 2:30
It’s sad that you just learned this. But well done.
@@flashclynes give your mother a call. I'll answer.
When I was working in a Staphylococcus Aureus Epidemiology Laboratory in 1963, it was already known that the previous overuse of penicillin had led to antibiotic resistance. . . to the extent that there were bacterial strains that happily considered penicillin as food. Overuse included having penicillin to swab down lab benches. . .
And, by the way, we were using phages to identify the various strains of Staph. Phages would selectively “have no effect”, “inhibit the Staph growth” or “catalyze the Staph Culture”.
Can I ask you something?
We've known about this for so long. I remember watching a Nova episode on PBS in the 1970s, fer gawd's sake, and scientists were warning of bacterial resistance to antibiotics back then. Their dire predictions have come true.
3:03 this was old news even in the 1970s.
I was given £250 worth of flucloxacillin for a viral sore throat in 1978 Paris... Multiply by millions, there you have it.
This is becoming a theme in our age.
Happy Easter, Fräu!
Excellent as always, Sabine! You did a great job of relating many of the selection issues in your video. I sat in on a deep discussion on the AMR problem a few years ago. What I learned was that better management strategies have some lower hanging fruit than finding new antimicrobials. The fact that most resistance mutations are mal-adapted in the absence of selection means that the resistance genes will be lost rather quickly when selection is removed (alas too slowly to help a sick person, but quickly enough to reduce the load of resistance genes or resistant microbes in the environment if done well). This ties into the comment by exscape below.
I guess it's a whole topic unto itself, but the detrimental effect of antibiotics on gut biome bears mention in any discussion about antibiotics. Also, how antibiotics strip away mucosal lining in the GI tract is another counter intuitive way antibiotics work and why taking enough but not too much of a course of antibiotics is so important.
Hell yes, any doctor is going to have to do some fast talking to get me to take antibiotics. It always screws up my guts and I get diarrhea real bad. I have to eat real light and eat the Jamie Lee Curtis yogurt for a couple days to get back to normal, it SUCKS.
I have CVID a severe auto immune disorder. Some might think I'd be prescribed antibiotics early and often but it's exactly the opposite. Unless I'm hospital level ill I don't take them. Difficulty in managing gut bacteria is the primary reason. If not given the correct antibiotics I'm at risk for another Cdiff outbreak which I've spent weeks in the hospital trying to recover from.
@@Skank_and_Gutterboy I would've killed for only 4 days discomfort. I had to take antibiotics to fight a bad case of h. Pylori. Now is my 4th month of a bloated and painful stomach and there's nothing they can do.
Yeah, I had a bad infection at the beginning of 2019. Numerous anti-biotic injections and pills killed it, but gave me diarrhea, from which I still have not recovered. I still have frequent and very loose stool, even after trying probiotics and regularly eating greek yogurt. Still, it's better than loosing my leg - or my life.
@@aliensoup2420 Too many don't understand the complexity of biology and thus treatment.
As Sean Carroll says he chose physics because biology was too complicated
The problem is public pressure on doctors to give me them "something" to cure them even in cases when its not necessary. So many people demand a magic pill and doctors want to keep their patients (money) that they cave in as long as the customer (patient) is satisfied.
That's not how it works, if all the doctors do it that way, which is the way they should be doing it, then where is the patient going to go? cuz they go to another doctor they won't get the medicine either.
The overuse of antibiotics started with the government. They had it first, and were pumping it into everybody that needed it , even a little.
Because like almost always, no one ever considers long-term consequences. So right from the start we developed the habit of using them for everything, no matter how minuscule.
This also applies in UK where the money thing does not so obviously apply.
@@tim40gabby25 There's an opioid crisis for a reason. Whether its driven by money directly by unscrupulous doctors acting alone, or in concert with lobbyists, donors or what have you....and the government. The path/mechanism is ultimately irrelevant. The underlying issue is and always will be a profit motive.
@@MarcSylex Indeed. In the UK, I joined the National Health Service precisely because staff were paid a salary, so no financial inducements to behave badly. That's being eroded.
I read somewhere that the way Bacteria must adapted to phages is completely different to how they adapted to antibiotics. Therefore have a treatment with both would be highly effective.
Until it isn't 😂
It's my understanding that one of the advantages of phage "therapy" is that phages, being capable of Darwinian evolution, eventually adapt to bacterial adaptations - a sort of evolutionary "arms race". Hence, any adaptive advantage obtained by bacteria is but temporary.
usually antibiotics target a specific protien and bind in a specific site
this is a one to one relationship that is much easier to evolve resistance against because bacteria just needs to mutat the binding site of the antibiotics (there is a flib side to this though which is that fact that mutant protein is usually less effective at doing its job compared to the wild type that is targeted by the antibiotic. But it is better to be slightly ill than being dead haha). (there are other forms of developing antibiotic resistance though, like having enzymes that would change the structure of the antibiotic rendering it ineffective).
But when it comes to phage, it is much more complex to develop resistance against because they usually don't target a specific protein but they are rather have systematic effects
Perhaps we need to resume research into sulfa drugs or other similar compounds. There's an excellent history book about the accidental discovery of sulfa drugs titled "The Demon Under the Microscope".
@@AhmedAshraf-pd7mu Plus Phage can evolve just as do bacteria.
I did a presentation on this artificial intelligence paper in a class recently and I was absolutely dumb founded and inspired by the deep neural network molecular representations that allowed such a dynamic search through chemical space of THEORETICALLY ANY CHEMICAL FUNCTION that can be said to have dynamic functionality that is not dependent on the existence of a single chemical moiety as long as there is a large enough base of objective positive and negatives (chemicals documented to do and not do the function) to train a deeply heuristic neural function-specific chemical recognition system.
And breathe! :)
This channel has provided content that has induced emotions of both hope for and anger towards humanity. It's a fantastic and thought inducing ride; keep up to good work.
I would be cautious about nurturing that "anger towards humanity" thing. Don't ascribe to malice what can be accounted for by ignorance. Besides, that kind of resentment could lead you to join the mad-scientist technocrats at the World Economic Forum, evil people whose disdain for humanity has blinded them to their own moral corruptibility, as they seek to render the people into livestock. Science is a remarkable intellectual tool, but it has no inherent wisdom or morality built into it. Science objectifies and mathematizes what it examines in order to render it more predictable and manipulable. It is an inherently manipulative take on reality, and when its objects of inquiry are other human beings, it is as likely to push social scientists toward broken moral compasses and away from wisdom. Technical prowess does not confer moral superiority.
This is the first time that I see a video where you talk about something that I actually went to school for 😂. But the fact that you where able to deliver such good quality information giving the basics and also cover some of the newest developments and pointing the gobbledygook, confirms that you are one of the best science chanels. Being able to cover something so "different" with such good quality for the first time (mine at least)really took me by surprise. Great video and amazing channel!!
A world wide abolition of factory farming and general consumption of animals will drastically decrease the risks of antibiotic resistance.
…and pandemics.
I took antibiotics off and on from the age of 19 till about 40 for severe acne. Yes it was cosmetic treatment but also helped with the anxiety of looking ugly , as if a swarm of bees recently attacked my face and neck .🤦♂️
Well, to be fair, under certain circumstances acne could either cause or result from a systemic infection
Fantastic video, as always. For all the hopeful developments, by far the most effective approach today to limit bacterial resistance development is the prudent use of antibiotics. A lot of scientists are working on strategies how to best educate patients, parents, and doctors to use fewer antibiotics in everyday care.
Yes but when you use it make sure to eat the hole dose.
the solution is eather take your ATB in enough Doses or don't at all.
I'd like to hear more about benevolent or benign skin bacteria. They could help limit the growth of malign bacteria on the skin, either by competing for the same resource niches or by secreting molecules that affect malign bacteria.
They do, your protective layer of lactobacillus (one of the multiple microbes in yogurt and its variations) probably reduces skin infections.
@@zacharyb2723 : 1. Doesn't yogurt bacteria grow in the gut, not on the skin? Why do you think it's relevant to skin? EDIT: You're right... I googled and found recent research that says lactobacillus is normally found on skin.
2. There are many probiotic products on the market to replenish good gut bacteria, but I've never heard of a product to replenish good skin bacteria. EDIT: I found some by googling. (I assume they're overpriced.)
3. I assume there are a variety of good skin bacteria, because of the variety of characteristics of skin niches. For example, armpits are warmer, more moist, and probably receive less oxygen & light than the skin on more exposed limbs. After thousands of baths & showers, the skin bacteria we're born with is presumably completely replaced by opportunistic bacteria in our environment, and maybe it would be healthier to reinstate the skin bacteria of our younger selves, or some other more optimal skin bacteria.
those with clear skin i need your dandruff and dead skin flash frozen and shipped to me. i want your microbiome
@@brothermine2292 yea, i think humans "hygiene revolution " for lack of a better term probably did quite a lot of unseen damage, maybe thats why skin problems are so common? ¯\_(ツ)_/¯ good idea, replenishing it, i think
@@brothermine2292 The bacteria in our environment ARE the bacteria we're born with. We acquire our first set of bacteria from mom's vagina and breasts, our first contact points. While they have a nice turnover, it's still the same overall kinds of organisms. Mostly Gram+ bacteria.
There are two types of skin microorganisms. Resident and transient bacteria. The residents live there permanently, such as S. epidermidis. The transient ones will colonize for one or two weeks, then leave. These are the ones that will potentially cause an infection.
With the water treatment centers recycling higher percentages of useable water to high population cities the problem of antibiotic pollution becomes more prolific. Hope the Phage Therapy introduced into differing ecosystems doesn’t overwhelm our drinking water supplies.
Hi Sabine - thank you for your videos which I enjoy immensely. Living in Vancouver, I have been unable to attend your talk. You have said that the measurement problem is a fundamental paradox of QM. But I arrived at a different result indulging in QM, and later discovered that Carlo Rovelli agrees with my interpretation, which he calls "Relational QM". In the double slit experiment, a coherent buckyball or B (Zilinger) traveling through the double slit interferes with itself and its wave function develops an interference pattern. Then at some point, the WF collapses and the buckyball is realized probabilistically on a detector screen D which statistically results in a fringe pattern. The measurement problem then says the buckyball doesn't exist until an observer measures the WF, which causes it to collapse, and that is obviously paradoxical.
In the relational interpretation, the reason we have lost knowledge of B is because when B sublimates from its glowing source chunk, it gains energy and breaks all its entanglement ties with the environment (E) - that is, it becomes coherent. Losing knowledge is not the same as the particle B going out of existence. We just don't know its state. As soon as B interacts with D, it gets entangled with D, and since D is part of E, and observer Charlie (C) is entangled with D, C comes to discover B's state such as its location on D. The act of a formerly disentangled B getting entangled with D or any system X is decoherence (with respect to D or X).
Now let's say it is possible to miniaturize Sabine (S) so that she can ride on top of B. So imagine a coherent SB system hurtling to the double slit. For observer C, all information is lost about SB and SB is in a mixed state governed by the WF. But for S, B is not coherent, and S knows exactly where B is and S is 100% entangled with B in a pure state. Thus as you can see, the fact that C has lost touch with B and B is superposed for C, does not mean this is an absolute quality, or that B has to be superposed to all systems including S. B can be superposed with C, D, E but entangled with S. In other words a quantum mixed state is BETWEEN two systems, and is NOT an absolute property. The fact that there is a mixed state, it is always with respect to another system which can be E. If B is traveling through the double slit, it will be superposed to C, but not to S riding on B. A system B can thus be in a mixed state or a pure state at the same time. Its state depends on its relation to another system.
For C, SB is travelling through both slits. But SB does not see herself or B in superposition or that they are behaving in a probabilistic wave function manner. She sees herself traversing a straight line in the classical sense and there is no WF. Thus she is not going through both slits which is what C knows is happening. How do we resolve this contradiction? Simple. Since SB has lost all entanglement with C, D, E, it has also lost entanglement with the double slit apparatus (A). SB sees A as a mixed state superposition. I.e. A is coherent to SB, and coherency is a symmetric or commutative property. So when SB sees itself going in a straight line and in a single state arrives at the slits, the two slits of A may just happen to be superposed for SB in the same place in her line of travel! So S is riding a straight deterministic classical path and it is the world (E, A, D, C) that is superposed to SB! For SB, A and D are no longer classical but have a combined WF. There is a probability that the two slits line up just right in her path! And D will be interfering with itself and will have a fringe like existence (to SB but not to C). SB travels through both superposed slits untouched and depending on the interference pattern for D it entangles with D in specific locations thus giving rise to the statistical interference pattern that C observes.
There is no such thing as an absolute wave function WF(X). For the same system X, its wave function will be very different, depending on who is asking! Thus for S, the wave function for B is WF(B, S). For observer C it is WF(B, C) which is very different. And there is always a WF(B, E).
Let's say between two systems A and B, S is the degree of superposition (from 0 to 1), and T the degree of entanglement (from 0 to 1). Thus if B is coherent to A, then S(A, B) = 1. If B is fully entangled to A then T(A, B) = 1.
Thus S(A, B) + T(A, B) = 1; [or S(A, B) = 1/T(A, B)]
Commutative: S(A, B) = S(B, A) also for T()
Transitive: S(A, B) x S(B, C) = S(A, C) also for T()
And strangely enough, WF(B, X) = WF(X, B). That is why when from the perspective of B, the detector D interferes with itself, you get the same WF frequencies and interference pattern as a coherent B travelling to the detector D. Since D is hugely massive compared to B, WF(B, D) = WF(D, B) is dominated by B. That is why physicists have ignored D and speak only of WF(B) in an absolute sense. But this is a mistake and this gives rise to the measurement problem.
I hope this makes sense. I would really love to find out from you if this resolves the measurement problem. -Brom N.
Thanks Sabine for this very interesting video. You always teach me about new and exciting breakthroughs and studies in science and I feel smarter every week!
Another fascinating video, thank you. I have considered suggesting topics but you are always way ahead of me,
Great post Sabine. I appreciate you and your content helping me to learn and grow my base knowledge on an array of topics. 💛⭐🥰😇
That's pretty scary... 😬
Thanks, Sabine!!!
Stay safe there with your family! 🖖😊
Excellent video this week. Phages are everywhere, but finding the right one to combat an infection is difficult, huh.... Well, there goes my plan to lick every random thing in sight the next time I have a bacterial infection.
You could still do that.
*Results may vary.
Everyone's got to have a hobby.
That sounds like a great way to give yourself even more infections!
What doesn't kill you makes you stronger.
Safe and efficacious
Side note on antibiotics overuse: as a pharmacist I constantly encounter such cases where the patient doesn't even have a fever, just coughing a little and the doctor immediately prescribes amoxicillin, levofloxacin, azithromycin, doxycyclin etc. Especially during this pandemic, doctors seem to be totally convinced that antibiotics work against covid. I can't understand why they think that covid is any different from other viruses in this respect. Thousands of people are taking them, in the majority of cases completely unnecessary, then everybody's wondering why the patient has developed a nice pneumonia despite taking AB-s. Maybe it's BECAUSE OF that? Mankind is actively, willingly and ardently working on destroying itself, that's all I want to say...
Glücklich Schokolade-Wochenende, Sabine und alles Menschen! 🐰🐣
Danke! Beste Grüße nach Australien!
@@SabineHossenfelder I detect a hidden variable :)
@@tim40gabby25 What would that be?
@@CAThompson Sabine must have knowledge of you, as otherwise how does she infer you are Australian? :)
@@tim40gabby25 I've been hanging about her blog and now Patreon for over a year, I've mentioned Australia and Sydney, where I live, a few times.
I'm one of the penicillin allergic you spoke about from back in the antibio heyday, as were other family members. It's life threatening. Learn the signs and get to the doctor or call 911 immediately. But don't fear it, it's still one of the best antibiotics. I know, from the frustration of not being able to take it for 50yrs. Hopefully penicillin allergy is not as common now.
I have it (supposedly - just what my mother told me). When I recently had a bad infection and told the doctors I was allergic to penicillin, they grimaced as if I had just taken away their easy options. They threw a cocktail of injections and oral drugs at it, and killed it in a matter of several weeks.
As a 3rd year student in biology, I have to say: great video!
Phagetherapy has a long history in Russia, including a large "library".
Really ? I didn’t know they could be used to poison the opposition.
An excellent overview of the current status of the field, but missing out on one important aspect. Lack of public funding, which is required because any new antibiotic would be reserved to treat the difficult cases only, which means that big pharma would not get any significant return of the billion dollar investment it would take to bring a new antibiotic to the market.
Well, you can replace 'big pharma' by 'researchers' there. If no-one's going to pay, no-one will do the work.
Superbly informative, definitely caught me incorrect; can’t wait to share during discourse.
Knew of phages but didn't know of the other alternatives. Makes me feel better but is shocking how we don't ban non-medical use of a antibiotics already.
Beautiful job,.. Sabine!
Thank you for an excellent summary. I started my medical career in the honeymoon days when antibiotics usually worked and watched the situation change by the year. One problem was/is non-prescription use of these drugs, especially in undeveloped countries. I once confiscated a bottle of 'cough mixture' from a patient that contained chloramphenicol and betamethasone, bought in a European country that has since developed and would be unfair to name.
Interesting. Chloramphenicol was barred after 1:30,000 risk aplastic anaemia. Starting to look like decent odds? Just asking.
@@tim40gabby25 In 1963 we sometimes gave penicillin + chloramphenicol to patients with chest infections in hospital, though I felt uncomfortable about it even then. It was alarming to see it being sold over the counter.
@@johnwilson6721 Indeed. For me as a student in '78 to be given flucloxacillin for a sore throat was criminally opportunistic on the part of the treating Parisian - at least it was given orally, so that I avoided the French full house :)
really loving the variety in scientific topics
Thanks so much for tackling these different topics, because you know not everyone can.
Also I hope bacteria don't develop resistance against the peptides, since I'd assume that that would be a way bigger issue than losing anti-biotics.
In India Multi drug resistant tuberculosis is a problem as patients often don't complete their full dosage and TB relapses.
Wonderful episode Sabine!
Great update!
I've always been afraid of a headlong rush into something that kills the beneficial bacteria and viruses in our bodies.
_something that kills the beneficial bacteria_
That's already every single antibiotic on the market today.
I visited a graveyard in Seville, Spain, popular with bullfighters. It was noticeable that until the invention of antibiotics, many of the graves were of young torreadors often under twenty years old. Typically the bull would sever the femeral artery which the surgeon could sew up, but it was luck whether the bullfighter would later die of an infection or not. The discovery of penecillin meant many more lived to fight another day, which was not such good news for the bulls!
Good point. Antibiotics are terrible for life in general since there are 4 billion too many people on the planet already. Bulls and many other creatures suffer as a result.
It would be interesting to know how much each potential cause contributed to actual antimicrobial resistance. Was the current situation caused more by abuse in factory farming or by prematurely discontinued antibiotic therapy? Are there any studies on this?
The specific antibiotics employed in agriculture are not used in medicine.
We can talk on that
Hello Sabine! We love your channel! And we were left dying of suspense at the end of this video. What DO rotting eggplants have to do with it all? Thanks for your excellent content!
Scientists: "What should we name this drug that an AI helped us find?"
Marketing Team: "We could name it after a fictional AI that went crazy and killed everyone on its spaceship."
A subject ive had some interest in for a long time.
Lack of funding post 70's is what directly caused the problems we face today.
The UN touched on this se years ago and started new studies to find new and better antibiotics.
Its not a conspiricy, its a criminal conspiricy.
Fantastic video Sabine.
patient: imma stop taking these pills.
Halicin: Im afraid, i cant let you do that.
It’s said that Alexander Fleming discovered antibiotics but Otzi the 4,000 years old iceman found in the Alps had a leather sachet containing beech fungus active ingredient antibiotics.
I saw a video on another "science" channel that tried to quantify various existential risks to humanity, essentially looking at measures of 1) how many humans could be killed, and 2) how likely the risk was. Anti-biotic resistant bacteria by far had the largest metric of anything on the chart, indicating it is the most pressing risk to humanity.
Of course, the video focused exclusively on climate change and COVID (this was back in mid 2020), both of which had *significantly* lower risk than resistant bacteria. They simply ignored this huge threat....
An other important factor to mention are nosocomial (aka hospital-acquired) infections and infection control in hospitals. Even to this day, general hygiene can be bad in health care facilities (especially but not exclusively in developing countries) that leads to more frequent infections. Hospitals are a well known breeding ground of multi-resistant bacteria and are often part of the "normal flora" there. The over-use of broad-spectrum antibiotics is a big issue even today and I hoped the video would talk more about this. One of the things we could do to combat resistence is to have better microbial diagnosis that identifies the resistance and vulnerability of the infective bacteria in the patient, so they can be given the adequate narrow(er) spectrum antibiotic, thus slowing down the selective breeding of multi-resistant bacteria.
Had MRSA back in the early days and feel like Bactrim via IV saved my life, or at least one of my legs... Very scary when they're talking about cutting things off....
I love that you have featured xkcd. ^^
The history of the discovery of antibiotics is much more nuanced than the usual story crediting Alexander Fleming.
Penicillin had been used for nearly a thousand years by North African Arabs to treat their horses and cattle. French scientist Ernest Duchesne observed that and wrote about it shortly before he died of tuberculosis. It wasn't until decades later that Fleming "discovered" antibiotics.
But the Arabs didn't know why it worked, they just knew that it did work.
@@RS-ls7mm
That's how discoveries work. First someone discovers then someone explains. There are plenty of drugs for which we ignore the mechanisms of action nowadays, but we still use them.
@@nas8318 You missed the point. Credit goes to the one who figures it out.
@@RS-ls7mm
I did not miss the point. Credit goes to the one who discovers and the one who figures it out.
By the way, Fleming did not know how it worked either, so your point is moot either way.
@@nas8318 Fleming isolated penicillin, therefore figured out how the mold worked.
The one big thing I'm missing in this video is the actual main reason for the situation we're in: big pharma bought most companies that have been working on new antibiotics, but without continuing the research afterwards. Now they tell everyone there is no real financial interest and we cannot expect anything from them in the far future. Also the reason why all of your examples giving for promising "new routes" came from universities. But I really don't want to put me trust in academic research when it comes to comething urgent as this :(
There also is the option you talked about in a previous video of yours on protein folding, if I recall rightly.
Interesting new approaches to antibiotic treatment. Thanks for the update!
Good presentation. Very important topic. Thanks.
I really enjoy your content Sabine.
Thank you so much for another really informative video!!! So appreciate you!!! Phage therapy sounds very promising, but what are the downsides? Viruses have an annoying habit of mutating to survive. Once the specific bacteria are gone, is there risk of mutation and the viruses attacking healthy cells or bacteria?
You're worrying unnecessarily Roy Wells. If we splice in some 'gain of function' RNA/DNA taken from bats into the phage that should make it much safer. Scientists always know best!
I am so thankful for plant antibacterials, as I’ve had Lyme for decades and failed antibiotic treatments. Antibiotics are terrible at killing round body and biofilm forms of Borellia, but some plants have constituents which inhibit efflux pumps, which pump out antibiotics from a bacterial cell. Also some plants are anti quorum sensing, which prevent free floating bacteria from gathering in a biofilm.
YES I WANTED TO KNOW MORE ABOUT THIS TOPIC
There’s an XKCD for everything 1:20
Thanks for an informative video. Good to know there are alternatives to present antibiotics suffering resistance.
My dad nearly died of a resistant bacterial infection. He's fine now, but was in the hospital for a month and was in really rough shape, until they could find a super-fancy rare antibiotic that worked on this specific strain and that he could tolerate.
Problem is, that developing new antibiotics and getting them through all the tests and into action is quite expensive. This means that for most pharmaceutical companies there’s little interest to spend that money, that patients receive for days to weeks and not for long periods as betablockers for example. This mechanism slows the process far beyond the time bacteria need to adept… unfortunately I am sceptical, that all the really remarkable efforts by the scientists actually lead to some substantial breakthrough soon.
Then... governize healthcare?
@@fragileomniscience7647 yes. Other than everybody‘s statement in the us, that is is pure evil communism… it’s actually not!
This used to be the case for vaccines as well. Until Covid...
@8:35 “… or, otherwise, I’m too dumb to get it”
I **love** the droll way you call out bullshit. It is so refreshing! Thank you!!
If Sabine doesn't get something, it didn't explain itself sufficiently.
Or, we're doomed.
Sabine, I would love to hear what you think of the recent discovery that the W Boson is more massive than would be predicted by the Standard model! If its as significant as what I've been hearing, it may point to the first new physics in 40 years--or not? Would love to hear it coming from you!
Great, informative video. Thanks so much. More!
I'd say very. As a paraplegic I have (had) recurring UTIs every 3-4 months for years and years and by now, only two antibiotics are effective. For some reason I haven't had one yet since the pandemic hit and I can't say it's because I'm less outgoing than before.
@@froggystyle5396 , It would be interesting to see the statistics for rate of hospital-acquired infections in the last year and a half or so since the pandemic spurred hospitals to expend more time, money, and effort on cleaning and sterilizing.
Interesting and serendipitous observation, needing to be shared with those professional number crunchers who have an interest in this sort of thing... Stay healthy :)
@@tim40gabby25 Thanks! Yea, that's the only reason I mentioned it. I live in a quite rural part of a country that has accessibility issues even in urbanized areas, so I've had the same amount of contact with the same few people as before 2020. Furthermore, I've been using the same amount of hand sanitizer as before the pandemic, nothing about my hygienic routine changed, yet somehow the pandemic completely zeroed several chronic infections. I've had two different infections in total since early 2020, and I'm convinced that even those two were psychosomatic in nature.
That's very interesting. Some people hypothesized that there has been less spread of other infections due to viral interference, I wonder if that could be the case too for bacterial infections.
Sabine, thank you for all of your great research, you have challenged me to buckle down on the mechanics of math and science which looks through the celebrity. What can you say about Unzicker's perspective on physics ?
I was just prescribed antibiotics and saw this video 😂
Gotta take what the doctor tells me but thank you for the information lol. Hope our world makes advances in this field 🙏🏻
Thank you so much for this video.
Very interesting video!
And on a subject that'll become more and more important.
Just have one thing to add, which I heard on the scishow on the same subject.
Bacteria can adapt and eventually resist antibiotics or macrophages, but apparently (at least so far) it seems that when they adapt to resist one they also become more vulnerable to the other.
So a possible therapy is to prescribe both and basically let the bacteria choose who to kill them :)
Love the xkcd reference
Good one, (they are all good), thank you Sabine.
Very very informative.
The last time I had antibiotic was probably 10+ years ago........you don't need antibiotics for mild cold/flu etc, you don't need it for everything
I would get nasty head-colds that would become chest infections. The chesty stage was when antibiotics were useful because otherwise the infection would linger for weeks.
Myself as well. Sinus infection. 15 years ago this month.
Every time I go to the hospital or even my doctor's office, their fighting some new super bug that has become resistant.
I don't think we're winning the battle.
This is definitely a very important subject, and one reason we shouldn't go to a doctor which just throws antibiotics at any little sniffle or cough. And if you are prescribed antibiotics, you absolutely must take them as prescribed and finish all of them!
You mentioned antibiotic additions to animals' feed, and even in/on milk or meat products. It needed stopped, definitely! Ending it wasn't all good, though. One side effect of my country banning antibiotics in feeds for farm animals: if one of my pet chickens, guineas, etc., gets an injury infected, I can't just get a soluble antibiotic to put in her water to help her heal. I must use injections, which can cause serious injuries if she wiggles at the wrong moment.
This is because vets around here aren't impressed with chickens as pets, and look on them as replaceable livestock. I would otherwise need to find a specialist veterinarian, which would require driving around 65 miles, minimum, and pay through the nose for the exact same treatment I was able to give her myself for about 5% of the cost, only the year before.
So we need to be able to care for our farm *pets* _without price-gouging,_ while keeping a tight control on the meds in factory farms. There should be a happy medium!
I love the way you explain science in a clear direct way. Thank you! Could I just ask for less use of this plopping item sound please? It's used allot in your last uploads.
In the Netherlands when you're sick and go see a doctor you have a very high chance to be sent home with paracetamol to somewhat ease the symptoms. Antibiotics are rarely prescribed. Most common illnesses are of viral nature so why bother taking some drug that doesn't work anyway? It's not going to cut that cold any bit shorter.
thank you, i really am interested in this matter and would like to contribute to this as a public health doctor, if i manage to complete my studies :)
I think you covered the matter really well, personally I think I would have dedicated a bit more time to discussing the problem of (no) novel molecules in the pipeline and metoo drugs, which would in turn lead to the need of a general overhaul of research in terms of funding schemes and governance.
Also highlighting the need for proper antibiotic stewardship, better cycling schemes and administrative regulation on animal consumption of antibiotics (even without getting too political) would deserve a whole new video! For example I would bring up that an early 2022 ruling (took years to approve) from EU ended up limiting use of antibiotic for profilactic and metafilactic purposes (edit - in veterinary context, i'm sorry i created a misunderstanding!), which i think is a huge step forward in the right direction!
Thanks for the feedback!
Prophylactic and metaphylactic antibiotic use is analogous to wearing seatbelts in automobiles: have the protection in place before it is needed. Of course, in the case of seatbelts this strategy is logically required while in the case of of antibiotics the protection can be applied after the bad event and still often be effective. But doctors, dentists, and veterenarians are going to continue to be tempted to do whatever they can to cover the small chance of a bad outcome for their patients (which carries the possibility of a bad outcome for them if they get sued).
@@robertbutsch1802 It seems worth saying that under specific circumstances, prophylactic treatment with antibiotics is generally considered a good idea. From what I've been told, in many countries it's SOP to give antibiotics 10-15 minutes before an operation, because the statistics say it helps often enough to be worth doing.
@@ccreutzig You would be correct. It's standard to give antibiotics before many operations. Since it is one or two doses, aimed at skin bacteria, it does not significantly contribute to resistance, as long as the appropriate antibiotics are used. Cephazolin is most common where I am, and it really only targets skin bacteria, which is great if you are cutting through skin to get at something [sterile] inside.
Not all surgeries require antibiotics, they are divided among clean, clean-contaminated, contaminated and infected. By the book, only the middle ones use prophylaxis, the fourth one uses treatment, not prophylaxis, and the first one forgoes it completely (unless there is a prothesis).
@@robertbutsch1802 "have the protection in place before it is needed" - isn't that what we call vaccination? That doesn't sound like antibiotics to me.
Really interesting, thank you for the content.
Thanks for the video :)
You have an error, bacteriophage research was used in USSR, in particular Georgia. The Lancet wrote about it.
The institute is George Eliava institute.
Tiblisi
Another challenge for antibiotics is determining what the infection is quickly enough to treat it effectively. I’m not sure if this has changed in the last 5-10 years or so, but if you have bacteremia (bacteria in the blood) you will likely be given broad spectrum antibiotics first, as the bacteria need to be cultured before sequencing (to get a large enough DNA sample), which can take too long to wait. This might be changing though, with modern sequencing technology that can work with much smaller samples
Do you have a podcast? I'd like to listen while I drive.
so interesting - Thank you very much
Is the era that began with that moldy cantaloupe from Peoria going to end with a rotting eggplant from Pretoria?
The first production strain from the first antibiotic, penicillin, came from a moldy cantaloupe at the Peoria Farmer's market. This new engineered phage comes from South Africa. I added the Pretoria for the similarity of the place names, actually the bug came from Cape Town.
Never!
One thing Sabine did not cover was combination therapy... there are compounds that can effectively reset a bacterial pathogen's ability to resist a drug.
So, I know Dr. Hossenfelder and even Dr. Feynman would appreciate this aspect, this means everything old can be new again... in the right frame.
I read at least 2 or 3 years ago that "big pharma" had decided antibiotics were _no longer cost effective_ due to the increasing antibiotic resistance. The text stated they were no longer researching new antibiotics, but only working with those already in the product development pipeline. This was in Stephen Bohler's book _Herbal Antibiotics_ which presents a great deal of detai on bacterial infection and plant-sourced treatments for the same, including preparation methods. The point is that, either with or without continued commercial research into new antibiotics, the bacterial resistance is going to win. Plant sources have been combating bacteria for millions of years and is a good addition to supplement our own immune systems. He gets very deep into bacterial details.
His parallel book _Herbal Antivirals_ addresses the other great category of pathogens. Both are worth a read.
Bacteria are amazing creatures to be "single cell organisms". They have multiple abilities, such as pumps to flow liquid through a cylindrical body to extract nutrients. When an antibiotic attacker is recognized, they speed up that pump (ion transport actually) to push it through before it can cause damage. MOST INTERESTINGLY is their ability to record a pathogen (antibiotic) in a section of their DNA. This can be copied many times and dispersed into the environment. When another bacterium encounters this snippet of DNA, it will recognize it, copy it into its own DNA, and become resistant to an antibiotic it has never "personally" encountered. Such activities are the reason I said the bacteria are going to win the antibiotic wars. We need another method.
Bacteriophage (aka "phage") technology was largely shelved and ignored once antibiotics became popular and readily available. The only place phage research has continued is in (Russian) Georgia. The last I read they were wiling to work with anyone interested in phage technology.
The issue with "big pharma" is that it is likely to cost $1b+ to identify, test and bring to market a new antibiotic. Any novel formualtion will then be locked in a cupboard as a antibiotic of last resort while the patent life ticks down therefore it just isn't profitable.
Sabine, please produce more content on super determinism. General Relativity + Quantum Field Theory MUST reveal this. However, our species is yet to even accept evidence from Special Relativity. You're on the right track and you're not alone. You have established enough online fame to alter current human beliefs. I truly believe you to be the next Galileo. It's about time history remembers women changing the world. You can change global human belief. I will support you with my knowledge. You're not alone. YOU can change the world.
The free will lobby are trying their hardest to keep superdeterminism as obscure and under-researched as possible.
Could those strengthened peptides have a runaway effect where after destroying the targeted bacteria, it attacks our healthy bacteria?
That’s also a problem with regular anti biotics
I remember TV ads for Geomycin (antibiotic from Tetracycline group) additive for feed for egg-laying hens over here in Croatia. I am _that_ old.