Morano, the Godfather, contacts moi? About superbugs?

So Marc Morano is justifiably offended by the conflating of superbug problems with climate or warming or change–whatever.

Here’s Moran’s note:
“But it’s kind of like global warming. It’s not an immediate catastrophe, but it could become one if we don’t do something soon.” As with the issue of climate change, there’s no single solution to the problem of antimicrobial resistance. Researchers around the world, including several at U of T, are pursuing a variety of strategies.”

Superbugs


The false problem of global warming being used to bolster the real problem of hospital superbugs… amazing.
You know how this works, make every issue relate so you don’t have to build the propaganda edifice.
The reality is that when we use antibiotics, sometimes more than we should, we sort out the bad boys, because they survive our antibiotic assault.
As some German philosopher said–what does not kill me makes me stronger–duuuuuh.
Claustridium Dificile, mentioned here, has been around since I was a baby physician. Dificile developed in the 80s when dentists used what was their favorite tooth abscess antibiotic Cleocin (clindamycin), still a wonderful all-purpose antibiotic for anaerobes and gram positives (a little doctor lingo, you don’t need to know) and then their tooth patients would develop bad diarrhea caused by claustridium dificile. In the recent times dificile has been found to arise in people who aren’t on antibiotics. Has people anxious.
Dificile is a problem that arose 30 plus years ago and is still manageable. when it goes bad people get toxic megacolon and can get infection in the blood that is life threatening.
So it hasn’t stopped the world, has it? However this journalist is discovering how scary it is, and after all making people panicky is important to journalists.
Ok, so let’s go after the evil Methicilin resistant staph aureus, MRSA–the flesh eating bacterium du jour, well not exactly, since it has been around for more than 2 decades. Probably selected out in populations where the kids get lots of antibiotics. Found in noses of family members. Causes bad and aggressive skin infections–rarely other infections, like pneumonia (I have only seen or heard about a few in 20 plus years.
So I treat MRSA dozens of times a year, used to be more common, soldiers, fairly common jail inmates–I take care of both. Goes to abscesses, but the way I prevent abscesses in inmates is the jailors call–got a red spot, the inmate blames it on a spider, it’s staph–treat Bactrim (antibiotic) warm compresses, I never have to lance an abscess, hardly ever.
Now the last one in this journalist’s line up is Vancomycin (antibiotic, exotic) resistant enterobacteria. Well I checked with my infectious disease guy and he says in our little town he’s seen it 5 times in many years, but it is a more serious problem in hospitalized patients in urban settings.
The worst resistant bug I have read about isn’t talked about in the article, it’s the multi resistant superbug coming out of India where people can buy antibiotics over the counter without a prescription. It’s called New Delhi Metallo-beta-lactamase-1 (NDM-1) and it is an impressive critter. Many people in India are carrying the bug and the way it get’s going is these hospitalization cases, including the medical tourism people who pick it up in India and take it elsewhere.
Another is multi drug resistant TB bugs, not to trifle with because of the awful nature of TB.
In a modern world where we kill bugs with drugs, don’t be surprised if a bug that is resistant gets selected out.
Problem, serious for the patient that has it, not related to warming or climate, as Morano noted. Related to modern medical therapy and the use of antibiotics.

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