Of Particular Significance

Evolution [in]-Action

POSTED BY Matt Strassler

POSTED BY Matt Strassler

ON 11/21/2013

For general readership

Evolution really happens in nature: we know this from the frightening rate at which bacterial species, faced with our most powerful antibiotics, manage to find ways around them.

More precisely, a certain amount of natural variability and accidental mutations within bacterial populations, and the huge rate at which bacteria reproduce themselves (a single bacterium at dawn may be billions by sunset), essentially assures that eventually, simply by accident, and relatively soon, a bacterium will be “born” that is immune to any particular antibiotic. And then this bacterium, the sole survivor of the onslaught to which its siblings have succumbed, and reproducing by dividing into “children” that also can survive, soon gives rise to a subspecies of its own, against which this antibiotic is useless.  By using the antibiotic again and again, killing off the bacteria from other subspecies, we eventually assure that this unbeatable subspecies becomes more and more common compared to its cousins.

In recent years, bacteria have appeared for which no antibiotic treatment exists.  The rate of the evolution of these bacteria has outpaced the rate at which biologists and medical researchers can find and develop new antibiotic treatments.  The Center for Disease Control is extremely worried about this, and its director Tom Frieden just published a blog post that everyone should read.  Here’s one quotation:

To help draw attention to CRE and other top antibiotic-resistance threats, the Center for Disease Control recently published its first report on the current antibiotic resistance threat to the U.S. The report estimates that each year in the United States, at least 2 million people become infected with bacteria resistant to antibiotics, and at least 23,000 people die as a result.

Note this extraordinary statement: every year, 1 in 150 people in the United States will be infected with bacteria that are resistant to a classic antibiotic every year, and 1% of them will die, some fraction of them because of this resistance.  Let’s put that in perspective: assuming there were no increase in the number of bacteria or improvements in treatment over the next 50 years, your chance of being infected by such a bacterium during that time is roughly 25%.  In short, this will very likely happen to someone you know in the next few years, and someone in your family in coming decades.  (It’s already happened to someone in my extended family.)  And of course, since they are hard to fight, these bacteria are likely to spread, so the rate of infection will become worse if nothing is done.

Here’s another quotation: 

Every doctor must commit to use antibiotics only when needed, and to use antibiotics for only as long as they are needed. Patients need to understand that “more” drugs does not equal “better” drugs. The right treatment is the best treatment – and that isn’t antibiotics for every infection or every illness.

Now why is he making this point so strongly? Let me end by quoting from the preamble to the report he mentions:

The use of antibiotics is the single most important factor leading to antibiotic resistance around the world. Antibiotics are among the most commonly prescribed drugs used in human medicine. However, up to 50% of all the antibiotics prescribed for people are not needed or are not optimally effective as prescribed. Antibiotics are also commonly used in food animals to prevent, control, and treat disease, and to promote the growth of food-producing animals. The use of antibiotics for promoting growth is not necessary,
and the practice should be phased out.

I hope everyone pays close attention to Frieden’s post and its message, and spreads the word among the people that they know.  Doing so may someday help save the life of someone you care about, or even your own.

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39 Responses

  1. Dear Sean: No Frieden did not mention at all the problem of antibiotic feed in his CNN admonition. It is hard for me to gather all my sources to the level of certainty I would like to project, just to demonstrate corruption in USA academia. It would be a bit like quoting my sources on 1 + 1 = 2. Europe banned this stuff nearly a decade ago. The FDA nearly did in… 1977. Nevertheless, I did something of this sort in:

  2. Regarding the impact of antibiotics use in herds (cattle and others, like sheep, horses, buffalos, etc.) in comparison to antibiotics use in humans, the use in animals is by default and scheduled, while the use in humans is exclusively incidental.

    Besides this factor, we should also consider that use is proportional to the size of the herds, which means that with larger herds there will be an increase in the amount of antibiotics used, and we should expect that the herds will increase with an increase in the size of the human population.

  3. Patrice;

    I am not sure the Frieden blog or the report it linked to were intended to focus on the causes of the problem as much as the response to it; and both did pay attention to the issue of antibiotic misuse in agriculture; perhaps not as much as they should have.

    Which brings me to a question: can you provide some evidence for your claiim that “most of the resistance, aside from Eastern European prisons, comes from daily antibiotic feed for animals in the USA”. You say it has been demonstrated so that should not be hard for you.

    sean s.

  4. Antibiotics are systematically given to animals in the USA, everyday, so that they can grow more and bring more profit. Explicit plasmids have been tracked to this practice, which is unlawful in Europe. In Europe, antibiotics can be given to animals, if and only, they are sick.
    That later treatment, Dr. Frieden wants to discourage in humans. Why? So that meat producers from the USA can better keep on giving antibiotics to animals, day in, day out?
    Indeed, in his post, the good doctor talks explicitly only about human usage. He “forgets” the animal feed problem in the USA. Thus his ethical level is compromised below plausibility, as his expertise is beyond any suspicion.
    Antibiotics resistant TB grows in Russian and Georgian prisons. Dr Frieden himself implicitly admits USA hospitals are not clean enough. Why does not he go clean them with bleach? When antibiotic resistant TB patients from Eastern Europe make it to French hospitals, they are cured with (semi secret) new antibiotics.

      1. Dear Matt: I am a philosopher, and a serious one. I read very seriously what you wrote, and you indeed mentioned antibiotics in animals, and so did the linked report, and that’s very good. But, the only thing Frieden did was to mention nebulously “leaders in agriculture”. That’s astounding. (I just re-read Frieden’s post, alarmed by the alleged clear lack of care you imputed to me).
        Once again, most of the resistance, aside from Eastern European prisons, comes from daily antibiotic feed for animals in the USA, that has been demonstrated, by careful study of the plasmids, and Frieden knows it. That he avoids the subject speaks volumes to me, as I described. My conclusion? The arm of plutocratic corruption reaches deep in the soul of academia and the like. In the guise of looking real smart and helping everybody, while not forgetting to sound sanctimonious to awe the humble into submission. Not exactly the image scientists should project, if science is what they care about first.

  5. “Invariance” or “Invariant” is a size that does not change under a certain transformation in physics.
    “A conserved belongs to every continuous symmetry of a physical system.” — Emmy Noether.

    The Evolution is as reality as the rest mass (invariant mass) – but only within “unnaturalness”!

  6. Well, I’ll be a monkey’s uncle. Hasn’t everyone heard that phrase? Do you people remember the Laurel and Hardy movie where a scientist invented a potion that restored youth to those who drank of it, even just a glass, well, they fell into a vat of it and came out as monkeys. Ha, what more proof do we need.

  7. While I hesitate to offer something that could be considered a non-scientific response, I have read for many years about the US resistance to the concept of so-called “phages” but it would appear that such a concept is worth investigating. The rest of the world has considered the concept superior to just relying on antibiotics for a very long time. I am no expert but it would appear that our immune system’s stance of chemically binding to alien cells is a form of phage, and liking for artificial pages could be easier than building more antibiotics with more side-effects.

    1. This, of course, depends a lot on what you think “believe” means. The SEP defines belief “to refer to the attitude we have, roughly, whenever we take something to be the case or regard it as true.” Thus, even scientific results and theories are “believed”. Belief is, in this case a general term that includes “knowledge” as well as “faith”.

      So, Tony’s rendering is reasonable. The proper clarification is that believing in evolution is not the same as believing in deities because belief in evolution has been an can be justified by facts; belief in deities remains an act of faith (trust).

      sean s.

  8. In this day and age not believing in evolution is just wrong, wrong, wrong, and as one who battled a case of staph in the not too distant past, it was, I can assure you, not in the least fun. Happy to be alive.

  9. Great finding, Matt!

    Besides the fact that the news is really positive, the article includes certain concepts and ideas that are interesting for discussion.

    One of the interesting comments in the article is the following:

    “We’ve known for a long time that psychoactive (psychopharmacological) drugs have an antibiotic effect”.

    Even though that could seem at first glance to be an unexpected twist, it should not be so: neurotransmitters are also a part of the immune system, so, it should not surprise us to find that molecules that can operate on neurotransmitters pertaining to their neurological functions could not also work along with them in their role in the immune system.

    Kind regards, GEN

  10. I agree that this is a growing and significant problem. We live near the U of IA hospitals and clinics. There are more frequent articles published by them about the challenge and steps they must take to minimize these risks to patients. It is so counter-intuitive to have a major center for health care and research being challenged with bacterial strains they cannot fight.

    Thanks for the post.

  11. I enjoy your particle physics posts, but I don’t appreciate your delving into evolution. There is no evidence for evolution, and abundant evidence for natural selection and the fit surviving. My guess is that your foray into evolution is on some publisher’s agenda for you, no?

    1. @Tim: I would like to understand better some details of your post, Tim.

      It seems like you consider that “natural selection” and “evolution” are aspects that belong to two different theories, which is not so, as they are concepts that pertain to the very same theory, the theory of evolution.

      Could you be so kind to clarify this, so I can understand more clearly your comment?

      Kind regards, GEN

    2. Tim, you do know (don’t you) that natural selection and “survival of the fittest” ARE Evolution?

      sorry about the repetition.

      sean s.

      1. >you do know (don’t you) that natural selection and “survival of the fittest” ARE Evolution?

        Not quite. Evolution is the change of the phenotype distribution of a population over time. Natural selection aka “survival of the fittest” is a, but not the only – and certainly not always the most important, mechanism of evolution.

    3. Offspring are related, but slightly different than their parents. This is descent with modification, ie Evolution. From this we can infer that all forms of life share a common ancestor. Lo and behold DNA is discovered which is the mechanism for inheriting traits which agrees with common descent. The fossil record has thus far supported common descent, and morphology, the study of the form and structure of organisms also implies common descent. Those are all fantastic evidence that Evolution is actually true and we can therefore use the theory in science labs for medicine and agriculture which are absolutely integral to society. If Evolution has no evidence, how is it successfully in use in a couple of the largest sectors of the global economy? It would get thrown out in a heartbeat if it wasn’t useful and failed every test thrown at it in laboratories around the world.

    4. Tim,

      I too am a big believer in the Galactic Organization of Democracies (GOD) but have you not read: “Man does not live by particle physics alone, but by whatever topic tickles his fancy.”

      Seriously, this is the USA – we have no thought police here (at least not yet, I’m sure the NSA is working on it). Who are you to tell someone what topic they may or may not delve into?

      Oh, just a little tip – the Flintstones was not a documentary! (Stole that from the comedian Lewis Black, sorry couldn’t resist…)

      A little more on topic: Last year my neighbor went to the hospital for a minor operation. She never came out! She got some drug-resistant infection while the hospital and died. We should indeed take Friedens message seriously.

      Also even as I write this – the first case of “locally acquired” DENGUE fever has been reported here in New York…

        1. I would consider a few things regarding the probability of dengue becoming an endemic disease during the summer season of northern states in the US: to start with, the “tropicalization” of the US due to climate change.

  12. Something tangential to this that I only learnt recently, copper alloys appear to have antibacterial qualities. If it is utilised on constantly touched surfaces in hospitals it can greatly reduce the opportunity for spreading microbes like MRSA.

    I must note that out of the 5 papers Ive now read on the subject not one wasnt connected to the copper industry. Even the ‘independent’ source that guided the American organisation EPA note that they have a conflict of interest with funding from the Copper Development Association.

    Im not too familiar with how everything works with research funding and whether the alarm bells that are ringing in my head are justified, but if the efficacy of the alloys does hold up to scrutiny the benefits could be considerable.

    If anyone has further information or can confirm I am just being paranoid/unlucky about the research, I would like to share this with my MP and encourage others to do the same.
    (The NHS are of course already aware of the research going on but bringing more attention to it could be a big help.)

  13. I could not find in this post a reference to an important aspect of the complex process that gives rise to antibiotic resistance in germs (mainly bacteria an fungi):

    Many patients stop taking the medication ahead of time, and this is a major factor in the creation of proper conditions for germs to become resistant.

    Kind regards, GEN

    1. Excellent point; it is true that it wasn’t emphasized. But of course, if the antibiotics were less often prescribed when not needed, this too would become a bit less of an issue.

      1. Indeed.

        Besides, it is important to achieve that the community of physicians, in a disciplined fashion, follow stricter rules regarding the proper prescription of antibiotics.

        Drug companies should be involved in this process, by developing new drugs with a different set of properties, like say, avoid the “broad spectrum” categories for antibiotics.

        Broad spectrum antibiotics can target many types of bacteria, but these drugs are not equally effective on all targeted types (parcially targeted species may develop resistance more easily), so, even though the approach makes sense from a business perspective, it does not necessarily make a lot of sense from a scientific / medical perspective.

        Kind regards, GEN

    2. Tim, don’t you know that natural selection and “survival of the fittest” ARE Evolution?

      sean s.

  14. My aunt passed away some years ago due to a drug-resistant hospital infection, so I support this message 100%.

    I’ll also leave with this quotation: “Nothing in biology makes sense except in the light of evolution.”

  15. I have fought against ‘profolactic’ antibiotic treatments in aquaculture with decient success. More and more companies have stopped doing this. Also during my time on the sea sites managing i am proud to say the fish i raised never needed treatment due to good husbandry practices. I am now consulting and designing land bases systems for aquaculture.

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