mcgloughlin -good bugs, bad bugs

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Good Bugs and Bad Bugs Why we need to know….. Steve McGloughlin The Alfred

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Page 1: McGloughlin -Good Bugs, Bad Bugs

Good Bugs and Bad BugsWhy we need to know…..

Steve McGloughlinThe Alfred

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Intensivists

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An Infectious Diseases Physician

+

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Intensivists

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Intensivists

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Intensivists

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Intensivists

?

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Intensivists

?AntibioticsSurgeryImmunosuppressionAnticoagulationTime?

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There has always been bugs…

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“We live in the Age of Bacteria (as it was in the beginning, it is now and ever shall

be until the world ends)

Steven Jay GouldCambridge MA 1993

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The Black Death

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Spanish Flu

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Emerging Infectious Diseases

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Good Bugs….

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The Human Microbiome

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And then came……

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NNT

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1 million Avoidable deaths in 2013 in under 5’s from pneumonia

170 000 deaths in India avoidable with

Antibiotics

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Bad Bugs….

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Nobel Prize LectureIt is not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them.

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Pandrug resistant

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214000 neonatal sepsis deaths attributable to resistant pathogens

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The Future…..

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Loss of Biodiversity

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Teixobactin

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The Narrow Spectrum Era…….

Golden EraNature

products

Medicinal Chemistry EraSynthetic tweaking

Resistance eraTarget based, broad

spectrumNarrow-Spectrum era

UnconventionalCombination

approachesDiagnostic

development

1925

1975

2000

2025

1950

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Subclass A Subclass B Subclass C

The patient…….

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The End……

Fleming

The thoughtless person playing with penicillin treatment is morally responsible for the death of the person who succumbs

to infection with the penicillin resistant organism.