mcgloughlin -good bugs, bad bugs
TRANSCRIPT
Good Bugs and Bad BugsWhy we need to know…..
Steve McGloughlinThe Alfred
Intensivists
An Infectious Diseases Physician
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Intensivists
Intensivists
Intensivists
Intensivists
?
Intensivists
?AntibioticsSurgeryImmunosuppressionAnticoagulationTime?
There has always been bugs…
“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
The Black Death
Spanish Flu
Emerging Infectious Diseases
Good Bugs….
The Human Microbiome
And then came……
NNT
1 million Avoidable deaths in 2013 in under 5’s from pneumonia
170 000 deaths in India avoidable with
Antibiotics
Bad Bugs….
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.
Pandrug resistant
214000 neonatal sepsis deaths attributable to resistant pathogens
The Future…..
Loss of Biodiversity
Teixobactin
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
Subclass A Subclass B Subclass C
The patient…….
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.