mcgloughlin -good bugs, bad bugs

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

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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.