September 6, 2024 • 42 mins
Antibiotics, antivirals, and antifungals have revolutionized modern medicine, saving countless lives and transforming our approach to infectious diseases. In this episode of our podcast, we delve into the differences between these powerful tools of modern medicine. We explore their discovery, impacts, and the pressing issue of evolving resistance.
We dive into where we get antibiotics, how they work and why responsible antibiotic use is so important to prevent antibiotic resistance. We highlight the critical role of accurate diagnosis and appropriate treatment of bacterial infections to prevent resistance from developing.
We also dive in to the intricate interactions between microorganisms and our immune system. For instance, certain fungi and bacteria are essential for maintaining a healthy balance, but under specific conditions, they can cause infections. We discuss fungal pathogens like rose gardener's disease and aspergillus, emphasizing the importance of understanding fungal infections, especially in the context of rising global temperatures and their impact on fungal behavior.
Antivirals, another critical class of antimicrobials, target viral infections by preventing viruses from replicating. This episode explores the challenges in developing effective antivirals, such as the rapid mutation rates of viruses and the difficulty of targeting viral components without harming host cells. Effective antiviral treatment often requires early administration, and the episode discusses the various forms these medications can take, from pills to intravenous injections.
This episode provides a comprehensive guide to the world of antimicrobials, blending historical insights and scientific knowledge. We underscore the importance of responsible antibiotic use, the challenges of treating evolving and emerging diseases, and the critical role of the human microbiome. Listeners are encouraged to rethink their interactions with these microscopic beings and appreciate the delicate balance required to maintain health in the face of evolving pathogens. Whether you're a healthcare professional, a science enthusiast, or someone interested in the history or future of medicine, this episode offers valuable insights into the complex and fascinating world of antimicrobials. Tune in to learn more about how these powerful drugs have shaped our past, present, and future in the fight against infectious diseases.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 2 (00:09):
This is a podcast about One Health the idea that
the health of humans, animals,plants and the environment that
we all share are intrinsicallylinked.
Speaker 1 (00:17):
Coming to you from the University of Texas Medical
Branch and the GalvestonNational Laboratory.
Speaker 2 (00:21):
This is Infectious Science, where enthusiasm for
science is contagious.
Speaker 3 (00:30):
All right, hello everyone and welcome to this
episode of Infectious Science.
We are so excited to be herewith you today.
My name is Camilla Du and we'regoing to be talking about
antivirals, antifungals andantibiotics and the difference
between all of these.
So when we get an infection,the drugs to treat it fall into
those three main categories andeach of them treats a different
type of infection.
(00:50):
So viruses like COVID-19 or theflu are treated with antivirals
, bacterial infections likestrep or Lyme are treated with
antibiotics, and then fungalinfections like yeast infections
or ringworm are treated withantifungals.
So in this episode we're goingto break down the difference
between these categories ofdrugs.
Speaker 4 (01:07):
Rock on and I guess we can go ahead and we can start
with antibiotics, because Ifeel like that's probably the
medication that most people areEverybody's probably taking
antibiotics.
Exactly.
Most people are aware That'd bean interesting study.
Speaker 3 (01:18):
Are there populations that haven't taken antibiotics?
And then what does that looklike?
Speaker 5 (01:22):
And then now studies that show that even species or
animals that have not takenantibiotics, that they pick up
the antibiotic resistance fromhumans.
Oh, that's pretty wild, right I?
Speaker 3 (01:32):
wonder too, with like amphibians and stuff, does that
affect them?
Because if it's in our watersupply, so if it's in like
wastewater, if you haveantibiotic residue, it'd be
really interesting.
There's been other studies onthings that are in our
wastewater that are affectingamphibians.
Speaker 4 (01:44):
That's really interesting.
I didn't even think about that.
Well, let's get into thegeneral idea of what antibiotics
are, and then we'll discuss theeffects on amphibian
populations.
What are antibiotics?
A lot of people probably don'tknow, but antibiotics actually
originate from fungi and fromsoil bacteria, and it kind of
makes sense when you think aboutit, right.
(02:04):
So these fungi have been around, and also bacteria have been
around for thousands andthousands of years before us,
and they were each other'scompetition when it comes down
to it.
And what do you have to do inorder to survive amongst your
competition?
You got to have a way to killthem.
Speaker 3 (02:19):
That's all I'm going to say, especially because it's
close quarters, right Like a lotof our antibiotics are from
soil bacteria, right, exactly sothey're very densely packed
together, so if you aren'treally moving around a bunch,
you got to compete with yourneighbors for nutrients.
Speaker 4 (02:33):
Yeah, exactly, and so the way that most of these
antibiotics work.
Well, let's be real, a lot ofdifferent antibiotics have
different mechanisms, right, butsome common ways that they work
are, for example, by attackingthe bacterial cell wall or the
bacterial cell membrane, and soit's basically attacking the
skin of the bacteria, let's say,and getting rid of the bacteria
skin.
And if you get rid of a humanskin, a human's not going to
(02:55):
survive.
It's the same thing with thebacteria.
So that's one way theantibiotics work.
Maybe another way that we cantalk about is just interfering
with the actual bacterialreplication in general.
It's definitely a way that wecan talk about is just
interfering with the actualbacterial replication in general
.
It's definitely a way thatantibiotics can work and that
they are effective.
And then also by blocking someprotein production.
But that's kind of getting intothe nitty gritty of things.
So I did want to talk a littlebit about how antibiotics were
(03:19):
originally found, though,because that's always a really
fun story, and you guys actuallycorrected me on this when I
first told you guys.
So in 1928, I believe,alexander Fleming was a
scientist, he was working withbacteria, and I think you said
that he had tossed his plateswith cultures into the trash.
And then he came back.
He was frustrated, I guess,left the lab, tossed the
(03:40):
cultures, came back and noticedthat there were these clear
spots, so clear zones, where thebacteria was actually not able
to grow Around the fungus thathad grown Around, fungus that
had contaminated the plates, andthat fungus came from whatever
was in the trash, right?
Speaker 3 (03:56):
Well, I think as we'll get to later.
Yeah we're going to talk about.
There's fungus everywhere.
So if you're taking a deepbreath right now, you're
inhaling fungus, I guarantee it.
It's really cool to seeclearing zones.
I used to work at abacteriology lab and we would
treat with different antibioticson these little discs and then
you set them on the plate and Ijust thought they looked really
cool.
It's like modern art.
Speaker 4 (04:15):
Yeah, exactly Because you have this plate.
Imagine a plate, guys like fullof fuzz or a growth or
something right, and then whatis a clear zone?
It's literally a zone wherethat growth cannot form.
So there are these clear spotson a plate.
For those who don't know what aclear zone is or what a petri
dish is or what an auger plateis, that's what it looks like,
(04:37):
and so you can really make artwith it.
Speaker 3 (04:39):
Yes, also, that's a fun thing to do if you have
bacteria that'll fluoresce.
Speaker 1 (04:42):
Yeah, that was always a thing we would like.
Speaker 3 (04:44):
I did something.
It was not an actual labactivity, it was just a fun
science thing.
It was very benign bacteria andthey were like yeah, like just
make your little art Someonemade like a.
It was like the ocean and asurfboard and it was very well
done.
It was impressive.
Mine was like squiggles, but itstill of them.
Speaker 5 (05:01):
They're so cool, very interesting.
Did you go to a Waldorf schoolor Montessori?
Speaker 4 (05:07):
It's actually at.
Speaker 3 (05:07):
Cornell, where I did this Montessori.
Speaker 4 (05:09):
Dennis, are we like playing with bacteria in
kindergarten?
Is that what we're doing?
Speaker 5 (05:13):
I don't know.
It's free thinking, free spirit.
I've never heard of a Waldorfschool.
No.
Speaker 4 (05:18):
Yeah, they're Kind of a Montessori.
Speaker 3 (05:26):
Isn't it the self-teach?
Speaker 4 (05:28):
Yeah, they have a lot of pre-thinking.
Teach yourself.
Speaker 5 (05:30):
Do they use antibiotics in the Waldorf
school?
I don't know.
Speaker 3 (05:35):
Isn't the antibiotic free zone?
Speaker 5 (05:36):
It's a clear zone.
It's a clear zone.
Speaker 3 (05:38):
It's a clear zone.
Oh my gosh, making me think ofthose signs I see of slow down.
This is a school zone.
This is a clear zone.
Speaker 4 (05:47):
Oh no.
So just going back to thehistory of antibiotics in
general, one event that I didwant to talk about is the
Coconut Grove Fire.
Speaker 5 (05:59):
So that was a fire that happened in.
Is it a club somewhere inHouston?
Speaker 4 (06:02):
It's a club somewhere in Boston.
It was a club in Houston.
It's a club somewhere in Boston.
Speaker 1 (06:05):
It was a club in 1942 .
Speaker 4 (06:08):
And it was the place to go to if you were an athlete,
if you were a politician, ifyou were a celebrity.
Everyone was going to CoconutGrove.
However, coconut Grove only hadone main entrance, one main
exit.
It was the same door and it wasa revolving door and, of course
, this was back in 1942.
They still had lots ofcandlelit things and they had,
(06:30):
of course, electricity, but thatelectricity was shoddy, let's
be real.
So there was a light bulb thatwent out in Coconut Grove and
apparently the story goes that aworker was sent to change the
light bulb but because there wasno light there, he couldn't see
what he was doing.
So he lit a match and you guysknow what happened.
And with only one main exit,with fire exits jammed and with
(06:55):
the other exits only known topeople who actually worked at
the club, there was a hugeamount of injuries and also
casualties from the actualincident and, of course, many of
those injuries were seriousburns.
As we all know, burns areincredibly susceptible to
infection because you're, as Isaid previously, taking out the
(07:16):
skin of a human.
The skin is our protection fromso much and it also side note
has a lot of bacteria on it thatare really good for us.
But when you get rid of thatepidermal layer, you expose the
body to a lot of bacteria, fungiand potential infections that
your body normally wouldn't besusceptible to, and so back in
(07:38):
1942, when this occurred, theydidn't have antibiotics.
So a lot of people whosustained really serious burns
ended up getting not onlyinjured but also sustaining
really serious infections thatcould potentially lead to death.
However, our lovely littlefriend penicillin had recently
been not only discovered butsomewhat developed just not in
(07:59):
the mainstream labs, and itwasn't heavily funded until the
scientists managed to get theopportunity to treat the
patients with penicillin.
I have a stat here Merck andCompany was the company that was
working with penicillin.
They were allowed to rush a 32liter supply of penicillin to
(08:20):
Boston to treat the patientswith these serious birds 32
liters of liquid penicillin.
Speaker 5 (08:27):
Wasn't probably super potent back then, though right
Probably not Probably not.
When did Fleming discover thestuff?
Do you remember In?
Speaker 4 (08:34):
1928.
Speaker 5 (08:36):
Oh wow, and this was in 1942.
Speaker 4 (08:38):
Yeah, okay, several years between the two events.
And it was only after thepenicillin was proven to keep
these patients from developinginfections that penicillin was
then funded.
The research into penicillinand the mass development of
penicillin was actually fundedby the US government.
Speaker 3 (08:57):
It's really wild.
I always assumed it was theSecond World War was where we
got penicillin from.
Speaker 5 (09:02):
I think it was also used during the Second World War
, which was right around thattime, right.
Speaker 3 (09:06):
Right.
Okay, so maybe this was acivilian population that got
tested on, but I wonder you'remaking me think now.
I think you brought up a greatpoint that I want to highlight,
in that, as much as we'retalking about antibiotics and
wanting to kill bacteria thatare harming us, we do have a
fabulous amount of bacteria onour skin, living inside of us.
The world would not do well asa sterile place without bacteria
.
We need them for so manyprocesses.
(09:29):
I think microbiome is reallyfascinating.
Speaker 4 (09:31):
Microbiome is incredible.
Microbiome is all over.
Speaker 3 (09:33):
But back to your history.
I definitely would have died inthe coconut grove fire because
I struggle with revolving doorswhen I'm not under duress and I
actually actively avoid them.
Speaker 5 (09:42):
Do you think you would have gone to a club back
then?
Speaker 3 (09:44):
Probably not.
No, I'm going to read a bookand drink, you know, a nice Earl
Grey tea.
Speaker 4 (09:52):
On a.
Speaker 3 (09:52):
Friday night, my Friday nights yeah, they're wild
.
Speaker 4 (10:02):
Hey, kudos to you, though, and I just looked it up.
Actually, it says that thesuccess of penicillin in
treating these burn victims fromthe coconut grill fire led to
the US government to support theproduction and distribution to
the armed forces, so that wasprobably what allowed you know.
Speaker 5 (10:12):
So, Mrs Stats, do you have some stats on how many
people died of bacterialdiseases before penicillin and
then after penicillin?
Speaker 4 (10:21):
That I don't A lot.
Yeah, I could imagine a lot,because I'm almost certain that
the number one cause of deathwas these common pathogens that
now we can fight with a simpleantifungal or an antibiotic.
And I know that was the numberone cause of death before these
medications were invented.
And that actually is a nicelittle segue into.
What I did want to talk aboutwas antibiotic resistance.
(10:44):
So antibiotic resistance is aserious global health problem
for sure, and it occurs whenbacteria evolve to resist the
effects of antibiotics.
And there are several ways thatthis can happen.
One of the ways is to wherebacteria themselves, just when
they're replicating, mutationshappen, as they always do, and
then they just develop thesemeans of resistance to an
(11:07):
antibiotic.
Another way is when antibioticsaren't taken correctly, whether
they're taken for a viralinfection that they did not need
the antibiotics for, whethersomeone's given a course of
antibiotics and they don'tfinish the course of antibiotics
or they don't take theantibiotic as properly
prescribed.
That introduces the medicationto bacterial populations and it
(11:29):
also gives the bacteria who areresistant to the medication the
opportunity to pass these geneson from themselves to other
bacteria and also to proliferatein the face of this antibiotics
.
And then there's also sexualtransmission between bacteria.
Speaker 1 (11:44):
Conjugation Conjugation there you go.
Speaker 4 (11:47):
The good old conjugation.
It's weird.
They just kind of like theyliterally pass their DNA to each
other.
They're like here, mate, hereyou go.
Speaker 3 (11:56):
Yeah, and some bacteria can just pick it up
from the environment, just youknow, like eating DNA kind of
stuff.
It's really weird.
Bacteria are fun littlecreatures, yeah, but I think
also what you're talking aboutis if someone hasn't finished
their course of antibiotics,like you take it every 12 hours
or whatever.
It's meant to keep a certainlevel present in your body.
And so then, if you are like, oh, I feel good you drop off, you
(12:18):
might not continue taking it,then that potentially allows the
populations that haven't diedto then kind of rebound or just
sort of continue to thrive, andthat's you know, Camille, it's
so difficult.
Speaker 5 (12:30):
You feel really bad.
You go to the doctor, theyprescribe you antibiotics and
you feel much better.
Within like two, three days thepain is gone.
So you're not reminded to takethe antibiotics.
So isn't it super tricky tokeep on taking?
Speaker 3 (12:46):
your stuff.
I think that's a really goodpoint.
That's with any medication,right, Like even if you're
diabetic and taking insulin orsomething.
But yeah, especially forsomething like antibiotics, it
can, I think, be very hard forpeople to remember to take them,
or just that there's thisfeeling that the effects upon
you have passed.
But also our health is globallyinterconnected, right, and so
the effects of my health affecteveryone else, right, and I
think that that's something tokeep in mind and I think that
(13:08):
that is something that everyonekind of struggles with.
But it's worth it to put thereminder on your phone or get a
pill case, you know, if you tookit today.
I always do.
I'm like did I take?
Speaker 4 (13:16):
this today.
Yeah, that's fair.
Whatever works for you,honestly, and I think it's also
important.
Obviously.
This is why we're doing thisshow right.
I don't think a lot of peopleare actually educated on what
antibiotics are, how to takeantibiotics, why it's important
to take antibiotics, the waythat you should take them.
So don't feel embarrassed toall of our listeners If you
haven't in the past taken acourse of antibiotics properly.
(13:38):
I think we've all been there,done that.
But, moving forward, do yourbest and just know that doctors
prescribe medications in acertain way, because sometimes
you need to take them in thatcertain way to help not only
yourself, but also your friends,your family and those around
you.
Speaker 3 (13:52):
And antibiotic-resistant infections
are nasty, nasty things to treat.
Speaker 4 (13:56):
They are really nasty , they are expensive to treat
and they are not fun to have.
Speaker 3 (14:01):
And it's sometimes they can throw everything at it
that they can, and I think thatthat's also an aspect of you may
have never taken antibiotics inyour life, but you can still
pick up an antibiotic-resistantinfection because we have them
in our environment.
Someone else might have it, itmight be in something that
you're exposed to and so,keeping this in mind, it's not
just your personal use ofsomething, but it affects
everyone around you.
Speaker 5 (14:21):
Absolutely so.
Can we just quickly summarizefor our listeners why should you
continue taking yourantibiotics, although you feel
better?
Just in a few sentences, whatwould you say?
What's your slogan?
Speaker 3 (14:33):
Continue taking your antibiotics even though you feel
better.
Because it keeps the medicationat a level in your body that's
going to ensure that there's nobacteria that are persisting
that might then cause theinfection to resurge, but also
because just out of respect foreveryone else around you.
Speaker 5 (14:51):
In a sense that we don't want to generate
resistance.
Speaker 3 (14:53):
That we don't want to generate resistance.
We have a lot of bugs that arealready resistant and we're
really struggling to treat manyof them, and we only have so
many antibiotics, and some ofthe antibiotics that work
against resistant infections areincredibly expensive, expensive
, yes, incredibly expensive.
Speaker 4 (15:11):
And just so you guys know we're not making any of
this up.
You know E coli has a 42%resistance to third-generation
cephalosporins.
Staphylococcus aureus I'm sureeveryone in the healthcare
system has heard of MRSAMethicillin-resistant
Staphylococcus aureus.
That is a nasty bugger.
Okay, this is actually a thing.
We're not making this up.
Speaker 3 (15:31):
Yeah, there's so many infections that people get that
they might have compromisedimmune systems, so they're like
diabetic or something.
They pick up an infection andthey end up having to get things
like amputation Because that'sthe last recourse.
It's not treatable withantibiotics and that's a very
grim reality that we are talkingin 2024.
And that's how we deal with someinfections to this day is like
(15:52):
amputation is the only optionbecause if it's between your leg
or your life and that's reallyscary yeah, I'd rather give my
leg and we also don't want thatto be a reality for ourselves in
the future you know, if youwant to be able to get a hip
replacement or a kneereplacement in the future
because you might need one.
You know you don't want moreantibiotic resistant bugs just
kind of hanging around andthere's ways to treat them, but
(16:14):
a lot of it's also very longcourses of antibiotics and
that's not great for yourmicrobiome.
Speaker 4 (16:18):
I was going to say and then that has other effects.
Right, it's like rippling sideeffects.
So it's great to maintain thislevel of antibiotic
effectiveness as long as we can.
But anyway.
Speaker 5 (16:31):
So for you as a future physician, christina,
yeah, what can you do?
Speaker 4 (16:36):
I think educating your patients is going to be the
best way possible to for you asa doctor and, as a physician,
definitely not over prescribingantibiotics.
I mean, I personally have beenprescribed antibiotics for what
is more than likely a viralinfection.
Right so, like for the common,there's definitely multiple
cases in which patients alsowill ask for antibiotics, even
(16:58):
though maybe a physician says,hey, I'm pretty sure this is a
viral infection, let's justwrite it out, treat your
symptoms.
Patients will persist.
So there's kind of that finebalance between wanting to
respect your patients and theirautonomy but also wanting to
respect the global health, thebroader community and the health
of the broader community.
I think it's just beingdiligent about making those
decisions with education, right.
(17:19):
You just want to understand theprocesses behind the things
that you're prescribing andunderstand why you're
prescribing things and educateyour patients on why you're
prescribing things, and that'sthe best you can do.
Speaker 3 (17:29):
Yeah, and I think it's totally fair for people who
are patients to, if theirdoctor's like hey, I want to
prescribe you antibiotics, askoh, did you take a throat
culture, like if it's somethinglike a sinus infection, are you
really sure it's bacterial?
Or, you know, has that personbeen tested for COVID, that kind
of stuff?
Because the symptoms can lookvery similar when it's like an
uspiro-respiratory thing.
Speaker 4 (17:46):
Absolutely, absolutely.
Camille, you want to let usknow about antifungals.
Speaker 3 (17:55):
Yes, let's, let's, let's talk about fungus among us
.
Speaker 4 (17:57):
I love I think.
Oh my gosh.
I need to do an episode just onfungus and call it the fungus
among us.
Speaker 3 (18:05):
I think fungi are so cool.
So just to start off again kindof with a broad definition
basically, antifungals aremedicines that kill or stop the
growth of fungi that causeinfections.
But what exactly are fungi?
Fungi include yeast, molds,basically things that reproduce
through these really, reallytiny spores, and so, as we were
talking about, you know, withbacteria, we also have a
(18:28):
naturally occurring microbiomeof, you know, fungi and viruses
that exist on our body as well,which is pretty cool that we've
just evolved to live with them.
Right, they live on our skin,in our gut, in the female
reproductive system, and sothere's definitely some really
common fungal infections thatmost people have probably heard
of, things like yeast infectionsor even, because she and I were
really surprised to discoverthat dandruff might be caused by
(18:50):
fungi.
I had no idea, which I think isreally wild.
I always thought it was justlike that's how people's scalp
are yeah, like maybe you justhad more sensitive skin.
Yeah but apparently it'spossible that it's like an
overgrowth of normal fungalflora, which is exactly what a
yeast infection is.
So I think that that's reallyinteresting that these things
exist on our bodies.
This is always a really coolinteraction for me that these
(19:11):
things exist in our bodies andwe've evolved to live with them
because in some way these thingsare beneficial or, at the very
least, not harmful to us.
But in certain conditions, likewhen there's stress or maybe
someone's super over shampooingtheir scalp or something like,
maybe you end up developing kindof an overgrowth of these
things that naturally occur onor within our bodies.
Speaker 4 (19:29):
And isn't that a testament to like how incredible
the body is?
So you just have this perfectbalance of these microbes that
if that balance is thrown off,even by hair, you're in trouble.
Speaker 3 (19:40):
You know what I mean.
Speaker 4 (19:40):
So it's incredible.
The body really is amazing,absolutely yeah.
Speaker 3 (19:44):
I've been listening to I Contain Multitudes by Ed
Yong.
I don't know if either of youhave listened to that, but it's
about the microbiome.
It's really interesting becausewe're not really just human.
Right, our genomes contain allthis viral stuff and then, like
on and within our bodies is likeso much bacteria and so many
viruses and fungi, and so that'san interesting way to put it
yeah, we have more bacteria inour guts than we have cells in
(20:08):
our bodies.
Yeah, that's crazy and I've alsoseen that just references that
it might be actually like poundsof our body weight.
It's just not human cells, yeah, and that's so cool to me that
just kind of exists with us.
But I do want to talk about tworeally cool fungal pathogens.
Yeah, so the first one I wantto jump into.
So when?
Speaker 5 (20:25):
you say cool.
Speaker 3 (20:26):
Cool in that they're in our environment, and so the
one that I think is really coolis rose gardener's disease.
So it's a fungi that lives onsoil and plants and rose bushes.
So if you're out there, ifyou're an avid gardener, and you
are out there clipping and likepicking roses, and you get a
cut or a scrape or things likethat, the fungi can sort of get
within the epidermis, so withinthe skin, and especially if
(20:48):
you're not wearing gloves, youget a cut, you scrape and then
you can get this fungalinfection, and I think that
that's so wild.
We've cultivated these rosebushes which are.
I don't even know what roses arenative to, but probably not
wherever most people are growing.
I'm assuming they're added in,but it can just kind of be like
living on them and then we comein contact with them and so it's
just normally there in ourenvironment.
(21:10):
But then it can become aninfection in the right
circumstances, and I think thatthat's always what I think about
with pathogens is that maybenot necessarily with viruses,
but a lot of times withsomething like fungi, it's there
in the environment and it'scompletely fine.
I guarantee all of us arebreathing in fungi right now.
Whoever's listening to this,even if you're in like ultra
(21:30):
purified no-transcript really,really fascinating that these
tiny little things that we can'tsee are just there.
But speaking of breathing it inand I know this is also one
that Christina finds fascinatingis aspergillus.
Do you want to talk about whyyou find it?
Speaker 4 (21:49):
so interesting?
Yeah, so I worked in veterinarymedicine for several years.
I think I've already said that.
So aspergillus, at least inTexas, is a fungal infection
that predominantly infectsGerman shepherds and everything.
So if you see a German shepherdthat is really sick like really
sick, this infection is no joke.
This German Shepherd is on thebrink of death.
(22:11):
Aspergillus is probably likeyour number one on the
differential because of howvicious this infection is, and I
know that humans can also getAspergillus and I know that you
have some information on thelittle Aspergillus balls in your
lungs.
So you want to talk about that.
Speaker 5 (22:26):
Hey, I have a question for you, christina.
So what's the clinicalpresentation in those German
Shepherds, and why is it only aGerman Shepherd thing?
Speaker 4 (22:34):
So it's not only a German Shepherd thing.
Other dogs can have it, but itjust particularly likes German
Shepherds.
I'm not sure why.
Speaker 5 (22:41):
So genetic predisposition or something like
that Potentially yeah.
Speaker 4 (22:43):
But that's definitely an infection that favors German
Shepherds and the presentationcan be so diverse.
So you can have a dog thatcan't even walk.
They're so lethargic, they'reso weak, hypotensive, they are
panting up a storm.
Their heart rate, theirbradycardic heart rate, is super
low and they have aspergillus.
(23:05):
Or you can have a patient thatis blind and you don't know why
they're blind.
Turns out it's aspergus.
Aspergillus can affect thenervous system.
It can affect so many differentsystems and cause sepsis.
It is wild.
Speaker 3 (23:17):
That makes me think of like the last of us.
Yeah, I don't know if you'veseen the last of us, but I
really love pathogen horror.
I just think it's a great genre, but it's based on a video game
, the idea that a fungalpathogen gets distributed all
over the world and then, in thiscase, it's really infecting the
brain and making people funguszombies.
Speaker 5 (23:34):
So how do you diagnose the disease?
So the spores are found, or thevegetative states are found in
the eyes, if it's in the eye, orit's found in the lungs, if
it's a systemic infection.
Speaker 4 (23:44):
So you would do a serology testing, essentially.
So you pull blood and you sendit to a lab.
And you my dear scientists knowmore about this than I do.
It's a fungal culture,essentially that you grow.
So that's how we officiallydiagnose Aspergillus.
But you want to preemptivelytreat for Aspergillus while the
patient's there, if you reallysuspect Aspergillus, because if
(24:05):
that dog goes the week that theserology results take to come
back without treatment, they'remore than likely not going to
make it.
It depending on, of course, theway the dog presents.
There can be dogs that are,like I said, doing just fine.
They just maybe have a limp orthey're like holding their paw
up or something that can beaspergillus.
There can be a dog that's aboutto pass away, unfortunately,
(24:26):
aspergillus, a blind patientAspergillus it presents in so
many different ways.
Speaker 5 (24:31):
That's really wild.
It sounds a littlefear-mongering.
Speaker 3 (24:33):
A little fear-mongering.
Well, in humans it's a littledifferent.
So for my PhD program we take ayear in med school and it is
one of the wildest things.
It's stuck with me ever since.
It's called aspergilloma, soit's also caused by aspergillus.
This fungi is literallyeverywhere.
So you know, you talk and dogs,but this is something that's
(24:57):
just everywhere.
And what you see in people isthat those with like chronic
lung conditions, like peoplehave emphysema or tuberculosis,
they can end up with fungusballs in their lungs, so like
we're all breathing it in rightnow, but there's not necessarily
a good space for it to grow inhealthy lung tissue.
And at first they're not havinga lot of symptoms.
They might have like a mildcough or something like that,
but they might already have that, and so then they'll start
coughing up blood, feelingfatigue, really having shortness
(25:19):
of breath, and these mold ballscan just continue to grow and
grow and grow within the lungtissue and sometimes they
actually have to be taken outsurgically, which is really wild
.
And that's because in this caseantifungal medications don't
penetrate them very well becauseit's like a solid ball of
fungus.
And so how a really commonantifungal works, the azole
(25:39):
class of antifungals, which mostpeople can probably pick up at
like a drugstore or somethinghonestly they're there.
How that works is that itbasically prevents the synthesis
of what's known as anergosterol, which is just
basically part of the fungalcell membrane, so kind of
interrupting that.
But if you have somethingthat's just very densely packed
or how do you even really get itjust into the lungs, and so
(26:01):
being able to treat that isreally really difficult.
So yeah, it's definitelysomething that's seen in humans
as well, but I don't know thatit's necessarily the first
thought, like kind of how youwere describing it with dogs.
It's like the first oh, we'rein Texas.
And people can also get these intheir sinuses, and so I was
wondering, if you got one inyour sinuses like, would you
just smell mold?
(26:21):
All the time, um, but it turnsout the cleveland clinic doesn't
say so, like it doesn't saylike, oh, you'll smell mold.
That would be a sign, right, Iguess it smells really bad,
which makes sense.
You have like a ball of fungusin your sinuses.
Speaker 4 (26:33):
I guess it would be a very gradual smell change too,
so you probably wouldn't evennotice.
Speaker 3 (26:37):
Yeah, but like I think it would cause pressure,
right your sinuses like canexpand a bit if anyone's ever
had a sinus infection?
Speaker 5 (26:44):
Yeah, and your body will probably try to wall it off
as well, right?
So it's not just free growing.
That's true.
That's true, yeah.
Speaker 4 (26:51):
But touch a little bit, camille.
I know you kind of skipped overit, but why do aspergillomas
form in patients withpre-existing conditions Again?
Speaker 3 (26:58):
TB.
So I think, again, it's notsomething that it's necessarily
going to take root in healthylung tissue and I believe what I
read about it is it's like thespace that it has.
So if there's damage, I thinkit's almost like there's not
like pockets of air, but kind oflike that, and that's what is
allowing it to like take
Speaker 4 (27:14):
root and then start to grow Exactly Like little
tissues within the pockets, andthat damaged tissue is for some
reason sought out by this fungiand that's where the aspergillum
was.
Yeah, at least that was myunderstanding of it.
Speaker 3 (27:27):
Yeah, yeah, yeah, and I think I want to end the
fungal section with just talkingabout why this is so important
right now.
And what I think is interestingis that most people have heard
of bacterial and viralinfections.
Right, they're, you know, very,very common, but you very
rarely hear about like seriousfungal infection.
I mean, I can count on one handthe amount of people I've heard
of with a fungal pneumonia orsomething.
(27:47):
It's just not as common, andwhat's interesting about that is
that's changing.
And so why that's changing isthat a lot of fungi don't love
to live at human bodytemperature.
We run pretty warm, but as wesee the temperature of the
planet increasing, fungi arehaving to adapt to that and
begin to live at temperaturesthat are getting closer and
(28:09):
closer to human body temperature, and that's going to be bad
news for us, right, we've kindof given the planet a fever, and
so, as that global temperatureincreases, fungi are adapting
and we might possibly see anincrease in the cases that we
see, or even in fungal pathogensthat we just previously didn't
really struggle with, like a tonof cases, just because we've
(28:30):
changed our environment, and sothese things are already
naturally there, they'reeverywhere, and I think that
that's a really cool One Healthtie-in that I just want to
emphasize, because these thingsare just adapting to live and
the environment we've given themto live in is getting closer
and closer to our own bodytemperature, which is bad news
for us from a health perspective.
Speaker 5 (28:47):
So do you think people should watch the Last of
Us to prepare themselves for thefuture?
Speaker 3 (28:52):
No, no, no, not necessarily to prepare
themselves.
I hope we're not heading towardlike a dystopian fungal zombie
apocalypse.
I watch it with other friendswho are also like PhD students.
I was watching it with a friendof mine who studies plague and
we watch these things becausewe're like how accurate is this?
That's always our question.
And it's wild because I thinkthe idea that there's a global
distribution of a fungi is youknow, it's not too far off.
(29:15):
I think the effects the fungihad the way it grew inside the
body, maybe not.
Speaker 4 (29:23):
Yeah, I mean, you're not going to turn to a fungus
zombie, you're not going to cutopen someone's leg and have the
actual plant.
Speaker 3 (29:28):
Obviously it's horror Right, and so much of it is
taken sort of beyond into therealm of science fiction.
Right but the idea that we mighthave to deal with fungal
pathogens I think is very real,and especially there in so much
of our environment.
We're talking about the RoseGardner's disease.
That's in soil.
What else do we grow in soil,right?
We have all kinds of?
You know so much of our foodand stuff like that, so I think
(29:50):
it's worth thinking about.
There's certainly beneficialfungi, right.
People eat fungi too.
It's something to consider thatthings are changing and we
don't always know what thatmeans, but everyone's health is
interconnected and that'ssomething that the Last of Us, I
think, does get accurate,nothing else.
Speaker 4 (30:04):
Yeah, so does this mean I have to stop eating
mushrooms, because I lovemushrooms, I hate mushrooms.
Speaker 3 (30:10):
I mean, I've researched this whole thing and
I eat mushrooms.
Oh, I'm joking, I lovemushrooms Also, like just come
across mold and I can't say I'mscared of mold, I don't love it,
but like I've seen it and I'venot been like ah.
Speaker 5 (30:21):
Well, I think one thing we should also mention is
that we haven't talked aboutantivirals yet, but the thing
that we should also point out isthat under the microscope, all
of the three differentcategories look very different,
right, and they also havesubcategories.
So you talked about mold, youtalked about yeast, right and
bacteria.
(30:41):
They're like gram negative andgram positive, and so they're
not just names on the paper.
If you look at them under themicroscope, they're all very
different.
Speaker 3 (30:50):
Yes, definitely worth the Google, for like cool
images of viruses, bacteria,fungi.
Speaker 4 (30:55):
And I think that's probably a good point to make,
dennis, because you may wonderoh, I have this antibiotic left
over in my cabinet, I'm going totake it, and it doesn't work
for a certain infection that youhave.
That's because, like Dennissaid, it's not just every
bacteria is the exact samebacteria.
There's so many differentbacteria, so many different
(31:19):
morphologies of these bacterias,and not every medication works
for every bacteria.
That's why it's so important togo to the physician when you
have an infection, because ifyou take an antibiotic that is
not appropriate for theinfection that you have.
That's just another way toenforce.
Or an antifungal, yeah, or anantifungal Exactly.
Speaker 3 (31:29):
And that's why cultures are so important.
From a physician's office.
Speaker 4 (31:32):
That is a way that we avoid resistance.
Speaker 3 (31:37):
We're treating this with the appropriate medication
that actually targets it in away that's going to be effective
.
Speaker 4 (31:42):
So it won't only benefit you in the time being,
but also you in the future andothers in the long run as well.
Speaker 3 (31:52):
Yeah, and we don't want to overuse any of these
categories, right?
Because, as we've been talkingabout, they naturally coexist
with us and so we don't want tobe sterile human beings with no
microbiota.
It was interesting because Ialways thought we would just be
dead if we were sterile.
I guess we're one of the fewspecies that wouldn't be
immediately dead if we wereentirely sterile of bacteria and
stuff.
Speaker 4 (32:08):
I wonder what our quality of life would be then.
Speaker 3 (32:10):
It would be very low, because from all of our food
any animals that we use for anytype of food production, and
then also all kinds of plants.
Speaker 4 (32:17):
Like your nitrogen cycle is, really messed up One
day about how much bacteria helpyou with digestion and stuff
like that too.
Speaker 3 (32:23):
But some species, like cattle, rely so much they
can't really break down grasses.
It's the bacteria that's intheir stomach.
We at least are able to breakdown some things.
Speaker 4 (32:32):
I can't imagine our bodies without bacteria.
I love bacteria.
Speaker 5 (32:39):
And I think we should also make sure that we're
giving the listeners not theimpression that there's so many
fungi and bacteria and virusesout there that are just out
there to kill us, rightSurrounded by fungi and bacteria
and so on.
And they're everywhere and 99%of them are really really good
and really helpful.
Right, if you jump into thewater on the beach, in one liter
(33:00):
of water is tons ofbacteriophages right.
And they have a function theyclean the water.
So you know we like to focus onthese bad things and because
they cause interesting diseases.
But I think there's much goodout there, much more good than
bad.
Speaker 3 (33:19):
Absolutely.
Yeah, yeah, yeah, and theyexisted far before us, right,
like bacteria and other smallmicroorganisms.
That was goes around and and isstill continuing to perpetuate
through all these other animalsthat have gone, extinct, you
know surviving, and they're inan integral part of our
environment.
You're absolutely right.
Speaker 4 (33:39):
So on that note, Dennis, did you want to move on
to talking about retrovirals?
Speaker 5 (33:43):
Retrovirals.
I'm sorry, about antivirals.
Speaker 4 (33:45):
We don't have to get into retrovirals right now.
Speaker 5 (33:49):
That would take way too long.
No, I'm going to talk aboutantivirals, and antivirals are
special meds that can help yourbody fight off viruses.
So if you get sick from a virus,like the flu or a cold, the
virus sneaks into your body andinfects the cells of your body
and starts making copies ofitself.
(34:09):
This is how the virus spreadsand this is also how the virus
makes you feel bad.
Antivirals work by stopping thevirus from making those copies,
from replicating, so yourbody's natural defenses or your
immune system gets a betterchance of fighting the disease
right, so you're helping yourimmune system by stopping that
(34:31):
virus replication, the virusmaking copies of itself.
So I think, for the listenersout there, I think a good way of
thinking of antivirals is thatthey are a shield that blocks
the virus from spreading furtherin your body.
And I think one interestingfact is that they don't kill the
virus directly.
So it's not like they touch thevirus and then the virus
(34:54):
explodes or something like that,but they just slow down the
virus proliferating, copyingitself, and that gives the body
enough time to catch up, to rampup the immune response and stop
the virus.
Speaker 3 (35:09):
And I think that's why a lot of times it's
important when we're prescribingantivirals, the earlier an
infection you can get them, thebetter.
Because then, especially forsomething like I think of, like
Paxlovid, or even for COVID-19,or for people that are getting
triple drug therapy for HIV, thefaster those antivirals are in
the system, the less replicationhas already gotten out of
control.
Yeah, absolutely.
Speaker 5 (35:30):
This is Camille.
This is the perfect segue.
I'd written down some keythings, some key takeaways from
antivirals, and actually thefirst thing that I had written
down is they work best when youstart taking them soon after you
get sick Nailed it.
You nailed it, gold star, yeah.
So they help you to feel betterfaster and they keep you from
(35:50):
getting really, really sick.
So the sooner the better.
Then doctors prescribe them forspecific viruses, so not all
viruses can be treated withantivirals.
So not every virus that's outthere has a specific antiviral.
So at this point in time wehave antivirals only for certain
types of viruses.
Speaker 4 (36:09):
And can you tell us a little bit about why that's the
case?
Because I know we have so manyantibiotics that we pull from.
I know that we don't have a lotof antifungals, but we have
more than we have antivirals.
Speaker 3 (36:19):
We also don't have a ton of antifungal pathogens.
Speaker 4 (36:21):
Right, exactly, but how come it's so hard to make
antivirals?
Speaker 5 (36:34):
them.
But you're right, there are farless antivirals than there are
antibiotics, and antiviralstypically, just like antibiotics
, intervene somewhere in thebiology of the virus, in the
replication.
So they maybe work with anenzyme or they work and stop the
virus from forming a virusparticle or something like that.
But you need specific targetsand not every virus family will
(36:54):
give you these specific targetsand then often the virus is
reproduced so quickly withinhours that the antivirals have
to be in every cell of the bodyand they have to reach that
specific target quickly.
So that's why that's one of thetwo things that I can think of,
why we don't have enoughantivirals.
Speaker 3 (37:13):
Yeah, and that's really interesting to think
about.
There's definitely places inthe body that are
immunoprivileged.
So, as someone who works in alab that studies HIV, originally
the antivirals didn't cross theblood-brain barrier and so we
weren't controlling HIV in thecentral nervous system.
And now the antivirals arebetter and they do cross the
blood-brain barrier and preventthe progression and the damage
(37:34):
that can be caused.
But it's difficult to getsomething everywhere in the body
because the body is set up sothat doesn't happen, because if
there is some type of infection,you don't want it to go into
places that are incrediblyimportant, like the central
nervous system.
Speaker 4 (37:48):
I was going to say the CNS specifically is really
hard to get medications to ifyou're not giving it just like
directly into the CNS.
So that's yeah, thosemedications that can cross the
blood-brain barrier.
They're so rare because they doa lot of work and they're
awesome.
Speaker 5 (38:02):
And maybe just coming back to what I said earlier
about the specific targets thatare so difficult to find for
viruses, remember that virusesare obligate intracellular
parasites, right?
So they take hostage of thehost cell and so for their
replication they take goodchunks from the cell.
(38:24):
So if you're targeting the cellthat the virus uses, you're
targeting the rest of the cellsin your body, and there's high
toxicity.
Yeah, that's fair, and you don'twant to just be torching those,
so you have to find somethingthat is unique to the virus and
not something that the virusstole from our body.
And that's the huge differenceto bacteria, where they grow on
their own, they don't need partsof well, sometimes they need
(38:47):
part of the cell, but most ofthe time they can grow and it's
easier to target than somethingthat runs 80% based on the stuff
that's in the cell.
Speaker 4 (38:57):
Yeah, that's fair, yep.
Speaker 5 (38:59):
So then I have two more.
Speaker 4 (39:02):
Okay, let's hear it.
Speaker 5 (39:03):
A couple of key things left.
So the antivirals are usuallypills or liquids taken by mouth,
but sometimes they're giventhrough IV.
Speaker 4 (39:13):
I was going to say I don't really know of any IV
antivirals, like off the top ofmy dome.
You know what I mean.
Versus antibiotics, I don'tknow either.
Speaker 5 (39:20):
Paxlovid is pills right.
Speaker 3 (39:23):
Actually.
Well, it's not an IV, but I doknow that there's a new HIV drug
and it's an injectable, butit's not IV.
But yeah, most antivirals.
Speaker 5 (39:31):
But I remember like in the beginning of covid
remdesivir was given and that'san iv version, or the iv
versions is more work, I thoughtit wasn't as effective.
Not as effective as they.
Yeah, yeah, okay.
And then the last point isprobably the most important one
antivirals are different fromantibiotics, which fight
(39:51):
bacteria instead of viruses, sothey are also different from
vaccines, which help peopleprevent from getting sick in the
first place.
Speaker 4 (40:00):
That's a good point.
Speaker 3 (40:00):
Yeah, absolutely, and I think, touching on vaccines,
it's not always just prevention,right.
If you do get sick, it lessensthe severity and duration of the
disease, and that's really thepoint.
So if you get a COVID-19vaccine or something like that,
you won't necessarily not getCOVID, but when you do get it,
it is likely to be much lesssevere and won't last as long
than if you hadn't beenvaccinated at all Exactly.
(40:22):
Which I think is always a pointthat I feel is kind of missed in
the vaccine discourse that Ialways want to have.
Speaker 5 (40:34):
Yeah, that's a best to talk to your doctor.
Speaker 1 (40:36):
Yes, absolutely.
Speaker 5 (40:38):
If you feel sick, right, yes, please Don't take
our advice here and just takeantibiotics.
Go to a doctor and they candecide what medicine.
Speaker 3 (40:50):
Yeah, don't just self-medicate with like
over-the-counter items.
Speaker 4 (40:53):
Exactly Like please, if you're sick, go to the doctor
.
Speaker 5 (40:57):
Okay, anything else we should talk about, you think?
Speaker 4 (41:01):
I think we did a pretty good job summarizing
these three general topics.
We hit on antibiotics, we hiton antifungals and we hit on
antivirals and I hope, afterhearing this episode, our
listeners at least feel a littlebit more educated on the three
topics and a little bit moreself-sufficient when it comes
down to understanding what theyneed to do for themselves.
(41:21):
Yeah, thanks for listening.
Speaker 5 (41:23):
Yeah, thank you, and if you have questions, send us a
message.
Absolutely.
Speaker 4 (41:27):
You know where to find us.
Speaker 1 (41:30):
Until next time.
Speaker 2 (41:45):
Thanks for listening to the Infectious Science
Podcast.
Until next time, and go aheadand share this episode with some
of your friends.
Speaker 1 (41:52):
Also, don't hesitate to ask questions and tell us
what topics you'd like us tocover for future episodes.
To get in touch, drop a line inthe comments section or send us
a message on social media.
Speaker 2 (42:01):
So we'll see you next time for a new episode, and in
the meantime, stay happy stayhealthy, stay interested.
Speaker 4 (42:16):
Thank you.
This is a podcast about One Health the idea that
the health of humans, animals,plants and the environment that
we all share are intrinsicallylinked.
Speaker 1 (00:17):
Coming to you from the University of Texas Medical
Branch and the GalvestonNational Laboratory.
Speaker 2 (00:21):
This is Infectious Science, where enthusiasm for
science is contagious.
Speaker 3 (00:30):
All right, hello everyone and welcome to this
episode of Infectious Science.
We are so excited to be herewith you today.
My name is Camilla Du and we'regoing to be talking about
antivirals, antifungals andantibiotics and the difference
between all of these.
So when we get an infection,the drugs to treat it fall into
those three main categories andeach of them treats a different
type of infection.
(00:50):
So viruses like COVID-19 or theflu are treated with antivirals
, bacterial infections likestrep or Lyme are treated with
antibiotics, and then fungalinfections like yeast infections
or ringworm are treated withantifungals.
So in this episode we're goingto break down the difference
between these categories ofdrugs.
Speaker 4 (01:07):
Rock on and I guess we can go ahead and we can start
with antibiotics, because Ifeel like that's probably the
medication that most people areEverybody's probably taking
antibiotics.
Exactly.
Most people are aware That'd bean interesting study.
Speaker 3 (01:18):
Are there populations that haven't taken antibiotics?
And then what does that looklike?
Speaker 5 (01:22):
And then now studies that show that even species or
animals that have not takenantibiotics, that they pick up
the antibiotic resistance fromhumans.
Oh, that's pretty wild, right I?
Speaker 3 (01:32):
wonder too, with like amphibians and stuff, does that
affect them?
Because if it's in our watersupply, so if it's in like
wastewater, if you haveantibiotic residue, it'd be
really interesting.
There's been other studies onthings that are in our
wastewater that are affectingamphibians.
Speaker 4 (01:44):
That's really interesting.
I didn't even think about that.
Well, let's get into thegeneral idea of what antibiotics
are, and then we'll discuss theeffects on amphibian
populations.
What are antibiotics?
A lot of people probably don'tknow, but antibiotics actually
originate from fungi and fromsoil bacteria, and it kind of
makes sense when you think aboutit, right.
(02:04):
So these fungi have been around, and also bacteria have been
around for thousands andthousands of years before us,
and they were each other'scompetition when it comes down
to it.
And what do you have to do inorder to survive amongst your
competition?
You got to have a way to killthem.
Speaker 3 (02:19):
That's all I'm going to say, especially because it's
close quarters, right Like a lotof our antibiotics are from
soil bacteria, right, exactly sothey're very densely packed
together, so if you aren'treally moving around a bunch,
you got to compete with yourneighbors for nutrients.
Speaker 4 (02:33):
Yeah, exactly, and so the way that most of these
antibiotics work.
Well, let's be real, a lot ofdifferent antibiotics have
different mechanisms, right, butsome common ways that they work
are, for example, by attackingthe bacterial cell wall or the
bacterial cell membrane, and soit's basically attacking the
skin of the bacteria, let's say,and getting rid of the bacteria
skin.
And if you get rid of a humanskin, a human's not going to
(02:55):
survive.
It's the same thing with thebacteria.
So that's one way theantibiotics work.
Maybe another way that we cantalk about is just interfering
with the actual bacterialreplication in general.
It's definitely a way that wecan talk about is just
interfering with the actualbacterial replication in general
.
It's definitely a way thatantibiotics can work and that
they are effective.
And then also by blocking someprotein production.
But that's kind of getting intothe nitty gritty of things.
So I did want to talk a littlebit about how antibiotics were
(03:19):
originally found, though,because that's always a really
fun story, and you guys actuallycorrected me on this when I
first told you guys.
So in 1928, I believe,alexander Fleming was a
scientist, he was working withbacteria, and I think you said
that he had tossed his plateswith cultures into the trash.
And then he came back.
He was frustrated, I guess,left the lab, tossed the
(03:40):
cultures, came back and noticedthat there were these clear
spots, so clear zones, where thebacteria was actually not able
to grow Around the fungus thathad grown Around, fungus that
had contaminated the plates, andthat fungus came from whatever
was in the trash, right?
Speaker 3 (03:56):
Well, I think as we'll get to later.
Yeah we're going to talk about.
There's fungus everywhere.
So if you're taking a deepbreath right now, you're
inhaling fungus, I guarantee it.
It's really cool to seeclearing zones.
I used to work at abacteriology lab and we would
treat with different antibioticson these little discs and then
you set them on the plate and Ijust thought they looked really
cool.
It's like modern art.
Speaker 4 (04:15):
Yeah, exactly Because you have this plate.
Imagine a plate, guys like fullof fuzz or a growth or
something right, and then whatis a clear zone?
It's literally a zone wherethat growth cannot form.
So there are these clear spotson a plate.
For those who don't know what aclear zone is or what a petri
dish is or what an auger plateis, that's what it looks like,
(04:37):
and so you can really make artwith it.
Speaker 3 (04:39):
Yes, also, that's a fun thing to do if you have
bacteria that'll fluoresce.
Speaker 1 (04:42):
Yeah, that was always a thing we would like.
Speaker 3 (04:44):
I did something.
It was not an actual labactivity, it was just a fun
science thing.
It was very benign bacteria andthey were like yeah, like just
make your little art Someonemade like a.
It was like the ocean and asurfboard and it was very well
done.
It was impressive.
Mine was like squiggles, but itstill of them.
Speaker 5 (05:01):
They're so cool, very interesting.
Did you go to a Waldorf schoolor Montessori?
Speaker 4 (05:07):
It's actually at.
Speaker 3 (05:07):
Cornell, where I did this Montessori.
Speaker 4 (05:09):
Dennis, are we like playing with bacteria in
kindergarten?
Is that what we're doing?
Speaker 5 (05:13):
I don't know.
It's free thinking, free spirit.
I've never heard of a Waldorfschool.
No.
Speaker 4 (05:18):
Yeah, they're Kind of a Montessori.
Speaker 3 (05:26):
Isn't it the self-teach?
Speaker 4 (05:28):
Yeah, they have a lot of pre-thinking.
Teach yourself.
Speaker 5 (05:30):
Do they use antibiotics in the Waldorf
school?
I don't know.
Speaker 3 (05:35):
Isn't the antibiotic free zone?
Speaker 5 (05:36):
It's a clear zone.
It's a clear zone.
Speaker 3 (05:38):
It's a clear zone.
Oh my gosh, making me think ofthose signs I see of slow down.
This is a school zone.
This is a clear zone.
Speaker 4 (05:47):
Oh no.
So just going back to thehistory of antibiotics in
general, one event that I didwant to talk about is the
Coconut Grove Fire.
Speaker 5 (05:59):
So that was a fire that happened in.
Is it a club somewhere inHouston?
Speaker 4 (06:02):
It's a club somewhere in Boston.
It was a club in Houston.
It's a club somewhere in Boston.
Speaker 1 (06:05):
It was a club in 1942 .
Speaker 4 (06:08):
And it was the place to go to if you were an athlete,
if you were a politician, ifyou were a celebrity.
Everyone was going to CoconutGrove.
However, coconut Grove only hadone main entrance, one main
exit.
It was the same door and it wasa revolving door and, of course
, this was back in 1942.
They still had lots ofcandlelit things and they had,
(06:30):
of course, electricity, but thatelectricity was shoddy, let's
be real.
So there was a light bulb thatwent out in Coconut Grove and
apparently the story goes that aworker was sent to change the
light bulb but because there wasno light there, he couldn't see
what he was doing.
So he lit a match and you guysknow what happened.
And with only one main exit,with fire exits jammed and with
(06:55):
the other exits only known topeople who actually worked at
the club, there was a hugeamount of injuries and also
casualties from the actualincident and, of course, many of
those injuries were seriousburns.
As we all know, burns areincredibly susceptible to
infection because you're, as Isaid previously, taking out the
(07:16):
skin of a human.
The skin is our protection fromso much and it also side note
has a lot of bacteria on it thatare really good for us.
But when you get rid of thatepidermal layer, you expose the
body to a lot of bacteria, fungiand potential infections that
your body normally wouldn't besusceptible to, and so back in
(07:38):
1942, when this occurred, theydidn't have antibiotics.
So a lot of people whosustained really serious burns
ended up getting not onlyinjured but also sustaining
really serious infections thatcould potentially lead to death.
However, our lovely littlefriend penicillin had recently
been not only discovered butsomewhat developed just not in
(07:59):
the mainstream labs, and itwasn't heavily funded until the
scientists managed to get theopportunity to treat the
patients with penicillin.
I have a stat here Merck andCompany was the company that was
working with penicillin.
They were allowed to rush a 32liter supply of penicillin to
(08:20):
Boston to treat the patientswith these serious birds 32
liters of liquid penicillin.
Speaker 5 (08:27):
Wasn't probably super potent back then, though right
Probably not Probably not.
When did Fleming discover thestuff?
Do you remember In?
Speaker 4 (08:34):
1928.
Speaker 5 (08:36):
Oh wow, and this was in 1942.
Speaker 4 (08:38):
Yeah, okay, several years between the two events.
And it was only after thepenicillin was proven to keep
these patients from developinginfections that penicillin was
then funded.
The research into penicillinand the mass development of
penicillin was actually fundedby the US government.
Speaker 3 (08:57):
It's really wild.
I always assumed it was theSecond World War was where we
got penicillin from.
Speaker 5 (09:02):
I think it was also used during the Second World War
, which was right around thattime, right.
Speaker 3 (09:06):
Right.
Okay, so maybe this was acivilian population that got
tested on, but I wonder you'remaking me think now.
I think you brought up a greatpoint that I want to highlight,
in that, as much as we'retalking about antibiotics and
wanting to kill bacteria thatare harming us, we do have a
fabulous amount of bacteria onour skin, living inside of us.
The world would not do well asa sterile place without bacteria
.
We need them for so manyprocesses.
(09:29):
I think microbiome is reallyfascinating.
Speaker 4 (09:31):
Microbiome is incredible.
Microbiome is all over.
Speaker 3 (09:33):
But back to your history.
I definitely would have died inthe coconut grove fire because
I struggle with revolving doorswhen I'm not under duress and I
actually actively avoid them.
Speaker 5 (09:42):
Do you think you would have gone to a club back
then?
Speaker 3 (09:44):
Probably not.
No, I'm going to read a bookand drink, you know, a nice Earl
Grey tea.
Speaker 4 (09:52):
On a.
Speaker 3 (09:52):
Friday night, my Friday nights yeah, they're wild
.
Speaker 4 (10:02):
Hey, kudos to you, though, and I just looked it up.
Actually, it says that thesuccess of penicillin in
treating these burn victims fromthe coconut grill fire led to
the US government to support theproduction and distribution to
the armed forces, so that wasprobably what allowed you know.
Speaker 5 (10:12):
So, Mrs Stats, do you have some stats on how many
people died of bacterialdiseases before penicillin and
then after penicillin?
Speaker 4 (10:21):
That I don't A lot.
Yeah, I could imagine a lot,because I'm almost certain that
the number one cause of deathwas these common pathogens that
now we can fight with a simpleantifungal or an antibiotic.
And I know that was the numberone cause of death before these
medications were invented.
And that actually is a nicelittle segue into.
What I did want to talk aboutwas antibiotic resistance.
(10:44):
So antibiotic resistance is aserious global health problem
for sure, and it occurs whenbacteria evolve to resist the
effects of antibiotics.
And there are several ways thatthis can happen.
One of the ways is to wherebacteria themselves, just when
they're replicating, mutationshappen, as they always do, and
then they just develop thesemeans of resistance to an
(11:07):
antibiotic.
Another way is when antibioticsaren't taken correctly, whether
they're taken for a viralinfection that they did not need
the antibiotics for, whethersomeone's given a course of
antibiotics and they don'tfinish the course of antibiotics
or they don't take theantibiotic as properly
prescribed.
That introduces the medicationto bacterial populations and it
(11:29):
also gives the bacteria who areresistant to the medication the
opportunity to pass these geneson from themselves to other
bacteria and also to proliferatein the face of this antibiotics
.
And then there's also sexualtransmission between bacteria.
Speaker 1 (11:44):
Conjugation Conjugation there you go.
Speaker 4 (11:47):
The good old conjugation.
It's weird.
They just kind of like theyliterally pass their DNA to each
other.
They're like here, mate, hereyou go.
Speaker 3 (11:56):
Yeah, and some bacteria can just pick it up
from the environment, just youknow, like eating DNA kind of
stuff.
It's really weird.
Bacteria are fun littlecreatures, yeah, but I think
also what you're talking aboutis if someone hasn't finished
their course of antibiotics,like you take it every 12 hours
or whatever.
It's meant to keep a certainlevel present in your body.
And so then, if you are like, oh, I feel good you drop off, you
(12:18):
might not continue taking it,then that potentially allows the
populations that haven't diedto then kind of rebound or just
sort of continue to thrive, andthat's you know, Camille, it's
so difficult.
Speaker 5 (12:30):
You feel really bad.
You go to the doctor, theyprescribe you antibiotics and
you feel much better.
Within like two, three days thepain is gone.
So you're not reminded to takethe antibiotics.
So isn't it super tricky tokeep on taking?
Speaker 3 (12:46):
your stuff.
I think that's a really goodpoint.
That's with any medication,right, Like even if you're
diabetic and taking insulin orsomething.
But yeah, especially forsomething like antibiotics, it
can, I think, be very hard forpeople to remember to take them,
or just that there's thisfeeling that the effects upon
you have passed.
But also our health is globallyinterconnected, right, and so
the effects of my health affecteveryone else, right, and I
think that that's something tokeep in mind and I think that
(13:08):
that is something that everyonekind of struggles with.
But it's worth it to put thereminder on your phone or get a
pill case, you know, if you tookit today.
I always do.
I'm like did I take?
Speaker 4 (13:16):
this today.
Yeah, that's fair.
Whatever works for you,honestly, and I think it's also
important.
Obviously.
This is why we're doing thisshow right.
I don't think a lot of peopleare actually educated on what
antibiotics are, how to takeantibiotics, why it's important
to take antibiotics, the waythat you should take them.
So don't feel embarrassed toall of our listeners If you
haven't in the past taken acourse of antibiotics properly.
(13:38):
I think we've all been there,done that.
But, moving forward, do yourbest and just know that doctors
prescribe medications in acertain way, because sometimes
you need to take them in thatcertain way to help not only
yourself, but also your friends,your family and those around
you.
Speaker 3 (13:52):
And antibiotic-resistant infections
are nasty, nasty things to treat.
Speaker 4 (13:56):
They are really nasty , they are expensive to treat
and they are not fun to have.
Speaker 3 (14:01):
And it's sometimes they can throw everything at it
that they can, and I think thatthat's also an aspect of you may
have never taken antibiotics inyour life, but you can still
pick up an antibiotic-resistantinfection because we have them
in our environment.
Someone else might have it, itmight be in something that
you're exposed to and so,keeping this in mind, it's not
just your personal use ofsomething, but it affects
everyone around you.
Speaker 5 (14:21):
Absolutely so.
Can we just quickly summarizefor our listeners why should you
continue taking yourantibiotics, although you feel
better?
Just in a few sentences, whatwould you say?
What's your slogan?
Speaker 3 (14:33):
Continue taking your antibiotics even though you feel
better.
Because it keeps the medicationat a level in your body that's
going to ensure that there's nobacteria that are persisting
that might then cause theinfection to resurge, but also
because just out of respect foreveryone else around you.
Speaker 5 (14:51):
In a sense that we don't want to generate
resistance.
Speaker 3 (14:53):
That we don't want to generate resistance.
We have a lot of bugs that arealready resistant and we're
really struggling to treat manyof them, and we only have so
many antibiotics, and some ofthe antibiotics that work
against resistant infections areincredibly expensive, expensive
, yes, incredibly expensive.
Speaker 4 (15:11):
And just so you guys know we're not making any of
this up.
You know E coli has a 42%resistance to third-generation
cephalosporins.
Staphylococcus aureus I'm sureeveryone in the healthcare
system has heard of MRSAMethicillin-resistant
Staphylococcus aureus.
That is a nasty bugger.
Okay, this is actually a thing.
We're not making this up.
Speaker 3 (15:31):
Yeah, there's so many infections that people get that
they might have compromisedimmune systems, so they're like
diabetic or something.
They pick up an infection andthey end up having to get things
like amputation Because that'sthe last recourse.
It's not treatable withantibiotics and that's a very
grim reality that we are talkingin 2024.
And that's how we deal with someinfections to this day is like
(15:52):
amputation is the only optionbecause if it's between your leg
or your life and that's reallyscary yeah, I'd rather give my
leg and we also don't want thatto be a reality for ourselves in
the future you know, if youwant to be able to get a hip
replacement or a kneereplacement in the future
because you might need one.
You know you don't want moreantibiotic resistant bugs just
kind of hanging around andthere's ways to treat them, but
(16:14):
a lot of it's also very longcourses of antibiotics and
that's not great for yourmicrobiome.
Speaker 4 (16:18):
I was going to say and then that has other effects.
Right, it's like rippling sideeffects.
So it's great to maintain thislevel of antibiotic
effectiveness as long as we can.
But anyway.
Speaker 5 (16:31):
So for you as a future physician, christina,
yeah, what can you do?
Speaker 4 (16:36):
I think educating your patients is going to be the
best way possible to for you asa doctor and, as a physician,
definitely not over prescribingantibiotics.
I mean, I personally have beenprescribed antibiotics for what
is more than likely a viralinfection.
Right so, like for the common,there's definitely multiple
cases in which patients alsowill ask for antibiotics, even
(16:58):
though maybe a physician says,hey, I'm pretty sure this is a
viral infection, let's justwrite it out, treat your
symptoms.
Patients will persist.
So there's kind of that finebalance between wanting to
respect your patients and theirautonomy but also wanting to
respect the global health, thebroader community and the health
of the broader community.
I think it's just beingdiligent about making those
decisions with education, right.
(17:19):
You just want to understand theprocesses behind the things
that you're prescribing andunderstand why you're
prescribing things and educateyour patients on why you're
prescribing things, and that'sthe best you can do.
Speaker 3 (17:29):
Yeah, and I think it's totally fair for people who
are patients to, if theirdoctor's like hey, I want to
prescribe you antibiotics, askoh, did you take a throat
culture, like if it's somethinglike a sinus infection, are you
really sure it's bacterial?
Or, you know, has that personbeen tested for COVID, that kind
of stuff?
Because the symptoms can lookvery similar when it's like an
uspiro-respiratory thing.
Speaker 4 (17:46):
Absolutely, absolutely.
Camille, you want to let usknow about antifungals.
Speaker 3 (17:55):
Yes, let's, let's, let's talk about fungus among us
.
Speaker 4 (17:57):
I love I think.
Oh my gosh.
I need to do an episode just onfungus and call it the fungus
among us.
Speaker 3 (18:05):
I think fungi are so cool.
So just to start off again kindof with a broad definition
basically, antifungals aremedicines that kill or stop the
growth of fungi that causeinfections.
But what exactly are fungi?
Fungi include yeast, molds,basically things that reproduce
through these really, reallytiny spores, and so, as we were
talking about, you know, withbacteria, we also have a
(18:28):
naturally occurring microbiomeof, you know, fungi and viruses
that exist on our body as well,which is pretty cool that we've
just evolved to live with them.
Right, they live on our skin,in our gut, in the female
reproductive system, and sothere's definitely some really
common fungal infections thatmost people have probably heard
of, things like yeast infectionsor even, because she and I were
really surprised to discoverthat dandruff might be caused by
(18:50):
fungi.
I had no idea, which I think isreally wild.
I always thought it was justlike that's how people's scalp
are yeah, like maybe you justhad more sensitive skin.
Yeah but apparently it'spossible that it's like an
overgrowth of normal fungalflora, which is exactly what a
yeast infection is.
So I think that that's reallyinteresting that these things
exist on our bodies.
This is always a really coolinteraction for me that these
(19:11):
things exist in our bodies andwe've evolved to live with them
because in some way these thingsare beneficial or, at the very
least, not harmful to us.
But in certain conditions, likewhen there's stress or maybe
someone's super over shampooingtheir scalp or something like,
maybe you end up developing kindof an overgrowth of these
things that naturally occur onor within our bodies.
Speaker 4 (19:29):
And isn't that a testament to like how incredible
the body is?
So you just have this perfectbalance of these microbes that
if that balance is thrown off,even by hair, you're in trouble.
Speaker 3 (19:40):
You know what I mean.
Speaker 4 (19:40):
So it's incredible.
The body really is amazing,absolutely yeah.
Speaker 3 (19:44):
I've been listening to I Contain Multitudes by Ed
Yong.
I don't know if either of youhave listened to that, but it's
about the microbiome.
It's really interesting becausewe're not really just human.
Right, our genomes contain allthis viral stuff and then, like
on and within our bodies is likeso much bacteria and so many
viruses and fungi, and so that'san interesting way to put it
yeah, we have more bacteria inour guts than we have cells in
(20:08):
our bodies.
Yeah, that's crazy and I've alsoseen that just references that
it might be actually like poundsof our body weight.
It's just not human cells, yeah, and that's so cool to me that
just kind of exists with us.
But I do want to talk about tworeally cool fungal pathogens.
Yeah, so the first one I wantto jump into.
So when?
Speaker 5 (20:25):
you say cool.
Speaker 3 (20:26):
Cool in that they're in our environment, and so the
one that I think is really coolis rose gardener's disease.
So it's a fungi that lives onsoil and plants and rose bushes.
So if you're out there, ifyou're an avid gardener, and you
are out there clipping and likepicking roses, and you get a
cut or a scrape or things likethat, the fungi can sort of get
within the epidermis, so withinthe skin, and especially if
(20:48):
you're not wearing gloves, youget a cut, you scrape and then
you can get this fungalinfection, and I think that
that's so wild.
We've cultivated these rosebushes which are.
I don't even know what roses arenative to, but probably not
wherever most people are growing.
I'm assuming they're added in,but it can just kind of be like
living on them and then we comein contact with them and so it's
just normally there in ourenvironment.
(21:10):
But then it can become aninfection in the right
circumstances, and I think thatthat's always what I think about
with pathogens is that maybenot necessarily with viruses,
but a lot of times withsomething like fungi, it's there
in the environment and it'scompletely fine.
I guarantee all of us arebreathing in fungi right now.
Whoever's listening to this,even if you're in like ultra
(21:30):
purified no-transcript really,really fascinating that these
tiny little things that we can'tsee are just there.
But speaking of breathing it inand I know this is also one
that Christina finds fascinatingis aspergillus.
Do you want to talk about whyyou find it?
Speaker 4 (21:49):
so interesting?
Yeah, so I worked in veterinarymedicine for several years.
I think I've already said that.
So aspergillus, at least inTexas, is a fungal infection
that predominantly infectsGerman shepherds and everything.
So if you see a German shepherdthat is really sick like really
sick, this infection is no joke.
This German Shepherd is on thebrink of death.
(22:11):
Aspergillus is probably likeyour number one on the
differential because of howvicious this infection is, and I
know that humans can also getAspergillus and I know that you
have some information on thelittle Aspergillus balls in your
lungs.
So you want to talk about that.
Speaker 5 (22:26):
Hey, I have a question for you, christina.
So what's the clinicalpresentation in those German
Shepherds, and why is it only aGerman Shepherd thing?
Speaker 4 (22:34):
So it's not only a German Shepherd thing.
Other dogs can have it, but itjust particularly likes German
Shepherds.
I'm not sure why.
Speaker 5 (22:41):
So genetic predisposition or something like
that Potentially yeah.
Speaker 4 (22:43):
But that's definitely an infection that favors German
Shepherds and the presentationcan be so diverse.
So you can have a dog thatcan't even walk.
They're so lethargic, they'reso weak, hypotensive, they are
panting up a storm.
Their heart rate, theirbradycardic heart rate, is super
low and they have aspergillus.
(23:05):
Or you can have a patient thatis blind and you don't know why
they're blind.
Turns out it's aspergus.
Aspergillus can affect thenervous system.
It can affect so many differentsystems and cause sepsis.
It is wild.
Speaker 3 (23:17):
That makes me think of like the last of us.
Yeah, I don't know if you'veseen the last of us, but I
really love pathogen horror.
I just think it's a great genre, but it's based on a video game
, the idea that a fungalpathogen gets distributed all
over the world and then, in thiscase, it's really infecting the
brain and making people funguszombies.
Speaker 5 (23:34):
So how do you diagnose the disease?
So the spores are found, or thevegetative states are found in
the eyes, if it's in the eye, orit's found in the lungs, if
it's a systemic infection.
Speaker 4 (23:44):
So you would do a serology testing, essentially.
So you pull blood and you sendit to a lab.
And you my dear scientists knowmore about this than I do.
It's a fungal culture,essentially that you grow.
So that's how we officiallydiagnose Aspergillus.
But you want to preemptivelytreat for Aspergillus while the
patient's there, if you reallysuspect Aspergillus, because if
(24:05):
that dog goes the week that theserology results take to come
back without treatment, they'remore than likely not going to
make it.
It depending on, of course, theway the dog presents.
There can be dogs that are,like I said, doing just fine.
They just maybe have a limp orthey're like holding their paw
up or something that can beaspergillus.
There can be a dog that's aboutto pass away, unfortunately,
(24:26):
aspergillus, a blind patientAspergillus it presents in so
many different ways.
Speaker 5 (24:31):
That's really wild.
It sounds a littlefear-mongering.
Speaker 3 (24:33):
A little fear-mongering.
Well, in humans it's a littledifferent.
So for my PhD program we take ayear in med school and it is
one of the wildest things.
It's stuck with me ever since.
It's called aspergilloma, soit's also caused by aspergillus.
This fungi is literallyeverywhere.
So you know, you talk and dogs,but this is something that's
(24:57):
just everywhere.
And what you see in people isthat those with like chronic
lung conditions, like peoplehave emphysema or tuberculosis,
they can end up with fungusballs in their lungs, so like
we're all breathing it in rightnow, but there's not necessarily
a good space for it to grow inhealthy lung tissue.
And at first they're not havinga lot of symptoms.
They might have like a mildcough or something like that,
but they might already have that, and so then they'll start
coughing up blood, feelingfatigue, really having shortness
(25:19):
of breath, and these mold ballscan just continue to grow and
grow and grow within the lungtissue and sometimes they
actually have to be taken outsurgically, which is really wild
.
And that's because in this caseantifungal medications don't
penetrate them very well becauseit's like a solid ball of
fungus.
And so how a really commonantifungal works, the azole
(25:39):
class of antifungals, which mostpeople can probably pick up at
like a drugstore or somethinghonestly they're there.
How that works is that itbasically prevents the synthesis
of what's known as anergosterol, which is just
basically part of the fungalcell membrane, so kind of
interrupting that.
But if you have somethingthat's just very densely packed
or how do you even really get itjust into the lungs, and so
(26:01):
being able to treat that isreally really difficult.
So yeah, it's definitelysomething that's seen in humans
as well, but I don't know thatit's necessarily the first
thought, like kind of how youwere describing it with dogs.
It's like the first oh, we'rein Texas.
And people can also get these intheir sinuses, and so I was
wondering, if you got one inyour sinuses like, would you
just smell mold?
(26:21):
All the time, um, but it turnsout the cleveland clinic doesn't
say so, like it doesn't saylike, oh, you'll smell mold.
That would be a sign, right, Iguess it smells really bad,
which makes sense.
You have like a ball of fungusin your sinuses.
Speaker 4 (26:33):
I guess it would be a very gradual smell change too,
so you probably wouldn't evennotice.
Speaker 3 (26:37):
Yeah, but like I think it would cause pressure,
right your sinuses like canexpand a bit if anyone's ever
had a sinus infection?
Speaker 5 (26:44):
Yeah, and your body will probably try to wall it off
as well, right?
So it's not just free growing.
That's true.
That's true, yeah.
Speaker 4 (26:51):
But touch a little bit, camille.
I know you kind of skipped overit, but why do aspergillomas
form in patients withpre-existing conditions Again?
Speaker 3 (26:58):
TB.
So I think, again, it's notsomething that it's necessarily
going to take root in healthylung tissue and I believe what I
read about it is it's like thespace that it has.
So if there's damage, I thinkit's almost like there's not
like pockets of air, but kind oflike that, and that's what is
allowing it to like take
Speaker 4 (27:14):
root and then start to grow Exactly Like little
tissues within the pockets, andthat damaged tissue is for some
reason sought out by this fungiand that's where the aspergillum
was.
Yeah, at least that was myunderstanding of it.
Speaker 3 (27:27):
Yeah, yeah, yeah, and I think I want to end the
fungal section with just talkingabout why this is so important
right now.
And what I think is interestingis that most people have heard
of bacterial and viralinfections.
Right, they're, you know, very,very common, but you very
rarely hear about like seriousfungal infection.
I mean, I can count on one handthe amount of people I've heard
of with a fungal pneumonia orsomething.
(27:47):
It's just not as common, andwhat's interesting about that is
that's changing.
And so why that's changing isthat a lot of fungi don't love
to live at human bodytemperature.
We run pretty warm, but as wesee the temperature of the
planet increasing, fungi arehaving to adapt to that and
begin to live at temperaturesthat are getting closer and
(28:09):
closer to human body temperature, and that's going to be bad
news for us, right, we've kindof given the planet a fever, and
so, as that global temperatureincreases, fungi are adapting
and we might possibly see anincrease in the cases that we
see, or even in fungal pathogensthat we just previously didn't
really struggle with, like a tonof cases, just because we've
(28:30):
changed our environment, and sothese things are already
naturally there, they'reeverywhere, and I think that
that's a really cool One Healthtie-in that I just want to
emphasize, because these thingsare just adapting to live and
the environment we've given themto live in is getting closer
and closer to our own bodytemperature, which is bad news
for us from a health perspective.
Speaker 5 (28:47):
So do you think people should watch the Last of
Us to prepare themselves for thefuture?
Speaker 3 (28:52):
No, no, no, not necessarily to prepare
themselves.
I hope we're not heading towardlike a dystopian fungal zombie
apocalypse.
I watch it with other friendswho are also like PhD students.
I was watching it with a friendof mine who studies plague and
we watch these things becausewe're like how accurate is this?
That's always our question.
And it's wild because I thinkthe idea that there's a global
distribution of a fungi is youknow, it's not too far off.
(29:15):
I think the effects the fungihad the way it grew inside the
body, maybe not.
Speaker 4 (29:23):
Yeah, I mean, you're not going to turn to a fungus
zombie, you're not going to cutopen someone's leg and have the
actual plant.
Speaker 3 (29:28):
Obviously it's horror Right, and so much of it is
taken sort of beyond into therealm of science fiction.
Right but the idea that we mighthave to deal with fungal
pathogens I think is very real,and especially there in so much
of our environment.
We're talking about the RoseGardner's disease.
That's in soil.
What else do we grow in soil,right?
We have all kinds of?
You know so much of our foodand stuff like that, so I think
(29:50):
it's worth thinking about.
There's certainly beneficialfungi, right.
People eat fungi too.
It's something to consider thatthings are changing and we
don't always know what thatmeans, but everyone's health is
interconnected and that'ssomething that the Last of Us, I
think, does get accurate,nothing else.
Speaker 4 (30:04):
Yeah, so does this mean I have to stop eating
mushrooms, because I lovemushrooms, I hate mushrooms.
Speaker 3 (30:10):
I mean, I've researched this whole thing and
I eat mushrooms.
Oh, I'm joking, I lovemushrooms Also, like just come
across mold and I can't say I'mscared of mold, I don't love it,
but like I've seen it and I'venot been like ah.
Speaker 5 (30:21):
Well, I think one thing we should also mention is
that we haven't talked aboutantivirals yet, but the thing
that we should also point out isthat under the microscope, all
of the three differentcategories look very different,
right, and they also havesubcategories.
So you talked about mold, youtalked about yeast, right and
bacteria.
(30:41):
They're like gram negative andgram positive, and so they're
not just names on the paper.
If you look at them under themicroscope, they're all very
different.
Speaker 3 (30:50):
Yes, definitely worth the Google, for like cool
images of viruses, bacteria,fungi.
Speaker 4 (30:55):
And I think that's probably a good point to make,
dennis, because you may wonderoh, I have this antibiotic left
over in my cabinet, I'm going totake it, and it doesn't work
for a certain infection that youhave.
That's because, like Dennissaid, it's not just every
bacteria is the exact samebacteria.
There's so many differentbacteria, so many different
(31:19):
morphologies of these bacterias,and not every medication works
for every bacteria.
That's why it's so important togo to the physician when you
have an infection, because ifyou take an antibiotic that is
not appropriate for theinfection that you have.
That's just another way toenforce.
Or an antifungal, yeah, or anantifungal Exactly.
Speaker 3 (31:29):
And that's why cultures are so important.
From a physician's office.
Speaker 4 (31:32):
That is a way that we avoid resistance.
Speaker 3 (31:37):
We're treating this with the appropriate medication
that actually targets it in away that's going to be effective
.
Speaker 4 (31:42):
So it won't only benefit you in the time being,
but also you in the future andothers in the long run as well.
Speaker 3 (31:52):
Yeah, and we don't want to overuse any of these
categories, right?
Because, as we've been talkingabout, they naturally coexist
with us and so we don't want tobe sterile human beings with no
microbiota.
It was interesting because Ialways thought we would just be
dead if we were sterile.
I guess we're one of the fewspecies that wouldn't be
immediately dead if we wereentirely sterile of bacteria and
stuff.
Speaker 4 (32:08):
I wonder what our quality of life would be then.
Speaker 3 (32:10):
It would be very low, because from all of our food
any animals that we use for anytype of food production, and
then also all kinds of plants.
Speaker 4 (32:17):
Like your nitrogen cycle is, really messed up One
day about how much bacteria helpyou with digestion and stuff
like that too.
Speaker 3 (32:23):
But some species, like cattle, rely so much they
can't really break down grasses.
It's the bacteria that's intheir stomach.
We at least are able to breakdown some things.
Speaker 4 (32:32):
I can't imagine our bodies without bacteria.
I love bacteria.
Speaker 5 (32:39):
And I think we should also make sure that we're
giving the listeners not theimpression that there's so many
fungi and bacteria and virusesout there that are just out
there to kill us, rightSurrounded by fungi and bacteria
and so on.
And they're everywhere and 99%of them are really really good
and really helpful.
Right, if you jump into thewater on the beach, in one liter
(33:00):
of water is tons ofbacteriophages right.
And they have a function theyclean the water.
So you know we like to focus onthese bad things and because
they cause interesting diseases.
But I think there's much goodout there, much more good than
bad.
Speaker 3 (33:19):
Absolutely.
Yeah, yeah, yeah, and theyexisted far before us, right,
like bacteria and other smallmicroorganisms.
That was goes around and and isstill continuing to perpetuate
through all these other animalsthat have gone, extinct, you
know surviving, and they're inan integral part of our
environment.
You're absolutely right.
Speaker 4 (33:39):
So on that note, Dennis, did you want to move on
to talking about retrovirals?
Speaker 5 (33:43):
Retrovirals.
I'm sorry, about antivirals.
Speaker 4 (33:45):
We don't have to get into retrovirals right now.
Speaker 5 (33:49):
That would take way too long.
No, I'm going to talk aboutantivirals, and antivirals are
special meds that can help yourbody fight off viruses.
So if you get sick from a virus,like the flu or a cold, the
virus sneaks into your body andinfects the cells of your body
and starts making copies ofitself.
(34:09):
This is how the virus spreadsand this is also how the virus
makes you feel bad.
Antivirals work by stopping thevirus from making those copies,
from replicating, so yourbody's natural defenses or your
immune system gets a betterchance of fighting the disease
right, so you're helping yourimmune system by stopping that
(34:31):
virus replication, the virusmaking copies of itself.
So I think, for the listenersout there, I think a good way of
thinking of antivirals is thatthey are a shield that blocks
the virus from spreading furtherin your body.
And I think one interestingfact is that they don't kill the
virus directly.
So it's not like they touch thevirus and then the virus
(34:54):
explodes or something like that,but they just slow down the
virus proliferating, copyingitself, and that gives the body
enough time to catch up, to rampup the immune response and stop
the virus.
Speaker 3 (35:09):
And I think that's why a lot of times it's
important when we're prescribingantivirals, the earlier an
infection you can get them, thebetter.
Because then, especially forsomething like I think of, like
Paxlovid, or even for COVID-19,or for people that are getting
triple drug therapy for HIV, thefaster those antivirals are in
the system, the less replicationhas already gotten out of
control.
Yeah, absolutely.
Speaker 5 (35:30):
This is Camille.
This is the perfect segue.
I'd written down some keythings, some key takeaways from
antivirals, and actually thefirst thing that I had written
down is they work best when youstart taking them soon after you
get sick Nailed it.
You nailed it, gold star, yeah.
So they help you to feel betterfaster and they keep you from
(35:50):
getting really, really sick.
So the sooner the better.
Then doctors prescribe them forspecific viruses, so not all
viruses can be treated withantivirals.
So not every virus that's outthere has a specific antiviral.
So at this point in time wehave antivirals only for certain
types of viruses.
Speaker 4 (36:09):
And can you tell us a little bit about why that's the
case?
Because I know we have so manyantibiotics that we pull from.
I know that we don't have a lotof antifungals, but we have
more than we have antivirals.
Speaker 3 (36:19):
We also don't have a ton of antifungal pathogens.
Speaker 4 (36:21):
Right, exactly, but how come it's so hard to make
antivirals?
Speaker 5 (36:34):
them.
But you're right, there are farless antivirals than there are
antibiotics, and antiviralstypically, just like antibiotics
, intervene somewhere in thebiology of the virus, in the
replication.
So they maybe work with anenzyme or they work and stop the
virus from forming a virusparticle or something like that.
But you need specific targetsand not every virus family will
(36:54):
give you these specific targetsand then often the virus is
reproduced so quickly withinhours that the antivirals have
to be in every cell of the bodyand they have to reach that
specific target quickly.
So that's why that's one of thetwo things that I can think of,
why we don't have enoughantivirals.
Speaker 3 (37:13):
Yeah, and that's really interesting to think
about.
There's definitely places inthe body that are
immunoprivileged.
So, as someone who works in alab that studies HIV, originally
the antivirals didn't cross theblood-brain barrier and so we
weren't controlling HIV in thecentral nervous system.
And now the antivirals arebetter and they do cross the
blood-brain barrier and preventthe progression and the damage
(37:34):
that can be caused.
But it's difficult to getsomething everywhere in the body
because the body is set up sothat doesn't happen, because if
there is some type of infection,you don't want it to go into
places that are incrediblyimportant, like the central
nervous system.
Speaker 4 (37:48):
I was going to say the CNS specifically is really
hard to get medications to ifyou're not giving it just like
directly into the CNS.
So that's yeah, thosemedications that can cross the
blood-brain barrier.
They're so rare because they doa lot of work and they're
awesome.
Speaker 5 (38:02):
And maybe just coming back to what I said earlier
about the specific targets thatare so difficult to find for
viruses, remember that virusesare obligate intracellular
parasites, right?
So they take hostage of thehost cell and so for their
replication they take goodchunks from the cell.
(38:24):
So if you're targeting the cellthat the virus uses, you're
targeting the rest of the cellsin your body, and there's high
toxicity.
Yeah, that's fair, and you don'twant to just be torching those,
so you have to find somethingthat is unique to the virus and
not something that the virusstole from our body.
And that's the huge differenceto bacteria, where they grow on
their own, they don't need partsof well, sometimes they need
(38:47):
part of the cell, but most ofthe time they can grow and it's
easier to target than somethingthat runs 80% based on the stuff
that's in the cell.
Speaker 4 (38:57):
Yeah, that's fair, yep.
Speaker 5 (38:59):
So then I have two more.
Speaker 4 (39:02):
Okay, let's hear it.
Speaker 5 (39:03):
A couple of key things left.
So the antivirals are usuallypills or liquids taken by mouth,
but sometimes they're giventhrough IV.
Speaker 4 (39:13):
I was going to say I don't really know of any IV
antivirals, like off the top ofmy dome.
You know what I mean.
Versus antibiotics, I don'tknow either.
Speaker 5 (39:20):
Paxlovid is pills right.
Speaker 3 (39:23):
Actually.
Well, it's not an IV, but I doknow that there's a new HIV drug
and it's an injectable, butit's not IV.
But yeah, most antivirals.
Speaker 5 (39:31):
But I remember like in the beginning of covid
remdesivir was given and that'san iv version, or the iv
versions is more work, I thoughtit wasn't as effective.
Not as effective as they.
Yeah, yeah, okay.
And then the last point isprobably the most important one
antivirals are different fromantibiotics, which fight
(39:51):
bacteria instead of viruses, sothey are also different from
vaccines, which help peopleprevent from getting sick in the
first place.
Speaker 4 (40:00):
That's a good point.
Speaker 3 (40:00):
Yeah, absolutely, and I think, touching on vaccines,
it's not always just prevention,right.
If you do get sick, it lessensthe severity and duration of the
disease, and that's really thepoint.
So if you get a COVID-19vaccine or something like that,
you won't necessarily not getCOVID, but when you do get it,
it is likely to be much lesssevere and won't last as long
than if you hadn't beenvaccinated at all Exactly.
(40:22):
Which I think is always a pointthat I feel is kind of missed in
the vaccine discourse that Ialways want to have.
Speaker 5 (40:34):
Yeah, that's a best to talk to your doctor.
Speaker 1 (40:36):
Yes, absolutely.
Speaker 5 (40:38):
If you feel sick, right, yes, please Don't take
our advice here and just takeantibiotics.
Go to a doctor and they candecide what medicine.
Speaker 3 (40:50):
Yeah, don't just self-medicate with like
over-the-counter items.
Speaker 4 (40:53):
Exactly Like please, if you're sick, go to the doctor
.
Speaker 5 (40:57):
Okay, anything else we should talk about, you think?
Speaker 4 (41:01):
I think we did a pretty good job summarizing
these three general topics.
We hit on antibiotics, we hiton antifungals and we hit on
antivirals and I hope, afterhearing this episode, our
listeners at least feel a littlebit more educated on the three
topics and a little bit moreself-sufficient when it comes
down to understanding what theyneed to do for themselves.
(41:21):
Yeah, thanks for listening.
Speaker 5 (41:23):
Yeah, thank you, and if you have questions, send us a
message.
Absolutely.
Speaker 4 (41:27):
You know where to find us.
Speaker 1 (41:30):
Until next time.
Speaker 2 (41:45):
Thanks for listening to the Infectious Science
Podcast.
Until next time, and go aheadand share this episode with some
of your friends.
Speaker 1 (41:52):
Also, don't hesitate to ask questions and tell us
what topics you'd like us tocover for future episodes.
To get in touch, drop a line inthe comments section or send us
a message on social media.
Speaker 2 (42:01):
So we'll see you next time for a new episode, and in
the meantime, stay happy stayhealthy, stay interested.
Speaker 4 (42:16):
Thank you.
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