mahiwaga

Thinking about the fact that candidates are actually campaigning in California despite having a very late primary, I’m wondering how the state could have more of an impact on the rest of the country.

Almost 1 out of every 8 people in the U.S. is Californian (~12%)¹ and if California were a separate country it would have the 8th largest economy in the world, but it doesn’t seem like we have a proportional say.

Hollywood probably magnifies cultural dominance (and accentuates the cultural divide with the rest of the country) but it’s scarcely a substitute for true political power.

Which got me thinking again about how partitioning the state would probably make it more relevant to national politics.

Partitioning states is very rare but has precedent. Kentucky and West Virginia were both carved out of Virginia and Maine seceded from Massachusetts. I know there have been many failed attempts at dividing large states like Texas and California, but I wonder if someday it might actually happen.

Turns out, the E. coli isolated from a woman’s infected urine isn’t actually pan-resistant.

No, this isn’t the start of the antibiotic apocalypse, just bad reporting • 2016 May 26 • Beth Mole • Ars Technica

The misleading sentence is in the paper itself, though. “The recent discovery of a plasmid-borne colistin resistance gene, mcr-1, heralds the emergence of truly pan-drug resistant bacteria.” Pan-resistant would mean it’s not just resistant to colistin but every other antibiotic in our armamentarium: beta-lactams, cephalosporins, sulfa, tetracyclines, fluoroquinolones, aminoglycosides and colistin. But the resistance patterns of the isolated organism actually show that it’s still susceptible to amikacin, all the carbapenems, and nitrofurantoin. Don’t get me wrong, this is not great, since amikacin is nephrotoxic, and while nitrofurantoin is great for bladder infections, it’s not great for systemic infections.

I think what they’re trying to say is that finding mcr-1 on a plasmid makes it very likely that we’ll have pathogens with both carbapenem-resistance and colistin resistance soon enough.

When you get right down to it, the antibiotic resistance crisis is mostly driven by profitability. It simply isn’t profitable to invest all that money in R&D, clinical trials, and marketing of antibiotics. Despite their obvious critical utility, the demand for antibiotics that are effective against multidrug-resistant pathogens is, overall, not very high.

Meanwhile, it is profitable to feed livestock antibiotics to increase yields, and it is profitable to prescribe azithromycin to patients who demand it because spending an extra fifteen minutes in a futile attempt to convince them that antibiotics are useless for viral infections will significantly cut down on the volume of patients you can see and might jeopardize your customer satisfaction rating.