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   McNadoMD (mcnado@mstdn.social)'s status on Tuesday, 04-Mar-2025 00:53:52 JST McNadoMD

   When you partially treat tuberculosis (TB), the bacteria that survive “learn”. You killed off the easy ones, and the ones that are left are bacteria that have genetic changes that make them drug resistant.

   The US just shut down a program that supplies tuberculosis treatment around the globe. People in the middle of treatment for dangerous strains are being left without complete treatment.

   This will kill people, and may make more drug-resistant TB. This is bad for the US, and world.

   • Embed this notice
     Kim Scheinberg (kims@mas.to)'s status on Wednesday, 05-Mar-2025 03:32:03 JST Kim Scheinberg

     in reply to

     • eswillwalker
     • Sam Levine

     @SRLevine @ELS @mcnado
     Is this true for NTM (nontuberculous mycobacteria) as well?

     I ask as someone who is on month thirteen of a triple antibiotic cocktail, whose cultures finally came up negative in late October, and still has six months of treatment left

     [Weirdly, the side effects have gotten worse since December. It's almost as if without the infection to fight, the antibiotics are just attacking random shit in my body so they don't feel useless. Or something]

   • Embed this notice
     Sam Levine (srlevine@neuromatch.social)'s status on Wednesday, 05-Mar-2025 03:32:04 JST Sam Levine

     in reply to

     • eswillwalker

     @ELS @mcnado It's neither in this case. Mycobateria in their latent states exhibit phenotypic rather than genotypic drug resistance, which is the problem with eradication since infected people host multiple sub-populations in different growth sates and you have to keep up treatment until you've gotten all of them (it's much, much easier to kill actively growing Mtb than those in their latent state). I did Mtb research as a postdoc that included studying latent vs. active TB, if you'd like references I'd be happy to dig some up later.

   • Embed this notice
     eswillwalker (els@sfba.social)'s status on Wednesday, 05-Mar-2025 03:32:05 JST eswillwalker

     in reply to

     @mcnado I know you know, but you are misleading people with your metaphor. The process you describe is not about bacteria “learning.” Learning is a process by which individuals change in response to experience. Evolution is a process by which populations change in response to experience.

     You are describing evolution by natural selection against the more susceptible bacteria. The natural selection is caused by the antibiotic in their environment.