New thought on gram negative treatment

[Lifelongaquaria]

it seems common for fish to die even after the symptoms of these type of bacterial infections are not apparent. I was talking with someone who works in the medical industry training nurses And he made me aware of how these things are treated differently than other bacterial infections in people. He made me aware that when these bacteria die the patient can be easily sent into toxic shock and die. For this reason the treatment is done on a minimum of ten day ( sometimes more) regimen which is started at low doses and incrementally increased over the course of the regimen schedule so the toxins released do not kill the patient. I had always thought that it was shock of medication or the stress of such long treatment periods that was probably Responsible for these deaths in seemingly cured fish. Now I am beginning to think that some of these deaths might be more avoidable if an incremental increase of treatment is applied. This thought might not be new to others but it is too me and thought some others might find this interesting.

 

[Gareth elliott]

A lot of gram negative infectious diseases are antibiotic resistant in our health care system. And there hasnt been an approved new class in several decades This requires health care professionals to fall back on older drugs that carry toxic side effects.

Might be worth looking into with cipro treatment of fish that has a few well reported incidence of toxicity in humans.(though small compared to the number of prescriptions filled world wide)

 

[Jose Mayo]

it seems common for fish to die even after the symptoms of these type of bacterial infections are not apparent. I was talking with someone who works in the medical industry training nurses And he made me aware of how these things are treated differently than other bacterial infections in people. He made me aware that when these bacteria die the patient can be easily sent into toxic shock and die. For this reason the treatment is done on a minimum of ten day ( sometimes more) regimen which is started at low doses and incrementally increased over the course of the regimen schedule so the toxins released do not kill the patient. I had always thought that it was shock of medication or the stress of such long treatment periods that was probably Responsible for these deaths in seemingly cured fish. Now I am beginning to think that some of these deaths might be more avoidable if an incremental increase of treatment is applied. This thought might not be new to others but it is too me and thought some others might find this interesting.

This thinking does not meet the logic of human antibiotic therapy; antibiotic treatments are prolonged in time because these drugs generally act at the time of bacterial cell division, and bacteria do not all divide at the same time. In many cases, what happens in practice is the opposite of the incremental dose; the treatment is started with a higher "attack dose" and a lower "standard dose" is maintained, aiming to maintain drug levels within the laboratory-determined range as the "minimum inhibitory concentration", which is equivalent to "minimum effective dose" of a given drug, for the control of a particular micro-organism.

Regards

 

[Lifelongaquaria]

I know that these types of bacteria are resistant to antibiotics by nature but did not know the antibiotics themselves used are more toxic. However he was very clear in his words though not a doctor that the die off of the bacteria themselves produces a considerable enough amount of toxins to render toxic shock.

 

[Lifelongaquaria]

@Jose Mayo. Thank you

 

[Lifelongaquaria]

I certainly must do more research on antibiotic therapy in general. I have no medical training other than first aid which really is none at all and appreciate everyone's thoughts on this.

 

[Lifelongaquaria]

So along these lines of thinking it probably is the stress of treatment that gets the fish that are seemingly cured?

 

[Jose Mayo]

I know that these types of bacteria are resistant to antibiotics by nature but did not know the antibiotics themselves used are more toxic. However he was very clear in his words though not a doctor that the die off of the bacteria themselves produces a considerable enough amount of toxins to render toxic shock.

Yes, bacterial metabolism produces toxins that may be (and are) possibly responsible for septic shock (toxic), but this septic shock is not considered to be produced by antibiotics or by bacterial death because of the use of antibiotics; septic shock is directly related to the increase in the extent of infection and its spread in the body, especially through the hematogenic route (septicaemia).

 

[Humblefish]

Most ABX we use on fish have bad side effects, and for an already sick fish this can be too much. I personally prefer to use an antiseptic (e.g. 90 minute acriflavine bath) before the fish goes into QT to be treated with antibiotics. I feel this gives a jump on the infection, and then hopefully the use of prolonged ABX can aid the fish's natural immune system in overcoming the infection. I also prefer using an ABX concoction which contains Methylene Blue, because that healing agent helps to repair damaged scales/tissue after the infection has been eliminated.

I see slowly ramping up ABX dosage as risky, especially when treating a fast killing gram negative infection. It might work on a slow spreading gram positive one. But you'd need a skin scrape/scope ID to know for sure which was afflicting your fish, as many bacterial infections present similar looking visible physical symptoms.

 

[Rispa]

Interesting thoughts. We also need an easier way to tell if it's gram negative though

 

[Humblefish]

Interesting thoughts. We also need an easier way to tell if it's gram negative though

At present time, taking a skin biopsy of an affected area and then ID'ing the offending bacterium by using a microscope is the only way.

 

[Lifelongaquaria]

Does anyone know where to get the the crystalline dye used in the gram test without having a license? I am obviously obsessed with biology and would like to have some around. Not dealing with a gram negative right now if I were to guess but guessing is pretty useless and as I have been infected from my tanks before it would be nice to know when I am dealing with particularly nasty strains.

 

[Rispa]

Look up gram stain kit on Amazon

 

[Toofattofish]

it seems common for fish to die even after the symptoms of these type of bacterial infections are not apparent. I was talking with someone who works in the medical industry training nurses And he made me aware of how these things are treated differently than other bacterial infections in people. He made me aware that when these bacteria die the patient can be easily sent into toxic shock and die.

This really applies more to parasites/helminths than bacteria. There is no bacterial infection that I am aware of where the treatment is ramped up.

For this reason the treatment is done on a minimum of ten day ( sometimes more) regimen which is started at low doses and incrementally increased over the course of the regimen schedule so the toxins released do not kill the patient. I had always thought that it was shock of medication or the stress of such long treatment periods that was probably Responsible for these deaths in seemingly cured fish. Now I am beginning to think that some of these deaths might be more avoidable if an incremental increase of treatment is applied. This thought might not be new to others but it is too me and thought some others might find this interesting.

This thinking does not meet the logic of human antibiotic therapy; antibiotic treatments are prolonged in time because these drugs generally act at the time of bacterial cell division, and bacteria do not all divide at the same time. In many cases, what happens in practice is the opposite of the incremental dose; the treatment is started with a higher "attack dose" and a lower "standard dose" is maintained, aiming to maintain drug levels within the laboratory-determined range as the "minimum inhibitory concentration", which is equivalent to "minimum effective dose" of a given drug, for the control of a particular micro-organism.

Regards

+1.

Interesting thoughts. We also need an easier way to tell if it's gram negative though

I doubt this would change all that much. Seems like most people use kanamycin or furan. If it's gram positive no reason to use kanamycin, but if it's gram negative might still want to use both just to be sure.

 

[Big G]

Does anyone know where to get the the crystalline dye used in the gram test without having a license? I am obviously obsessed with biology and would like to have some around. Not dealing with a gram negative right now if I were to guess but guessing is pretty useless and as I have been infected from my tanks before it would be nice to know when I am dealing with particularly nasty strains.

https://amazon.com/gp/product/B00BUV7I3K/ref=ox_sc_sfl_title_13?ie=UTF8&psc=1&smid=ACTB8CBED46SR
https://amazon.com/gp/product/B00ANPEZP8/ref=ox_sc_sfl_title_14?ie=UTF8&psc=1&smid=A35BV4NHHC5J5C

 

[Lifelongaquaria]

@Toofattofish it might not change much in the way of how we treat the fish but it would change how seriously I handle it as far as protecting myself. Even though don't think I could do to much more than I do would just be nice to know when I'm dealing with strins that are especially resistant to antibiotics.

 

[Toofattofish]

@Toofattofish it might not change much in the way of how we treat the fish but it would change how seriously I handle it as far as protecting myself. Even though don't think I could do to much more than I do would just be nice to know when I'm dealing with strins that are especially resistant to antibiotics.

A gram stain won't tell you anything about resistance to antibiotics. You would need to use something like this to determine antibiotic sensitivity/resistance.

 

[Lifelongaquaria]

Hmm, gram negative bacteria are certainly resistant to antibiotics by their very nature due to the type of cell wall they have and accompanying biofilms. The link in your description is more about determining which antibiotics have what effect and to what extent. Very useful information but do not see how knowing something is gram negative and therefore more resistant to antibiotics in general would not lead me to approach it with more care.

 

[Toofattofish]

Hmm, gram negative bacteria are certainly resistant to antibiotics by their very nature due to the type of cell wall they have and accompanying biofilms. The link in your description is more about determining which antibiotics have what effect and to what extent. Very useful information but do not see how knowing something is gram negative and therefore more resistant to antibiotics in general would not lead me to approach it with more care.

The spectrum of effective antibiotics is different because of their cell wall components; however their resistance mechanisms are fairly similar and resistance is fairly common in both gram negative and positive.

 

[Matta Simaan]

a very informative and nice discussion; but please dont be offended and let me clear some point:

first of all i am new to the reefing hobby and i must say that without REEF2REEF help especially HUMBLEFISH posts, i am probably out of this hobby at an very early stage;

so lets talk bacteria:
- gram negative and also gram positive in humans may cause septic shock.. its an exaggerated way that our body fight the infections.. septic shock must be treated with supportive care aka intravenous fluids.. steroids and others...
- as the gram negative also gram positive may be resistant to antibiotics (you all heared about MRSA) and also there are many gram negative bacteria that are not resistant
- to identify a bacteria and its susceptibility to antibiotics you need not just a gram stain and microscope (it just will tell you if it gram +/-) and not all bacteria can be identified by their shape; there is many other tests that help in identifying bacterial strain; if you need to know its susceptibility to AB you must culture it and but in the culture a DISC with antibiotics to see if the bacterial colonies fade around specific antibiotic...
- mostly a resistant strain will develop from non resistant one by one of those two ways: 1 - acquired from other bacteria 2 - exposure to AB but not within the correct level - so here what happen that the bacteria will fight back the antibiotic... and its very important to complete the full course with the optimum dosage of an AB to prevent this event ..

i am hoping that my post was simple and informative and helping you guys in understanding bacterial infection..

by the way i have a successful case of treating a tang with an bacterial infection with ciprofloxacin dips.. i dont know if the cipro helped or it was a self limiting disease...