The myth that the Raven does not peck out the Raven’s eye

Crow crow does not eat the eye – it is also a myth. Calm eat dog, if need be, without hesitation. But we’re not talking about crows, we’re talking about germs.

It is considered that all microbes are at war only with us, as well as with animals and plants. But not among themselves. Why would they fight among themselves? What do they share?

Many things. Competition in the world of microorganisms will be tougher than among managers-“salespeople” or insurance agents. But since we’re talking about fighting, let’s debunk the Most Enduring Myth of germs.

The most Persistent Myth is not an exaggeration and writing words with capital letters is not accidental. Such titles should be written only in this way, by analogy with His Imperial Majesty. After all, this is not just a myth, but a myth that doctors believe in! Well, at least a third of the medical community does. Paramedics and nurses do, too.

The question itself arises – well, how can people with higher and secondary medical education believe in myths of a medico-biological nature (and the myth in question, just refers to those)?

Do not ask the author of this book about how this could happen. He doesn’t. Happened and that’s all!

Okay, that’s enough to fog the truth and to escalate the intrigue. It’s time to meet His Mythological Highness the Most Enduring Myth of germs.

TA-da-da-da! (fanfare, timpani and drums).

Anyone who has an acute respiratory infection or something like that, knows that you should not rush to “shoot down” high temperature, because it benefits – kills pathogenic microbes that caused the disease. Useful microbes living in the body, too, probably suffer from fever, but during the disease their interests fade into the background. Not until fat, as the saying goes, be would live. The main thing – to defeat the pathogen (or pathogens) disease, and the restoration of normal microflora can be enjoyed after.

The rise in temperature is very painful for most people. I’m aching all over-turns, a headache and not thinking, lethargy, weakness, and even may feel sick on top of… Hands and reach for antipyretic drugs, but the mind, the voice of the attending physician, says: “No! Don’t you dare! High temperature kills germs! If you want to recover quickly, then endure, endure, endure… you can only bring Down the temperature, “stepped” for thirty-nine degrees!”Or – for forty, on this issue the medical community has no consensus.

No, you realize what we’re up to now? In the Holy of holies! The author will not be surprised if some readers now slam the book and will continue to use it only as a stand for cups. And even at all – in the furnace thrown. Well, those who read “from the screen”, just delete the file and use the search engine to make sure the author is wrong. And after all will be convinced! One has only to type “is it possible to bring down a high temperature?”, and the Network will answer you with a slender thousand-voiced chorus – “No! Up to thirty-nine degrees is impossible!»

But in fact…

No, you do not laugh, do not snort and do not be angry, but just read on.

In fact – you can! Many people already at thirty-seven and a half degrees feel bad. Or even thirty-seven point two. But they endure, endure, endure… Suffer, but endure. Because they want to get well soon. Some enthusiasts can be in a similar state to steam in the bath. In order to warm up properly to hit these malicious infectious agents “from all barrels”! To become absolutely healthy tomorrow!

I must say that in the presence of acute inflammatory diseases, as well as exacerbations of chronic diseases, as well as any (any!) malaise expose your body to such a load as a visit to the bath (any, even “sparing” Turkish Hammam) is not recommended. Smart doctors are not recommended. The key word is “smart.” So if your doctor advised you with acute bronchitis “a good steam bath”, then draw conclusions and look for another doctor.

But back to our rams. That is, to our microbes.

Temperature is one of the most important factors for the life of any organism, including microorganisms. According to their temperature preferences, all microbes are divided into three groups.

The first group – psychrophiles. These are microorganisms-“polar explorers”, fans of cold, who live and reproduce at temperatures from -20 to 10 °C.

Please note that we are now talking about the normal functioning of microorganisms, and not about their “wintering” (waiting out adverse conditions) in the form of disputes!

The second group – mesophiles, for which the most favorable are temperatures from 25 to 45 °C, the minimum permissible – from 5 to 10 °C, and the maximum permissible – from 50 to 60 °C.

The third group consists of thermophiles that feel good at temperatures of the order of 50-65 °C, but not above 70 °C. Temperatures above 70 °C can tolerate only individual “extreme Stoics” like archaea living in hot springs. By the way, the archaea constitute the majority of the thermophiles.

But extreme people can do whatever they want. We are now interested in the second group, since most of the pathogens of human infectious diseases are mesophiles. And some are psychrophiles, like the plague stick. But there are no thermophiles among our infectious agents, not the conditions in our body.

An increase in body temperature by half a degree can already be felt by a sick person as unpleasant. A degree – so not maybe, but will definitely be felt as unpleasant. Any disease is accompanied by a whole set of unshaven sensations. From some, such as intoxication – poisoning of the body by the products of the life of infectious agents or products formed as a result of their disintegration, “in an instant”, that is, in a short time it is impossible to get rid of. Does that create an intense “flushing” the body by intravenous drip delivering fluids with the concomitant introduction of diuretics. And the temperature is easy to lower – took one or two tablets of antipyretic or, say, a tablespoon of syrup, and an hour later (or even earlier) the temperature has already decreased to the usual value. The headache stopped, the ache disappeared, the weakness decreased – isn’t it good?

Well, that’s good, but the germs… They lower the temperature, too, on hand. Less of them will die, the disease will last longer.

Yes, it is not a “benefit” to them, and a shit (pardon Moi)! Microbes increase in body temperature by two or three degrees almost no trouble. Here is if higher 50 °C – another matter. But to such an extent the body temperature we have never increased. The maximum limit is 45 °C, and in General,the metabolism and energy in the human body is violated in life-threatening limits already at 43 °C, why before this value was called “lethal”, that is, deadly temperature.

For a human – lethal, but for microbes only a small change in the conditions of life for the worse. Temperature rise up to 40 °C microorganisms do not “notice”, because such fluctuations are covered by the range of their normal life. Temperatures above 40 °C may slightly slow down the reproduction of some bacteria… the Key words “slightly” and “some”. And Yes, here’s something else – all that was said above applies to bacteria and protozoa, to cellular organisms. Viruses, because of their simple organization, are more resistant to temperature changes and die only at temperatures above 60 °C.

So if you the flu added to the misery discomfort caused by fever, your behavior can be classified as masochism – the tendency to enjoy or better to say – the satisfaction of experiencing suffering. And excuse the author, if he is someone that phrase hurt, but the other words just do not pick up. By the way, for people suffering from cardiovascular diseases, fever can be not only unpleasant, but also dangerous.

You want it? Scarcely. And in General, the treatment of any disease as one of the goals involves creating maximum comfort for a sick person. “The more tears, the more relief” is the wrong principle. Tears and other sufferings only hinder recovery. And there is also such a question as the degree of disability in the disease. Yes, of course, the welder with the flu in any case can not work. But an accountant, a screenwriter or some other “laptop slave” is quite possible with the flu to do part of their work. If the state allows, i.e., no headache and thinking straight, and not really shake. Some “lucky” argue that at home, in a sick state, they have time to do much more than in the office, because at home during the illness no one and nothing distracts them. You can turn off all the phones, get out of all the mailboxes and other “communications” and work in the “invisible”… Is not it happiness? Oh, if only there was no cough with a runny nose…

Let’s summarize what was said.

To endure the suffering caused by an increase in body temperature in infectious diseases, for the sake of the mythical death of infectious agents from this increase, is unreasonable. It is reasonable to be ill with the greatest possible comfort. Of course, we must be aware that taking antipyretic drug is a symptomatic treatment, eliminating not the cause of the disease, but only its individual manifestations. But symptomatic treatment is part of the overall treatment.

Necessary clarification – the author of this book does not encourage readers to necessarily take antipyretics at the slightest increase in body temperature. He only explains that the increase in body temperature has virtually no adverse effects on the microorganisms that live in it, neither on infectious agents nor on the normal microflora. In short, if you want to “bring down” high temperature, then “bring down” it with a pure heart and a light soul. And, of course, with the exact and strict observance of all the rules of this particular drug! These rules can be found in the attending physician or read in the instructions attached to the drug.

“But doctors themselves recommend…” – some readers will persist.

Yes, recommended. This myth was born by doctors (now it is not to say who exactly) in the second half of the XIX century soon after the French microbiologist Louis Pasteur proposed a technology of single heating of food products for their disinfection and for extending their shelf life. This process was called pasteurization in honor of its inventor. Is pasteurized milk familiar to everyone? Thanks to grandpa Pasteur.

So, if when heated to 60 °C for sixty minutes or heated to 70-80 °C for thirty minutes, most of the bacteria contained in the products die (about viruses in the XIX century had no idea), then they will die when heated to 40 °C for several hours, for example five or six. Or die partially, but will certainly die…

Do you see the logic? Heating is detrimental to microorganisms, this time. The lower the temperature, the longer the exposure, these two. In the body just like that, without any purpose, nothing happens, it’s three.

One! Two! Three! A new myth was born! Yes, what!

And as for the increase in body temperature as such, it is caused by both the products of the life of microbes and substances formed in our body during the disease, and is not a specific way to protect the body from an infectious agent, and a complication of the disease, “concomitant” factor. Roughly speaking – the intensification of metabolic processes in the disease, as well as increased muscle tone (muscle tremor) lead to increased heat production by the body, and the narrowing of small blood vessels of the skin and the inhibition of sweating – to reduce heat transfer. When heat production begins to prevail over heat transfer, the body temperature rises. That’s it.

Viruses are much more resistant to drugs, and therefore there is a perception that viral infections are much more dangerous, much harder, etc. In fact, such a statement is fundamentally wrong. In the root, because in assessing the severity and prospects of cure of any disease should be based on the properties of a particular pathogen, that is, from the assessment of its effects on the human body, and not from the pathogen belonging to viruses, bacteria or protozoa. “It is not necessary to generalize – I would advise about this legendary Kozma Bars. Look at the root!”Yes, on the one hand viruses cause such dangerous diseases as AIDS, rabies or hepatitis C, but bacteria cause plague, anthrax, cholera and malaria. And if you compare an acute respiratory viral infection with tuberculosis, which is caused by a bacterium of the genus Mycobacterium, better known as Koch’s wand, then… Yes, in fact, there is nothing to compare, it’s like comparing a Bicycle with a tank.

By the way – about mycobacteria, since they were mentioned. The prefix “Miko-” indicates a mushroom. This name was given to these bacteria for some of their similarity with fungi.

Now let’s get back to where this Chapter began – the interaction of microorganisms with each other.

There is one General evolutionary rule that States that organisms of similar species will compete for an ecological niche. The ecological niche is a natural place of one kind. If in one niche there are suddenly two species, the competition between them will continue until one species displaces the other completely. This rule applies to all organisms, regardless of their size.

If any niche suddenly released, it will take a neighbor. “Housing” can’t be empty, has no right. An example is the already mentioned above candidiasis – intensive reproduction of fungi of the genus Candida in the intestine, vagina or mouth, arising from the use of powerful broad-spectrum antibiotics. Antibiotics kill various microorganisms, which are replaced by quick and resistant to antibiotics “candidates”. So there is no “single microbial front”.

And viruses on top (Oh, those sneaky viruses!) can infect bacteria. We have already talked about bacteriophages and will talk more. Bacteriophages and myths associated with them, we will devote (in part) one of the following chapters. By the way, the name of these viruses was given is not very accurate, because bacteriophages do not eat bacteria, and tear them apart, but what really came up, so we use. But not in the name of the matter, and that between viruses and bacteria “cooperation” is possible only in one form – in the form of parasitizing viruses in bacteria, fatal for the latter.

In a familiar fiction of “Eternal bread” excessively multiply bacteria destroyed by some fungus. It was enough to throw a few grams of fungus into the bacterial “dough”, as it began to settle, and very soon a small amount of gray mold remained from the “father-in-law” mountains, which, drying up, turned into dust. Thus, “pitting” microorganisms, humanity was able to win back from actively multiplying bacteria “their” planet.

It is considered that the majority of infectious diseases is “mixed”, that is caused not by one, but several infectious agents. Like, microbes prefer to attack our body not alone, but in whole groups (and I want to say – gangs). Trouble, as they say, does not come alone, and germs – too. Together microbes easier to overcome the immune defense of the body and cause disease.

What does this myth lead to? To the fact that patients wish to be treated with broad-spectrum antibiotics that kill microorganisms of different species. It seems quite logical – more efficient to attack the enemy on all fronts, so rather to achieve victory.

Oh, really?

In addition to the breadth of the spectrum of each antibiotic, there are many other indicators that doctors take into account when prescribing and pass by when reading the instructions of patients.

The main complaint of angry patients is: “My doctor does not listen to my words at all. I said a thousand times that I was in exacerbations of bronchitis helps bullbaiting, and he gave me markallen’t want to cancel!»

What an ugly doctor! To drive out of medicine!

Or maybe not drive? Maybe it is worth remembering or learn that resistance to any antibiotic in microorganisms is formed with long-term use. The mechanism is as follows – the first application of the antibiotic survives some part of the bacteria, which due to mutations (changes in genetic material) is resistant to this antibiotic. Resistant bacteria are few, but with each use of antibiotics their share in the population (community of organisms of one species) is becoming more and more. Sooner or later, the moment will come when 99.9 % of bacteria in this population (that is, in this body) will become insensitive to the action of this antibiotic. That’s why smart doctor prescribes, several times treated with marqueterie, bullbaiting.

We began with the friendship and enmity of microbes, but constantly deviate from the main theme of this Chapter. Now about the rules of prescribing antibiotics are talking. But since we touched on such an important topic, let’s bring it to the end. All the more that this theme the main topic quite close.

The second most abundant “antibiotic” complaints of angry patients is: “My doctor prescribed me an antibiotic to a narrow-action burchalkin’t want to cancel! And I do not trust these “narrow” antibiotics!»

In fact, in the public mind are mixed into one pile two different processes – mixed infection and secondary infection. Yes, there are cases of mixed infection, when two microorganisms together and at the same time (the key word – at the same time!) affect the body. For example, the pathogens of measles and scarlet fever, dysentery and typhoid, tuberculosis and human immunodeficiency virus can go hand in hand.

Note – not always “hand in hand” are cellular microorganisms, as in the case of mixed lesions of the body pathogens dysentery and typhoid. Measles is caused by a virus, and scarlet fever by Streptococcus, tuberculosis by a rod-shaped bacterium, and immunodeficiency by a virus. For viruses, as you know, antibiotics have no effect. So why is certainly prescribed for infectious bacterial diseases antibiotics broad-spectrum? If we talk about the mind, it is necessary to select for a particular infectious disease in a particular patient a specific antibiotic that will destroy the infectious agent better than others. And not to shoot all of the guns in the defunct sparrows.

Too much specifics? In medicine, you can not do without it. And in General, antibiotics are prescribed deliberately, taking into account what kind of microorganism should be suppressed, and not selected by the “width” of their spectrum of action. If you want to know, this is the widest range of need is not so much the attending physicians as pharmacists, hospital and ordinary (in every hospital, if anyone does not know, has its own pharmacy that stores medicines and other pharmaceutical products and issues them to the Department). It is convenient to work with twenty broad-spectrum antibiotics instead of one hundred and fifty names of narrow-acting antibiotics.

The third most common complaint is perhaps the most tragic of all: “My short-sighted and inattentive doctor did not prescribe me antibiotics in time (or, alternatively – prescribed me a narrow-spectrum antibiotic), and now my condition has worsened – my mixed infection “raised his head.”

Most cases, which in everyday life are called “mixed infection”, are actually secondary infection. About secondary infection say in those cases, when on backdrop of one infectious disease evolves another. In the background, pay attention. That is, when the first disease has already manifested itself. In secondary infections, microbes of different types attack the body not immediately, as in mixed infections, but in turn – first one, then the other. We can say that the first infectious agent “opens the gate” to the second, reducing the body’s resistance. Most often, against the background of viral infections, infectious diseases caused by bacteria develop (for example, pneumonia against the background of influenza).

Doctors blame is easy, but to understand is much harder. But let’s try to do this on the example of complications of influenza pneumonia caused by Streptococcus.

The patient goes to the doctor with characteristic complaints and clinical picture allowing to diagnose flu. The doctor prescribes treatment in which antibiotics can not enter, because they are not needed for the flu. Prophylactically, just in case, antibiotics are never prescribed, since there is no sense in such “prevention”. The non-existent disease – pneumonia – cannot be treated. (If you can explain to the world how to treat, and successfully, non-existent diseases, then consider that the Nobel prize is in your pocket.) But the antibiotic will kill part of the normal microflora of the patient’s body, especially the intestinal, which can lead to digestive disorders. There will be no benefit, and harm can be easily.

When the viral disease is complicated by bacterial pneumonia, the doctor prescribes antibiotics, because they become necessary. You cannot say that “mixed infection raised its head due to the negligence of the doctor”, in fact, was not a mixed infection or negligence. In fact, one disease was complicated by another and no one could foresee this complication in advance.

Secondary infections are much more common than mixed infections. As “accomplices” microorganisms attack our body rarely. Too many factors must coincide for the microbes to become “accomplices” and could affect the body at the same time. By the way, not always microbes-“accomplices” support each other. Between them can be observed and irreconcilable hostility. For example, Pseudomonas aeruginosa in contact with the wound with Staphylococcus aureus suppresses the growth of the latter. The patient, however, this is not the best, because the horseradish radish is not sweeter. Pseudomonas aeruginosa and alone can do a lot of trouble.

The interesting thing about Pseudomonas aeruginosa is that it has a kind of social consciousness and social behavior. Here, imagine – there is no brain, and social consciousness is. These sticks, which received their name due to two abilities – the development of blue-green pigment and causing purulent inflammation of tissues, can communicate with each other with the help of special “signal” protein molecules. It is this ability to communicate – or rather, the ability to act in concert – that makes Pseudomonas aeruginosa resistant to antibiotics, even very powerful and in large doses. “Smart” (do we need quotes here?) Pseudomonas aeruginosa sticks envelop their colonies with a strong biofilm consisting of bacteria glued to each other, covered with a composite protective mucus. Antibiotics can be very difficult, if not impossible, to “break” such protection and penetrate through the biofilm deep into the colony.

The stability of Pseudomonas aeruginosa is so great that it is reflected in folklore. When doctors and microbiologists want to say something like, “nothing takes it,” or “nothing can take it,” or “nothing can affect it,” they say – “it’s like a Pseudomonas aeruginosa.” And immediately everything becomes clear without further explanation.

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