The key here is using this with a remote code execution exploit. As an example, there are already ways to exploit this remotely with metasploit and @OSXReverser has published work on how to install root kits in conjunction with the exploit.
From what I've seen, Metasploit's access to patched OS X boxes depends on Java over the web. Smart people should have disabled Java in the browser long ago - they'll never miss it. Another frequently popular vector, Flash, can be mitigated with FlashBlock.
But, unfortunately a lot of people haven't learned their lesson with regards to either technology.
However I pointed out the guest account access because that is present on pretty much all modern OS X boxes, and is enabled by default for some reason. Giving unauthenticated users access that way just seems dumb - even without the presence of Rootpipe. Local privilege escalation exploits are just not that uncommon on pretty much any mainstream OS - including Linux and Windows (maybe not on the BSDs, but they're not exactly mainstream).