REFLEXIONS

On Our Antibiotic World

By Robert Ross

“Antibiotic resistance is no longer a prediction for the future; it is happening right now, across the world, and is putting at risk the ability to treat common infections in the community and hospitals . . . Without urgent, coordinated action, the world is heading towards a post-antibiotic era, in which common infections and minor injuries, which have been treatable for decades, can once again kill.”

—               World Health Organization 2014

A few years ago world travelers worried about malaria, hepatitis or Dengue fever. Now new diseases threaten: antibiotic resistant Tuberculosis, Carbapenem-resistant Enterobacteriaceae, known as CRE’s, Klebsiella pneumoniae carbapenemase, aka KPC’s and the spread of New Delhi metallo-beta-lactamase, NDM1. The old line-of-defense, antibiotics, are no longer working. These tried-and-true disease fighters are up against a new unstoppable enemy, the superbug.

Antibiotics are fungal poisons called mycotoxins that kill bacteria. Penicillin is the best example. Its discovery in 1928, allowing for safer surgeries, along with the ability to combat bacterial infections, was a turning point in history. Viewed by many as a miracle, today this miraculous aid is slipping away uncontrollably, and we are facing what the CDC describes as “a nightmare.”

Bacteria are like little people. Over time they evolve and adapt; and like humans they’re very cunning. They have a survival gene built into their very existence. So, along comes Dr. Alexander Fleming with a discovery — penicillin — that can kill bacteria. Champagne bottles are uncorked in hospitals across the globe. Death from infection plummets. And, surgeries that were once considered too dangerous, become commonplace. Bacteria, both good and bad, are being decimated like turkeys in a turkey shoot.

Doctors, encouraged by pharmaceutical companies and the public, prescribe antibiotics in record numbers for anything that resembles an illness. Over-prescribing be-comes the modus operandi. Colds and influenza — both viral infections — are treated with antibiotics, even though they will not help. Dentists take advantage of this miracle drug. The food industry pumps antibiotics into animals and poultry. Western countries, third-world countries, every-one jumps on-board. Overnight we are an antibiotic world.

This world-wide use of antibiotics threatens the very existence of certain bacteria. To survive they evolve and adapt.

In a speech given in 1945, Alexander Fleming warned of the overuse and abuse of antibiotics. The warning wasn’t heeded though. Consequently, research centers throughout the world are now referring to antibiotics as the “perfect-storm.” The more we expose bacteria to antibiotics, the more likely resistance will develop. Diseases like TB, once considered controlled, are now on the rise with drug resistant strains. In 2012, there were an estimated 450,000 new cases of drug resistant TB in the world. So troubling is this trend of drug-resistant bacteria, Dr. Arjun Srinivasan, of the CDC recently declared: “We’ve reached the end of antibiotics!”

The Paradox

In America, we have an abundance of food. Walk down any supermarket aisle and the choices can be overwhelming. We have so much food  that America is a world leader in obesity. But this abundance of food causes more harm than just contributing to obesity.

Sunday breakfast for many families includes ham or bacon, eggs, and a glass of milk for the kids. Although this menu sounds nice and relatively healthy, in reality, it’s a buffet of antibiotics. Antibiotics have been fed to food animals, since it was discovered that by doing so, they gained an average of 3 percent more weight. More weight translates into greater profit margins. Stuart B. Levy, M.D., who has studied the subject for years, estimates there are 15-17 million pounds of antibiotics fed to food animals yearly.

In a family of five, statistically, four will have taken a doctor-prescribed dose of antibiotics during the previous year. Surprisingly, public health officials have stated that over half of the antibiotics used in the U.S are inappropriate or not necessary.

Two issues arise from this over-consumption of antibiotics. First, antibiotics kill all bacteria, the good bacteria which are needed for proper digestion of nutrients, along with the harmful bacteria. Second, the more bacteria-killing antibiotics we consume, the more we’re alerting those insidious little devils to evolve and adapt — to survive. “The bad bugs are getting stronger and they’re getting stronger faster,” says Mark Plotkin, in the book, The Killers Within. Dr. John I. Pitt, in his book The Genus Penicillium, was more ominous in his prediction: “It is ironic that this humbled fungus, hailed as a benefactor of mankind, may by its very success prove to be a deciding factor in the decline of the present civilization.”

PBS on its Frontline series investigated the rise of deadly drug-resistant bacteria with the program: Hunting the Nightmare Bacteria.

The show featured a segment on KPC, a deadly bug that infected the National Institute of Health in Bethesda, Md. leaving twelve patients dead. Over a period of months and isolation wards, doctors were unable to ward off the deadly bacteria. Antibiotics did not work. The last KPC patient fatality came to NIH for bone marrow issues. A year after the initial outbreak, this patient entered the hospital, was soon infected with the KPC virus and died.

Methicillin-resistant Staphylococcus aureus — MRSA, another deadly bacteria, was also featured in the Frontline program. MRSA, like KPC makes its home in hospital settings and is almost impossible to detect and eliminate. Yearly it is estimated that approximately 19,000 people die from MRSA infections; infections that had been contracted in a hospital setting. In some cases, as with NDM1, once these drug-resistant bacteria invade the body of a patient, they co-opt the bacteria in the body to become drug-resistant bacteria. As one medical professional described it: “it’s like putting a new red unwashed t-shirt into the laundry with white t-shirts; at the end of the wash, they’re all pink.” Unfortunately, once this invasion takes place, little can be done medically.

To date, 44 states have reported hospital outbreaks for these deadly untreatable bacteria. But, apparently states are not required to report these drug-resistant outbreaks, so it is believed by many that more states and hospitals may be involved.

Transitioning to a world without antibiotics is unimaginable. Going back in time, to when common infections could kill; and when surgeries were rarely done, is difficult for the mind to grasp. Yet, health care professionals around the world are sounding the warning.

This step-back-in-time medical environment won’t happen overnight, however, if the experts are correct, the world is going to change dramatically in the coming years.

In the meantime, this writer will be washing his hands a lot, looking for non-antibiotic organic food labels, and avoiding hospitals like the plague, no pun intended.

Robert Ross can be reached by e-mail at: SanDiegoRoss@Yahoo.com

Copyright 2014 by Robert Ross, all rights reserved