We think humans are on the top of the food chain, but those small predators we cannot see can kill us. Several years ago, my son caught strep throat when he was at grad school in LA. He was heading home to New Jersey to help me move to Breckenridge. It was a particularly multi-drug resistant strain. He had gone to doctors in LA, NJ, Doc PJ in Breck, and again in LA as it kept recurring. He finally got better, but it took many months. Those clever little bacteria keep swapping genes and mutating in their quest for survival and, because they multiply so rapidly and in such prodigious numbers, their chances for survival in a challenging world are pretty high. They can even form spores which survive tough environmental conditions and lurk around for years only to grow again and divide when the conditions become favorable, like the nice moist lungs of an unfortunate victim. They were here on earth before we humans and will probably survive if the human species becomes extinct. As soon as penicillin was able to be produced in large amounts and used to save many soldiers from infections in WWII, there was evidence of resistant strains occurring. When you do not take the prescribed dosage for the full amount of time, usually a week, you are killing off the weak ones and selecting for the strong, more drug-resistant variety to survive, multiply and pass on their genes. For a disease like TB, you might need to take multiple drugs for months and even years; patient compliance is difficult, and drugs are expensive. As a consequence, multi-drug resistant TB is a major health threat.
Our biggest problem is that we are selecting for the fittest bugs when we bombard the environment with unnecessary antibiotics, like asking for a prescription when we have a cold or flu. Antibiotics work only against bacteria, and some bacteria are susceptible to certain antibiotics and not others; some are broad spectrum and some more specific. Colds and flues are caused by viruses and not bacteria. Some antibiotics work, for instance, to inhibit the cell wall synthesis of certain bacteria. Viruses do not have cell walls. The agriculture industry routinely puts antibiotics in feed, which apparently improves growth, and this is a major contributor to antibiotic-resistant superbugs like E. coli, which lives in the intestines of all animal species and can get into vegetables through contact with manure – and then jump into people. In hospital settings, we are seeing bacteria resistant to the strongest of antibiotics, so in essence we no longer have drugs to treat victims of once-common infections. Nearly 19,000 Americans, for instance died from MRSA (staph) infections in 2005, surpassing the death rate from AIDS.
Very few new antibiotics have appeared on the market. They are expensive to develop, put through clinical trials and get then get FDA approval. It takes years. Big pharmaceuticals don’t consider it a lucrative market. Recently, some small biotech companies are producing some new antibiotics. There are three in clinical trials or awaiting approval from the FDA. “Phage therapy” is being looked into again. These are tiny viruses which attack specific bacteria and destroy them. This therapy was being developed primarily in the former Soviet Union before it collapsed.
So take all of the prescribed antibiotic for a bacterial infection, don’t keep a few for “later,” and don’t share it with friends or family. If you do, you are not helping anyone, but those little bacteria. Whether we know it or not, like it or not, microbes rule the world.
Breckenridge resident Dr. Joanne Stolen is a former professor of microbiology from Rutgers now teaching classes at CMC. Her scientific interests are in emerging infectious diseases and environmental pollution.
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