Be very scared of the post-antibiotic world

I keep hearing ever more and ever more scary stories about the growing antibiotic resistance of many harmful bacteria.  I still remain optimistic that we’ll figure something out before we see millions and millions of people again dying of routine bacterial infections (largely based on the fascinating research I read about in Good Germs, Bad Germs)but I might just be naively optimistic.  This Wired story is scary and really puts things in perspective:

This week, health authorities in New Zealand announced that the tightly quarantined island nation — the only place I’ve ever been where you get x-rayed on the way into the country as well as leaving it — has experienced its first case, and first death, from  a strain of totally drug-resistant bacteria. From theNew Zealand Herald:

In January, while he was teaching English in Vietnam, (Brian) Pool suffered a brain hemorrhage and was operated on in a Vietnamese hospital.

He was flown to Wellington Hospital where tests found he was carrying the strain of bacterium known as KPC-Oxa 48 – an organism that rejects every kind of antibiotic.

Wellington Hospital clinical microbiologist Mark Jones (said): “Nothing would touch it. Absolutely nothing. It’s the first one that we’ve ever seen that is resistant to every single antibiotic known.”

Pool’s death is an appalling tragedy. But it is also a lesson, twice over: It illustrates that antibiotic resistance can spread anywhere, no matter the defenses we put up — and it demonstrates that we are on the verge of entering a new era in history. Jones, the doctor who treated Pool, says in the story linked above: “This man was in the post-antibiotic era.”

And here’s the really scary part:

If we really lost antibiotics to advancing drug resistance — and trust me, we’re not far off — here’s what we would lose. Not just the ability to treat infectious disease; that’s obvious.

But also: The ability to treat cancer, and to transplant organs, because doing those successfully relies on suppressing the immune system and willingly making ourselves vulnerable to infection. Any treatment that relies on a permanent port into the bloodstream — for instance, kidney dialysis. Any major open-cavity surgery, on the heart, the lungs, the abdomen. Any surgery on a part of the body that already harbors a population of bacteria: the guts, the bladder, the genitals. Implantable devices: new hips, new knees, new heart valves. Cosmetic plastic surgery. Liposuction. Tattoos.

We’d lose the ability to treat people after traumatic accidents, as major as crashing your car and as minor as your kid falling out of a tree. We’d lose the safety of modern childbirth: Before the antibiotic era, 5 women died out of every 1,000 who gave birth. One out of every nine skin infections killed. Three out of every 10 people who got pneumonia died from it.

Yowza!  I hope somebody has written a good science fiction book about this.  I sure hope it doesn’t become science reality.

About Steve Greene
Professor of Political Science at NC State http://faculty.chass.ncsu.edu/shgreene

3 Responses to Be very scared of the post-antibiotic world

  1. Mike from Canada says:

    I heard a podcast article slash interview on bacteriophage therapy via the Scientific American podcast. The therapy seems promising but is not without it’s problems. I couldn’t find the podcast, but I did find this excerpt from a book on the subject published in 2011 called “The Forgotten Cure” by Anna Kuchment.

    http://www.scientificamerican.com/article.cfm?id=are-phage-viruses-forgotten-cure-for-superbugs

    A bacteriophage is a virus for bacteria. Bacteriophage are thought to be the most prevalent life form on earth.

    Scientists have engineered bacteriophage to carry a targeted gene to the bacteria which makes the bacteria susceptible to antibiotics again. This could be used to treat strains such as MRSA.
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3264097/

    The problems with the technology:

    You need to use a specific virus for a specific bacteria or more practically use a dose containing numerous strains to fight an unknown bacterial infection.

    The FDA requires each and every bacteriophage to be used to be tested first. This makes it extremely uneconomical to test.

    They are a preexisting organism, and not patentable under current law so combined with being expensive to get past the FDA makes them of little interest to the pharmaceutical companies.
    Targeted specific changes to the patent law could help, and the US is currently pushing a trade bill that would make some organisms patentable in jurisdictions where they currently are not.

    If or when antibacterial resistant strains become common I suppose there will be a demand to change the regulations. We will demand change if people start dying again, or losing limbs because a small cut became infected.

    On the more good news front a new type of antibiotic has been found:
    http://www.medicalnewstoday.com/releases/254246.php

    Rather then destroying the bacteria cell wall like common antibiotics this drug interrupts an interior mechanism called the thioredoxin system that is required for growth and DNA replication in bacteria. But the drug “has a long way to go” Swedish researchers say.

    So in the meantime try to avoid hospitals, stepping on any rusty nails or getting bit by animals.

    • Steve Greene says:

      Love your advice in that last paragraph. If we do truly reach a crisis point, I just think there’s enough smart people working on this that we’ll get something figured out before the plot of my theoretical dystopian novella becomes real.

  2. Mike from Canada says:

    I should have differentiated that the main bacteriophage treatment is simply using a virus to destroy the bacterial infection.

    The link to the engineered bacteriophage that makes them susceptible to antibacterials is a secondary line of research.

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