Small things #4: Why a little bug is a big cause for concern

Posted: September 16, 2010 in Drugs, Medical wonders, Uncategorized
Tags: , , , , , ,

Drug resistant bacteria. Image from the Centre for Disease Control, via Wikimedia Commons

Bacteria. They’re tiny. Often useful. And deadly, when our immune systems are unable to keep them in check. In today’s first world we’re so used to taking antibiotics at the first sign of an infection that the idea we could actually die from one seems improbable, almost laughable.

But bacteria are wildly prolific – and so fast in reproducing that new varieties spring up with relative ease. And the latest varieties are nastier than anything we’ve seen in a long, long time. They are resistant to almost every form of antibiotic we’ve created. And all because they carry a gene, which makes them produce an enzyme, which single-handedly puts most antibiotics out of action.

A medical study released last month has tracked the emergence and spread of new drug resistant bacteria carrying this enzyme, called NDM-1 (New Delhi metallo-beta-lactamase). They appear to have sprung up first in India and Pakistan, upon whose populations this new misery can be expected to wreak havoc, while also spreading inexorably worldwide.

Here in the comfort of our first-world cities, it’s easy to think we’ll be safe. After all, our hospitals are good, our sanitation excellent, our vigilance high. And we trust our drug companies to stay ahead of the game, when there’s money to be made from the creation of new drugs.

But drug development is painstakingly slow, and as global travellers return from trips abroad, the newly antibiotic-resistant bacteria are spreading. Already, cases are reported from the USA, Asia, Canada and Europe, with the first mortality recorded in Belgium.

Right now, we don’t know much about the exact origins or spread of the new bacteria. But almost all that stands between us and a return to pre-1930’s mortality rates due to bacterial infection are 2 antibiotics. One is more than 50 years old. The other is new, but not suitable for use in pregnancy or childhood. And this should have us worried.

The stats on what we could expect from a new ‘superbug’ are sobering. Before the discovery of antibiotics, death from bacterial infections was common. They killed people undergoing all kinds of surgery and after giving birth, those with open wounds, severe burns and respiratory illnesses.

This should be a huge concern to all of us. Science is good at finding solutions to problems. But when it comes to the development of new drugs, it’s neither fast nor cheap. Right now, there’s very little in the development pipeline to help us in the short term.

So what will?
Firstly, good sanitation is urgently needed in the developing world, and particularly in India and Pakistan where millions of people are currently exposed to raw sewage. Fix this, and you immediately slow down the rate of exposure.

Secondly, medical tourism must be curtailed, starting immediately. It may be cheaper in the short term to get your dental, cosmetic or surgical work done overseas, but is it worth risking your life, or others to possible infection? Once a superbug arrives, it’s here to stay – just think golden staph, and it’s multiple-drug-resistant cousin, MRSA.

Thirdly, new types of antibiotics are needed, and urgently. Governments need to start throwing money into research which will help us keep ahead of this looming crisis.

Fourthly, all countries need to be highly vigilant about tracking and stopping the spread of these resistant bacteria. Once they get into our hospital systems, they will be extremely difficult to eradicate – increasing misery and mortality within our communities, and putting our lives in jeopardy.

Finally, we need to stop using antibiotics so regularly. This means reducing their use in food production, not demanding a cure every time we have a cold, ensuring doctors prescribe them only where necessary, and preventing their sale over-the-counter, particularly in the developing world. We also need to take them properly – in the right amount, at the right time, and without cutting corners. So that our own bodies don’t become incubators for new types of drug-resistant bacteria.

Basically, it’s the over-use of antibiotics which has landed us in this situation in the first place. As history shows, they are one of our most precious resources – and they’ve just become a whole lot more scarce. Which should give us all the heeby-jeebies.

For more information, check out the ABC’s short history of antibiotics, the original research paper in The Lancet, and this news article from The Globe.

  1. Antibiotic-resistant bacteria have been an emerging worry for public health officials: Earlier this year, the World Health Organization warned that gonorrhea was quickly becoming untreatable , and antibiotic-resistant bacteria was found in 37 states earlier this year.

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