The Catastrophe of Antibiotic Resistance

March 6, 2015

By Medical Discovery News

The Catastrophe of Antibiotic Resistance

The World Health Organization has categorized antibiotic resistance as “a major global threat” and multidisciplinary research teams estimate it could lead to 10 million deaths each year by 2050. Bacteria that cause disease in humans can become resistant to the drugs used to treat them, and this poses a growing problem to public health.

Antibiotics were first introduced in the 1940s with the discovery and development of penicillin and saved many people from otherwise life-threatening infections. This one class of drugs has had an incredible impact on decreasing the severity of infections and saving lives.

Lately antibiotics have become overused and misused, which has allowed bacteria to mutate in ways that render antibiotics relatively powerless. Bacteria were one of the earliest life forms on Earth and remain one of the most successful, present everywhere from Arctic glaciers to geothermal springs. Because they are masters of adaptation, exposure to antibiotics causes the bacteria to accumulate mutations that will allow them to ignore the action of the antibiotics. That’s why doctors should only prescribe an antibiotic in the likelihood of a bacterial infection, and why it’s important to take all of the prescribed doses of an antibiotic. Otherwise, you can give the bacteria enough contact with the antibiotic to mutate but not enough to kill them, and they can come back stronger.

Half the use of antibiotics does not come from a doctor’s office or hospital, but a farm. Chickens, pigs, cows, and other livestock raised for food production are fed antibiotics to prevent infections and for faster weight gain. Many countries now ban this practice, and in 2013 the U.S. Food and Drug Administration (FDA) asked pharmaceutical companies to voluntarily curtail the sale of antibiotics directly to famers. Today, 26 pharmaceutical companies will only issue antibiotics for animals with a veterinarian’s prescription.

Infections by drug-resistant bacteria can be twice as likely to result in hospitalization and death. And while some bacteria are resistant to a single antibiotic, others are resistant to many. Methicillin-resistant Staphylococcus aureus (MRSA), multi-drug-resistant Neisseria gonorrhea, and multi-drug-resistant Clostridium difficile are superbugs taking a devastating toll worldwide. Some bacteria have mutated against all forms of antibiotics normally used to treat them, leaving no effective treatment options. Such infections are occurring around the globe in both rich and developing countries.

Legislation in the U.S. Congress proposes to permanently ban antibiotics that are used in humans from being used in livestock as well.  However, some argue that there is not a clear link between the antibiotic-resistant bacterial strains generated in livestock practices and those seen in human disease, which requires more intense research to answer. Whatever the outcome, the emergence and spread of antibiotic-resistant bacteria must be stopped. We also desperately need to develop new antimicrobials human use.

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First in the No. 2 Business

June 13, 2014

By Medical Discovery News

Antibiotic resistance among disease-causing bacteria is a growing and dangerous problem. Bacteria resistant to one or antibiotics, like Staph and Strep, are approaching catastrophic levels. Bacteria so resistant to common antibiotics that few if any drugs are available to treat them have been dubbed superbugs. One widely feared bacterium, called Clostridium difficle or C. diff for short, causes intestinal disease so severe that it can become life-threatening. It kills almost 15,000 Americans every year, mostly the elderly. Super-resistant forms of this microbe are almost impossible to treat with antibiotics. 

This bacterium produces a powerful toxin that destroys intestinal cells and can rupture small blood vessels. It also causes abnormal intestinal behavior, mainly excess water that produces diarrhea. It’s an unpleasant and painful prospect for those infected with C. diff. 

Roughly 5-15 percent of the population carries this bacterium in their digestive system naturally, but it is kept in check by the rest of the bacterial population. But an underlying disease, antibiotics, another infection, or chemotherapy can weaken bacterial systems, allowing C. diff to expand into an infection. And a super-resistant version of C. diff can be a real problem.

As gross as it may sound, fecal transplants are getting lots of attention as an option for C. diff infections. First tried in the late 1950s, the rationale for this approach is that the disease occurs because the bacterial populations are disrupted, so providing a source of normal bacteria restores the ecology of the intestine and prevents C. diff from growing. 

Where exactly does one find fecal matter for such a transplant? It’s not as if anyone wants to ask family or friends to share their poop. Actually, there are major regulatory obstacles for fecal transplants. For instance, the fecal source must test negative for disease-causing bacteria, viruses, and parasites. Basically, it’s not something anyone can find at Whole Foods or on Amazon.

So a group of enterprising graduate students at the Massachusetts Institute of Technology (MIT) who observed a friend’s struggle with C. diff formed a company to distribute safe, certified fecal matter for transplant. OpenBiome collects, tests, and distributes fecal matter like a blood bank distributes blood. Samples are certified by Food and Drug Administration (FDA) procedures, which cost about $3,000. Then they are frozen at super-cold temperatures (-112 degrees) and shipped to hospitals and physicians. Currently, the company operates as a nonprofit and only collects a shipping and processing fee for transplant material.

We already know that our normal bacterial systems, which together make up our microbiome, help protect us from skin, urogenital, and oral diseases. Changes in our microbiome may also contribute to an underlying disease like diabetes. There is still much to be discovered about these organisms that call our bodies home, especially since we house 10 times more microbes than our own cells!

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