An Article Written by Dr. Wise
Drug Resistant Bacteria
One of the current questions patients ask Me quite often today Is “What about bacteria which are resistant to antibiotics?”
The media is loaded with scary stories about such bacteria these days, seemingly looking for who is to blame. I know who is to blame.
Firstly what are the concerns? Much has been raised about methacillin resistant staph aureus (MRSA) and vancomycin resistant enterococcus (VRE). By reading those sensational articles It would seem that these new superbugs have been purposely created by hospitals and purposely given to the hapless for unknown malicious reasons. Rather than review actuality, hysteriae have been set forth on our country.
Nothing much has been said about multi-drug resistant tuberculosis bacteria or entero-pathogenic E Coli (EEC) which have become increasingly common.
When did you ever see a report about penicillin resistant bacteria? The last one I remember seeing was when I was in training as a medical technologist in the 1970’s.
Remember that wild and crazy guy named Darwin who sailed in a boat called the beagle to some lost islands somewhere off the coast of south america to study the animals which had been trapped as individual populations on those rockpiles to change over time into distinctly different forms? His famous study of finches and iguanas is masterful in it’s scientific importance. Basically, over time there is the survival of those forms best suited for a specific environment. The faster the generation time, the quicker the selection process is evident. Populations of Tortoises take a longer time to adapt than quickly replicating forms like fruit flies. Even faster adaptation can occur with fast dividing lifeforms like bacteriae. It doesn’t take long to exterminate the weak germs and select out the strong (resistant ) ones. Had Darwin known more about his future discovery at the time of his voyage ,He would have collected bacterial specimens also.
Tuberculosis is a bacteria which grows relatively slowly but is fairly resistant (like the sloth of the germ world). Typically , treatment with antibiotics is recommended for extended periods of time (12 months) in order to have a “curative” effect. The problem is that within a relatively short time after starting the medications to treat TB, the afflicted will feel better, move away and stop taking the antibiotics. This selects out the bacteria which are not killed by the antibiotics and they grow to cause more infections in other exposed persons. The result of this selection are strains of tuberculosis which are almost impossible to treat. This is a major world health problem that is not properly addressed.
EEC is a major problem, driven by greed and improper livestock practices. When cattle are crowded into unnaturally confined spaces such as feedlots to be fattened up for market, they get stressed and get severe diarrhea called the scours. This makes the cattle fail to fatten up, lose weight or even die. This causes the feedlot to lose money. The answer by the industry was to load the feed up with antibiotics to prevent the scours and increase weight gain. The bovine e-coli then can become resistant to all the antibiotics given. Soon they are resistant to all know oral antibiotic families. When bacteria from the cattle’s intestines get onto the meat products because of unsanitary slaughter the product is tons of hamburger full of dangerous bacteria. When that hamburger is handled non-hygeincally the cooks get sick and if not adequately cooked, those who eat the product often die.
Proper feedlot management can essentially prevent the scours without using antibiotic feeds and produce healthy fattened cattle, but not as fast . Proper slaughter techniques can minimize bacterial contamination of the meat, but is slower and less profitable. Bulk grinding of meat trimmings can produce prodigious volumes of inoculated burgers.
Greed , greed, and more greed.
Estimates of prevalence for VRE and MRSA in the united states is roughly %50 of the population! So, if you went to the mall and cultured 100 people in a row, 1/2 of them would have MRSA . Out of that same 100 people, 1/2 would have VRE . I have no idea what percentage of those 100 would have both, but it is known that bacteria are often very friendly to one another (even EEC to MRSA) and freely exchange genetic material called plasmids which contain drug resistance coding. That is the mechanism by which most of these resistances have spread in our population. We all have staphylococcus and enterococcus bacteria , and resistance development is inevitable with sufficient drug exposure.
Why are there no more reports about penicillin resistant bacteria? It is because essentially all bacteria in our bodies have become resistant to penicillin since it was discovered by Alexander Fleming on September 3rd 1928. After that date , antibiotic production and distribution has reached humongous industrial proportions. Just look at the ads on TV for a clue.
We could blame it all on the father of antibiotics but please don’t. Instead, why not Ask for rational policy on antibiotic usage in all areas of application from feedlots to clinics to hospitals? Please Don’t take antibiotics unneeded. Have cultures taken to assure proper selection of antibiotics and effective completion of treatment. Be certain to finish your course of antibiotic treatment properly , how many partial bottles are sitting in your medicine cabinet?
Remember that we live because of a delicate balance between that which is within and that which is outside of us all. Very Few live in a bubble. Neglecting the rules of our ecology will result in unintended, negative consequence.
Use your brain first and Stay Healthy !
Sam Wise MD