Chemicals that kill bacteria—termed antibiotics—are essentials tools for physicians to help cure disease. Until recent times, infectious illnesses were the major causes of death in all age groups, but a strategy of careful diagnosis and treatment, coupled with broad-based prevention efforts, has made this much less common. Unfortunately, though, the ability to successfully treated specific infections is imperiled due to the rise of “super bugs.”
A “super bug is defined as a strain of bacteria that is resistant to more than one of the antibiotics that typically would destroy it. For instance, there is a very common bacterium called staphylococcus—or staph—that is a frequent cause of skin infection. Many types of antibiotics, including a penicillin-relative named methicillin, are classically extremely effective at eradicating staph infections. But now there is an increasingly common strain called MRSA: this stands for methicillin-resistant staph aureus. It is a classic example of a superbug, for none of the typically-used antibiotics have any power to thwart it. MRSA, like other “super bug” infections progress despite standard medical care. Specialized treatment may be needed, sometimes even surgery to remove the infected tissue that cannot be cured by medication. People who develop infections with super bugs have a higher rate of hospitalization and even death.
While some superbugs originate from strains that predate antibiotics, the overall percentage of highly resistant bacteria has risen dramatically with the rise in use of antibiotics world-wide. Think about it: if the gene that confers antibiotic resistance is just a “useless quirk” in a group of bacteria—useless because there are no antibiotics around—then those bacteria have no advantage, they will not be unusually prosperous. But if there are antibiotics in the environment, then suddenly the bacteria with the gene for antibiotic resistance have a huge advantage. The surrounding/susceptible organisms will be killed, leaving extra space and nutrients for the superbugs, which will then divide and multiply unhindered until they are the sole strain of bacteria present. This is why it is commonly said “antibiotics cause antibiotic resistance,” though in reality the antibiotic resistance was always there and antibiotic use simply allowed those difficult-to-treat bacteria to flourish.
There are many examples of superbugs. The causer of that famous childhood scourge, strep throat, used to be reliably susceptible to penicillin, but now there are many strains that are impervious to its powers. Clostridium difficile (nicknamed “c.diff”) is a bacterium that can “take over” the intestinal tract of a previously asymptomatic carrier IF that carrier receives antibiotics for any reason. The kinder “good guy” bacteria of the gut get destroyed and c. diff becomes the boss! C. Diff infections cause very severe diarrhea that can result in hospitalization or even death. Another superbug example is multi-drug resistant tuberculosis. This is a major health problem in at risk populations; even combinations of up to seven powerful antimicrobials can be ineffective at saving the patient’s life.
What can be done to suppress the prevalence of superbugs? Ironically, the key strategy is to let the “non-super” bugs thrive! Avoiding unnecessary antibiotic use is essential; there are several ways to ensure this. The majority of antibiotics used in this country are agricultural, so, firstly, whether it is by consumer demand, farmer election or government regulation, the use of antibiotics in the food system must be drastically reduced. Antimicrobials are currently given to animals not just to treat, or to prevent illness, but because for an unknown reason the animals treated with them gain weight more quickly. People who ingest the meat of these animals run the risk of contracting illness with any superbug that the animal may have developed. This risk can be negated by being sure to properly handle and cook food. But more commonly, it is felt that chronic, low level of exposure to antibiotics in the food is the impetus for allowing increased superbug development in the ingestor. Avoiding food raised with antibiotics entirely is the only way to prevent this mechanism of resistance from occurring.
Reducing medical antibiotic use is important to controlling the prevalence of superbugs, too. The doctor part of this is obvious; physicians need to abstain from prescribing antibiotics unless there is evidence of a clear bacterial infection deemed too severe for the patient’s own immune system to handle. But there is an important patient aspect to this strategy, as well. By staying healthy—by NOT hampering the immune system with tobacco smoke or poorly-controlled diabetes, for example—a person markedly improves the chance that they’ll be able to vanquish an infection solely with the power of their own immune system.
Superbugs are increasingly common and cause increasingly difficult infections to treat. A common theme in All Things Human has been the value of the preventive approach, and this is a perfect example. By being selective in your food choice, fostering a healthy immune system, and engaging in a conversation with your doctor when you are ill regarding the true utility of antibiotics, you can reduce your likelihood of hosting that most unwelcome of all guests, the Super Bug.