Seven Scary Facts about Antibiotic-resistant Superbugs
7 scary facts about antibiotic-resistant superbugsJulia Belluz, "Vox".
Translated by InoSMI.
Scientists and doctors are cautious people, and they rarely draw apocalyptic scenarios. However, if we are not talking about antibiotic resistance. As we learn more and more that antibiotic-resistant superbugs can literally destroy humanity, we have an anxiety akin to concern about climate change. This is a terrible, but intangible threat, against which it is difficult to rally.
Despite the dire warnings about the impact of antibiotic-resistant bacteria on human health, this problem is still an abstraction for many; industry resists attempts to resolve it, and laws aimed at eliminating it are constantly blocked. We continue to abuse and squander one of the greatest gifts of science, which saves our lives. Inaction is puzzling and only exacerbates the problem associated with antibiotic resistance.
1) Superbugs will soon kill more people than cancerThere are billions of bacteria living inside and around us, and most of them help us survive and thrive.
But sometimes we get infected with bacteria that can make us sick. Antibiotics are chemicals from the organisms around us that can kill these harmful microbes. They don't just heal us when we get sick. These miracle drugs revolutionized medicine and changed the scale of modern food production.
But there is one major drawback in the use of antibiotics: the more we consume them, the faster they stop their effects. Since Alexander Fleming discovered the first antibiotic (penicillin in 1928), many scientists, healthcare executives and doctors have been increasingly sounding the alarm about antibiotic resistance.
Antibiotic resistance is a natural reaction to a drug. Bacteria multiply by billions, and some of them randomly mutate. Changes occur in their DNA, thanks to which these bacteria are able to outwit the drugs designed to destroy them. The situation is further aggravated by the fact that we use antibiotics too often, taking them in the wrong dosage. When we do not complete the course of treatment, or give antibiotics to animals in small doses to increase their weight, we create an environment in which the weakest superbugs die, and the strongest survive.
In recent years, such misuse of antibiotics has accelerated the natural process of resistance, which makes some antibiotics useless, forcing experts to warn that we are entering a "post-antibiotic era", which will become a nightmare for healthcare and a catastrophic threat not inferior to terrorism.
In the United States alone, 23,000 people die every year due to antibiotic-resistant infections, and two million diseases occur. We have already witnessed a number of bacterial infections (gonorrhea, carbapenem-resistant enterobacteria, tuberculosis strains) that are no longer cured by the medicines we have.
Excessive use of antibiotics also kills beneficial bacteria in the human body, can disrupt our intestinal flora and weaken the immune system. And this means that more people will get sick, that they will get sick longer and die from resistant infections, for which we have no medicines. And the cost of antibiotic resistance treatment will increase.
Recently, a report was prepared on behalf of the British government, which contains a very alarming forecast that by 2050 antimicrobial-resistant infections will kill 10 million people worldwide. This is more than the number of people currently dying from cancer.
This nightmarish scenario is very plausible for one simple reason: there is no way we can take the actions necessary to prevent it. There is simply incredible inertia in medicine, and the agricultural sector has been denying the data of science for many years for economic and political reasons.
2) Without antibiotics, medicine will collapseIt is no exaggeration to say that most of modern medicine, as well as our health, depend on the effectiveness of antibiotics.
Whenever we go to the hospital for surgery (hip replacement, anterior cruciate ligament surgery, heart surgery), almost all doctors, without exception, prescribe antibiotics to prevent infection. Antibiotics also make it possible to perform a caesarean section, and this operation ensures the salvation of the largest number of lives on our planet.
If there are no effective antibiotics, ordinary medical procedures such as hip surgery, cesarean section and chemotherapy will become much more dangerous, and some medical interventions such as organ transplants or the same chemotherapy will invariably have a fatal outcome. In one of her popular science articles, Maryn McKenna describes the world before the advent of antibiotics, as well as what awaits us if the available antibiotics cease to work:
"Before the advent of antibiotics, five women out of a thousand died during childbirth. Every ninth person died with a skin infection, which could be obtained from a trifling scratch or insect bite. Thirty percent of people with pneumonia died. Infectious diseases of the ear led to deafness, angina could be followed by a heart attack."
"It's just unimaginable," says Professor Kevin Outterson from Boston University Law School, "how a return to the pre–antibiotic era will affect American healthcare." An analyst from the Rand Corporation research center, Jirka Taylor, states: "When you have a five percent chance of contracting an infection, the mortality rate from which is 40 percent, do you want to agree to fairly simple operations such as hip replacement, if your life does not depend on it?"
3) We make the problem worse by using antibiotics incorrectly Most often we use antibiotics incorrectly and unnecessarily.
In agriculture, farmers give them in small doses to animals to increase weight and prevent infections (but not to treat them). In hospitals and polyclinics, doctors prescribe medications when they are not sure of the diagnosis, but want to fulfill the requirement of patients to cure them – despite the fact that they may suffer from a contagious disease (but not bacterial).
As Sarah Kliff noted recently, doctors have long known that it is impossible to cure bronchitis with antibiotics, and yet, in 71 percent of cases (!) they continue to treat it with antibiotics. According to the journal Nature, the average American child undergoes a course of antibiotic treatment 10-20 times before reaching adulthood. It turns out that he receives a dose of antibiotics every year or every two years. But according to authoritative estimates, in half of the cases he does not need antibiotics.
But most often we use antibiotics on farms. About 80 percent of the total amount of antibiotics produced annually, which ranges from 100,000 to 200,000 tons, is used for animals.
This happens for two main reasons: farmers have found that if animals are given small doses of antibiotics, they grow faster. And if you use antibiotics to prevent diseases, then they can be kept in a neglected state. This practice allows us to get cheap food, but it also exacerbates the problem of antibiotic resistance.
When animals pumped up with antibiotics are kept in mud and cramped, this creates ideal conditions for antibiotic resistance: small doses destroy the weakest bacteria, and the strongest survive.
4) We do not produce new and more effective antibiotics to fight superbugsOne of the most frightening features of today's antibiotic resistance crisis is that pharmaceutical companies are not creating new drugs to combat it.
Antibiotics simply do not bring them much profit, do not provide significant financial revenue. Unlike the treatment of chronic diseases, people use antibiotics for a short time. And now we know that we need to apply them even more legibly and carefully than before, which is not very pleasing to large pharmaceutical companies.
For this reason, many complain that "the supply of medicines has dried up." Over the past decade, only a small number of new antibiotics have entered the market, and medical organizations such as the American Society of Infectious Diseases are alarmed that new drugs are "unacceptably few."
5) Large companies like McDonald's are fighting the abuse of antibiotics, but there are a lot of loopholes in this case Food companies like Chipotle, Panera Bread, Applegate, and more recently McDonald's are joining the fight where the state fails.
They counteract the excessive use of antibiotics by taking various measures to limit the drugs that their suppliers can use, as well as to limit the duration of their use.
But such measures are often insufficient. McDonald's, for example, recently announced that within two years it will refuse to purchase chickens that are raised on human antibiotics.
However, this restaurant chain allows suppliers to use antibiotics for animals called ionophores. Such antibiotics are not prescribed to humans, but their excessive use for animals can negatively affect human health, since we know that resistance crosses the boundaries of types and classes of drugs.
This policy of McDonald's applies only to American restaurants, but not to tens of thousands of other food outlets that the company owns abroad. And it applies only to chicken meat, but not to beef, which is most often used in the company's menu. Yes, this is a step in the right direction, but given that food manufacturers are more interested in profit than in the health of the population, if McDonald's starts cheating, it should not be surprising.
Nevertheless, food manufacturers repeat in chorus that they are responding to consumer requirements. Such opponents of antibiotics as Louise Slaughter, a member of the House of Representatives, say that buyers should continue to put pressure on leading food companies by voting with their money. "We must force the American people to declare that they will not buy steaks stuffed with antibiotics; that they do not want chickens dipped in clorox bleach; that they demand to feed him and his children healthy and healthy foods; that antibiotics should be protected for sick animals and people."
6) Agriculture is strongly against reforms, which is why the US is late with its measures.Not only do we lack new and effective antibiotics; we are unable to implement measures to reduce the consumption of antibiotics.
American lawmakers have repeatedly put forward bills to reduce the excessive use of antibiotics. But the agricultural industry invariably torpedoes these efforts, and the bills have not yet passed through Congress.
For example, Rep. Louise Slaughter, who is the only microbiologist in Congress, is leading efforts to end the overuse of antibiotics on farms. To this end, a draft law "On saving antibiotics for medical treatment" was prepared. Since Slaughter came to Congress in 2007, this bill has been put forward four times, and each time it failed in the House of Representatives.
As Slaughter says, "450 organizations, that is, every single consumer association, scientific groups, every medical association imaginable, support our bill. But 88 percent of the money that is spent on lobbying on this issue is spent against us."
Other efforts are being made at the federal level to address the problem of antibiotics on farms. The Food and Drug Administration reports that the use of antibiotics in food production has been causing problems since the 1970s. But the agricultural industry and pharmaceutical companies disrupt and block efforts aimed at combating this phenomenon, and large food businesses need cheap products.
For example, in December last year, the Food and Drug Administration issued a guideline calling for the reasonable and careful use of antibiotics on farms to increase animal weight. But this guide is optional. "Over the years that I have been working on this issue," Slaughter says, "I have come to the conclusion that the Food and Drug Administration does not intend to protect us. Similarly, the Department of Agriculture and the White House do not intend to protect us."
Scientists and legislators, concerned about the growing problem of antibiotic resistance, are trying to force the American agricultural sector to follow the example of Denmark and other European countries, where farmers use antibiotics only to treat animals.
7) We know that we need to solve the problem of antibiotic resistance. We just don't do anything for it.To truly solve the problem of antibiotic resistance, we need a global plan.
Superbugs move around the world as easily as people on airplanes. Actions on a global scale will not only protect us all, but also minimize the costs of this work, making sure that the use of antibiotics in agriculture equally affects farmers around the world.
As stated in the editorial of the latest issue of the Bulletin of the World Health Organization, "a binding international legal mechanism covering issues of access, conservation and innovation is needed. When international law receives a powerful mechanism of implementation, it becomes the strongest incentive to action for all countries."
To solve the problem, we need to rationally use the available stock of antibiotics and create new species. But having known about this for more than a hundred years, we are nevertheless doing terribly little to contain the crisis of antibiotic resistance. We continue to abuse antibiotics in medicine, use them in our food and use them in literally everything, from yoga mats to sanitary and disinfectants.
However, there is some good news. Last year, something like a turning point came when a number of states and international organizations promised to start the fight against superbugs. One researcher in the pages of the New England Journal of Medicine described these efforts as follows:
"In April, WHO announced that this problem poses a "threat to the achievements of modern medicine." The post-antibiotic era, in which common infections and minor wounds will become deadly, is a very real prospect of the 21st century. In May, the World Health Assembly commissioned WHO to draw up a global action plan on antimicrobial resistance. In June, the British society voted to award a state prize of 10 million pounds for the best solution to the problem of antibiotic resistance. And in September, the Presidential Council on Science and Technology published a report on antibiotic resistance, timed to coincide with the decree of President Barack Obama, who instructed the National Security Council, in cooperation with a government expert group and a non-governmental advisory council, to develop a nationwide action plan by February."
The Obama administration also established a $20 million award for the creation of a new system of diagnostics and tests at the place of medical services, and also proposed to double federal spending on research in the field of antibiotic resistance.
No similar actions have been taken in matters of saving, although other countries have been engaged in the prudent use of their antibiotics for decades. So, in 1971, Britain banned the use of certain antibiotics in agriculture to accelerate the growth of animals. Following her example, Denmark also gradually abandoned growth stimulants, followed by Norway and Sweden. By 2006, the entire European Union had abandoned the use of antibiotics to accelerate growth.
It's amazing, but these efforts did not affect production in any way. According to one Danish study, although the agricultural sector halved the use of antibiotics in pig farming between 1992 and 2008, it managed to increase productivity, and at the same time production costs did not increase one iota. In America, this experience has not been used, and there politics and economics continue to suppress science. Only time will tell whether we are doing enough in this regard, and whether it is too late.
Portal "Eternal youth" http://vechnayamolodost.ru17.03.2015