Working for the Enemy

            After all this extensive talk about the science behind antibiotic resistance, and possible alternatives for the future, it’s time to address what solutions can be put in place immediately. These solutions can be put in place through policy changes and greater awareness. Which is why it needs to be noted that antibiotics are here to stay for the time being because there have been no concrete alternatives yet. Bacteriophage therapy is a possible solution but great science takes time and rushing a solution from such an unknown source can be extremely risky. It may take years before alternative medicines engineered from bacteriophages can effectively eliminate all possible bacterial infections and used without any harmful side effects.

         If changes can be made to the way people use these drugs or to the areas where these drugs are used profusely then maybe we can make antibiotics work for us until a foreseeable future where these drugs are no longer needed.

         What are these changes? Well…most of them are simple common sense ones that can be done by the individual through making good choices everyday. As mentioned in previous articles people can be more careful when taking their doses of antibiotics, finishing all their prescribed courses properly, using less antimicrobial soap or hand sanitizers that can kill off good bacteria and disrupt the human microbiome. However, a larger issue needs to be discussed: the agricultural industry.

         Even if more regulation is put in place for stricter oversight of prescription antibiotics and people become more conscious of their daily habits, antibiotic use in the food industry is still the elephant in the room.

         According to an annual report published by the Food and Drug Administration, it was stated that the amount of antibiotics sold to farmers and ranchers for use for increasing livestock growth went up by 16% from 2009 to 2012. This number seems to be steadily increasing at high rates.

         The National Chicken Council spoke for the industry and stated that it didn’t matter that antibiotics are used in agriculture because they are not the same ones used in human medicine. However, the FDA states that this is not the case.

         Sale of cephalosporins, a class of antibiotics that are prescribed in human medicine, to farmers rose by 37% from 2009 to 2012. This contradicts industry claims. After extensive pressure from public interest groups and the Congress, the FDA introduced a federal policy in 2013 that stated that food manufacturers had to change their labels and ensure that they no longer use antibiotics to increase growth rates in animals and that they can only use antibiotics to treat a sick animal.

This policy has been criticized, however, for being weak and full of loopholes. The FDA has been accused in the past of being too lenient with factory farms because until 2013 the FDA’s policy on antibiotic use was that they would request or suggest companies to change their stance on drug use but not coerce or force. Many critics accuse the FDA of being under the influence of big industry.

Until the FDA can come up with stricter standards, overexposure to antibiotics is always going to be a risk. Modifying your diet and buying antibiotic free meat and dairy is a start but it is not a comprehensive solution because you can still risk consuming antibiotics when going out to eat at fast food chains or restaurants that don’t prescribe to the antibiotic free meat policy. The only thing to do in this case is make better food choices and make more people aware of this problem and urge the consumers to demand a better product.

References:

Blaser, M. (2014). Missing Microbes: How the Overuse of Antibiotics Is Fueling Our Modern Plagues (1st ed., Vol. 1). New York City: Henry Holt and Company.

Tavernise, S. (2014a, September 18). U.S. Aims to Curb Peril of Antibiotic Resistance. The New York Times. Retrieved from http://www.nytimes.com/2014/09/19/health/us-lays-out-strategy-to-combat-crisis-of-antibiotic-resistance.html

Tavernise, S. (2014b, October 2). Antibiotics in Livestock: F.D.A. Finds Use Is Rising. The New York Times. Retrieved from http://www.nytimes.com/2014/10/03/science/antibiotics-in-livestock-fda-finds-use-is-rising.html

http://www.fda.gov/downloads/ForIndustry/UserFees/AnimalDrugUserFeeActADUFA/UCM416983.pdf

Fighting fire with fire

The past few blog posts have been all about information and awareness about a growing health concern: antibiotic resistance. After all the facts and examples have been considered, it is clear that this phenomenon cannot be ignored any longer. However, is it a lost cause or an inevitable fight against organisms that will just continue to evolve against anything we throw at them?

In order to come up with innovative solutions we must examine what bacteria are and what they can do to survive. Pathogenic or disease-causing bacteria are parasites. They invade the host, prey upon and colonize healthy tissue. Antibiotics can help fight these infections but overuse of them results in these predators evolving resistance. How do we work around this?

Researchers came up with a very unique solution for this conundrum. They reasoned that the only way to defeat a predator is with a higher predator, namely viruses. 

There are viruses in nature that prey on very specific bacterial hosts. These species are classified as bacteriophages. Biologists are convinced that these species are the key to a new solution for bacterial infections. They believe this approach can be ideal because bacteriophages are host specific parasites that can only attack the species of bacteria that they are compatible with. Essentially, each phage species have only one species of bacteria as a host. They are incapable of invading any other types of cells because of this specificity.

A recent study published in 2014 investigates the possibility of using these bacteriophages to target infectious Escherichia coli. E. coli is a fairly common species found in a wide range of hosts including humans, however, there are several highly pathogenic strains that infect cows, sheep and other livestock. These pathogens can be found in beef, poultry, and dairy. To prevent the cases of these infections food manufacturers have to resort to the overuse of antibiotics on farm animals.

The researchers injected a cocktail of designed bacteriophages that target E. coli into white mice in order to see if there was a reduction in level of the bacteria present in the mice. The results showed that the bacteriophages were effective in reducing the level of E. coli exponentially. The authors state they saw the lowest levels of E.coli in the mice on the 7^th and 8^th day after the injection. They stress that this method can be beneficial in the agriculture industry as a form of biocontrol used to prevent the growth of E.coli in livestock and processed food. This solution is also promising because 70 percent of antibiotics in the U.S. are used up by the agricultural industry. Cutting this number down will mean that antibiotic exposure will reduce to a level that will ensure that they won’t become obsolete before people are ready for them to be.

The study that was cited in this post was not the only approach being considered. Several studies have been done over the years to examine bacteriophages that target pneumonia, salmonella, and tuberculosis to name a few. It is possible that within the next few decades these bacteriophages will make using antibiotics an old fashioned remedy.  

References

Abdulamir, A. S., Jassim, S. A., & Abu Bakar, F. (2014). Novel approach of using a cocktail of designed bacteriophages against gut pathogenic E. coli for bacterial load biocontrol. Annals of Clinical Microbiology and Antimicrobials, 13, 39. doi:http://dx.doi.org.mutex.gmu.edu/10.1186/s12941-014-0039-z

Fighting Against the Modern Plagues

         In today’s post, it is time to talk about awareness, but most importantly about who is spreading this awareness. One individual who is taking up arms against antibiotic abuse and incompetent health practices is Dr. Martin J. Blaser who will be the main topic of this blog post. 

         Dr. Blaser has a long list of reasons why he is qualified to comment on this particular subject. He has studied microbiology for over 30 years, been the President of the Infectious Disease Society of America, the founder of the Foundation for Bacteriology and served as the Chair of the Board of Scientific Counselor of the National Cancer Institute.

         Recently however, Dr. Blaser has been a frequent appearance in media due to his new book which came out in 2014 called Missing Microbes: How the Overuse of Antibiotics is Fueling Our Modern Plagues. The book explains in detail Dr. Blaser’s personal experiences in the healthcare industry related to antibiotics, but also research pusblished by other biologists over the years. Dr. Blaser addressed many concerns about antibiotics in the book, from the increase of the use since the world wars to the importance of the human microbiome. It is a very interesting read that is designed for people from all types of education levels and occupations and not just the scientific community. That’s what makes this book an invaluable resource when it comes to spreading the message about the flaws in health practices concerning antibiotics.

         Dr. Blaser does discuss several of these flaws in detail. In his webpage discussing the release of the book, he talks about the human microbiome which is defined as a community of microorganisms that live in symbiosis within the human body. Some of these bacteria are useful or even essential for proper biological function, some are inert or neutral, and some are harmful. However, the harmful species of bacteria are never allowed full reign of the human body because there are other species that keep the system in a tenuous balance. This means that overuse of antibiotics not only have the potential of increasing the resistance of the harmful bacteria in our microbiome but also killing off the good or the neutral species that keep the microbiome stable.

How do we start to fix this problem? This cannot be done overnight and Dr. Blaser stresses this point as well. Although his book tries to inform the public about an issue that has been kept out of the spotlight of the media over the last few decades for most of the chapters, it also ends on a very promising note. The last chapters of the book emphasize common sense solutions until modern science discover new alternatives that can truly declare antibiotics obsolete.

Some of the solutions are remarkable simple like asking your doctor if there are other options besides antibiotics, keeping track of every course of antibiotics you take throughout the year, following the doctor’s presecription faithfully and not skipping doses, or not choosing to take antibiotics altogether for minor infections that just require time and rest to heal.

Other solutions are ones that most people don’t often consider like cutting back the use of hand sanitizers and using ordinary soap instead. Overuse of these can kill off the good bacteria on the skin. One other solution is to buy only anti-biotic free dairy, produce and meat. This is often an area where people can consume antibiotics without even knowing just how much they are putting in their body.

         There are many more issues, examples and solutions that Dr. Blaser goes over in his book. If you want to stay informed, stay healthy and stay antibiotic-resistance free then give Missing Microbes a read!

References

Blaser, M. (2014). Missing Microbes: How the Overuse of Antibiotics Is Fueling Our Modern Plagues (1st ed., Vol. 1). New York City: Henry Holt and Company.

A National Strategy?

Human beings are locked in a perpetual arms race with bacteria that constantly adapt to whatever antibiotics we throw at them. Since they hand off these adaptations as “weapons” to other non-resistant species through DNA transfer and essentially recruit new members to the superbug army it is time to start leading a charge against these microbial invaders.

Who better to do that than the commander-in-chief himself? On September 18^th President Obama signed an executive order to establish a strategy to deal with this looming health crisis. This order was written after the President’s Council of Advisors on Science and Technology submitted a 65-page report to the President for consideration.

The national strategy includes ideas for the development of new drugs, more regulation in the dispensing of existing ones, and improvements in tracking the bacteria that are resistant to them. This is the first time the White House has directly addressed this issue. The President created a national task force composed of officials from Health and Human Services. He also required that the task force provide a 5-year action plan by February 15, 2015.

Can this national strategy be the first step in winning this war?

Biologists and health experts who criticize the strategy state very compelling points. New drugs, regulation and oversight cannot account for the fact that Americans use more antibiotics that any other industrialized countries.

The executive order also completely ignores a very important contribution to antibiotic resistance: agriculture. The FDA estimates that over 70 percent of antibiotics in the US are given to animals and that this amount is six times that of Denmark and Norway. These drugs are used to prevent infections in closely packed livestock and to increase growth rates.

What use are brand new drugs and oversight of resistant species when the antibiotics that create these bacteria are present in every bite of chicken or sip of milk we take? Biologists and health experts are disappointed that the White House has not taken any steps to cut back this abuse of antibiotics in large-scale factory farming.

         The CDC states that this constant exposure to antibiotics from food can lead to selective pressure on bacteria to evolve a certain way. We are essentially challenging these organisms to survive an antibiotic-saturated world. The data gathered over the years shows that they are more than capable of accepting this challenge several times over. A timeline created by the CDC shows that as soon as a new antibiotic is introduced into the population it only takes a few short years for a strain that is resistant to the new antibiotic to emerge and spread.

If it is the administration’s intention to overwhelm these organisms with new “miracle” drugs then it just means that we are providing them with a new challenge. Natural selection will ensure that they will succeed in these endeavors too.

        

         After observing all the evidence that shows how disastrous this situation can be for the future, can a solution ever be possible? A solution where you can eliminate bacterial infections AND ensure that the bacteria don’t get wise to the plan and evolve. Several experiments have been done and an innovative new approach is that fights fire with fire is possible. However, that is a potential topic for another blog post!

References

Obama Administration Takes Actions to Combat Antibiotic-Resistant Bacteria. (n.d.). Retrieved November 16, 2014, from http://www.whitehouse.gov/embeds/footer

Tavernise, S. (2014, September 18). U.S. Aims to Curb Peril of Antibiotic Resistance. The New York Times. Retrieved from http://www.nytimes.com/2014/09/19/health/us-lays-out-strategy-to-combat-crisis-of-antibiotic-resistance.html

Threat Report 2013 | Antimicrobial Resistance | CDC. (n.d.). Retrieved November 12, 2014, from http://www.cdc.gov/drugresistance/threat-report-2013/index.html