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You, drug-resistant superbugs, and what's for dinner?

Updated 12-16-22

Just learning about superbugs and antibiotic resistance? Listen to Maryn McKenna's TED talk and then read her oeuvre (links below) and more on the subject.

 What do we do when antibiotics don't work anymore? "Penicillin changed everything. Infections that had previously killed were suddenly quickly curable. Yet as Maryn McKenna shares in this sobering talk, we've squandered the advantages afforded us by that and later antibiotics. Drug-resistant bacteria mean we're entering a post-antibiotic world — and it won't be pretty. There are, however, things we can do if we start right now." A large percentage "of the antibiotics sold in the United States each year are given to livestock as "growth promoters" that allow animals to put on weight more quickly, or as prophylactic regimens that protect against the confined conditions in which they are raised." Listen and/or read transcript. (March 2015)
Can a Federally Funded ‘Netflix Model’ Fix the Broken Market for Antibiotics? (Andrew Jacobs, NY Times, 12-16-22) Shortages and drug-resistant germs have renewed attention on a $6 billion proposal in Congress that would reconfigure the way antimicrobial drugs are developed and sold. Recent shortages of amoxicillin, an effective antibiotic that pediatricians have long relied upon to treat strep throat and ear infections in children, have put a spotlight on an urgent global threat: the world’s shrinking arsenal of potent antibiotics and the lack of incentives to develop them. The broken marketplace for new antimicrobial drugs has stirred debate over a bill, languishing in Congress, that would dramatically reconfigure the way antibiotics are discovered and sold in the United States.

      "The measure attempts to address the vexing economics of antibiotics: Promising new drugs often gather dust on pharmacy shelves because health providers would rather save them for patients whose infections don’t respond to existing ones. That’s because the more frequently an antibiotic is used, the more quickly it will lose its curative punch as the targeted bacteria develop the ability to survive. New antibiotics also tend to be expensive, a disincentive for hospital-based prescribers who will often turn to cheaper ones, making it even harder for drug companies to earn back their initial investment." [A complex issue: Do read the whole article.]
‘Superbug’ scourge spreads as U.S. fails to track rising human toll (Ryan McNeill, Deborah J. Nelson and Yasmeen Abutaleb, Reuters, 9-7-16) Fifteen years after the U.S. declared drug-resistant infections to be a grave threat, the crisis is only worsening, a Reuters investigation finds, as government agencies remain unwilling or unable to impose reporting requirements on a healthcare industry that often hides the problem. Even when recorded, tens of thousands of deaths from drug-resistant infections – as well as many more infections that sicken but don’t kill people – go uncounted because federal and state agencies are doing a poor job of tracking them.
Superbugs in Your Supper (More, March 2015) Whenever you eat chicken or beef, you’re probably also eating a side order of antibiotic-resistant bacteria. Learn how to protect yourself.
Drug-resistant superbug spreading in hospitals: study (Patrick Galey, MedicalXPress, 9-3-18) "A superbug resistant to all known antibiotics that can cause "severe" infections or even death is spreading undetected through hospital wards across the world, scientists in Australia warned on Monday....Researchers at the University of Melbourne discovered three variants of the multidrug-resistant bug in samples from 10 countries, including strains in Europe that cannot be reliably tamed by any drug currently on the market....The bacteria, known as Staphylococcus epidermidis, is related to the better-known and more deadly MRSA. It's found naturally on human skin and most commonly infects the elderly or patients who have had prosthetic materials implanted, such as catheters and joint replacements.
Deadly, Drug-Resistant ‘Superbugs’ Pose Huge Threat, W.H.O. Says (Donald G. McNeil Jr., NY Times, 2-27-17) 'The rate at which new strains of drug-resistant bacteria have emerged in recent years, prompted by overuse of antibiotics in humans and livestock, terrifies public health experts. Many consider the new strains just as dangerous as emerging viruses like Zika or Ebola. “If we leave it to market forces alone, the new antibiotics we most urgently need are not going to be developed in time." ...Most of these deaths occur among older patients in hospitals or nursing homes, or among transplant and cancer patients whose immune systems are suppressed. But some are among the young and healthy: A new study of 48 American pediatric hospitals found that drug-resistant infections in children, while still rare, had increased sevenfold in eight years, which the authors called “ominous.”
'The W.H.O. listed six pathogens as “high” priority. They include methicillin-resistant Staphylococcus aureus, better known as MRSA, which is responsible for about a third of “flesh-eating bacteria” infections in the United States, and antibiotic-resistant Neisseria gonorrhoeae, which causes gonorrhea. The W.H.O.’s third category was “medium priority,” which included drug-resistant versions of Streptococcus pneumoniae, Haemophilus influenzae and shigella, all three of which cause common childhood infections. For now, most of those infections are curable, but doctors fear that resistant strains will push out weaker ones. Tuberculosis was not on the W.H.O.’s list even though lethal drug-resistant strains — known as MDR-TB and XDR-TB — pose a major threat, because there are programs targeted at it.'
How Your Chicken Dinner Is Creating a Drug-Resistant Superbug (Maryn McKenna, The Atlantic, 7-11-01) "Continuing to treat urinary tract infections as a short-term, routine ailment rather than a long-term food safety issue risks turning the responsible bacteria into a major health crisis." "There is no national registry for drug-resistant infections, and so no one can say for sure how many resistant UTIs there are. But they have become so common that last year the specialty society for infectious-disease physicians had to revise its recommendations for which drugs to prescribe for cystitis -- and many infectious-disease physicians and gynecologists say informally that they see such infections every week...."The E. coli that is circulating at the same time, and in the same area -- from food animal sources, retail meat, and the E. coli that's causing women's infections -- is very closely related genetically," said Amee Manges, Ph.D., an associate professor of epidemiology at McGill University in Montreal who has been researching resistant UTIs for a decade. "And the E. coli that you recover from poultry meat tends to have the highest levels of resistance. Of all retail meats, it's the most problematic that way."... 'About 80 percent of the antibiotics sold in the United States each year are given to livestock as "growth promoters" that allow animals to put on weight more quickly, or as prophylactic regimens that protect against the confined conditions in which they are raised.'
The Meat Industry Refuses to Track Drugs on America’s Farms—and It’s Making Superbugs Worse (Maryn McKenna, Mother Jones, 7-14-17) Alternatives to antibiotics exist, but farmers have no way to know when to use them.
Imagining the Post-Antibiotics Future (Maryn McKenna, Medium). After 85 years, antibiotics are growing impotent. So what will medicine, agriculture and everyday life look like if we lose these drugs entirely? (Produced in collaboration with the Food & Environment Reporting Network, an independent, non-profit news organization producing investigative reporting on food, agriculture and environmental health.)
Maryn McKenna's archive (she's the go-to source for information on superbugs)
Hunting for Antibiotics in the World’s Dirtiest Places (Maryn McKenna, The Atlantic, July/Aug 2017) Investigating possible sources: “Compost bin. Pig trough. Dog-food bowl. Laptop keyboard.” Investigating possible solutions: "“The hard thing isn’t finding things that kill bacteria; steam, fire, bleach can do that,” says John Rex, who led clinical antibiotic development at AstraZeneca and now is the chief medical officer at F2G, a firm working on new antifungal drugs. “The challenge is to find things that kill bacteria but don’t harm the person taking them. You’re talking about a chemical that goes into your mouth, into your gut, into your blood, unchanged, and winds up where the infection is and kills the bacteria, and yet is not toxic to you.” Taking the numbers seriously: Every year, at least 700,000 people die worldwide from infections that no longer respond to antibiotics. That toll could balloon to 10 million by 2050.

A little something extra in case you aren't concerned enough about our ability to treat serious infection:
Sepsis, defined (Sepsis Alliance) sep•sis -- "Sometimes called blood poisoning, sepsis is the body's often deadly response to infection....Sepsis has been named as the most expensive in-patient cost in American hospitals in 2011 at over $20 billion each year. Forty percent of patients diagnosed with severe sepsis do not survive. Until a cure for sepsis is found, early detection is the surest hope for survival. Up to 50% of survivors suffer from post-sepsis syndrome."
Links to more stories about sepsis "Sepsis can rage in response to incidents as seemingly benign as a playground scrape or a nicked cuticle from the beauty parlor."--Sepsis Alliance
Superbug: The Fatal Menace of MRSA by Maryn McKenna
New horizons?> Swapping Germs: Should Fecal Transplants Become Routine for Debilitating Diarrhea? (Maryn McKenna, Scientific American,11-2-11) A potentially beneficial but unusual treatment for serious intestinal ailments may fall victim to regulatory difficulties
For a deep and serious read: The Antibiotic Resistance Crisis. Part 1: Causes & Threats. (C. Lee Ventola, Pharmacy & Therapeutics, April 2015, on PubMed) and The Antibiotic Resistance Crisis, Part 2: Management Strategies and New Agents (C. Lee Ventola, Pharmacy & Therapeutics, April 2015).
Please let me know of other important, useful articles on the subject.

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