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Superbugs: How Antibiotic-Resistant Bugs Are Killing Mankind

Forget ISIS, Obama, Trump, Clinton, and the Kardashians. Set aside even cancer, diabetes, and traffic accidents. The No. 1 threat to civilization might very well be good old bacteria.

At the conclusion of his December 11, 1945, Nobel Lecture, Sir Alexander Fleming hypothesized about an “ignorant man” giving himself “not enough to kill the streptococci but enough to educate them to resist penicillin.”

The man who shared the 1945 Nobel Prize in Physiology or Medicine with Ernst Boris Chain and Sir Howard Walter Florey “for the discovery of penicillin and its curative effect in various infectious diseases” warned of what we now refer to as “antimicrobial resistance” (AMR).

Random changes in organisms’ DNA can have no effect, they can be helpful, and they can be harmful. How you describe such effects is all a matter of perspective.

Take bacteria. Here, courtesy of BoingBoing and Harvard Medical School, you can “watch bacteria become resistant to antibiotics in a matter of days.”

That’s good for the bacteria. But at the very best, that’s neutral for us humans. And it may indeed signal something really, really bad.

The Harvard Medical School video is titled “The Evolution of Bacteria on a ‘Mega-Plate’ Petri Dish.” This mega-plate petri dish measures two feet by four feet.

Random changes in organisms’ DNA can have no effect, they can be helpful, and they can be harmful. How you describe such effects is all a matter of perspective.

Researchers divided the petri dish into nine bands and lined the base of it with normal levels of agar. The background is black, while the bacteria — Escherichia coli, or E. coli — are white.

In the two outside bands, the researchers put no antibiotic. In the next two bands, “there’s barely more than E. coli can survive,” with a value of one for purposes of the experiment.

The next two bands contained 10 times as much, the next two after that 100 times as much. The center band contained 1,000 times as much antibiotic as E. coli can survive.

After 11 days, the bacteria penetrated and dominated the center band.

The experiment illustrates “the process of accumulating successive mutations” that allows the bacteria “normally sensitive to an antibiotic” to “evolve resistance to extremely high concentrations in a short period of time.”

We’ve been using antibiotics and similar drugs — collectively known as “antimicrobial agents” — for more than seven decades. Such drugs are used to treat patients who have infectious diseases.

But their use has proliferated to an extent that we’re now confronting a novel challenge: AMR.

According to an October 2015 study published by the journal PLoS Biology, “Antibiotics are commonly used in animal husbandry, beekeeping, fish-farming and other forms of aquaculture, ethanol production, horticulture, anti-fouling paints, food preservation, and domestically. This provides multiple opportunities for the selection and spread of antibiotic-resistant bacteria.”

These are what are commonly referred to now as “superbugs.”

Dame Sally Davies, currently Chief Medical Officer for England and formerly a professor with the London School of Medicine, framed the problem during a September 23, 2016, conversation with William Karesh of the Council on Foreign Relations:

We misuse antibiotics everywhere.

So over 50% of antibiotics worldwide are used in animals and agriculture, including fish farming, actually. In the States, about 80% of your antibiotics are used in animal production. They’re used for growth promotion and in well animals. So they’re actually substituting for good hygiene and sanitation. And as a result, infections — drug-resistant infections — are more prevalent in the States. My working assumption is that your waste disposal is effective, your sewage is effective. But if you go to big farms in China, where they also use antibiotics for growth promotion, the runoff from those farms is full of antibiotics because when animals, including the human animal, eat antibiotics and/or take them, we excrete 70% to 80% of the antibiotics as they are. The rest is residue. So it goes straight into the environment, unless you’ve got good waste management.

According to the Centers for Disease Control and Prevention, “at least 2 million people per year in the United States become infected with bacteria that are resistant to antibiotics, and at least 23,000 people die as a direct result of these infections.”

These are what are commonly referred to now as “superbugs.”

Worldwide, the number is more than 700,000. By 2050, we could be looking at 10 million AMR-related deaths per year.

For reference’s sake, cancer kills about 8.2 million worldwide annually.

We’re doing fantastic things in medical science and biotechnology these days — immunotherapy holds significant cancer-cure promise, gene editing could help us solve Alzheimer’s, robotic surgery will make operations less invasive and more precise, we’re helping quadriplegics “feel” things via neural implants.

But we’ve fallen behind on some of the basics.

One problem is that the market for antibiotics just isn’t very lucrative. There’s much more money in cancer drugs, for example, or diabetes and hypertension drugs, which have small margins but generate profits over the long haul because patients use them for life.

And that’s where pharmaceutical companies’ research and development dollars are going.

We can treat cancer, but a cancer patient might, along the way, develop an infection for which there is no antibiotic. So they survive the cancer but die from the infection.

Vaccination — which is just a way to stimulate the body’s natural immune response in order to fight infection — is another alternative to widespread human use of antibiotics.

Right now, the problem is a lack of access to antibiotics, rather than resistance of bacteria to antibiotics.

But that could change. And it will change we continue to prescribe antibiotics without a diagnosis supporting that prescription. Persistent overuse in agriculture is also a significant problem.

Government entities can wave the flag for “new antibiotics and better diagnostics and better ways of surveillance,” as Dame Sally Davies put it.

At the same time, “It’s not in our hands to impact the veterinary use or the fish-farm use. It’s not in our hands to do more than to comment and advise on the environmental contamination.”

We can treat cancer, but a cancer patient might, along the way, develop an infection for which there is no antibiotic. So they survive the cancer but die from the infection.

Innovation is now getting a jump-start in the AMR race.

France-based Eligo Bioscience recently secured 2 million euros from Seventure Partners to fund research into a potential CRISPR-based solution to the AMR problem.

And Iterum Therapeutics will use $40 million in Series A funding to launch an antibiotic licensed from another, unnamed company.

Iterum was founded by former executives of Durata, the subject of a November 2014 $675 million buyout by Actavis, which itself was subsequently acquired by Allergan.

Durata’s antibiotic Dalvance is used to treat adults with skin infections.

Heavyweights are also making their presence felt, as Allergan Plc (AGN), AstraZeneca Plc (AZN), GlaxoSmithKline Plc (GSK), Johnson & Johnson (JNJ), Merck & Co. Inc. (MRK), Novartis AG (NVS), Pfizer Inc. (PFE), and Sanofi SA (SNY) are among the “signatory companies” to a “roadmap to combat antimicrobial resistance” announced September 20, 2016.

Mutations — the “raw materials of evolution” — are what made us. But mutations may, ultimately, be the death of us, too.


A group of undergraduate students at Stanford University’s Chemistry, Engineering & Medicine for Human Health institute (ChEM-H) are working on “novel antibiotics from scratch that might one day stand up to superbugs.”

The students are focusing on two bacteria with high mortality rates that are resistant to nearly all antibiotics, Pseudomonas aeruginosa and Acinetobacter baumannii. Their plan has already attracted a $10,000 grant from the ChEM-H institute.

Filsinger Interrante, one of the students, told Stanford News, “We believe that these diseases are so bad that if we develop something that actually works, doctors will use it and hospitals will want to have it.”

Smart Investing,

David Dittman
Editorial Director, Wall Street Daily

David Dittman

, Contributing Writer

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