So I have been engaged in an ongoing discussion recently about antimicrobial resistance, which is a subject that has both interested and concerned me since I was an undergraduate student studying microbiology. I even spent a summer working in Purdue University’s Animal Disease Diagnostic Lab. My project was part of a large, ongoing study to monitor changes in antibiotic resistance of pathogens found in domesticated animals. Given that I have some familiarity with the nature of antimicrobial resistance, I thought that this would be both an interesting subject about which I could write, and also a valuable topic about which to raise awareness.
So first things first. I suppose that I should make sure everyone is on the same page here. What do I mean by “antimicrobial resistance”? Well, the World Health Organization (WHO) offers this definition: “Resistant organisms (they include bacteria, fungi, viruses and some parasites) are able to withstand attack by antimicrobial medicines, such as antibiotics, antifungals, antivirals, and antimalarials, so that standard treatments become ineffective…” This means that infections can only be fought off by the individual’s immune system. Infections persist longer, are more likely to be spread, and are more likely to lead to severe complications, or even death. This also means that the cost of treating the infection increases.
Frankly, I find this idea terrifying. Antibiotics are the reason that you and I seldom think twice about cuts, scrapes, and scratches. People used to die from such things (consider reading the tragic tale of Albert Alexander, the first person to be treated with penicillin). Antibiotics are one of the main reasons that surgeries are so much more successful now, as they reduce the risk of dying from an infection acquired as a result of cutting your body open. Antibiotics contribute to the success of chemotherapy by preventing infection as a result of having your immune system suppressed by chemotherapy drugs. Antibiotics allow organ transplants, joint replacement, and implants of all sorts to be more successful, since these operations require suppressing the immune system. Antibiotics are literally a life-saver for people suffering from auto-immune disorders, as their immune system must also be suppressed lest it eventually kill them.
These are the obvious benefits, but did you realize that antibiotics also help to keep prices low for the meat, eggs, and dairy that you buy at the grocery store or Walmart? If you have never wondered why a steak at the grocery store costs so much less than a locally-raised, grass-fed, antibiotic and hormone free steak from your local farmer’s market, the simple answer is volume. Factory farms can pack chickens or cows into a very small space, and feed them on a very tightly-controlled diet. The drawback of a high-density feedlot, however, is that the animals are more prone to infection than free-range animals. Not only must they contend with the immune-dampening stress of such crowded conditions, but the enforced proximity ensures that infections are rapidly spread through the flock or herd. The popular solution to this problem has been to lace their feed with antibiotics as a preventative measure to reduce the risk of infection.
So with this information in mind, consider what our world would be like without antibiotics. Imagine going back to a world where the common cold could lead to your death from pneumonia because there are no drugs that can treat the infection. Imagine going back to a world where surgery must be considered a last resort, because surviving the operation itself is no guarantee that you will be able to survive an ensuing infection. This is a frightening scenario to me, but one that we might very well have to face someday. In this post I have given a brief overview of what antimicrobial resistance is, and how it affects us. In my next post (or possibly posts, depending on how verbose I end up being), I would like to discuss how resistance develops, and why the problem of resistance is growing.