Losing Our Last Resort

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As we head into 2016, we have much to feel grateful for in this modern age. Technological marvels such as computers and high-speed Internet define an era of advancement that has exponentially sped up our society’s growth and capabilities. But amidst this impressive and fast-paced development, one crucial feature of humankind’s modern society is perilously close to collapsing.

        Of the many things we take for granted in the 21st century, protection against bacteria probably ranks the highest in terms of human impact. Of course, given our track record against such killer pathogens, this shouldn’t come as much of a surprise. Our species has lost repeatedly to plagues and disease since the start of human history. Pathogens such as bacteria, viruses, and other microorganisms are our oldest enemy.

        When it comes to fatal illnesses, a large portion of human history was spent without an adequate solution. In Europe, terrors such as the Bubonic Plague brought death to every door and we had no way of fighting back. It wasn’t until 1796 that our first real counterattack came with the invention of vaccines by English physician Edward Jenner. About 120 years later, Scottish biologist Alexander Fleming discovered penicillin, a powerful antibiotic produced by the blue Penicillium fungi, cementing our defenses against the pathogens and saving millions of lives. But the bad news is that we only thought we vanquished our invisible adversaries. In fact, they have only gotten stronger.

        You see, microorganisms like bacteria are not like fearsome monsters that disappear once you slay them. They’re much tinier, but there are so many of them that they are almost impossible to completely eradicate. And thanks to evolution, the ones that survive due to some bizarre mutation multiply uncontrollably until we’re faced with an upgraded version of our old foe. Every time this has happened in the past, scientists have responded with stronger, more toxic antibiotics, which deadly bacteria eventually thwart. Thus, advancements in antibiotics have always led to more-resistant bacterial strains with new ways to survive, causing an endless microbiological arms race that’s becoming more tenacious with each cycle.

        So, how long until our microbial enemies catch up to our highly sophisticated, advanced medicine? A hundred years? Two hundred? Actually, they already have. In a recent study conducted this year, a team of experts in China discovered strains of E.coli bacteria in livestock that could not be killed by antibiotics. Normal, right? Except the antibiotics in question were polymyxins, a class of antibiotics that have remained effective for the past sixty years since its discovery. These drugs represent the most potent of our arsenal against bacterial infections, our “last resort,” and they have proven to be useless against this new, impervious strand.

        Upon further investigation, the team identified the gene responsible to be MCR-1. Unfortunately, they also found this gene in 15% of the meat samples from food markets and 21% of livestock in Southern China over the span of four years. Even worse, the E.coli with this gene has already moved onto humans. Of the 1,322 samples from patients with bacterial infections, 16 of them had the MCR-1 gene.

According to Mark Woolhouse, a Professor of Infectious Disease Epidemiology at the University of Edinburgh, infections from antibiotic-resistant bacteria are already causing the deaths of tens of thousands of people every year. Taking the spread of the MCR-1 gene into consideration, that number will surely increase in the future. This could very well start an era of “pandrug-resistant” bacteria3 or, as some others have called it, the “antibiotic apocalypse.”

        But how did this become such a widespread problem so quickly? It turns out that the MCR-1 gene is found on plasmids, a mobile form of DNA that can jump from one organism to another. Therefore, bacteria can easily spread this gene to other bacteria through a process called horizontal gene transfer, which is the primary reason why antibiotic resistance is a problem in the first place. This is an awfully serious development since bugs like E.coli are “the most common form of hospital-acquired infection.” Scientists worry that there may soon come a time when more patients become ill from bacterial infections and doctors won’t be able to do a thing about it.

        To emphasize, this isn’t just some isolated, freak incident. A study from 2011 similarly found that the number of cases with bacteria resistant to carbapenems, one of strongest type of antibiotics in our possession, has increased dramatically from just 3 cases in 2003 to 333 cases in 2010. That’s an increase of over 11,000% in just 7 years.

        Experts have been worrying about this day since they realized bacteria could adapt to penicillin. Sure, scientists can just make a new, even stronger antibiotic, but unfortunately, we have long since passed the age of rapid antibiotic development — in fact, we’ve fallen several decades behind. In truth, our advancement in medicine has been steadily slowing down to a plateau, and bacteria have finally caught up and passed us.  

        It is rather ironic that this terrible news came in the middle of the first World Antibiotic Awareness Week. Just when this global campaign was trying to raise awareness and encourage strict regulations on antibiotics, this study further shows the urgency of the situation. But as much as this crisis seemed inevitable, it really wasn’t. Just as in any story with a moral, we essentially did this to ourselves. Almost every one of us contributed to this situation without even being aware of it. Because you see, the main reason why everything spiraled out of control was because our love of meat.

        It turns out that we have been using antibiotics beyond recklessly in the agriculture industry. According to reports, farmers around the world feed 63,000 tonnes of antibiotics to pigs, cattle, and chicken every year. That number is estimated to grow by 67% to 106,000 tonnes by 2030. That’s right: we have been feeding humanity’s most powerful antibiotics, our last resort against disease, into the mouths of livestock by the truckload. This is because people all over the world have been growing more prosperous in recent years, causing them to buy more meat products. According to the UN Food and Agriculture Organization (FAO), people in developing countries “now eat 50 per cent more meat per person, on average, than they did in 1983.” Livestock– including fish as well as eggs and dairy since they also come from livestock– has become a fast-growing market that we no longer can live without or get enough of.

        Thanks to skyrocketing demand, quick and efficient factory farms have become the norm. In order to keep the animals alive and fat, these farms feed them high doses of antibiotics. A whopping 80% of antibiotics consumed in the United States go towards livestock, and America is only in second place. On the list of excessive antibiotics use, China is the worst offender, consuming 50% more than the U.S. with a total of 15,000 tonnes per year, and that number is projected to double by 2030. India, Brazil, Indonesia, and Nigeria are all showing a worrisome upward trend in antibiotic use as well.

        Even if countries started banning the use of antibiotics as growth promoters in livestock, it’s too late to preserve antibiotics that already exist. Epidemiologists compare that to “closing the barn door after the horse has bolted.” By the time resistant bacteria are multiplying in humans (which they are), the problem is way beyond the control of farmers.

        There are other contributors to this problem besides livestock. Any unnecessary use of antibiotics only serves to further tip the scale in favor of deadly bacteria. Careless use of antibiotics to treat colds and the flu contribute to antibiotic resistance, since those sicknesses are caused solely by viruses, not bacteria. Overall, it seems lack of knowledge is the biggest factor in all this. A report by the World Health Organization (WHO) showed that 64% of everyday people who thought they knew about antibiotic resistance believed that antibiotics could be used for colds and the flu.

However, our doom isn’t quite sealed yet. Despite the grim forecast, experts still say that rigorously limiting the use of antibiotics could help greatly. The US Food and Drug Administration states that while banning antibiotics in animals may not stop all resistant strains, it can prevent bacterial infections like Salmonella, which sometimes infects meat, eggs, and dairy, from reaching the same danger levels.  Additionally, the U.S. Centers for Disease Control and Prevention advise people to take their antibiotics exactly as the doctor prescribes them, to never share leftover antibiotics, and to not ask for antibiotics if the doctor doesn’t think they’re necessary.

        While the situation does look bleak now, it still holds more hope than it did before the creation of vaccines and penicillin. Unlike before, we have weapons and defenses that stand a chance against one of the most powerful forces of nature. Under a united effort, humankind can still achieve a turnabout of miraculous proportions.

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