It is naive to think we can win.
David Livermore, MD
In the late 1940s, the successes of Waksman and Schatz (streptomycin) and Duggar (tetracycline) led many to believe that bacterial infections were basically conquered. That conceit led to widespread misuse and outright abuse of antibacterial agents. Nonetheless, we still neither fully understand nor appreciate resistance to antibacterial agents…. Many important advances in the practice of medicine are actually at serious risk. Multi-drug resistant bacteria are compromising our ability to perform what are now considered routine surgical procedures…. A ubiquitous phrase encountered in obituaries is “died from complications following surgery,” but what is not well understood is that these “complications” are quite frequently multi-drug resistant infections.
—Steven Projan, Bacterial Resistance to Antimicrobials
We have let our profligate use of antibiotics reshape the evolution of the microbial world and wrest any hope of safe management from us…. Resistance to antibiotics has spread to so many different, and such unanticipated types of bacteria, that the only fair appraisal is that we have succeeded in upsetting the balance of nature.
—Marc Lappé, When Antibiotics Fail
It’s hard to escape the realization that when it comes to bacterial disease we are in trouble. Twenty years ago, when my interest was first stimulated by it, there might have been a newspaper article on antibiotic resistance or a resistant disease outbreak perhaps once a month. I come across them almost daily now. The headlines often look like this:
Hospital Continues to Limit Visitors as It Fights Superbugs
Ottawa Citizen, December 21, 2010
Staph Bacteria: Blood-Sucking Superbug Prefers Taste of Humans
Science Daily, December 16, 2010
Hospitals preparing for killer bug
AsiaOne, December 2, 2010
Eight Deadly Superbugs Lurking in Hospitals
Nikhil Hutheesing, Health Care, October 17, 2010
New “superbugs” raising concerns worldwide
Rob Stein, Washington Post, October 11, 2010
New Drug-Resistant Superbugs Found in 3 States
Associated Press, September 14, 2010
The Spread of Superbugs
Nicholas Kristof, New York Times, March 7, 2010
Report: Superbugs killed record number
UPI, May 23, 2008
Sometimes they take a more personal turn:
The fight for life against superbugs
Boonsri Dickenson, Smartplanet, March 24, 2010
‘The NHS failed my mum,’ says distraught daughter
Grantham Journal, December 14, 2010
The ‘catalogue of errors’ that cost this father his life
Denis Campbell and Anushka Asthana, The Guardian, November 27, 2010
The first sort of article (i.e., “Superbugs on the increase in care homes,” Daniel Martin, The Mail Online, July 16, 2007) tends to focus on numbers and statistics and rarely reflects the human face of the problem. Such articles often end with a statement from a government or medical authority mentioning how new procedures are being instituted or that new antibiotics are just down the road a ways (they aren’t). Nothing to be concerned about even though it sounds a bit scary, say the experts; we have it all in hand (they don’t).
The second sort of piece, growing more common every year, presents the human face of the problem. These articles are rarely so blasé. This report, from an article by Sarah White, “The empowered patient,” is representative. It recounts the story of Jeanine Thomas (who later began a “survivors of MRSA support group”) and the moment when all those headlines changed from the theoretical to the very personal:
Thomas’ expertise in the MRSA patient perspective comes from her life-threatening battle with bacteria. In 2001, she was in critical condition after contracting MRSA [methicillin-resistant Staphylococcus aureus] following ankle surgery.
“You’re just living a normal life—never been sick, never been unhealthy, and all of a sudden you are fighting for your life. And this is happening to individuals every day,” Thomas said.
The infection went to her blood stream and bone marrow and caused septic shock and organ failure. After undergoing multiple surgeries including a bone-marrow transplant and a “never-ending cycle of antibiotics,” she survived the ordeal.1
Thomas survived relatively intact. Some don’t, losing limbs in a desperate bid to stop the infection from spreading and then living permanently debilitated lives. Others aren’t even that “lucky.”
Denis Campbell’s and Anushka Asthana’s article appeared in November 2010 in the English paper The Guardian. It describes the last few months of Frank Collinson’s life.
Ex-docker Frank Collinson, 72, was admitted to hospital following a fall in May 2009. When he went home days later he had cracked ribs and a skin infection…. Four months later he was dead….
Soon after arriving in Hull’s main hospital, Collinson contracted the deadly superbug MRSA. Astonishingly, no health professional told his son, Gary. It was only by Googling the name of the drug being administered through a drip that Gary discovered that it was a strong antibiotic and that his father had the potentially fatal infection. “I went ballistic,” he said.2
This is often how the personal face of the resistance epidemic emerges into someone’s awareness. They, or a relative, go into the hospital for a minor procedure or for help after an accident but what they find in the hospital is far worse than the trouble that sent them there in the first place.
Devastated siblings still reeling from the death of their mother several months ago continue to push for answers on how she contracted a deadly superbug.
Fiona Weatherstone and her four brothers were shocked when their 73-year-old mother, Sylvia Weatherstone, died at Lincoln County Hospital after being admitted for a simple pain-killing injection….
It was in January that Mrs. Weatherstone, formerly of Bristol Close, was admitted for a nerve root injection to numb pain in her back, caused by severe pressure on a nerve root.
The following day, Mrs. Weatherstone’s health began to deteriorate and tests were undertaken to find the source of an infection.
Several days later, C. Diff [Clostridium difficile] was diagnosed and Mrs. Weatherstone later passed away after a month in hospital.3
In fact, other than factory farms, hospitals and doctors’ offices are the primary breeding ground of superbugs. A simple injection or a minor surgery can now, fairly routinely, lead to months in the hospital, or loss of limb, or loss of life. It’s a new world out there, or rather it’s an old one that is letting us know there is a price to be paid for hubris….