I was shocked as I read the news to find out that scientists found significant quantities of multiresistant bacteria in some German rivers and lakes. Some of them can cause severe diseases in humans and are especially dangerous to elder patients and newborns.
Now we know that this summer when you swim in the clear waters of Niedersachsen rivers, you may be surrounded by some deadly bacteria.
What does this mean?
Maybe not (directly) a problem for you, because your immune system is robust and healthy. But it could be dangerous to someone with a weaker or immature immune system.
Typically, when you get a bacterial infection if the medical doctors find it appropriate, they prescribe you antibiotics. The bad and also some good bacteria in your body die, and you recover. End.
But there is more.
Some bacteria just won’t die with any antibiotic. You may not recover as quickly or even suffer a very devastating disease.
This happens because the survival bacteria have been already in contact with the antibiotics before. And they have learned a couple of tricks. From an evolutionary point of view, a great example of natural selection.
From a human health point of view, means infections more difficult to treat.
Four things you can do to protect yourself, your family and your community
- Prevent the spread of resistance: the most important action we can all do is use antibiotics responsibly. Not long ago, every second child died of severe infections in the first year of life. Today, this can be primarily prevented thanks to in some cases simple medicine. Let’s keep this working! Take antibiotics only when adviced by a physician, take your pills regularly without missing any and bring back any leftovers to the pharmacy (in Germany you will be told to throw them to the bin, although I think it may be wiser to be more careful about antibiotics). This is called “Antibiotic stewardship.”
- Prevent infections: wash your hands, get your vaccines and prepare food safely.
- Advocate for antibiotic-free animal welfare.
- The truth is that resistance is a natural evolution fact in bacteria, we will not be able to stop it. Therefore we will always need new antibiotics. Support research!
What did the researchers find?
The technicians took the samples in places where they expected that the spread of resistant bacteria was possible. And oh, were they right!
The bacteria found in the rivers and near purification plants were resistant to antibiotics like Carbapenem. Carbapenem is a “reserve” antibiotic (it means that when all the other medicines don’t cure the patient, the medical doctors will try this antimicrobial. Mmmh… or maybe not anymore.)
The WHO published last year the first list of the deadliest bacteria to make clear who are our new small enemies so that scientists and the pharma industry can put the effort in the discovery of new treatments for these bacteria. The top 3 bacteria of the “WHO’s dirty dozen” list are resistant to Carbapenem, like the ones found in Germany.
Colistin, another antibiotic used almost exclusively in livestock (because of its side effects in humans), could also not kill the bacteria sampled from the rivers. Colistin resistance is unfortunate because like carbapenem, physicians use it as a treatment in humans when nothing else works.
The origin of these multiresistant bacteria seems easy to track to either the Clinic, the Nursing home or the farm because it is where the patients or livestock use it. But in reality, it is a bit more complicated.
What is antibiotic resistance?
That bacteria are resistant to antibiotics is not something new. Antibiotics can be highly specific for one subset of bacteria (narrow-spectrum) or fight a wide range of them (broad-spectrum). The selectivity of the medicine depends on what its biological target in the bacteria is.
A highly specific antibiotic will target only the bacteria that is causing the disease and not all the other “good” bacteria that colonise our digestive tract (we have circa ten times more bacteria than cells in our bodies, we can talk about our microbiome some other time).
But, it is not easy to know what type of bacteria is the cause of the infection. And it can be more than one type. For this reason, it is crucial to perform an Antibiogram: a laboratory test used to know the sensitivity of the bacteria to different antibiotics. This information helps practitioners use the right medicine.
Unfortunately, this test takes time (and money), and typically the treatment starts before the results come back from the lab.
After a couple of days, some of the bacteria examined will be killed by one or two, or all the tested antibiotics. But, what is not normal is that none of the antibiotics work.
These extremely difficult to kill bacteria are called multiresistant or superbugs.
It has been a while though, that the scientific community is talking more and more about the worldwide increase in multiresistant bacteria. Last month WHO released the first result of its multiresistant bacteria surveillance program GLASS (Global Antimicrobial Resistance Surveillance System): they reported that multiresistant bacteria are increasing everywhere in the world.
How does antibiotic resistance work?
Most of the bacteria that cause an infection will probably die with antibiotics. But likely, there will be one or two, or very few that will survive. Maybe they have a particular gene that confers them resistance, or they just did not get the right dose of antibiotic. In any case, bacteria multiply like crazy. Very fast this survivor bacteria will increase, and soon we will have a population of resistant bacteria.
But bacteria are like a wise old guy, and over millions of years have learned how to survive in this world. Bacteria share the information about resistance among them by a process called genetic transfer (actually, biology labs around the world use this method every day with different purposes, but we can talk about that in another post).
The increase in multiresistant bacteria in our environment means that we need to do something urgent about how we are using antibiotics for ourselves and for the animals we breed.
The best option you have at a personal level is to reduce the unnecessary treatments and wash your hands. Here in Germany, I can assure you it is challenging to get an antibiotic prescription. If you need to take them, do not forget to follow the instructions and finish the treatment. Think about that bacteria that is just sitting there being naughty and multiplying at speed light because the antibiotic that killed the others has just ended and you forgot to take the pill.
Another reason why you should care: did you know that you can be a healthy carrier of multiresistant bacteria? Even if you are feeling well, does not mean that you have nothing to do with the superbugs.
At a local level, we as consumers have the responsibility and the right to demand that the livestock be breed without antibiotics or at least use them responsibly. You can always choose meat from local farms that have a more traditional approach to breeding and take a distance from industrial animal husbandry. The meat industry has a lot of responsibility in the increase of multiresistant bacteria.
What do you think? Are we overreacting or are we facing a real problem for the 21st Century? Will it be easy to develop new antibiotics? I’m interested to know what you think. In the meantime, do not forget to wash your hands.
Image: Dr Graham Beards via Wikimedia Commons