The Race to Stay Ahead of Antibiotic-Resistant Superbugs

October 27, 2015 | l

By Dr. Mercola

Antibiotics are a foundational component of modern medicine, without which many of our current treatment modalities and medical procedures become exceedingly dangerous.

Due to overuse, and the downright reckless misuse of antibiotics for growth promotion purposes among livestock, bacteria are becoming increasingly resistant to these drugs. As a result, even “simple” infections like urinary tract infections can become lethal.

A recent example that drives home this point is New York Giants player Daniel Fells, whose foot may have to be amputated due to an antibiotic-resistant infection.

As reported by Scientific American:1

“[T]he NFL reports that Fells was taken to the emergency room with a high fever a week after getting a cortisone shot to relieve pain from toe and ankle injuries.

Doctors found that his ankle was infected with a bacterium called methicillin-resistant Staphylococcus aureus, or MRSA, and they fear that the infection might have spread to Fells' bone, which could make an amputation necessary...”

Most MRSA Infections Are Acquired in Hospital Settings

According to data from the Centers for Disease Control and Prevention (CDC), more than 75,000 cases of life-threatening MRSA infections were reported in 2012. The vast majority of them, nearly 60,000, were acquired in health care settings.

It’s unclear whether Fells’ MRSA infection was transmitted via the cortisone injection he received. Dr. Bo Shopsin, who was interviewed for the Scientific American story, noted he sees up to 10 people a year who acquired a staph infection from a medical injection.

Either way, cases such as these show just how risky it can get when there are no effective antibiotics left. It’s also driving up health care costs — a price that livestock manufacturers do not take into account when calculating the cost of not using antibiotics.

As previously noted by Scientific American:2

“[R]esearchers estimate that antibiotic resistance causes Americans upwards of $20 billion in additional healthcare costs every year stemming from the treatment of otherwise preventable infections.”

One in 25 Patients Contract a Hospital-Acquired Infection

MRSA infections are only one type of infection resistant to drugs. There are many others.

In the CDC’s 2013 report “Antibiotic Resistance Threats in the United States,” no less than 18 superbugs were identified as “urgent, serious, and concerning threats” to humankind.3 

The majority of these dangerous bacteria are in the gram-negative category, because that variety has body armor that makes it extremely resistant to the immune response.

Most disturbing of all, some forms are now exhibiting “panresistance” — meaning, resistance to every antibiotic in existence. One of the latest multi-drug resistant bacteria that is gaining ground is Carbapenem-resistantEnterobacteriaceae (CRE), which produces an enzyme that breaks down antibiotics.

Hospitals are again the most common source of this infection, which is lethal in about 9 percent of all cases. When the CRE infection affects the blood, the death rate jumps to 50 percent.4

According to the most recent CDC data,5 hospital-acquired infections now affect 1 in 25 patients. In 2011, an estimated 722,000 patients contracted an infection during a stay in an acute care hospital in the US, and about 75,000 of them died as a result of it.

Moreover, a study6, 7 published online in The Lancet Infectious Diseases on October 15, 2015 warns that half of all post-surgical infections, and over a quarter of infections occurring after chemotherapy, are now caused by antibiotic-resistant organisms!

As reported by Medical News Today:8

“A 30 percent reduction in the efficacy of antibiotic prophylaxis (preventive use of antibiotics) could result in 120,000 additional infections and 6,300 infection-related deaths every year in the US alone.”

A report9 commissioned by the British government estimates that by the year 2050, drug-resistant disease will cause more than 10 million deaths and cost the global economy $100 trillion annually.

But that’s not all.

Add to the danger of drug-resistant infection the increased risk for other more chronic health problems, such as obesity and allergies10 — both of which have been linked to antibiotic overexposure — and the cost of antibiotic overuse mounts even further...

The Routes of Contamination in Hospitals Are Many...

Besides injections, other common modes of transmission of infections in hospital settings include invasive procedures such as central lines and catheters. 

However, researchers have also discovered that health care personnel often transfer pathogens onto their skin during the removal of protective gear such as gloves and gowns.

Using a black light to check for contamination, the researchers found that contamination of the hands, forearms, neck, face, hair, or clothing occurred 46 percent of the time. What’s worse, when personnel failed to use proper protective equipment technique, contamination occurred 70 percent of the time.

This drives home the point that even minor flaws in anti-contamination technique, such as putting on or pulling off your protective gear in the wrong sequence, can have a dramatic impact on the spread of deadly bacteria. Senior author Dr. Curtis J. Donskey told Scientific American:11

"Most of the participants appeared to be unaware of the high risk for contamination and many reported receiving minimal or no training in putting on and taking off (personal protective equipment).”

Antibiotic-Susceptibility Testing Is Flawed, Experts Say

Interestingly, researchers have also discovered that the routine test used to determine which antibiotic to use for hard-to-treat infections doesn’t work properly when used on antibiotic resistant bugs, because while they behave one way in the lab test, they behave differently in the human body. And this only adds to the difficulty in treating these kinds of infections.

As reported by Bloomberg:12

“‘We’re saying the standard way the world does this is wrong,’ said Michael J. Mahan, a professor of Microbiology at the University of California, Santa Barbara. That standard protocol, established in the 1960s, is called antibiotic susceptibility testing: Bacteria are grown in a solution called Mueller-Hinton broth, and then attacked with various antibiotics to see which one works best...

When [Mahan’s] team tested salmonella in the petri dishes that labs typically use, an antibiotic called polymyxin killed the bacteria. But when they grew salmonella in petri dishes formulated with a material that more closely resembles the cells the bacteria infect, the antibiotic was useless. They concluded that the bacteria's defenses — essentially the mechanisms that make superbugs ‘super’ — can switch on or off depending on their surroundings.”

Another study found similar results. In this case, the antibiotic azithromycin failed to kill antibiotic-resistant bacteria in the lab test, yet worked fine in infected mice. Apparently, once inside animal tissue, the perceived “superbug” lost its superpowers.

According to the lead researcher, the antibiotic-susceptibility test does not accurately translate into how the drug will perform in an actual patient, noting that, "The patient’s not made out of Mueller-Hinton broth." Stanley Maloy, former president of the American Society for Microbiology also told Bloomberg that:

"It’s really clear from these papers that there are key examples where the way we’ve been doing things up until now is probably inadequate. It is a very big shift."

Agriculture Is a Primary Driver of Antibiotic Resistance

It’s important to realize that just about any infection can become life-threatening these days. This is why the irresponsible approach of the agricultural industry is so egregious. Use of antibiotics in food production is a major factor driving the development of antibiotic resistant bacteria, yet the industry is doing very little to address its role in this growing health threat.

The US uses nearly 30 million pounds of antibiotics each year to raise food animals.13,14 This accounts for about 80 percent of all antibiotics used in the US,15 and nearly 70 percent of these antibiotics are considered “medically important” for humans.16

Even the US Food and Drug Administration (FDA) acknowledges that antibiotic-resistant disease can be spread via ingestion or contact with contaminated foods, yet despite that knowledge the agency has opted not to ban the use of antibiotics in agriculture. Instead, three years ago the FDA simply recommended that pharmaceutical companies voluntarily re-label certain antibiotics,17,18 reserving them for use in sick animals only. As reported by Mother Jones,19 this has had virtually no effect on the way antibiotics are used:

“The FDA's policy phases out growth promotion but leaves prevention intact — even though giving animals small daily doses of antibiotics to ‘prevent’ disease is virtually indistinguishable from giving them small daily doses to promote growth.

A 2014 Pew analysis found no fewer than 66 antibiotic products that the FDA allows to be used for ‘disease prevention’ at levels that are ‘fully within the range of growth promotion dosages and with no limit on the duration of treatment.’ In other words, you change the language you use to describe the practice and continue giving your herd of 4,000 confined pigs the same old daily dose of antibiotics.”

California Passes Law to Curb Use of Antibiotics in Food Production

To address these federal regulatory shortcomings, California recently passed its own state law to restrict antibiotic use in livestock.20 While the bill still allows antibiotics to be used as “prophylaxis to address an elevated risk of contraction of a particular disease or infection," the drugs cannot be used “in a regular pattern.” This minor detail closes the loophole that allows farmers to simply change the stated reason for why they’re dosing their herd. The bill, which was signed by on October 10, will go into effect in 2018.

Between now and then, California livestock producers will have to figure out how to keep their animals healthy without the routine use of antibiotics. As reported by Aljazeera,21 researchers are investigating the use of probiotics, probiotics, and certain herb and plant extracts, such as oregano and thyme, known for their antimicrobial properties. Others are working on more potentially disturbing alternatives. According to the article:

“Other scientists are tinkering with genetic innovations that boost animals’ immunity...  Animal scientist Mark Cook and his team at the University of Wisconsin at Madison discovered a way to disable an off switch in chickens’ immune systems and have replicated the results in cattle. ‘It works in all of them,’ said Jordan Sand, an associate scientist with the University of Wisconsin team and the chief technical officer of Ab E Discovery, the spinoff company the team founded to continue its research and take it to market.”

The research involves the protein interleukin-10 (IL-10), which acts as a signaling agent, telling the immune system when to stop working. The team vaccinated egg-laying hens to create antibodies for IL-10, and then mixed the antibody-producing eggs into feed given to chickens infected with an intestinal disease. 

By eating the eggs, the chickens became “immune” to the IL-10 signal telling their immune systems to shut off, and few ended up developing the disease. The question here is, what does eating such chickens mean to human health? Will it provide a benefit, or might it affect human health in some unsuspected adverse way?

Shoddy Drug Manufacturing Practices Also Promote Antibiotic Resistance

The pharmaceutical industry also shoulders a significant burden for promoting the spread of antibiotic resistance. As noted in a recent paper22 published in Chemical and Engineering News, makers of antibiotics promote resistance by dumping the drugs right into wastewater during the manufacturing process.

Forbes Magazine23 addressed this issue in a previous article, noting that many drug companies have located their manufacturing facilities in countries where production costs are low, such as China and India. But such countries also tend to have far less rigorous water treatment protocols. 

For example, in Patancheru, India, 90 different pharmaceutical companies discharge 400,000 gallons daily24 into the local water treatment plant, and less than 25 percent of this waste water undergoes treatment. As reported by Forbes:

“Researchers from Sweden have studied the area around Hyderabad for a number of years, publishing a series of reports since 200725... The worst pollutant was ciprofloxacin, with concentrations up to 31 mg/L and in only one day totaling ‘44 kg, which is equivalent to Sweden’s entire consumption over 5 days, or, expressed in another manner, sufficient to treat everyone in a city with 44 000 inhabitants.’ 

These researchers also found that the effluent was toxic to many organisms, and that it promoted resistance genes.26Almost two percent of DNA samples from downstream sites sampled had resistance genes.27” [Emphasis mine]

Contaminated wastewater also finds its way onto crop fields via irrigation and sludge (biosolids) used as fertilizer. In this way, drug resistant genes are spread far and wide throughout the environment. According to a 2008 CDC report,28 E.coli bacteria resistant to multiple drugs have even been found in the Arctic; brought there by migrating birds!

What's the Solution?

The impending superbug crisis has a four-prong solution:

• Improved infection prevention, with a focus on strengthening your immune system naturally. Avoiding sugars, processed foods, and grains, optimizing stress reduction, sleep, and vitamin D levels are foundational for this. Adding in traditionally fermented and cultured foods is equally important, as this will help optimize your microflora
• More responsible use of antibiotics in human medicine
• Limiting use of antibiotics in livestock animals, along with a return to biodynamic farming and a complete overhaul of our food system
• Innovative new approaches to the treatment of infections from all branches of science, natural as well as allopathic. Fortunately, Mother Nature gives us a cornucopia of botanicals with inherent antibiotic activity that does not promote resistance like antibiotic drugs do. Natural compounds with antimicrobial activity include:

Garlic	Cinnamon	Oregano extract	Colloidal silver
Manuka honey (Clinical trials have found that Manuka honey can effectively eradicate more than 250 clinical strains of bacteria, including some resistant varieties, such as MRSA)	Probiotics and fermented foods	Echinacea	Sunlight and vitamin D

How to Avoid Promoting Antibiotic Resistance

Optimizing your own immune system function will help keep you safe from developing a potentially lethal infection in the first place. I also urge you to consider the following strategies, which will help curtail the spread of antibiotic resistance in general. While the problem of antibiotic resistance needs to be stemmed through public policy on a nationwide level, the more people who get involved on a personal level, the better.

Such strategies include:

• Use antibiotics only when absolutely necessary. For example, antibiotics are typically unnecessary for most ear infections, and they do NOT work on the common cold or flu, both of which are caused by viruses. Antibiotics only work on bacterial infections, and even then, they're best reserved for more serious infections.
• Avoid antibacterial household products, such as antibacterial soaps, hand sanitizers, and wipes, etc., as these also promote antibiotic resistance by allowing the strongest bacteria to survive and thrive.
• Properly wash your hands with warm water and plain soap, to prevent the spread of bacteria. Be particularly mindful of washing your hands and kitchen surfaces after handling raw meats, as about half of all meat sold in American grocery stores is likely to be contaminated with pathogenic bacteria. Avoid antibiotic soaps that typically have dangerous chemicals like triclosan.
• Take common-sense precautions in the kitchen: Kitchens are notorious breeding grounds for disease-causing bacteria, courtesy of contaminated meat products, including antibiotic-resistant strains of E-coli. To avoid cross-contamination between foods in your kitchen, I suggest adhering to the following recommendations:
• Use a designated cutting board, preferably wood, not plastic, for raw meat and poultry, and never use this board for other food preparation, such as cutting up vegetables. Color coding your cutting boards is a simple way to distinguish between them
• To sanitize your cutting board, be sure to use hot water and detergent. Simply wiping it off with a rag will not destroy the bacteria
• For an inexpensive, safe, and effective kitchen counter and cutting board sanitizer, use 3 percent hydrogen peroxide and vinegar. Keep each liquid in a separate spray bottle, and then spray the surface with one, followed by the other, and wipe off
• Coconut oil can also be used to clean, treat, and sanitize your wooden cutting boards. It's loaded with lauric acid that has potent antimicrobial actions. The fats will also help condition the wood
• Purchase organic, antibiotic-free meats and other foods. Reducing the spread of antibiotic-resistant bacteria is a significant reason for making sure you're only eating grass-fed, organically-raised meats, and animal products. Besides growing and raising your own, buying your food from responsible, high-quality, sustainable sources is your best bet, and I strongly encourage you to support the small family farms in your area.