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Are Antibiotic-Resistant Diseases Mother Nature’s Revenge?

The methicillin-impervious infection Staphylococcus aureus is the most common post-surgery illness.

by
Theodore Dalrymple

Bio

June 18, 2013 - 9:00 am

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Resistance to antibiotics is often described by neo-pagans as Mother Nature’s vengeance on Man for having had the temerity to interfere in her natural biological processes. According to the neo-pagans, this vengeance has left Man (deservedly) worse off than if he had never discovered antibiotics at all. I do not see the logic of this.

There is no doubt, however, that bacterial resistance to antibiotics is a serious problem worldwide. It is particularly serious in hospitals, where patients may pick up infections that they never had before admission. Many patients die from these infections, which may be of epidemic proportions.

The most important such infection is MRSA, methicillin-resistant Staphylococcus aureus. (Methicillin is a semi-artificial penicillin that was developed when the Staphylococcus first became resistant to ordinary penicillin, and soon met with resistance itself.) MRSA accounts for most post-surgical infections; the proportion of patients infected by it is often taken in research as a measure of a hospital’s hygiene.

An important paper in a recent edition of the New England Journal of Medicine compares various strategies for reducing the spread of MRSA in intensive care units, a common place for patients to become infected.

The method of control usually employed is to screen patients for MRSA on admission to the ICU and to institute special precautions such as isolation and barrier nursing if they test positive. The authors compared this method with attempts by means of antibacterial products at “decolonization” of those who tested positive, and similar “decolonization” practiced on every patient admitted to an ICU irrespective of whether or not he tested positive for MRSA.

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The authors then compared the overall rate of blood-borne infections with MRSA between the groups. They found universal decolonization – the prophylactic use of antibacterials regardless of whether or not patients were initially infected – was by far the most effective, with decolonization of those initially infected next best, and the method most widely used around the world — isolation and special nursing precautions — the least effective.

One of the reasons for the superior efficacy of universal decolonization might have been that those who were infected with MRSA on admission were disinfected straight away rather than after a delay while laboratory results were awaited, and thus the offending organism had no opportunity to spread in the meantime.

The authors estimated that 54 patients under the scheme of universal decolonization had to be treated in order to prevent one blood-borne infection. The cost of universal decolonization was $40 a head: that is to say, one blood-borne infection was prevented at a cost of $2160. If, as seems likely (though the authors are hesitant on the point), such an infection involves the extra expenditure of more than $2160 per patient, then universal decolonization would lead to economic savings as well as – presumably – to less suffering. (Additional savings would be made by the need for fewer initial laboratory tests.) The trial was not large enough, however, to determine whether any lives would be saved by universal decolonization and if so, how many. It seems to me likely, though, that lives would be saved.

The neo-pagans, however, could take some comfort from a caveat issued by the authors. If universal decolonization were instituted, as seems to be the logical practical consequence of the experiment, the bacteria might develop resistance to the products (chlorhexidine and mupirocin) used to disinfect. Indeed, there is already some evidence that this is happening. Thus victory over bacterial infection is only temporary, not final and probably never to be final, given the genetic flexibility of bacteria; medicine is thus an aspect of Man’s Promethean bargain. But temporary victory is to be preferred to perpetual defeat.

*****

images courtesy shutterstock / BioMedical / stefanolunardi

Theodore Dalrymple, a physician, is a contributing editor of City Journal and the Dietrich Weismann Fellow at the Manhattan Institute. His new book is Second Opinion: A Doctor's Notes from the Inner City.

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All Comments   (39)
All Comments   (39)
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Americans have found the perfect way to fight diseases and other ailments. They simply design a ribbon and begin a campaign to force everyone to wear said ribbon; then they spend thousands of dollars "raising our consciousness" and then they enlist the hordes of brainless media and Hollywood stars to strut around preaching whatever the controllers want them to spread. and so it goes.
1 year ago
1 year ago Link To Comment
"Resistance to antibiotics is often described by neo-pagans as Mother Nature’s vengeance on Man for having had the temerity to interfere in her natural biological processes. According to the neo-pagans, this vengeance has left Man (deservedly) worse off than if he had never discovered antibiotics at all. I do not see the logic of this."

Well, Neo-pagans aren't microbiologists. Ask one and they'll tell you its evolution. Kill off the weak bacteria with anti-biotics and the ones that survive will be the ones with resistance. Add a new anti-biotics to kill those and the survivors will be stronger. Evolution, not mother nature.
1 year ago
1 year ago Link To Comment
Except.... it's not.

Bacteria become resistant because of a loss of a particular receptor which allows the drug to enter the cell and kill it. No receptor, no kill.

This is a net LOSS of genetic information. It's fortuitous for the bacteria cells that have this mutation, but it's still not evolution.

This is just old stuff dumbed down, which just happens to survive better in a particular (artificial) environment.

Evolution requires a GAIN in genetic information. NEW stuff.

There's no new stuff here.
1 year ago
1 year ago Link To Comment
BAN antibiotics from Agricultural use.

They feed it in high amounts to live stock and poultry to get bigger yields.

It was a seriously stupid idea to begin with.
1 year ago
1 year ago Link To Comment
All primitives fear the Earth Goddess, and attempt to propitiate her
with human sacrifice. As a society's technology advances, it reaches
a point at which it can build medicines which can defeat any germ,
and not long after that learns to improve the immune system so that
medicines are no longer necessary.
1 year ago
1 year ago Link To Comment
Nice theory. Still waiting for some evidence that such a utopia is possible.
1 year ago
1 year ago Link To Comment
Well, there is another solution, but no one would like it. We could always go cold turkey on antibiotics. Scientists theorize that it would take about three years for all the drug resistant bacteria to lose their resistance genes if we stopped using our antibiotics. It would be a hard reboot to the system, and it would be hellish in the meantime.
1 year ago
1 year ago Link To Comment
I have suspected that the first real crisis that human beings will face since the Black Plague, will be another massive disease that will kill a third or more of the world's population. It is nature's way of correcting over population and culling out the weak. As cruel as this may sound, it may be the best thing that could happen for the perpetuation of humanity.
1 year ago
1 year ago Link To Comment
And "Mother Nature" knows the correct population... how?


HINT: There is no population problem. Not then, not today. Do the arithmetic.
1 year ago
1 year ago Link To Comment
check out MERS virus after the hajj to Mecca. The story that is not on anyone's page 1. yet.
1 year ago
1 year ago Link To Comment
It's more like the introduction of a new disease into a population which had never encountered it before. The Black Death seems to have originated in East Africa and it followed the trades routes of the day into Europe. It maybe have gotten its start due to a cold snap that forced infected fleas to use humans as hosts instead of the rats they normally preyed upon.

Starvation has been the greater "population leveler" than disease. Famines were common before global transportation and still are in the animal world, except in parts of the West where animals have learned to live near humans and are doing very well. Take the people away though and many animals will starve.
1 year ago
1 year ago Link To Comment
It's also been speculated that The Black Death was so devastating because it hit Europe during the opening years of the The Little Ice Age. European populations were weakened by successive years of severe winters and bad harvests meaning that people weren't all that healthy to begin with making them ripe targets for the first serious disease to come along.
1 year ago
1 year ago Link To Comment
Adding silver to anit-biotics makes them 10 to 1000 time more effective.

http://www.bbc.co.uk/news/health-22967727
1 year ago
1 year ago Link To Comment
And if you get the mix wrong you can be blue for life.
1 year ago
1 year ago Link To Comment
Well, gray, not blue, and you have to get MASSIVE quantities over a long period of time to go gray.

The good news is, once you do, it's permanent! :D
1 year ago
1 year ago Link To Comment
Is that where the term blue bloods come from?

I dont know why, but I thought of this...

"Poor George, he can't hep it, he was born with a silver spoon in his mouth. - Ann Richards
1 year ago
1 year ago Link To Comment
For the kind of money dumped into Solyndra, the NIH could sponsor antibiotic R&D for a decade. Biotech is just getting to the point where it can make all kinds of new counterattacks. Though I suppose private enterprise will eventually stumble into the area on its own, horrendous up-front costs being the roadblock, though I don't wonder if some of the other hesitation is more that it just seems less fashionable (read: profitable) than some "biologic" that they can sell for $20k/year indefinitely for chronic conditions like rheumatoid arthritis.

But it is also an ongoing indictment of the filth of most hospitals, I think there was an episode of House where it turned out some candy-striper handing out stuffed bears, was spreading some horrible (infant-killing?) infection. If just the hospital *rooms* could be sterilized between patients, I don't doubt it would cut infections in half. Filter and sterilize the air, aggressively. Maybe have visitors wear color-coded lab coats and disposable booties. Most of all, study the issue and MOVE.

1 year ago
1 year ago Link To Comment
Yes, and we all know what a reliable source of factual medical information those TV shows are!


Oy.
1 year ago
1 year ago Link To Comment
Don't worry. Once Obamacare unionizes all the hospital employees, we'll really see filth taking a toll in our hospitals. Just take a look at the NHS to see what road we're marching down.

As to medical research, if our society would stop being so overly litigious, there would be a lot of new research being done that isn't done now in the private sector. Anything that's hideously expensive is unlikely to get much attention because regulations and the process to get new drugs approved makes it so unlikely anything will ever see market.
1 year ago
1 year ago Link To Comment
This is just the result of human stupidity. The threat of producing drug resistant bugs has been known for a very long time. This did not affect doctor's behavior of prescribing antibiotics for everything, adding antibiotic to healthy animals' food, or even adding them to soap. So for decades every germ that survived passed on that resistance to its descendents and may even have spread it to other bugs via RNA exchanges.

Human got proud and forgot basic biology.
1 year ago
1 year ago Link To Comment
Well, how about some perspective? How many people died or were seriously sickened by various microbes before our antiseptic day and age? And how does that compare to these resistant infections today? Numerically, I mean? Where would one find this information?
1 year ago
1 year ago Link To Comment
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