Saturday, April 1, 2017

Armies of Microbes Take Arms: Are We Ready to Fight? (OP-ED)

An eight year old girl smiles while she gazes towards the window as the trees sway in the breeze, the children jump rope on the street, and the life monitor beeps loudly beside her head. The girl falls prey to a deadly infection that rampages through her bloodstream, resilient to all the antibiotics the doctors scramble to test.

The ineffectiveness of antibiotics remains a direct result of the misuse of antibiotics in modern society. The overuse, prevalent in doctors offices, causes our once-powerful medications to provide little to no aid. In a world where disease rates continue to spike due to medicine’s dwindling power, we need to resist the urge to jump to antibiotics immediately.

We’ve all experienced the pain that comes with a debilitating illness. Wishing to eradicate the pain promptly, we flock to the doors of our doctors hoping for a prescription to rescue us. However, each time we accept the prescription the doctor hands over quickly, we expose the bacteria within our bodies to the antibiotic’s method of attack. With the enemy’s plan in possession, the surviving bacterial strains train a whole army in the art of surviving against the antibiotic. We equip armies to fight against us, yet 30% of antibiotic prescriptions remain “inappropriate” according to a study by the Centers for Disease Control and Prevention.

When patients visit their doctor with symptoms that hint at a bacterial infection, many doctors jump immediately to parceling out antibiotics --before receiving definitive proof of infection-- to escape the risk of a misdiagnosis. Martin J. Blaser, famed bacterial researcher, advocates that the continued overuse of antibiotics due to precaution “is like carpet bombing when a laser strike is needed.” So why do we continue to trust our doctors so wholeheartedly?

Unbeknownst by many, the escalation of antibiotic resistance continues to mount a great threat against the human race. Sonia Shah, an acclaimed writer for the New York Times, delineates the shocking costs the fight against drug resistant infections elicits in the United States: up to eight million additional hospital days and over $34 billion every year. In addition to the financial burdens, the CDC reports that 23,000 American deaths and two million illnesses a year occur due to antibiotic resistant strains. As a result of the surmounting costs, the World Health Organization claimed the dire status of the antibiotic resistance crisis along with the National Health Association declaring our emergence into the post-antibiotic age.

Even though our doctors continue to prescribe antibiotics without waiting for proper test results, we possess the power to save ourselves before time runs out. To stall the spread, we can insist on waiting to receive lab results before accepting antibiotics. This obstinance may seem small, but it will help save us from the fate of the eight year old girl who lays in a hospital bed waiting for her last breath. The choice lays in the hands of our generation; will we arm ourselves and fight the war against resistant bacterial strains stampeding towards us? Or, will we continue to neglect the legion of diseases that grant mercy to none?

Monday, March 20, 2017

The Sound of a War Cry

The time to address the threatening reality of increased antibiotic resistance in our era arrived a long time ago. The time became signified with the increased prevalence of disease sweeping around the world, knocking out vulnerable children and strong athletes alike. The need to address antibiotic resistance became shouted from the roof tops as healthy people began to drop like flies to infections cured so easily a mere twenty years ago. The time arrived with warning signs flashing bright enough for thousands upon thousands to see. However, thousands upon thousands continue to look the other way. With neglectance continuing in our society, the window of action dwindles with greater rapidity. Without working quickly, bacteria will continue to evolve and build further armor that shields them from the wrath of our “powerful” antibiotics. However, the antibiotics we continue to depend on are failing us. According to Nicholas Bagley in his article “We Will Miss Antibiotics When They’re Gone,” staying one step ahead of the numerous and adaptive bacteria “will require ingenuity, money and radical change.” Which means, and I dare say it, that we need to stop pushing the problem of resistance onto future generations and fight with all of our might now.

Major pharmaceutical companies satisfy their pockets by placing higher emphasis on drugs that will garner a higher profit--leaving antibiotic development largely ignored. Without new antibiotics, doctors around the world continue to prescribe antibiotics which no longer possess the effectiveness necessary to eradicate strong-- or even mild-- infections. As a result, the danger looming within hospitals spikes in severity as antibiotic-resistant infections spreads through hospital corridors. Resistant infections within hospitals not only result in a longer and more expensive stay but “common surgeries would start looking like Russian roulette.” In addition, the overuse of old antibiotics only continues to expose bacteria to the same stimulus, allowing select strains to develop resistance and spread it among millions of other colonies. As more colonies receive resistant genes from their neighbors, the amount of effective medicine diminishes even further. The limited amount of effective antibiotics causes the larger numbers of deaths prevalent in recent years. Quick and merciless bacteria acted as a grim reaper to a woman killed by “the bacteria that were resistant to every antibiotic doctors could throw at them,” and will continue to play a similar role in the lives of thousands (if not millions) more.

Members within society need to weigh the outcomes of continuing to pay attention to the blatant warning signs. Does the extra money pharmaceutical companies gain from neglecting antibiotic development or the promise of a quick fix with antibiotics truly outweigh the detrimental effects of our population slowly dying off to bacterial strains that were once controllable? The time for battle arrived with the advent of antibiotic resistance in recent years; and we possess no other option but to fight.

Thursday, March 9, 2017

Watch What You Eat

The doors within doctor’s offices revolve weekly, providing new patients by the minute. Each patient possesses unique symptoms that provide clues on the nasty infection or virus thriving inside. However, doctors around the world continue to notice that one type of pain and discomfort continues to spike among female patients in recent years: the urinary tract infection. In fact, “in the United States, one out of every nine women has a UTI every year,” according to the article “How Your Chicken Dinner is Creating a Drug-Resistant Superbug” by Maryn McKenna. The price of dealing with highly painful UTIs hovers just above $1 billion per year, and it continues to skyrocket with the increasing prevalence in modern day society. To make matters worse, engaging in a quick and successful battle against these nasty bacterial strains continues to grow in difficulty. This difficulty increases due to certain strains becoming resistant to multiple antibiotics, causing thousands of women to suffer with prolonged illness as their doctors scramble to find the right medicine to eradicate the infection.

The question on the minds of thousands of scientists’ minds across the world revolves around what the possible cause could be that continues to trigger the enormous spike in UTIs. The answer remains highly controversial. On the one hand, some researches argue that a strong link persists between the meat we consume and the bacteria we then acquire. These researchers highlight the “close genetic matches between resistant E.coli from human patients and resistant strains found on chicken or turkey sold in supermarkets,” in order to make the argument that resistance could be spreading with every bite from our chicken dinners. While on the other hand, other researchers don’t agree as antibiotic resistance remains extremely common in our society therefore, “it isn’t surprising that genes carried by human E.coli are going to be similar to resistance genes in chicken E.coli.” However, after taking both arguments into account, I believe that a strong link exists between the antibiotic treated meat we consume and the resistant bacterial strains which grow in frequency within our bodies. The fact remains that “80 percent of the antibiotics sold in the United States each year are given to livestock as ‘growth promoters’,” therefore large sums of antibiotics flow through the bloodstreams of these animals, allowing millions of bacterial cells in their bodies to adapt and eventually become resistant. Some of these resistant bacterial cells still thrive in the meat of the animals when we put them in our mouths while enjoying a dinner with our families. After dinner, these cells travel through our bodies, passing on the resistant gene to other cells within our bodies. Then, when our bodies become infected, they become far harder to cure. Although many farmers continue to deny the link between animals and humans in transferring resistant cells in an attempt to keep their meat output as high as possible, I believe the link remains quite obvious when observing the patterns in doctor’s offices. For instance, the fact remains that there has been a plethora of patients with UTIs who haven’t been recently exposed to medical centers in which antibiotics remain highly overused. Without the exposure to antibiotic overuse, why do the UTIs display high resistance to antibiotic treatment? The common factor observed by many doctors remains recent exposure to meat grown with the aid of antibiotics. Therefore, to fight the pain growing among millions, the use of antibiotics in agriculture needs to become severely regulated.

Monday, March 6, 2017

Why Thousands Continue to Ignore the Ticking Time Bomb

Most, if not all, of us visited the doctor at some point in our lives, griping about the pain exploding in our ears, throat, sinuses, etc. Almost immediately, the doctor prescribed each of us antibiotics to eliminate our pain as soon as possible. When we visit the doctor, millions of people around the world depend on the large variety of antibiotics available to eliminate our suffering. The beginning of the pain-reducing miracle drugs occurred in the year of 1928 with the discovery of penicillin, thus beginning the antibiotic age. When someone became plagued with an infection, hundreds of doors remained available to provide a relatively quick and easy escape from their problems. The eradication of these problems, being infections, occurred through the use of amoxicillin, doxycycline, cephalexin, penicillin, and many other different antibiotics which offered pathways out of the infection. However, some doorways began to be used too much. The hinges rusted, the wood began to splinter, and handles began to break making it more difficult to take that route. As a result, the usage of different doors began with the implementation of different medicinal treatments. Then, the new pathways deteriorated as well. Why did the possible routes of eradication close down so swiftly? The answer remains antibiotic resistance. Antibiotic resistance spreads through natural selection and bacteria-to-bacteria contact each time a person implements antibiotics within their bodies. And, this antibiotic resistance closes down the doors of possibilities one by one. If the spread of antibiotic resistance continues to at its current rate, each door will continue to shut until someone with a body plagued with infection will remain trapped, without a route of escape back to their healthy self. So, why does antibiotic resistance continue to be pushed to the backburner? In the article “The Antibiotic Resistance Crisis” author C. Lee Ventola explores the reasons for the lack of a strong fight against the advent of antibiotic resistance.

Pharmaceutical companies acted as the major producers of new antibiotics in the past, however the rate of new creations continues to dwindle. The decline in production occurs due to the economic burden of developing antibiotics and the increased regulatory obstacles. Due to these issues, “of the 18 largest pharmaceutical companies, 15 abandoned the antibiotic field.” Companies remain unmotivated to develop antibiotics because they do not provide grand economic benefits with the small window of usage and their overall unprofitability. The contrast in profitability between antibiotics and specialized drugs remains extremely stark as “the net present value of a new antibiotic is only about $50 million, compared to approximately $1 billion for a drug used to treat a neuromuscular disease.” In addition to the low income generated for the creation of antibiotics, in recent years, the number of antibiotic approvals depreciated greatly due to new trial requirements and regulatory and licensing laws. Thus, even if a company tackles the challenge of discovering a new antibiotic, their expensive design remains susceptible to brutal rejection. Even with the newly implemented regulatory maze and the daunting economic burdens of undertaking the development of new antibiotics, the fact remains that if we proceed to push developing weapons to combat the bacterial strains armed with resistance to the backburner, there will barely be a fight. The war will arrive as armies of resistant bacteria infest our bodies and, without a successful method of eradication, humans will brutally lose. The time has come to build up our arsenal of antibiotics, “the CDC declared in 2013 that the human race is now in the ‘post-antibiotic era,” along with the World Health Organization warning “that the antibiotic resistance crisis is becoming dire.” Dillydalling cannot continue as the time to fight arrived years ago.

Thursday, March 2, 2017

Breaking News: Mass Murderer Under the Name "Ignorance" Expected to Strike

The nine year old boy gazes with a smile towards the window as the trees sway in the breeze, the children jump rope on the street, and the life monitor beeps loudly beside his head. The harsh hospital lights above him illuminate the deep bags underneath his eyes that grow with every minute. The infection permeates throughout his veins, continuously sucking the life out of the young boy. The boy focuses his gaze on the door his parents departed from a short while ago to retrieve his favorite sandwich from the nearby deli, knowing that he will draw his last breath before the sun drifts below the horizon. A cure remains nonexistent for him, as he suffers from a severe infection initiated by NDM-1, which no antibiotic can eradicate. Left without a solution, the boy’s life will be shortened to a measly nine years. In the article “When Superbugs Attack: Antibiotic-resistant NDM-1 Is Undermining India’s Medical Sector,” author Sonia Shah tackles the growing prevalence of NDM-1, an extremely dangerous bacterial strain, as well as expostulating the greater actions necessary to fight off antibiotic resistance in the extremely interconnected world.

The prevalence of NDM-1 bacterial strains continues to spike in India, causing concern as NDM-1 remains amongst the most antibiotic resistant of all bacterial strains. In fact, NDM-1 holds responsibility for the unusually efficient transfer of extremely high drug-resistance to “thirteen percent” of bacterial infections “making treatment options exceedingly limited.” However, no one seems to be taking definitive actions to stunt the progression of antibiotic resistance. In fact, “the drug industry has actively avoided developing new antibiotics” as a “business decision,” due to the fact that such antibiotics remain extremely costly to cultivate and eventually grow antiquated. Meanwhile, Indian governments continue to leave the unregulated antibiotic use in the country untouched. While politicians and scientists drag their feet in taking a stand against the spread of antibiotic resistance, people continue to die around the world.

No, the problem of extremely resistant bacteria strains does not simply exist in the country of India. However, NDM-1’s birthplace, and largest distributer, continues to be India. India receives millions of visitors, allowing NDM-1 to infiltrate the bodies of hundreds of thousands of these visitors, who unknowingly smuggle the lethal strain back to their countries. Therefore, no country possesses immunity as “NDM-1 infections already turned up in more than 35 countries last year.” NDM-1 only exemplifies one of the many bacterial strains growing with greater resistance to the very antibiotics we rely on to save millions of lives. Without a deliberate attack on antibiotic resistance, the amount lost to these strains of bacterial will continue to surmount as even “in the United States alone, fighting drug-resistant infections cost up to 8 million additional patient hospital days and up to $34 billion every year.” Losses will continue to surmount in the modern day world which remains highly interconnected, with expansive land and sea trade routes, efficient transportation systems, millions of places to come into contact with nasty bacteria. Neglecting the growing prevalence of antibiotic resistant strains such as NDM-1 only digs the fate of humankind a deeper grave. Without action, none of our antibiotics will provide solace from infections like that of the nine year old boy, and there won’t be anyone left to make us our favorite sandwich either.

Monday, February 27, 2017

The Battlefield Lies Before Us, are we Ready to Fight?

A rise in obesity, celiac disease, diabetes, and down syndrome plagues our society. These modern plagues must be triggered by something in our modern day lifestyle, right? The lifestyle of lessened activity as we spend much of our time captivated by luminescent screens that act as a portal into the digital world, that must be the cause. What if I were to tell you that a major contributor in the spike of modern plagues continues to be parceled out in thousands by doctors around the world everyday: antibiotics. In his book, Missing Microbes: How the Overuse of Antibiotics is Fueling our Modern Plagues, author Martin J. Blaser draws the direct link between increased antibiotic usage in recent years to the staggering increase in modern plagues.

How can antibiotics, designed for maintaining human health, initiate plagues such as diabetes, down syndrome, and obesity? Obesity’s correlation with antibiotic usage became unmasked through Blaser’s series of experiments with mice which consistently revealed that mice receiving antibiotics throughout the experiment “gained 10-15 percent more total weight and 30-60 percent in fat compared to the antibiotic-free control mice,” (159). The introduction of antibiotics into the young mice slaughtered many of the microbes inside, thus changing the whole microbiome within the mouse. The resulting, less diversified, microbiome thereby affected the body composition of the mouse and triggered obesity. In addition to obesity, Blaser also developed evidence that the alteration of the microbiome caused by antibiotics leads to a direct rise in Type I diabetes, and this case amplifies significantly when exposing young children to antibiotics. Exposure of antibiotics into children also leads to mental development issues as 100 million neurons live in weblike layers in human intestines. In fact, these neurons continuously send messages to the human brain in addition to maintaining extensive contact with the microbes in human stomachs. These interactions result in the development of serotonin and gangliosides and other chemicals which the brain needs to function normally. However, this normalcy becomes severely perturbed when antibiotic usage wipes out the millions of important cells in the stomach. Without the microbial cells producing necessary chemicals for the brain, communication between the brain and the body, as well as brain development, falters. Failing brain communication, obesity, and diabetes remain only some examples of many which attest to the negative effects antibiotic misuse triggers in human bodies.

With the overuse of antibiotics comes the armies of microbes who grow resilient to our weapons. These weapons, our antibiotics, will falter when faced with the microbial cells which survived the previous waves of drugs. After encountering the drugs, the bacterial cells learn the secrets of our drugs and then reproduce, thus passing the secret to survival along. The growth in these knowledgeable and resilient cells creates the threat we now face, and no one is safe. For example, a horrendous bacterial infection, C.diff thrives in society “like a lion escaped from the zoo, C. diff has escaped the confines of the hospital and is now loose in the community,” (188). Infections like C.diff will continue to thrive in our populous and crowded world as the number of effective antibiotics dwindles. Although many remain hesitant to develop the new drugs necessary to fight off the deadly “antibiotic winter,” the truth remains that “we can pay now to prevent or we can pay later to treat,” (207). The choice lays in the hands of our generation, will we bundle up and fight the antibiotic winter blowing towards us, or will we continue to neglect the storm of diseases which grant mercy to none?

Thursday, February 23, 2017

A Classic Jekyll and Hyde: Is H.pylori Friend or Foe?

What words do you associate with the word bacteria? If your mind jumped to thoughts of illness, germs, and harmful infections, then your views align with the majority of the population. However, throughout the study of antibiotic resistance I discovered that many strains of bacteria wield positive, sometimes vital, functions for our bodies. In his book, Missing Microbes: How the Overuse of Antibiotics is Fueling our Modern Plagues, author Martin J. Blaser divulges that the world of bacteria remains far from clean-cut by elaborating on the controversial status of the H.pylori bacterial strain existing as foe, friend, or… both.

H.pylori is a strain of bacteria that thrives solely in human stomachs. In the 1980s, Scientist Dr. Barry Marshall pulled out all the stops to prove that H.pylori plays a role in causing gastritis by employing himself as the guinea pig and downing a culture of the bacteria. Sure enough, a few days later he developed stomach pain and bad breath, both common symptoms of gastritis. Marshall then wasted no time in applying this information to stomach ulcers. He administered antibiotics that possessed the power to kill H.pylori to ulcer patients and the results proved that the rate of ulcer recurrence in those who received the antibiotics were much lower. The findings didn’t stop here. Blaser conducted his own experiments on Japanese-Americans in Hawaii. His findings further spurred the negative thoughts toward H.pylori as he discovered that those hosting H.pylori remain six times more likely to obtain stomach cancer later in life than those without it. Based on all of this information, H.pylori must obviously be a foe. How could there be a bright side to gastritis, ulcers, and stomach cancers? There can’t possibly be a debate, “it was like smoking and lung cancer: no argument about cause and effect”, (115).

Many people, including leading scientists around the world, would presume a debate is nonexistent. However, I believe that a strong case exists to substantiate that H.pylori continues to be extremely important in the bodies of humans; and I’ll tell you why. Following the official labeling of H.pylori as a carcinogen, many doctors scrambled to eradicate the bacterial strain at every slight stomach pain among their patients. Have you noticed the stark proliferation of medical issues arising in the early 21st century? The advent of modern diseases can be justified by the habit of people around the world to jump to antibiotics as a quick and easy solution to eradicate “harmful” bacteria. But what if this “harmful” bacteria is actually extremely important? Could the fact that “these old troupers are fast disappearing… be sufficient to explain the growth of asthma” (140) along with the increase in heart burn and obesity? For example, farmers supply their animals large amounts of antibiotics to fatten them up, therefore “the idea that antibiotics might be causing weight gain in our children, that they could be a ‘missing link in the obesity epidemic” (150) remains far from abstract. In fact, Blaser’s many experiments reveal that people who do not carry H.pylori possess an increased chance of suffering from heartburn, asthma, and obesity.

Despite the evidence proposed by Blaser, many of the proponents for the pathogenic nature of H.pylori remain rooted in their old beliefs due to the giant practice grown around the need to eradicate H.pylori. Many of these proponents assume that because of the extensive evidence of H.pylori as extremely negative, the idea of H.pylori doing good remains impossible. However, I believe that H.pylori exists as extremely versatile in its ability to play both hero and villain. How is that possible? The answer lies in amphibious, “the condition in which two-life forms create relationships that are either symbiotic or parasitic, depending on the context,” (105).

How to tell if you carry H.pylori without a blood test:
You probably possess H.pylori if you or your family exhibits:
  • A history of gastritis, ulcers, or stomach cancer
  • A low level of allergies
  • Little prevalence of asthma
  • Small rate of heartburn (acid reflux)
  • A smaller height compared to others

You probably are not a carrier of H.pylori if you or your family exhibits:

  • Little history of stomach problems
  • A high amount of allergies
  • High rate of asthma (especially early onset)
  • Acid reflux issues (especially early onset)
  • A taller height compared to others