Superbugs: Are we headed for another pandemic?

I have worked in the microbiology industry for many years and have seen a multitude of bacterial, parasitic and fungal organisms through culture and light microscopy.  But I had never experienced the alarming rate an infection can take hold until my son became infected with methicillin-resistant Staphylococcus aureus (MRSA).  Within a period of 24 hours, we made four ER visits for what began as an infected hair follicle, a pimple actually, and quickly became many abscesses.  At the fourth visit, he was admitted and immediately placed on the IV antibiotic, clindamycin.  Fortunately, the first treatment was affective and he was discharged on oral antibiotics after 72 hours.  The outcome could have been much worse.

There has been a great deal of media coverage over the course of the past year about our creation of ‘super bugs’ and the possibility of an infectious pandemic with finger-pointing at the overuse of antibiotics by physicians and the agriculture trade.  Because of the development of these ‘super bugs’ which are virtually resistant to all antibiotics, guidelines for treating infections such as ear infections in children and sinus infections are changing.  It is now recommended that pediatricians not treat ear infections with antibiotics, that the infection will gradually clear on its own.  These same recommendations are being made for sinus infections.  And the unnecessary use of antibiotics for respiratory illnesses which are usually viral in nature is being frowned upon.

But is this new awareness and the new guidelines enough to ward off a pandemic such as the Spanish influenza pandemic in 1918 or the Black Death pandemic both of which killed millions of people worldwide?  And just what organism is the most likely candidate to create a pandemic?  One of the bacteria listed as our most urgent by the Center for Disease Control (CDC) is the sexually transmitted disease (STD), gonorrhea.  Doctors are warning that a drug-resistant strain of gonorrhea could be more deadly than AIDS and has been found in several countries including Japan.  The two other bacteria deemed as urgent threats in antibiotic resistance are CRE-bacteria which are bacteria resistant to a family of antibiotics called the carbapenems including certain strains of E. coli and thirdly, Clostridium difficile, or C. diff for short, a gastrointestinal illness that results from the use of antibiotics that wipe out the ‘good’ bacteria in the intestine. 

One of the major hurdles now for medical practitioners is the pharmaceutical companies have shied away from developing new antibiotics because they are not big money makers when compared to medications such as hypertensive medications.  Antibiotics are taken for a specific, short course and then discontinued whereas many people will take hypertension medications for a lifetime.  Currently, only five pharmaceutical companies are left that are still actively researching new antibiotic formation.  There are some novel approaches to antibiotics being researched including using bacteriophages—viruses that attack bacteria—and the use of lytic enzymes that are normally found in saliva and mucus that would kill the ‘bad’ bacteria. 

While there is no one right way to curb antibiotic resistance, it is going to take the effort of the medical community as well as research scientists for us to come up with a solution.  Reducing the amount of antibiotics prescribed as well as increasing the production of novel antimicrobial agents is a beginning.  And as for consumers, if prescribed an antibiotic, take it exactly as prescribed.