Antibiotic Resistance

Source: Antibiotic Resistance project,

Preface. Just a few of the many articles in the media on antibiotic resistance, which like climate change, will make matters worse for whoever survives Peak Oil.  And it won’t be just bacterial resistance, fungi are now growing resistant to drugs as well, probably because of excessive use of fungicides in agriculture.

Alice Friedemann  author of “When Trucks Stop Running: Energy and the Future of Transportation”, 2015, Springer and “Crunch! Whole Grain Artisan Chips and Crackers”. Podcasts: Derrick Jensen, Practical Prepping, KunstlerCast 253, KunstlerCast278, Peak Prosperity , XX2 report

2019-4-6. A Mysterious Infection, Spanning the Globe in a Climate of Secrecy. New York Times.

My summary: Lately there has been an explosion of resistant fungi such as Candida auris, which preys on people with weakened immune systems. It is spreading around the world — to Venezuela, Spain, Britain, India, Pakistan, South Africa and recently New York, New Jersey, and Illinois.

C. auris is tenacious because it is impervious to major anti-fungal medications, making it a new example of one of the world’s most intractable health threats: the rise of drug-resistant infections. C. auris infections are resistant to at least one drug, and 30% are resistant to two or more drugs.  Nearly half of patients who contract C. auris die within 90 days.

In the U.S. 2 million people get resistant infections every year, and 162,000 die from them.

Some scientists cite evidence that heavy use of fungicides on crops is contributing to the surge in drug-resistant fungi infecting humans.

2017-3-3 WHO’S dirty dozen microbes.  Science 355:890

You may never have heard of Acinetobacter baumannii, Pseudomonas aeruginosa, or the Enterobacteriaceae—but these three killers top a new list, drawn up by the World Health Organization (WHO) in Geneva, Switzerland, of bacteria for which new drugs are desperately needed. Unveiled today, the list contains 12 bacteria and bacterial families, with the top three making up the category “critical”.

WHO hopes that pharmaceutical companies will give these bugs priority in developing antibiotics, but these drugs are not an attractive investment because they’re only taken a short time and usage restricted. Far more profitable are the drugs for chronic diseases.

Doctors, researchers, and health officials have been sounding the alarm for years about the rise of antibiotic resistance. The list took into account the level of resistance each class of pathogen has already acquired, how deadly it can be, how widespread, and the burden it causes to health systems.

The top three are all gram-negative bacteria that are resistant to multiple drugs. They aren’t widespread yet, but they do cause severe, frequently deadly infections in hospitals, especially in people who are already immune compromised—including transplant recipients, chemotherapy patients, and elderly people.  These bacteria can cause deadly infections if they take up residence in the respiratory system or bloodstream. The most dangerous strains have recently acquired resistance to a class of antibiotics called carbapenems, the only group that still killed them effectively.

Nine more pathogens round out the agency’s dirty dozen: Six are listed as high priority, including drug-resistant strains of Neisseria gonorrhoeae, which causes gonorrhea, and food-borne agents like Salmonella and Campylobacter. Bacteria in this category cause infections that are less deadly than those caused by the three critical-level bugs, but they are much more widespread. Three “medium” priority organisms all are susceptible to some drugs, but are increasingly becoming resistant.

2016-9-30. Antibiotic-resistant bugs in British supermarket chicken reach record levels.

A food poisoning bug found in three-quarters of British supermarket chicken is showing drastically increased resistance to antibiotics, which may mean it will become harder for doctors to treat. The Food Standards Agency (FSA) tested campylobacter bacteria found in poultry. It said resistance to certain antibiotics, including a commonly used drug to treat the bug, ciprofloxacin, had more than doubled in some strains. It also found a big increase in resistance to the antibiotic nalidixic acid, with more than half of two common strains, C.jejuni and C.Coli, found to be resistant to the drug. Both antibiotics are classed as “critically important,” which means a drug is the only option or one of very few alternatives for treating human illnesses. Across the 283 samples tested by the FSA, 5% had developed resistance to multiple drugs. The FSA noted that 900 million chickens are produced in the UK every year, which means millions could be carrying multi-resistant-bacteria.  According to The Bureau of Investigative Journalism (TBIJ), campylobacter is responsible for half a million infections, 100 deaths and 80,000 GP consultations every year, costing a total of £900 million (US$1.17 billion).

Melissa Healy. July 2016. A ‘slow catastrophe’ unfolds as the golden age of antibiotics comes to an end. Los Angeles Times.

Important antibiotics for which resistance has developed: Penicillin, The golden age of antibiotics appears to be coming to an end. Now, common ailments are regaining the power to kill.

More than 100 antibiotic compounds have been introduced since penicillin, and many important ones have developed resistance, such as: Tetracycline, Erythromycin, Methicillin, Gentamicin, Vancomycin, Imipenem, ceftazidime, Levofloxacin, Linezolid, Daptomycin, Ceftaroline.

Researchers haven’t identified a new class of antibiotic medication since 1987.

But almost as soon as they were given to patients, scientists began finding evidence that disease-causing bacteria were developing resistance to these new wonder drugs.

Bacteria meet, mate, compete and evolve inside living bodies. When an antibiotic is added to the mix, only the strongest survive. Yet only 30% of Americans believe that antibiotic resistance is a significant problem for public health.

Humans have accelerated this natural process by indiscriminately prescribing antibiotics and by routinely feeding the drugs to livestock, scientists say. Multiply the number of humans and animals taking these drugs, and you multiply the opportunities for antibiotic-resistant strains to emerge.

Each year, more than 2 million people in the U.S. are infected with a bacterium that has become resistant to one or more antibiotic medication designed to kill it, according to the federal Centers for Disease Control and Prevention. At least 23,000 people die as a direct result of antibiotic-resistant infections, and many more die from other conditions that were complicated by an antibiotic-resistant infection, the agency says.

The problem goes beyond treating infections. As bacterial resistance grows, Lesho said, “we’re all at risk of losing our access” to medical miracles we’ve come to take for granted: elective surgeries, joint replacements, organ transplants, cancer chemotherapies. These treatments give bacteria an opportunity to hitch a ride on a catheter or an unwashed hand and invade an already vulnerable patient.

May 24, 2014. Four Bacteria of the Apocalypse. NewScientist.

Multi-drug resistant tuberculosis (MDR-TB) is growing. Existing drugs for TB cure only about half of those treated for MDR-TB. Only one new drug has been introduced in 40 years, despite global efforts.

MRSA – or methicillin-resistant Staphylococcus aureus – has been joined by a staph that resists another last-resort drug, vancomycin. Livestock reared using antibiotics can develop MRSA infections. Such strains can spread among humans, as shown by recent human cases in Denmark even though it has banned antibiotic growth-promoters in livestock.

CRE – or carbapenem-resistant Enterobacteriaceae – is a group of gut bacteria that resists carbapenems – antibiotics of last resort. One set of CRE genes was first seen in India in 2009 and has since been found around the world. The bacteria can cause urinary tract infections, and the resistant strain is making this widespread ailment untreatable.

Gonorrhoea – a sexual infection also known as “the clap” – is becoming increasingly resistant to antibiotics. Untreatable cases have emerged.

Jones, Tamera. 21 July 2014. Sewage treatment contributes to antibiotic resistance

Amos, G. C. A. Amos, et al. May 5, 2014.  Waste water effluent contributes to the dissemination of CTX-M-15 in the natural environment, Journal of Antimicrobial Chemotherapy2014; 69: 1785 – 1791.

Wastewater treatment plants could be unwittingly helping to spread antibiotic resistance, say scientists.  Their research suggests that processing human, farm and industrial waste all together in one place might be making it easier for bacteria to become resistant to a wide range of even the most clinically-effective antibiotics. With so many different types of bacteria coming together in sewage plants we could be giving them a perfect opportunity to swap genes that confer resistance, helping them live. This means antibiotic-resistant bacteria may be evolving much faster than they would in isolation.

The research, published in Journal of Antimicrobial Chemotherapy, shows that there are now reservoirs of highly resistant gut bacteria in the environment, threatening human and animal health.

We urgently need to find new ways to process waste more effectively so we don’t inadvertently contribute to the problem of drug-resistant bacteria.

Earlier studies have suggested that farming and waste processing methods contribute to reservoirs of resistant bacteria in the environment. But, until now, very few studies had looked at whether or not wastewater effluent contributes to the problem.

We’re on the brink of Armageddon and this is just contributing to it. Antibiotics could just stop working and we could all be colonized by antibiotic-resistant bacteria.’ Professor Elizabeth Wellington of the University of Warwick.

Mackenzie, D. June 16, 2012. WHO demands action on drug-resistant gonorrhoea. NewScientist.

Gonorrhoea, a sexually transmitted infection also known as “the clap”, is making a comeback – and this time it may be incurable. New strains have emerged that resist the last few antibiotics that still worked against the disease. In a rare public alert last week, the World Health Organization warned that highly resistant cases of gonorrhoea have now been detected in Japan, Europe and Australia. It is calling for a worldwide effort to track the superbug – and to develop new gonorrhoea drugs and vaccines.

That’s a slim hope. Between the limited profits to be made from drugs that cure infections and the previous success of antibiotics against gonorrhoea, there has been little investment in the disease. “There are no new therapeutic drugs in development,” says Manjula Lusti-Narasimhan of the WHO’s Department of Reproductive Health and Research.

Yet epidemiological models show that the current official policies for managing gonorrhoea are virtually guaranteed to lead to a rebound in cases, and to antibiotic resistance.

Neisseria gonorrhoeae, also known as Gonococcus, infect an estimated 106 million people a year worldwide. The infection causes painful urination in men and can be symptomless in women, but left untreated it may cause painful pelvic inflammation and potentially fatal ectopic pregnancy. It can cause blindness in babies, and makes it easier to contract HIV.

N. gonorrhoeae is now resistant to penicillin, and the subsequent families of antibiotics used to treat it.  Now only a couple of third-generation cephalosporin antibiotics are left. But resistance to these has been creeping up, and last year N. gonorrhoeae resistant enough to be dubbed a “superbug” was reported in Japan. Worse, the models show that relying on one drug until resistance builds up, then switching to another – precisely what health agencies have done – causes resistance fastest.

But people who change partners such as sex workers and promiscuous communities of men who have sex with men, are likely to pass on the infection. Targeting such groups for treatment caused gonorrhoea infection rates to drop steeply in industrialized countries since the 1970s – but now they are climbing again.

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One Response to Antibiotic Resistance

  1. Keith Akers says:

    Why not just shut down all the factory farms? Or, at least, prohibit the use of antibiotics for promoting growth in farm animals.