Making Peace With Bacteria To End Antibiotic Resistance

Antibiotics were supposed to usher us into a future where deadly infections are a thing of the past. Unfortunately, future isn’t what it used to be.

Ninety years ago the discovery of antibiotics was hailed as a modern blessing against bacterial infections and deadly diseases. Today, antibiotic resistance has become an existential threat, due to overuse of antibiotics.

Two million people get an antibiotic-resistant infection per year in the US alone, according to the CDC. A December 2014 Review On Antibiotic Resistance warned that at least 10 million people could die every year from untreatable infections – along with $100 trillion worth of economic losses through higher mortality and morbidity rates – if we fail to tackle antibiotic resistance. Meanwhile, antibiotic consumption continues to accelerate worldwide, sans regulatory mechanisms to curb the increasing use in prescriptions, animal husbandry, personal care and food supply.

The downward spiral began with a fairly common human misconception, namely our tendency to perceive the unknown as a threat. Antibiotics were the culmination point of developing armory against  microbial lifeforms, without realizing that we house more than 100 trillion bacteria in our body, three times more than the total amount of human cells, that perform vital functions.

Thousands of species of bacteria live in our gut, aiding with digestion, warding off pathogens, maintaining the immune system, synthesizing vitamins, decomposing fecal matter, creating enzymes, harnessing energy from carbohydrates, absorbing fatty acids, and producing hormones. Thousands more perform vital functions on our skin, in our lungs, mouth, hair, organs, blood, and genitalia.

Useful little critters.  Had we not declared a war on them soon after their discovery.

Confusing The Enemy

“All the water . . . seemed to be alive,” observed Dutch scientist Anton Van Leeuwenhoek when he first pointed a microscope on a sample of human plaque in 1683. At first the little critters didn’t seem to represent a threat – they were just everywhere.

Leeuwenhoek’s successor Nicolas Andry called microbes “worms” and proposed they could transfer disease. “Worms” metamorphosed into “germs”, as the hunt for pathogenic bacteria accelerated.

By the late 1800s when the scientists had isolated Black Death, cholera, chlamydia, and a handful of other notorious infectious diseases; bugs were in for a century of prejudice. We only recognized their dark side.

During the early antimicrobial revolution, the chemical industry introduced disinfectants for our homes, antiseptics for our skin, pesticides for our agriculture, while researchers were looking for the perfect weapon to eliminate any infectious threat.

The first early 20^th century vaccines saved hundreds of millions of lives and brought small pox, diphtheria, tetanus, yellow fever, whooping cough, polio, and measles under control. Yet vaccines were only able to stimulate the body’s immune system against disease, not cure it.

“If we could intervene in the antagonism between bacteria, it would offer perhaps the greatest hopes for therapeutics,” biologist Louis Pasteur wrote in 1876, expressing the idea of antibiosis (latin for “against life”): the promise for the next generation weaponry against bugs.

“Antibiosis” means the ability to harness one microbe’s defenses against another. It was a big leap from Pasteur’s previous idea of pasteurization, which uses heat to zap bacteria (to conserve consumables, for example).

Once Pasteur and his colleague Robert Koch demonstrated that an airborne bug could inhibit anthrax, scientists began to pursue antagonistic, targetable microbes with a vengeance.

Jump to 1928, when microbiologist Alexander Fleming accidentally left his petri dish of staphylococci (common respiratory and skin bacterium in humans) exposed to a penicillin mold. The halo of dead staph bacteria on the edges of the petri dish that Fleming encountered the next morning, signaled the future of antibiotics.

Penicillin, the precursor of modern antibiotics, works by preventing enzymes in bacteria from forming new cell walls. The scope of exploitation for penicillin was limitless from day one. Tuberculosis, step, staph, typhoid, ulcers, abscesses, food poisonings, infections from surgeries, all needed a reliable bug buster.

Mass production of penicillin began just in time for WWII, where it quickly gained a lifesaver reputation by dramatically reducing casualties from wounds and amputations. US pharmaceutical giants Merck, Squibb, Pfizer, and Abbot grew production from 21 billion units in 1943 to 6.8 trillion units in 1945.

Meanwhile, Bayer stumbled on a synthesized dye that was able to cure strep in mice, which they patented without further ado as Prontosil in 1932. The active compound was later identified as sulfanilamide, a 1906 dye industry chemical with an expired patent. This began the “sulfa craze,” with hundreds of manufacturers producing tens of thousands of tons of sulfa as the new miracle panacea. Even American first-aid kits instructed soldiers to sprinkle sulfa on “any open wound.”

Hundreds of antibiotics followed suit over the next half a century, targeting an increasingly common variety of ailments. Bronchitis. Pneumonia. Diarrhea. Sore throat.

False Promises

The antibiotic revolution saved millions of lives – but triggered a microbial blowback.

By developing smart weapons against pathogens we accelerated their evolution over and beyond any other bacterial species, thereby creating an unnaturally rare breed of hostiles. Bacteria can mutate in seconds, thousands of times a day to lock in a resistant gene. Only a few of them have to survive and replicate to make their species resistant to a drug – a drug that took about a decade for our best minds to develop.

The first drug-resistant bacteria surfaced in the early 1950s. Fleming himself had warned about drug resistance in his 1945 Nobel lecture.

“The time may come when penicillin can be bought by anyone in the shops. Then there is the danger that the ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant. Here is a hypothetical illustration. Mr. X. has a sore throat. He buys some penicillin and gives himself, not enough to kill the streptococci but enough to educate them to resist penicillin. He then infects his wife. Mrs. X gets pneumonia and is treated with penicillin. As the stretococci are now resistant to penicillin the treatment fails. Mrs. X dies.”

George Orwell is a case in point. While finishing his book 1984, Orwell developed an early antibiotic-resistant mutation of M. Tuberculosis in response to repeated prescriptions of Streptomycin. Soon after, he died from lung hemorrhage.

Superbugs didn’t receive much publicity until end of the century, when rampant hospital infections began to be routine. By then, millions of metric tons of antibiotics were routinely fed to both humans and livestock every year. Antibiotic resistance didn’t deter the health care industry from issuing prescriptions at an ever faster rate.

In 2010, doctors prescribed 258 million courses of antibiotics for a population of 309 million people. The biggest visible impact can be seen in the number of superbug infections, 80 percent of which take place in hospitals.

The CDC records up to 1.7 million hospital infections per year, out of which at least 20 percent evolve into superbugs. One of the nastiest of these superbugs is the MRSA, Methicillin-resistant Staphylococcus aureus, which can cause widespread infection in vital organs, toxic shock syndrome, before finishing you off with flesh-eating pneumonia.

Two billion people carry staph naturally on their skin, nose or respiratory tract. It can only cause an infection if it enters a wound and the patient has a weak immune system. Antibiotics have essentially weaponized staph to an extremely hostile, rapidly propagating beast.

Out of 500,000 staph infections in U.S. today, 100,000 today evolve into MRSA, of which at least 20,000 become fatal. The figure is growing fast, partly because of the prescription doctors use against MRSA, namely more antibiotics.

MRSA today also afflicts our livestock – for an obvious reason. Over 63,000 tons of antibiotics (more than the weight of the Titanic), or 80 percent of the total annual antibiotic consumption is used in animal husbandry alone. As a result, a 2011 study reported that up to 24 percent of the meat and poultry sold in U.S. grocery stores contained MRSA strains.

Food borne superbugs such as Salmonella and Escheria Coli have also jumped from livestock to humans. The drug-resistant strains of E. coli, for example, which causes urinary tract infections in women, can be traced back to antibiotics in chicken.

Gonorrhea and chlamydia have also developed resistance. Tuberculosis has evolved into a multi-resistant strain. The pace of proliferation isn’t slowing down. China, Brazil, India, Russia and South Africa are looking at a 100 percent increase in antibiotic consumption by 2030. Antibiotics can be found in 75 percent of liquid soaps, in Band-Aids, cleaners, and topical OTC ointments like Neosporin (also linked to MRSA).

Distribution is also heavily subsidized. 17,000 doctors received $250 million in sales commissions in 2010 from seven pharmaceutical companies alone. A 2013 survey found that doctors prescribe antibiotics to 2/3rds of patients who have symptoms of viral infections like sore throat or bronchitis with antibiotics that don’t cure viral infections. These type of prescriptions only serve to crash the immune system.

By 2050, 10 million people per year could die from antimicrobial resistance, according to KPMG and RAND Europe.

Somewhere along the line, industry profit hijacked the Hippocratic Oath – and rigged the game to maximize revenue. Today we are paying the price.

It takes a decade to develop a new antibiotic, and five seconds for a staph bacterium to mutate.

It’s time to rethink antibiotics. At least on a personal level, as the medical system fails to respond to biological reality.

Back To Year Zero

”We may look back at the antibiotic era as just a passing phase in the history of medicine, an era when a great natural resource was squandered, and the bugs proved smarter than the scientists” – Cannon G. 1995

Today’s microbiologists acknowledge the human body as a microbiome – a bacterial cloud living inside another – in which the diversity of species correlates with health of the host.

We need to learn from the hunter-gatherer tribe in the Amazon who carry a natural resistance to disease and infections because of their uniquely rich microbiome. Some progressive practitioners are shifting therapeutic focus to bacterial versatility with novel approaches like fermented diets, probiotics and fecal transplants.

The drug-resistant backlash is also finally bringing some natural antimicrobials back into the medical fold. Silver, for example, used by natural healers for thousands of years against a spectrum of infectious diseases, was crossed out of medicinal books in the last century during the antibiotic revolution, but is now resurfacing as a clinically proven method to counter infections without negative side effects like antibiotic resistance.

A 1978 Science Digest article that extolled silver as the “best all-around germ fighter that kills over 650 disease-causing organisms… and it is absolutely non-toxic,” was largely ignored at the time because everyone believed in the modern antibiotic age. Today silver is wiping out superbugs in modern lab conditions, the same superbugs that antibiotics are already powerless against.

Adopting grandma’s antimicrobial wisdom such as silver and other natural alternatives (see below) can help us regain our resistance against most common and exotic infections. The key is to try and avoid the next antibiotic prescription unless the situation is acute and life threatening, so that the body can start rebuild its own defense system. Often healthy eating and lifestyle habits that bring us into contact with a broader world of bacteria (such as gardening or carousing with nature or other living species) may help us avoid those infections in the first place, by propping our own natural resistance.

The biological reality is that we either carry or are exposed to most of the nightmare bacteria out there, but they only get an upper hand if our resistance is down. Attacking the culprit is therefore self-defeating in most cases.

As long as our bacterial commune is rich and diverse, we can count on the body to remain self-healing. That’s how we were designed by nature.

By Jan Wellmann

LIST OF COMMONLY USED NATURAL ANTIMICROBIALS