- Antibiotic resistant superbugs are a serious health threat with what will likely have catastrophic consequences as we begin to enter a post-antibiotic era.
- Resistance is not just to one class of drugs, like penicillin, but to multiple classes of drugs—multi-drug resistance.
- The antibiotic resistance threat is akin to that of climate change.
- Estimates place 10 million people dying every year by 2050 and would cost the world up to $100 trillion dollars.
- More than half the world’s antibiotics are attributed to animal agricultural use and researchers have found that antibiotic resistant bacteria found in American cattle yards have become airborne.
Table of Contents
- 1 The Rise of Antibiotic Resistant Superbugs
- 1.1 A New Era of Superbugs
- 1.2 The Development of Antibiotic Resistant Bacteria
- 1.3 How We’re Making it Worse
- 1.4 Worldwide Impact
- 1.5 The Future of Antibiotics
- 1.6 What Can We Do?
The Rise of Antibiotic Resistant Superbugs
Developing antibiotics to treat bacterial infections was one of the most significant medical leaps ever taken by humanity—saving countless millions of lives. Before the mid-1940s a tooth abscess might have killed, scarlet fever was often lethal and gangrene claimed limbs as a matter of course. If 3 people caught pneumonia, it was likely that only 2—or even 1—would survive. Then the wonder drug penicillin came along and suddenly the future looked entirely different.
But while human lives were improving across the globe, animal lives were a different story. In the US and other parts of the world farmed animals were being tightly packed into factory farms in disgracefully cruel confinement conditions, all of which continue today across the globe, and as a result bacteria and disease began to spread.
All too soon, the animal agriculture industry began using antibiotics in the animals’ water and food to mitigate the spread of disease and pestilence exacerbated by these crowded living conditions
A New Era of Superbugs
Bacteria are everywhere and in most cases, that’s a good thing. Those tiny, single-celled organisms are keeping us alive by helping us digest food and aiding our bodies in fighting off infection and disease. They’re strong, resourceful and plentiful. Microbes outnumber us by 10,000,000,000,000,000,000,000 to 1 (that’s 10 sextillion to 1), they have existed 1,000 times longer than Homo Sapiens, and they are capable of creating 500,000 generations in 1 human’s lifetime.
Antimicrobial or antibiotic resistance is a complex problem and is one of our most serious health threats with what will likely have catastrophic consequences where our world is taken into a post-antibiotic era.
An antimicrobial is an agent that kills micro-organisms, or inhibits their growth, and are used to treat bacterial infections. Unfortunately, during the last 70 years, bacteria have shown the ability to become resistant to every antibiotic that has been developed and this has been identified since the 1950s amid postwar outbreaks of dysentery.
Bacteria can gain mutations or otherwise adapt to escape the toxic effect of drugs, and like viruses and parasites, bacteria can transfer their resistance from parent to offspring. However, the magnitude of the resistance was not truly realised until it was discovered that bacteria have a unique feature where their resistance can be transferred horizontally—from neighbour to neighbour—creating an even greater threat.
Bacteria can be passed to neighbouring bacteria by direct contact or by bridge-like links between cells.
To make matters even worse, the resistance itself is contagious. Related species of bacteria, when mixed with multi-drug resistant bacteria, also become resistant to multiple antibiotics. The more antibiotics are used, the more quickly bacteria develop resistance. Anytime antibiotics are used, it puts biological pressure on bacteria that promotes the development of resistance.
Bacteria can transfer drug-resistance where the resistance traits are packed into the virus infecting the cell and injected into any new bacteria the virus attacks.
The Development of Antibiotic Resistant Bacteria
There are two reasons for why antibiotic resistant superbugs have developed and remain an ongoing driver: The over-prescription and misuse of antibiotics in human medicine, and the misuse of antibiotics in animal agriculture to meet the ever increasing demand for animal meat across the globe.
Misuse in Human Medicine
Hospital environments and cultural influences inadvertently promote and perpetuate unnecessary use of antibiotics and the overuse of the most potent, broad-spectrum antibiotics because doctors are focused almost exclusively on treating the potential infection in front of them, in their individual patient. Long-term risks are not prioritised and the judicious use of antibiotics is not valued.
Hospital environments and cultural influences inadvertently promote and perpetuate unnecessary use of antibiotics.
A recent Australian study found that while approximately 40% of hospital in-patients receive antibiotics, nearly half of those are actually unnecessary or sub-optimal. Contributing are unnecessary prescriptions for viral infections like the common cold and most cases of bronchitis are 90-95% of the time viral as well, passing after a few weeks.
Misuse in Animal Agriculture
Cramped, cruel confinement conditions in factory farms maximise space and profit while the spread of bacteria and disease are mitigated by heavy antibiotic use. A side effect was discovered where the antibiotics also acted as growth promoters and began pushing farmed animals far beyond their natural body weight.
Factory farms cause the spread of bacteria and disease with ease.
63,000 tons (64,154,422 litres) of antibiotics were feed to farmed animals across the globe in 2010. By 2030, it is expected that the number to rise to more than 105,000 tons (106,924,036 litres).
Since the 1970s when factory farming began to peak, societal demand has resulted in farmed animals consuming more than half of the entire world’s production of antibiotics annually—in the US, it’s nearly four-fifths of all antibiotics.
It has been known for decades that the overuse and misuse of antibiotics—in the medical and agricultural industries—promotes the emergence of antibiotic resistant pathogens. Using sub-therapeutic doses, or ineffectively targeting the intended bacteria, leads to survival of the fittest; resistant bacteria remain and reproduce exponentially.
This map shows the current global antibiotic consumption in farmed animals in milligrams per 10 square kilometre pixels.
Because of this knowledge, antibiotics being used as growth promoters has been banned in Europe since 2006 and antibiotics are only used to treat sick animals—which is still extremely common given factory farming environments. However, antibiotics being used as growth promoters is still standard practice in the US, Australia and elsewhere in the world
How We’re Making it Worse
The pollution of waste water with leftover drugs provides a breeding ground for resistant bacteria and their genes.
Despite an early warning sign of antibiotics being present in waste water when penicillin was found in soldiers’ urine during WW2, there’s been no end to the pharmaceutical pollution that is found in the world’s water—analgesics, antibiotics, lipid regulators, antiseptics, beta-blockers, contraceptive hormones, anticonvulsants and X-ray contrast agents. There are even detectable levels of clofibrate now found throughout the North Sea
Patancheru, India, where drug factories dump enough of a single powerful antibiotic was being spewed into one stream each day to treat every person in a city of 90,000.
Water treatment plants are the last attempt at some kind of barrier to drug residues and other synthetic chemicals being set loose into soils and waterways. As the use of recycled water increases in many countries, the quality of this water becomes more critical and pharmaceuticals are being identified as a risk in recycled water risk-management systems.
Meanwhile, freely administered antibiotics in animal agriculture have no barrier and compounds such as sulphasalazine and oxytetracycline are deposited straight to ground, dumped into waterways and the ocean via feces and urine.
Animal agriculture is the leading contributor to global water pollution
An ongoing driver in the rise of antibiotic resistant bacteria is climate change as it will increase the spread of infectious disease across the globe. As we experience significant global changes in temperature and weather patterns, it’s expected that both the range of infectious diseases and the timing, intensity and location of disease outbreaks will become more severe.
A newly identified driver comes from a new study which finds that the DNA from antibiotic resistant bacteria found in American cattle yards has actually become airborne.
This study shows that a new pathway has been created by which bacteria can potentially spread to humans and hinder treatment of life-threatening infections. Researchers found the air downwind of the cattle yards contained antibiotics, bacteria and a “significantly greater” number of microbial communities containing antibiotic resistant genes.
Because antibodies are poorly absorbed by cows they are released into the environment through excretion. The genes that have gone airborne are contained in dried fecal matter that has become dust and gets picked up by winds as they whip through the stockyards.
Antibiotic resistance is a worldwide problem. New forms of antibiotic resistance can cross international boundaries and spread between continents with ease. Many forms of resistance spread with remarkable speed and world health leaders have described antibiotic resistant micro-organisms as “nightmare bacteria” that pose a catastrophic threat to people in every country in the world.
There are approximately 25,000 deaths in Europe annually with an associated healthcare cost and productivity loss of at least €1·5 billion. Each year in the US, approximately 2 million people acquire serious infections with resistant bacteria and at least 23,000 of those people die each year as a result, reflected in an estimated $20 billion in additional medical costs.
In Australia, there’s an estimated annual $250 million cost to the Australian healthcare budget and additional $400 million burden to the community. While the situation is currently better in Australia compared to many other parts of the world, it does not mean we’re immune—major resistant organisms including multi-resistant gram negative bacilli (MRGNB), methicillin-resistant Staphylococcus aureus (MRSA) and Vancomycin resistant Enterococci (VRE) are already present in Australia
Resistant bacteria reproduce and the body’s natural defences struggle to deal with the onslaught which can be seen here, as MRSA bacteria overwhelm a white blood cell (red).
By 2050, it is estimated that with the continued rise in resistance would lead to 10 million people dying every year. We would then see a reduction of 2% to 3.5% in Gross Domestic Product (GDP) which would cost the world up to 100 trillion USD.
Deaths attributable to antibiotic resistance every year by 2050 (via the Review on Antimicrobial Resistance).
The Future of Antibiotics
Throughout history there has been a continual battle between humans and pathogens. For the last half century, this battle has taken the form of bacteria versus drugs. However, the euphoria that came with the discovery of penicillin and the potential conquest of infectious diseases was short lived.
In response to our offensive, bacteria developed an enzyme that essentially ate penicillin for breakfast—in fact, bacteria can excrete such large quantities of the enzyme that they can destroy the drug before it even comes into contact. In another offensive, we developed a drug that blocks the penicillin-eating enzyme. But the bacteria outsmarted us again by developing a blocker blocking blocker—and so it goes back and forth.
Antibiotics are very expensive to develop and takes approximately 10 years and a billion dollars to bring a new drug to market. Only 1% of the world’s bacteria have actually been examined—there is no doubt that many more are out there.
Even with the discovery of the first new antibiotic in 30 years, which has been hailed as a ‘paradigm shift’ in the fight against the growing resistance to drugs, however hard we try and however clever we are, there is no question that organisms that have been around for 3 billion years, and have adapted to survive under the most extreme conditions, will always overcome whatever we decide to throw at them.
Are Antibiotic Resistant Superbug Threats Being Monitored?
In short, no. The establishment of the required programs and resources to collect and analyse data are not in place in any substantial way across the globe.
There is no systematic international surveillance of antibiotic resistance threats, no data systematically collected on antibiotic use in human healthcare and in agriculture, no widely used programs to improve antibiotic prescribing in the US, and there is no national system to monitor how many antibiotics are given to farmed animals in Australia.
What Can We Do?
Researchers say that the only way to create a change is through consumer demand. If we don’t want to be antibiotic resistant in the near future, it’s time we decrease our worldwide demand for meat and increase our concerns over antibiotic resistant bacteria. The best option is to go vegan to avoid animal products that contain antibiotics and hormones and to stop supporting the industry that is creating this disaster, as well as to question doctors on their prescriptions of antibiotics and if they’re in fact necessary.
What you think you’re “giving up” when you say no to animal-based food products is actually a chance to gain so much more, for yourself and the world.
Sources: OGP: Superbug Treat, Review on Antimicrobial Resistance, CDC Antibiotic Resistant Threats 2013, Links between Climate Change, the Spread of Disease and Animal Agriculture, US Now Consumes Four-Fifths of All Antibiotics, NCBI: Pneumonia before Antibiotics, Harvard Magazine: Superbugs, NCBI: Inappropriate Antibiotic Use, Origins and Evolution of Antibiotic Resistance, European Commission: Ban on Antibiotics as Growth Promoters, Chemical: Penicillin, PUBS: Pharmaceuticals Hormones and Other Organic Wastewater Contaminants in US Streams, Discharge of Pharmaceuticals Dutch Coast North Sea, Evaluating and Controlling Pharmaceutical Emissions, FAO: Antibiotics in Farm Animal Production, Conversation: The Water Industry, Climate Change and Security, Time: Airborne Bacteria and Study, Global Health, Australian One Health Antimicrobial Resistance Colloquium, The Conversation: Infection Control, Resistant Staph Detected Australian Pigs, NCBI: Mechanisms of Antimicrobial Resistance in Bacteria, NCBI: Purification and Characterisation of Penicillinases from Salmonella Typhimurium and Escherichia Coli, First New Antibiotic in 30 Years Discovered.