We’re one step closer to a dreaded post-antibiotic world
We saw it coming for 70 years, but that doesn’t mean we can stop it
As with natural resources, fast food, and reality TV, the U.S.’s biggest problem with antibiotics has been overconsumption. While the creation and introduction of antibiotics to the public in the 1940’s was a total game-changer for modern medicine and has since saved millions of lives, prolific use over the past several decades has led to “the single most important infectious disease threat of our time,” according to Beth Bell of the Centers for Disease Control. Evolution is catching up to our inventions.
Bacteria have been evolving in conjunction with humanity’s adaptive use of antibiotics. Certain strains have finally developed the “dreaded” mcr-1 gene that makes them insusceptible to colistin, the last resort drug reserved for treatment of especially dangerous superbugs.
We’ll be in serious trouble if (or when, some say) bacteria possessing the mcr-1 gene were to transfer the gene to bacteria that are currently only treatable by colistin. It would lead to the creation of a super-superbug — untreatable by any and every antibiotic available. Immunologists and public health officials are rightly freaking out — each new discovery of bacteria carrying the mcr-1 gene increases the chances of the gene spreading and sending humanity into a post-antibiotic era.
Well, the USDA’s Agricultural Research Service has just discovered the third case of an antibiotic-resistant superbug in the US while performing an analysis of 2,000 intestinal samples from cattle, pigs, turkeys, and chickens. This newest strain of bacteria is different from each of the previous two, making it more likely than not that the mcr-1 gene is already circulating in the US.
The first cases of colistin-resistant bacteria were only found in China in November of 2015, but the problem of antibiotic resistance has been looming above humanity for decades.
So, how did we not prepare a solution for this issue sooner?
On September 3, 1928, a bacteriologist by the name of Sir Alexander Fleming noticed a small amount of Penicillin notatum (now known as P. chrysogenum) growing on one of his culture plates of Staphylococcus aureus. The effect he noticed that day would later lead to the creation of the revolutionary antibiotic penicillin.
Fleming was also the first physician to raise the alarm around overuse, however, as far back as 1945. People just weren’t ready to listen.
After great success in treating serious infections in the 1940’s and then treating and managing the infections of soldiers during WWII, antibiotics weren’t going anywhere. They had saved millions of lives and allowed for immense medical advancement — they were miracle drugs. So when penicillin resistance first became a serious clinical issue in the 1950’s, pharmaceutical companies simply opted to create new antibiotics. The troubling trend of making new drugs when resistance arose to those already in use would carry on for half a century.
Then in 1958, the United States Surgeon General issued a warning that over-reliance on antibiotics had contributed to the dramatic spread of Staph. aureus. While improved hospital hygiene and asepsis were suggested, more antibiotics were not. It wasn’t just government agencies that were keeping a wary eye toward overconsumption: the popular press took notice as well.
A Science News Letter article from 1953 titled, “Fear Man-Made Epidemics,” warned that antibiotics should not be used prophylactically.
In 1960, Time published an article titled “Medicine: Cooling the Hot Staph” that read, “Almost as fast as new antibiotics are marketed, there evolve a few strains of disease-causing microbes that are resistant to the most potent germ killers. Recently, thanks largely to overuse and outright abuse of favorite antibiotics — especially penicillin — it has seemed that medical scientists were fighting a losing battle.”
In 1961 and 1964, Good Housekeeping also warned against casual antibiotic use.
The New York Times published three articles between March 1961 and September 1962 that detailed “a steady increase in antibiotic-resistant hospital infections.”
Newsweek published a story in August of 1967 explaining plasmids and horizontal gene transfer (HGT). The article went on to warn of the dangers of mutant E.coli that would result from cattle being fed antibiotic-laced feed.
This handful of warnings all came before the production of antibiotics slowed in the 1980’s due to economic and regulatory hurdles. Before those hurdles ever posed a significant threat to production, though, scientists had already proven that every antibiotic created would eventually be resisted by bacteria. We may currently be in a crisis, but scientists, medical professionals, and pharmaceutical companies have known for decades that every antibiotic has an eventual expiration date.
Why then has antibiotic use continued increasing to a point of ineffectiveness without any sort of backup plan?
A 2014 paper, “The Future of Antibiotics and Resistance,” attributed the phenomenon, in part, to an economic concept referred to as the Tragedy of Commons. They explain that it “results from tension between what individuals perceive as being to their own short-term benefit weighed against a small collective longer-term harm to society.” Quite simply put, it’s hard to get people to ditch self-interest in the present in the name of a nebulous greater good in the future.
It’s also quite likely that many people who viewed these concerns seriously in the latter half of the 1900’s did not push more heavily for an alternative because they assumed that science would advance faster than the problem — as it had reliably been doing. Until now.
“Crisis,” “nightmare scenario,” and “catastrophic consequences” have all been used in reference to the recent antibiotic resistance upheaval, but significant warning signs have predicted this moment for nearly seventy years. Had serious action been taken to mitigate the problem in, say, the 1970s, there’s a good chance this would be a manageable problem, instead of a crisis nightmare scenario with catastrophic consequences.
