Superbugs: The Bacteria That Are Defeating Antibiotics

You may have read the recent disturbing reports about how antibiotics are being rendered useless, as superbugs evolve faster than the men and women in white coats can develop new drugs to wipe them out.

Inside our bodies there is an on-going war being waged on a microscopic level - a war with bacteria so determined to survive that they adapt to whatever antibiotics we invent to fight them.

I've asked HSI US Panellist, Dr Allan Spreen, to give us his take on the situation and offer some advice on how we can best protect ourselves from super-bugs, and bugs in general.

The more things change...

Everyone living this side of a cave has heard about drug resistant bacteria. It's practically a catch phrase that the media throws at us from the medical side of things when there's no major headline to play with.

Keep in mind that the reputation of modern medicine to deliver 'miracle' drugs is built almost entirely on antibiotic successes. Starting with penicillin for pneumococcal pneumonia (once highly fatal, then becoming a minor player in terms of mortality statistics), the antibiotic is the agent that really opened the world's eyes to drug therapy successes. If there ever was a real problem with one type not working, there was always a new one, or even an entire new class of antibiotic, waiting in the wings to take over and blow our minds again.

Well, that's changing.

Superbugs at large

There has now been a case reported of a new bacterium that is completely resistant to vancomycin - a powerful antibiotic that's been so effective that it's referred to as a 'last line of defence.' This new drug-resistant bacterium is a variation on Staphylococcus aureus (SA), a super-bug that sometimes causes wound infections.

The Centres for Disease Control (CDC) led the bacterial analysis in this case, and said that more mutated organisms like SA are expected. New antibiotics under development have already encountered mutated strains of SA that are resistant to the new drugs.

The US Wall Street Journal published an article a few months back, entitled 'Drug-Resistant Bacteria Cases No Longer Are Just in Hospitals.' An international panel of experts on the topic warned that Super-bugs once confined to hospitals are now on the loose 'in the general community.' This news comes to us from an International Forum on Antibiotic Resistance, so somebody up there is worried.

Dr. Gary Doern, professor of medicine and director of clinical microbiology at the University of Iowa, summarised the data this way, 'There are now patients with pneumococcal infections for whom there is no antibiotic.' He also mentioned that methicillin-resistant SA, originally only encountered in hospitals, is now occurring in some communities up to 30% of the time.

Methicillin, penicillin, vancomycin, ciprofloxacin, whatever...the drug company gurus will cook up a new class of antibiotic and away we'll go - no problem.

Well, maybe just a little problem.

Bottom of the barrel

BiomedNet News, an Internet news service for the scientific community, expanded on some details the Wall Street Journal omitted. In the September 2002 26 edition they have Dr. Doern saying a few other things.

It seems that the speed with which bacteria develop antibiotic resistance is far faster than the hotshots figured. In the last 2 years drug resistance to fluoroquinolone antibiotics (Cipro is a member of this class) has nearly tripled. Said Doern, 'Literally as we speak, fluoroquinolones are being compromised by resistance.'

But here's the article's kicker: 'This time, Doern says, no new drugs are forthcoming.' Again quoting directly from the article (they do it so much better than I), 'Developing a new antibiotic can cost close to a billion dollars, and the US Food and Drug Administration (FDA) has tightened rules for approval. The ketolide Ketek, manufactured by Aventis and awaiting approval in February 2003, had to be tested with 25,000 patients in its phase III trial before being submitted for FDA approval, Doern noted. Ketek is 'arguably the only new antibiotic - and that's no exaggeration - we're likely to see in the next 10 years.''

The alternative

It's now evident that bacteria contain the genetic material to resist alien biochemistries... synthetic drug efforts to kill them. This does not, however, seem to be the case in the area of natural agents possessing antibacterial properties, and those agents do exist. We hear little about them because of the fact that they are not patentable and therefore have no profit potential, at least nowhere near the level drug companies desire.

Tomorrow I'll tell you about four natural anti-bacterial (and anti-viral) agents that have a lot of what many would call 'anecdotal evidence' behind them. Nonetheless, they may be our only hope of being pulled out of the fire.