Dr. Arjun Srinivasan is an associate director at the Centers for Disease Control and Prevention. He spoke with Frontlineabout the need for more action at the local level to combat the problem of antibacterial resistance.
Explain to me why the discovery of antibiotics was so important for medicine.
Antibiotics were one of [the most], if not the most, transformational discoveries in all of medicine. Infections are something that we struggled to treat for many, many years, for centuries before the advent of antibiotics, and infections were a major cause of death before the advent of antibiotics.
So with the discovery of this new class of drugs, we overnight had an ability to care for people and offer them not just a treatment but a cure for an illness that previously would have taken their lives in a rapid manner. They really are miracle drugs, and not only have they saved the lives of millions and millions of people … but antibiotics have opened up new frontiers in medicine that would be impossible without them.
For example, organ transplantation. One of the major causes of death in patients who would have an organ transplant would be an infection. Without antibiotics, we wouldn’t be able to treat any of those infections. More:
From BBC: A new superbug that is resistant to even the most powerful antibiotics has entered UK hospitals, experts warn. They say bacteria that make an enzyme called NDM-1 (New Delhi metallo-ß-lactamase-1) have travelled back with NHS patients who went abroad to countries like India and Pakistan for treatments such as cosmetic surgery.
Although there have only been about 50 cases identified in the UK so far, scientists fear it will go global. Tight surveillance and new drugs are needed says Lancet Infectious Diseases. More:
What is NDM-1?
New Delhi metallo-ß-lactamase-1, or NDM-1 for short, is a gene carried by bacteria that makes the strain resistant to carbapenem antibiotics. This is concerning because these antibiotics are some of the most powerful ones, used on hard-to-treat infections that evade other drugs. More
From Daily Mail: Dr David Livermore, director of antibiotic resistance monitoring at HPA, said resistance to one of the major groups of antibiotics, the carbapenems, is found throughout India.
‘This is important because carbapenems were often the last ‘good’ antibiotics active against bacteria that already were more resistant to more standard drugs.’
The first two patients confirmed to have been infected had traveled abroad shortly before they were admitted to hospital in the UK. One patient carrying the tainted bacteria was transferred to a Nottingham hospital at the end of last year after suffering a trauma injury in Pakistan. More:
We’ve only got ourselves to blame for the indestructible Indian superbug
From Daily Mail: Knowing what we know now, if we could go back in time we would have prescribed antibiotics sparingly and only when they were really needed.
If we had done that, we may not have been facing the prospect of superbugs for the next 100 years.
Instead, antibiotics have been massively overprescribed, thrown willy-nilly at patients by harassed and time-pressed doctors for a host of minor ailments – often coughs and colds that aren’t even caused by bacteria in the first place.
As Professor Enright says: ‘Every time you throw enough antibiotics at enough people, you encourage the evolution of drug-resistant mutants.’
This happens everywhere, from GP surgeries in Britain and the U.S. – where antibiotics are the medicine of choice for just about every minor childhood snuffle – to India, where antibiotics are available cheaply over the counter without a prescription. More:
Are you ready for a world without antibiotics?
In The Guardian: The era of antibiotics is coming to a close. In just a couple of generations, what once appeared to be miracle medicines have been beaten into ineffectiveness by the bacteria they were designed to knock out. Once, scientists hailed the end of infectious diseases. Now, the post-antibiotic apocalypse is within sight.
Hyperbole? Unfortunately not. The highly serious journal Lancet Infectious Diseases yesterday posed the question itself over a paper revealing the rapid spread of multi-drug-resistant bacteria. “Is this the end of antibiotics?” it asked.
Doctors and scientists have not been complacent, but the paper by Professor Tim Walsh and colleagues takes the anxiety to a new level.More:
As the country prepares to vote in a discredited referendum, Rachel Aspden visits the forgotten Burmese resistance – the eastern ethnic groups promised independence 60 years ago. From New Statesman:
As the sun sinks over the steep jungle hills of the Thailand-Burma border, a saffron-robed monk walks towards his temple’s golden shrine. Across a shallow gully, four grey- uniformed Burmese soldiers watch him through binoculars, their rifles poised. Below them is a huddle of abandoned, burnt-out houses.
“Six years ago, they destroyed the temple and ran the new border straight through the middle,” says the monk. “On the Thai side we are safe for the moment. On the other . . .”
Pra Preecha is a refugee from Shan State in eastern Burma. Last September, when his fellow monks led 50,000 street protesters against the military government in Rangoon, the international media heralded a “saffron revolution”. It seemed that one of the world’s most brutal and insular regimes was about to crumble. But the ruling State Peace and Development Council (SPDC) clamped down hard on protesters and sympathisers – “scores, perhaps hundreds, of monks were abducted, tortured and killed”, says Pra Preecha – and the moment for change passed.