Antibiotic-resistant bacterial infections are the cause of 700,000 deaths worldwide each year, including 23,000 in the U.S. That is scary enough. What is even more frightening is that, according to a recent study, they will kill an additional 10 million people annually by the year 2050, more people than will die of cancer. That statistic was put forth in 2014 by Jim O’Neill, an economist appointed by British Prime Minister David Cameron to head a review of microbial resistance.
Dr. Aisha Thomas-St. Cyr, MD, is a board certified infectious disease specialist in Sebastian. She “cautiously agrees” with that statistic; she says exposure to resistant bacterial infections will continue to increase, causing an exponential rise in illness and death.
Antibiotics, in one shape or form, have been around since ancient times. An antibiotic can be loosely defined as a substance derived from bacterial sources that controls the growth of, or kills, other bacteria. The Greeks and Serbs used moldy bread to treat wounds; Babylonian doctors mixed frog bile and sour milk to heal eye infections; and peasants in Russia cured infected wounds with warm soil.
It is well known that certain strains of bacteria – superbugs – have become resistant to antibiotics due to antibiotic overuse and misuse. Intended to treat bacterial infections, antibiotics are among the most commonly prescribed drugs in the world. If erroneously prescribed for viral infections, like the flu, antibiotics will indiscriminately destroy bacteria – including “good” bacteria, which help us digest food, fight infection, and stay healthy, and give “bad” bacteria more opportunities to develop resistance.
Dr. Thomas-St. Cyr says, despite the public health danger, prescribing antibiotics for viral infections still happens, but is less prevalent than it once was. That’s good news, because the bacteria that survive the mis-prescribed antibiotic may get stronger, multiply, and become a drug-resistant superbug.
Superbugs are no longer primarily confined to hospital settings; an example is MRSA – an infection caused by a strain of staph bacteria. There is Healthcare-Associated (HA) MRSA, which is mostly seen in healthcare settings or nursing homes after some sort of invasive procedure, but there’s also Community-Associated (CA) MRSA, which occurs in the wider, healthy, population. CA-MRSA is spread by skin-to-skin contact; risk factors include participating in contact sports (high school wrestling is a prime example), and living or working in crowded or unsanitary conditions (child care centers, military training camps, prisons).
Both forms of MRSA most often cause mild skin infections, like sores or boils, and are not usually serious. Dr. Thomas-St. Cyr says, “We all have staph on our skin, not necessarily the strain we call MRSA. Even if it is MRSA, it’s often confined to one area; for example, some people may have it only in their nose. But with other people it can develop into sepsis.” In those cases, MRSA can cause dangerous skin infections.
MRSA can also enter the body through a cut or a surgical wound, and cause an infection of the bloodstream, lungs, or urinary tract. In the United States, superbugs (of which MRSA is just one) infect more than 2 million people each year, killing at least 23,000.
There are not many antibiotics in the drug development pipeline, because it is hard for pharmaceutical companies to make money off of them. They are as expensive to develop as many other drugs, but are only taken for short periods, not months or years like blood pressure or anti-depressant medications, so development costs are more difficult to recoup.
For that reason, it is critically to use correctly the existing antibiotics that still work. If your doctor says you have a virus – the flu or flu-like symptoms – he or she will prescribe rest, plenty of clear fluids, use of a humidifier, cool compresses, and maybe chicken soup. Don’t insist on an antibiotic – your doctor may give in to appease you, but it will not help your symptoms and it may lead to a superbug being bred in your body.
If you do have a bacterial infection, don’t insist on the strongest available antibiotic – in the long run, you may be better off starting with one that is milder, only moving to a stronger version if needed. Dr. Thomas-Cyr agrees with that, saying, “If the patient is well enough to wait for the culture to be completed, I’ll start with a weak antibiotic.” An exception is critically ill patients or those in the ICU; in those situations, it’s not prudent to wait, and Dr. Thomas Cyr will start with a strong antibiotic.
The best guidance is what we all learned in kindergarten – to avoid germs in the first place. Of course, at the top of the list is frequent and prolonged hand-washing with soap and water. We also need to be aware of other germ hotbeds; they include:
- Airplanes. Avoid hand-to-hand contact, use hand sanitizer frequently, and always drink liquids through a straw.
- Bathrooms. Shower curtains and liners should be made of fabric, not plastic, so that they can be washed in hot water.
- Elevators. Think how many hands have touched those buttons; use a disposable tissue or wipe when choosing your floor.
- Smart phones. Your phone may be the most germ-ridden thing you own. Sanitize every few days with a damp (not wet) disinfecting wipe.
- Dining out. Germs fester everywhere—menus, rims of glasses, salt & pepper shakers, seats, even lemon wedges. Wash your hands thoroughly after you order and before you eat.
- Home kitchens. Most dangerous is cross-contamination of raw foods – chicken, eggs, seafood, meat – make sure you keep them separated. And when you buy any raw product, use or freeze within 2 days of purchase. The sell-by date is misleading; it’s based on refrigeration temperatures in the store, which are much colder than home refrigeration.
There is promising news out of Northeastern University in Boston. Researchers produced a powerful antibiotic by extracting drugs from bacteria that live in dirt. This is an unusual method; usually bacteria are grown in a lab dish. The new drug is called teixobactin and it cleared severe infections in mice with no side effects. Better yet, the way it works makes it unlikely that bacteria will become resistant to it.
However, it’s not yet time to ask your doctor to prescribe it the next time you have a bacterial infection – testing in humans is likely about two years away.
Dr. Thomas-Cyr says that awareness of the dangers of bacterial infections is key, and advises the community to be cautious when entering a hospital, as a visitor or as a patient. “We like patients, especially older patients, to go home as soon as possible. There is more exposure to staph and other infections in the hospital than at home.”
Dr. Thomas-Cyr’s office is located at 7955 Bay St., Suite 2, in Sebastian; the office phone is 772-388-9155.