A gene known as NDM1 (New Delhi metallo-beta-lactamase) was recently discovered in a bacteria in India. This gene gives the bacteria the power to escape some of the strongest antibiotics; only colistin and tigecycline have shown the strength to fight it. In India, the bacteria has become a widespread issue because of poor sanitary conditions and the unnecessary use of antibiotics. Such conditions provide for weaker immune systems and higher drug-resistance, allowing the bacteria to spread rapidly. Passed from hand-to-mouth contact, the bacteria is highly contagious and should be prevented by good hygiene. Since this discovery, the bacteria has spread to several cases in the United States. In California, Massachusetts, and Illinois, three people who had traveled to India were infected with the bacteria. Luckily, the three patients survived, but that does not mean that the bacteria died.
What could this mean for the future? As far as India is concerned, how can they stop the spread of this germ without making drastic changes to their society? The bacteria is spreading so rapidly because of overpopulation and unsanitary conditions. These are issues India has been fighting for years and cannot be solved in a short amount of time. Without more government regulation, the bacteria will continue to spread through sewage, or just regular person to person contact. It appears that antibiotics are both a gift and a curse in this case. Although we are in desperate need of more antibiotics that can fight off such bacteria, we also need to stop using them when they are not completely necessary. It is the overuse of antibiotics that causes the drug resistance in the first place, yet the bacteria cannot be killed without their use. "White Coat Notes" claims that the solution lies in spending more time and money on developing more antibiotics. However, with new drug resistant bacteria forming, how truly effective is this? According to guardian.co.uk, Professor Tim Walsh claims that there needs to be "co-ordinated efforts across the world to put in place good surveillance systems to find out what resistance is developing and where, and then look for interventions."
How far are governments willing to go to prevent the development and spread of these superbugs?
Resources:
http://www.boston.com/news/health/blog/2010/09/new_drug-resist.html
http://www.guardian.co.uk/society/2010/aug/12/the-end-of-antibiotics-health-infections
8 comments:
I believe that the fight against disease and illness is an unwinnable war because antibiotics will kill off most of a bacteria, but there's always going to be ones that survive. I think the future looks pretty bad for us, because bacteria mutate extremely fast, which prevents any antibiotic from being effective for an extended period of time. The government can step in to help fight "superbugs", but it's going to be an on-going battle. The superbugs will mutate and improve and its up to drug companies to develop a new drug to combat this improved superbug, and this cycle will just continue. Even with government regulation, it's just impractical to effectively resolve this issue of disease. I don't believe that spending more money will solve this issue. We can make more antibiotics, but it's only a matter of time before the superbugs become resistant to these as well. I wish that everyone could be saved, but I feel governments should only go far enough to maximize the cost-effect relationship because there are other things that the government needs to deal with.
This isn't really completely new. Superbugs have existed for a long time already. If you take a sample of the bacteria living in a hospital, you can find bacteria immune to nearly everything due to the massive use of antibiotics there.
Unfortunately there really isn't an efficient way to track every mutation and resistance the bacteria create. Remember, bacteria gain resistances from irresponsible people who decide not to finish their prescriptions. Then the bacteria can exchange this new resistance with other ones. This generates huge amounts of new resistances. There are simply too many.
The interventions mentioned by Professor Tim Walsh are most likely either going to be vaccines or more antibiotics. Government regulation will not work very well; people will come in contact with each other anyway, and unsanitary conditions cannot be brought about instantly. Without a quarantine, there is no practical way to prevent the spreading of resistant bacteria, as they always find some other way to be transmitted. Either way, more antibiotics need to be discovered to treat these new resistances, contrary to what Tony says.
I believe that the federal government should be handing out more grants to scientists. Without more raw research, the drug-resistant bacteria will be here to stay. More antibiotics will give us more options in the long-run, and more data can give more ideas for how we can resolve this problem. Of course it might be a fool's errand, but at least we would have a chance.
Instead of creating new antibiotics, why not put the money into actually reforming the sanitary conditions of India? I don't believe that more antibiotics will necessarily resolve the issue, as Tony mentioned, it will only perpetuate the problem since the bacteria will eventually become resistant. India is one of the most populous and fastest growing countries in the world, yet it is also one that is most stricken with poverty.
One of the largest sanitary problems found in India is the lack of toilets (only 15% of rural people actually have access to a toilet!), which leave many people left to openly defecate in open areas or use a manual bucket. This exposes many people to the harmful germs found in human waste and will eventually cause health problems. In fact, over 700,000 school children die every year due to poor hygiene and sanitation. Although things may not change in a matter of months or even years, India could definitely implement some minor policies or services to better the sanitary conditions that are affecting their own people!
I agree with Michelle, putting the money into finding new antibiotics will perpetuate the problem because bacteria will eventually become resistant to that new antibiotic. i don't think it should just be India's responsiblity to find better options for sanitation, other countries also need to step in and help. Although the sanitation problem is in India, other countries are exposed to the same bacteria by travelers. India so far hasn't been able to fix this sanitation problem they've been facing for year now, they need international intervention so an pandemic doesn't start.
I completely agree with Charlie on this issue. Super bugs will always exist in the world, and creating antibiotics to stop the ones we currently have, will allow the viruses to mutate into a more deadly disease. I suggest we spend money researching the bug on what ii can possibly do or if/when it mutates, but the best way for prevention is good sanitary practices.
I agree with Tony Z, life threatening bacteria is everywhere and that it seems impractical for the government to spend large amounts of money on something that will only grow unaccountably. When the cost-effect relationship begins to slope downward, the line should be drawn immediately for the growth of these superbugs will never cease. It would only make sense for the government to continue researching on these things only if progress was being made.
I also agree with Michelle, instead of directing funds to the costly superbug research, why not go to the source first? The very reasons, such as sanitary conditions, that caused such bacteria to be created could be prevented with far less spending. Basically, it's a whole lot cheaper to prevent these diseases than to fight it.
I agree with Tony that this is an unwinnable war. Antibiotics are something we always turn to whenever there is some sort of illness, but it is this frequent use that causes resistance to antiobiotics which defeat the purpose of them. India is an ideal place for this bacteria to grow because of the unsanitary conditions and the large population. There is no easy way to put it an end to the "superbug" because the government can't just put an end to poverty and unsanitary conditions. The government should let its people know how to avoid the bug and try to raise awareness on how to prevent this. Hopefully the government can prevent it from getting more and more people.
The fact of the matter is that this particular superbug is the result of poverty-stricken and poor sanitary conditions in India, a point that was brought up by Michelle a while ago. Judging by the rare cases of the bug spreading in America (an effect primarily due to our raised standards of sanitation), it's unlikely that either the US or any other well-to-do country will step in to find an antibiotic. Personally, I think that the situation and sanitary issues in the third world and poverty-stricken countries like India will continue until enough people die so that the people become angry with their government. Things will most certainly get worse before they get better, and changing India's social fabric is not a miracle process that we can just "look into" or "just improve."
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