By Dr. Mercola
According to Margaret Chan,1 Director-General of the World Health Organization (WHO), antibiotic resistance is now a global health crisis. In a recent telebriefing she said the problem is "reaching dangerously high levels" in all parts of the world and may lead to "the end of modern medicine as we know it."
Already, multi-drug-resistant typhoid, tuberculosis, and gonorrhea kill hundreds of thousands of people each year. And it looks like it's only going to get worse, until or unless dramatic and rapid changes in policy and public awareness about antibiotics occur.
Scientists have been warning about this for a number of years already, but now it seems the "antibiotic apocalypse" is really close at hand.
Researchers recently discovered a new gene, called mcr-1, in pigs and people in China2,3,4 — a gene mutation that makes bacteria resistant to our last-resort class of antibiotics. Moreover, the resistance has "epidemic potential," as the rate of transfer between bacteria is exceptionally high.
Polymoxin-Resistant Bacteria May Kill Tens of Millions in Coming Years
Between 2011 and 2014, the researchers, led by Hua Liu from the South China Agricultural University, collected bacteria samples from:
- Pork and chicken sold at open markets and grocery stores in four Chinese provinces
- Pigs at slaughter across four Chinese provinces
- 1,322 patients being treated for infections at two Chinese hospitals
Fifteen percent of raw meats and about 20 percent of slaughtered animals had the mcr-1 gene, and the number of positive samples increased with each passing year. Disturbingly, mcr-1 was also found in 16 patients being treated for infections.
As reported by Scientific American:5
"Researchers ... found the gene, called mcr-1, on plasmids — mobile DNA that can be easily copied and transferred between different bacteria. This suggests 'an alarming potential' for it to spread and diversify between bacterial populations, they said.
The team already has evidence of the gene being transferred between common bacteria such as E.coli ... and Klesbsiella pneumoniae ...
This suggests 'the progression from extensive drug resistance to pan drug resistance6 [i.e. bacteria resistant to all treatment] is inevitable,' they said. '(And) although currently confined to China, mcr-1 is likely to emulate other resistance genes ... and spread worldwide.'"
Livestock Farmers Must End Use of Antibiotics — and Fast!
The researchers describe their findings7 as "alarming," calling for "urgent restrictions" on the use of polymyxins, including colistin, which is widely used in livestock farming despite being a drug of last resort against a host of bacterial infections that are common in humans.
China alone uses 12,000 tons of colistin in animal farming each year. The US uses 800 tons annually, and another 400 tons is used in Europe. The mcr-1 gene essentially prevents colistin and other drugs of this class from killing the gene-carrying bacteria.
According to David Paterson and Patrick Harris from Australia's University of Queensland, who wrote a commentary to the study, the links between colistin use in livestock farming and colistin-resistance in animals, food, and humans is now complete, and warn that:8
"One of the few solutions to uncoupling these connections is limitation or cessation of colistin use in agriculture. Failure to do so will create a public health problem of major dimensions."
Professor Timothy Walsh of the University of Cardiff, who co-authored the study, drove home the severity of the situation in a statement to the BBC: 9
"All the key players are now in place to make the post-antibiotic world a reality.
If MCR-1 becomes global, which is a case of when not if, and the gene aligns itself with other antibiotic resistance genes, which is inevitable, then we will have very likely reached the start of the post-antibiotic era.
At that point if a patient is seriously ill, say with E. coli, then there is virtually nothing you can do."
Antibiotic-resistant infections already kill an estimated 23,000 Americans each year, and projections10 suggest that by 2050, drug-resistant infections will claim the lives of:
- 317,000 in North America
- 392,000 in South America
- 390,000 in Europe
- 4.73 million in Asia
- 4,15 million in Africa
American Academy of Pediatrics Warn Antibiotics in Food Threaten Children's Health
The American Academy of Pediatrics also recently issued a paper11 detailing how antibiotics are used in animal husbandry, how this contributes to the development of drug-resistant bacteria, and how national and global initiatives to curb the use of antibiotics in agriculture are needed to protect children's health.
As reported by Scientific American:12
"Infants and children are affected by antibiotic-resistant bacteria in the food supply, direct contact with animals, and exposure in the environment, the researchers report.
For most infections, incidence was highest among children under age five, according to data the researchers cited from Center for Disease Control and Prevention's Foodborne Diseases Active Surveillance Network ...
Pediatricians and parents can help combat antibiotic resistance by avoiding use of antibiotics to treat colds or other viral illnesses. Parents and other consumers may also help discourage the use of antibiotics in livestock feed by choosing to buy only organic products or foods labeled as 'raised without antibiotics,' said Urvashi Rangan, executive director of the Consumer Reports Food Safety and Sustainability Center ..."
Public Is Grossly Undereducated on Proper Use of Antibiotics
According to a new report by the Wellcome Trust,13,14 medical personnel, government, and the media have failed to teach the public about proper antibiotic use, and that also needs to be remedied. According to the report — for which 10,000 people in 12 countries were queried about their knowledge about antibiotics — people are "alarmingly confused" and ignorant on this issue:
- 64 percent of people wrongly believe that antibiotics treat viral infections such as colds and flu, despite the fact such medicines can only treat bacterial infections, not viruses
- 75 percent of people wrongly believe "antibiotic resistance" means that your body is resistant to the drug, opposed to the bacteria being resistant
- About one-third of people wrongly believe you should stop taking the antibiotic once you feel better to avoid building "immunity" to the drug, rather than completing the prescribed treatment course
- About 66 percent wrongly believe you're not at risk of drug-resistant infection as long as you take your antibiotics as prescribed
- Nearly half wrongly believe drug-resistant infections only affect people who frequently use antibiotics, when in fact antibiotic-resistant infections can occur in anyone, anywhere, and at any time
According to Keiji Fukuda, WHO's special representative for antimicrobial resistance:15 "The findings ... point to the urgent need to improve understanding around antibiotic resistance. One of the biggest health challenges of the 21st century will require global behavior change by individuals and societies."
Important Facts About Antibiotics and Their Use
To recap, it's important to realize that:
- Antibiotics can ONLY treat bacterial infections, not viral infections such as cold and flu
- Unless the disease-causing bacteria are completely wiped out, the infection may recur, so it's important to finish the entire course as prescribed
- Antibiotics should be reserved for SEVERE bacterial infections only. Please understand that they can damage your microbiome for up to a year or even longer (see next section) so you want to make darn sure you are going to get more benefit that harm. Only take antibiotics if they are the last resort
- Your food can be a major source of low-dose antibiotics if you're eating meats and animal products originating in concentrated animal feeding operations (CAFOs). You can avoid a majority of this risk by buying organically raised animal foods, as USDA organic standards do not permit antibiotics for growth promotion and prophylactic purposes
- One in 25 hospital patients end up contracting a hospital-acquired infection, some of which are drug-resistant, so avoid unnecessary hospital stays. In 2011, an estimated 722,000 patients contracted an infection during a stay in an acute care hospital in the US, and about 75,000 of them died as a result of it. As drug-resistant infections become more common, this number is likely to skyrocket in coming years
A Course of Antibiotics Can Alter Your Gut Microbiome for Up to One Year
It's also important to realize the impact antibiotics have on your overall health, as they kill not just the disease-causing bacteria but the beneficial bacteria too. Recent research demonstrates that when you take a course of antibiotics, your gut microbiome may be adversely affected for up to a year afterwards, depending on the antibiotic you're taking.
This is a significant reason for limiting antibiotics to severe infections only, as a healthy gut microbiome is part of your immune function, serving as a primary defense against all disease.
The randomized, placebo-controlled clinical trial,16 which took place in two locations, Sweden and Great Britain, evaluated the effects of four commonly-prescribed antibiotics: clindamycin, ciprofloxacin, minocycline, and amoxicillin. The bacteria in the participants' oral and gut microbiomes were analyzed before the experiment, right after finishing the one-week long course of antibiotics, and again one, two, four, and 12 months afterward.
The oral microbiome normalized fairly quickly, but the gut microbiome typically did not. As reported by The Atlantic:17
"People who took clindamycin and ciprofloxacin saw a decrease in types of bacteria that produce butyrate, a fatty acid that lowers oxidative stress and inflammation in the intestines. The reduced microbiome diversity for clindamycin-takers lasted up to four months; for some who took ciprofloxacin, it was still going on at the 12-month check-up. Amoxicillin, on the plus side, seemed to have no significant effect on either the oral or gut microbiome, and minocycline-takers were back to normal at the one-month check-up."
But that's not all. The study also demonstrated that when you take an antibiotic, you may indeed raise your risk of antibiotic-resistant disease.
Antibiotic-resistance genes were found in both British and Swedish participants at the outset of the study, although the British had on average a 1.13-times-higher load of antibiotic resistance genes than the Swedes. (The authors speculate that this may be a result of the fact that Sweden has significantly decreased use of antibiotics over the past 20 years, due to the Swedish Strategic Program for the Rational Use of Antimicrobial Agents and Surveillance of Resistance [STRAMA], launched in 1994.)
After exposure to antibiotics, the antibiotic resistance gene load increased across the board. According to the authors:
"Among the antibiotics tested, exposure to amoxicillin resulted in the least discernible effects on the microbiome composition, while these samples had the highest number with antibiotic resistance-associated genes and the most classes that were increased in the predicted metagenomes and in the full metagenomes, respectively, a week after the exposure ...
Clearly, even a single antibiotic treatment in healthy individuals contributes to the risk of resistance development and leads to long-lasting detrimental shifts in the gut microbiome."
What's the Solution?
I'm afraid I have no good news with which to brighten the picture for you. We really are at a critical junction, and we have to get serious about this issue. Tens of millions of people are likely going to die in the coming decades as a result of widespread antibiotic abuses. The presence of mcr-1 may further speed up the prevalence of bacteria impervious to every single antibiotic currently available
Unfortunately, as revealed by Dr. Marcia Angell — former editor-in-chief of the New England Journal of Medicine— in her book, "The Truth About the Drug Companies",18 the pharmaceutical industry wields enormous power over the US government, and pharmaceutical companies have been less than enthusiastic about spending money on antibiotic research and restricting the use of antibiotics in agriculture.
After all, agriculture accounts for 80 percent of their antibiotic sales. So we cannot depend on them for a solution. There are no quick and easy answers here. The impending superbug crisis needs to be addressed from a number of different angles, including the following:
- Elimination of antibiotics for growth promotion and prophylactic purposes in livestock and fish production. As with people, animals should be given antibiotics only when ill, and not for prophylactic purposes to "hide" poor hygiene and living conditions in CAFOs.
To make your voice heard, please sign the Organic Consumer's Association's petition, calling for a mandatory ban on sub-therapeutic doses of antibiotics for livestock. The issue of antibiotic-resistance is a major reason for choosing organic, pastured meats and other animal products, including eggs and dairy. It is in fact the only animal products I recommend eating
- Improved infection prevention, with a focus on strengthening your immune system naturally. As an all-around preventive measure, you'll want to make sure your vitamin D level is optimized year-round, especially during pregnancy, along with vitamin K2
- More responsible use of antibiotics in medicine. Use antibiotics only when absolutely necessary
- Also avoid antibacterial household products
- Innovative new approaches to the treatment of infections from all branches of science, natural as well as allopathic