Wednesday, April 6, 2016

Dirty Little Secrets-- The Rise of the Superbug

The Rise of the Superbug
By M.J. Louis, RN
(Chapter 11 of "Go In Peace--When Letting Go Is The Greatest Act Of Love")

What is a Superbug?
     The term “Superbug” is currently being used to describe microbe[1] pathogens[2] that modern medicine struggles to combat. Superbugs earned their dubious name due to their resistance to most antibiotics[3], antivirals[4], and antifungals[5]. These medications are commonly referred to as Antimicrobials. Superbugs are simply created by the inappropriate and overuse of antimicrobials on an infected human or animal host.  
     Most people don’t consider microbe pathogens such as bacteria, viruses, and fungi as having intelligence. I would beg to differ. A definition for intelligence is; to have the ability to gather, process, and use information to ones advantage.  As a critical care nurse, it is common place for me to administer up to five different powerful antimicrobials at one time to an infected patient only to witness their white blood cell[6] count (WBCs) rise exponentially. An increase in the WBCs signifies an increase in the pathogen(s).
     They say the superhero gives rise to the supervillain. Never has this analogy held so true as it does in describing the relationship between antimicrobials and Superbugs. To understand why these microbes are considered to be the supervillains’ in modern medicine, you must first understand what their superpower is and how they became endowed with such a power. The foremost superpower of the Superbug is DRUG RESISTANCE[7]. A drug resistant pathogen can simply laugh in the face of an antimicrobial that is meant to kill it.   
     Antibiotics and similar drugs used to fight infection have been in widespread use since the 1940’s. Microbes have been around for over three billion years. That’s quite a head start. Unlike human beings, they are very simple organisms; therefore possess the ability to adapt very easily and quickly through evolution.
     Let’s follow the age old battle between the old school antibacterial hero, Penicillin verses the dreaded pathogen villain MRSA; aka Methicillin-resistant Staphylococcus aureus, aka Staph Infection. In the 1940’s Penicillin came on the scene and save the lives of millions suffering from bacterial infections. It seemed like no bacteria stood a chance against the mighty Penicillin. People believed in the superpowers of Penicillin so much they called upon it even when they didn’t need it. The overuse of Penicillin was causing the immune systems of its consumers to become lazy.  Unbeknownst to the medical community, Bacteria’s instinct to survive kicked in causing it to mutate into the Superbug MRSA.
     The new superbug MRSA passed on its new Penicillin resistant gene into other bacteria in similar fashion to the cloning abilities of MR. Smith of Matrix fame (see image below). By the 1950’s MRSA was raking havoc in hospitals and the first generation of Penicillin was rendered helpless against this new super villain that it helped create.

University of California Museum of Paleontology's Understanding Evolution (http://evolution.berkeley.edu)


Center for Disease Control Antibiotic/Antimicrobial Resistance
     Drug-resistant Superbugs are a global threat. According to the 2014 World Health Organization (WHO) report, Antimicrobial resistance: global report on surveillance; only 34 out of the 133 countries surveyed on their preparedness to handle an outbreak had a prepared comprehensive plan.  The report identifies countries not having the proper infrastructure to properly survey drug resistance diseases and the widespread sale of antibiotics without prescriptions to be major contributing factors. The WHO states, without a worldwide coordinated effort we are headed to a post-antibiotic error.
     The WHO 2014 report focuses on the seven bacteria which are responsible for common, serious diseases such as bloodstream infections (sepsis), diarrhea, pneumonia, urinary tract infections, and gonorrhea. Each of the seven has developed Superbug strains that are resistant even to “last resort” antibiotics.     



[1] Microbes are tiny single cell organisms that cannot be seen with the naked eye.
[2] Pathogens are infection or illness causing microbes.
[3] An Antibiotic is a medication used to kill or inhibit the growth of bacteria.
[4] An Antiviral is a medication used to kill or inhibit the growth of a virus.
[5] An Antifungal is a medication used to kill or inhibit the growth of fungus.
[6] White blood cells are cells in the body that help fight infection and are part of the immune system.
[7] Drug Resistance occurs when a drug used to kill a particular pathogen is ineffective in doing so due to the pathogen’s tolerance to that drug.

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