Antibiotic Resistance Q&A

HEALTH

The idea of people dying from infections that were once easily cured may seem outlandish. But it is happening—and now, an antibiotic-resistant “superbug” has reached the U.S. (New York Times)

Download an image of an infectious microbe here.

Teachers, scroll down for a quick list of key resources in our Teachers Toolkit.

Discussion Ideas
Read through the great New York Times article and work through its questions as we did here.

• What are antibiotics?
  • Antibiotics are substances that can stop or slow the growth of certain living (biotic) microbes, such as bacteria. Penicillins are probably the most famous strain of antibiotic.

 

• What are bugs?
  • In this case, “bug” means a microscopic organism, such as a bacterium or fungus. Sometimes, when microbiologists refer to “bugs,” they mean a pathogenic subset of these microbes—ones that cause or augment infection. These bugs are also called germs.

 

• What is antibiotic resistance?
  • Antibiotic resistance (also called antimicrobial resistance) describes the way bugs have evolved to resist antibiotics.

 

• Is antibiotic resistance a new phenomenon?
  • No. “For some years now, infectious disease doctors have been warning that unless we rein in use of antibiotics in both people and livestock, there will come a day when they will be powerless against the most ferocious bugs, turning the clock back to the early years of the 20th century,” when infectious diseases now targeted by antibiotics, such as pneumonia, killed thousands.

 

• Do we want antibiotics to get rid of all the bugs in our bodies?
  • Nooooooo! Humans all have a rich microbiome of commensal and symbiotic, as well as pathogenic microorganisms. We want to keep these microbiomes healthy.

 

• What is CRE?
  • “CRE, which stands for carbapenem-resistant Enterobacteriaceae, is the most fearsome family of germs because it is resistant even to last-resort antibiotics.” Klebsiella pneumoniae (associated with pneumonia) and Escherichia coli (E.coli) are both in the Enterobacteriaceae family and can become carbapenem-resistant.

 

• How has antibiotic resistance changed medicine?
  • Doctors say the “spread of resistant bugs means doctors are having to blast patients’ infections with increasingly stronger antibiotics.”
  • Patients are more susceptible to “C. difficile, a gut germ that flourishes when the patient has taken a lot of antibiotics.” Last year, more than 20,000 people died after being diagnosed with a C. difficile infection.

 

• Why aren’t there more new antibiotics?
  • Profit, or lack of it. “Compared with other drugs, antibiotics are not big moneymakers, and some manufacturers have gotten out of the business.”
    • The reason antibiotics are not as profitable as other drugs is because “[m]ost people take antibiotics just once in a while, for a short time—unlike drugs for blood pressure, high cholesterol or diabetes, which most patients will take every day for the rest of their lives.”
    • Also, “[o]nce the drug gets more widespread use, germs may become resistant to it, and doctors will quit prescribing it. So an antibiotic that required lots of time and money to develop may have a short life on the market.”

 

• Should I be scared about antibiotic resistance?
  • Not yet. CRE infections are still relatively rare, responsible for about 600 deaths a year. Even the woman with the “superbug” made a full recovery thanks to antibiotics.

 

• So what are health officials worried about?
  • The “superbug” gene “is mobile and can be picked up by other bugs—in sewer systems, in animal feed lots, in people’s guts or urinary tracts. That can make more bugs more resistant. The biggest worry is that a strain of CRE will pick up the gene.”

 

• Is there anything I can do to protect myself?
  • Wash your hands frequently.
  • Since hospitals are incubators of dangerous germs, if you end up in one, try to get out as fast as you possibly can.
  • If you get sick, try not to use antibiotics.

 

• Is there really a risk in taking an antibiotic for a cold?
  • Yes, it might disrupt your microbiome. “[H]ealthy people normally carry billions of bacteria in their noses, throats, skin, genitals, and gut. Antibiotics change the balance of those microbes, killing off susceptible ones and allowing drug-resistant ones to flourish.”

 

• Why are antibiotics given to livestock?
  • “Antibiotics are believed by many in the food production industry to promote overall health, increasing the number of animals that can be sold for food and improving the quality of the meat.”

 

• Do humans and livestock get the same antibiotics?
  • Yes, most antibiotics used for humans are also used for livestock.

 

• How can the use of antibiotics in animals pose a risk to humans?
  • “The genes that produce resistance to antibiotics can be easily transferred between bacterial species. So resistant bacteria can pass their resistance to other strains.”
    • Humans can come in contact with resistant bacteria through eating insufficiently cooked meat.
    • Humans can come in contact with resistant bacteria through eating food products that have come into contact with antibiotics, such as crops that have been fertilized with manure from animals treated with antibiotics.
    • Farmworkers and people working in slaughterhouses or food-production facilities are particularly at risk.

 

• Is the government addressing the issue of antibiotic resistance?
  • Yes, but industry compliance is voluntary.
    • “Under F.D.A policies that will take effect in 2017, antibiotics that are considered ‘medically important’ for humans will no longer be approved for use to promote growth in livestock.”
    • “The policies also require that a veterinarian supervise the use of antibiotics in feed or water for livestock.”

 

TEACHERS TOOLKIT

New York Times: Short Answers to Hard Questions About Antibiotic Resistance

Nat Geo: MRSA photo

CDC: Carbapenem-resistant Enterobacteriaceae in Healthcare Settings

Nat Geo: White House Drops the Microbiome