A gene that helps bacteria resist the last remaining antibiotic group, which works when all of the other antibiotic groups fail, has been discovered by Chinese and British scientists. Even more alarmingly, Denmark just announced it has found the very same resistance factor and confirmed for the world that the resistance to the very last-ditch antibiotic is already spreading globally.
Last Thursday, researchers from several Chinese, British and US universities announced in the journal Lancet Infectious Diseases that they have identified a new form of resistance, to the very last-ditch drug colistin—and that it is present in both farmed animals and people. A research collaboration shared between George Washington University and the Statens Serum Institute and National Food Institute in Denmark is announcing today that they have found that same resistance factor in stored bacterial samples dating back as far as 2012.
We are quite literally entering a post-antibiotic era and estimates place 10 million people dying every year by 2050, while costing the world up to $100 trillion dollars.
Some background history on colistin shows that it was introduced in 1959 and did not see much use as it can toxic to the kidneys. Because it hasn’t been used much, bacteria have not develop much resistance to it. This was fortunate as other resistant bacteria began rearing their heads over the last several years. All of which made bacteria invincible to a group of drugs called carbapenems that had been considered our last line of defence—they took care of complex infections that happen in hospitals caused by gut-dwelling organisms like E. coli, Klebsiella, and Acinetobacter.
Naturally, the use of colistin began to rise as others were becoming more and more ineffective. Colistin is cheap. This old drug, which wasn’t used much, became likably affordable in animal agriculture where production cost is everything. Antibiotics keep factory farming infections and diseases at bay (mostly, at least until now) and also accelerate growth causing animals to fatten up fast. All beneficial things when humans are exploiting animals.
Now, China are known as being one of the biggest users of colistin in animal agriculture. The first report finds that the the global demand for colistin in agriculture, driven largely by China, is expected to reach 11,942 tonnes per annum by the end of 2015 (with associated revenues of $229·5 million), rising to 16,500 tonnes by the year 2021.
The development of antibiotics to treat bacterial infections was arguably the most significant medical leap ever taken by the human species. During the 1950s and 1960s, entire classes of antibiotics were discovered faster than bacteria could adapt to them. Today, the case is now reversed because of the tremendous use in animal agriculture.
Scientists in China were looking for resistance in the E. coli that reside in the guts of farmed animals. Since 2013 their samples expanded to include those animals who were slaughtered, but also retail meat, street markets, and hospital patients.
Present in raw pig and chicken meat, pigs in slaughterhouses, and hospital patients, resistant bacteria (a gene known as MCR-1) are already causing infections in humans. Of course, there were a number of superbug scares in the 2000s (vancomycin, MRSA and VRSA) which didn’t turn into anything massive, but what makes colistin resistance, MCR-1, different is the key role animal agriculture is playing in antibiotic resistant bacteria evolution and dispersal.
Millions of animals receive this drug and projects that are funded to discover genes such as MCR-1 are rare. With the confirmation that Denmark have found the same resistance factor confirms that the colistin resistance is on the move globally.
Of course, antibiotic resistance in agriculture is a quite a complex interaction of elements in our physical environment (e.g. air, soil, water) with social exchanges (e.g. between animals in a herd, farmers and animals, domestic and migratory birds), in processing steps (e.g. farming activities, transportation, storage), and in human use patterns (e.g. food prep, meat consumption, susceptibility to infection).
Antibiotic use in animals can have direct and indirect effects on human health. Direct effects are those which can be casual linked to contact with resistant bacteria from farmed animals. Indirect effects are those that result from contact with resistant organisms that have been spread to various components of the ecosystem, such as water and soil, as a result of antibiotic use in farmed animals.
Where to From Here?
The Antibiotic Resistance Action Center released a statement on the spread of dangerous superbug gene from China to Denmark. The statement indicated that we must act swiftly to contain the spread of colistin-resistant bacteria, or we will face increasing numbers of untreatable infections. Indeed, we must recognise why colistin is now the last drug available for treating dangerous infections—it was moved into use due to the preferred drug case (carbapenems) becoming powerless due to overuse.
How long do we have with antibiotic resistant bacteria? It’s hard to say. While the Action Centre calls for a ban on colistin and carbapenems to protect future generations, would it not make more sense to revolutionise the industry creating the problem in the first place which will lead to the deaths of millions of people?
When we know that humans can live healthy, nutritious lives on plant-based foods (which do not require antibiotics to survive), the problem is in animal agriculture itself and the meat-centric diets that drive it onwards. A growing human population expected to be near 10 billion by 2050 with meat-centric diets only exacerbates the problem and will create a whirlwind of painful suffering and the death of millions that we will likely not be able to recover from.
If you want to put aside the argument for animal rights—fine. Go ahead and put aside debates on the warming of our atmosphere. Forget about the blatant destruction of the environment as well. But do you honestly want to go back to a time where you can die from a simple cut, a tooth abscess or pneumonia? How close to the dotted line do we as a species have to get before we’ve signed away our death warrant?
Antibiotic resistant bacteria, comin’ to an animal-based meal near you.
Sources: AnonHQ, NatGeo, The Lancet, DTU, NCBI.