Wendy Stueck recently published a disturbing article in The Globe and Mail entitled, “B.C. Steps Up Battle with ‘Nightmare Bacteria’ Cluster.” She reports that since last summer at least 41 patients have been affected by carbapenum-resistant enterobacteriaceae (CRE). This “super bug” is resistant to carbapenum, sometimes referred to as the “antibiotic of last resort.”
Stueck says that, “Carbapenemase-producing enterobacteriaceae (CPE) are germs that produce an enzyme that breaks down antibiotics, rendering them useless.” Although normally found in the digestive tracts of humans and animals, the problem begins when they get into wrong places like the bladder or the bloodstream. Until recently carbapenems could always be called upon to take care of such infections, but more recently CPEs have been showing signs of resistance to this powerful antibiotic.
Dr. Linda Hoang, a medical microbiologist with the B.C. Centre for Disease Control, says that this development is not a surprise to her. “It is maybe a wake-up call to general health-care professionals in B.C. compared with other provinces and states in North America. But for those in the field, for microbiologists and infection-control practitioners, it is not a wake-up call. We have been waiting for this to happen.”
Many of us will have noticed the heightened vigilance in our hospitals in Manitoba. Gowns and gloves for visitors and more visits to the hospital to get intravenous antibiotics instead of taking antibiotics orally alert us to the fact that something new has arrived.
Stueck notes that “CREs, like other multidrug-resistant organisms, evolved as a result of the misuse and overuse of antibiotics. They are resistant to nearly all antibiotics, including carbapenems…Up to 50 percent of people who get a carbapenem-resistant infection in their bloodstream die as a result.”
So where does that leave us as a society and as individuals? For one, the Mayo Clinic has issued an alert for individuals to use antibiotics wisely. They say that infections caused by antibiotic resistant strains of bacteria, “…are difficult to treat and can mean longer lasting illnesses, more doctor visits or extended hospital stays, and the need for more expensive and toxic medications…Although experts are working to develop new antibiotics…infectious organisms can adapt quickly.” We must take care not to use antibiotics when not required, and when they are, to use them as directed.
On another front, we have to take a second look at the use of antibiotics used in the raising of livestock for human consumption. The Ontario Medical Association (OMA) is issuing an alarm. Dr. Doug Weir notes that many more tonnes of drugs are used in agricultural operations than in human medicine, a practice that is fueling the development of resistance. Further he notes that “…if antibiotic use isn’t curbed, the world faces a future in which some infections will be incurable.” The OMA position paper suggests that “access to antibiotics for agricultural operations should be limited to cases where veterinarians write prescriptions for drugs.” Now that would be a great move in our collective battle against antibiotic resistant bacteria.