Relentlessly Evolving Microbial Drug Resistance May Take Us Back to Pre-Antibiotic Days — Other People’s Sexual Liasons Affect Everyone’s Vulnerability to Non-Sexually Transmitted Bacterial Diseases

© 2011 Peter Free

 

20 September 2011

 

 

Why this topic?

 

Developing antibiotic resistance reminds us how difficult it is to wall the rich world off from the planet’s more characteristic experiences with rampant diseases.

 

 

Gonorrhea as source of other bacterial species’ antibiotic resistance

 

An editorial in the Canadian Medical Association Journal warned that:

 

Neisseria gonorrhoea is rapidly evolving into a multi-resistant bacteria, recalcitrant to all single-dose antibiotics in common use including second- and third-generation cephalosporins.

 

Without serious attention, multiresistant gonorrhea will spread globally, causing increased rates of pelvic inflammatory disease and urethritis.

 

Worse, it will promote antibiotic resistance in nongonococcal microbes by direct gene transfer and other mechanisms as it travels around the world. As a result, life-threatening infections may become untreatable.

 

Without action, we are heading back to the pre-antibiotic era, with an escalation in the number of deaths from other multi-resistant organisms as well as rampant gonococcal infections — with treatment options for urethritis limited to painkillers, baths and catheterization for strictures.

 

© 2011  Noni E. MacDonald, Matthew B. Stanbrook, Ken Flegel, Paul C. Hébert, and Daniel Rosenfield, Gonorrhea: what goes around comes around, Canadian Medical Association Journal, DOI: 10.1503/cmaj.111393 (early online publication, 19 September 2011) (paragraphs split)

 

The key point here is that one bacterial species can transmit its drug-resistance to other species.  Most of the public is unaware of this.

 

This means that the generalized evolution of multi-drug resistant bacteria progresses faster and more widely than one might anticipate.

 

 

The prevalence of sexually transmitted diseases makes them a good incubator for the development of antimicrobial drug resistance(s)

 

Sexually transmitted diseases probably rank near the top of commonly acquired diseases.  That means that these ailments provide microbes with ample opportunities to evolve their defenses against antimicrobial drugs.

 

Like a human enemy with good battlefield communications, some bacteria (like gonorrhea) are good at transmitting successful adaptations to their non-sexually transmitted colleagues.  Which means that other people’s sexual endeavors indirectly affect the general pool of human bacterial illnesses.

 

 

Education? — Necessary, but ultimately not enough

 

The Journal’s editorial recommends disease-prevention programs among sexually active youth.  Although helpful, this step will not prevent the evolution of completely resistant bacteria.

 

A substantial group of people always ignore recommended precautions.  Just as they did with AIDs, where even the anticipation of death did not change risky behavior and the evolution of drug resistant virus subtypes.

 

 

Staying ahead of microbial illness requires never-ending inventions

 

The world simply uses too many antimicrobials in medicine and agriculture to slow down the evolutionary arms race that exists between antimicrobial drugs and constantly adapting microbes.

 

Unfortunately, humanity has been experiencing a lull in our inventive ability to stay ahead of the evolution of multi-drug resistance.

 

 

The outlook?

 

The developed world will almost certainly begin to experience some aspects of the third world’s vulnerability to previously treatable illnesses.

 

It is possible that this trend will result in the emergence of a new political willingness to consider more actively integrating private and government pharmaceutical efforts.