Superthreat

One major hazard to human wellbeing today has nothing to do with crime, war or terrorism. In fact, it is invisible, but lethal all the same. The threat is “superbugs,” and the danger posed is immediate and real.

Global leaders held a high-level meeting last week at the U.N. to discuss the fact that some infections once treatable with antibiotics no longer are, and how to prevent that development from becoming the mere tip of a medical nightmare iceberg. It was only the fourth time in history that heads of state have met to face a health issue.

Bacteria, some of which cause a host of infections and illnesses, have long been vulnerable to antibiotics, drugs that weaken or kill them. But in every population of an illness-causing bacteria, there are heartier individual members, whose genetic makeups allow them to survive the onslaught of antibiotic agents.

Some viruses, fungi and parasites have also developed resistance to drugs that were once effective in killing them. The rapid replication rates of microbes make the problem spread quickly.

What has happened, it has become clear, is that widespread use of antibiotics — which are not only widely prescribed by doctors but given to livestock in order to fight infections, prevent bacteria from being transferred to humans and to promote growth rates — has decimated many bacterial populations, and, as an unwanted result, allowed heartier, antibiotic-resistant bacteria to thrive and fill the biological niche that once held their less-hearty cousins. Natural mutations in existent strains of bacteria can also confer the ability to survive antibiotic treatment.

That means that strains of microbes that were once easily killed no longer can be, and in some cases, what results is great suffering and increased mortality.

The urgency of the current crisis of drug-resistant germs is evident: it’s estimated that the number of people who die from antibiotic-resistant infections will reach 10 million a year in 2050. More than 20,000 newborn children are expected to die each year from infections that do not respond to antibiotics.

Currently, the greatest threat is to developing countries, but there is little reason to imagine that the problem, if not effectively dealt with, will not only intensify but spread. Drug-resistant strains of germs are already a problem in hospitals in developed countries, including our own.

At the U.N., 193 countries signed a landmark declaration that they will endeavor to rid the world of superbugs. Among the strategies to arrest the proliferation of drug-resistant infections discussed at the U.N. meeting was the bolstering of surveillance systems to monitor drug-resistant infections and antibiotic use in medicine and farming. Also discussed was the importance of limiting the use of antibiotics for livestock to treating infections, which would remove a major vector for the explosion of drug-resistant bacteria. The European Union already forbids the use of antibiotics in animals for other purposes. Although no such ban is yet in place in the United States, the FDA has issued guidelines aimed at limiting unnecessary antibiotic use in animals.

As drug-resistant infectious agents increase, childbirth and procedures like cesarean sections, organ transplants, wound treatments and other forms of surgery will become high-risk, as doctors lose access to effective antimicrobials that would normally protect patients from infection on the operating table.

On the large scale, the solution to the superbug challenge will have to come from world leaders committing to end the problem, as many did last week.

But there is a role for individuals, too. When antibiotics are introduced into humans, or discarded into the environment, that adds to the natural development of drug-resistant bacteria, which can then spread, infect others and prove untreatable.

Frequent hand-washing, especially when visiting hospitals or immunosuppressed people, can help avoid both the contracting and the spreading of infections.

And antimicrobials, when they are prescribed, should be taken as directed, to help ensure that the germs they target are entirely wiped out.

Most important, perhaps, in light of reports that doctors are often pressured by patients to prescribe antibiotics where they are not necessary, or even pointless (as in colds, the flu and most ear infections), is that we accept physicians’ decisions that antibiotics aren’t needed for a particular medical condition.

In the case of such drugs, it is now clear, attitudes like “the more the better” and “it can’t hurt” are not only misguided, they are dangerous.