In 2016, a woman in Reno, Nevada died of a bacterial infection that was “incurable”. She had sustained a femur fracture in her leg while living in India and subsequently developed an infection. Last August she was seen in a hospital in Reno. Public health officials stated her Klebsiella pneumonia infection was apart of the CRE — carbapenem-resistant enterobacteriaceae. The CDC has been monitoring these superbugs, named by director Dr. Tom Frieden, “nightmare bacteria”, due to their dangerous drug resistance, but this particular case in this woman who is unidentified and in her 70’s was pan-resistant to every antibiotic tested. Subsequently she died in September. India has been battling many drug resistant superbugs and the CDC has been tracking cases as they surface in the US. This case, albeit rare, reminds us of how powerless we are to these bacteria that outsmart our fanciest of antibiotics.
How can we fight superbugs?
Well to begin, let’s understand what we’re dealing with. A superbug is a pathogen, most commonly bacteria, that can survive antibiotics that most species would buckle under. It’s resistance could be caused by a variety of factors. Maybe it has a mutation that makes it stronger. Maybe its genetic material shields it from the toxic medicine. Maybe it’s luck. So shortly after it celebrates surviving the antibiotic assault, it divides to reproduce, making more bacteria. If this progeny bacteria maintain the same genetic material as its parent, or if included, mutation, they can be now be resistant to the antibiotics as well.
Since the birth of antibiotics in 1928 with Sir Alexander Fleming’s discovery of Penicillin, we’ve aimed to make them stronger and shrewder than the bacteria. However, nature always wins, and some bacteria have outsmarted our fanciest of antibiotics, as we’ve seen with CRE. The more antibiotics we make and use, the stronger the bacteria become. Fueling this fire may not be the way to go. The key to fighting superbugs may not lie in the antibiotic arsenal. So thinking ahead may require us to look back.
Sir Alexander Fleming (Corbis)
During the Roman empire and Middle Ages, Silver had been used as healing agent. During the Civil War, silver nitrate was used to cure Gonorrhea, another bacteria currently becoming drug resistant. The silver nitrate was eventually replaced by a colloidal silver. But in 2013 researchers at Boston University discovered why silver was so antibacterial. Its properties interfered with the cell metabolism of the pathogen as well as disrupted its wall. This mimics what antibiotics have been designed to do. Silver may be able to be used as an agent by itself, in a non toxic form of course, or used in conjunction with current antibiotics who cannot break into the bacteria wall by themselves.
Yep, the enemy of your enemy is your friend. Discovered in 1915 by Frederick Twort in great Britain, bacteriophages, viruses that attack bacteria, have been found to target certain strains including superbugs. Current research done at Yale University has found success in treating Pseudomonas aeruginosa, a bacteria known to have resistant forms to some of the fanciest of antibiotics.
At the end of 2018 MIT researchers found that the venom from the Brazilian Polybia paulista wasp was effective at killing antibiotic resistant Pseudomonas aeruginosa, a bacteria known to cause many types of infections, including those contracted during a hospital stay. This MP1 toxin may also be effective in combating cancer cells.
In 2016, researchers from Sydney University found a protein in Tasmanian Devil milk that allowed the immunologically immature young baby devils to withstand the superbug that was killing their parents. They found the milk to successfully kill most superbugs. The milk contains antimicrobial peptides called cathelicidins, which were found to kill the superbugs MRSA and Vancomycin-resistant enterococcus. This looks promising.
In 2008, researchers at University College London, found a laser activated dye to kill a wide variety of bacteria. Kind of a Da Vinci meets Star Wars sort of treatment…..
Red Berry Extract from the Brazilian Peppertree
This staple of Brazilian traditional medicine has treated skin lesions and wounds with its leaves and bark. But the fruit has been found to have an extract that can weaken superbugs such as MRSA so the body’s defenses can fight the bacteria more successfully.
(Photo: Emory University)
Heading off the infection at the pass by boosting our immune system has played a huge role in protecting us against pneumonia, meningitis, tetanus to name a few. Superbug vaccines may be difficult because of the mutative nature of these bacteria but generic immune boosters may be the strategy here.
This is just the beginning of what researchers have been testing. Last fall, scientists created the Multivalent Adhesion Molecule 7, or MAM7, that essentially “blinded” the bacteria, preventing it from sticking to the host and spreading.
Although we need to continue to develop stronger antibiotics, our efforts should also focus on non-antibiotic bacteria busters. The answer to solving our superbug problem could be right under our noses…..
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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician