Superbugs

In the seventh annual High School Essay Contest, the SQ Community Outreach team asked high school students to write a 500-750 word piece about a global issue affecting the world today and its connection to biology. SQ hopes this experience will encourage and celebrate science communication among future scientists and inspire them to think about biology in a broader context. Below is the winning essay by Megan Haubrich from Fred C. Beyer High School.

Superbugs: A Global Threat

In Twilight of the Idols, Freidrich Nietzsche dramatically acclaims that “what does not destroy me, makes me stronger.” Unbeknownst to him, Nietzsche had identified a phenomenon evident in numerous biological processes. One notable example is that of acquired antibiotic resistance, the evolution of bacterial strains to withstand drugs that once eliminated them, a prominent topic of discussion amongst public health experts, physicians, and international leaders. Exacerbated by the overuse of antibiotics in medical and animal agricultural industries, the proliferation of these “superbugs” severely threatens the health of our globalized society. Particularly vulnerable are marginalized communities disadvantaged by financial circumstances and a lack of reliable health-promoting resources.

The emergence of resistant bacteria in response to the overuse of penicillin during the 1940s was a byproduct of natural selection. Organisms with mutations that protect them from the hazards of their environment tend to thrive. This was the crux of Darwin’s theory of evolution by natural selection. A single bacterium may spontaneously evolve a resistant mutation which can then be transferred via phages, lysis, or plasmids to neighboring bacteria. Unfortunately, this captivating dance of genetic adaptation became accelerated by human activities. A significant factor was the over-prescription of antibiotics in medical facilities. According to the Centers for Disease Control and Prevention, 30% of antibiotics prescribed in the United States are unnecessary. When adjusted for inappropriate selection, dosing, and duration, the figure rises to an astonishing 50%. Additionally, patients may use prescribed antibiotics improperly by failing to follow instructions for duration and dosage. This can result in failed treatment and necessitate more expensive and invasive therapies.

A single bacterium contains a mutation that confers resistance. This mutation can be transferred to neighboring bacteria, allowing the bacteria colony to develop antibiotic resistance.

Illustration by Yichen Wang

The animal agriculture industry is also largely responsible. 80% of the antibiotics sold in the United States go to stimulate animal growth—not even to treat or prevent illness. The inappropriate introduction of antibiotics allows for existing bacteria to develop the aforementioned resistance. These traits inevitably proliferate to cause widespread genetic change amongst highly transmissible microorganisms like Staphylococcus aureus and Streptococcus pneumoniae.

The apocalyptic ramifications of antibiotic resistance have already gripped the public, threatening global health. By reducing the efficacy of traditional treatments like penicillin, physicians are often forced to utilize stronger and more expensive medications. This has magnified global health care inequality by rendering necessary therapies less affordable. Similarly, countries with inadequate access to clean water and lack of sanitation systems suffer worse outcomes. The World Health Organization asserts that over 2 billion people rely on drinking water tainted by feces and human-born pathogens. Coupled with the lack of soap-and-water handwashing stations, infections requiring professional intervention are inevitable. Unfortunately, the promises of the medical mantra “first, do no harm” do not always materialize. Between 1995 and 2008, over 15% of patients in low and middle-income countries acquired at least one additional infection each hospital stay. In addition to endangering global health, commercial and sustenance animal agriculture may suffer declining productivity when faced with outbreaks of antibiotic-resistant infection, potentially threatening the food security of dependent populations. Groups with already unstable food supplies can face malnourishment, a general contributor to poor health. These challenges threaten to increase global morbidity and mortality rates concerning infectious disease, jeopardizing disadvantaged communities.

The severity of these outcomes prompts a critical question: what can we do to mitigate the consequences of antibiotic resistance? On an individual level, abstaining from improperly using these medications is of primary importance. This includes taking antibiotics only as prescribed for bacterial illnesses. Stopping treatment prematurely or skipping doses makes medications less effective and provides an opportunity for resistance to develop. In addition to individual efforts, a multitude of widespread reforms must occur. This includes enforcing stricter regulations on antibiotic use and a global collaboration to address underlying issues of inadequate access to healthcare, water, and sanitation facing vulnerable populations. Tending to these needs would diminish the spread of resistant bacteria while increasing treatment options, thus decreasing the burden of antibiotic resistance on developing countries and those financially hampered. Additionally, innovative methods of reversing antibiotic resistance are emerging. Researchers at UC San Diego, for example, have developed a gene drive which inactivates the resistance gene on a plasmid at an efficiency 100 times greater than traditional CRISPR technologies.

By refusing to surrender to these “superbugs,” humanity will indisputably manifest Nietzsche’s philosophy, for what doesn’t kill us can only make us stronger.