Antibiotic Resistance

What you need to know to stay healthy

Antibiotic Resistance

The World Health Organization calls antibiotic resistance one of the biggest threats to human health today. So how can we win the battle against bacteria and stay healthy?

If you knew that meat from conventionally raised farm animals could be harbouring antibiotic-resistant bacteria, would you still eat it? The fact is that Canada has not yet dealt with the problem of faulty and excessive use of antibiotics both in humans and in animal farms, which creates bacteria that are resistant to existing antibiotics.

Antibiotic resistance

One of the biggest threats to human health today, according to the World Health Organization (WHO), is antibiotic resistance. With very few new antibiotics to be created in the near future, but with increasing antibiotic resistance, we could return to the conditions of a pre-antibiotic era, when infections such as meningitis or a respiratory infection could kill people.

Some argue that we’ve already reached that stage. “We are essentially back to an era without antibiotics,” writes John Conly, professor of medicine at the Centre for Antimicrobial Resistance at the University of Calgary, in a WHO bulletin.

Infectious disease is the second most important killer in the world, with an estimated 17 million people a year dying of bacterial infections. Chilling statistics, yet oftentimes they do what statistics do: they shock and then get forgotten. Is it too late to work our way out? Not yet, experts say.

Small world

They make up the world we cannot see, but we cannot live without them. Bacteria allow life as we know it to exist. The human body contains an average of 10 times more bacteria in and on the human body than actual cells: on the skin and in our mouths, eyes, and guts, as well as in our urogenital and respiratory tracts.

Vital yet vilified

Bacteria keep the digestive system in working order by helping us digest food and synthesize vitamins, and they keep potentially harmful bugs at bay. Yet the word “bacteria” makes most people cringe. With the recent advances in identifying bacteria that populate the human body, scientists continue to uncover new species of bacteria, some with roles we don’t yet fully understand.

Bacteria in the trillions

“Humans are hosts to more than a thousand different types of bacteria; humans are, in fact, 90 percent bacteria,” says Dr. Julian Davies, professor emeritus in the microbiology and immunology department at the University of British Columbia.

“We don’t know what the use of antibiotics has done to us and our health,” Davies says. “Recent studies have shown that some antibiotics can disrupt the composition of gut bacteria for several years,” he explains.

Antibacterials cause vulnerability

The negative associations with bacteria today come from our ever-growing fear of bugs and the obsession with cleanliness. Bacteria, fungi, and yeast have always coexisted with humans. When the delicate symbiotic balance is affected in any way, due to hormonal changes, stress, medication, age, or diet, the normal flora of the human body changes.

But the most damaging effects are caused by use and misuse of antibacterial drugs: bacteria develop resistance and humans become vulnerable.

Antibiotics then and now

Penicillin was discovered in the late 1920s, and since then many other antibiotics have been developed.

Miracle drug

Shortly after their discovery, antibiotics were dubbed miracle drugs—and for good reason: previously deadly diseases were now contained by compounds that had minimal side effects compared to their benefits.

Superbugs

Yet nowadays health organizations such as WHO warn about antibiotic resistance and its dire consequences, including the rise of so-called superbugs, such as MRSA (methicillin-resistant Staphylococcus aureus), and the inefficacy of the latest generation of antibiotics due to overuse and misuse.

Antibiotic resistance

Antibiotic resistance is not a modern-day phenomenon but rather an evolutionary feature of bacteria. During antibiotic treatment of any kind, some bacteria die and a few will carry on with an improved genetic arsenal that allows them to survive and also to pass on their antibiotic-resistant genetic material to the next generation.

Antibiotic overuse

Antibiotics should only be prescribed as needed, and they should be taken for the entire duration of the treatment. “We have to assume that all organisms living with us have some role in our life,” explains Davies. Any drastic alteration, he says, due to faulty antibiotic treatment or overuse of antibiotics, leads to some form of disease.

Drastic changes in the bacteria composition affect health. The main reason, according to Davies, is that in the human body everything is connected and highly controlled, including cell-to-cell interactions and interactions with our live-in bacteria.

The balance is disrupted every time we take antibiotics, and it takes a while for bacteria to grow back, Davies says. When antibiotics are needed, losing some indigenous bacteria in order to get rid of an infection seems like a small price to pay.

But antibiotic use has highly surpassed the real need, and while efforts are being made by some organizations to reduce unnecessary use, there’s still a lack of sustained campaigns to educate and help in the war against superbugs.

Meat with a side of antibiotics

The use of antibiotics by the agri-food industry far exceeds the human numbers. It is estimated that the use of antibiotics in farm animals and fish is almost a thousandfold that of human use. It’s tonnes we are talking about.

Used to prevent and treat infections, antibiotic drugs have a dark side that few know about when it comes to animals: in small doses they are used as growth promoters or for disease prevention.

We pay less for our meat, but it comes with a side of antibiotics that we don’t need, occasionally sprinkled with antibiotic-resistant bacteria such as certain types of Staphylococcus aureus and MRSA. Add some E. coli, Campylobacter, and Salmonella and the menu is decidedly hard to stomach.

Growth and disease prevention

Why this dark side? Mostly because of the continuous, low-dose administration of antibiotics to farm animals to encourage their rapid growth. Antibiotics encourage the development of bacteria that produce nutrients required for growth and eliminate nutrient thieves.

Adverse effects

The adverse effects of such practices are serious and, even worse, they are long term.

  • The number of antibiotic-resistant bacteria is on the rise, and some transfer to humans.
  • Previously uncomplicated diseases, such as bacteria-caused colds that doctors could once treat with the available antibiotics, are now hard or impossible to treat with the antibiotics at hand.
  • Third-, fourth-, and fifth-generation cephalosporins are being used in farm animals to prevent infections and enhance growth—and the impact on human health is deadly.

Advisory committee

An advisory committee reporting to Health Canada in 2002 recommended that antibiotics used to treat animals should only be available by prescription. They also recommended that antibiotics used for growth promotion should not be imported, sold, and used in Canada unless evaluated and registered by Health Canada.

Medical community weighs in

Many years later, the “own use” loophole the report tried to eliminate still allows Canadian farmers to use unscrutinized antimicrobial drugs. According to an article published in 2009 in the Canadian Medical Association Journal, the alleged loophole allows Canadian farmers to import approximately $100 million worth of drugs, including some not approved for use in Canada.

Still no changes

A June 2012 editorial in the same journal urges the ban of off-label antimicrobial use in agriculture. Many European countries have done so already and the cost to consumers has suffered only a slight increase. Of all the Canadian provinces, only Quebec has a strict policy regarding antibiotic use in farm animals.

The dark side of cleanliness

We have come to fear bacteria so much that the word “antibacterial” on many personal and household products brings reassurance. Instead, it should cause concern. But whether on the skin or in the mouth, gut, or respiratory tract, resident bacteria guard against deleterious types that would otherwise cause infections or flora imbalances.

Excessive use of antibacterial products that contain a chemical called triclosan can reduce the good bacteria population and thus lower the defence mechanisms. Davies explains: “Triclosan affects the bacterial population in our mouths and the effects are not known. We need a population of bacteria in our mouths for good health.”

Triclosan is found in many products, including soaps, toothpaste, mouthwash, kitchenware, computer equipment, clothing, and toys.

“I don’t believe we need antibacterial compounds outside of hospital settings,” Davies says. Even in hospitals, overuse can backfire. Overexposure of MRSA to triclosan encourages resistance.

Although limited, research shows that overexposure to triclosan may also be a factor in developing resistance toward other antimicrobials. Not only that, but triclosan has been shown to suppress thyroid hormone and have estrogenic effects.

We cannot and should not get rid of bacteria. After all, Davies explains, out of the billions of bacteria we know of, relatively few are potentially dangerous to humans. What we should do instead is to reduce the overuse of antibiotics in humans and livestock and to avoid antibacterial applications of any kind unless it is necessary.

What you can do

  • Buy animal products from local organic farms that believe in animal welfare and healthy farm practices and do not use antibiotics to enhance growth.
  • Avoid buying antibacterial personal hygiene and cleaning products. Practise good hygiene by washing hands with soap and water for at least 20 seconds.
  • Avoid buying any product that may be treated with triclosan (found in fabrics, cutting boards, mops, paint, floor tiles, wallpaper, and toys), and ask companies that produce them to stop using triclosan.
  • Spread the word: antibiotics should be used only when necessary and must be used exactly as prescribed.
  • Act: urge your MP and MLA to champion the issue of regulating antibiotic use in livestock.

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