Maryn McKenna has a terrifying “report from the field” of the fast-approaching post-antibiotic world. That we are living in New Zealand amplifies the report only slightly, because this reality is happening everywhere — and the origin of the particular KPC-Oxa 48 bacterium was Vietnam, not NZ.
This week, [health authorities in New Zealand announced] that the tightly quarantined island nation — the only place I’ve ever been where you get x-rayed on the way into the country as well as leaving it — has experienced its first case, and first death, from a strain of totally drug-resistant bacteria. From the New Zealand Herald:
In January, while he was teaching English in Vietnam, (Brian) Pool suffered a brain hemorrhage and was operated on in a Vietnamese hospital.
He was flown to Wellington Hospital where tests found he was carrying the strain of bacterium known as KPC-Oxa 48 – an organism that rejects every kind of antibiotic.
Wellington Hospital clinical microbiologist Mark Jones (said): “Nothing would touch it. Absolutely nothing. It’s the first one that we’ve ever seen that is resistant to every single antibiotic known.”
Pool’s death is an appalling tragedy. But it is also a lesson, twice over: It illustrates that antibiotic resistance can spread anywhere, no matter the defenses we put up — and it demonstrates that we are on the verge of entering a new era in history. Jones, the doctor who treated Pool, says in the story linked above: “This man was in the post-antibiotic era.”
If we really lost antibiotics to advancing drug resistance — and trust me, we’re not far off — here’s what we would lose. Not just the ability to treat infectious disease; that’s obvious.
But also: The ability to treat cancer, and to transplant organs, because doing those successfully relies on suppressing the immune system and willingly making ourselves vulnerable to infection. Any treatment that relies on a permanent port into the bloodstream — for instance, kidney dialysis. Any major open-cavity surgery, on the heart, the lungs, the abdomen. Any surgery on a part of the body that already harbors a population of bacteria: the guts, the bladder, the genitals. Implantable devices: new hips, new knees, new heart valves. Cosmetic plastic surgery. Liposuction. Tattoos.
We’d lose the ability to treat people after traumatic accidents, as major as crashing your car and as minor as your kid falling out of a tree. We’d lose the safety of modern childbirth: Before the antibiotic era, 5 women died out of every 1,000 who gave birth. One out of every nine skin infections killed. Three out of every 10 people who got pneumonia died from it.
And we’d lose, as well, a good portion of our cheap modern food supply. Most of the meat we eat in the industrialized world is raised with the routine use of antibiotics, to fatten livestock and protect them from the conditions in which the animals are raised. Without the drugs that keep livestock healthy in concentrated agriculture, we’d lose the ability to raise them that way. Either animals would sicken, or farmers would have to change their raising practices, spending more money when their margins are thin. Either way, meat — and fish and seafood, also raised with abundant antibiotics in the fish farms of Asia — would become much more expensive.
The last paragraph I quoted bumps the priority on my todo list – to understand better the realities of agricultural antibiotics. I’m carrying around the idea that the Danes have demonstrated on the farm that pigs could be raised without antibiotics at lower cost, higher productivity and healthier pigs. Yes, the farmers did have to innovate and adopt new husbandry methods. But there must be more to the story than my simple memory.
More important, do not miss Maryn’s new in-depth report “Imagining a Post-Antibiotics Future“.