Pandemic Perspective #26   September 19, 2020

                This week’s perspective veers a little off the COVID issue but not by much. There is increasing concern regarding the rapid emergence of the so-called superbugs, bacteria that are resistant to all currently available antibiotics. Infectious disease specialists, of which I am one, worry that unless there are several – not just one – breakthroughs in the development of antibiotics, we are facing an antibiotic winter, meaning that humanity will be as susceptible to common but deadly infections as we were prior to the 1930s, when something as minor as a splinter could lead to death.

            This is already a common problem, especially for hospitalized persons. On the other hand, there are now strains of the agent of gonorrhea, the second leading cause of sexually transmitted diseases that have developed extreme resistance.

            What does this have to do with the current pandemic? Persons who are seriously ill from COVID-19 have several characteristics that make them extremely vulnerable to hospital-acquired infections. They are often obese and diabetic; both conditions lower immunity. They are burdened with multiple pathways to infection – intravenous lines, urinary catheters, breathing tubes, drains to remove accumulations of fluid and pus within the chest cavity, etc. They are hospitalized for weeks, sometimes months, allowing plenty of time to be exposed to infectious agents.

            A new form of treatment is emerging: bacteriophage. The term comes the Greek – bacteria eater. These are viruses that are present throughout the environment but especially in the foulest places such as sewage. They attack and destroy bacteria, a battle that has raged for millions of years. This form of treatment for bacterial infection originated several decades ago but research declined dramatically when penicillin arrived on the scene.

            Tens of thousands of persons succumb to these antibiotic-resistant bacteria every year. The best way to avoid them is to stay out of the hospital by following public health precautions and by maintaining a strong immune system, as described in multiple postings on this site.

            For an extremely informative narrative of this challenge I highly recommend The Perfect Predator by Steffanie Strathdee and Thomas Patterson. When Steffanie’s husband Tom developed a serious abdominal infection with a highly virulent bacterium, she initiated a hunt for a bacteriophage that would cure him when all known antibiotics failed. The book is extremely well written, the audio version * is superbly narrated and it takes place in San Diego, where the couple are on the faculty at UCSD. The medicalese is handled very well; non-physicians will not feel left behind. You can also find their story on YouTube and a Ted Talk.

* – You can download it free from the Libby app at http://www.overdrive.com via your local library membership.

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