Emerging Diseases Linked to Antibiotic Resistant Organisms
By Melinda Cassidy
Outreach and Engagement Communications Student Intern
Alarming increases in antibiotic-resistant organisms have led the World Health Organization and the Centers for Disease Control to declare a global health disaster, and some members of Ohio State's faculty are doing their part to combat these "superbugs."
Debra Goff, associate professor of pharmacy and infectious disease specialist, started a transatlantic partnership in 2013 with physicians and pharmacists in South Africa to help improve antibiotic stewardship - the correct and effective prescription of antibiotics - in the country*.
Antibiotics and similar drugs, referred to collectively as antimicrobial agents, have been commonly used to treat bacterial infections since the 1940s, when penicillin debuted in medicine. However, widespread misuse and ineffective prescription since then have driven the selection of bacteria resistant to multiple antibiotics, rendering many drugs ineffective and posing a threat to the international community, Goff said.
"The world is one," she said. "So it's not like we can say we don't need to worry about what's in South Africa because it's so far away, because everything can be here in 24 hours."
In order to stop the stock of effective antimicrobial agents from disappearing, Goff and her team have begun training South Africa's pharmacists to the level of Ohio State's own, starting with teaching the scenarios that call for antibiotics and then moving to which drugs work best.
Marc Mendelson, infectious diseases specialist and co-chair of the South African Antibiotic Stewardship Program, said the rise in antibiotic resistance is due to several contributing factors that need to be addressed if there is hope in delaying further increases.
"There's the patient - you - that wants something," he said. "You don't go to the doctor the first time you get a cough, you go when your symptoms are at their highest, so you want something done. The doctor wants to feel as if they're doing something, and there's also a complete underestimation of the fact that inappropriate antibiotic use actually drives the problem of resistance."
One crucial mistake doctors make is prescribing antibiotics for viral - not bacterial - infections, Mendelson said. According to the CDC, common viral infections include colds, flu, bronchitis and sore throats, with the exception of strep throat.
"Antibiotics have no effect on viruses," Mendelson said. "If you're giving antibiotics to all these people, all that's doing is allowing antibiotic-resistant bacteria to come to the fore front and potentially spread. So by giving an antibiotic, there's a collateral damage."
Factors outside of antibiotic prescriptions to humans also contribute to the crisis.
Wondwossen Gebreyes, professor and director of Global Health Programs in the College of Veterinary Medicine, said the improper use of antibiotics in poultry and livestock contributes to the transfer of the "superbugs" to humans once they consume the treated animals - where the resistant bacteria then remain.
"Gaining a resistance is usually a quick process, but the bacteria do not easily lose it," he said. "They stay resistant for a long time."
In fact, Gebreyes said about a quarter of all Salmonella cases in the United States contain chloramphenicol-resistant bacteria, an antibiotic that Goff said she has never seen used in her career.
This tendency for bacteria to develop and maintain drug-resistant genes does more than illustrate the Darwinian idea of "survival of the fittest," it necessitates the multidisciplinary approach that Goff has taken alongside Mendelson and Gebreyes.
"It's almost like we're returning to the pre-penicillin era," Goff said. "When you think of the impact globally ... you have a heart attack and you need to have a cardiac surgery - if you don't have antibiotics, you can't do those surgeries because the risk of getting an infection in the surgical wound could be catastrophic if there was no antibiotic to treat that infection.
"The ramifications are so big, and that's part of why we're trying to collaborate globally to prevent this. We've learned that every infectious disease drug-resistant organism is a plane ride away."
* Supported by a 2014 Engagement Impact Grant from the Office of Outreach and Engagement. Find more information at outreach.osu.edu.
Discovery Themes Initiative
This work on antibiotic resistance aligns with Emerging and Re-emerging Diseases – one of the initial investment areas in The Ohio State University’s Discovery Themes Initiative.
The Discovery Themes Initiative is a significant investment in three thematic areas in which the university will make a global impact: Energy and the Environment, Food Production and Security, and Health and Wellness. As the nation’s most comprehensive university and one of the top institutions for industry-sponsored research, Ohio State is able to develop solutions that will transform our world. Discovery.osu.edu
Contact: Debra Goff, Debbie.Goff@osumc.edu