While the events of the past few days may make the apocalypse seem to be coming via other means, I still feel that climate change and the terrorists won’t knock us off quickly enough for us to avoid death by the scourge of antibiotic resistance.

Here’s a Cape Talk interview with the WHO’s Dr Marc Sprenger on the pisspoor Kieno Kammies show this morning.

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But it seems that a lot of people simply don’t understand what a antibiotic resistance and superbugs are. Research has shown that there are two main categories of misunderstanding here. Both are bad, but you can completely understand the confusion of the 20% of people who have simply misheard the word and believe that it’s actually a “Superb Hug”. That wouldn’t be bad at all. It would be… well… superb. And a hug. Everyone loves hugs. Especially superb ones.

That’s not going to kill you.

The other 80% of those who don’t get what antibiotic resistance is, think that it’s the patient who becomes resistant to the antibiotic:

The researchers asked them about it and got blank faces in response. When probed—and here’s the bit that really shocked me—almost everyone assumed that it’s the person who becomes resistant to antibiotics, not the microbes. You take enough of something, they reasoned, and your body gets used to it and builds up a tolerance. It’s such an intuitive idea that even after they read simple descriptions that explained how bacteria become resistant, they reverted to the resistant-patient idea.

I hope his probe was properly sterilised between interviews.
The implication of this misconception is:

…a pretty serious one, because some people reasoned that if they don’t finish their courses, they’re less likely to become “resistant.” Ironically, that decision could increase the odds of developing an actual drug-resistant infection by leaving a pool of surviving microbes that have experienced and withstood the antibiotics.

Even the term “Superbugs” was described as misleading. Oh dear. I’ve buggered up the title of my post. Properly.

The issues here seem to be much greater than merely the apparent apathy over the dangers of antibiotic resistance, or, as we’re now suggested to describe it: “drug-resistant infection”.

If you change the noun to infections or germs, and make resistant the adjective, you make a huge difference to people’s ability to work out what’s going on. It’s opened my eyes to how much more research we need to be doing on public-health communication.

The problem is that people don’t even understand the concept of what they supposed to be apathetic about. And if we’re ever going to get them to be apathetic about it (and don’t worry, yes, this is merely the first step of my master plan), then we, as microbiologists and healthcare professionals, need to remedy that.

Even though, soon, we’re not going to be able to remedy anything else.

Are you listening yet?

It was about a year ago that I wrote the We’re All Buggered post, referring to antibiotic resistance and the potential threat of living in a post-antibiotic era. At that point, it wasn’t really news to anyone in the microbiological community: indeed, in that post I mentioned a seminar I attended ten years ago in Oxford, and even then it wasn’t really news to us.

But slowly, surely, these stories are beginning to infiltrate the media more and more often. And the reasons for this are fairly clear – scientists are becoming ever more concerned about the impending problems we are facing and moreover, a great number of the public are being affected by the issue, thus it’s becoming more relevant and therefore, more newsworthy.

Of course, if this problem wasn’t so insidious, we’d all be panicking about it already. If there were a 9/11 or a Hurricane Sandy – a single event – there would be far more awareness. (Not that awareness would really help anyway.)
But that’s not the case with the antibiotic resistance problem. It’s sneaking up on us and, for those of us in the know, it’s rather worrying*.

The latest “big name” to have come out with a stark warning is an associate director for the CDC, Dr. Arjun Srinivasan:

For a long time, there have been newspaper stories and covers of magazines that talked about “The end of antibiotics, question mark?” Well, now I would say you can change the title to “The end of antibiotics, period.”

We’re here. We’re in the post-antibiotic era. There are patients for whom we have no therapy, and we are literally in a position of having a patient in a bed who has an infection, something that five years ago even we could have treated, but now we can’t.

Quote via (take tinfoil hat along for some of the comments). Here’s the full programme on, with the suitably dramatic title: Hunting The Nightmare Bacteria. (Hint: it’s not difficult – just go to any major hospital and they’ll come find you.)

Jason Kottke suggests that drug-resistant infectious diseases should be added to the list of “disasters with no clear low point”, and he’s probably correct. Remember that Dame Sally Davies (the Chief Medical Officer in the UK) thought that:

“…the threat from infections that are resistant to frontline antibiotics was so serious that the issue should be added to the government’s national risk register of civil emergencies.”

and that puts it alongside threats like “explosive volcanic eruptions” and “catastrophic terrorist acts”.

As previously, I don’t expect this post to do anything to make a difference to the situation. There’s actually nothing we can do to prevent this now. I just thought that you ought to know.

Have a great weekend.

* The latter part of this sentence contains a fair amount of understatement.