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The cynical, easily news-fatigued among us are probably rather bored with being proverbially hit over the head with reports about antibiotic resistance by now. There's seemingly a new warning that the world is teetering on the edge of the post-antibiotic era each week, and if you are a healthy person who has not encountered an antibiotic-resistant bug (yet), these reports may not seem terribly relevant right now.
Though antibiotic resistance is rising exponentially, the fact is that antibiotics are still available, and the odds are still overwhelmingly in your favor that antibiotics will work for you if you need them — for most bacterial infections, that is. That may change. Our children or their children may find themselves living in a world where simple infections can kill and now minor operations become high-risk, high-mortality procedures. We may be living in an era where new technology is being developed constantly, and 3-D printers, robotics, and nanotechnology can achieve things that would have been thought impossible just a few decades ago, but without antibiotics, we'd be back in the dark ages before long. If that sounds horrendously catastrophic, that's because it is.
You've already heard the advice to make sure you only take antibiotics when they are prescribed by a doctor, to refrain from insisting on antibiotics for viral infections, to make sure that you finish any course of antibiotics you start, and to practice meticulous hand hygiene to lower your risk of acquiring a bacterial infection in the first place.
What's Up With Colistin?
In November 2015, a Lancet study reported that a mutation — the MCR-1 gene — was found in bacteria that makes them highly resistant not just to any antibiotic, but to Colistin, a "last-resort drug". These resistant bacteria was mostly found in pigs and poultry in China, but in rare cases also in humans. The resistant gene was first located on a pig farm in Shanghai four years ago, but there is evidence that it can easily be transferred between common bacteria, such as E coli and Klesbsiella pneumoniae. The research team said: "although currently confined to China, MCR-1 is likely to emulate other resistance genes ... and spread worldwide."
How did common bacteria become resistant to such a serious drug? The Lancet report estimates that around 12,000 tons of Colistin are purchased for use in agriculture on a yearly basis worldwide, and pigs in China are routinely given the drug. As a result of the report, the Chinese ministry of agriculture has said that it will now better monitor the use of Colistin.