Antibiotic Resistance

Jessica Bahan
Environmental Health 2000

Antibiotics have been used in the medical world for decades. In fact, they have
been used for so long that according to the Centers for Disease Control and Prevention
(CDC), the infectious organisms that antibiotics are killing are adapting to the drugs,
making them less effective (1). In Stuart Levys article, The Challenge of Antibiotic
Resistance, he lists all the places antibiotics are being used and misused. He says
antibiotics are used heavily in [home] disinfectants, hospitals, patient care and livestock
(3). The issue at hand with antibiotics is their applications will soon be nonexistent
because of the powerful infections people are acquiring due to bacteria adapting strong
resistances towards them. Antibiotic resistance is a global, large-scale issue ranging from
the environment to hospitals; with the right science and research antibiotic resistance can
successfully decline.
To fully grasp this phenomena, understanding the background and original use for
antibiotics is essential. Antibiotics had been created and identified since the early 1900s,
but did not receive their real claim to fame until 1928. Alexander Fleming was
consistently working with penicillin for 12 years and in 1928 he discovered its antibiotic
properties (4). According to The University of Utah, antibiotics are agents from different
biotic sources that kill bacteria. Antibiotics work in the body in numerous ways
including the following: Some of the ways they work are: dissolving the membrane in
bacterial cells, affecting protein-building or DNA-copying machinery that is specific to
bacteria and keeping bacterium from building a cell wall around human cells (2).
Environmentally, antibiotics have affected how livestock are raised and waterway
systems. The direct use of antibiotics to animals indirectly affects humans.
Microbiologist Dr. Glenn Morris explains that when humans ingest undercooked meats,

that were fed antibiotics, they will not respond to antibiotic treatment because of the
resistant bacteria ingested. The World Health Organization (WHO) wants to reduce the
misuse of antibiotics that are given to livestock in order to protect the human health (6).
According to The New England Journal of Medicine, resistance cannot be confronted
unless massive quantities are not exposed to the environment (5).
Public Broadcast Service (PBS) reported the use of an antibiotic called Baytril
which was used on chickens and turkeys to prevent E. coli infection. If just one bird on
the farm was infected, then the whole flock received the antibiotic in their drinking water.
This brought up the controversy of using antibiotics for therapeutic reasons and subtherapeutic reasons. Baytril is the sister drug of Cipro which helps humans with
infections like campylobacteriosis and salmonellosis. The Food and Drug Administration
(FDA), doctors, and consumer groups urged Baytril to be removed from the market
because, when ingested, it was intervening with the affect Cipro had to fight infections.
This is just one example of resistance increasing from the use of antibiotics in livestock
(4).
Since antibiotic resistance has become such a large issue, alternatives are
necessary. In Host Behaviour and Opportunism in Parasite Life Cycles, author R.C.
Tinsley discusses how parasites are opportunists. This essentially means that if there is a
weak immune system there is a greater change of contracting a parasite (7). The United
State Department of Agriculture (USDA) has specified some of these immune building
alternatives. Instead of farmers giving their livestock antibiotics, immunologists have
found that giving animals food supplements and probiotics strengthen their immune
systems. This method also helps fight parasite related diseases. Another alternative that

the USDA suggests is selective breeding, finding genes that are disease resistance and
breeding those birds (8).
The most common disease in dairy cattle is mastitis. Mastitis is currently being
treated with antibiotics, but Scientists at the USDAs Agriculture Research Service
(ARS) found that vitamin D is a natural remedy and can delay and reduce the severity of
this infection. Increasing levels of vitamin D to cows will increase proper immune
function. Cows that have been treated with vitamin D have had a lower bacterial count
and fewer signs of infection than untreated cows. Overall, alternatives to antibiotics are
needed for livestock. The national program leader for animal health with the ARS, Cyril
Gay states, Finding alternative strategies to prevent and control animal diseases has
become a global issue and a critical component of efforts to alleviate poverty and world
hunger (8).
The American Society for Microbiology states that antibiotic resistance is literally
streaming across the nation. The issue they discuss is antibiotics in the nations
waterways. Scientists, like Ronald Ash, test the water all throughout the country and
samples waterborne bacteria. He found that there is no pattern with antibiotics in
waterways, which makes diagnosing the issue harder. Some rivers like in Ohio, Colorado
and Mississippi are resistant to ampicillin, which is synthetic penicillin. Ash expected
water in New Orleans to be filled with resistant microbes, but was not nearly the amount
he expected. Monica Tischler, who is in the department of biological sciences at
Benedictine University, says the biggest issue is livestock being fed low doses of
antibiotics that leaves manure-tainted fields that causes antibiotic filled water runoff.

As previously stated, antibiotics in livestock is a big issue for why there are
antibiotics in that nations waterways. Alternatives to livestock being given antibiotics
will help reduce the amount of antibiotic filled runoff. According to Harvard Health
Letter, only portions of antibiotics are properly disposed of. To combat this problem,
there are have been drug take-back programs made by the federal Drug Enforcement
Agency. This makes it so drugs are not flushed or put down drains that lead to
waterways.
Other big issues causing antibiotic resistance are medical hygiene and how
doctors are prescribing antibiotics. According to Philip Stewart and J Costerton, bacteria
stay in medical devices and damaged tissue. The bacteria encase themselves in a layer
called a biofilm. These biofilms adhere to devices like central venous catheters, urinary
catheters, prosthetic heart valves and orthopaedic devices. The bacteria in these biofilms
are so resistant they can even withstand antibacterial chemotherapy. In Stewart and
Costertons article it also explains how bacteria that are not in a biofilm can be greatly
sensitive to antibiotics, but once in a biofilm they are scarcely affected by antibiotics.
The CDC reported overusing and wrongly prescribing are also driving resistance to
antibiotics. There are also a growing number of healthcare related infections due to
resistant bacteria. Some of the infections include: MRSA, E coli, and resistant strands of
pneumonia (11).
The CDC lists ways that patients and doctors can reduce antibiotic resistance. A
few things patients can do are: Asks for tests to make sure they are prescribed the right
antibiotic, only take prescribed antibiotics, and do not ask for antibiotics when a
healthcare provider does not feel its needed. Doctors can reduce antibiotic resistance by:

prescribing antibiotics correctly, document dosing, and watching antibiotic resistant

patterns in facility. One thing patients and doctors can do is practice good hygiene so no
further infections occur. Hospital hygiene is also essential to prevent biofilms from
forming (1). Stewart and Costerton also suggest different therapies for decreasing
biofilms from forming. One way is to disrupt the multicellular structure of the biofilm.
This essentially means that the biofilm will not be as powerful and could increase the
chance of an antibiotic fighting the bacteria. A way to disrupt the structure is to use an
enzyme that dissolves the matrix polymers of the biofilm (11).
Since the incline of antibiotic resistance has caused so many different issues the
U.S. created the National Antimicrobial Resistance Monitoring System (NARMS). This
program has helped monitor human and animal bacterial resistance (Bren, 2002).
NARMS is a joint effort by the CDC, FDA, and USDA. Throughout different states
animal specimens are collected and tested by NARMS. The data provided by NARMS
helps provide information like: New treatment guidelines, shape national policy
regarding the use of antibiotics in animals, and determine effects of drug usage (Bren,
2002). Constant research is being done by NARMS to stay updated on antibiotics,
infections caused by them, and understanding mechanisms for designing new drugs (10).
Antibiotics have had beneficial health benefits and have even cured lifethreatening diseases throughout decades. Unfortunately, with the good results came the
bad affects. Antibiotic resistance is not just from one source and throughout the years
scientists and researches have found different sources of the issue. Sources like:
waterways, livestock and hospitals are major places antibiotic resistances have stemmed

from. With a growing sense of urgency and scientific action, antibiotic resistance can be
decreased.

Citation
1. Centers for Disease Control and Prevention. (2014, August 6). Centers for Disease
Control and Prevention. Retrieved from http://www.cdc.gov/drugresistance/

2. University of Utah. (2014). University of Utah. Retrieved from

http://learn.genetics.utah.edu/content/microbiome/antibiotics/

3. Levy, Stuart. (1998, March). The Challenge of Antibiotic Resistance. Retrieved from
http://schimizzi.cmswiki.wikispaces.net/file/view/antibiotic%20resistance.pdf/493
751958/antibiotic%20resistance.pdf

4. Aminov, Rustam. (2010, December 8). US National Library of Medicine National

Institutes of Health. Retrieved from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3109405/

5. Spellberg, B., Bartlett J., and Gilbert D. (2013, January 24). The New England Journal
of Medicine. Retrieved from
http://www.nejm.org/doi/full/10.1056/NEJMp1215093

6. Raloff, J. ( 1999, June 5). Waterways Carry Antibiotic Resistance. Retrieved from
http://dwb4.unl.edu/Chem/CHEM869K/CHEM869KLinks/www.sciencenews.org
/sn_arc99/6_5_99/fob1.htm

7. Tinsley, R.C. (1990). Host Behaviour and Opportunism in Parasite Life Cycles.
Retrieved from http://www.cabdirect.org/abstracts/19910882205.html

8. Avant, Sandra. (2012, May 14). United States Department of Agriculture: Agricultural
Research Service. Retrieved from
http://www.ars.usda.gov/is/AR/archive/may12/animal0512.htm

9. Harvard Medical School. (2011, June). Harvard Health Publications.

Retrieved from
http://www.health.harvard.edu/newsletters/Harvard_Health_Letter/2011/June/dru
gs-in-the-water

10. Bren, Linda. (2002, July-August). FDA Consumer. Retrieved from

http://www.tufts.edu/med/apua/about_issue/FDA%20Consumer.pdf

11. Stewart P., Costerton J. (2001 July 14). The Lancet. Retrieved from
http://www.sciencedirect.com/science/article/pii/S0140673601053211