Image: kat m research
At some time in our lives we are going to get hit by a virus or a bacterium that lays us low. Thankfully that is not so much of a problem since all we have to do is pop along to the doctor, pick up some medicine and then crash out on the couch watching daytime television until we are better. Lurking on the horizon, however, is something we should be more worried about: the rise of the superbug. Diseases, viruses and bacteria which we had previously dealt with have rallied, come back stronger and are now capable of doing more than just laying us low. Here are just a few of them.
Image: Pulmonary Pathology
5. Carbapenem-resistant Klebsiella pneumoniae (CRKP)
Pneumonia is not a great illness to have. It is a respiratory condition in which there is an infection of the lung, and it can be caused by a virus, bacteria or even by accidentally breathing in liquid. It is, however, relatively easy to treat with antibiotics and bed rest, it rarely gets you sent to hospital, and mortality rates from the illness are not high. In fact, it only tends to be fatal if complications occur.
Carbapenem-resistant Klebsiella pneumonia or CRKP is another matter entirely. This is a strain of pneumonia acquired in hospital which has become resistant to nearly all of the antibiotics that are currently used to treat the condition. If that weren’t bad enough, the Klebsiella bacterium produces an enzyme that degrades powerful antibiotics and confers a low-level resistance to others. Oh, and to make matters worse, that enzyme can be passed to other bacteria in the body.
Image: Pulmonary Pathology
During the period of October 2005–October 2008, a university training hospital studied cases of CRKP. It discovered that people struck down with this superbug were more likely to have to spend time in intensive care and spend more time on a ventilator than non-infected people. Possibly the scariest thing they found, however, is that the mortality rate of people infected with this strain of pneumonia is 50%.
4. Methicillin Resistant Staphylococcus Aureus (MRSA)
Possibly one of the most infamous superbugs, this bacterium always hits the headlines of local papers when it appears in hospitals throughout the world. Staphylococcus Aureus is more common than people think as it is often carried on the skin or inside the nostrils or throat. In this form all it will do is cause mild skin infections which are easily treated. If it gets into a cut or skin wound, however, things can get nasty.
If MRSA – a strain of Staphylococcus aureus – gets into the bloodstream it can reach and infect nearly every part of the body. Blood poisoning, lung and heart infection and abscesses inside the body are all common complications once a person is infected. Treatment is currently a mixture of antibiotic types, but it will definitely take a couple of weeks to deal with. This is not something that will only take merely a few days to get over.
What makes this bacterium so dangerous is the fact that it is immune to nearly all antibiotics. It spreads easily from physical contact, and recently outbreaks of MRSA in communities away from hospitals have occurred. This could be due to the fact that large amounts of the population, around 2%, carry an antibiotic-resistant strain of Staphylococcus Aureus. The thirty-day mortality rate has been seen to be as high as 30%.
3. Resistant E. Coli
Usually the only time you hear about Escherichia coli, or E. Coli, is when you or someone you know suffers from a case of food poisoning. A low-grade fever, nausea, vomiting and diarrhoea are the main symptoms that occur when an E. Coli infection hits the body. Although it is nasty to go through, it isn’t that dangerous unless you are very old or very young.
However, earlier this year a particularly virulent strain of E. Coli struck Germany. Eleven countries were hit, 2,000 people were infected and 18 deaths resulted from this infection. While the death rate isn’t that bad compared to other superbugs (being roughly equal to normal mortality rates), what makes this new strain so dangerous is the associated risk of haemolytic uraemic syndrome or HUS as a complication. Over 500 cases have been reported in Germany so far, which is a 25% secondary infection rate.
Haemolytic uraemic syndrome is predominantly seen in children, but when it occurs in adults the symptoms can be nasty. Typically the patient will become jaundiced and or anaemic. High blood pressure, bloody urine and nervous system symptoms can also develop. In 25% of cases people with HUS will suffer kidney damage and high blood pressure. In 5% of cases the patient will die. So if Resistant E. Coli doesn’t get you, the secondary infections might.
Image: kat m research
2. Resistant Acinetobacter Baumannii
This is being seen as the successor to MRSA by some doctors. Like many hospital-acquired infections, Acinetobacter baumannii will enter the human body through open wounds on the body. Having a compromised immune system will enable the bacterium to gain a foothold, and from there it will wreak havoc on the body.
Until just recently this was a relatively rare infection, but in 2003 a large number of wounded soldiers coming back from Iraq were found to have Acinetobacter baumannii infections. It was thought that the infection was getting picked up from the soil, where it can reside, and brought back to the hospital with the injured. This resulted in cross-contamination in a similar way to MRSA, and eventually it appeared in non-serving civilians.
What makes this dangerous is the fact that it can affect you in a variety of ways. If it attacks your skin it will affect it like necrotising fasciitis, a nasty flesh-eating disease that can literally eat you to death if left untreated. If it attacks the lungs, you can get pneumonia. in fact, Acinetobacter baumannii will cause an infection almost anywhere it lands.
It gets worse though. Fifty-five percent of all A. baumannii bacteria found in hospital infections were shown to be resistant to three types of antibiotic, and 17% were found to be resistant to four types – which could mean that the bacterium is still evolving resistances. It is also twice as likely to contaminate health workers’ clothes and gloves as MRSA, meaning it spreads quicker and more easily. It also has mortality rates of up to 50%, making this one very scary bacterium.
Image: Pulmonary Pathology
1. Antibiotic Resistant Neisseria Gonorrhoea
Most superbugs are rare. The latest infection to become resistant to its cure, however, is very common. Gonorrhoea is one of the most widespread sexually transmitted diseases around today. It is caught by having any kind of unprotected sex, and in some people symptoms do not even appear, making it more likely to be passed on. Symptoms can range from a simple sore throat to discharge to infertility.
As many as 700,000 people in the USA alone are believed to get gonorrhoea, with woman only having a 50% chance of showing any symptoms. Once gonorrhoea has been treated and has gone away it can be caught again, meaning no resistance is created even after it has been cured.
What makes this new strain of untreatable gonorrhoea so dangerous is not the risk of death but rather the risk of never being able to get rid of the infection. The longer you have the infection, the greater the chance of severe secondary infections. Infertility, ectopic pregnancies and scrotal swelling could become more and more common. If that wasn’t bad enough, there is a chance of passing the condition on to a newborn infant during delivery.
Overall it is estimated by the Centers for Disease Control and Prevention that roughly 1.7 million cases of hospital-associated infections cause 99,000 deaths each year in the United States alone. The more we rely on antibiotics, the greater the chance of a new drug-resistant strain of bacteria evolving. The war between the bacteria and the drug companies will never be over, and with feint after feint being directed at each side in this war, it is a situation that can only get worse.