Sciences Participating with Arts & Culture in Education

The Antibiotic Crisis: How Bacterial Resistance is Threatening our World

Illustrated by Annie Lafrenière

The mistreatment of farm animals that are raised for the purpose of meat and dairy is something most of us are aware of. That’s why, a couple weeks ago when I was browsing the grocery store with my mother, the packaging on a chicken breast caught my eye. “Raised without antibiotics,” it proudly read. “Well that’s great,” I thought, “Something more about the atrocity of factory farming that I wasn’t aware of.” But what were antibiotics doing in a chicken breast anyway?

I have always avoided investigating the lives of farm animals because I have always been an animal lover, and the stories of mistreatment are often too much for me to bear. However, because I’ve also been taught about antibiotic resistance in school, discovering meat advertised as antibiotic-free made me curious. I know that this phenomenon can lead to the creation of dangerous super bacteria, and I was wondering how important the antibiotics used on farm animals were to the emergence of these super bacteria.

Let’s face it; factory farms are very far from the ideal setting for an animal’s life. The conditions in which these animals are being raised are incredibly poor. They are kept in huge metal confines with no access to sunlight or fresh air. Moreover, they are often so tightly packed within a small area that they can barely move. Many factory farms also use mutilation techniques to adapt the animals to the factory farm setting. Cows are most often dehorned, castrated (unless they will be used for breeding), and “tail-docked”, which means two thirds of the animal’s tail is cut off. All of these procedures are usually done using no anesthesia or post-operation pain relievers, even though they have been proven to be extremely painful for the animal. Piglets have their teeth and tails clipped shortly after they are born, and chickens and turkeys are routinely de-beaked to avoid them pecking at each other.

The majority of the above mentioned procedures are done to animals in order to reduce the risk of infections. However, since this blatant torture is often ineffective, or it is done in such an irresponsible and haphazard way that it doesn’t even reduce the risk of infections, factory farmers also inject or feed their animals with antibiotics. Since infections spread incredibly quickly and easily between animals in such an environment, the farmers will include a wide variety of antibiotics in all of the animals’ food and water. This way, any kind of lurking bacteria or threat of an infection in any of the animals will be eliminated.

According to the Johns Hopkins University Center for a Livable Future, based on data from the United States Food and Drug Administration, 79.8% of antibiotics sold in the United States are used in agriculture. This statistic doesn’t exactly show the whole picture, since there are many differences between the antibiotics given to animals and those given to humans. For example, ionophores, which account for 23% of the antibiotics sold in the United States (see table to right), are not approved for human use. However, whether or not a type of antibiotic is used on humans does not change the fact that an excess amount of antibiotic use creates more resistant and dangerous bacteria. So there we have it. The large majority of antibiotics sold in the United States are used on animals.

Let’s put aside the issue of infections for a moment. The majority of the antibiotics used on farm animals are actually given for another reason: to increase rate of growth and size. The Food and Agriculture Organization of the United Nations and the Animal Health Institute of America estimate that “Without the use of growth promoting antibiotics, the USA would require an additional 452 million chickens, 23 million more cattle and 12 million more pigs to reach the levels of production attained by the current practices.” That statement definitely gives us an idea of how beneficial these antibiotics are for factory farmers.

Bacteria physically become resistant to antibiotics thanks to a very special evolutionary adaptation called a plasmid. A plasmid is a circular gene of DNA that only some lucky bacteria carry along with their regular chromosomal DNA. In the simplest terms, the plasmid is the superhero component of the bacterial cell. Plasmids usually carry genes that allow the bacteria to have certain biological advantages, including resistance to certain antibiotics. Since bacteria perform asexual reproduction, a bacterial cell becomes two perfectly identical daughter cells when it divides. In that sense, plasmids are also transmitted to both daughter cells. This means that if one bacterial cell has a plasmid resistant to a certain antibiotic, thousands of bacteria resistant to that antibiotic can be created within two hours.

Bacteria, like every living organism, are also subjected to the process of natural selection. Small errors often occur during the copying of DNA from one organism to another during reproduction, which can give the organism a trait that makes it either stronger or weaker based on its environment. In nature, there is always a struggle for survival within every population of a species. Because the ones with a trait that make it stronger will survive over the ones without that trait, this mutation will then be passed along to the organism’s offspring because of heredity. This is the whole “survival of the fittest” theory in evolutionary biology. Over time, certain traits become more and more prominent in a population, whereas others might disappear, and this is the mechanism of natural selection. In bacteria, those with plasmids that make the bacteria immune to an antibiotic will survive over the ones who do not. The immune bacteria will then multiply, and travel.

When I was younger, I had a friend named Julie who had earaches constantly. It seemed that every other week she would complain about her ears hurting, and as a child, I had no sympathy because, well, I had never gotten one and I didn’t know what it was like. But whenever she would get a new earache, she would take what I now know to be antibiotics only until the pain in her ear subsided. She once told me that her mother told her to always stop taking the antibiotics when her ear stopped hurting, because she believed that antibiotics were harmful to a child’s health. While in one sense this is true––antibiotics do have certain harmful effects on the body––I now know that this is the absolute worst way to use antibiotics. Despite the fact that when Julie stopped taking the antibiotics she felt no pain, little did she know that the antibiotics had only killed off about two thirds of the bacteria, and only the bacteria that were the weakest and most susceptible to the antibiotic. Because the remaining bacteria were the more resistant ones, and once half the other bacteria were gone they had much less competition for food and other vital resources, they started to reproduce very quickly. Sooner than Julie knew it, her infection was back and worse than before.  This is why it’s important to always complete the dose of antibiotics that’s been prescribed, as doctors know how many pills it takes until all of the bacteria is wiped out.

Livestock farmers certainly do not go through the trouble of deciding which doses will be safest because, well, they don’t even wait until there’s an infection to treat the animal. The freedom they have when injecting or feeding their animals with antibiotics may seem to work for them because their animals have less infections than if they didn’t inject them, and they grow to be much larger and meatier. However, with time, more and more antibiotics will be needed because the bacteria living in the animals will become stronger and stronger as time goes on and uncalculated doses of antibiotics are given.

After years of random antibiotic injection, some mighty bacteria can be found in these animals. The resistant bacteria moves freely between the animals since their living conditions are so poor, and they can be then transmitted to people by fecal matter and soil runoff, biological vectors, or simply by direct contact with workers. This phenomenon creates a never-ending slippery slope of bacteria growing stronger, replicating, and being transmitted to people.

It is easy to see how this heavy use of antibiotics might be at the root of the phenomenon that is quietly but quickly becoming an incredibly dangerous threat to our medical world. Microbiologists have been coming across bacteria that are resistant to every single antibiotic they have access to, and it is very concerning. In December of 2013, a man from New Zealand died after being diagnosed with a brain infection that was resistant to every antibiotic the doctors had access to.

Before 1928, back when antibiotics were not yet discovered, there was no cure for bacterial infections, and people would pass away from simple infections such as those resulting from cuts, wounds and childbirth. The discovery of antibiotics was one of the most revolutionizing medical breakthroughs, and it is what made us able to readily treat infections like tuberculosis, cholera, bacterial meningitis, syphilis, gonorrhea and many more, within a week. However, a future where those infections are no longer treatable may be not only possible but likely, and closer than we imagine.

The amount by which our society relies on antibiotics is actually quite surprising. Without effective antibiotics, not only would simple infections and infectious diseases be incurable by antibiotics, but there would be many more medical procedures that will be impossible to perform. For instance, cancer treatment and organ transplants are impossible without antibiotics because of the fact that they weaken the immune system, which makes infections very probable. Furthermore, the majority of surgeries that require the opening of a body cavity would be impossible to perform due to the high risk of infections. Finally, tattoos, plastic surgery, and orthopedic operations such as prosthetic hip replacements would all be impossible.

According to Dr. Brian Ward, professor of medicine and microbiology at McGill University and past-Chief of the Division of Infectious Diseases at McGill, bacterial resistance imposes a massive risk on the future of medicine. I had the honour of meeting with Dr. Ward, who gave me some insight on bacterial resistance and the possible ways we will treat infections in the cases where antibiotics are not effective. He explained two of the techniques that we will most likely start using in place of antibiotics, which are stool transplants and phage therapy. Yes, I did say stool transplants! This is actually a technique that has already been used, mostly on patients infected with a certain fairly resistant strain of bacteria called Clostridium difficile, and believe it or not, it has incredible results. The treatment is called fecal bacteriotherapy, and it involves taking the stool of someone who has a healthy gut and transplanting it into the infected person’s colon by enema or by throat tube (which is the most effective way, but decidedly the least desirable). The goal is to reintroduce a healthy and diverse bacterial gut flora into one that was previously completely populated with the vicious C. difficile. The second technique, phage therapy, uses a group of viruses called bacteriophages, which thrive by infecting bacteria and reproducing inside of them to kill off the bacteria. However, these are only ideas that are currently being explored. Stool transplants are not yet effective on much more than gastrointestinal infections or diseases, and phage therapy is not even approved yet in most western countries. The fact remains that bacteria are becoming stronger and more difficult to treat, and the most effective method is slowly becoming futile.

However, when asked about whether or not there is a concrete amount of time when all antibiotics will become ineffective, Dr. Ward gave a very interesting answer. “Well, what is the ultimate motive for creating drugs?” he asked me, “Demand?” I responded, “No, profit” he told me. He explained that drug companies will always put their money into research for illnesses and diseases that require long-term treatments, because in that case, the patient is forced to consume the drugs over a very long period of time. “As far as drug companies go,” Dr. Ward explained, “treatment for diseases such as HIV and Alzheimer’s are the ultimate cash cows. Why would a company put money into antibiotics when the majority of infections are treated within a couple of days?”

Like everything else, it seems, the problem comes down to profit. Large multinational companies are treating farm animals like objects who don’t feel pain, ceaselessly administering antibiotics, and not funding research where it is truly needed. They are failing to grasp the magnitude of the situation, or to consider the impact otherwise profitable actions might have on our future. This is something which seems to be a recurring theme in our capitalist world. Until profit ceases to be the priority and the focus turns to the health of living beings and the environment, we will continue to be faced with increasing danger of irreversible damage to our future.