Research Assessment #2

Date: October 13, 2017

Subject: Antibiotics Resistance in Cancer Patients

MLA citation: G. McNeil, Donald. “Deadly, Drug-Resistant ‘Superbugs’ Pose Huge

Threat, W.H.O. Says.”The New York Times, The New York Times, 27 Feb. 2017

www.nytimes.com/2017/02/27/health/who-bacteria-pathogens-antibiotic-

resistant-superbugs.html

Analysis:

In the past years antibiotics resistance has become an emerging crisis and public health

concern. However many individuals in our society today are taking antibiotics resistance too

lightly of a deal . The article “Deadly, Drug-Resistant ‘Superbugs’ Pose Huge Threat, W.H.O

Say”, by Donald McNeil, highlights the fact that “antibiotic resistant superbugs” are a real threat

to individuals all around the world. The author, Donald McNeil, specifically refers to antibiotic

resistance as a larger threat than terrorism today. McNeil and many others today believe that one

possible reason for the resistance to be so high is because it comes directly from the overuse of

antibiotics in our society.

Every time a patient is given a specific antibiotic to kill specific bacteria, a small number

of bacteria cells are not destroyed. These cells later reproduce multiple times, and create bacterial

cells that are antibiotic resistant, meaning they will not be destroyed from the antibiotics. Many

medical professionals and scientists believe this phenomenon, antibiotics resistance, to be the

reason of death for many. Specifically patients who are hospitalized, for reasons, such as

transplants and cancer, more likely will be victimized by this resistance, as their immune systems

are weaker.
 After reading about antibiotics resistance I thought about how deadly it could be for

cancer patients. If cancer patients have drug resistance to their chemotherapy drugs, there

treatment will not go any further. I researched about this and learned this to be called multiple

drug resistance, specifically multiple resistance to chemotherapy drugs. Treatments to this are

being explored as it is a deadly phenomenon just like antibiotics resistance.

Statistics also show that the number of people being killed by these superbugs every year

to be not far from people dying from car crashes. The article specifically states that

approximately these superbugs kill 23,000 Americans yearly, which is a significant number.

Many countries are giving money towards research in antibiotics in order to save lives of many

in the future. Research is being conducted in order to save these individuals, however If

something is not done soon there can be the deaths of many innocent individuals who have

bacterial infections.

This article was insightful for me as it taught me that individuals should always do

something while looking at the consequences it could create, and preparing for those

consequences. When antibiotics were at first used, doctors should have paid attention to the fact

that not all of the bacteria could have been killed. They should have then thought about ways to

prevent the resistance, while saving the patients from the bacteria infection. Today as a result of

the overuse of antibiotics there are multiple antibiotics resistant bacteria.

Deadly, Drug-Resistant ‘Superbugs’ Pose
Huge Threat, W.H.O. Says
Leer en español
By DONALD G. McNEIL Jr. FEB. 27, 2017

The World Health Organization warned on Monday that a dozen antibiotic-

resistant “superbugs” pose an enormous threat to human health, and urged

hospital infection-control experts and pharmaceutical researchers to focus on

fighting the most dangerous pathogens first.
The rate at which new strains of drug-resistant bacteria have emerged in
recent years, prompted by overuse of antibiotics in humans and livestock, terrifies
public health experts. Many consider the new strains just as dangerous as
emerging viruses like Zika or Ebola.
“We are fast running out of treatment options,” said Dr. Marie-Paule Kieny,
the W.H.O. assistant director general who released the list. “If we leave it to market
forces alone, the new antibiotics we most urgently need are not going to be
developed in time.”
Britain’s chief medical officer, Sally C. Davies, has described drug-resistant
pathogens as a national security threat equivalent to terrorism, and Dr. Thomas R.
Frieden, the recently retired director of the Centers for Disease Control and
Prevention, called them “one of our most serious health threats.”
Last week, the European Food Safety Authority and European Center for
Disease Prevention and Control estimated that superbugs kill 25,000 Europeans
9/11/2017 Deadly, Drug-Resistant ‘Superbugs’ Pose Huge Threat, W.H.O. Says - The New York Times

https://www.nytimes.com/2017/02/27/health/who-bacteria-pathogens-antibiotic-resistant-superbugs.html?mcubz=0
2/5
each year; the C.D.C. has estimated that they kill at least 23,000 Americans a year.
(For comparison, about 38,000 Americans die in car crashes yearly.)
Most of these deaths occur among older patients in hospitals or nursing homes, or
among transplant and cancer patients whose immune systems are suppressed. But
some are among the young and healthy: A new study of 48 American pediatric
hospitals found that drug-resistant infections in children, while still rare, had
increased sevenfold in eight years, which the authors called “ominous.”
The W.H.O. report rated research on three pathogens as “critical priority.”
They are carbapenem-resistant Acinetobacter baumannii and Pseudomonas
aeruginosa, along with all members of the Enterobacteriaceae family resistant to
both carbapenems and third-generation cephalosporins.
(The Enterobacteriaceae family includes familiar names like E. coli and
salmonella, which live in human and animal guts and can cause food poisoning,
and Yersinia pestis, which causes bubonic plague. Carbapenems and
cephalosporins are each “families” of related antibiotics; both break down bacterial
cell walls.)

The W.H.O. listed six pathogens as “high” priority. They include methicillin-
resistant Staphylococcus aureus, better known as MRSA, which is responsible for

about a third of “flesh-eating bacteria” infections in the United States, and

antibiotic-resistant Neisseria gonorrhoeae, which causes gonorrhea.

The W.H.O.’s third category was “medium priority,” which included drug-
resistant versions of Streptococcus pneumoniae, Haemophilus influenzae and

shigella, all three of which cause common childhood infections. For now, most of
those infections are curable, but doctors fear that resistant strains will push out
weaker ones.
Tuberculosis was not on the W.H.O.’s list even though lethal drug-resistant
strains — known as MDR-TB and XDR-TB — pose a major threat, because there
are programs targeted at it.

9/11/2017 Deadly, Drug-Resistant ‘Superbugs’ Pose Huge Threat, W.H.O. Says - The New York Times

https://www.nytimes.com/2017/02/27/health/who-bacteria-pathogens-antibiotic-resistant-superbugs.html?mcubz=0
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New antibiotic candidates are in short supply, Dr. Kieny said, because 70 years
of research have made it harder to find new ones, and because they are not very
profitable for pharmaceutical companies. Patients are typically cured with a few
pills and, to prevent the emergence of resistant strains, doctors are pressured to
avoid prescribing the newest drugs except in extreme cases.
The W.H.O. hopes countries will consider ways to encourage more research.
Britain has proposed $1 billion “prizes” for any new family discovered, and it and
China have pledged $72 million toward a fund to support antibiotic research.
The agency would also like to see more collaboration between medical doctors
and veterinarians, she said, because resistance that arises in animals can spread to
humans.
The C.D.C. released a similar report in 2013, ranking 18 drug-resistant
bacteria and fungi in three categories: urgent, serious and concerning.
The two lists have some differences, noted Jean B. Patel, a C.D.C. specialist in
drug-resistant bacteria who consulted with the W.H.O. For example, N.
gonorrhoeae was a higher priority on the C.D.C. list because it is hard to treat, even
though it rarely kills; the W.H.O. list focused more on fatal infections.
The C.D.C. does not consider H. influenzae — better known as Hib — to be as
big a threat as the W.H.O. does, she said, because nearly all American babies get
Hib shots, which prevent it. In poor countries, according to a 2009 study, more
than 300,000 children a year die of Hib-related meningitis or pneumonia.
Some bacteria resistant to all known antibiotics have been found. They are
rare and, thus far, usually strike patients whose immune systems are weak. But
once they take hold, they are virtually unstoppable, and victims usually die.

It’s useful for the W.H.O. to set global research priorities because drug-
resistant strains are not evenly spread around the world. Some strains are more

common on some continents, although jet travel and medical tourism are making
most spread worldwide.
Strains can even vary within hospitals.

9/11/2017 Deadly, Drug-Resistant ‘Superbugs’ Pose Huge Threat, W.H.O. Says - The New York Times

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For example, the antibiotics used in a transplant unit often differ from those
used in neonatal intensive care, so different resistant bacteria may circulate, said
Dr. William Schaffner, head of preventive medicine at Vanderbilt University
Medical Center.
Infants in eastern Tennessee, he said, had more antibiotic-resistant ear
infections than those in the state’s western half or in many other states. Doctors
there are “exuberant prescribers,” he said, which drives antibiotic resistance.
Resistance to carbapenems, which had been reliable “last line of defense”
drugs, has developed recently among pathogens, as a gene first found in India in
2008 — and named NDM, for New Delhi metallo-beta-lactamase — spread around
the world.
The latest last-ditch antibiotic to start failing is colistin, which was invented in
1959 but shelved because it caused kidney damage. Chinese pig farmers adopted it
and feed nearly 12,000 tons to their pigs each year to speed their growth.
Drug-resistant strains were first found in China in 2015, with a disturbing
aspect: the resistance-conferring gene was not in the bacteria’s own DNA but on a
plasmid, a small DNA ring that can jump from one bacterial species to another.
The Chinese study found it in 21 percent of pigs sampled, and 1 percent of
hospitalized humans. The first American patient with it was found last year.
Colistin resistance “sent shock waves through the medical and scientific
communities,” Dr. Margaret Chan, the W.H.O.’s director general, said last year. “If
we lose colistin, as several experts are predicting, we lose our last medicine for a
number of serious infections.”
In the United States, although constant vigilance is crucial, the problem has
actually declined in the last decade, said Dr. John Quale, an infectious disease
specialist at SUNY Downstate Medical Center in Brooklyn who tracks resistance.
The W.H.O. list, Dr. Patel said, will also help a project the W.H.O. began in
2015, the Global Antimicrobial Resistance Surveillance System.

9/11/2017 Deadly, Drug-Resistant ‘Superbugs’ Pose Huge Threat, W.H.O. Says - The New York Times

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“We’re at a tipping point,” Dr. Patel said. “We can take action and turn the tide
— or lose the drugs we have.”
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A version of this article appears in print on February 28, 2017, on Page A8 of the New York edition with the
headline: Deadly ‘Superbugs’ Pose a Huge Threat, W.H.O. Says.