Health and Disability

Penicillin is now available in copious amounts, as are other bacteria-killing antibiotics. A thorn scratch today seems a minor irritant, not a potential killer. But that may be too sanguine. A study by America’s Centres for Disease Control (CDC) found that the number of cases of sepsis rose from 621,000 to 1,141,00 between 2000 and 2008, with deaths rising from 154,000 to 207,000. One reason for that is the emergence of MRSA (pictured being attacked by a white blood cell)—a variety of Staphylococcus aureus that cannot be killed with methicillin, one of penicillin’s most effective descendants. This could just be a taste of things to come. Three years ago the CDC produced a list of 18 antibiotic-resistant microbes that threaten the health of Americans (see table). Five of them (including MRSA) cause sepsis.

Such worsenings would not be restricted to hospitals. “Multi-drug resistant” and “extensively drug resistant” strains of tuberculosis cause 200,000 deaths a year, mostly in poor countries. Most people who die of tuberculosis at the moment do not die of one of these strains. But they are responsible for more than an eighth of fatal cases, and those cases might otherwise be susceptible to treatment.  

Neisseria gonorrhoeae is another bug that has repeatedly developed resistance to antibiotics. When penicillin was first introduced it worked very well against gonorrhoea. When its effectiveness began to fall, it was replaced by tetracyclines. Those gave way to fluoroquinolones, and those, in turn, to cephalosporins. Now, some strains can be tackled only with a combination of ceftriaxone, a cephalosporin, and azythromicin, an azalide. There is nothing else in the locker.

If worries about microbial resistance are cast wider to include not just antibiotics (which attack bacteria) but drugs against parasites, like malaria, and viruses, like HIV, the problem multiplies, particularly in poor countries.