Today, many are so used to the idea an antibiotic can cure almost any infection, few consider the possibility this remedy may soon no longer be an option. Antibiotics have increased human life span by nearly a decade and certain conditions could simply not be treated without them.1

In many ways, modern medicine is built on a foundation of antibiotics. It is now severely threatened, however, by the emergence and phenomenal growth of antibiotic-resistant bacteria. Prior to the development of antibiotics, half of the world's population died from infections.

The reality is antibiotic-resistant microbes have now become a major threat to public health worldwide. According to the British Office of National Statistics, for the first time life expectancy in the U.K. has dropped as the result of antibiotic resistance.2 This is a man-made epidemic triggered by the widespread misuse of antibiotics.3

In the U.S., resistant pathogens are conservatively estimated to cause at least 2 million infections annually and lead to 23,000 deaths each year. An estimated 25 to 60 percent of Klebsiella pneumoniae (K. pneumoniae) blood infections are now resistant to several strains of antibiotics.

The rise in resistance to multiple drugs has increased the use of carbapenems, a class of last-line antibiotics. Research from Australia now demonstrates multidrug-resistant Staphylococcus epidermidis (S. epidermidis), found on the skin of all humans, may be responsible for an alarming number of antibiotic-resistant sepsis infections.4

Mutated Common Bacteria Found

Sepsis is a massive immunological response to a bacterial infection in the blood. It often leads to organ failure or injury and is a medical emergency responsible for killing over 250,000 Americans each year.5 During the infection, the body releases chemicals to fight bacteria, which also trigger widespread inflammation.6

In severe cases, one or more organs may fail. Anyone can get sepsis, but those at higher risk are infants, children, the elderly and those with serious injuries or medical problems. Although triggered by a blood infection in many cases, it may also result from an infection confined to one part, such as the lungs, urinary tract, skin or abdomen.7

A sepsis infection with an antibiotic-resistant bacteria is even more lethal. Australian scientists have discovered three new strains of S. epidermidis resistant to all known antibiotics in hospitals across the world. Microbiologist Ben Howden, Ph.D., involved in the discovery, commented8 the bacteria often just colonizes the skin, not leading to infection.

Potentially colonized on the skin of patients and hospital care workers, the bacterium is now poised to cause serious invasive infection. After studying samples from 78 institutions in 10 countries the researchers were able to identify the bacteria. Howden believes it has been spreading, unrecognized, for a number of years.9

Catheters and Prosthetic Joint Replacement Present Increased Risk of Sepsis

Researchers from the Doherty Institute believe antibiotic impregnated medical devices, such as catheters and prosthetic joint replacements, maybe one of the causes for mutations and rise in antibiotic resistant infections.10 The researchers suggested implanting catheters with antibiotics as a strategy to prevent infection was potentially promoting the development of resistance.

They also stated the use of antibiotics in the intensive care unit where patients were sickest and the strongest drugs were liberally prescribed, was promoting the development of additional resistance. Howden commented on those who had a compromised immune system or had a prosthetic material implanted, such as a catheter or joint replacement, saying:11

“The discovery of these new strains means we are now routinely using our last line antibiotics that are expensive and toxic. This makes these infections very costly and difficult to treat.”

The researchers were surprised to discover the bacteria had made small changes in DNA leading to resistance to two major, unrelated antibiotics. Dr. Jean Lee commented on the importance of this discovery, saying:12

“Our study suggests current guidelines for treating these infections with the combination of these two antibiotics that were thought to protect one another against developing resistance are based on an incorrect assumption and that current treatment recommendations need to be reviewed.”

Growth of Antibiotic Resistance Related to Overuse

In past decades the drugs have been widely overprescribed for infections that don't respond to antibiotics. For instance, viral infections cannot be treated with antibiotics as the drugs only kill bacteria. Yet, many have taken a course of antibiotics for a cold or flu caused by a virus.13

Each time a new antimicrobial medication is introduced, drug resistance quickly follows. Antimicrobial treatments place selective pressure on the organism, favoring the emergence of a drug-resistant strain.14 In fact, antibiotic resistance emerged within a decade of the first clinical trials of penicillin, with more than 50 percent of Staphylococcus aureus being resistant by the end of the 1940s.

While this should have been a red flag, predicting the rise of greater resistance with each new medication, the use of antimicrobials has only risen. Bacteria have an amazing ability to adapt to their environment. Unless completely wiped out, the survivors pass on their resistance to the next generation.

Bacteria are also able to share genetic material among themselves with remarkable ease, conferring resistance to others in close proximity through a plasmid, which rapidly transfers genetic information between bacteria.15 Overuse in humans is only one way resistance is gaining a foothold.

Concentrated animal feeding operations (CAFOs) routinely use antibiotics to speed growth and counteract poor hygiene and crowded conditions. In 2017, the U.S. Food and Drug Administration (FDA) banned antibiotics for the express purpose of growth promotion.16 However, few changes have resulted as antibiotics are still used prophylactically to prevent disease in animals raised in confinement.17

The Centers for Disease Control and Prevention (CDC) estimates 400,000 Americans get sick from antibiotic-resistant foodborne bacteria every year, stating,18 “Antibiotic use in food animals allows antibiotic-resistant bacteria to grow and crowd out the bacteria that do respond to antibiotics.”

A report by consumer advocacy group Food and Water Watch19 noted nearly 22 percent of annual antibiotic-resistant infections in the U.S. originate from foodborne pathogens. They explain these bacteria spread from farm animals to humans through food and contaminated waste used in fertilizer or entering waterways. Increasingly, these bacteria show the potential to affect anyone.

Physicians Find Inexpensive Treatment for Sepsis Increases Survival Rate

Antibiotic resistance occurs naturally, but the misuse and overuse in humans and animals is accelerating the process as a growing number of infections, including sepsis, are becoming harder to treat. Resistance is leading to longer hospital stays, higher medical cost and an increase in mortality.20

Dr. Paul Marik, chief of pulmonary and critical care medicine at Sentara Norfolk General Hospital on Eastern Virginia medical campus, recently discovered a simple and inexpensive way to treat sepsis using intravenous vitamin C and thiamine (vitamin B1) in combination with hydrocortisone.21

In a small retrospective before-after clinical study,22 data showed using this cocktail for two days reduce mortality nearly fivefold, from 40 percent to 8.5 percent. Of the 50 patients treated using this protocol, only four died, but none actually died from sepsis; they died from their underlying disease.

His first patient presented in January 2016, a 48-year-old woman with a severe case of sepsis. Marik described her condition, saying:23 “Her kidneys weren't working. Her lungs weren't working. She was going to die.”

After reading a study by researchers who had moderate success treating individuals with sepsis using intravenous vitamin C, he decided to give it a try. He added hydrocortisone and thiamine to the infusion. In combination with vitamin C, hydrocortisone is able to eradicate the infection. Thiamine is important in the metabolism of vitamin C metabolites and reduces the risk of renal failure.

Marik expected his patient would not survive the night but was surprised to find her well on the road to recovery the next morning. After treating 50 patients with this combination and experiencing stunning results, he documented and published the results. Marik has used this protocol with more than 150 patients suffering from sepsis and only one has died from the condition.24

Although cause for celebration, there have been detractors who think these results may only be valid at Marik’s hospital and may not be corroborated with a larger group study over multiple centers. Drug companies have spent billions of dollars searching for an effective treatment for sepsis and selling specific antibiotic cocktails.

Developing an effective treatment could reap billions of dollars. However, in this case, profit is not the motive, as the cost of ingredients for the protocol are as little as a single dose of antibiotics. Marik said,25 "I obviously have no vested interest. Nobody's going to make money from this — so this is a very anti-capitalistic thing!" This may in fact be one reason it has not been widely studied and utilized.

Treating and Preventing the Spread of Infection

In the high stakes real-life game against antibiotic-resistant superbugs, the Defense Advanced Research Project Agency (DARPA) developed their own Pathogen Predators project26 in an effort to defend against biological warfare. Their project began in 201427 with a call for proposals to demonstrate infections may be treated with live predatory bacteria.

While some studies have demonstrated positive results28 and there is some hope to use this protocol in the treatment of antibiotic-resistant bacteria,29 the concept may fail in use for treatment of current infections, as the predatory bacteria do not demonstrate the ability to completely eradicate infectious bacteria.

Prevention continues to be the best option for spreading infection, at home and in the hospital. Alcohol-based hand washes, commonly used by health care professionals between patients are also losing their effectiveness against superbugs.30

Specifically, it is the alcohol that bacteria are becoming more resistant to. In particular, a group of bacteria known as Vancomycin-resistant enterococci have mutated to prevent alcohol from bursting their cell walls.

Laboratory research has also been duplicated in animal studies, demonstrating it's not just a laboratory phenomenon, but a characteristic of the bacteria being able to escape a standard infection control procedure. The bacteria called Enterococcus faecium is a leading cause of hospital-acquired infections and recognized by the World Health Organization and CDC as a superbug.31

Washing your hands is generally recognized as the most important infection control strategy you can use. However, it needs to be done correctly in order to be truly effective. Simply rinsing your hands with water or a quick scrub with soap is not enough to remove germs. To actually remove bacteria when you wash your hands follow these guidelines:32

• Use warm, running water and a mild soap. You do not need antibacterial soap. As stated by the FDA,33 "There is currently no evidence that [antibacterial soaps] are any more effective at preventing illness than washing with plain soap and water."
• Start with wet hands, add soap and work up a good lather, all the way up to your wrists, scrubbing for at least 15 or 20 seconds (most people only wash for about six seconds). A good way to time this is to sing the "Happy Birthday" song twice.
• Make sure you cover all surfaces, including the backs of your hands, wrists, between your fingers and around and below your fingernails.
• Rinse thoroughly under running water.
• Thoroughly dry your hands. In public places, use a paper towel to open the door as a protection from germs the handles may harbor.