Maine Mud - It's a Good Thing?

01/20/2015

Maine Mud - It's a Good Thing?
Healthy Living - January 20, 2015
William Sturrock, MD

 
Earlier this month, the journal ‘Nature’ reported on the findings of a research team from Northeastern University based on samples taken from the dirt in a southern Maine field. This seemingly obscure news bit holds the potential of being the biggest microbiologic breakthrough in the past 30 years. The research team, led by Dr. Kim Lewis, used a new technique of isolating and growing bacteria that previously could not be cultured by the standard lab techniques like the venerable Petri-dish. They discovered a bacterium that produces a unique toxin they have labeled ‘teixobactin’, which can kill other bacteria by a cellular mechanism that is unique among the other antibiotic classes. This new drug has already shown activity against known germs such as Methicillen-Resistant Staph (MRSA) in mice, as well as a host of other human pathogens in cell cultures. Although it is a long way from being mass produced and marketed, it holds great promise for treating many powerful organisms that have developed resistance to our available treatment agents. 

In 1928 when the Scottish researcher Alexander Fleming discovered that penicillin was produced by the lowly bread mold fungus, and that this could be used to cure infections that previously would have been fatal, many mistakenly thought we had found the ‘magic bullet’ that would forever establish the new treatment standard for these diseases. However, scientists failed to appreciate until later that the process of evolution works on these bacteria under siege from these new medicines called antibiotics, and that these organisms could evolve their own defense mechanisms to survive and thrive despite our new pharmacologic weapons. It has been one of the greatest challenges in infectious disease over the last half century to slow the adaptation of pathogens to our drugs, as well as to constantly search for new potential medicines to our replace our formerly effective ones. The last time research was successful in finding a new class of agents was in 1987. 

This new research is particularly exciting because not only has it isolated a new antibiotic toxin, it also has demonstrated the effectiveness of a novel technique for growing and studying the bacteria that could not previously be cultured -- and some experts indicate this may be 99% of the worlds bacteria, most of which are still yet to be isolated! This may open the door for future discoveries of a whole host of potentially useful compounds. 

Despite such promising news, infectious disease experts caution that these new treatments are not ready for prime-time, as it will still take years of careful research to determine safe application in humans. In the meantime, we all need to know the basic principles that will help prevent our current treatments from losing effectiveness: 

1. Limit your own exposure to antibiotics unless really necessary in order to prevent germs from adapting resistance to these medications. For most upper respiratory infections (URI’s, including sinusitis and bronchitis) antibiotics are not needed and may be harmful. Now exceptions may be made if your provider has determined that you are in a high risk group due to a less competent immune system (infants under two months or those who have not been properly immunized; those with severe renal, lung, cardiac, organ dysfunction; those with certain cancers or undergoing certain treatments that affect the immune system, etc). However, most of us can tolerate a fever for a couple of days, and we can clear these URI’s without a prescription in 5-7 days. Most doctors expect that patients whose symptoms have lasted more than 7-10 days without showing signs of improvement should make an appointment to determine if they might benefit from antibiotics. But remember, the fewer of us that are treated with these medications, the longer that medication will remain available to all of us when we have a more serious infection. 

2. When you are prescribed an antibiotic, take the entire course instead of stopping when you are feeling better or saving a few for the next time you begin to feel ill. The reason for this advice is that if you only expose germs to antibiotics briefly, you may only knock that infection back, allowing some survivor germs to have a much higher chance of developing resistance to that antibiotic next time. By not taking the full course (and depending on the infection it may take 7, 10, 14 days or sometimes longer) you may have unwittingly helped speed-up the process of evolution for these germs to come back as a more dangerous pathogen for all. 

3. Don’t take another person’s antibiotic, or assume that you need the same antibiotic as another household member simply because you have similar symptoms. There are certain germs that are an exception, such as pertussis which can cause a potentially deadly whooping-cough infection, but most bacterial infections that cause pneumonia or sinus infections are only a problem for that individual person. If you have similar symptoms and it is less than 10 days into your illness, it is more likely that you are fighting the URI virus that preceded your household contacts infection before they developed the bronchitis or sinusitis. It turns out that bacteria that can cause sinus or lung infections are actually much less easily passed. You should first try the standard measures of fluids and over the counter supportive medications that will allow your own immune system to help you get better rather than take an antibiotic too soon. 

4. Now there are other strategies as a society that we need to encourage, such as keeping antibiotics out of the food chain, and maximizing the use of vaccines to prevent infections before they can ever start, but these will be topics for another day. 

For now, just remember the next time mud season comes around and your Bean boots are caked with a thick layer of gunk, just look down and rejoice in the knowledge that Maine mud is so wonderful that it might someday save your life!