DRHOOK- Bad bug: E coli becoming harder to kill

Oprah was sued by Texas cattle farmers in 1998 when she said she wouldn't eat another hamburger. Really! Was it her comment that caused the cattlemen to lose $11 million in sales, or was it the mad cow disease scare sweeping the UK? Should all newly converted vegetarians be sued by the cattle industry because they don't want to eat beef? Some people just make a big beef out of nothing, only to look like fools in the end– er, at least we hope they look like fools in the end.

Where's the beef? Is that a legitimate question?

E. coli once again has made people sick from contaminated beef patties and ground beef. About 1 million pounds of beef was believed to be contaminated with this bacterium. So this August, Valley Meat Co. beef that had been processed (mostly frozen) from October through January was recalled. In this case, the really bad strain of E. coli– 0157:H7– was found on the contaminated meat. This strain can cause kidney failure to death.

Now in India, some bacteria including E. coli are becoming resistant to the most basic type of antibiotics: beta-lactams like penicillin, amoxicillin, and Keflex. Back a hundred years ago when I was in medical school (okay, 20 years ago), we learned how a different bacterium, staphylococcus (i.e. staph), could be resistant to beta-lactam antibiotics. 

As we know, staph can be a tricky bacterium. There are different antibiotics to fight staph that are resistant to beta-lactam antibiotics. But even some of those staph are even meaner (i.e. the superbug, MRSA, that we hear about infecting millions of us). 

Will bacteria like E. coli and Klebsiella eventually be as difficult to treat as MRSA?

In 2009, the New Dehli metallo-beta-lactamase (NDM-1) gene was identified in a patient with Klebsiella pneumoniae infection in– where else?– New Delhi (though I read India is not happy with the name of NDM-1). NDM-1 is now seen in the UK, US, Canada, and Pakistan, mostly in patients who traveled to India to have cheap cosmetic surgery. "Holy Tummy Tuck, Batman!"

So E. coli and K. pneumoniae are the two most affected gram-negative bacteria with NDM-1. The affected bacteria produce an enzyme that resists the effects of beta-lactam antibiotics. The end result: survival of the bacteria. 

You see why this is bad news? If this gene spreads to different types of bacteria, the whole world could be facing infections that will be tough to beat. 

Bacteria are kind of like the Borg, on Star Trek: The Next Generation, a big flying box of cybernetically enhanced humanoid drones, all interconnected. Weapons initially hurt it, but the Borg learns to become resistant to each weapon. Bacteria are similar in that many become resistant to antibiotics, and so we create stronger antibiotics to combat them. However, we're running out of different types of antibiotics. 

What next? Napalm?

I hope this NDM-1 doesn't spread like wildfire. Who knows? Maybe the meat industry as a whole will be forced to stop giving antibiotics to animals. In the meantime, let's try to beef up our immune systems.

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Dr. Hook cracks a joke or two, but he's a renowned physician with an interesting website, drjohnhong.com. Email him with your questions.

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