The Rise of Superbugs: Investing in a Post-Antibiotic Era

For the last half-century, antibiotics have been the backbone for the treatment of infections in modern medicine.

Across the years, though, our over-reliance on these drugs has backfired. The sweeping use of antibacterial drugs has sparked an evolutionary arms race between us and bacteria… and we’re rapidly falling behind.

In 1945, Alexander Fleming won a Nobel Prize for the discovery of penicillin. In that very acceptance speech, he warned us of exactly what’s occurring today: The selective pressure caused by antibiotics would result in so-called “superbugs” that we would no longer be able to contain.

To get an example of just how serious this issue has become, consider the following:

• In 2014, there were ~450,000 new cases of multi-drug-resistant tuberculosis (MDR-TB).
• Full resistance to last-resort treatments for gonorrhea and TB have now been reported in over 10 countries, including many with advanced health care systems, such as Australia, Canada, France, Sweden, and Britain.
• Gonorrhea may soon become completely untreatable because no new drugs are in development.
• Nearly 2 million Americans become infected with antibacterial-resistant pathogens each year, and ~23,000 die as a direct result.
• The cost of superbugs to the U.S. health care system is $34 billion each year and more than 8 million additional hospital days.
• The last class of antibiotics approved for human use was discovered over three decades ago.

The simple fact is that without a new class of antibiotics or a new way of treating infection, bacteria will continue to evolve and overtake our outdated defenses. If we keep our current course, these superbugs will only get stronger, and we’ll eventually be forced into a post-antibiotic era.

Super Staph

In the 1970s, staph infections mutated to become resistant to penicillin, so doctors began using the antibiotics vancomycin and methicillin.

By the 1980s, they began overtaking these antibiotics as well, resulting in the emergence of even more resistant strains including MRSA (Methicillin-resistant Staphylococcus aureus) and VRSA (Vancomycin-resistant Staphylococcus aureus).

To get a scope of just how fast these mutations can occur, consider the following data:

In 1974, MRSA accounted for just 2% of staph infections. By 1995, that figure jumped to 22%, and by 2004, it was 64%. Today, MRSA accounts for 70% of all staph infections.

If you’ve heard of MRSA before, you know just how nasty it is. This stuff will literally eat your skin away to the bone if left untreated. Certain strains can even kill you in as little as 24 hours.

We’ll spare you the truly gruesome images, but this is what MRSA looks like early on:

What’s even scarier is that you can contract MRSA almost anywhere. It can live in the seat-back pockets on airplanes for as long as 168 hours or on a toilet seat for several days (I actually have a friend who caught MRSA this way).

Every demographic is equally susceptible, but it is primarily transmitted in hospital settings.

As for morbidity, the bug is responsible for about 94,000 infections and 18,650 deaths in the United States each year, making it more deadly than HIV/AIDS. Yahoo News was certainly justified in referring to MRSA as the “Godzilla of Superbugs.”

The Drug Behind the Iron Curtain

Many people don’t know this, but during the Cold War, political tension between the East and West created a major split in how we treat infections.

During this period, patients in the East were cut off from some of the best antibiotics being produced in the West. At the same time, though, medicine being developed by the Soviet Union was kept privy to those on the other side of the Iron Curtain.

While Western doctors took the approach of developing antibiotics, Eastern scientists opted to develop what’s called phage therapeutics — that is, viruses that attack foreign pathogens in your body.

Phage therapeutics that specifically attack bacteria have been granted the name bacteriophage, translating from Greek to “eater of bacteria” because, quite literally, that’s what they do.

Now, as counterintuitive as it may seem to use a virus as a therapeutic, phages are actually quite effective (and safe).

In fact, because of the growing threat of superbugs, bacteriophages may soon become the go-to treatment for a number of infectious diseases currently treated by antibiotics. The reason for this is that unlike antibiotics, bacteriophages do not result in rapid drug resistance.

Because phages are viruses, they have a much higher mutation and replication rate than bacteria. This means phages can out-compete with the adaptation of the bacteria, beating them at their own game.

Further, unlike antibiotics, which essentially carpet-bomb your entire body (destroying its neutral bacteria and intestinal flora in the process) phages are designed to only target specific harmful bacteria.

A rough analogy I like to make is comparing phages to common house spiders. Sure, they might creep us out a little, but the reality is that they don’t want to eat us — they only want to eat the things that can harm us (i.e. mosquitoes and other pests). Once there are no bugs left in your house, there will be no spiders, either.

In other words, because bacteriophages need to eat specific bacteria cells to survive, they die out once those bacteria are removed from your body. So not only are phages self-replicating, but they are self-limiting as well.

Despite the historical context, today, the most promising phage development is actually coming from small American biotech companies — not from Eastern Europe.

Specifically, two American companies we’ve recently located are collaborating to develop bacteriophages specialized to eat superbugs the likes of MRSA and VRSA.

Researchers at the University of Leicester are already referring to the treatment as a “magic bullet in the war on superbugs,” but we’re waiting for the drug to exit pre-clinical trials before we release any information to the public.

Fortunately, though, this is happening quite soon, so make sure to stay tuned in the weeks and months ahead.

Until next time,

Jason Stutman

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