How do bacteria manage to overcome antibiotics? And, will herbs rather than pharmaceuticals ultimately help us more?
By Rosalind Michahelles
Penicillin famously killed off some staphylococcus aureus in a petri dish in the lab of Alexander Fleming in the late ‘20’s and by the time we entered WWII, it was available for treating our war wounded. Civilians soon followed and I happened to be an early beneficiary in May of 1947, hospitalized for earache as an infant. The first semi-synthetic antibiotic, methicillin, appeared in 1960. It took only four years for the first resistant bacteria to be identified: methicillin resistant staphylococcus aureas, or MRSA. MRSA and other antibiotic resistant bacteria, like clostridium difficile, have become a scourge not just in hospitals but also occasionally in the population at large.
Jessica Snyder Sachs in her book Good Germs, Bad Germs: Health and Survival in a Bacterial World, starts her prologue with the story of a healthy, athletic teenage boy who gets what seems to be flu and is dead within a couple of days – from MRSA. There are such cases. She goes on to describe the history and development of antibiotics and then how the bacteria manage to defend themselves. When you think about it, it makes sense that they should be equipped to do so because, after all, they have been around a long time and have had to adapt to many situations and many hosts – like us – who offer many kinds of challenge.
Some of the ways bacteria have been observed protecting themselves from antibiotics are:
• Hiding “their surface proteins from the immune system inside a capsule made of polysaccharides;”
• Pumping the antibiotic out of the cell faster than it can get in, a system dubbed the efflux pump;
• Producing proteins that chemically render the antibiotic impotent; and
• Self-mutating so as to prevent antibiotics from binding to target enzymes or targets within the ribosome.
To be effective bacteria must respond en masse and they do this by using “a chemical language known as quorum sensing…to count their numbers, develop a critical mass, and then change their behavior in unison to carry out their task.” Beyond their inborn ability to protect themselves, they apparently also have the ability to communicate drug resistance once they have developed it – and not just to their own kind. They can do this across species, e.g., from enterococcus to staphylococcus. Their known methods are:
• Bacterial ‘sex’ via plasmids transmitted from bacterium to bacterium to “teach” antibiotic resistance;
• Transduction or “gene ferrying” from one bacterium to another to confer resistance;
• Transformation, during which the ability to encapsulate is transferred from bacterium to bacterium.
In short, “bacteria have a plethora of ways to pick up new traits. They can scavenge genes, swap them through conjugation …have them spliced into their chromosomes by bacteria-hopping phages, [or] …through the…so-called jumping genes, or transposons.”
We have been profligate with antibiotics and the result is that bacteria – even soil bacteria – show resistance to many antibiotics. Doctors have prescribed antibiotics prophylactically or inappropriately (e.g., against a virus), patients have wasted medicines by not completing their prescribed course, and farmers have dosed livestock in order to spur growth and avoid illness. Furthermore soaps and other cleaning agents have added triclosan, which can “trigger multi-drug resistance in Escherichia-coli (e-coli), salmonella” and others.
GMO’s (genetically modified organisms), so controversial in food may however find more public acceptance in medicines, pain being the persuasive motivator that it is. You may not want to eat a genetically modified tomato, but, if suffering from ulcerative colitis, would you consider a genetically modified probiotic? Ten years ago a Dutch farmer took the leap and followed a course of probiotics (lactococcis lactis) with a human gene spliced into it, a gene for the production of a specific calmative of the immune system because Crohn’s disease is an autoimmune problem in which the immune system attacks the walls of the intestines. This sort of development may interest the pharmaceutical industry which has been finding the search for effective antibiotics less and less profitable.
Definitions: Antibiotics are bacteria employed to kill other bacteria. Probiotics are beneficial bacteria, usually packaged in capsules. Prebiotics come in food that contains beneficial bacteria, e.g., yogurt with live cultures in it. Pre- and pro-biotics are intended to crowd out harmful bacteria, especially after a course of antibiotics. CHECK THIS, especially prebiotics.
As we aren’t defeating harmful bacteria through our own efforts, hope comes from working with nature rather than trying to outsmart her. Stephen Harrod Buhner’s useful and inspiring book, Herbal Antibiotics: Natural Alternatives for Treating Drug-resistant Bacteria, provides such hope. As the author says, “…bacteria are not our enemies…they are our ancestors…”
Buhner is a master herbalist sprung from a family of doctors. He writes comfortably and cogently about medical science, traditional herbalism, and phytotherapy — the use of plants for healing. In chapter 2 he gives what he recommends for cases of MRSA, clostridium difficile, Streptococcus pyrogenes (strep throat), Eschericia coli (e.coli), salmonella, etc. His recommendations are specific as to form and dose and length of treatment so a reader is able to administer to himself, once the problem has been properly diagnosed.
The central sections of the book are given over to three kinds of herbs: those that act systemically, i.e., reaching all parts of the body, and those that act locally in the gastro-intestinal tract or on the skin or in a particular organ, and lastly those he calls the synergists, which “increase the activity of other plants” and “stimulate immune responses to disease and, as well, the body’s own highly elegant repair mechanisms.” (Buhner, pp. 211 & 208) Western medicine has isolated active ingredients from plants; Buhner instead proposes using the plant itself since it evolved to operate efficiently as a whole. However, in recommending herbs he does not eschew Western medicines. For example, he cites the effectiveness of thyme in boosting tetracycline used against MRSA. The “effectiveness threshold” of the antibiotic went from 4.0 to 0.12 mg/L, meaning that a great deal less tetracycline was needed when coupled with thyme.
Buhner’s position is plausible and encouraging. His book is the one I recommend highest in the list below. He summarizes the ways in which bacteria “outwit” antibiotics and argues against what he calls the reductionist approach of Western medicine, while providing concrete information about alternatives in the plant world. The last sections of the book tells those with opportunity and interest how they can grow these herbs themselves. Good luck to you, if you take up that challenge!
The Antibiotic Paradox, Stuart B. Levy, Perseus, 2002 (2nd ed.)
Boost Your Health with Bacteria, Fred Pescatore & Karolyn A. Gazella, Active Interest Media, 2009
Good Germs, Bad Germs: Health and Survival in a Bacterial World, Jessica Snyder Sachs, Hill & Wang, 2007
Herbal Antibiotics: Natural Alternatives for Treating Drug-resistant Bacteria, Stephen Harrod Buhner, Storey Publishing, 2013, (2nd ed.)
Revenge of the Microbes: How Bacterial Resistance is Undermining the Antibiotic Miracle, Abigail A. Salyers & Dixie D. Whitt, ASM Press, 2005.
Rosalind Michahelles is a Certified Holistic Health Counselor in Cambridge. For questions about this essay or related issues please call 617-491-3239 or visit www.nutrition-matters.info