fact that for most of the time, potentially dangerous bacteria live in and on us without causing harm, highlights what has been called the ‘garbage can’ effect.
If a garbage can contains a great deal of waste which is decaying, rotting or putrefying, it will act as a magnet to flies and other scavengers who are attracted to just such material. An environment will have been created which is just right for them to use, to eat the garbage, or to lay their eggs in it perhaps.
If we create a similar environment in our own bodies, one which is ‘just right’ for a particular bacteria, virus or fungus, which offers it the chance to breed and eat well and where the normal controls have been relaxed, we have to expect these scavengers to take advantage of the situation.
If you were to see a garbage can overflowing with putrid material and surrounded by swarms of flies, would you be tempted to think that the problem would be solved by spraying and killing the flies? Such an approach might offer a very short-term answer to the problem, but would do nothing at all about the underlying cause as to why they were there.
Instead of trying to poison the flies, would you not consider it likely that the flies would not be there at all if the garbage can was emptied and cleaned?
The analogy in which I have compared a garbage can with an unhealthy human body is not completely accurate. However, it is true that one of the factors which can allow an explosion of activity on the part of usually inactive but potentially dangerous microorganisms in the body is a toxic state of the tissues.
A toxic condition would also involve a reduction in the efficient working of at least local aspects of the protective (immune) system, which would have been controlling the activity of bacteria, yeasts and viruses.
OPPORTUNISM
All organisms on the planet – bacteria or people – thrive if they are given the right surroundings, a condition which includes accommodation, safety from attack, adequate nourishment and a chance to breed. Therefore, if we offer bacteria, yeasts and viruses an environment in which our natural defense mechanisms offer only weak and inadequate controls, so that they will not be vigorously attacked, and if at the same time the environment (in this case part of your body) offers them surroundings which are suitable (for them) and which meet their needs – offering food and a chance to multiply – we should not be surprised if they take advantage of this. As a result, infection occurs.
And if infection occurs and involves a particular microorganism which is resistant to antibiotics, as well as being confronted by enfeebled defense systems (our immune system can become weakened for any of a number of reasons which we will explore in later chapters), we will have placed ourselves in great peril.
When bacteria (or other microorganisms) take advantage of a weak immune system, they are said to be acting opportunistically – taking their chances because they have been offered an easy ride.
The degree to which our immune system is operating efficiently or inefficiently, and the excellence, or lack of it, with which our tissues are presenting ideal, or less than ideal, conditions for potential invaders, decides how vulnerable or susceptible we are.
The comparison of this scenario with the defense of a country by its army is obvious, and as we will see in later chapters there is a great deal we can do to enhance our own personal defenses and so deny opportunities to potential enemies.
If our natural defense systems have been weakened (again, for whatever reasons) and infection threatens life itself, we need to have available options.
One choice which a suitably qualified health care provider may make in such a crisis would be to use antibiotics. But what if the organism involved is not vulnerable, has become resistant to antibiotics?
This is the scenario faced by many doctors today, often in hospital settings, where superbugs have emerged as being almost impervious to antibiotic use.
It is also happening in the community, for example as TB reappears, involving strains of bacteria which have become resistant to the medications which previously controlled them.
The ways in which this has happened will be summarized later in Chapter 2, after which we will meet some of the leading characters in the story, the superbugs.
WILL GENETIC MODIFICATION HELP?
New research has suggested that genetic engineering may allow scientists to develop ways of modifying the genetic material of bacteria such as Staphylococcus aureus to remove their acquired or inherited resistance to antibiotics, so once again making them vulnerable and easier to control.
In a speech to the National Academy of Sciences, Nobel Laureate Professor Sidney Altman announced that, ‘This method may one day allow us to restore the full usefulness of today’s front-line antibiotics.’7
The research which led to this statement was performed at Yale, where scientists used synthetic genetic material to ‘switch off’ the genes in the bacteria which produce resistance. They were in this way able to restore the sensitivity of E. coli bacteria to ampicillin, to which the E. coli bacteria had become resistant. An enormous amount of research remains to be done, most notably as to how to get the synthetic genetic material into the infecting bacteria, nevertheless this research at least offers some hope for the future.
But even if this approach proves possible and ultimately ‘successful’, it will only represent the continuation of a method which has led us to the present crisis situation. This is, after all, still an approach which focuses attention on ‘killing the enemy’ rather than improving natural defenses, which many would say was doomed to failure from the start. It is likely, therefore, that initial success in using genetic engineering on resistant bacteria to once again make them vulnerable to antibiotics is almost certain to result, in time, in these bacteria finding other ways of becoming resistant, as they have so successfully done up till now.
WHY DO BACTERIA DEVELOP RESISTANCE TO ANTIBIOTICS?
In his book Alternatives to Antibiotics, Dr John McKenna reports that in the early days of the use of penicillin, its discoverer, Alexander Fleming, warned that if antibiotics were used inappropriately bacterial strains would mutate to produce resistance to the drugs.8 This would be more likely, and possibly more serious, if:
Clearly Fleming was correct.
And to this
