So currently I am reading Complications in Small Animal Surgery which was published in January this year so is maybe one of the most recent surgical veterinary textbooks out there. It opens with an entire section dedicated to infections, and last night I came across the news that the FDA in America is banning antibacterial hand soap.
Some people may have heard about something called antibiotic resistance – this is where bacteria evolve to no longer be killable by antibiotics. This got the initial media attention a few years ago when the big superbug MRSA started appearing in UK hospitals. However unless you’ve visited a hospital since then you have probably heard very little about it.
Since then it has evolved to something called MRS which stands for Methicillin Resistant Staphylococcus. Why? Because the last letter is the species of the bacteria called Staphylococcus which is resistant. Now there is both MRSA (which is Aureus) and MRSP (which is Pseudointermedius). Before I was reading the new textbook earlier today I had never heard of MRSP.
In veterinary practice we deal with many of the same bacteria and the same drugs that are used in humans. And a lot of these compounds have also been built into hand soaps which are used daily in homes across the world.
The latest research when it comes to cleaning hands in veterinary practice generally recommends alcohol hand gels as both effective at killing germs, and with the addition of things like vitamin E a lot better dermatologically for your skin. There are still some conditions where normal soap and water is recommended such as with Parvovirus or when there is visible dirt however antibacterial soap is not recommended. This is because it is no better than normal soap and water – yet when used can increase the problem of antimicrobial resistance.
So back to MRS – these bacteria cannot be treated using ordinary antibiotic drugs. Instead they need newer more powerful antibiotics – however the problem is that the more we use these newer more powerful drugs the higher the risk that bacteria will also evolve resistance to these. And so these drugs will not work anymore. And then we have a problem…
There are limited drugs available – it’s difficult, expensive and takes a long time to discover and produce new drugs. And it is not just new drugs that are needed but new ways for the drugs to find and destroy the bacterial cells.
I watched a TV show recently called The Knick which I found very interesting as it is based in the early 1900’s before antibiotics were discovered in 1928. In the show people die from really simple infections that are now cured with an injection or couple of tablets. If we do not have working antibiotics then I wonder if this is what we will go back to?