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Thursday, 21 July 2011

All bugs are superbugs!

"Superbugs now resistant to all antibiotics"

"New superbug found in UK hospitals"

"Gonorrhoea superbug widespread"

Headlines like this are commonplace. Not least because in generating fear they generate newspaper sales. I spend my life dealing with "bugs" (the microscopic sort; that is bacteria, viruses, fungi, parasites) and headlines like this irritate me!
What, after all, is a superbug? In the examples above, antibiotic-resistant bacteria are implied. Those who are a bit long in the tooth, like me, might remember the outbreaks of "flesh-eating superbugs" (necrotising fasciitis) in the early 1990s in  Gloucestershire (UK). That was a "superbug", causing fear out of all proportion to the actual  number of cases. But the bug, group A streptococcus (or GAS) was and still is, actually distinguished by the fact it remains universally sensitive to penicillin, the first antibiotic of all. Not so super?In this case the "super" was generated by the extra ability of the bacterium to invade, causing deep tissue infection; in scientific parlance, GAS has become more pathogenic. GAS used to be a common cause of outbreaks, scarlet fever and "childbed" fever were major causes of premature demise in our ancestors. That it no longer is is largely due to improved sanitation, hygiene and antibiotics.

Alternatively, a "superbug" might be one which is more infectious, that is, spreads more easily between people. Swine flu became a pandemic because the virus changed from being primarily a piggy problem to one that could live and spread in humans. But just as "super" is the cholera bacterium strain, known as El Tor, which is responsible for the current global pandemic. It continues to cause outbreaks because it is actually less infectious than classical cholera and so can be persistently carried and passed on without making some people ill.

But what about a friendly superbug? After all Superman's superpowers were good. Vitamin K is made in the gut by bacteria which are normal residents. This is the principle source of the vitamin which is vital for blood clotting. Friendly gut bacteria also suppress or keep out unwanted visitors and metabolise food components for which we humans lack the enzymes.

Outside the human body, bacteria are able to do all sorts of amazing things. they live in the volcanic vents of the deepest oceans, using sulphur instead of carbon for energy , survive the winter in the antarctic ice, persist for years in the driest soils, share their DNA freely with unrelated species....I could go on.

Bacteria can also be harnessed to do all sorts of amazing tasks, from detoxifying mine slag heaps, to the mundane task of cleaning up sewage. Most of the developed world's insulin-dependent diabetics get their treatment from bacterial "factories".
 We share our lives with bacteria, like it or not (probably 90% of the cells in your body are bacteria, not human at all). All of them are super in some way.
Infectious disease is a real and present hazard and the loose use of the term "superbug" tends to obscure the genuine story behind the headline.

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