"Antibiotic Resistance in Louisiana"
fdabramoI situate my research at the crossroads of history, philosophy, sociology and anthropology of science. In the past, I have focused on epigenetics, environmental research, empirical bioethics and environmental justice, within and outside the academia, as you can read here, or here. Now I am focusing on antibiotic resistance, and I use it as a lens to interpret the contradictions of the last century derived by industrial production, environmental degradation and biomedical cultures.
What interests me is the (at that time) new epistemic discourse that since the Forties has been produced to explain morphological changes of organisms produce when they experience new environmental conditions or perturbations. Through an important experiment at the base of the so-called concept of genetic assimilation, Conrad H. Waddington showed that a thermic shock can produce changes in wings’ veins of fruit flies, changes that can eventually be inherited across generations, without the environmental trigger that caused them.
This focus on production and (genetic) storage of biological differences elicited by the environment is nowadays coupled with the knowledge produced through microbiome research that explains the phenotypic patterns that recur across generations.
In a thought-provoking twist, with microbiome research, the focus shifts from production and inheritance of biological differences to production and inheritance of biological similarities. Microbiome research shows that some phenotypic patterns are allowed by ecological communities of microorganisms composing all animals. Bacteria allow the development and functioning of our bodies within an epistemic framework that is now key to understand biology. The network of vessels composing mammals’ stomach is formed through cellular differentiation and expression of genes coordinated by bacteria. The same is true for our immune system that is coordinated by gut bacteria. Food, which is an important aspect of our lives also impacts on this microecology and mediates between our biological functions and functioning of means of production whose parts dedicated to food production have immense importance for our biology and our internal and external ecologies. Antibiotic resistance is one of the crossroads where culture, biology, history and the Anthropocene meet. Indeed, Antibiotic resistance shows that means of production of our societies have an even more widespread, deep and allegedly unexpected impact on the biology of animals and plants. The microorganism can indeed adapt to resist the selective toxicity of antibiotics. Moreover, bacteria can transfer their genetic code horizontally, by touch, so that we can acquire antibiotic resistance by eating food that functions as a vector, by hosting lice on our heads and many other contacts. Bacteria that are resistant to antibiotics that have been used as growth factors in animal husbandry and to prevent diseases in livestock and aquaculture, spread in natural ecosystems and can be found in wild species. Rivers and estuarine waters are places hosting antibiotic resistance.
Searching on PubMed (the search engine for biomedical literature) titles of articles containing the terms ‘antimicrobial’ and ‘Louisiana’ I retrieved just one twelve-years-old article. No results with terms such as 'Mississippi' or 'New Orleans'. The authors collected and analysed Oysters from both waters of Louisiana Gulf and in restaurants and food retailers in Baton Rouge. In most of the samples gathered, scientists recognised the presence of bacteria (Vibrio parahaemolyticus and Vibrio vulnificus) resistant to specific antimicrobials. Food production is indeed the first factor in terms of the quantity of antibiotics used. This use and related antibiotic resistance impact all the living beings present in a specific area, and can easily travel around the globe through many channels. As Littman & Viens have highlighted, a sustainable future is a future without antibiotics as “there may be no truly sustainable way of using antibiotics in the long-run, as microorganisms have shown to be almost infinitely adaptable since the first introduction of antibiotics” (Littman & Viens 2015). But in the meanwhile, we need to use them and antibiotic resistance is a phenomenon that can be better studied through environmental research, by analysing wild species and emissions nearby livestock, for instance.
The study that I retrieved focuses on Oysters. But what about antibiotic resistance conveyed through food that is consumed by the most?
What about exposures of communities that are living in highly polluted areas?
And what is the additive value on antibiotic resistance for individuals who experience the presence of industrial pollutants and that live in areas where cancer epidemics are registered?
In this respect, there is a strategy to cope with the issue of antibiotic resistance promoted by the Center for Disease Control and Prevention. The document doesn’t mention any action to monitor and regulate the production and usage of antibiotics in livestock. Nevertheless, the CDC wants to scrutinise, through genome sequencing, “Listeria, Salmonella, Campylobacter, and E. coli and uploads sequence data into PulseNet for nationwide monitoring of outbreaks and trends.” Moreover, the document reports that “In Fiscal Year 2019, Louisiana will begin simultaneously monitoring these isolates for resistance genes. When outbreaks are detected, local CDC-supported epidemiologists investigate the cases to stop spread.”
The questions that I would like to ask (to local ppl, activists, researchers, practitioners..) are:
What could be the epidemiologic characteristics (socioeconomic status, gender, residence..) of the populations more vulnerable to antibiotic resistance?
What is the additive role of antibiotic resistance for people living in highly polluted areas?
What is the impact of antibiotic resistance for people and patients living in areas where cancer incidence is high?
And on the long run I am interested in imagining possible strategies to not only living with the problem but also to tackle the problem itself, which means to develop strategies to answer the questions:
Why antibiotic resistance, which is known since a century, it’s a problem on the rise?
What is the role and interest of capitalism, in terms of profit-making of corporations, knowledge production and environmental degradation, in not being able to resolve antibiotic resistance?
What can be strategies of local communities to tackle the problem and to promote environmental justice in terms of alliances with ecologists, doctors, epidemiologists and other activists?
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maryclare.crochiereThe real threats of air quality were covered up due to politics and other reasons, wanting to get america back to work. Instead, the reports were edited and people were sent back into the dirty air to clean up the scene or back to office jobs in the area, with contaminated air surrounding everything. Decontanimation efforts did not start until very late in the process. Bush did not wear a mask and the workers were told they didn't need to, so they didn't. As a result, there were severe health problems afterwards.
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maryclare.crochiereInterviews were conducted with inmates and politicians.
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maryclare.crochiereIt was created to further outline the uses and resposibilities of medicaid, specifically with IMDs. It places more responsibility on the states for middle-aged people in need of this type of care, rather than the federal government. These changes and specifications occurred throughout the 1970's and 80's, when mental health was becoming more of an understood issue, and treatment of those with mental diseases was being improved.
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maryclare.crochiereIt is funded through member states' voluntary contributions, and in cases where additional funding is needed, they look for money in other areas or from other contributions.
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maryclare.crochiereThe arguments are supported by the stories told by individuals and families and cultural reasearch to help understand the stories.
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maryclare.crochiereWomen in some countries are much more familiar and used to rape, in fact, they will openly answer questions about it in front of others. There is debate as to whether rape should be treated the same as other humanitarian efforts, or differently, as each way has benefits and drawbacks for the feminist movements and for humanitarian workers. This pushes humanitarianism to a stage with politics, world progress, and other changes. They only meant to help those in need, but by using their work to see where changes can be made, the world will hopefully be a better place.
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maryclare.crochiereThe references list for this article shows a wide variety of resources that were used to write the paper. They vary in topics, some directly looking at nuclear energy, others at the risks society takes, regulations, and organizational structures.
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maryclare.crochiereEmergency responders are only seen in the film when bringing patients in, but it is assumed that they face some of the same struggles since they work in the same system. They have to deal with people who can't pay or those who use the emergency as their only medical care.