Skip to main content

Search

"Antibiotic Resistance in Louisiana"

fdabramo

I 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?

pece_annotation_1480273848

Sara.Till

This report has been cited by 22 other works-- including articles, books, reports, reviews, and studies. This includes several these, book chapters, and dissertations. It appears mostly in anthropological and STSS works, indicating it has yet to move from these social sciences into the realms of policy. 

pece_annotation_1473614637

Sara.Till

"Unfortunately, 'normal' in Haiti includes perpetual political turmoil... That kind of political morass is one big reason-- though by no means the only one-- why the billions in relief and recovery aid haven't been enough to rescue Haiti from the disaster that fate keeps flinging its way."

"A growing reliance on U.S. and other international contractors helps explain why the payoff of foreign aid in Haiti often seems so low."

""International companies had to fly in, rent hotels and cars, and spend USAID allowances for food and cost­of­living expenses," Johnston wrote in the Boston Review last year. So­called danger pay and hardship pay inflated salaries by more than 50 percent"

pece_annotation_1480890445

Sara.Till

1) "On an individual level, disagreements over treatment can arise when there are competing ideas about the cause and most appropriate treatment of disease. The weak and sometimes nonfunctioning health systems that often characterize complex security environments can compound these challenges and contribute to a milieu of mistrust that sets the stage for violence against health workers, facilities and transportation"

2) "There are also often inconsistencies in the categories used to describe perpetrators e e.g. terrorist, state actors, non-state actor e and these categories have legal ramifications under both International Humanitarian Law and in national legal frameworks. Although a standardizing of terminology and scope of study would be welcome, this has proven difficult."

3) "Although violence directly affecting health service delivery in complex security environments has received a great deal of media attention, there is very little publically available research, particularly peer-reviewed, original research. Only thirty-eight articles met the original search criteria outlined in the methods section, of which only eleven contained original research; a further citation search yielded another four original research articles."

pece_annotation_1474205355

Sara.Till

The policy was the multi-tiered approach designed by New York City officials in the event of an Ebola case. This included designation of eight hospitals as being care centers for Ebola cases, teaching non-designated hospitals or care centers how to identify Ebola candidates, communication with transportation services (both EMS and non-EMS), and running unscheduled drills to practice handling scenes with an Ebola candidate (the example given was someone falling ill in a subway car). The poly aimed to standardize the approaches and protocols used when dealing with a possible Ebola case. It focused on minimizing the excessive risk to citizens, EMS personnel, and healthcare workers in the event of a patient with Ebola. The policy also sought to train and drill these protocols, including unscheduled calls (mentioned above) and continued inspections to ensure preparedness. The obvious end goal was to minimize the possibility of wide-spread infection, either through improper handling or failed detection of an Ebola case.

pece_annotation_1474496038

Sara.Till

1) "About 2,000 tons of asbestos and 424,000 tons of concrete were used to build the towers, and when they came crashing down they released dust laden with toxins."

2 "But as early as Sept. 13, Mrs. Whitman and the agency put out press releases saying that the air near ground zero was relatively safe and that there were "no significant levels" of asbestos dust in the air. They gave a green light for residents to return to their homes near the trade center site"

pece_annotation_1475372945

Sara.Till

The Center for Prisoner Health and Human Rights believes that failings within public health systems indirectly contributed to the high incarceration rates in America. The program seeks to advocate and educate in order to better the health and human rights of incarcerated populations. It appears to be focusing on educating the public, law/policy makers, and students about issues facing prison populations. It also seeks to address health care issues within the prison systems itself, as many offenders struggle with issues tied to mental health (drug and alcohol abuse, sexual abuse, mental illness, ect.); limited treatment options and prison conditions can often compound these issues, creating a vicious cycle for incarcerated individuals.

pece_annotation_1476029512

Sara.Till

The creators of the platform and film are part of a C3 non-profit called NOVAC-- New Orleans Video Access Center. There are several organizational partners that work on the ground accomplishing the organization's goals. These partners also provide a measure of funding; as a non-profit, most of the support comes from outside donations, either to the organization or through one of their proxy groups.

pece_annotation_1477263268

Sara.Till

1) PFA: the article currently contends that most governmental agencies use this 3-pronged approach to mitigate effects after a disaster. I'd be interested in learning which agencies do not use this approach and what their alternative strategies may be.

2) Resilience: this is a term specifically described in the article, detailing the phenomena of how some individuals manage to survive horrific disasters but are devoid of psychological symptoms after. As a relatively new concept, not much is understood at this time. However, much of PTSD, MDD, and other post-traumatic mood disorders focus on traits predisposing an individual to develop the disorder-- I'd be intrigued to know what traits (if any) predisposed resilience.

3) Cocoanut Grove night club fire: a disaster event I had never heard of, was the deadliest nightclub fire in American history. Almost 500 perished, and hundreds more were injured. This, apparently, led to a huge tightening of fire and safety protocols throughout the US