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"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?

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michael.lee
  • "Until the early 1990s, illness was used as grounds for seeking a residence permit in only exceptional cases. Ten years later, the health criterion had become one of the primary grounds for legalization, and one that was increasing most rapidly."
  • “The compassion protocol is thus a procedure of the last resort that derives from a form of sympathy evoked in the face of suffering. It demands the right to keep alive individuals who have nothing except their mere existence."
  • “Sometimes the foreigner, too, is no more than his body, but this body is no longer the same: useless to the political economy, it now finds its place in a new moral economy that values suffering over labor and compassion more than rights.”

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michael.lee
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Natural disasters are the first type of disaster that comes to mind when assessing FEMA's response efforts, but the organization is also concerned with response to acts of terrorism, acts of war by a foreign nation, and other manmade disasters. That being said, FEMA was heavily criticized for its response during and after Hurricane Andrew in 1992 and Hurricane Katrina in 2005. 

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michael.lee

"These initiatives build on a growing perception among diverse actors — life scientists and public health officials, policymakers and security analysts — that new biological threats challenge existing ways of understanding and managing collective health and security. From the vantage point of such actors, the global scale of these threats crosses and confounds the boundaries of existing regulatory jurisdictions. Moreover, their pathogenicity and mutability pushes the limits of current technical capacities to detect and treat disease."

"However, the ideal of dual use faces many difficulties, in part because public health professionals often do not agree with security experts about which problems deserve attention, and how interventions should be implemented. Such disagreements point to broader tensions provoked by the current intersection of public health and national security. Public health officials and national security experts promoting preparedness strategies have very different ways of evaluating threats and responses. As a result, programs that depend on coordination between these groups may often founder."

"The report defines emerging disease as one among a number of new threats to security that 'do not stem from the actions of clearly defined individual states but from diffuse issues that transcend sovereign borders and bear directly on the effects of increasing globalization that challenge extant frameworks for thinking about national and international security.' Proposed responses to this new 'global threat' have come from various kinds of organizations, with diverse agendas."

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michael.lee

OSHA is a part of the United States Department of Labor and is overseen by the Secretary of Labor. The chief administrator of OSHA is the Assistant Secretary of Labor for Occupational Safety and Health, who is supported by a Chief of Staff and several Senior Advisors. The Assistant Secretary oversees two Deputy Assistant Secretaries who supervises various directors and administrators. The full organization chart can be found on the OSHA website.

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michael.lee
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As part of the evidence in this article, the author cites Gerard R. and Hailey-Means who are two former inmates of Rikers' Island, Martin Horn who is a former NYC DOC commissioner, Mayor DeBlasio, John Boston of the Legal Aid Society, Kim Knowlton who is a senior scientist at the Natural Resources Defense Council, Susi Vassallo who is an associate professor of emergency medicine at the NYU School of Medicine, and a number of additional individuals and organizations.

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michael.lee
  • "In a place of tremendous economic desperation, people competed for work in the zone of exclusion, where salaries were relatively high and steadily paid. Prospective workers engaged in a troubling cost benefit assessment that went something like this: if I work in the zone, I lose my health. But I can send my son to law school."
  • "Opinions about how the state should address the fate of these Chemobyl victims also serve as a kind of barometer of the country's changing moral fabric."
  • "At stake in the Chernobyl aftermath is a distinctive postsocialist field of power-in-the-making that is using science and scientific categories to establish the state's reach. Scientists and victims are also establishing their own modes of knowledge related to injury as a means of negotiating public accountability, political power, and further state protections in the form of financial compensation and medical care."