"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?
pece_annotation_1473103443
josh.correiraThe author is Sonja D. Schmid who is a professor of Science and Technology in Society at Virginia Tech. Her area of expertise is the social aspect of science and technology, esp. during the Cold War, as well as science and technology policy, science and democracy, qualitative studies of risk, energy policy, and nuclear emergency response. As a professor and researcher she has does relevant studies on Fukushima and nuclear disasters relevant to the DSTS network. One such article titled "The unbearable ambiguity of knowing: making sense of Fukushima" is cited below:
Schmid, Sonja D. "The Unbearable Ambiguity of Knowing: Making Sense of Fukushima." Bulletin of the Atomic Scientists. N.p., 2013. Web.
pece_annotation_1473112288
josh.correiraThe program consists of a Radiation Disaster Medicine Course (4-year integrated PhD program), a Radioactivity Environmental Protection Course (5-year integrated PhD program), and a Radioactivity Social Recovery Course (5-year Integrated PhD program)
pece_annotation_1473634175
josh.correiraThe report is written by Doctors Without Borders (Médecin sans Frontières)
pece_annotation_1474433757
josh.correiraThis policy directly affects first responders and technical professionals as they will be the ones interacting with patients and following the protocols outlined in this plan. First responders are required to recognize and report suspected ebola incidents, use appropriate PPE, and transport to appropriate facilities if feasible.
pece_annotation_1475596578
josh.correiraThe IHS is funded by Congress after being reviewed by The House, Senate, and Congressional committees annually. A budget is formulated by a division within the IHS for approval each year. This means that their way of thinking about disaster and health must be approved by Congress, since they are a Federal agency.
pece_annotation_1473109702
josh.correiraThis is supported by analyzing the current emergency response system for nuclear disasters. Schmid notes that disaster prevention was the focus of the nuclear industry and disasters were rare up until recent and emergency response was hardly focused on. She also notes that as the nuclear sectors grows in size the frequency of disasters will likely increase and there has been a noticeable shift in focus towards emergency response.
pece_annotation_1473631952
josh.correiraThe authors are Paul E. Farmer, Bruce Nizeye, Sara Stulac, Salmaan Keshavjee. Paul. E. Farmer is a physician and anthropologist and co-founder of Partners in Health (PIH). He has been described as “the man who would cure the world.” PIH was involved in the disaster response after the earthquake in Haiti. Dr. Farmer has a number of publications including one titled “AIDS and Accusation: Haiti and the Geography of Blame.”
pece_annotation_1473634230
josh.correiraThe report states that funding is passed down from the top while reports are passed up from the bottom leading to a lot of dysfunction in the chain of aid, especially for technical professionals an the bottom of the chain.