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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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joerene.aviles

The author of the article seemed to conduct their research from NPR reporters in Haiti, interviews with various organizations (U.N, Center for Economic Policy and Research, and the Institute for Justice and Democracy in Haiti), and other reports (one from the  U.S. Government Accountability Office was referenced). 

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joerene.aviles

The author is Scott Gabriel Knowles, an Associate Professor and Department Head at Drexel University. He specializes in the history of technology, disasters, and public policy. His work looks at the policies and technologies created for emergency response.

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joerene.aviles

Vincanne Adams is a professor at the UCSF School of Medicine with research done in global health, critical medical anthropology, and Asian medical systems among other topics. Taslim Van Hattum is an artist and social worker, and is currently Director of the Maternal and Child Health Portfolio at the Louisiana Public Health Institute. Diana English is an Assistant Clinical Professor of gynecologic oncology at Stanford Hospital. She has published research on uterine serous carcinoma, but also participates in community/ international service in developing countries.

When it comes to emergency response, they deal with the populations that are most affected by disasters or are socially/ economically disadvantaged and are more often in need of EMS. 

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joerene.aviles

1. Arguably, the new Ukrainian accounting of the Cherobyl unknown was part and parcel of the government's strategies for "knowledge-based" governance and social mobilization. In 1991 and in its first set of laws, the new parliament denounced the Soviet management of Chemobyl as "an act of genocide."

2. On the one hand, the Ukrainian government rejected Western neoliberal prescriptions to downsize its social welfare domain; on the other hand, it presented itself as informed by the principles of a moder risk society. On the one hand, these Chernobyl laws allowed for unprecedented civic organizing; on the other hand, they became distinct venues of corruption through which informal practices of providing or selling access to state privileges and protections (blat) expanded.

3. Government-operated radiation research clinics and non- governmental organizations mediate an informal economy of illness and claims to a "biological citizenship"-a demand for, but limited access to, a form of social welfare based on medical, scientific, and legal criteria that recognize injury and compensate for it.

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joerene.aviles

Byron J. Good is a Professor of Medical Anthropology at Harvard Medical School and Harvard University. His current research is on mental health services development in Asian societies, with a focus on Indonesia. He also has interests in the theory of subjectivity in society, and how political, cultural, and psychological aspects affect the subject and experience. Because the author mostly followed chronic diseases in subjects like in this article, he mostly has an overarching view of emergency response, especially if subjects don't involve emergency medical services in their narratives.

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joerene.aviles
Annotation of

Teach 3.11 was developed to serve students and general public. It allows the public to have more access to different books, teaching material, and research regarding disasters. The website was built in response to the Fukushima disaster of 2011, in order to provide "an educational space for understanding the history, memory, and context of social disasters" (Teach 3.11). The editorial team has members from different countries, reflecting the international collaboration that natural and nuclear disasters require. With it's availability in six different languages, public contribution and comments enabled on articles gives a global platform for discussion and sharing. They are currently accepting papers for their "Terms of Disaster" collection.