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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?

The Red Spot

The 2008 financial crisis was one of the biggest shifts of wealth away from the Black community.

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Sara_Nesheiwat

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Sara_Nesheiwat

The authors are Emily Goldmann and Sandro Galea. Emily Goldmann is a PhD, MPH, and assistant research professor of global public health at the College of Global Public Health at NYU. Her work focuses on social and environmental determinants of mental health consequences of health events such as strokes. She has an interest in epidemiology and she studied economics and Mandarin as an undergraduate at Columbia University and got her Masters and PhD in epidemiology from University of Michigan.

Sandor Galea is an MD, MPH and DrPHD. He is the Dean at Boston University School of Public Health. He has worked at the University of Michigan and New York Academy of Medicine. His works centers around the social production of health of urban populations and he focuses on the causes of brain disorders. Both very public health oriented. 

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Sara_Nesheiwat

Looking at the citations at the end of each page, it is clear that the research done for this article was both extensive and thorough. There are numerous different forms of citations and resources, varying from news articles to studies and reports. There is also a very wide date range showing an effort to understand and present data and information on the topic both pre and post disaster as well as show updated findings and information as it became discovered. 

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Sara_Nesheiwat

The author addresses emergency response by analyzing the responses different nations had to nuclear plant disasters and compared those emergency responses to each other as well as the fallout in Japan. She then analyzed the areas where there was apparent needs that had to be addressed in terms of emergency response. She shows exactly why a nuclear emergency response plan is necessary. The author analyzes the effect that post nuclear disaster had on the people, leaders and areas surrounding Chernobyl and Three Mile Island as well as Fukushima. She also addresses not only the importance of having an international emergency response team, but also the need for integration between the public and scientists/elite that decide protocol. 

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Sara_Nesheiwat

Requirements to apply are a Bachelor’s degree or its equivalent and demonstrable evidence of promise in the field of narrative medicine according to the admissions website. Ultimately, those looking to enter the medical field in any capacity are the main targeted demographic for this program. The goal is to instill into doctors, nurses, PAs, social workers, etc, the idea of incorporating narrative medicine into their clinical work. Those predisposed to healthcare fields are likely optimal candidates for this program. 

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Sara_Nesheiwat

Emergency response isn't really addressed to the degree of the disaster discussed last week. The response discussed in this article isn't about immediate emergency response, triage or even fallout aftermath. The response discussed in this article was more about the analysis of social parameters on the spread of disease. The response in this case would be the need to better address these social influences on the spread of disease in certain populations. 

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Sara_Nesheiwat

There are many facts, statistics and data provided by the MSF collection of essays. Along with data provided by these essays and other organizations such as WHO and other cited works, expert analysis is also used as a common method throughout this article to support the arguments.

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Sara_Nesheiwat

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