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_1474778113

ciera.williams

This act provides ongoing support to the first responders and other professionals involved in the rescue efforts of 9/11/2001. The adverse health affects are still being discovered 15 years after the attacks, and the EMS community is still in need of the support provided. This policy also outlines a precedent for future attacks. In the event of another large-scale act of terrorism, the responders would likely receive similar support and "compensation" for the affects that might have them. 

pece_annotation_1475447106

ciera.williams

The main theme of this article is the conditions leading up to, during, and following a policy passed in France in 1998. The policy allowed residency to "any foreigner habitually resident in France and suffering from a serious medical condition requiring medical treatment, and for whom deportation would result in exceptionally serious consequences, provided that he or she would be unable to receive appropriate treatment in the country to which he or she is returned" The author likens the poicy to "compassion protocol" or palliative care. The law should only apply in extreme circumstances and is based on an emotional response to pain/suffering. 

This policy had good intentions, but led to a number of resulting issues, such as disparity in care due to ambiguity in the law. For the enforcers of the law, there was much interpretation which allowed for individuals to exercise "humanitarian reason" and decide what conditions were a "serious medical condition" and what was not. This politicized medical care for foreigners/immigrants, as medical proffessionals no longer diagnosed based on symptoms, but socioeconomic status as well. 

pece_annotation_1476931956

ciera.williams

This article presents some statistics on common psychological issues post- disaster. PTSD and Major Depression are the two most commonly studied issues in realtion to post-disaster. A realtively new term "resilience" has been brought to the table, defining the ability of people to "bounce-back" after disasters. Substance abuse is another studied issue, with some reporting an increase in substance use following disasters. However, it is noted that the post-disaster abuse of substances is highest in those already using or abusing these ubstances. Other conditions such as generalized anxiety disorder, phobias, and other stress disorders are studied and have links to disaster experience.

The article also discusses some risk factors for post-disaster psychological disorders. Prior to disasters, women tend to be less resilient, and more suscpetible to disorders, excepting substance abuse. Children are especially vulnerable to issues. Socioeconomic status, ethnicity, and community support are also factors in the outcome of a person's mental state post-disaster. During a disaster, the degree of exposure to the incident is the greatest factor in outcome. After a disaster, support network and ongoing life stressors play a large rold in the outcome. The biggests steps to preventing poor outcome post-disaster are prepartion and anticipation of the disaster, and recognition/prevention of mental illness. 

Generally, only a small percentage of victims seek help from services provided for mental health disorders. This makes it difficult to accurately research the affects and prevalence of mental health disorders.