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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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ciera.williams

"'In the globalized world of the 21st Century,'... simply stopping disease at national borders is not adequate"

"Early advocates of such [biodefense] efforts...argued that adequate preparation for a biological attack would require a massive infusion of resources into both biomedical research and public health response capacity" 

"Security experts and some life scientists worry that existing biosafety protocols focused on material controls in laboratories will not be sufficient as techniques of genetic manipulation become more powerful and routine, and as expertise in molecular biology becomes increasingly widespread."

"In all of them, we find that health experts, policy advocates, and politicians have competing visions about how to characterize the problem of biosecurity and about what constitutes the most appropriate response. Thus, the question is not just whether certain events (or potential events) have been characterized as "biosecurity" threats that require attention; we also need to ask what kind of biosecurity problem they are seen to pose, what techniques are used to assess them, and how certain kinds of responses to them are justified" 

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ciera.williams

The 1814 burning of the Captiol Building was in response to the American's burning fown York. The British decided to return the favor and burn down the captiol buildings and other cities in the Union. The building itslef had structural issues with poor ventilation, rotting timbers, and leaking roofs. In the efforts to reconstruct the capitol building, the engineer was met with public criticism, which could be considered out of line to an expert. He stated that the buildings left from the fire were already doomed, regardless of the fire's destruction. Other questions were brought by the public after the fire, such as the defense of the capitol and the war of 1812 itself. The engineer, Latrobe, conducted his own "investigation" of the buildings. In the end, the investiagtion revealed that the public was not as concerned with the how, but more the reasons why. 

In 1850 , a boiler exploded in the basement of a printing press factory in Manhattan. The diasaster led to a number of workers, notable children and adults alike, being trapped in the rubble in need of rescue. These rescue attempts were repeatedly halted in order to put out emerging fires around the explosion site. The total death toll was 67, with an additonal 50 injured. Seventeen jurors were brought to the site to observe the boiler (what remained of it) for its strength and fitness for use. Out of all the witnesses called forward for questioning on the boiler's fitness, numerous named any number of issues, specific to their area of expertise. The engineer who designed the boiler stated it was not properly constructed wiht numerous defects. The maker of the boiler had examined the boiler and found cracks prior to the explosion. The end result of the investiagtion revealed that the public had a fair amount of knowledge on the workings and issues with boilers. The incident also effected change in the inspection policies. 

The Iroquois Theater Fire happened in part due to the design of the theater and in part from the mistakes of the managers of the building. Exits were blocked or locked. The investigation revealed that the inspections of the theater were never truly enforced and many things did not meet code (such as fire sprinklers placement). The public, in this case, played a crucial role in pushing for a public investiagtion of the Iroquois, and other theaters. 

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ciera.williams

"... pathology, which previously aroused suspicion, has therefore become a source of social recognition"

"The issuing of a diagnosis and prognosis- an every-day act for the clinician, in principle involving no difficulties other than technical ones- became a problem of conscience that seemed like to invovle ideological of ethical issues" 

"The logic of state sovereignty in the control of immigration clearly prevailed over the universality of the priciple of the right to life. The compassion protocol had met its limit" 

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ciera.williams

The app was actually designed originally as an experiement by the Institute for the Study of Coherence and Emergence. The members of their Affirmative Consent Division were given the app as an experiment on the context of discussion around cosent. The idea was to test how discussion about consent affects the consent itself and the acts following. The Institute page doesn't really say where the funding is from, though I'd say privately through members and sponsors.

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ciera.williams

The purpose of this program is to educate students to become global leaders (dubbed Phoenix Leaders) in radiation disaster response. The program aims to use experience from the aftermath for Hiroshima to create an overarching program of “Radiation Disaster Recovery Studies”, with multiple disciplines of Medicine, Environmental Studies, Engineering, Sciences, Sociology, Education and Psychology. The eventual aim is to create a new and evolving system of response, safety, and security.