Big Think

Question: What are super-resistant bugs?

Charles Knirsch: Very often these are bacteria, viruses or parasites that were formerly, completely susceptible to a therapeutic. Many people don’t so, one such bacteria is MRSA and people hear about it in the news, which is Methicillin-resistant Staphylococcus aureus.

When [Alexander] Fleming first discovered penicillin, penicillin would treat staph aureus. That didn’t last very long. Other agents have been synthesized including different penicillins, completely new classes of agents. And I would say now that staph aureus is pretty well served, so what I would expect would be there’ll be a lack of further discovery in development for staph aureus, and maybe in a period of time, 5 years, 10 years or 15 years, we’ll be back to the problem of not having agents for staph aureus.

Right now we have gram-negative organisms so these are bacteria, they are found in water supplies especially in hospitals because of the antibiotic pressure there, where, again, if you were to get infected with one of these organisms, there may not be a therapeutic that will help fight against these organisms. These are the super-resistant bugs that you asked about.

Topic: Super-resistant bugs in New York City and South Africa.

Charles Knirsch: In New York City, just to make the case locally, in the late 80s early 90s there was relaxed control of tuberculosis and so that patients would be admitted with tuberculosis at the hospital for isolation and therapy after two weeks they’d feel better, but they needed six more months of therapy, would be sent out. They would often get disorganized, as they were often in their cities, or actually had mental illness, and this would happen three or four times until they developed multi-drug resistant tuberculosis, and in layman’s jargon a super-resistant bug, and this was frightening.

This situation is now prying out in places like South Africa where they have something called XDR Tuberculosis. I had many patients. And these epidemics will have outbursts in clinics and hospitals; I knew healthcare providers that were infected and got sick. Sometimes both the patients and the healthcare providers were HIV positive. That seems to promote actually the aggressiveness of the bacteria progressing in these patients; so it was quite a frightening situation.

Conducted on: July 15, 2009.