The Milwaukee harbor looked especially beautiful from the air as I flew above it today, bright blue and sparkling on this uncharacteristically warm and sunny February day. Unfortunately, my enjoyment of it was marred by the knowledge that the harbor contained a particularly unsavory collection of bacteria – the kind of antibiotic-resistant “superbugs” increasingly causing hard-to-treat infections. A recent study revealed that bacteria in water samples from that harbor had extremely high rates of resistance to multiple antibiotics. In fact, bacteria in the harbor were far more likely to be multiply drug resistant than bacteria obtained from sewage samples or from hospitalized patients! It turns out that antibiotics that get into the water – from being excreted in the urine of patients taking them, from unused medications being flushed down the drain, from agricultural runoff from farms that use antibiotics in animal feed – concentrate in the lake sediment. This persistence of low levels of antibiotics provides the sort of selective pressure that, through natural selection, leads to the emergence of resistant organisms.
This is a striking example of the way our health care system, designed to heal disease and promote health, can have unintended negative consequences. Overuse of antibiotics and other antimicrobial compounds (the kinds found in “germ killing” soaps, lotions, fabrics, etc.), and their improper disposal, is paradoxically creating a reservoir of bacteria that will be increasingly hard to destroy. It’s like an antimicrobial arms race. And the bacteria are winning.
Our value of health calls on us not only to take care of ourselves, but to think about the impact of what we do on the health of the environment. After all, environmental factors have a bigger impact on our health than medical care does. The antibiotic stewardship program at Children’s Hospital of Wisconsin promotes more appropriate antibiotic prescribing. As individuals, we can also only take (or prescribe) antibiotics when truly necessary. As tempting as it may be to flush that expired bottle of cefdinir down the toilet, take it to a medication collection station instead. Consider purchasing antibiotic-free meat and dairy products. The next time you drive by and admire the beauty of Lake Michigan, consider whether you are inadvertently helping create monsters lurking on the bottom.