Writing Exercise #6

I can only recall being prescribed antibiotics a few times in my life, due to my family’s tendency to feel like hospitals/clinics were reserved for dire circumstances. Usually choosing to “sweat it out” over a hospital bill and prescription medication, I didn’t know much about antibiotics in general prior to coming to college and becoming a pharmacy technician. I’m much more familiar with them now, in terms of how they are prescribed, the various kinds, the side effects, etc., due to my exposure to them in the pharmacy.

I am still fairly set in my ways when it comes to pursuing professional medical opinions on my health, typically assuming I can handle things on my own. Overall, I’ve developed the mindset that in most cases it isn’t necessary to rush to antibiotics to treat something that your own body could overcome and potentially strengthen your immune system from. There certainly are more serious circumstances where I would accept antibiotics as a course of treatment, but I think there are more important factors to take into consideration when battling something that while inconvenient, can soon be fought off by your body’s own natural defense system.

Since learning about the recent increase in concern over bacterial acquisition of antibiotic resistance, I’m even more wary of potentially overusing our first line of defense. I wouldn’t want to contribute to this widespread problem by giving any pathogenic bacteria the chance to familiarize, mutate, and adapt to antibiotics when the infection could be resolved with time or by other means.

One aspect of antibiotic use that still surprises me is in the minimal education given to the patients. I can’t recall having doctors ever stress to me in the past the importance of finishing the treatment regimen. In fact, I was sorting through a tub of old medications not too long ago and found an vial for antibiotics, prescribed to me my first year of college, with two tablets still inside—a full day’s worth of the seven day course. It’s only been a few years since then and I was shocked that I didn’t even know that long ago what the consequences of stopping early could be.

Doctor’s aren’t the only culprits of failing to stress the importance of a completed regimen, though. I am constantly listening to the pharmacists counsel on ciprofloxacin, levofloxacin, cephalexin, clarithromycin, amoxicillin, penicillin, sulfa antibiotics, etc., all day long at my job. While finishing the course is almost always mentioned, I don’t feel like the patients are made fully aware of the significance of this suggestion. Other than the simple direction to finish it, customers aren’t educated on the reasons why and the possible consequences. If the doctors are not educating the patients, and our pharmacists aren’t, patients will never learn and the bacterial resistance predicament will continue to worsen.

Writing Exercise #5

When first reading this prompt, a choice that I make almost every week immediately popped into my head—to fast food or not to fast food? The most obvious point of discussion would be the lack of nutritional value in our popular drive-thru/delivery choices. Failing to provide much nutritional benefit to the one consuming it, I would not expect it give much nourishment to our commensal gut bacteria either, which would only hamper their ability to survive and thrive.

However, something that I have been considering as I become more microbially aware, is what invisible pathogenic microbes could be hitching a ride from an unsanitary food facility to a comfortable new home in my metabolic organ, via my burrito. Accidental consumption of an undesirable bacterial strain could certainly disrupt the balanced microbiome (dysbiosis) and displace the commensal microorganisms dwelling there. Though the outcome is unintentional, our inability to trust how our food is being prepared and handled before it reaches us could yield potentially fatal consequences and any lapse in judgement made by the food handler could contribute to their likelihood.

A popular topic these days, choosing to receive treatment by antibiotics could have the desired result with unintended fallout. At the very least, the antibiotics will eradicate the infection, but at the expense of preexisting microflora that were either beneficial or not harmful. With so much real estate becoming available, the door is left open for unfamiliar and potentially pathogenic microorganisms to fill in those vacancies, leaving the host at risk for even more health problems.

On the other hand, the introduction of antibiotics could lead to a far worse outcome that has become a rather large concern recently: bacterial acquisition of antibiotic immunity. If the patient chose to discontinue treatment, or if the treatment were to fail altogether, the invasive bacteria have the chance to increase their tolerance against our first line of defense. Furthermore, this advancement isn’t a personal hurdle presented to each bacterium—once earned, bacteria can spread their resistance to others via horizontal gene transfer or binary fission and selection (“vertical”). Once resistant, the offending bacteria will be able to dominate the microbiome and the host much more easily.

Writing Exercise #4

Upon working through the materials this week, I became more aware of the incredible size and diversity of microorganism  communities that have integrated themselves into the human gut, as well as the substantial role they play there.

The readings explained that an alteration to the microbial communities could positively or negatively impact their host; either improving physiology, metabolism and immune functions, or contributing to the cause of numerous intestinal conditions, diseases and disorders. The continued survival of our commensal relationship with good gut-dwelling bacteria relies on the nature of our behaviors and the consequences they hold.

Prebiotics For Our Probiotics:

Ingestion of foods or pills containing prebiotics (carbohydrates that humans are unable to digest) acts as a direct delivery system for the nourishment that our natural probiotics (the intestinal “good bacteria”) need. Without this purposeful push in the right direction, the concentration of beneficial bacteria within our gut may dwindle, leaving only the phyla that bolster disease and alter our physiology for the worse. Introduction of prebiotics as a treatment in intestinal disorders has yielded favorable results in the health of individuals monitored in research studies. Overall, promoting the growth and health of our more desirable probiotic communities helps to maintain their beneficial existence and negate the impact our less-helpful behaviors might have on them.

Faecal Microbial Transplant (FMT)

As the name might suggest, treatment by FMT relies on the transplantation of a model microbial community, given by the faecal matter belonging to a healthy donor, to an individual suffering the consequences of imbalanced and unsettled microbial populations within the gut. Introducing a matured crop of good bacteria into the GI tract of someone who severely lacks them would disrupt the uneven proportions of good to bad bacteria by diluting the heavy concentrations of the latter. Armed with the development of FMT against one bacterium in particular, Clostridium difficile (known for causing mild to fatal infection), resulted in remission in approximately 92% of reported and documented cases. When the usual route of treatment fails, due to the bacteria’s acquisition of immunity, or just the sheer severity of its infection, FMT offers a promising opportunity to regain optimal intestinal health.

Use of Antibiotics

A longtime course of treatment against numerous types of bacteria, the unintentional effects of antibiotics have recently become a cause for concern. While most notably offering the infecting bacteria an opportunity to familiarize itself with the exogenous attacker, allowing it to eventually develop an immunity against it, the popular therapeutic regimen can also have unintended effects on other bacteria present in the gut. The habitual use of antibiotics by humans has been shown to eliminate our beneficial, commensal bacteria as well, leaving our intestinal tract with an abundance of vacant real estate that many phyla of dangerous pathogens would be more than happy to occupy.

 

Citations:

Guinane, Caitriona M., Cotter, Paul D. 2013. Role of the gut microbiota in health and chronic gastrointestinal disease: understanding a hidden metabolic organ. Therapeutic Advances in Gastroenterology: SAGE Journals. 6(4): 295-308.

Mayo Clinic Staff. 2016. C. difficile Infection. Mayo Foundation for Medical Education and Research. www.mayoclinic.org/diseases-conditions/c-difficile/symptoms-causes/syc-20351691.

Smith, Michael W., Martin,  Laura J. 2012. Probiotics and Prebiotics: Ask the Nutritionist on WebMD. WebMD. www.webmd.com/vitamins-and-supplements/nutrition-vitamins-11/probiotics.

 

Writing Exercise #1

In terms of non-infectious diseases that are influenced by microorganisms, nothing came to mind immediately, as I usually associate infectious diseases with the involvement of some sort of microorganism.  I was surprised to find that the two were even linked once I did some research. It appears that previous infections with certain microorganisms can prime and increases the likelihood of the onset of a non-infectious disease in a human. Coming into contact with some microorganisms can permanently alter aspects of your body and ultimately they way it responds to certain non-infectious threats. A common example is the correlation between H. pylori and the development of gastric cancer – a connection I had never considered in my life.

 

Source: https://www.frontiersin.org/research-topics/5691/viral-and-bacterial-infections-leading-to-non-infectious-diseases-unveiling-the-missing-links