There are many reasons why people write about the looming threat of antibiotic resistance. Academics do it to share their research. Politicians and public health experts do it to show what’s working and what isn’t. I do it because getting an infection that nearly took my life is not something I want to see happen to anyone else.
In 2011, I was a 19-year-old volunteer working with HIV/AIDS orphans in Kolkata, India. One morning on my way to the orphanage, I was hit and dragged by a train, which severely damaged my right leg. Due to the damage, doctors at a nearby clinic had to amputate the leg above the knee, without anesthetic to numb the pain.
When I returned home to Seattle a few weeks later, the wound became infected with multiple drug-resistant bacteria, including Pseudomonas aeruginosa, Klebsiella pneumoniae, Morganella morganii, and Enterococcus.
Some of these tested positive for New Delhi metallo-beta-lactamase-1 (NDM-1), an enzyme that makes bacteria resistant to a class of important antibiotics known as carbapenems. First identified in a patient from India, NDM-1 is now found in scores of countries, including the United States. Bacteria resistant to carbapenem antibiotics are listed as “Urgent Threats” in the latest Antibiotic Resistance Threats Report published by the Centers for Disease Control and Prevention.
In the months after my accident, I underwent several more surgeries, and the NDM-1 infections kept returning. Each time they did, I had to be kept in isolation. My doctors needed to use stronger “last-resort” antibiotics, such as colistin and tigecycline, which can have drastic side effects. I developed kidney failure and a severely compromised immune system.
These infections also interfered with my physical therapy. As an outdoor enthusiast, I wanted to be fully active again. But I had to restart physical therapy after each surgery, as these procedures removed more of my leg tissue, making the prosthetic harder to fit and harder to work.
As an undergraduate, I had majored in history and took only a few science courses. But my accident and the odyssey that followed inspired me to learn more about biology, especially about microbes. I have since graduated with a biology degree from the University of Washington Bothell, where I did research on multi-locus sequence typing, a technique for locating genes on a bacterial chromosome. It serves as a sort of fingerprint for identifying bacteria.
I also work with the Institute for Systems Biology (ISB) on its AMR360 team, an international network of scientists, physicians, professionals, educators, and students with two main aims: developing new antibiotics and creating curricula on antimicrobial resistance for high school and undergraduate students and teachers.
Since 2003, approximately 2.5 million students, working with thousands of teachers across all 50 states and in 100 countries, have accessed Institute for Systems Biology curriculum modules via the Internet. Individuals affiliated with ISB also meet with teachers and students in their schools.
For example, I and another ISB biologist, Rachel Calder, recently traveled to a high school outside Seattle to work with its biology teachers and their students for an entire school day. Since they were using the ISB curriculum, I shared my story with the students, then asked them questions about the lesson they were working on. My colleague and I also answered questions about bacteria and antibiotics the teachers couldn’t answer.
Both teachers, who were marine biologists, said that having the opportunity to spend time with people who work with bacteria and who have expertise in antimicrobial resistance was invaluable and would help them work on these concepts with their students.
The sooner we can get teachers and students to understand the concepts of antibiotic resistance, the better our chance of maintaining proper stewardship of existing antimicrobial drugs and developing new ones.
All of us need to be aware of this threat and work to fight it. That’s why I joined the Antimicrobial Resistance Fighter Coalition, a non-commercial organization devoted to increasing awareness of antimicrobial resistance, encouraging personal responsibility to combat it, and mobilizing action across a wide range of groups interested in it or affected by it.
The CDC estimates that nearly 3 million people in the U.S. alone develop infections that are antibiotic resistant, and more than 35,000 people die from them. A British report estimated that without work to stop the spread of antimicrobial resistance, 10 million people could die from it globally each year.
I know from first-hand experience the suffering that antimicrobial resistance can cause. This threat to human health can’t be left solely to the “experts” to fix. If everyone plays a part — from not asking for unnecessary antibiotics to outright activism — we can drive action for change.
David Mateo Ricci is a biologist and activist against antibiotic resistance. The non-commercial Antimicrobial Resistance Fighter Coalition is supported by BD (Becton, Dickinson, and Company).