A Super-Heroic Fight Against Superbugs

  • October 02, 2017
  • by Carol Kaufmann

Each year, antibiotic-resistant bacteria sicken 2 million Americans, killing 23,000 of them. Pew works to combat this growing threat with a group called Supermoms Against Superbugs—survivors, parents, doctors, farmers, chefs, and others who know firsthand about the dangerous bacteria.

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When Washington state resident Chris Linaman traveled this spring to the nation’s capital to meet with members of Congress, he told the story of the basketball game that changed his life. Twelve years ago, the then athletic and healthy 32-year-old tore the ACL in his left knee, and like some 100,000 Americans do each year, he had surgery to repair it. But a few weeks later, his knee swelled to the size of “a bright red melon” and, he says, even grew hot to the touch.

Within hours, doctors diagnosed him with methicillin-resistant Staphylococcus aureus (MRSA)—a bacterium that’s tough to treat because it resists many commonly prescribed antibiotics—and rushed him into emergency surgery, the first of several he would need over the next four days. Still, the bug persisted. Not long after he was sent home to recover, his wife found him nearly unconscious, and nearly unrecognizable, with a severely swollen face and a 105-degree temperature. The infection had become so severe that doctors told her to prepare for the worst. After more surgeries and antibiotics, Linaman’s entire top layer of skin peeled off because of an allergic reaction to one of the antibiotics, leaving him even more vulnerable.

Eventually, doctors reined in the bacteria, but not without lasting effects. The episode took a financial toll on the family, he needed extensive physical therapy for his weakened leg muscles, and his young children didn’t understand why their daddy couldn’t wrestle with them like he used to.

Still, Linaman says, “as horrible as my MRSA infection was, I’m the good outcome—I survived. Way too many others have not. The number of people who die from antibacterial resistant infections each year is the equivalent to a 747 crashing once a week.”

Simple infections, such as pneumonia or those in open wounds or the urinary tract, accounted for at least a third of all deaths in the United States before antibiotics such as penicillin revolutionized medicine in the decade after World War II. But as time progressed, there has been a downside: The more antibiotics are used—either in human medicine or in food-producing animals—the less effective they become as bacteria adapt and become resistant.

“Antibiotic resistance is a critical public health issue,” says Kathy Talkington, who directs Pew’s efforts to encourage development of new antibiotics and ensure proper use of the drugs in health care and food animal production. “If we don’t have effective antibiotics, we jeopardize our ability to treat cancer, do heart transplants, perform joint replacements—all the basic kinds of health care.” Leaders in the World Health Organization agree: In 2016, they called drug resistance a “major global threat” and estimated that it will kill 10 million people annually by 2050.

Trust Magazine Fall 2017

Ellen Walsh-Rosmann, her husband Daniel, and their two children Xavier, 4, and Geneva, 1, check on a sow that is about to give birth on their certified organic farm in western Iowa. When Walsh-Rosmann was pregnant with her daughter, she developed kidney problems and had to use many antibiotics before doctors found an effective one—an experience that led her to join Supermoms Against Superbugs. (© Misty Prochasko for The Pew Charitable Trusts)

But conveying the magnitude of the problem has been difficult—and that’s where Linaman and others in the Supermoms group come in. “They put a human face on a real problem,” says Talkington.

Each year, the group comes to Washington to meet with members of Congress and their staffs, as well as with other policymakers working to address antibiotic-resistant bacteria.

They encourage funding for new antibiotics, noting that nearly every antibiotic in use today is based on discoveries from more than 30 years ago. They also urge that antibiotics be used judiciously and only when medically necessary in humans and food animals so that the drugs remain effective.

Lauri Hicks, an osteopathic physician and director of the Office of Antibiotic Stewardship at the Centers for Disease Control and Prevention, has worked on the antibiotic-resistant bacteria fight with Pew and says the Supermoms group has made a tremendous difference. “Personal stories are incredibly valuable,” says Hicks. “It shows that this is something that can happen to anyone.”

Everly Macario, a Chicago-based public health consultant and researcher, knows this all too well. Even with a doctorate in public health from Harvard University, she wasn’t aware of antibiotic-resistant bacteria when her 18-month-old son, Simon, contracted an infection later identified as a new superbug, community-associated MRSA, in 2004. He died the day after he was admitted to the hospital.

Four years later, Macario began speaking publicly to raise awareness about antibiotic resistance and the need for more research funding, and in 2012, when the Supermoms initiative started, began traveling to Washington to meet with lawmakers.

“No one can imagine going back to pre-penicillin” days, she says. But she worries that is where the world may be headed.

Though initially discouraged by the slow-moving federal bureaucracy and legislative process, Macario says she has seen real progress in the past five years. One of the biggest improvements, she says, has been the commitment by poultry producers Perdue Foods and Tyson Foods, and by fast-food companies such as Chick-fil-A, Chipotle, McDonald’s, Panera Bread, and Subway, to begin using and sourcing meat raised with responsible use of antibiotics. “The consumer … has spoken,” says Macario. “Companies are changing. They have to adapt.”

Trust Magazine Fall 2017

Everly Macario (left) meets with Representative Rosa DeLauro (D-CT) on Capitol Hill to urge continued funding to fight the growing threat of antibiotic-resistant bacteria. When talking with members of Congress or other officials, Macario often shares the story of her son, Simon (below), who died suddenly from MRSA, an antibiotic-resistant bacterium, when he was 18 months old. “I’m doing what I can so that other people don’t lose their children,” she says. (© Evelyn Hockstein for The Pew Charitable Trusts)

Trust Magazine Fall 2017

(Courtesy of Everly Macario)

Chris Linaman also helps drive demand for responsibly raised food. Now the executive chef at Overlake Medical Center in Bellevue, Washington, he is known for his menus featuring meats and poultry from producers who use antibiotics responsibly, as well as for spreading the word at national conferences about the increase in antibiotic resistance.

While Linaman may be at the end of the food chain, serving up meals, other members of the Supermoms group are working right at ground level. One of them, Ellen Walsh-Rosmann from Harlan, Iowa, runs a farm with her husband, Daniel, and his parents that produces certified organic beef, pork, and eggs. They work 700 acres of certified organic corn, soybeans, small grains, popcorn, alfalfa, and pastureland. She also has two more jobs in the food chain, distributing food from 40 local producers to schools, grocery stores, and restaurants; and operating a food-to-table restaurant in Harlan, called Milk & Honey.

Like Macario and Linaman, Walsh-Rosmann has had personal encounters with antibiotic resistance. She watched her sister-in-law, who was battling cancer, contract hospital-acquired infections that antibiotics couldn’t fight, complicating her condition. Walsh-Rosmann herself developed kidney problems when she was pregnant with her younger child. When her daughter was 5 weeks old, Walsh-Rosmann developed sepsis and went through several antibiotics before doctors found one that would work.

“What if there wasn’t an antibiotic? I had a baby and a toddler,” she says, echoing the fear any parent has of leaving a young child behind.

Trust Magazine Fall 2017

Shannon Ross, a pediatric infectious disease specialist, believes education is key to fighting superbugs. “Patients and parents can be an important part of the antimicrobial stewardship team,” she says. “When patients are seeing physicians, it’s always prudent to ask, ‘Do I absolutely need this antibiotic?’” Patients should never assume that a cold or a sniffle always warrants an antibiotic, she says. (© Rob Culpepper for The Pew Charitable Trusts)

The welfare of children also motivates Shannon Ross, a pediatric infectious diseases specialist at the University of Alabama, Birmingham. “My worst fear as a doctor is not being able to treat a patient,” says Ross, “and then having to tell the family that there are no options.”

Ross signed on as a Supermom “to have an impact, on a broader scale, on the whole antimicrobial-resistance crisis,” she says. “As a pediatrician, it’s also important to educate from the children’s perspective because it is such a different population of patients.” Young children simply have fewer antibiotic options than adults because not as many are approved for use in kids.

And, like most of the Supermoms, Ross has a personal motivation. “My daughter is allergic to some classes of antibiotics,” Ross says, “so if she were to get a serious infection, she may not already be able to get all the antibiotics available. And if it’s a resistant organism, there are even fewer options. If my kids were to become sick, I would want to make sure that they have choices.

She says many parents are shocked when they find out that not all infections can be treated by antibiotics. But it is a sad lesson that some families have learned.

Trust Magazine Fall 2017

Nevada residents Joyce and Chris Romm visit the nation’s capital to draw greater attention to the plight of antibiotic-resistant bacteria. Seven years ago, they lost their son, Carl, a 27-year-old Army veteran, to antibiotic-resistant infections that could not be treated. “I didn’t realize until Carl became ill how devastating and overwhelming the problem really is, and how it’s getting worse by the day,” says Chris. “It’s a threat to our national security and to the well-being of humanity. (© Evelyn Hockstein for The Pew Charitable Trusts)

A few months after 27-year-old Carl Romm came home to Sparks, Nevada, after an honorable discharge from the Army, he was diagnosed with a strain of Staphylococcus aureus, a bloodstream infection that was resistant to vancomycin, an antibiotic usually given as treatment. After numerous hospital trips and surgeries, he developed further antibiotic-resistant infections and died of cardiac arrest, a consequence of heart inflammation caused by the infections.

“Naively, I thought whatever he gets, they have something for him,” says his mother, Joyce. “I thought they had a cure for everything.”

Says his father, Chris, “I didn’t realize until Carl become ill how devastating and overwhelming the problem [of antibiotic resistance] really is and how it’s getting worse by the day.” The couple also has good friends who lost their 24-year-old daughter to a drug-resistant infection—the same day she entered the hospital.

The Romms work to keep their son’s memory alive by making sure others know that there are simply not enough types of antibiotics to combat today’s bacteria. “Every medical professional that we speak with tells us that they firmly believe that Mother Nature, in the form of bacteria … is coming at us like a freight train, and we are ill-prepared,” says Chris. “We’re here for Carl, and for others like him, hoping that they won’t have to go through this.”