Don’t let the superbugs bite

As a child, Sean Norman spent a month in the hospital battling an antibiotic-resistant strain of bacteria that he picked up at his family's Georgia farm. Today, Norman studies these so-called "superbugs" and their impact on public health.

As an environmental microbiologist in the Arnold School of Public Health, he knows that the potential for resistance is high in farm use, or in clinical situations like hospitals, and is especially interested in what happens when a hospital releases waste from patients who are being treated with antibiotics out into the environment, such as into wastewater treatment plants. "I see the environment as a sink that captures material, and it can be a generator for new types of resistance," he says.

Wastewater treatment plants in particular are a perfect incubator for antibiotic-resistant microbes because they provide a lot of oxygen and nutrients to a very active pool of microbes that are simultaneously exposed to low concentrations of antibiotics and antibiotic-resistance genes. Thus, this environment provides the selective pressure for the propagation of previously resistant microbes and the generation of new types of superbugs.

Antibiotic resistance is only a component of how society impacts the evolution of microbes in areas that receive our waste whether it comes from the farm, a hospital or residential areas. "I am looking more broadly at how people influence the evolution of microbes at the level of the genome and if we are making microbes more pathogenic," Norman says. "Waste from society may influence how the microbes are adapting based on exposure to point and non-point source releases into the environment."

Climate change, as well as an influx of material from society into local ecosystems is affecting microbes, and Norman is trying to understand what is happening with those microbes at the ecosystem level. "Once you get out of the lab, it's a situation where all of these components get very complex but that's the reality of science."

Antibiotic resistance is one of the most pressing health concerns both currently and in the future, says Norman. For the longest time, the mindset of doctors prescribing antibiotics has been "What can it hurt?" but now researchers are seeing that overprescribing can hurt, Norman says.

Coming full circle from his childhood illness, Norman believes that educating people, physicians and agricultural practitioners about proper use of antibiotics is a top priority. "Antibiotics are not bad, they are one of the successes of public health," he says, "But at the same time, we are overusing them, which is causing them to become less effective."

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To find out how you can help support valuable public health research like Sean Norman's work on superbugs, visit Carolina's Promise.

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