Cuyahoga Moment - and the End of Antibiotics

Cleveland, even now I can remember

'Cause the Cuyahoga River

Goes smokin' through my dreams

-Randy Newman, "Burn On"

Dan's ICAAC-"Destroyer of Bundles" post last week was surprising for several reasons: (1) because my talk was an overview of which components of the bundles were most effective and never suggested bundles didn't work, i.e. we don't know exactly which components contribute most to the success of bundles and (2) because he mentioned ye olde burning river, the Cuyahoga.

We actually owe a lot to the Cuyahoga River. The Cuyahoga caught fire numerous times dating back to 1868, but it was the 1969 fire that caught the public imagination through a Time Magazine article that described the river as one that oozes rather than flows.  It was this 1969 fire and the attention associated with it that led to the creation of the EPA and the Clean Water Act. In fact, Paul Krugman, recently suggested that the Cuyahoga fire was the start of Environmentalism in this country. Because of the fire, the Cuyahoga and Lake Erie and numerous other bodies of water in the US have sprung back to life.  Thank you Cuyahoga and thank you Cleveland.

So, why am I writing about the Cuyahoga in an HAI blog?  Because I've been waiting for years for our "Cuyahoga Moment" that will start the process of the US taking antibiotic resistant organisms and antibiotic drug discovery seriously. Perhaps, someday we might even see an agency created that would be charged with guiding the creation and stewardship of antibiotics. How 'bout the Agency for Antibiotic Protection? I first thought perhaps VRE or MRSA, then VRSA would have gotten serious attention and I even thought the recent run of KPC and NDM-1 would have done the trick.  No such luck.  We are still left with an underfunded CDC that can barely afford to do simple quasi-experimental studies, a pharmaceutical industry that has closed down most antibiotic discovery efforts and an NIH that focuses almost entirely on non-bacterial pathogens.  I probably shouldn't even mention non-human use of antimicrobials.  Sadly, I suspect it will take a shuttering of a transplant program or a whole hospital or something far far worse to alert the public and the Government.  What do you think it will take?

Burn on, big river, burn on...