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martes, 17 de mayo de 2016

A day in the life of Staphylococcus aureus and other stories: winning essays from Nepal



22 Apr 2016
Authors: Pranjal Rokaya, Asheem Mahat

As a part of Nepal’s World Antibiotic Awareness Week, medical students got creative, putting their wits to the test in two school-wide essay competitions.

“When we were assigned the theme of ‘a world without antibiotics’ for the essay competition, the first thing I thought was that a world without antibiotics would be sad and gloomy,” Pranjal Rokaya, fourth year medical student at the Patan Academy of Health Sciences, told CDDEP analyst Molly Miller-Petrie. “But I didn’t want to write a sad story—I wanted to write something happy and satirical, while still getting a strong message across. So I decided to be a happy Staphylococcus bacteria who is overjoyed by the results of irresponsible antibiotic use.” The diary of his happy Staph took home the first place award at Patan.

Third year medical student Asheem Mahat was awarded first place at the B.P. Koirala institute of Health Sciences. “I first heard about antibiotic resistance in college,” he told Ms. Miller-Petrie. “It’s a growing problem in our country. I’ve seen a lot of multidrug resistant tuberculosis cases in my hospital that the government has to isolate in order to stop transmission. Anyone can buy antibiotics in Nepal, and few people know about the problem outside the medical community.”

In their interviews, both students stressed the need to educate the public and raise awareness about the issue. Their captivating tales are likely to do just that – in Nepal and beyond.

A Staph’s Diary
By Pranjal Rokaya
First place, Patan Academy of Health Sciences

Good morning, my name is S. aureus. Full name: Staphylococcus aureus. I am a bacterium that is currently living on your skin, in your nose, in your genitalia, in your mouth and even in the heart of some of you. You might hate me and call me ugly names like “germ” and “bug,” but remember that I still love you. You provide me with food, shelter, a place to regenerate myself, and even a place to excrete my waste products. I would not be in this world if you were not here. I love you, human beings.

There are 7 billion humans and you see them everywhere. For every human being, there are billions of us bacteria. But you can't see us - at least not with your naked eye. You humans are very arrogant. You think you control this world with your science and technology. But do you really think you're the master? You have only been in this world for about 5,000 years. That's just a blip in the radar of the timeline of the universe. But we have survived harsh ice ages and volcanic meteors. We saw the dinosaurs’ rise and fall. We saw oceans fade and mountains rise. You know who will survive if there is a nuclear holocaust? That's right, us. Don’t hate us just because you ain’t us.

We are not bad beings. Mostly we like to live peacefully in your body. We just take some nutrients from your body to survive. We have a family or colony to feed just like you do. Sometimes you can't produce enough of those bad guys called immune cells. In such cases, we like to migrate deeper into your body because there is more food available inside than in your skin or nose. After we finish our feeding frenzy, we secrete waste into your body, which sadly makes you very hot. When you get a fever, it's difficult for us to survive because we have limited tolerance for high temperatures. You even try to throw us out of your body with repeated coughing, urination and diarrhea. But usually we win and enjoy your body until you die. Everything was going fine, until this poison, this crazy evil thing called antibiotics, came along.

Ah! Let's talk about antibiotics. One day, my friend had a wonderful opportunity to go into the blood of a soldier who had a gunshot wound. She was enjoying all the proteins (yummy) when suddenly this penicillin came and started destroying her cell wall. Needless to say, she did not survive as we only have one cell. As if penicillin wasn't enough, you humans started producing more villains like cephalosporins, aminoglycosides and fluoroquinolones. For more than 50 years, we suffered serious calamities at the hands of antibiotics. Initially, they would just destroy our cell wall. Later, they started tearing our DNA apart, destroying our protein and shredding our nucleus. You almost defeated us. But then you humans grew more arrogant and less thoughtful.

In your vicious killing spree, you forgot that we can fight back. You started using antibiotics even when we were not really harming you. You forgot that you have your own immune cells to fight us and started bombarding us with same medicine again and again. When tiny viruses tickled your nose and made you sneeze, you used penicillin to fight them. Haha! Are you kidding me? Those tiny viruses don't even have a cell wall. Because of your injudicious use, we found out how your drugs work. We started producing B-lactamase. We developed mechanisms to throw your drugs out of our cells. We even found ways to inactivate those poisons. Slowly, we are becoming resistant and we love it.
Today, most of your antibiotics still work. But we are slowly catching up. There will be a day when none of your poisons will harm us. None will destroy our colonies. Imagine a world without antibiotics. That will be the day we will cry in joy, "Free at last!”