keep the registering and keep the slot machines doing. this is a money machine is a huge cash register that is ran by people who don't care about people's lives being lost. so welcome to sophie co visionaries. me sophie shepherd. nonsense. we're hardly been done with a cold 19 condemning, but scientists are warning that's something far worse is around the corner. to talk about this, i'm joined by professor peters calling. you know, it's actually vision and clinical microbiologist and a world harris organization expert on antibiotic resistance. professor peter calling you an infectious diseases physician and clinical microbiologist experts to the world health organization on antibiotic resistance. great to have

you on our show today. welcome. i do miami right. so tell us what is in brief happening with antibiotics? are they not working anymore? 7 why will anybody still working but less so than before? because it's super bugs and anybody resistance and what that means is if we have a really important infection and retreated more and more the antibiotics that work . so we have increasing death and increasing what we call morbidity or suffering. so people are in hospital for longer and have more complications. so supervise, and the spread of those, anybody resistant bacteria, and the genetic material that's responsible for that resistance is a real problem. because it means more and more copy treated properly and there's more and more debts and suffering as a result. so if i understand correctly at some point, if we don't do anything or more correctly, if we don't come up with anything,

health care, we'll be kind of thrown back to decades and we'll have what, like typhus. what exactly are we staring at here? well, if you look at the time before we had and you bought the not a twenty's for instance. if you look at data from numerous countries, if you had a serious infection in your blood, like the pneumonia, there was about a 70 or 80 percent mortality within 30 days. so high did rights. but anybody came along with penicillin, for instance. and that is right with down to about 10 percent saying with golden stack, very common in fiction, in people's blood, without antibiotics id, per se, mortality with anybody, much, much lower, b, 15 percent. and e call i a very common june. that's a common cause to be rechecked infections and bloodstream infections. again, if you're going antibodies, the mortality, most 90 percent of people survive. but if you don't have anybody, then a lot of people died. and a lot of people, even if i get better

a 6 weeks or months rather, they get very quickly. and so anybody resistance is a real problem because we can go back to what they call the pre everybody here. we effectively become post antibody and it's, you know, a lot of countries, particularly countries like india, china developing countries or low income countries that have particularly poor water supply, the resistance level. there are astronomical, you know, the common bacteria like a call i for practical purposes. i'm treatable now if you just have your tract infection, you probably get better most of the time by yourself. but if you've got a serious infection, a bone infection, a bloodstream infection, then you have a lot of dis where otherwise treatable or preventable when we had anybody that worked. i'm to buy out of efficiency is declining because of antibiotic over use. why? this isn't a problem. so it's

a problem because antibiotics are such wonderful drugs. i'm an infectious diseases physician. i treat people who are very sick. and one of the joys of my mission is you have people seriously ill. you give them a drug called an antibiotic and they get better very quickly, you know, often, you know, 5 days, 7 days. that's very different to a lot of other things in medicine where you have to stay on grad. so everybody said terrific drugs. the trouble is they're so good and they now so inexpensive, we only use them. people have for instance, a throat infection due to of ours. and we often give the man the body or a bit of a call, where the body is starting to get a different. so there's a huge be used that anybody can people but also in agriculture is you know, to chickens, for instance, to make them grow faster. and all of that combined to mean there's a lot more resistance or super bugs traveling between people to people traveling from, you know, animals to people, buy food and water. so we get rising rising levels that anybody resistance getting

worse and worse. and a lot of that is to do with the use of anti virus, particularly, and people in hospitals, in the community, but also in the agricultural sector. and then what's very important is how that spread from person to person or from one of people or from animals to water and then to people is spread of resistant bacteria, is making a much worse and the worst your resources in a country such as a whole water supply, sanitation, the worst the spread is. so the more soup about you have. so how exactly are. 7 on to buy arctic resistant bug spreading, i mean has this process accelerated? what are the observations of the past years? well, i think it is accelerating. now, if different germs spread different way, for instance, the pneumonia judah, and what we call new caucus is mighty spread from person to person, by being close to them. coughing sneezing, because one person sits in there. i'm lucky enough to develop pneumonia with it. i

get very sick, the same for the golden staff of secretaries, jim. it's the people who caused the skin to skin contact or touching benches off and that spread that way. but other job such as a call i, which is a common inspect, you recall in your ear infections in women, but also is a communist clothing, bloodstream infection. what we call the senior that's fred by numerous otherwise it can be directly posted. but more often is what we call fecal material. you know, your bases when you go to the toilet, that can be directly spread to people, but also through water, contaminated water. people then take the water and they come into their mouth, the germs, it's in their bow and most of the time it may not matter if i get a defective gallbladder or a unit check the patient and it can matter. and also if certain supervisors develop include animals, then when you process the animal it gets onto the neat. and then if you ingest the

role or the cross contaminate letters or tomatoes in your kitchen, then you get it in your mouth and it's super boxed inside there. and with the reason we know that's a problem and you get a lot through the mouth, is we did a study in australia where we looked at a home on a medical students and nurses before they went on a holiday to asia and numerous other places. they carried very little supervisor, but when i came back off of them carrying a call, i was just a supervisor that i just want to interacting with people say water for instance, going to have bugs in it, including golden staff, on occasion, fresh board. i can have numerous bugs, and you can see in some situations, for instance, in asia with culture, you have fish in ponds where they actually put in animal and human species, sometimes also antibiotics. and then when those fish had taken out, they coated with a supervisor. they can then spread not any in the local environment can spread

globally. you know, you can have super bugs you, you know, picked up in china, the philippines that are imported into other countries and spread. and we look at what happened in england and around the world, including a strike many years ago. there was a particular journal called that all resistance called the new daily the tell i be like, and i was named because it was 1st found in india. but that was resistant to most antibiotics with dot and people from india we traveled, they wrote effect england. and because then cross infection or infection in hospitals in england, but the same germ kind. it was great. we had a case of somebody who's gone to india plastic surgery, earliest requesting surgery, rome and i ended up in any chance a k unit came back to a stray and i needed to go to the hospital and they had a germ on them that i picked up in india, presumably in the hospital, but can be in the environment that was resistant to every antibiotic we had in the year. and so these germs do get onto aeroplanes, 7 or sevens,

and travel all around the world with people who then can spread it in a new environment where i live or where the home it's. and the way i see this is a multi layer problem, because i thought on to by our ex were needed by humans to treat infections. but now we're talking about antibiotic over using farming. great. can the food industry lay off using guns, biopics where they're animals and you know, still be able to sustain the level of wood production that we need? so my belief is i term there, you know, i've been involved in this for 20 or 30 years and the argument is, although we can't grow chickens without antibiotics. well, that's not true. antibiotics do. my animals grow a little bit faster, but my knees groaning relatively full conditions. if you grow them in good condition, good, having good. everybody start like that much difference. it's only when the housing

conditions at all it, it makes a bit of difference. but again, studies in australia, but particularly large studies in europe and in, in the us, the ones are saying they show that when you withdraw antibiotics, you can still produce chickens at the same, right? the same wipes in same period of time, you have to do a bit of modification how you grow them. but you can do it because there's lots of places now that can grow chickens in particular, without 8080 bodies. we using people use that all for the entire period. so while it can be a bit more difficult, it can be done capital for instance, if you put them in, in open past your cattle, which is what we might grow into stria. they don't name, but they actually take longer to get bigger because they are rating ross. if you put him in a lot, you can need anybody because i think and because of that, they get by sometimes you get infections and they live. but instead of growing them 100 days, if you buy them 103 dies, in other words,

grow them slightly slow up. you can do it without any bought it. so yes, that can be a lot more difficult at times, do not use anybody, but you can get the same result if you change your practices and you know, basically look around all welfare a bit better. my own view is you can use a lot of antibiotics to grow animals. there's a problem with animal welfare. the housing conditions are not, as they should be. they died is not as good as they should be. because if you do it properly, you use a lot less antibiotics. and another example is a no way where they were using a particular group or anybody's lines for their semen. but what they did, instead, they produced vaccines. and by giving the vaccines to the semen, they managed to drop the body, use each about 99 percent and got the same results. so you can achieve good food production, healthy food without using antibiotics or using a lot less if you modify your practices and use otherwise. as a professor, we're going to take a short break right now,

and when we're back we'll continue talking to professor peter calling. you on an infectious diseases physician and clinical microbiologist stay with us on oh, i wish i could look. i was off the field was still can you through that actually use the machine which is at the bill. mean,

you could put your budget that, ah, continue to tell you with a dinner each and cookie famous caught up by she was in so long ago humour was the domain of social critique and a means for us to laugh at ourselves. and the comic was a person who had the guts and skill to say what all of us might have been thinking . this is no longer the case, it would seem. now humour is just another political weapon. and you know, it's not very funny. me new gold rushes underway, and gunner thousands of ill equipped workers are flocking to the goldfields, hoping to strike it. rich children are torn

between gold and education. my family was very poor. i thought i was doing my best to get back to school, which still will have the strongest appeal as we were saying, shipping all of our jobs, factories the china was a bad idea. but the american people were ok with it because although their wages were going down, the stuff they were getting from china via wal mart was cheaper than ever. okay, now the chickens have come home the route. now, the china labor sink is finished. inflation is kicking in for real, and wages are going up, but not as fast as inflation the

and we're back with professor peter calling you on an infection physician and clinical microbiologist. an expert to the world has organization on antibiotic resistance. professor, in general, right to humans, use more antibiotics or animal farm animals, many who need to climb down on usage 1st. well, the biggest volume of anybody in the world is using animals about 80 percent by volume of all the antibiotics using the world. i used in chickens peaks and cows now and that's just what was most countries fine. if i actually look at the amount of use, so that way must be anybody use the way most of the class like be then produced, because the type of antibodies they use in animals is very similar to what you do in animals, even though they've got different names and often medical doctors know what i mean

because they, they different that has the same effect in people. a good example is a drug that used to be used as well. they call a growth promote, or in other was just was there an antibody? just my chickens go thought that i have a passion. now that's not used in people, but it's the same type of drug as we are using people frequently all around the world bank. and by using that drug and chickens and pigs, you produce drugs co bug. so they are a bank of moss and richardson and our progress. they come across the people to try and be and they got and cause infection, all the resistance drain could transferred to the ones you know, but, and in human bow. so what happens in one sector can transfer to another state. sometimes it takes a while, but it happens and there's numerous examples, how it's happened. and that's why we need to be judicious without use of anybody everywhere. in people we used to use list hospitals,

we need to use lists using sparingly, better infection control. so we don't spread infection, but exactly the same in the agricultural industry because it's also in their interest. do not use too many bodies because they run out of the bodies thing when they have to treat sick animals. so it's in all our interests to decrease and the body use. and to stop the spread of a super bugs, because we stop the spreading people in the hospital, we use less, sandy bikes have better results. the people exactly the same, it agriculture. so it's good for agriculture and equally then you get less cross over from the agriculture sick often by water to people and vice versa. because we've controlled it better. now i'm thinking right, human ones invented antibiotics. can't, would you do it all over again and invent? i don't know like a super antibiotic that would help us deal with this super bugs. well, we can, but every time we do it bugs, one step ahead or not probably honest and produce resistance. there's no antibiotic

resistance. and the interesting thing about antibiotic penicillin, we didn't in bank we found and it's produced by phone guy. and so they a lot of antibiotics and naturally out there in the environment. things that are similar. so other jims have already learned to. i don't want to be killed by this anybody. so there's natural protection out there in the environment. and what we do when we use the antibiotics, we actually then give an advantage to the germ, the bacteria that already got that resistance. we multiply and high numbers and then it spreads around in people in our country and, and then eventually traveled internationally. so most of the resistance is out there isn't just, you know, suddenly as a new mutation it often is, resistance genes are out there for other purposes. and then in fact is there and multiplied up. so that has an advantage by not being killed by the anybody use it multiplies to really high numbers compared to the one still and then is much more

able to spread through everyone else. phage therapy, there is the thing where we use the virus that it's certain bacteria instead of antibiotic that just killed bacteria and marks. and that sounds like a very refreshing alternative to on to biopics as it's far from being mainstream. well, it is 5 dramatic stream. i think rusher in the ukraine. my understanding is that a lot of research and this in the past and sides there would be pages of viruses and i particularly getting to certain bacteria kill them. and in fact, in australia are no way about 20 years ago. why we, for instance, what we told type of fingerprinted golden staff was to use 5 is that you know what number 87 would kill bacteria? so we would 9 bacteria. so in theory yes, very good. and i think it is a reason to advance it. the only thing about barges just like antibodies, you can develop resistance to it, and it doesn't work against every talk bacteria. it's selective,

which is good. but it also means you can have the same problem with it works for a while and it doesn't work because the bacteria develop resistance to the edge. but parges, i think something we need to develop all because in some ways you can develop more quickly and utilize quickly. but yeah, so far they haven't reached the same level of development. as dr. chemicals have particularly modifications of antibiotics to try and do the resistance, but it's an area where, where i think we need lots of work. and i think there's a lot of experience in russia you're trying to, my understanding where we and you know, other countries should be on the learn a lot from what's been done in the past. so such therapy seems to be more custom tailor to the exact harmful bacteria that i have in my body. can there be and destroy scales wash therapies, like we have with unter biopics? well in theory i think they could be because we know, for instance,

that certain badges feel golden staff or different brides all i and every other bacteria. so yes, i think they can. i understand one of the problems with 5 beat off of which the 1st time, but then it doesn't work the 2nd time in the same posting. you have to have a different 5 for instance. so i think it's got a lot of potential and it is an area that we need to develop because it's a different lanes of killing bacteria. what we're doing now and very selective. one of the advantages of antibiotic i q of about tyria and most of them don't have in our kidneys or liver. and this is saying with botch. the very selective is which bacteria they go into, which means hopville, they'll leave a cell. one cells not damaged by it, but it just not so bacteria which is what we want, something very selective. so basically we need a lot more research and development done. and the more super bucks we have, the more it's important to look at other alternatives. and fives therapy is one of those alternatives. so the new super bugs that we're talking about,

they're resistant, warranted by out. it's what are they exactly? are they new diseases? all diseases upgraded. well, they're all diseases caused by bacteria. we've known about for a long period of time. but now that bacteria don't respond to the drugs. randy barracks, we used to kill them. so the problem is, it's all diseases with all that curious, no longer killed by the drugs. so that's why we've got to come up with the new drugs, new antibody, or fudge therapy, or something else that might kill them, or sometimes antibody therapy is use, but whatever we use, we basically need to do things. the bacteria multiplying up an overwhelming the body and killing the hardest, making the very sick and fudge therapy. anybody. and he bought the anti body therapy. in other words, things produced by watch those appeal bacteria are all different wise. have tried to treat the super bugs, but none of them so far, you know, panacea or a complete answer. but the other important thing we tend to neglect,

we tend to be somewhat overwhelmed. i think in countries i all will come up with a new drug and that'll fix the problem. the vice, the problem is infection control and prevention. we have to stop these bags from spreading because we get more effects and more save more lives by stopping the spread, which is often not very high chicken by c like good water, good sanitizing, watching your hands often that's not done. and we instead think, look, we want to magic still to kill is when we would get much more effect and much more prevention if we just talked about spreading as much in the 1st place. so how contagious and dangerous can an antibiotic resistance bug be? i mean, we have right now we're having a situation with a virus which isn't treated by antibiotics and it is quiet bad, but it's not the end of the world batt. well, none of this is end of the world. i mean, you know, people before antibiotics were found, they would die very frequently,

but not everybody would die. most people who got a new fix, you got cells l n y cells alone. antibodies do a lot to kill them. curious, just the antibiotic cell. so it's really making sure you look at your body, it's when you get burned in your breach your skin that bugs in. if you type, you know, pictures down, people thrive hospital bugs get through a barrier that would normally stop them. so a lot of the basics of infection are not doing things to people that make the most susceptible to infection. if we can do that, there's obviously times where we can't do it. so a lot of the things we have to do, i think the basics. but on top of that, we do need to develop new drugs, new ways of combating the germ itself cove. it is a virus, but you know, it would be nice if we had any virals were very effective against him. but it's the same, even in height, i believe, which is a virus. we have very effective drugs, but you can get resistance to it. fun guy, which a different it back to your call is now more and more lung infection, particularly people with their immune system depressed. and again,

we can get resistance to that. and so another example where we used and you found was widely for farming. and particularly in holland, they found that some of those that those fund guy caused infections in people when they came, you don't respond to the standard drugs. bacteria are more of an issue because they more prevalent and we've got more drugs to kill them. that's why we call them and the body. but the other broader term, anti microtubules are covered. drugs that kill viruses, kill bacteria, or a parent friend is island, or any parasitic drugs, but also anti fungal, done. so there's a why gamble of anti, what we call anti microbial resistance, because every drug we use to kill either a virus, bacteria, fungus, all of them you can get resistance in the 1st place or develop. and then that can spread to other people. and the problem, the dresser, thank you so much for this wonderful insight to the world of antibiotics. you know, i'm thinking scientists are saying we're saying we're like decades that they can

demick is imminent. no one would listen and look at us now. so i really hope that the co condemning will give them a meant him to more action on the global health crisis brought. thanks a lot for this wonderful interview. good luck with everything. good. thank you. i. i will lose again.

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