Cleanliness is Next to Dangerous, Says Dr

by Jim Sliwa

"Dousing everything we touch with antibacterial soaps and taking antibiotic medications at the first sign of a cold can upset the natural balance of microorganisms in and around us, leaving behind only the 'superbugs,'" says Dr. Stuart Levy, a Tufts University School of Medicine physician and microbiologist. "By encouraging this 'unnatural selection' of bacteria that have grown immune to most if not all of today's antibiotics, we unwittingly endanger global health."

Overuse and misuse of bacteria killers leave an open field for opportunistic bacteria that would normally be kept in check by other germs. These antibiotic-resistant bacteria have developed cunning ways to foil even the strongest medications in some cases, says Levy.

He recommends a return to older cleansers that leave no residues, such as alcohol, chlorine bleach and hydrogen peroxide, as well as time-tested soap and hot water. Strong antibacterial cleansers make sense only when someone in the household is seriously ill or has low immunity, he added. Then, caregivers should wash their hands for at least a minute and leave antibacterial cleansers on kitchen surfaces for minutes, not seconds.

Not only is exposure to bacteria generally harmless, it is essential for the normal development of a baby's immune system. According to a recent Italian study, a baby during its first year must be exposed to germs in order to develop antibodies necessary to fight dangerous infections later in life. If the baby's environment is too clean, the production of T-helper 1 cells is not adequately stimulated and the immune system overproduces T-helper 2 cells, which in turn make antibodies to fight allergens. That imbalance of T-helper cells could result in lifelong allergies or asthma.

"Just as a child needs lots of exercise to develop strong bones and muscles, a child's immune system needs a rigorous workout to develop normal resistance to infections throughout life," says Levy, who also directs the Tuft's Center for Adaptation Genetics and Drug Resistance. The center focuses on finding solutions to the problem of antibiotic resistance.

Infectious diseases are the leading cause of death worldwide, and the third leading cause of death in the United States, following heart disease and strokes. Because many bacteria have learned to evade some or all of the 100 or so antibiotics developed in the last 60 years to fight them, deaths from infectious diseases like tuberculosis are once again on the rise. So concerned are leaders of the World Health Organization, American College of Physicians, the American Medical Association and the U.S. Centers for Disease Control and Prevention that they recently named antibiotic resistance as one of the top public health concerns of this decade.

"In the United States, we now have at least five organisms with strains that are resistant to all antibiotics that are available, including the drug vancomycin, which has been considered to be the last line of defense against drug-resistant infections," he says. "New antibiotic development lags several years behind the need, so there is no magic bullet around the corner. If we are to avert a crisis, people need to stop and think twice before using fortified cleansers and pressuring their doctors to give them antibiotics for every infection."

A truce with harmless bacteria is a good first step toward a solution. "Bacteria are a natural and needed part of life," says Levy. "Most live blamelessly. In fact, they often protect us from disease because they compete with and thus limit the proliferation of pathogenic bacteria. The benign competitors can be important allies in the fight against antibiotic-resistant pathogens."