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The World Health Organisation has warned the world is facing a time when antibiotics will be useless against mutated diseases.

ANDREA NIERHOFF (near-hoff) spoke with former pharmacy student SARAH NAGORCKA (nah-gor-kah) about her play “Love in the time of MRSA”, and what it predicts.


(sound of people talking, heart monitor beeping)
ANDREA NIERHOFF: It’s a cool Melbourne evening in Fitzroy and I’m in hospital.  Well it’s not a real hospital, but the set for SARAH NAGORCKA’S Fringe Festival play “Love in the time of MRSA”. The play follows young nurse Amy as her ex-boyfriend Jack gets sick and she has to play the dual roles of caretaker and moral role model.

GRAB FROM PLAY: “Amy it’s where the drip was, it really hurts”
“It is pretty red, have you finished your antibiotics yet?”
“Some…should I take another one?”

ANDREA NIERHOFF: MRSA-or methicillin-resistant staphylococcus aureus-is a strain of bacteria that can’t be treated with regular antibiotics. SARAH NAGORCKA says the play was inspired by her previous career as a hospital pharmacist, and she thinks it’s a preview of a dangerous future.

SARAH NAGORCKA: Part of my role was I had to do an antibiotic audit, so go ‘round in one day snapshot what was going on in all of the wards across the hospital with antibiotics, so that’s anything as small as a Doxycycline pill, to your heavy duty restricted things and just realising there was a lot of undocumented reasons for using them and just confusion. We’ve essentially built modern medicine including cancer therapy, including transplants all relies on having antibiotics, so it’s not as simple as people will just be like ‘oh I just have a chest infection I’ll just have an infection longer’

ANDREA NIERHOFF: Alfred Health’s Associate Professor of infectious diseases and microbiology, ANTON PELEG, says the most worrying feature of the bacteria is that it’s no longer confined to hospitals, but can be found in the wider community. And as in the play, confusion surrounds the bacteria’s origins.

ANTON PELEG: We worry about antibiotic use a whole in the population, and that might be in humans but that also may be in animals. Antibiotic use in agriculture is a big issue that changes the resistance profile of bacteria found in animals and we eat animals so it gets into our gut. And I think a bit of an unknown also relates to human travel. Humans are amazing vectors of antibiotic resistance so if we travel to an area that has high rates of resistance and then we come back to Australia we will remain colonized with those bacteria for a certain period of time. In that period of time we may transmit it to other people, we may develop an infection ourselves.

GRAB FROM PLAY: What’s wrong with you?
Well I have the exact same thing that you have, only in my arm.
Is that right?
Mm-hm, got it three weeks ago in hospital, came out, boom-right back in

ANDREA NIERHOFF: Fortunately for Jack, he recovers from his brush with MRSA, although not all patients are so lucky. SARAH says she didn’t want to make the play all doom and gloom.

SARAH NAGORCKA: A lot of infectious disease gets done really apocalyptically in the arts, like think about Contagion but I really wanted to focus on the everyday interactions, so not very ‘everybody dies’ kind of thing but just everyday ethical dilemmas. I’m trying to show I suppose that death is not necessarily the worst outcome and it’s never as simple as ‘MRSA has caused this many deaths and this many infections and this is where it came from’

ANDREA NIERHOFF: PROFESSOR PELEG says while there is currently no nationwide monitoring of cases of antibiotic resistance in Australia, the situation here is not critical—not yet.

ANTON PELEG: I think there needs to be new government policies to try and increase the incentive for drug companies to stay in antimicrobial drug development. We need some major infrastructure and structural change in our government policies on antibiotic use in agriculture, we need initiatives on education in general practitioners in terms of appropriate use of antibiotics, and also education in the community about when an antibiotic is required and when it’s not required.

SARAH NAGORCKA: At some point we’ve got to take some personal responsibility. We’ve kind of created this culture where ‘if I get ill the doctor will fix it’ so there’ll be something, some quick fix, some pill. That was why I really wanted to just create this play quickly, even if I don’t affect a massive amount of people, it just keeps the conversation going. Something needs to be started now.
(sound of heart monitor flatlining)


(image courtesy Andrea Nierhoff)

A pill to cure all ills

What should replace the UN's Millennium Development Goals when they expire in 2015?  

Andrea Nierhoff spoke with:
Annmarie O'Keefe: the Lowy Institute
Lynne Benson: Save the Children
Jack de Groot: Caritas
Dr Richard Denniss: the Australia Institute

