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While admiring pleasant scenery one can have particularly inspiring, yet random thoughts. Such was the case of Dr. Giuseppe Brotzu (1895-1976), director of the Instituto d’Igiene de Cagliari, Sardinia, Italy. On a sunny day he was looking out the window of the institution at the nearby beach. It was after World War II and everyone was trying to come back to a pre-war state of relaxation. However, it was not the abundance of people that were enjoying life on the beach triggered his inquiries, but the fact that a sewage pipe was dumping its load very close to the place where they were bathing yet he didn’t know of any epidemics that had gravely affected the locals. Judging by the quantity and variety of possible bacteria contacted, it was a mystery for Brotzu, which had a great interest in the matter, how their bodies somehow had managed to fight off different diseases. Or was it something else that kept them from harm? Taking matters into his own hands, Brotzu went to the beach and collected a bucket of the sewage enigma.

 

“It was after World War II and everyone was trying to come back to a pre-war state of relaxation. However, it was not the abundance of people that were enjoying life on the beach triggered his inquiries, but the fact that a sewage pipe was dumping its load very close to the place where they were bathing yet he didn’t know of any epidemics that had gravely affected the locals.”

 

Brotzu was an expert on tuberculosis, brucellosis and typhoid fever, so he knew his way around pathogenic bacteria and had an idea on how to go about examining the sewage drainage. He dispersed it on a few lab plates and incubated it. The result was a mold which he moved to another plate and divided in six points that formed a circle. At the center of it, the doctor added streaks of typhoid bacillus and sent it to incubation. After this process he saw that only one strand of the bacillus had extended and that one was at a point where the mold wasn’t close to it. For the rest, the mold had killed them off.

 

After seeing the effectiveness of the experiment, Brotzu isolated a strain of the Cephalosporium acremonium fungus, which he had obtained from the sewage discharge that produced a type of substance similar to an antibiotic, which he named cephalosporin. He skipped the animal trials and went directly to his patients with this discovery. Staphylococcal and streptococcal abscesses (pus build-ups in the tissue of the body) that were injected with cephalosporin regressed almost immediately, but the effect wasn’t what he had expected when it came to typhoid fever patients. They manifested aggressive allergic reactions and very high fevers until some improvement could be seen.

 

Brotzu did not lose faith in his finding and reasoned that these reactions were provoked by possible impurities that existed in the substance. To perfect cephalosporin, he turned to the drug companies, but was confronted with their lack of interest as they were still recovering from the war and were unwilling to take on a project that wasn’t surely successful. Still, he published a paper on the beneficial substance in Italian (La Ricerche su di Nuovo Antibtiotico), in the institute’s journal. In an attempt to encourage further research, he ended the article with: “other, better equipped institutes may be able to make greater progress in the selection of the fungus and in the extraction of the antibiotic.”*

 

Giuseppe Brotzu made a final effort for his work. He sent a copy of the paper to a friend and fellow scientist in Britain, Blyth Brook, which was a public health officer and had some connections to the Secretary of the Medical Research Council in London. After some time, the Cagliari mold ended up at Oxford for research, but waited around in the laboratory for almost three years until it got proper attention.

 

In the end, the mold got lucky because of the intervention of Sir Howard Florey, a scientist that was known for his perseverance and outstanding results. He urged the Oxford team to deal with the cephalosporin until they obtained the expected results, as he had a hunch that the foreign mold would have the answer to a series of problems that the medical world was encountering (such as bacteria becoming resistant to certain antibiotics and not having a specialized treatment for various infections). As it turned out, his presumption was correct: cephalosporin became a remedy against gram-positive staphylococci and streptococci, gram negative rods such as E.coli, and resistant micro-organisms.  

 

R.F.I. Sources: * Winters, Robert. Accidental Medical Discoveries: Tales of Tenacity, Sagacity, and Plain Dumb Luck, Denmark, 2013, pp. 94 Cephalosporins generations: http://www.drugs.com/drug-class/cephalosporins.html

1 comments on Cephalosporins: draining an antibiotic from the sewers
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    Christina Umbridge August 17th, 2016 at 7:28 pm
    Good thing he had such a keen sense of observation. What a way to put a rather disgusting situation to good use.
    Reply