The fight against bacteria and why we are losing

Pneumonia. Cholera. Tetanus. Gonorrhoea. Syphilis. Salmonella. Sepsis. Chlamydia. Meningitis. Typhoid fever. Tuberculosis. Anthrax. Leprosy.

This is just a very short compilation of bacterial diseases existing in the present-day, the majority of which have fatal consequences if left untreated.

However, all thanks to the miracle of modern medicine we are able to control and prevent the spread of these diseases. We can also treat the infected, reducing their symptoms or even providing cures.

Drugs are prescribed to the patient that kills the bacteria or prevents them from reproducing, whilst having little to no effect on the patient’s own cells.

So what is the issue? Why are we losing this fight against these microscopic single-celled beings? The answer is antibiotic resistance.

Antibiotic resistance is all about evolution. The World Health Organisation defines it as when bacteria change in response to the use of antibiotics. This occurs due to a mutation in the DNA of some bacteria so they become resistant to the drugs. The non-resistant bacteria are killed by the drug, whereas the resistant versions survive and reproduce, passing the resistant genes on to the next generation. Eventually, the whole population becomes resistant to the drug, so it is no longer effective.

This process of natural selection, which occurs in all species worldwide, is accelerated by the rapid reproductive cycle of bacteria, some strains dividing every 20 minutes.

Microorganisms that develop this resistance are referred to as ‘superbugs’ and threaten to cause devastating pandemics, especially in underdeveloped regions where sanitation is poor.

This very real issue is catching up with us at an astronomical rate; a rate that we have been struggling to keep up with since the discovery of penicillin, the first antibiotic, in 1928. This astounding new drug completely reshaped modern medicine: an infection no longer meant a death sentence. However by 1945, just two years after mass production began in 1943, many strains of bacteria had become resistant to penicillin. And so the endless game of cat and mouse began.

Tetracycline, introduced in 1950, was rendered useless by 1959. Methicillin only lasted two years from 1960 to 1962. Gentamicin, first produced in 1967, was effective only until 1979. This process of new drug, resistance continued up until a more recent discovery of ceftaroline in 2010. However, it only took one year for bacteria to develop resistance.

As a result of this ceaseless cycle, pharmaceutical companies are pulling out of developing antibiotics. New drugs that take many years and immense expenses to produce are being rendered useless within just a year. There is simply no money to be made in the industry.

Why is resistance emerging at such a rapid rate?

This is largely due to unnecessary prescription of antibiotics. Many infections, like flu, are caused by viruses and not bacteria, so antibiotics have no effect. Also, it is often the case that the wrong antibiotic is prescribed or a patient does not finish the full course of the antibiotic.

Another major issue is the use of antibiotics in animal agriculture. Factory farm animals are given antibiotics to protect them against illness caused by their confined and overcrowded conditions. In the USA 80% of antibiotics sold are given to farm animals.

As a result of our excessive overuse of antibiotics, we are handing bacteria a detailed instruction manual to overcoming our one and only defence again them.

What impact will this have on our everyday lives?

Firstly a large number of surgeries will become much more risky, for example, eye surgery. These routine procedures could lead to fatal outcomes due to post-operative infections.

In addition, the 8 out of 100 babies born prematurely will be unlikely to survive as without a functioning immune system they are very vulnerable to infection.

Also, life expectancy will plummet as the elderly falling victim to bacterial flu- or worse, pneumonia- will be helpless without antibiotic treatment.

Transplants will become a thing of the past as the immune system needs to be suppressed in order to prevent the body rejecting the new tissue. This will increase the risk of infection to such a degree that bacteria will be likely to kill you faster than the organ in question would take to fail.

Skin infections will lead to amputation. 1 in 100 women will die after childbirth.  Even a small cut could have extreme adverse effects.

 

What can we possibly do to stop or even slow down this catastrophic issue?

The scientific community needs to devote more time and funding into developing new antibiotics. It will be of paramount importance that technology is the main point of call for this research. For instance, technology is being introduced that can predict how bacteria will evolve and hence new drugs can be created prior to that bacteria becoming active.

Antibiotics must only be prescribed when wholly necessary and care must be taken to ensure that the right antibiotic is being used.

However these actions are far beyond an individual’s power to influence. Instead you can follow these simple steps to minimise your role in causing antibiotic resistance:

  • If you are ever prescribed antibiotics ensure you follow through with the full course as detailed by your prescription.
  • Research where your meat is coming from and try not to buy from companies that are known to use vast amounts of antibiotics. From personal research I have found that as a general rule fast food chains tend to use meat from animals that are given a lot of antibiotics, whereas locally sourced meat use less or none.
  • Where possible try to reduce your risk of needing antibiotics. If you cut yourself or sustain a minor injury that results in broken skin, ensure you keep the wound clean and sterile. This will greatly reduce risk of infection.

To conclude I would like to leave you with a telling quote from Alexander Fleming, the man who discovered the first antibiotic in 1928:

“The thoughtless person playing with penicillin treatment is morally responsible for the death of a man who succumbs to infection with a penicillin-resistant organism. I hope this evil can be averted.”

By Sophie Maddock

Related links:

https://www.nhs.uk/NHSEngland/ARC/Pages/AboutARC.aspx

https://www.gov.uk/government/collections/antimicrobial-resistance-amr-information-and-resources

https://www.ted.com/talks/maryn_mckenna_what_do_we_do_when_antibiotics_don_t_work_any_more

 

 

 

 

 

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