Are We Entering the Antibiotic Apocalypse?

Sir Alexander Fleming revolutionised the medical world when he discovered antibiotics. He ensured that, for the last 70 years at least, diseases such as tuberculosis and smallpox are now treatable and no longer pose the threat to society that they once did. Invasive surgeries can now be carried out with a massively-diminished risk of post-operative infection. Antibiotics are also an essential part of post-chemotherapy recuperation as this process has a debilitating affect on the body’s natural defences. One of the great scientific ‘accidents,’  Fleming noticed one day that mould growing on some of his petri dishes formed a ring free of bacteria. This mould was used to synthesize penicillin, which would go on to save millions of lives and won him the Nobel Prize in 1945. However, this revolutionary discovery came with one implicit and ominous caveat – that given certain circumstances microbes can develop a resistance to antibiotics.

As we fast forward to the present day, the spectre of drug-resistant microbes looms increasingly heavily over the medical world. Methicillin-resistant Staphylococcus aureus, or MRSA as it is more commonly known, has been one of more malignant buzzwords to emerge in medical discourse of recent times. This ‘superbug’ as it is known, is resistant to many forms of antibiotics and in many cases causes death from complications such as blood poisoning – in fact, it now kills more Americans per year that HIV or AIDS.

So why are these microbes developing resistance to drugs? Well, bacteria reproduces on a scale that makes animal reproduction look lethargic and with this rapid turnover of microbes, comes a rapid turnover of genetic mutations. Often these mutations result in genes which are resistant to antibiotics and these genes can also be shared across different species of bacteria.  One of the recently discovered genes of this kind is NDM-1, which gives resistance to carbapenems – one of the most powerful groups of antibiotics – and has been found in E. coli and Klebsiella. New Dehli Metallo-beta-lactamase-1 (NDM-1) is thought to have emerged in India where poor sanitation and antibiotic use have helped resistance spread. The main way to combat resistance has always been to introduce new drugs, but there hasn’t been a new antibiotic discovered in two decades.

Us humans aren’t doing ourselves any favours, either – if anything we are playing right into the hands of our unwanted microbial guests. International travel takes these bugs across borders making it increasingly difficult to isolate and quarantine the bug. The first discovery of NDM-1 on British soil was in 2011 and in February of last year a six month-old infant was identified here on Irish soil with a NDM-1-producing strain of Klebsiella.

The introduction of antibiotics to livestock as growth promoters also poses a potential worldwide health risk that would make the ‘horsemeat’ scandal seem tame in comparison. A recent study of pig farms in china – the world’s biggest consumer of antibiotics and a place where the administration of antibiotics to livestock is completely unregulated and unchecked – has shown that 149 unique antibiotic-resistant genes (ARGs) existed in the pigs they tested. This is three times more than in the control group who were never fed antibiotics. According to the study: “Microbes from manure, compost, or soil containing the ARGs are subject to dispersal via runoff into rivers, leaching to subsurface waters, air dispersal via dust, human travel, and distribution of agricultural products, including compost for gardening, which could expand a local contamination to regional and even global scales.” These results drove the European Union to ban antibiotics as growth promoters, and more recently the US has begun to ban more and more classes of antibiotics and Australia have done the same.

There is also the question of over use of antibiotics by ourselves. Patients are frequently prescribed antibiotics in response to the common cold which as a virus is unaffected by antibiotics. Prof Laura Piddock, from Birmingham University and the group Antibiotic Action, said: “These are valuable drugs and we need to use them carefully.” There have been suggestions that antibiotics should be more expensive as some kind of deterrent, but all this does is dance around the fact that this is a cultural issue that can be addressed by educating the populace as to what constitutes antibiotic use and what is misuse.

About the author: Conor Hughes works as a Marketing Executive at Life Science Recruitment

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