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Mumbles of a Medic: Antibiotic Resistance – Sleep Tight, Don’t Let the Superbugs Bite

Vibrio Vulnificus Bacterium

Column by aspiring Medic. student, Sahaj Kaur

As seen in Pegasus Pages, March 2013.

Without meaning to sound like a hypochondriac, I must say that I do agree with the Chief Medical Officer, Sally Davies, when she warns that the problem of antibiotic resistance is more grave and more dangerous than we would all like to admit. She calls it a ‘ticking time bomb’ and says it should be placed on the National Risk Register as high as threats such as Climate Change and terrorism. Even though the words ‘antibiotic resistance’ don’t elicit the same chill and cold fear that natural disasters or atomic bombs do, it must still be feared. It is a secret killer, only just emerging from its cocoon. An example of the ‘superbugs’ that antibiotic resistance has yielded is MRSA which kills almost 19000 people every year; this mortality count is much higher than other conditions such as HIV/AIDS. Scared yet? If not, keep reading and I promise this is the stuff nightmares are made of.

Antibiotics have been the holy grail of medicine ever since Sir Alexander Fleming discovered them in 1928 but it seems that we have now done a full circle, revisiting the same problems of the pre-antibiotic era. Some experts say that unless something is done about this, and fast, we could be plunged back into the health conditions of the 19th Century and seeing the return of some of the most serious killers of that time, such as tuberculosis and sepsis. This could potentially mean that a routine operation, anything that involves rupturing the skin and exposing it to the external environment, could turn deadly, pushing other advancements like transplants even further backhand. We’d truly be back to square one with untreatable illnesses. Ironically, this double-edged sword, the tragic, counter-productive loop of our victory over nature slowly turning against us to provide yet another problem, is mirrored elsewhere in our medical history; some examples include the joy of discovering that chemotherapy and radiotherapy can cure or alleviate the pain of patients, only to find out that not only can this have devastating side effects, but it can also actually cause cancer again.

Antibiotic resistance happens because of chance mutations in bacteria which is a process that, in isolation, is slow enough to not be a cause for alarm; however, our over-use of these remedies has resulted in the problem that we have today. Bacteria can become resistant to a certain antibiotic in two ways: a chance mutation or by taking up DNA from an antibiotic-resistant bacterium. They are continuously breaking up DNA, however, do not actively look for DNA to take up, but this response is increased when the bacterium is subjected to a high level of stress. So our widespread use of antibiotics has meant that not only is there a selection pressure that causes resistant bacteria to be more likely to survive but also that the bacteria actively take up more DNA when exposed to stress, i.e. an antibiotic.

This is the quintessential example of how the human race takes something good and abuses it until we land ourselves in a bigger mess than we started with, a similar comparison being our role in global warming.

‘Antibiotics have been around for a long time and our use of them hasn’t changed much so why is it a problem now?’, you might wonder. The reason behind this is more political than scientific. The discovery of penicillin sent pharmaceutical companies in a rush to farm this gold mine, so new drugs were continually being produced, masking any detrimental effects of inefficacy of old ones. This was until about 20 years ago but ever since then there has been a ‘discovery void’ and no new antibiotics have been developed.

This is in part due to a lack of funding. Pharmaceutical companies are more than happy to research drugs such as analgesics (painkillers) and those for lowering blood pressure as these have a regular use thus generate a higher income, whereas antibiotics are only used periodically. This means that, as Sally Davies has done, political awareness of this issue must be raised to generate funding for new and inventive solutions such as viral therapy. Instead of the top-down approach we were using before of randomly finding drugs that killed certain bacteria, a bottom-up approach is needed to tackle this problem; the exact mechanism of resistance must be studied to find ways to block it.

But for the moment, the only action being taken is the ever-so-effective rationing of antibiotics. So, on that note, sleep tight, don’t let the superbugs bite.

Image: Vibrio vulnificus bacterium – bacterium from the same family which causes cholera.

By Microbe World on Flickr (CC BY-NC-SA 2.0).

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