Thursday, 22 March 2012

The Resistance

The resistance is growing fast, and I am not referring to the good guys in ‘The Terminator’. We have all taken antibiotics at one time or another, which are vital for fighting against bacterial infections to keep us healthy. However, disease-causing bacteria are now becoming increasingly resistant to antibiotics and the development of new antibiotics is at an all time low, which in combination could lead to a post-antibiotic era, which would be bad news all round.

A NHS appeal as part of the
 European Antibiotic Awareness Day
So why has this resistance come about? Antibiotics have been widely used for the past 60 years, commonly used to treat various ailments and diseases, as well as being used in the meat industry to promote the growth of animals to make us bigger, juicier steaks. Furthermore, more people are taking antibiotics in an effort to feel better when in fact the course is non-essential. People suffering with colds or flu often request antibiotics, which is pointless as antibiotics fight bacterial infections, not viruses. Even worse are those who stop taking antibiotics before the course is over. Taking half a pack exposes the bacteria to the poison in a non-lethal dose, allowing resistance to prosper. In combination, these actions are leading to dangerously 
increased antibiotic resistance.

The implications of this resistance are pretty severe. Antibiotics are vital for the treatment of otherwise life threatening bacterial diseases, and without effective antibiotics currently treatable infections could become lethal. We've all heard of MRSA, which stands for Methicillin-resistant Staphylococcus aureus. Although when said aloud Staphylococcus aureus may sound like a dinosaur, this is in fact one of the most resistant species of bacteria, having overcome every antibiotic developed over the past 50 years. With the emergence of MRSA in hospitals, the scientists brought out the big guns, in the form of Vancomycin. This antibiotic has been known as ‘the drug of last resort’, generally being able to stop any bacteria in its path. However, strains of Vancomycin resistant S. aureus (VRSA) have now been identified. 

So how do bacteria actually become resistant? Well, there are various mechanisms of resistance; some bacteria have evolved pumps to get rid of any incoming antibiotics, others block antibiotics from entering their cell in the first place and others make enzymes which can inactivate the antibiotics. Bacteria can also pass on their genes for resistance, allowing different bacterial species to exchange their resistance to certain antibiotics with others quickly and efficiently. So basically these single-celled little critters are standing up for themselves, and telling their mates how to do the same.

The development of new antibiotics has declined significantly in recent decades because pharmaceutical companies want to maximise profits. Sending scientists to unscathed environments for years, only to discover few and far between compounds, does not bring in the big bucks. Considering the threat of antibiotic inefficiency to humanity, it is hard to understand this lack of research and funding. But of course, Mr Pharmaceutical-Company would rather spend his money on popular drugs which bring in higher revenue. After all, money makes the world go round.

So what of the future? The careless use of antibiotics, as well as negligent infection control has caused this extensive antibiotic resistance on a world wide scale. By identifying novel antibiotics, reducing human consumption, eradicating antibiotic use in the animal industry and increasing hygiene and infection control, the resistance could be significantly reduced and the problem could pretty much be solved. This isn’t impossible; just look at the recent remarkable declines in MRSA infections in England. So it's not all doom and gloom, but be aware. These little buggers are standing up for themselves and it's time for us to man-up.

References
Crossley, K.B., Archer, G., Jefferson, K., Fowler, V. (2010). Staphylococci in Human Disease. John Wiley and Sons.
Dandekar, T., Dandekar, G. (2010). Pharmacogenomic strategies against microbial resistance: from bright to bleak to innovative.
Pharmacogenetics, Vol. 11, No. 9, pp. 1139-1196
French, G.L. (2010). The continuing crisis in antibiotic resistance. The international Journal of Antimicrobial Agents.
Godsland, J., Osmond, R., Pini, P. (2008). Darwin’s Gifts: The Lancet. Elsevier Ltd.




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