We are living in a time where antibiotics are used as the ‘cure-all’, but imagine a hospital visit for minor surgery where antibiotics are no longer able to prevent us dying from a routine bacterial infection. This dystopian future has been described as “the return to the era before Alexander Fleming discovered penicillin”.
This is not a fantasy world that was envisaged by Stephen King. It is a world in which bacteria and other organisms have evolved to become ‘superbugs’ resistant to the very medicine that for decades has helped to destroy them. In such a future, where bacterial resistance overtakes antibiotics it will be the vulnerable most at risk; those with inadequate immune systems such as children and the elderly.
To better understand whether we are heading for an antibiotic apocalypse, I talked to Dr Kim Hardie at the Centre for Biomolecular Sciences, who had recently been interviewed for a BBC article on the topic of antibiotic resistance. After acknowledging I was a step down from the Beeb, I sat in her office to talk with her. I asked Dr Hardie how imminent she believed the threat was from antibiotic-resistant bacteria; her response was ‘well it’s happening right now’.
“Not only does the pocket of survivors multiply, but they are likely to be the most resistant bacteria persisting from the initial infection”
We dived into one of the major issues surrounding the misuse of antibiotics. A two-fold problem exists; in many cases patients are not completing the full course of antibiotics prescribed to them and so, failing to kill all of the infectious bacteria. The patient may be feeling healthy as their infection has waned but the sly bacteria that have managed to survive the antibiotic offensive multiply and the infection may return in full force.
Not only does the pocket of survivors multiply, but they are likely to be the most resistant bacteria persisting from the initial infection so that if symptoms do recur the antibiotic previously used may prove to be ineffective.
Another inherent problem surrounding antibiotic resistance is in the way the bacteria are able to swap genetic information with each other, similar to passing along cheat codes. In this way, bacteria that are resistant to an antibiotic may pass their resistance along to much more harmful bacteria that was not previously resistant.
Dr Hardie explained that because of gene swapping it is important that health care practitioners do not over-prescribe antibiotics by wrongly issuing them to patients not actually suffering a bacterial infection. For example, if you actually have a viral infection and take an antibiotic it may attack your harmless bacteria (the friendly ones that some yoghurt drinks claim to help) selecting for antibiotic resistance characteristics which could later be passed onto harmful pathogenic bacteria.
“It is vital that new discoveries and improvements are made to combat bacterial infections relying solely on the current antibiotics available”
The way forward in healthcare, Dr Hardie tells me, is the improvement of diagnostic methods used to identify whether a patient’s symptoms are indeed caused by bacteria or another type of infection. Education is also critically important for raising awareness among not just health care practitioners but also the public so that they know to use antibiotics correctly. It is vital that new discoveries and improvements are made to combat bacterial infections relying solely on the current antibiotics available.
Dr Hardie and other microbiologists at Nottingham are working on a fascinating strategy to disrupt bacteria from ‘talking’ with each other. They communicate at the start of an infection by sending signals to one another which alert individual bacteria that the environment (your body) is a suitable place in which to multiply and proceed with a full-blown infection.
Researchers hope to help develop a drug that stops harmful bacteria communicating that would work by either preventing bacterial signals from initially being made or by destroying the signals as they are en route to other bacteria. She thinks a drug based upon this principle could be available in the next ten years.
Now that drug-resistant infections are firmly on the global agenda the UK has pledged £369m to resistance programmes in the past two years. Following significant increases in resources and scientific support, it looks like we can avert the antibiotic apocalypse by developing diagnostic tools and novel medicines.
Alex Lethem
Image courtesy of Chilanga Cement via Flikr
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