Antimicrobial Resistance: A Global Race Against Time

Have you ever been prescribed a course of antibiotics to treat your bacterial infection, but neglected to complete the full course of medication? You may think that there will not be any serious repercussions, but in truth, there may be. If you were to stop your treatment early, there is a risk that the antibiotics may not have killed all the bacteria and that they will mutate and develop resistance to the antibiotic. Not only does this pose a danger to you, the individual, as the infection may recur and be more difficult to treat, but there is also an associated risk to the general population due to the infecting bacterium becoming more resistant to the specific antibiotic.
 
On September 9, 2016, Harvard Medical School released a video online titled ‘The Evolution of Bacteria on a “Mega-Plate” Petri Dish (Kishony Lab)”, wherein they carried out a lab experiment demonstrating how the bacterium E. coli adapts to increasingly higher doses of antibiotics. In less than two weeks, the researchers observed as the bacteria spread towards the highest drug concentration of the antibiotic trimethoprim at an alarmingly rapid rate. The bacteria produced mutant strains that were capable of surviving a dose of the antibiotic that was 1,000 times greater than the one that killed their progenitors. While this petri dish experiment does not perfectly imitate the conditions in the real world, it does provide insight to the adaptive and survival abilities of bacteria more accurately than traditional lab cultures. This study ultimately demonstrates the possible implications of people misusing and overdosing on antibiotics.

The implications of this example may not seem significant until it is applied to the real world. In the same month as the Harvard experiment above, a woman in her 70’s died from infection caused by carbapenem-resistant Enterobacteriaceae (CRE), a strain of bacteria that is now resistant to all existing antibiotics. But why haven’t we heard anything about it on the news? Last year, a Pew Charitable Trust report revealed that too few antibiotics are in development, and that a majority of antibiotics are being developed by small companies, rather than large pharmaceutical companies. Not only are these big pharmaceutical companies not stepping up to the plate, but there has been a complete lack of media coverage and awareness regarding these issues. This crisis of antimicrobial resistance has not been receiving the attention and coverage it deserves.
 
It is a lesser known fact that nowadays, antibiotics are not only used and abused by humans but also fed to livestock to keep the animals healthy, thus contaminating our environment and indirectly influencing us again. This puts us, as a global community at high risk of developing an accelerating resistance to many forms of harmful bacteria. As more and more antibiotics are exhausted, we are at a desperate need to discover more new antibiotics that the bacteria have never been exposed to before. Without time on our side, this is a concern that is quickly becoming a global crisis at an alarming rate.
 
However, not all hope is lost in this seeming futile battle against antibacterial resistance. Recently in November of 2016, professor Sean Brady, head of the Laboratory of Genetically Encoded Small Molecules at Rockefeller University, and his team discovered a new method of finding new antibiotics. They used computational methods to scan the genomes of many microbes for sequences that may produce useful antibiotics, and then synthesized these compounds in the lab. They produced two new antibiotics this way without having to culture any bacteria, which is a tricky process as not all bacteria can grow in labs, and often the genes that will code for antimicrobial resistance won’t be turned on. Brady says that he hopes his new method will inspire the scientific community to take advantage of new technologies to further digitally mine the genomes of many bacteria that have not been sequenced yet, to produce novel antibiotics efficiently.
 
But in essence, this does not solve the root problem of the antimicrobial resistance crisis, as resistance will still persist even as we continue to churn out new medicines. It’s a never-ending arms race, and we must continue to creatively max out all of our resources to discover novel ideas and approaches to counteract resistance. One thing to take home from all this, is that currently, antimicrobial resistance cannot be stopped, but can be slowed down - and that requires the global knowledge of the effects of antibiotics and its proper usage. In this fight, less is more, and controlling our intake of antibiotics is the first step in buying us more time in research and development.
 
For more readings:
WHO Antimicrobial Resistance Fact Sheet: http://www.who.int/mediacentre/factsheets/fs194/en/
Harvard Medical School Study: https://hms.harvard.edu/news/bugs-screen
Bacteria Resistant to All Antibiotics: http://www.forbes.com/sites/brucelee/2017/01/15/woman-dies-from-bacteria-resistant-to-all-antibiotics-why-dont-more-people-care/#37462a570329
Prof. Sean Brady of Rockefeller University: http://www.futuretimeline.net/blog/2016/11/20.htm#.WIpmtfkrKM8
 
Written by: Sherry Cui and Elenka Yu
Sherry and Elenka are currently in their first year of undergraduate studies at Western University and serve as UAEM Empowerment and Events’ representatives.

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