The single greatest threat to the world’s health care over the coming decade is the rise of the ‘super-bug’:
These are resistant bacteria which are able to withstand antimicrobial medicines including antibiotics, antifungals, antivirals and antimalarials
“Some bacteria are now so resistant that they are virtually untreatable with any of the currently available drugs. If we do not take action to address this threat, humankind will be on the brink of a post antibiotic era, where untreatable and fatal infections become increasingly common” – Simon Prasad and Phillippa Smith, Australian Office of the Chief Scientist.
The Antibiotic era begins: Most people would be at least remotely aware of Alexander Flemming’s discovery of penicillin in 1928 as an antibacterial agent. Although the antimicrobial effects of mold had been known for some time, Flemming’s discovery eventually led to penicillin’s mass production as an antibiotic medicine by the 1940s.
As the name suggests, antibiotics work to kill or destroy bacteria which invades our body. If bacteria infect our body and begin to reproduce, their cumulative effects on our body manifest as symptoms, making us ‘sick’. Although our immune system works overtime to fight off the infection it actually adds to many of the symptoms such as inflammation and makes us feel even sicker. Antibiotics are necessary to kill bacteria and help an immune system in overdrive. Different antibiotic drugs act on certain bacteria in different ways. Certain drugs may inhibit bacteria from converting glucose to energy or may prevent bacteria from building its cell walls. When antibiotics are at work the bacteria will die instead of reproducing. The problem with antibiotic resistant bacteria is that when our body is infected there is no means by which we can rid ourselves of the infection and their reproduction continues uninterrupted to a fatal point.
How do bacteria become resistant to antibiotics?
Bacterial evolution, which has always occurred, is the means by which bacteria may develop resistance to antibiotic drugs. While this is not new, nor is it surprising since all organisms evolve over time, the concern is the pace at which evolutionary changes are occurring. Bacteria may become resistant by receiving genes from already resistant bacteria or may achieve resistance through spontaneous mutations of DNA sequences during reproduction. If this mutation provides a favorable outcome for survival then it is passed on through reproduction to its offspring. The genetic changes that may occur include bacteria forming the ability to:
- produce chemicals that destroy antibiotics
- to build protein machinery to pump antibiotics out of the cell
- make the cell impenetrable by antibiotics
- modify its appearance so that it is unrecognisable to antibiotics
The misuse of antibiotics prevalent in today’s society is largely responsible for the rising resistance:
Many practitioners prescribe antibiotics for viral infections such as the common cold which provides no physiological benefit except promote the evolution of bacteria. Viruses are non-living particles of genetic material and cannot be killed by antibiotics. Immunizations are essential to protect against many viruses including influenza. With up to date immunizations our immune system can generally fight off viral infections.
Quite alarmingly, a study conducted in 2003 found that 99% of antibiotic prescriptions at a specific hospital’s emergency room where not necessary. While this on some level may be excused due to the nature and necessity for quick medicine in emergency rooms, the over prescription of antibiotics by general practitioners is creating an environment where bacterial evolution is resulting in antibiotic resistance.
The alarming decrease in research for new antibiotics is a critical issue in the rise of antibiotic resistance:
The lucrative nature of drugs other than antibiotics has caused a shift in commitments to other research areas. Some cancer drugs can be sold at as much as $20,000 a course while antibiotics are sold at no more than $20 a course. The commercialisation of healthcare has a seen a dramatic shift in commitments where many companies have completely abandoned their research into antibiotics.
Many antimicrobial products including hand sanitizers, bathroom and household cleaners, soaps, mouthwash, toothpaste and garbage bags also contribute significantly to the rise of an antibacterial resistant era. Most of these bacteria that these products kill are generally good bacteria essentially to building stronger immune systems and maintaining good intestinal function. The tag that these products carry as being antimicrobial is nothing more than an expert advertising ploy to alarm mothers of the health of their children. These products are no more effective at preventing infection within the home than good personal and household hygiene with ordinary soap, warm water and plain detergents.
According to the Director-General of the World Health Organization, Dr Margaret Chan, “a post-antibiotic era means, in effect, an end to modern medicine as we know it. Things as common as strep throat or a child’s scratched knee could once again kill.”