Crafting Our Own Killers
Facing a threat deadlier than cancer, and harder to fight, too, humanity has been plunged yet again into the forefront of one of its most challenging and immediate problems ever. The latest and greatest threat to human existence comes from our tiny unicellular friends, bacteria. While many bacteria play very important roles in the process and maintenance of each of our digestive systems, some are pathogenic – they cause diseases that can lead to some pretty nasty complications, including death.
Ever had food poisoning from that sushi place down the road? Pneumonia or strep throat? You have bacteria to blame. Those nasty microbes worked their way into your system and began to replicate themselves. A lot. One to two, two to four, four to eight, up until your body is overwhelmed with invading bacteria and begins a non-stop fight to get rid of the foreign threat.
If you’ve ever had an illness like pneumonia or strep throat, you might remember a doctor prescribing a certain type of medication known as antibiotics. Antibiotics are a type of antimicrobial drug used to treat bacterial infections, and the discovery of the first antibiotic, penicillin, in 1928 is regarded as one of the greatest developments in medicine ever. It caused a shift so dramatic that bacterial infections went from death sentences to easily curable, and medicine switched its focus to the administration of antibiotics to treat these diseases.
[endif]-- The widespread and unmatched effectiveness of antibiotics seemed a panacea, a cure-all, for many diseases. Along with vaccination, antibiotics helped bring an end to some bacterial diseases, such as tuberculosis, in the developed world.
What’s the problem, then? It seemed that many of the world’s worries were cured along with these bacterial infections, and to an extent this was true – but in the words of Robert Frost, “Nothing gold can stay.” Scientists began to see that bacterial colonies were not responding as well to antibiotics as time progressed. What they discovered was a mechanism of selection for bacteria which had developed a resistance to certain antibiotics. This happened because all the bacteria were being constantly bombarded with antibiotics. Most were killed in this process, but some bacteria expressed resistance to the antibiotics – they did not die off like the others. These few bacteria would be able to resist further treatment with antibiotics, spread exponentially, and eventually create an entire colony of resistant bacteria that still cause disease and can no longer be treated with the same or similar antibiotics.
[endif]-- Antibiotic resistance to penicillin was noticed relatively quickly after its widespread use as a “wonder drug” of sorts. Penicillin, and antibiotics similar to it, are known as beta-lactam (β-lactam) antibiotics because they contain a characteristic structure known as a β-lactam ring. Bacteria develop a resistance to these antibiotics by creating an enzyme known as β-lactamase which attacks and breaks down the antibiotics from the β-lactam ring. β-lactamase is just one of multiple ways that bacteria can develop a resistance to antibiotics, and inappropriate use of antibiotics where they may not be necessary results in the needless cultivation of resistant bacteria. Antimicrobial resistance is escalating so quickly that it is estimated to be the cause of over 10 million deaths per year by 2050, approximately 25% more deadly than cancer (O’Neill 2014).
The development of resistance in bacteria is due to the principle of Darwinian evolution. Developed by Charles Darwin in 1859, it explains the natural tendency of life to develop and adapt to its surroundings due to the genetic diversity of species – no two birds, bacteria, or humans are the same. This diversity causes some members of the species to have traits more suitable for a given environment. Over time, after less-suitable members of the species die off, the new trait dominates the genetics of the surviving group – this group has evolved. A primary goal of life is to keep living, and that’s no different for bacteria. The ones who can survive when we try to kill them off with antibiotics are the ones who will multiply and spread those genes until the bacterial species expresses complete resistance – invulnerable and bloodthirsty resistance. We can’t blame bacteria for wanting to survive, but we can blame ourselves for the excessive and inappropriate use of antibiotics that pressure them to evolve.
According to the Stanford Antimicrobial Safety and Sustainability Program: “On average, approximately 60% of hospitalized patients receive an antibiotic and in an estimated one-half of cases antibiotic use is inappropriate” (SASSP). In addition, perhaps the largest contributor to antibiotic resistance is often the most overlooked - the food and agriculture industry. Approximately 80% of antibiotics sold in the United States are used in the food industry alone (NRDC 2015). It is common practice to feed antibiotics to animals with no indication of disease or infection, creating a Darwinian breeding ground for the survival of the fittest – and most dangerous – bacteria.
This problem has reached such a level of concern that the UN has declared a global crisis at their most recent high-level meeting in New York on Sept 21, 2016. The World Health Organization, Food and Agriculture Organization, and the World Organization for Animal Health plan to work in tandem to bring an end to the potential AMR crisis. Details about the UN’s new protocols for combatting AMR will be revealed as time goes forward.
It is our job as consumers and potential patients to educate ourselves on the threat of antimicrobial resistance and to act accordingly to combat the rapid onset of total AMR. Take antibiotics only when prescribed, and take them for the entire time prescribed, regardless of symptoms. It is very easy for a few surviving bacteria to again start multiplying exponentially before the immune system can combat the threat. Next time you stop at the store, it might be a good idea to pick up the “antibiotic free” milk, regardless of what Peggy Sue next to you thinks about the price. As individuals, these actions may seem insignificant, but every waterfall starts as a drop, a trickle, then a stream.
Works Cited:
1 - http://biology-forums.com/gallery/77_07_06_11_5_45_43.jpeg
2 - https://upload.wikimedia.org/wikipedia/commons/thumb/d/d8/Beta-lactam_antibiotics_example_1.svg/280px-Beta-lactam_antibiotics_example_1.svg.png
3 - http://www.pulseheadlines.com/wp-content/uploads/2016/09/antibiotic_resistance-b.png
O'Neill, Jim. Antimicrobial Resistance: Tackling a Crisis for the Health and Wealth of Nations.
N.p.: n.p., n.d. AMR Review. Dec. 2014. Web.
Khor, Martin. "Why Are Antibiotics Becoming Useless All Over the World?". The Real News.
May 18, 2014. Web.
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