In the late 1800’s, medical associations were established linking bacteria to the cause and proliferation of various infectious diseases. However, there were not effective treatments available to treat these infections so death was common place even due to simple scratches, cuts and operations. Thanks to the discovery, albeit accidental, of the first antibiotic penicillin by Alexander Fleming in the late 1920’s, the tides began to shift in the treatment of bacterial infections. Antibiotics are naturally produced compounds that are made by mold or bacteria. Throughout the 20th century, antibiotics have been considered a “wonder drug” and a “miracle drug” and production of antibiotics became a priority goal, revolutionizing the practice of medicine and saving millions of lives. With that being said, sadly, many original antibiotics are no longer effective at treating bacteria that they once were able to combat. This is because bacteria have gotten smarter and some gained the ability to modify themselves in some way to resist the effects of antibiotics. In fact, there are real and emerging fears that the 21st century may see a reversion back to pre-antibiotic days when common infections and minor injuries could result in unfortunate deaths.
Antibiotic resistance is a serious concern both to research and the medical community at large. Microorganism can acquire resistance to antibiotics due to genetic changes such as horizontal gene transfer or spontaneous mutations. Moreover, recent research suggests resistant bacteria are a natural feature of all microbial populations, more so than a modification of existing bacteria. Regardless of their mode to attain resistance against antibiotics, it is evident that this trend is alarming. Even more egregious is the prominence of “superbug”. Superbug is a commonly used term to describe strains of bacteria that are resistant to the majority of antibiotics commonly used today. Superbugs have developed resulting in a common cause of pneumonia, some urinary tract and skin infections. One of those bacteria that have upgraded to the level of superbug is Staphylococcus aureus. Historically, there are many antibiotics effective against the staphylococci, yet over the last several decades antibiotic resistance, particularly resistance to beta-lactam antibiotics, has plagued antimicrobial therapy of S. aureus. Additionally, S. aureus is instrumental in displaying its varying ability to develop resistance to beta-lactam antibiotics, including developing “methicillin resistance” in a strain referred to as methicillin-resistant Staphylococcus aureus (MRSA).
What is causing this rise in antibiotic resistant microorganism? Well, there are many theories, including misuse over the years by physician and patients using antibiotics for treating infections that didn’t require antibiotics. This is because antibiotics not only kills the bad bugs that are causing infection but they can also deplete useful microbiota. Also, not taking the antibiotics like they are prescribed to maintain levels high enough in the blood to attack the bacteria. When blood levels of antibiotics drop below critical concentrations needed to combat bacteria, then resistant organism can emerge and proliferate. Additionally, antibiotics have become a regular staple in animal feed to help animals gain weight. It is thought that the levels present in feed is sufficient to help produce meatier animals but it results in over exposure to low doses of the medication, resulting in the bacteria developing resistance. So what are the ramifications of antibiotic resistance to the world as we know it? Well, we would see a re-emergence of simple infections leading to once preventable mortalities. Without antibiotics infections can overwhelm the body’s immune system system and may lead to deadly infections in the blood like bacteremia or septicemia causing death.
Given these costly outcomes to antibiotic resistance in the world it is no wonder that a lot of business producing foods are now advertising that their meats are “antibiotic free” but what does this term really mean? The linked consumer report mentions how for some companies that is just an advertising selling point. But some brands are making a concerted effort, noteably, the organic industry. According to the Department of Agreculture organic seal it means that animals were not giving antibiotics while being raised, including meat, poultry, dairy, and eggs. For other industry, this means that animals were not given antibiotic medically used to treat people—such as amoxicillin, erythromycin, and tetracycline.
Recently there has been discussions about how to treat cholera outbreaks in places like India. However, with the emergence of antibiotic resistance (ABR) in Vibrio cholerae, this has led to difficulties in case management since antibiotics have been established to be used in conjunction with early initiation of fluid and electrolyte replenishment using Oral Rehydration Salts (ORS) to reduce the duration and volume of diarrhea. It is suggested that antibiotics be used only in severe cases of cholera infection since the indiscriminate prescription of antibiotics is showing an emergence of resistance in the species.
Overall, the inappropriate use of antibiotics in humans and animals have resulted in a major threat to global public health because of the development of resistance of bacteria to these drugs. This is of global concern because we are seeing the loss of live and financial consequences to antimicrobial resistance. Thankfully, the problem has a public health platform that can be used to implement changes in the way doctor’s prescribe and how patient’s use antibiotics. Unfortunately, the development of new antimicrobial drugs have slowed significantly so we as a community need to be cognizant of our role in the problem and work with our health care provides to ensure that we don’t lose this gift we have in antibiotics.
Microbiology and You 