It is hard to grapple with the possibility that the smallest of entities may pose the biggest of problems for our society. However, new developments in the field of antibiotic and antimicrobial resistance, both in basic research and in institutional settings, raise red flags about a seemingly ‘clean’ society. It also poses the question: can anything be done to combat microbial resistance on a global scale?
Knowing the resistance
Antibiotics fight against infectious bacteria by either inhibiting bacterial growth or killing it. A common example of an antibiotic is penicillin, which often treats ear infections.
Antibiotic resistance occurs when bacteria become resistant to these antibiotic drugs. This presents a serious risk as antibiotics for previously treatable infections, such as pneumonia or strep throat, become rendered useless.
New research from Harvard University published in Science used visual observation of the unrelenting dominance of antibiotic resistance in an innovative laboratory setup. An easily accessible video distributed by Science News demonstrates the new technique and shows how Escherichia coli or E. coli bacteria divide inward against increasing concentrations of the trimethoprim and ciprofloxacin antibiotics.
By about 11 days, the bacteria is able to infiltrate 1,000 times as much antibiotic.
“So we can see by this process of accumulating successive mutations, that bacteria, which are normally sensitive to an antibiotic, can evolve resistance to extremely high concentrations in a short period of time,” explains Dr. Michael Baym of Harvard University.
Antibacterial washes down the drain
Some institutions have become aware of the issues surrounding this resistance and are consequently aiming to improve the everyday products that we use to maintain ‘cleanliness.’ In early September, the US Food and Drug Administration (FDA) banned over-the-counter antibacterial washes that contained certain active ingredients from being marketed in the country.
Janet Woodcock, MD, Director of the FDA’s Center for Drug Evaluation and Research (CDER) explains in the press release that “consumers may think antibacterial washes are more effective at preventing the spread of germs, but we have no scientific evidence that they are any better than plain soap and water.”
The FDA press release also explains that manufacturers could not show that these products were “safe for long-term daily use.”
A united resistance
The threat of antibiotic resistance is now an international concern. On September 21, the United Nations (UN) will discuss the threat of microbial resistance in a special “high-level” meeting. Several significant stakeholders will be present, including not-for-profit organizations, private sector corporations, and academic institutions such as the University of Oxford and the University of Minnesota; no Canadian institutions were listed to be present at the meeting.
At the conclusion of this meeting, a 15 point-resolution is expected to be passed to affirm the organization’s stance on the matter.
Point three of the proposed declaration reads, “Within the broader context of [antimicrobial resistance], resistance to antibiotics which are not like other medicines, including medicines for the treatment of tuberculosis, is the greatest and most urgent global risk that requires increased attention and coherence at the international, regional, and national levels.”
What lies ahead?
While the approaching resolution on September 21 confirms that the international community is aware of the need to address antibiotic resistance, there are growing concerns about what lies ahead, which may not be so easy to scrub off.
“We must understand that microbes will always be able to evolve resistance to whatever we throw at them. Microbes have been found that can survive in extreme conditions like boiling acid,” explains Dr. William Navarre, Associate Professor in Molecular Genetics at the University of Toronto. “Any drugs we develop will only buy us a window of a few years before we start seeing resistance emerge.”
Head of the Navarre Laboratory at U of T, he researches how and why bacteria have evolved to cause disease in humans and animals. While Navarre believes that antibiotic resistance is an extremely pressing matter, he thinks that a multi-pronged approach, which includes — but is not limited to — policy reform, the development of new drugs, and more controlled use of our current drugs, could provide some semblance of a solution.
“The data clearly show that antibiotic-resistant microbes are spreading rapidly in the countries where they do not have rules about how antibiotics are used, whereas it is far less of a problem in countries that have strict guidelines,” explains Navarre.
He paints a rather stark outlook for our society, if the problem of antibiotic resistance is not adequately addressed: “First of all — the future is already here. People are dying today of antibiotic-resistant microbes — not in small numbers either. More people die of antibiotic-resistant microbes each year in the US and Canada than… of AIDS.”
Navarre continues, “We’re not used to backwards progress in medicine but our fight against microbes is one arena where that’s exactly what is happening. Our anti-depressants won’t suddenly stop working. Our anti-cancer drugs won’t suddenly stop working.”
“Our antibiotics, on the other hand, are increasingly becoming useless,” concludes Navarre.
