The rebellion of the antibiotic-resistant superbugs

Author:?Liliana Sánchez Rocha

Read time: 7 minutes??

This tale warns us about an emerging danger that has been simmering for nearly a century: the rise of a new generation of super microbes. These superbugs bear the secret of survival within them; the genes of antibiotic resistance, making them the worst supervillain ever. Why, you wonder? Antibiotics were once hailed as a magic potion that could fight off any bacterial infection… but now we know that they’re not magic, and their power fades with every misuse. In 2019 alone, 1.27 million people lost their battle against any of the members of the superbug family, proving that in this new war, no enemy should be underestimated. But what are antibiotics? How do they work, and how has their misuse led to the rise of superbugs? Is this simply the result of evolution, or have we, by our own hands, pushed "survival of the fittest" to dangerous new extremes?

What are antibiotics?

Antibiotics are a powerful defense mechanism from different microorganisms to take down bacteria. This natural weapon comes in different “flavors”, each with its own tactic. Some punch holes in a bacterium's protective shell, others mess up its metabolism, and some block its ability to build a microscopic army.?But what makes these substances so extraordinary for us is their precision; they target structures that have important differences from those of plants and animal cells. For this reason, they can be seen as little guided missiles that hunt bacteria while traveling through the body. Are there flows? These “missiles” can’t distinguish between bad or positive bacteria, so collateral damage is often unavoidable. Besides this, not all bacteria are naturally susceptible to all antibiotics, making it essential to know the enemy before starting the attack. After all, bacteria also produce these magnificent weapons to ensure survival.

What is antibiotic resistance and how does it work?

Antibiotic resistance is the capacity of a bacteria to defend and survive an antibiotic attack. Resistance doesn’t occur in humans or animals themselves but in the bacteria living inside them. Yes! We are a hotel for microbes, hosting countless beneficial bacteria.?Interestingly, antibiotics aren’t new to bacteria; some had already developed spontaneous gene mutations that granted them the advantage of survival and resistance to these drugs. Their strategies? Ingenious: expelling the antibiotic from inside to the outside?with tiny pumps, building stronger walls to not let them sneak through, reshaping their internal targets, or simply breaking down the antibiotic molecule to pieces before they can act.?

Impressive, right? Some of these tricks were already lying dormant in bacteria's genetic code, it’s been estimated that resistant genes have been around for at least 30,000 years! Slowly being passed along to new generations, but also being shared with unrelated bacterium through an intriguing process called conjugation . This ensures that important genes for survival are spread and tested by other bacteria. But in a world where encountering antibiotics was more a remote chance, the bacteria with this hidden treasure were not better than others and thus were the minority... until now.?

How have antibiotics helped us?

In 1928, Alexander Fleming’s discovery of penicillin ?changed medicine forever. By 1945, this antibiotic became widely available to the public, making surgeries safer, infections treatable, and life expectancy increased by 23 years! Yet Fleming himself warned:?misuse of these “magic potion” could lead to resistance. Fast-forward to now, his prediction has become true, we have sped up evolution in favor of our microbial enemies.

Now the tables have turned. Bacteria armed with resistance genes are now?beginning to dominate the microbial world. Why is this bad news? Because now we’re running out of effective ways to stop these dangerous bacteria. For nearly a century, antibiotics have protected us from once-deadly infections, losing their power to cure put us in a real danger zone!?

What is the biggest cause of the antibiotic resistance crisis?

There are multiple causes that have forced the selection of strong and undefeatable bacteria:

• Medical Overuse:?In the early days, antibiotics became the go-to remedy at any hint of illness, often prescribed without confirming a bacterial infection. The result? Bacteria got endless practice in dodging our attacks.

• Agriculture misuse: Antibiotics were fed to animals to accelerate growth and enhance production. It is estimated that 73% of all antibiotics have been used for this practice, resulting in a massively resistant bacteria selection.

• Waste management: Pollution has dragged antibiotic waste to the most isolated places, fueling the rise of resistant bacteria. What’s worse, this environment also encourages the exchange of resistant genes among bacteria.

• Decline in antibiotic development: Pharmaceutical companies have largely shifted their focus into developing medicine that won’t lose its effect and?might be needed for a lifetime. As a result, we are still relying on the “golden age” antibiotics, those that are losing their effectiveness and for which there are not yet effective replacements.?

What can we do to slow antibiotic resistance?

As we’ve explored, antibiotic resistance is a natural defense to a natural weapon, we can’t revert it or stop it. Instead, we can try to slow down this crisis. While there is a strong need to develop new antibiotics and stricter global regulations in their use, we as individuals can help too, here?are some ideas:

• Don’t ask for antibiotics for colds or flu. They’re viral and antibiotics don’t work in viruses.

• Complete your prescribed antibiotic course, even if you feel better halfway through.

• Avoid self-medicating with leftover antibiotics or antibiotics bought without a prescription.

• Buy antibiotic-free meats: Reducing the use of antibiotics in animal farming reduces resistance.

• Dispose of leftover antibiotics properly: Don’t flush them down the toilet or throw them away.

• Spread awareness: The more people understand the risks, the stronger the response.

Let’s not wait until it’s too late to act, the power to slow down this crisis lies in our hands.

References:

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D’Costa VM, King CE, Kalan L, Morar M, Sung WWL, Schwarz C, et al. Antibiotic resistance is ancient . Nature. 2011 Aug 30;477(7365):457–61.?

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Huemer M, Mairpady Shambat S, Brugger SD, Zinkernagel AS. Antibiotic resistance and persistence-Implications for human health and treatment perspectives. EMBO Rep. 2020 Dec 3;21(12):e51034. doi: 10.15252/embr.202051034. Epub 2020 Dec 8. PMID: 33400359; PMCID: PMC7726816.

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