AN OUNCE OF PREVENTION | health & wellness ||
13
W
e are used to having re-
liable, readily available
antibiotics in the fight
against infectious dis-
eases; after all, in con-
cert with vaccines, they have saved
billions of people from fatal infec-
tions. Vaccines, thank goodness,
work dependably, but the era of fail-
safe antibiotics is apparently com-
ing to an end.
How do supermicrobes
come into being?
A supermicrobe can resist an
antibiotic in various ways. For exam-
ple, it can develop ferments that de-
compose an antimicrobial agent.
Sometimes it gets lucky: as a result
of mutations, its membrane—the
jacket against which drugs had pre-
viously delivered the coup de
grace—becomes
impenetrable.
Sometimes, as a result of horizontal
gene transfer, bacteria harmful to
people borrow protection against
drugs from useful bacteria. And
sometimes people turn their own
bodies into training centers for killer
bacteria. How? Well, suppose we’re
treating pneumonia with antibiotics.
The doctor has prescribed a ten-
day course of treatment. But on day
five the symptoms of the illness
have disappeared, we decide we’ve
had enough of saturating our body
with powerful stuff, and we stop tak-
ing it. By then we’ve already killed
off the bacteria that are least resist-
ant to the drug. But the strongest
ones are still alive and continue
multiplying, passing on resistance
to their descendants. Selection of
resistant microbes occurs espe-
cially actively in hospitals, where
people with various infections come
into contact with each other, and
where a lot of antibiotics are admin-
istered. The result is that hospital
pneumonia and other nosocomial
infections have begun spreading
widely. Moreover, bacteria com-
menced resisting especially aggres-
sively when antibiotics began to be
used in enormous quantities in agri-
culture, given to halt outbreaks of
disease among animals and often
simply as prophylactics, which lets
bacteria get to know their enemy
even better, to become accustomed
to it, and to develop resistance.
Has the war been lost?
The World Health Organization
Web site is publishing a gloomy
forecast: “Patients are finding it ever
more difficult to recover from infec-
tions, because the level of resist-
ance of pathogenic microorganisms
to the action of antibiotics and, what
is even worse, of antibiotics of the
reserve array, is growing steadily. In
combination with the extraordinarily
slow development of new antibi-
otics, that increases the likelihood
that respiratory and skin infections,
and infections of urinary tracts and
of blood circulation can become in-
curable, that is, fatal.” Malaria and
tuberculosis can be added to this
list of maladies: now they can kill
once again.
What army can we pit
against the invaders?
Scientists consider two ways of
fighting microbes to be the most
promising.
First, they are searching for new
antibiotics that target specific organ-
isms, developing drugs that begin to
act only once they get inside bacte-
ALPEON.COM