Discussion
to the next generation. An entire new population of bacteria which is immune to the antibiotic is therefore created.
The processes which take place due to the genetic changes responsible for antibiotic resistance are extremely complex; they are therefore not understood well, and very little progress has been made in trying to find ways to prevent it( Davies and Davies, 2010).
What are‘ Superbugs’?
Bacterial Superbugs are bacteria with very high levels of antibiotic resistance, such as MRSA. They can quickly infect patients and spread rapidly as there is little that can be done to stop them( ScienceNews, 2013); this is especially so because an important characteristic of bacterial Superbugs is resistance to several different antibiotics.
Infections caused by Superbugs can be very dangerous, making them the cause of an increasing number of deaths and disabilities throughout the world. Therefore, it is extremely important to control resistance to stop a superbug which is immune to all existing antibiotics from emerging( NHS, 2019).
Superbug bacteria show resistance by the same fundamental processes as other bacteria, but the processes are better adapted for resistance in Superbugs, with some modifications that are advantageous to survival against antibiotics( Benveniste and Davies, 1973; Foster, 2004; Chang et al., 2014).
Discussion
Causes of resistance
A major cause of antibiotic resistance has been the overuse of antibiotics. As mentioned previously, the use of an antibiotic on a population of bacteria has the potential to create a new, resistant population of the bacteria. More frequent use of an antibiotic therefore means a greater number of opportunities for a resistant population to be created.
Figure 1 shows the extent of antibiotic use in the
United States in 2017; it can be seen that a significant proportion of states are on the higher end of the scale. A few states are at the maximum level, with more than 900 antibiotic prescriptions per 1000 people in one year.
It is concerning that, in the US, at least 30 % of antibiotics that are prescribed in the outpatient setting( where around 80-90 % of human antibiotic use occurs) are done so unnecessarily, and that nearly 50 % of antibiotic use in the outpatient setting is inappropriate( Centers for Disease Control and Prevention, 2019).
Another issue is self-medication, which is when someone takes antibiotics without first consulting a certified medical professional. Unless a patient has expert knowledge, it is likely that when patients self-medicate, they do not know exactly what they are doing, and when it is appropriate or not to take antibiotics. Not consulting a medical professional increases the chances of an antibiotic being taken when it is not necessary.
Also, some antibiotics are available over the counter, without the need for a prescription. This encourages people to use these drugs as the fact that they are so easily available gives the impression that professional guidance is not required.
The general public does not fully understand antibiotic resistance and how to use antibiotics properly; in a recent study involving around 55,000 members of the public, only around 70 % of participants said they had heard about antibiotic resistance in the past. This means that a large number of people do not know about resistance, which means they are not aware of the most significant negative effect of inappropriate antibiotic use( Bajpai et al., 2017).
Resistance mechanisms
There are several mechanisms by which bacteria can show resistance to antibiotics, such as those shown in figure 2. The main categories of mechanism are modification of a bacterium’ s own structure, and modification of the structure of the antibiotic.
A bacterium can modify parts of its structure in a
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