Antibiotic Resistant Bacteria
Antibiotic resistance happens when bacteria and fungi develop the ability to defeat the drugs designed to kill them which are called antibiotics. Now that more and more are failing to kill them means the germs are not being wiped out and will continue to grow and multiply at an exponential rate . Antibiotic resistance does not mean the body is becoming resistant to antibiotics, instead it is the bacteria that has developed a resistance to the antibiotics designed to kill them (Centre for Disease Control and Prevention, 2020).
Some types of antibiotic resistant germs can spread from person to person. These ”Nightmare bacteria” such as Carbapenem-resistant Enterobacteriaceae can even survive and grow in sink drains at healthcare facilities and spread to patients and to the environment through the wastewater, leading to great causes for concern for hospitals. Resistant germs are able to spread between animals and people through food or contact with animals. For example Salmonella Heidelberg can make both livestock such as cattle and people sick with symptoms that commonly include diarrhoea, fever, and stomach cramps. Antibiotic resistant germs are able to spread throughout the environment, for example Aspergillus Fumigatus, a common mould found in dust, can make people with weakened immune systems develop infections in the lungs and sinuses (The Interconnected Threat of Antibiotic Resistance, 2020).
How does antibiotic resistance happen?
Antibiotic resistance in its simplest terms is when the bacteria that is immune to a form of antibiotic survives and then multiples and becomes dominant as there are less risks as it has no need to worry about the antibiotics anymore Some bacteria can naturally resist certain kinds of antibiotics. Others can become resistant if their genes change or they get drug-resistant genes from other bacteria (Jennifer Rainey Marquez, 2016). Bacteria can get resistant genes by mating and mutating to become different variants of bacteria. The longer and more often antibiotics are used, the less effective they are against those bacteria (Jennifer Rainey Marquez, 2016).
Current preventions
In 2015, the White house created a National Action Plan for Combating Antibiotic resistance, some of the solutions they mentioned were that scientists should step up the development of new antibiotics and vaccines as well as diagnostic tests to identify drug-resistant bacteria (Jennifer Rainey Marquez, 2016). The creation of diagnostic tests would help to reduce the use of the wrong antibiotic being used to treat a patient and possibly causing the antibiotic to become completely resistant to various types of other antibiotics as well. However, just increasing the amount of various types of antibiotics does not contribute to the fact that the main problem is that antibiotics are being overused and prescribed to illnesses, infections and diseases that they are not needed for. This leads to some bacteria being resistant to some of the most powerful antibiotics available in modern medicine today (The Danger of Antibiotic Overuse (for Parents) – KidsHealth, 2015).
Another solution that was recommended was that public health officials should monitor antibiotic resistance and track rates that it is spreading and how and where it is spreading the most (Jennifer Rainey Marquez, 2016). Tracking the rate of antibiotic resistance is beneficial because health professionals and organisations can target what places the resistance is occurring. However trying to keep up to date with the antibiotic resistance would be extremely difficult because of the constant change that the bacteria and virus go through when they mutate. Reliable estimates of the current and future disease burden of antimicrobial resistance (AMR) are essential to combat the global drug-resistant infection crisis. Yet, despite considerable global efforts, our understanding of the burden of resistant infections remains disturbingly sparse (Schnall et al., 2019).
In addition, an important recommendation that this plan mentioned was that doctors should help stop unnecessary antibiotic usage and develop safer practises in hospitals and health clinics (Jennifer Rainey Marquez, 2016). Having doctors overprescribe antibiotics is a huge problem because this causes more bacteria to mutate with other bacteria and their resistant genes which will increase the rates of antibiotic resistance. Doctors prescribe antibiotics for various different things because they know that antibiotics can treat infections that they may not be able to diagnose. Sometimes they prescribe them when they’re not sure if an illness is caused by bacteria or a virus or are waiting for test results. So, some patients might expect a prescription for an antibiotic and even ask their doctor for it. For example, strep throat is a bacterial infection, but most sore throats are due to viruses, allergies, or other things that antibiotics cannot treat. But many people with a sore throat will go to a health care provider expecting and receiving a prescription for antibiotics that they do not need (The Danger of Antibiotic Overuse (for Parents) – KidsHealth, 2015).
The final recommendation that this study made was that farmers should stop giving animals antibiotics needed to treat diseases within people (Jennifer Rainey Marquez, 2016). This means that people are getting antibiotics from the animal meat that they are eating, this means that people are getting exposed to antibiotics on a regular basis which means that bacteria have more of a chance to resist various antibiotics.
What bacteria are antibiotic resistant?
One of the most common and most infectious is MRSA. MRSA is Methicillin-resistant Staphylococcus aureus is a bacterium that causes infections in different parts of the body. MRSA is tougher to treat than most strains of staphylococcus because it is resistant to some of the most commonly used antibiotics (https://www.facebook.com/WebMD, 2005). MRSA is resistant to an entire class of antibiotics called Beta-lactams. This group of antibiotics includes methicillin and the more commonly prescribed penicillin, amoxicillin and oxacillin (Methicillin-Resistant Staphylococcus Aureus (MRSA), 2020). MRSA is mostly found in hospitals and health care settings.
Carbapenem-resistant Enterobacteriaceae (CRE) are strains of bacteria that are resistant to carbapenem, a class of antibiotic typically used as a last resort for treating severe infections when other antibiotics have failed. These organisms have been described as “nightmare bacteria” because they have become resistant to nearly all available antibiotics, making CRE infections extremely difficult to treat and potentially deadly (Bradford, 2018).
Another common word that is used for antibiotic resistance is called “superbugs”. These Superbugs are strains of bacteria, viruses, parasites and fungi that are resistant to most of the antibiotics and other medications commonly used to treat the infections that superbugs cause. A few examples of superbugs include resistant bacteria that can cause pneumonia, urinary tract infections and skin infections (Tosh, 2018).
Why are antibiotics so important and life before antibiotics?
Antibiotics are so important because they fight and kill diseases and illnesses caused by bacteria. Antibiotics also help to slow down the rate that bacteria grows and multiples. A Bactericidal antibiotic, such as penicillin kills the bacteria because these drugs usually interfere with either the formation of the bacterial cell wall or its cell contents. Whereas a bacteriostatic stops the bacteria from multiplying (Antibiotics: Uses, resistance, and side effects, 2019).
In the pre-antibiotic era of the early 1990s, people had no medicines against common germs and because of this, human suffering and mortality was enormous. Even though the body’s immune system can often successfully fight off bacterial infections this is not the case for all bacterial infections. Sometimes the microbes are too strong for your body to fight and antibiotics are used to fight the bacterial infections.
Before antibiotics, 90% of children with bacterial meningitis died. Among the approximate 10% of children that survived, those children had severe and lasting disabilities that ranged from deafness to disfigurement. During this time Strep throat was a fatal disease as well ear infections sometimes spreading from the ear to the brain causing severe problems.
Other serious infections, from tuberculosis , pneumonia and whooping cough. All of these bacterial infections were caused by aggressive bacteria that reproduced with extraordinary speed and led to serious illness and sometimes death (The History of Antibiotics, 2019).
Why is antibiotic resistance bad for everyone
Antibiotic resistance is a problem for everyone because antibiotics have become a major part of treating infections and diseases successfully. Without antibiotics we will go back to the lack of healthcare that we had in the 1930s. This means that infections that we know have that we see as trivial and infections that we don’t worry about now will become an enormous problem and mortality rates will increase significantly. If we lose the use of antibiotics, an infected cut or spot could potentially be life threatening and illnesses like pneumonia would become a mass killer once again (Ashiru-Oredope, 2014).
Why is antimicrobial resistance a problem?
Antimicrobial resistance is a problem because it is a naturally occurring phenomenon that can only be slowed and cannot be stopped because bacteria continues to change to ensure their survival before anything can be found to slow the process (Tosh, 2018)
What damage will antibiotic resistance cause modern infrastructures and areas within society
If the rate of antibiotic resistance continues to increase at the rate it is without intervention it will have a major impact on modern infrastructures for example healthcare settings, schools , pharmaceutical industries and the public sector.
One of the main areas that will be affected will be Cancer treatments and chemotherapy. Chemotherapy and antibiotics are used together because chemotherapy destroys our bodies white blood cells which help to fight off infections as well as the chemotherapy weakening our bodies immune system. Without antibiotics chemotherapy will become increasingly dangerous (Ashiru-Oredope, 2014).
An additional major factor that antibiotic resistance has is that on us as individuals, many people have the assumption that when faced with the prospects of these “superbugs” and “antibiotic resistance” that as a global issue it has to be faced by our best and brightest. Or the common misconception of “it could never happen to me” but the risk is a credible one. Taking antibiotics when you don’t need them, can increase your risk of carrying antibiotic resistance bacteria in your gut, if these bacteria go on to cause an infection, this can result in the antibiotics not working when you really need them (Ashiru-Oredope, 2014).
For example sepsis, is a common and potentially life-threatening condition that is caused by a bacterial infection. Each year more than 100,000 people in the UK are admitted to hospital with sepsis and around 37,000 people die each year. The best way to deal with sepsis is to treat it quickly with antibiotics to treat the infection. So if we lose the ability to use antibiotics to fight off infections this means that the risk of sepsis will increase as well as the rate of mortality (Ashiru-Oredope, 2014).
One of the biggest impacts that will damage our modern infrastructures is the human cost of antibiotic resistance and the mass amount of money that it costs to combat antibiotic resistance. As far back as 2009 the European Centre for Disease Prevention and Control said that antibiotic resistance was already costing the EU roughly 1.5 billion Euro per year in healthcare expenses and lost productivity. This high figure was believed to be significantly underestimated. If we can’t slow down or stop the increase in the rates of antibiotic resistance the cost will continue to increase. Not only will it mean cutting further into our already massively underfunded healthcare budgets but also individuals as well as families. (Ashiru-Oredope, 2014).
Another major impact antibiotic resistance will have on healthcare settings is that surgeries will become extremely dangerous because of the complexity of surgery paired with the high risk of infections that can occur. For example in heart bypass operations and joint replacements, if we lose the effectiveness of antibiotics these procedures that are designed to help people, extend lives and ease suffering could in reality lead to more deaths caused by bacterial infections (Ashiru-Oredope, 2014).
Antibiotic resistance could also ruin the concept of organ transplant because when a patient has an organ transplant they need antibiotics in order to survive, both because the transplant procedure itself can lead to infection but also because the patients receive drugs to intentionally suppress their immune system to reduce the risk of the body rejecting the new organ. By suppressing their immune system this means that they are more prone to bacteria infections, therefore if we lose antibiotics, this would be disastrous as it makes transplant more risky and could potentially become impossible all together (Ashiru-Oredope, 2014).
What are possible solutions in the face of antibiotic resistance?
Bacteriophages
A bacteriophage is a type of virus that infects bacteria. The word “bacteriophage” means “bacteria eater” this is because bacteriophages destroy their host cells in order to replicate. All bacteriophages are composed of a nucleic acid molecule that is surrounded by a protein structure. A bacteriophage attaches itself to a susceptible bacterium and infects the host cell . The bacteriophage hijacks the bacterium’s cellular machinery to prevent it from producing bacterial components and instead forces the cell to produce viral components. New bacteriophages assemble and brust out of the bacterium in a process called lysis. Bacteriophages occasionally remove a portion of their host cells’ bacterial DNA during the infection process and then transfer this DNA into the genome of new host cells. This process is known as transduction (bacteriophage / phage | Learn Science at Scitable, 2014).
An example of bacteriophages was in 2016, when there was an experimental treatment where doctors put 100 million OMKO1 viruses into a man’s chest to save his life. The man had a coronary artery bypass and found a Pseudomonas aeruginosa. The man was prescribed a heavy course of antibiotics to get rid of the infection. However the bacteria turned out to be resistant and couldn’t be eradicated. However the doctors decided to use bacteriophages because they thought that maybe viruses could kill bacteria that the antibiotics could not. After 3 months on antibiotics in the hospital he was sent home, however he still had a major infection which required him to keep an IV port in his chest and the man had to receive a massive dose of antibiotics to keep the bacteria at bay. After this experimental treatment of bacteriophages, the man made a full recovery in 3 months with 1000 bacteriophages and a cocktail of strong antibiotics injected into his chest.
The uses of bacteriophages were discovered over a century ago and by the 1920 phage therapy was common in Europe and North America. During this period of time you could buy phage-laced powder for skin infections over the counter, bacteriophages were also brought to countries including Egypt and India to tame outbreaks of cholera and other diseases. However once antibiotics were discovered and came to light, phage therapy virtually disappeared from most countries because doctors gained more confidence in the use of antibiotics and the success that they had. Doctors also had confidence in antibiotics because they are simple chemicals which can be tested rigorously. Because of this bacteriophages were not as understood and trusted, despite phage therapies successes, its proponents had not done enough to prove that it was reliably safe and effective. However there has been speculation around the concept of the possibility that bacteria could evolve resistance to bacteriophages, just like they do to antibiotics (Zimmer, 2016).
In addition to the bacteriophages, other solutions that have been put forward by governments and other leading medical bodies are the implementation of stricter regulations and legislation on how easy antibiotics are prescribed and enforce more stringent record keeping on those who are given courses and possibly even reducing the total duration on antibiotic course. In addition to this, a major issue that is exacerbating the problem is our extensive use of growth enhancing antibiotics on livestock which has spread the issue of antibiotic resistance into the wider biosphere and ecosystem which is having major impacts on the world as a whole so in limiting this and intern allowing for more natural evolutions of the bacteria to occur it is likely that these superbugs will go away as the adaptation to become resistant to something that isn’t as much of a threat is very costly and so is more likely to be weeded out as time progresses.
On the other side of the argument, many large pharmaceutical companies are striving to innovate and create new and stronger antibiotics to counter the new threat, with large amounts of support from the FDA and the WHO, who are intern becoming increasingly concerned about the emergence of highly dangerous strains of antibiotic resistant bacteria rendering all previous lines of defence pointless and may cause irreparable socio-economic damages if left unchecked.
The final step that has already begun to be implemented is informing the general public about the risks involved and what steps they as individuals can do to help. This was more heavily implemented in and around 2015 and with the younger generations learning about the risks involved at an earlier age thanks to it being included inside the school curriculum this will ensure that in the future people will be more well informed about the risks and so in conjunction with the promotions of the risk it will likely to be
In conclusion, misusing antibiotics continuously can be extremely dangerous for everyone even if you yourself are not misusing antibiotics actively. If the rates of antibiotic resistance keep increasing significantly we as a society will lose the ability to fight infections and mortality rates will exponentially grow as minor illness and injuries potentially become fatal as they were back in the 1930s. If the future solutions are not implemented there is a very likely chance that we will lose access to the innovations as well as massively hinder the further development of treatments and surgeries that have become both commonplace and vitally important. From the numerous possible avenues of solutions put forward some shine brighter than others in terms of longevity and successfulness, Primarily the use of bacteriophages and informing the public about the risks and how they might be stopped with innovation and research into new fields of study.
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