Life After the Golden Age of Antibacterials
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I was invited by Adamson University Biology Society to give a talk about antimicrobial resistance during their Biocon 2018: Insights on the Latest Trends on Applied Biological Sciences in Ozanam AVR, Adamson University last February 22, 2018
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Life After the Golden Age of Antibacterials
- 1. Life After the Golden Age of Antibacterials OURLAD ALZEUS G. TANTENGCO MD-PhD Molecular Medicine Candidate College of Medicine, UP Manila Biocon 2018: Insights on the Latest Trends on Applied Biological Sciences. Ozanam AVR, Adamson University. February 22, 2018
- 2. Infection after surgery in 1921 was a major risk
- 3. Fresh Air treatment for TB sufferers in London 1936
- 4. Giving birth was far more dangerous before antibiotics
- 5. Start of the Golden Era of Antibiotics
- 6. Sensors 2011, 11(10), 9450-9466; doi:10.3390/s111009450
- 8. But bacteria, evolve and develop defense against these compounds.
- 11. Nature 499: 394-396 (2013)
- 13. Antibiotic resistance crisis An increase in resistant organisms + A limited number of new antimicrobial drugs = a problematic scenario “The pharmaceutical industry has largely turned away from antibiotic research due to the low likelihood of getting a return on investment. Any new class of antibiotics would need to be used sparingly to conserve their effectiveness, meaning sales would be slow.” - WSJ
- 14. Post-antibiotic era Currently: - 80% of gonorrhoeal infections are now resistant to antibiotics. - 440,000 new cases of drug-resistant tuberculosis annually. Sally Davies (Britain’s Chief Medical Officer) “Antibiotic resistance should be added to the list of national emergencies”. In the future: - Strep throat to a scraped knee could kill you. - A simple hip replacement would result in 1 and 6 deaths. - The cost to treat drug-resistant cases is estimated to be at least double.
- 15. Top 10 Leading Causes of Morbidity in the Philippines (2013)
- 16. Top 10 Leading Causes of Mortality in the Philippines (2013)
- 22. “What is the use of treating people, only to send them back to conditions that gave rise to their illness in the first place?” Commission on the Social Determinants of Health, 2008
- 31. The Davos Declaration “International pharmaceutical, diagnostics and biotechnology companies, as well as key industry bodies, have come together to work in parallel in taking comprehensive action against drug-resistant infections “. 1. Reducing the development of drug resistance. 2. Increasing investment in R&D that meets global public health needs. 3. Improve access to high-quality antibiotics for all.
- 32. Discovering Antibiotics in New Ways Teixobactin: A new class of antibiotics Binds to lipids that build the cell wall. In the Nature study, teixobactin was shown to kill Staphylococcus aureus and Mycobacterium tuberculosis without the bacteria developing a resistance to the antibiotic. iChip
- 34. 'One Health' is an approach to designing and implementing programmes, policies, legislation and research in which multiple sectors communicate and work together to achieve better public health outcomes.
- 39. We can all take a tiny step to address an overwhelming problem of antibiotic resistance
Hinweis der Redaktion
- Before the antibiotic era, 5 women died out of every 1,000 who gave birth. One out of every nine skin infections killed. Three out of every 10 people who got pneumonia died from it. There was nothing they can do because the medicines to treat these infection did not exist yet. The first antibiotic penicillin is several years in the future.
- Fleming’s legendary discovery of penicillin occurred in 1928, while he was investigating staphylococcus, a common type of bacteria that causes boils and can also cause disastrous infections in patients with weakened immune systems. Before Fleming left for a two-week vacation, a petri dish containing a staphylococcus culture was left on a lab bench and never placed in the incubator as intended. Somehow, in preparing the culture, a Penicillium mold spore had been accidentally introduced into the medium—perhaps coming in through a window, or more likely floating up a stairwell from the lab below where various molds were being cultured. The temperature conditions that prevailed during Fleming’s absence permitted both the bacteria and the mold spores to grow; had the incubator been used, only the bacteria could have grown.
- Antibiotics changed the field of medicine. Suddenly infection which used to be a death sentence became something we recover from in a matter of days. It’s like a miracle.
- Historically people die due to infectious disease because they do not live long enough to have degenerative and lifestyle diseases. But now we see a paradigm shift from 46% deaths in 1910 due to infection to just 3% in 2010. We are coming to an end of it. We stand today at the threshold of the post antibiotic era. If you go to hospitals, people are dying due to nosocomial infections and most of the time these bacteria do not respond to our first line of antibiotics. People are dying of infections again because of the phenomenon called antibiotic resistance.
- Bacteria produce substances specifically to kill other nearby bacteria in order to gain an advantage when competing for food, water or other limited resources. This is actually the source of our first antibiotics. We studied these substances in the lab and synthesized them. But bacteria, evolve and develop defense against these compounds.
- But bacteria and other pathogens have always evolved so that they can resist the new drugs that medicine has used to combat them. We produce antibiotics and the bacteria develop resistance. It has been like that for almost 70 years. This is now a war, and one we are in severe danger of losing. So it is not surprising that there are infections that out of more than 100 antimicrobials in the market, only two will work, with side effects, some only one, some none
- The North Carolinan strain of Klebsiella turned that idea on its head. It produced an enzyme, dubbed KPC (for Klebsiella pneumoniae carbapenemase), that broke down carbapenems. What’s more, the gene that encoded the enzyme sat on a plasmid, a piece of DNA that can move easily from one bacterium to another. Carbapenem resistance had arrived. The enzyme is worrisome because it arms bacteria against carbapenems, a group of last-resort antibiotics. New Delhi metallo-beta-lactamase 1 (NDM-1)[1] is an enzyme that makes bacteria resistant to a broad range of beta-lactam antibiotics. Such bacteria are usually susceptible only to polymyxins and tigecycline.[2]
- Resistance has increasingly become a problem in recent years because the pace at which we are discovering novel antibiotics has slowed drastically, while antibiotic use is rising
- Without antibiotics, we will lose a lot of medical procedures, surgeries, dialysis, installation of foreign objects such as valve replacement, pacemaker, hip replacement. More than anything else we will lose the confident way we live our everyday lives. If you knew that a simple wound can kill you, will you still go out, play, do sports and all of the things that you enjoy?
- Today, economist Jim O’Neill’s 2016 Review on Antimicrobial Resistance for the UK government, states that 700,000 people worldwide die annually from AMR-related infections, and a predicted death toll of 10 million by 2050 will make AMR the world’s biggest cause of death, above cancer. How did we get to this point? That we are at the threshold of golden epoch of antibiotics and what we look forward is the most terrifying phenomenon of deaths ue to antibiotic resistance? Albert Alexander had scratched his face on a rose bush, the wound had become infected and the infection had spread We think that this will only affect people who are in ICU, people who are at the end of their life.
- When more people are exposed to more antibiotics, resistance is likely to build faster. And new alternatives are scarce, Kallen says, as the pace of developing novel antibiotics has slowed.
- The vast majority of all those antibiotics sold for use in livestock aren’t being given to chickens, pigs and cows that are sick. Instead, they are being mixed in with food and water and fed to food animals routinely to promote faster growth and prevent disease in crowded, stressful, and unsanitary conditions—essentially as a substitute for better management practices.
- As of April 1st, 2016, a total of 98 companies and 11 industry associations in 21 countries have signed the Declaration.
- We were previously limited by our ability to isolate bacteria on media in the lab (predicted to support only 1% microbial growth). By culturing in situ we increase our odds of developing new antibiotics (50% grow). Eleftheria terrae Kim Lewis at Northeastern
- 'One Health' is an approach to designing and implementing programmes, policies, legislation and research in which multiple sectors communicate and work together to achieve better public health outcomes. The areas of work in which a One Health approach is particularly relevant include food safety, the control of zoonoses (diseases that can spread between animals and humans, such as flu, rabies and Rift Valley Fever), and combatting antibiotic resistance (when bacteria change after being exposed to antibiotics and become more difficult to treat).