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Superbugs- Conquering the World with Antibiotic Resistance

Superkeime

The History of Superbugs

The fight of humans vs infec­tious dise­a­ses is as old as huma­ni­ty its­elf. It was until the dis­co­very of peni­cil­lin by Alex­an­der Fle­ming in 1928 that the homo sapi­ens final­ly gai­ned a mas­si­ve advan­ta­ge in this war. His dis­co­very was the start of the anti­bio­tic era and thanks to them, bac­te­ri­al infec­tions were no lon­ger the world­wi­de death cau­se num­ber one. In fact, anti­bio­tics were so effec­ti­ve that we were able to pro­long the avera­ge human life­time by 10 years! It is all good then, isn’t it? Well no, it isn’t becau­se micro­bes did find an ans­wer. Natu­re in fact always finds an ans­wer. This time it is cal­led super­bugs. We are on our way to losing the advan­ta­ge we got becau­se of the antibiotics. 

Superbugs

The Bacterial Nature

We need to under­stand the bac­te­ri­al beha­vi­or to under­stand how bac­te­ria beco­me resistant to anti­mi­cro­bi­als. Micro­bes (inclu­ding bac­te­ria) are ever­y­whe­re. In fact, they are pro­ba­b­ly the most suc­cessful when it is about sett­ling down in places that seem unp­lea­sant to us. Howe­ver, apart from popu­la­ting the who­le world (inclu­ding us), bac­te­ria are spe­cial becau­se of their love for divi­ding and replicating.

As soon as they found a place whe­re they feel at home, they mul­ti­ply rapidly. Howe­ver, we can not only redu­ce them on that abili­ty as they pos­sess one even more impres­si­ve cha­rac­te­ristic: they can share genes — an essen­ti­al abili­ty for the rise of superbugs.

Any­way, we won’t spoil any­thing yet. So let’s start tal­king about genes for a moment. Genes pret­ty much defi­ne who we are. They are respon­si­ble for our eye color, body size, hair color (colo­ring your hair does­n’t count as “modi­fy­ing your genes”!). All the­se things are (to a lar­ge extend) defi­ned by the genes we got from our mum & dad, and grand­ma & grand­pa, and… you get it. 

The same more or less appli­es to our micro­sco­pic fri­ends as they pret­ty much get the who­le gene­tic data­set of their direct ances­tor. Like that, bac­te­ria evol­ved over time to con­quer the world and live at the most fre­aky places you can think of.

Superkeime
And the same way they can have genes within their cell that makes them resistant to one or seve­ral anti­bio­tics. Howe­ver, we still did­n’t talk about the most impres­si­ve fea­ture bac­te­ria pos­sess. While humans pret­ty much have a fixed gene­tic data­set for their enti­re life­time and also don’t muta­te real­ly often when the genes of mum and dad form a new human, bac­te­ria are much more fle­xi­ble and can take up new genes throug­hout their jour­ney in life.
 
Superbugs

Pret­ty much, yes!

Superbugs

Superbugs and how they Evolve

Natu­re came up with seve­ral pos­si­bi­li­ties for bac­te­ria to gain new genes to make sure we won’t have an easy fight against them (real­ly, we don’t know the reason why natu­re came up with tho­se possibilities).

  1. They take up new genes from their envi­ron­ment. This can hap­pen when bac­te­ri­al cells in their direct envi­ron­ment die and set free their cell con­tents. This actual­ly comes quite clo­se to rob­bing a grave.

Transformation

2. They get infec­ted by a virus and got lucky. Yes, bac­te­ria also can get their own kind of the flu (dead­ly in many cases). Howe­ver, if a bac­te­ri­um gets infec­ted by a virus that infec­ted ano­ther bac­te­ri­um befo­re, it can hap­pen, that the virus does inject gene­tic mate­ri­al from the bac­te­ri­al cell it infec­ted recent­ly ins­tead of its own viral genes. As a result, the infec­ted bac­te­ri­um does­n’t need to worry about a virus repli­ca­ting within its cell but rather now has the pos­si­bi­li­ty to use the genes of the other bacteria.

Transduktion

3. They have “sex”… in their own weird way. Bac­te­ria can make cell cont­act through a so-cal­led “pili” and trans­fer genes through that bridge. This is a real­ly com­mon mecha­nism, that plays a big role in the spread of anti­bio­tic resis­tance and the deve­lo­p­ment of sueprbugs.

Konjugation

4. They muta­te. Muta­ti­ons are fight­ing with a bad image in the year 2021 due to the COVID-10 virus. Howe­ver, their image won’t real­ly impro­ve when we’­re tal­king about anti­bio­tic resis­tance. Most muta­ti­ons in bac­te­ria hap­pen during the repli­ca­ti­on pro­cess. Howe­ver, most of the­se muta­ti­ons are coun­ter­pro­duc­ti­ve. Nevert­hel­ess, tho­se few that give the bac­te­ri­um a sel­ec­ti­ve advan­ta­ge against other orga­nisms will estab­lish over time out of evo­lu­tio­na­ry reasons. Future bac­te­ri­al gene­ra­ti­ons will then also recei­ve the­se muta­ti­ons (as bac­te­ria are pas­sing on their gene­tic dataset).

Mutation

 

So that are the four easy ways how bac­te­ria can trans­form into super­bugs (and why humans are lucky enough to not share their ability).

Superbugs and how we add to this

We are not yet screwed but we need to under­stand how every one of us con­tri­bu­tes to the spread of anti­bio­tic resis­tance and the rise of superbugs.

Let’s have a look at a real-life exam­p­le some of you might have alre­a­dy expe­ri­en­ced. You’­re fee­ling sick and seek the help of a doc­tor who pre­scri­bes an anti­bio­tic the­ra­py. And you are lucky — it is working! After a few days alre­a­dy, you’­re fee­ling bet­ter. In fact, you are fee­ling that good, that you deci­de you don’t need to take your anti­bio­tics any­mo­re. No pro­blem so far. Howe­ver, let’s have a look at the inside.

Superbugs

First of all, we need to under­stand that 1. we are tee­ming with bac­te­ria insi­de and on us (just in our gut, the­re are 100 tril­li­on micro­bes — most of which, it’s worth not­ing, are bene­fi­ci­al to us) and 2. micro­or­ga­nisms divi­de when­ever the oppor­tu­ni­ty ari­ses. Par­ti­cu­lar­ly eager repre­sen­ta­ti­ves can dou­ble every 20 minutes! 

Through our anti­bio­tic the­ra­py, we’­ve essen­ti­al­ly clea­ned house in our gut. While the antibiotic’s tar­get was pri­ma­ri­ly the trou­ble­ma­ker that slip­ped in among the bene­fi­ci­al bac­te­ria, the anti­bac­te­ri­al agent could­n’t care less about that distinc­tion. But the good thing about the the­ra­py is that we’­ve likely eli­mi­na­ted the majo­ri­ty, if not all, of the intru­ders along­side all the col­la­te­ral dama­ge. The down­si­de, howe­ver, is that the orga­nisms that sur­vi­ved were eit­her very lucky or alre­a­dy pos­s­es­sed resis­tance to the anti­bio­tic. The­se could be com­ple­te­ly harm­less or even bene­fi­ci­al bac­te­ria — they just hap­pen to car­ry a resis­tance gene. Some might alre­a­dy see whe­re this is hea­ding. Our gut inha­bi­tants, inclu­ding their anti­bio­tic resis­tance, have litt­le com­pe­ti­ti­on now for living space and are taking advan­ta­ge of the moment to mul­ti­ply mas­si­ve­ly. So, our gut is now tee­ming with micro­or­ga­nisms car­ry­ing anti­bio­tic resis­tance genes. When you put two and two tog­e­ther, it quick­ly beco­mes clear that the likeli­hood of this gene being pas­sed on (e.g., to the next unwan­ted intru­der) has signi­fi­cant­ly increased — espe­ci­al­ly if you keep in mind the simp­le pathways for the spread of such genes. Thus, we can rela­tively easi­ly breed our own super­bug — if one desi­res to do so.

What might initi­al­ly sound like sci­ence fic­tion is hap­pe­ning dai­ly right befo­re our eyes. An uni­ma­gi­n­ab­ly lar­ge num­ber of micro­or­ga­nisms are con­stant­ly inter­ac­ting with each other and can evol­ve through rela­tively simp­le means. Anti­bio­tic resis­tances are also affec­ted by this evo­lu­ti­on. So, while it will be essen­ti­al from a sci­en­ti­fic per­spec­ti­ve to dis­co­ver new agents (such as Irre­sis­tin) to keep poten­ti­al infec­tious dise­a­se patho­gens in check, we can and must all con­tri­bu­te to ensu­ring that exis­ting anti­bio­tics retain their effec­ti­ve­ness for as long as pos­si­ble and that super­bugs do not emer­ge at all.

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