War against Antibiotic Resistant Bacteria in the recent times, bacterial resistance is exponentially outpacing the introduction of new antibiotics due to antibiotc misuse

Glossary

Antibiotics/Antimicrobial: A class of medicine that was designed to treat bacterial infections. They do this by interfering with normal bacterial functions such as cell wall repair which will cause them to die. To obtain antibiotics within the United States, a doctor's prescription is required.

Conjugation: The process of when 2 bacteria are exchanging plasmids via a microscopic tube or direct contact. There are few others ways that bacteria could use to exchange DNA, but conjugation is the most common method.

Plasmids: A microscopic and round shaped object within bacteria that contains DNA that is independent from the bacteria’s chromosomes. The DNA within the plasmids are not essential to the bacteria’s survival, they are activated when the bacteria would benefit from it under certain conditions. Plasmids can be exchanged between bacteria of different species.

Prescription: A form written by an doctors that allows a patient to access regulated drugs. In the United States, by federal law, all antibiotics requires a prescription by a certified physician.

Resistance/Resistant: A bacteria that has acquired the ability to neutralize the effect of a class of antibiotics. When a antibiotic cannot kill a bacteria, that bacteria is considered to have resistance.

Superbugs: Medical terminology for a single specimen or a strain of bacteria that is resistant to multiple or all antibiotics. Superbugs are usually rare but deadly if it infects a person.

How much damage will antibiotic bacteria cause if not controlled?

Antibiotic resistance spread among bacteria will make ordinary surgery much more dangerous and will stir up a economic and humanitarian disaster if not controlled. In fact, a research led by Dr. Ramanan Laxminarayan has concluded that, “... common surgical procedures and cancer chemotherapy will be virtually impossible if antibiotic resistance is not tackled urgently.” As a consequence, many of the medical advancement in the last few centuries will be rendered obsolete. If this problem is neglected, the long term consequences will be much more grim, “The true cost of antimicrobial resistance (AMR) will be 300 million premature deaths and up to $100 trillion (£64 trillion) lost to the global economy by 2050” as stated by Anthony King, a writer for “Scientific American”. Antibiotics is a revolutionary drug that saved many lives, but the misuse of antibiotic had led a severe decline in their effectiveness.

If the predictions holds true, the world may experience another event similar to the "Black Death"
How did antibiotic abuse become common?

Society have been abusing antibiotics by prescribing it when it is not necessary. Unnecessary overprescription by doctors is a major driving factor of why bacterias are evolving so quickly to defend themselves against antibiotics. As estimated by the CDC, “Each year in the United States, 47 million unnecessary antibiotic prescriptions are written in doctor’s offices, emergency rooms, and hospital-based clinic.” The amount of unnecessary antibiotics that are prescribed each year in the U.S. is contributing to an upcoming epidemic if it is not dramatically lowered in the near future. A prominent sector that has been abusing antibiotics is the agricultural industry. “The vast majority is used on healthy animals to promote growth, or prevent disease in crowded or unsanitary conditions,” reports the Consumer Union. Majority of the antibiotics used within the agricultural industry is not used for the animal’s welfare, but a preventive measure to reach an higher profit margin. Antibiotic resistant superbug will be an impending calamity in the future if no immediate is taken now, yet many do not know how bacterias attain resistance.

How do bacteria become resistant to antibiotics?

First, a bacteria must evolve a mechanism to protect itself against antibiotics, then it can pass the mutant gene to other bacteria in many ways. Due to the increased pressure from antibiotics, natural selection among bacteria speeds up; those that evolved resistance will be able to reproduce to pass on their genes according to Tufts University. The offspring of the resistant bacteria will be able to reproduce in exponential numbers since all other competitors were eliminated within its environment. Unlike humans who are born with a definite amount of unchangeable sets of genes, bacteria can transfer or take genes from other nearby bacteria. According to Matthew Ellington of the European Society of Clinical Infectious Diseases, ”The resistance genes encoding them, which may be incorporated into plasmids, transposons or integrons, or may exist either as gene cassettes or as partial gene fragments released from dead bacterial cells, are acquired by new host strains via horizontal transfer, mediated by conjugation, transformation or transduction.” Precautionary measures against antibiotic resistant bacterias were widely adopted only recently.

A Harvard experiment that helps to visualize how bacteria evolve resistance against antibiotics

What has been so far to stop antibiotic resistant bacteria?

Medical organizations has been on the heels of tracking and identifying resistant bacteria since the first cases were reported and recently governments had made controlling resistant bacteria a national priority. As a matter of fact, a Executive order issued on 18th of September during the year of 2014 by President Obama, launched a program that will coordinate many agencies and organization to work together to prevent that spread of antibiotic resistant bacteria domestically and internationally as reported by Targeted News Service. This will influence other policy makers throughout the world to also adapt measures to limit the spread of antibiotic resistant bacterias. But before many governments enacted procedures to control resistant bacteria, many organizations were zealous in promoting careful use of antibiotic that the term antibiotic stewardship was coined. As stated by Infectious Diseases Society of America, “Antimicrobial stewards seek to achieve optimal clinical outcomes related to antimicrobial use, minimize toxicity and other adverse events, reduce the costs of health care for infections, and limit the selection for antimicrobial resistant strains.” To completely derail the current trend of increasing antimicrobial resistance, it would require extensive effort from everybody from different paths of life to cooperate together.

What can do better to stop this from becoming a major catastrophe?

It is impossible to prevent bacteria from becoming resistant to antibiotics but the resistance could be delayed and controlled if the global medical infrastructure was to be overhauled. Physicians who took a communication course are far more likely to not prescribe antibiotics for minor infections. As stated by professor Jochen W.L. Cals of the Maastricht University Medical Centre located in the Netherlands, ”Patients who saw a family physician trained in enhanced communication skills were prescribed significantly fewer antibiotics during episodes of respiratory tract infection in the subsequent 3.5 years.” Less antibiotics were prescribed due to enhanced communication between the doctor and their patients that led to fewer misunderstandings. Designing an efficient global method to track antibiotic resistance would be huge leap because currently every country has their own procedure while some does not have any at all. According to an infographic that the CDC published, “There is no system in place to track antibiotic resistance globally.” All in all, increasing public knowledge and media coverage of antibiotic resistance will inspire policy makers and pharmaceutical companies to create new types of antibiotics and policies to stop the exponential growth of resistant superbugs.

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