Antibiotic ResistanceColin Orians
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Let’s take a trip back 50 years to November 29, 1942, the night of the tragic fire at the Coconut Grove, one of Boston’s popular entertainment establishments. This event that filled the front pages of the Boston Globe and the Boston Herald is now regarded as a historically momentous medical event—the trial of a new drug, penicillin.
It was used to combat Staphylococcus aureus, a bacterial contaminate of skin wounds of fire victims. Penicillin emerged from the Coconut Grove fire as a symbol of our ability to control the microbial world, earning the accolade of “miracle drug.” However, Alexander Fleming, the British bacteriologist who discovered the drug, set the potential for the development of resistant bacteria,
especially once penicillin became available in oral form. With the unmonitored misuse and overuse of antibiotics, Fleming’s predictions came true, but to more devastating effects than he could have possibly imagined. Antibiotic resistance occurs when an antibiotic has lost its ability to effectively control or kill bacterial growth.
It occurs when strains of bacteria in the human body become resistant and continue to multiply even in the presence of therapeutic levels of an antibiotic. Bacteria can become resistant to antibiotics in two ways: by genetic mutation or by acquired resistance from another bacterium. Mutations are rare spontaneous changes of the bacteria’s genetic material
that can allow the bacteria to produce chemicals to inactivate the antibiotic or eliminate entry points that allow antibiotics to enter the cell. Bacteria can also acquire antibiotic resistance from other bacterium. Conjugation allows the bacteria to transfer genetic material, including resistance. Viruses also can pass resistance traits between bacteria
which are packaged in the head of the virus and injected into new bacteria. By the early 1950’s penicillin-resistant Staph was at pandemic levels. Methicillin was soon introduced to fight this strain of Staph. However, MRSA, or Methicillin-resistant Staph, soon emerged and by the mid 1980’s MRSA had reached pandemic levels as well.
Annually in the US, MRSA alone represents over 100,000 infections. When taken, antibiotics should be prescribed only for bacterial infections, in the proper dose, and for the proper amount of time. The APUA, the Alliance for the Prudent Use of Antibiotics, emphasizes the importance of taking an antibiotic as long as it is prescribed.
A complete dose is needed to kill all of the harmful bacteria, but if not killed could restart an infection and potentially be spread to others. MRSA can spread rapidly. Infected patients are free to spread their infections to hospitals, staff, friends and families for up to two days before they are identified as MRSA carriers.
This is because the current diagnostic screening for hospital acquired infections, like MRSA, can take up to 48 hours to obtain a result. To prevent the spread of MRSA during those 48 hours, it is imperative that we find a more efficient screening technique. Currently, the Tufts University Biomedical Engineering Department is working to develop a bio-sensor
that only takes minutes instead of days to identify an infected patient. Hygiene is essential in taking action against antibiotic resistance. Increased sanitation and high standards of hygiene in clinical settings will help control the spread of infection.
But even basic measures like good hand washing technique can reduce the spread of bacteria. The microbial world is out of our control. Bacteria are evolving faster than our technology. We cannot win this arms race. What will happen when a new strain of bacteria emerges that we cannot cure?