Considering Resistance in World Antibiotic Awareness Week

Pills in world map shape

In the lead-up to our event, ‘Antibiotic resistance: A Global Ticking Timebomb?‘, in collaboration with ReThinkX, we explore why the question is of vital importance, and what the event has in store for our audience.


We have all, in some sense or another, heard of ‘antibiotic resistance’. But what does this actually mean in practice, and is this something we need to be aware of? Moreover, should our current state of affairs concern us?

In short – yes. But why?

In 1928, Scotsman Alexander Fleming serendipitously discovered penicillin when he noticed that bacteria did not grow around mould in a petri-dish left by a windowsill. Penicillins eventually came into clinical use in 1942.[1] Since then, the use of antibiotics has grown exponentially.

At one point or another, all of us have been prescribed a course of antibiotics to treat an infection – whether  tonsillitis, cellulitis, a water infection, up to meningitis, septicaemia and tuberculosis. No organ remains immune to invasion, and these miraculous medicines, together with vaccines, have transformed our world over the past century.

Indeed, their deployment has led to the decline and disappearance of previously life-threatening infectious diseases. However, it is their very target, living and growing bacteria, that is their weakness. Take a harder look at these pills. Because unlike other drugs, antibiotics can become ineffective over time.

What is resistance?

Between 1930 and 1962, more than 20 classes of antibiotics were developed and marketed. Each of these work on different aspects of a bacterium’s metabolism. In essence, bacteria develop strategies that can work around the unique mechanisms of these antibiotics.

Bacteria can also exchange genetic material; therefore, bacteria that survive pass on these resistance traits, thereby creating a ‘resistant’ population of bacteria. When bacteria become resistant to more than one antibiotic, they are also popularly termed ‘superbugs’.

These are now routinely screened for in hospitals – notably, MRSA (methicillin-resistance Staphylococcus aureus). Enter a microbiology laboratory, and you will notice biomedical scientists routinely testing all bacteria cultured from patient samples for their resistance to different antibiotics. By some estimates, we will need 20 new antibiotic classes in the next 50 years to support medicine for the next 50  – 100 years.[1]  A key U.K. government-commissioned report, ‘Review on Antimicrobial Resistance‘,  suggests that antimicrobial resistance may be the world’s biggest killer by 2050. At present, it accounts for at least 700,000 deaths per year.[2] Needless to say, this represents a huge economic burden.

This is the reality we live in today, and these warnings from our resident microbiologists must not go unheard. Indeed, the WHO has defined multiple antimicrobial resistance as:

a serious threat [that] is no longer a prediction for the future, it is happening right now in every region of the world and has the potential to affect anyone, of any age, in any country

Perhaps this phenomenon is no better illustrated than by the following video from the Kishony Lab at Harvard University, which recently went viral. The researchers elegantly demonstrate the evolution of antibiotic resistance in a bacterial strain on a gigantic petri-dish.

The evidence shows that resistance on a global scale has been catalysed by a multiplicity  of factors, ranging from inappropriate prescription and over-the-counter use of antibiotics, to their extensive and often prophylactic use in agricultural livestock – once these resistant genes develop, they can spread through water, air, and meat products.[3]

For individuals who are immunocompromised and more susceptible to developing infections, these are becoming increasingly difficult to treat as we begin to pull out our final defences.

Our solutions must reflect the widespread nature of this problem: we need to tackle it at the drug development stage, by investing in the synthesis of new antibiotics as well as in vaccines to help us offset antibiotic use, right up to changing and implementing public health policies that impact on agricultural and pharmacological practice. In addition, we must educate both professionals and the public on why antibiotics need protection. Indeed, all of these efforts are now in motion.[2]

Antibiotic resistance: A Global Ticking Timebomb?

To reflect the multi-pronged and coordinated approach that the ongoing challenge of antimicrobial demands, the Manchester Global Health Society, in collaboration with ReThinkX – the team behind the annual flagship conference that showcases the best in medical innovation – bring to you a unique and multidisciplinary event that aims to help the audience understand the issue in all its dimensions. We have invited historians, public health and health protection specialists,  and eminent experts in fields of health policy and economics, to discuss and shed light on this evolving problem. Scroll down to see our announced speakers so far.

The event, ‘Antibiotic Resistance: A Global Ticking Timebomb’, will take place between 5:30pm and 8 pm at Citylabs 1.0, Nelson Street, in Manchester, on 17th November, 2016, during the 2nd World Antibiotic Awareness Week.
All are welcome, strongly encouraged to attend, entrance is free, and tickets can be obtained here:
http://amrevening.eventbrite.co.uk

A recap of the event can be found here:

6 important lessons to learn about antibiotic resistance – AMR Event 2016


Speakers 

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References

  1. Coates, Anthony RM, Gerry Halls, and Yanmin Hu. “Novel Classes of Antibiotics or More of the Same?” British Journal of Pharmacology. Blackwell Publishing Ltd, May 2011. Web. 06 Nov. 2016.
  2. Review on Antimicrobial Resistance. HM Government, The Wellcome Trust, n.d. Web. 06 Nov. 2016.
  3. Smith, Tara C. “Antibiotic Resistance: Myths and Misunderstandings.” ScienceBlogs. ScienceBlogs, 10 Sept. 2015. Web.

Resources of interest

http://www.thelancet.com/series/antimicrobials-access-and-sustainable-effectiveness
The Lancet, the world’s most eminent medical journal, published a series on antimicrobial resistance in November, 2015, that examines the issue from multiple angles.

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