Circumventing Antibiotic Resistance​

Circumventing Antibiotic Resistance

Written by Elakkiya Prabaharan
Illustrated by Jenny Zhang
In May 2015, the World Health Organization (WHO) declared Antibiotic Resistance a major global threat to “health, food security, and development” and designated this issue as “high priority”. While WHO has been urging governments to increase regulatory measures in the food and medical industries, they have also asked that countries take a proactive approach to surveying and preventing the use of antibiotics to treat infections. But why is antibiotic resistance so dangerous to our health? And why is it a global emergency?

Antibiotics are drugs that kill bacteria and are prescribed by doctors to patients suffering from bacterial infections. The agricultural industry also uses them in small doses to prevent bacterial infections from spreading amongst their livestock. Antibiotic resistance arises when bacteria no longer respond to these drugs, and this problem is worsened by their misuse. For example, if you were prescribed antibiotics by a doctor, but didn’t complete the full treatment as instructed, the bacteria susceptible to the drug would have been killed, leaving those that are resistant to continue to grow. Thus, the infection would come back—only this time, the drug you were prescribed can’t kill it! These antibiotic-resistant bacteria would spread amongst other people and become especially dangerous to those who can’t fight the infection naturally: people who are immunocompromised, pregnant, or are elderly.

Our bodies are already equipped to defend against bacterial infections with an immune response, the symptoms of which include fever and swelling. As a part of this response, immune cells called neutrophils are recruited to the site of the infection to get rid of bacteria. One way they do this is by releasing a thick, sticky substance—made of their own DNA and antibacterial proteins—called neutrophil extracellular traps (NETs) that essentially ‘trap’ bacteria and kill them. Sounds great, right? But there is a reason NETs have been described as “the double-edged swords of innate immunity” by researchers: NETs can be incredibly detrimental to patients because they can lead to severe and dangerous inflammation. Even worse is that some bacteria have gained the ability to live inside the NETs without being killed, allowing them to continue dividing and spreading all over the body.

Pneumococcal meningitis, a type of bacterial meningitis, is caused by Streptococcus pneumoniae. These bacteria take advantage of our body’s defense system and cause the protective membrane around our brain and spinal cord to swell. An antibiotic-resistant strain of S. pneumoniae is becoming more and more prevalent, which means that we can no longer use antibiotics to fix the problem. However, a recent Nature publication discussed an alternative method to treat bacterial meningitis that could reduce the need for antibiotics.

Led by Dr. Tirthankar Mohanty, researchers from Lund University in Sweden found a new way to possibly treat meningitis: disrupting the release of NETs by neutrophils, so that any surviving bacteria in the body cannot be trapped within them. The researchers injected infected mice with an enzyme called DNase 1, which digests the DNA component of the NETs, and found that this significantly reduced the number of bacteria in the brains and spinal cords of the mice.

The implications of this article are groundbreaking, especially since we can prevent some of the most harmful bacteria from evolving into beasts that we cannot kill. However, we should still try to reduce the spread of antibiotic-resistant bacteria until treatments like the one described above are available to humans. As per WHO’s advice, we must only use antibiotics when absolutely necessary and prescribed by a doctor. Make sure that you carefully follow the instructions provided by your doctor and finish the entire treatment. We must also advocate for the regulation of antibiotic use in agriculture as antibiotic-resistant bacteria can evolve within livestock and eventually infect humans.

Sources:

  1. https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance
  2. https://www.nature.com/articles/s41467-019-09040-0