Antibiotic Resistance – A Biological Arms Race

An arms race by definition is “a competition between countries to achieve superiority in quantity and quality of military arms”. Although speaking of something as tiny as bacteria in connection to this concept may sound melodramatic, it doesn’t make the facts any less truthful.

        

The truth is that people are finding themselves on the losing side of this war against bacterial infectious disease for some time now. Ever since the world wars, antibiotics were heralded as “miracle” drugs and were used to beat back the advancement of many diseases like tuberculosis, cholera and syphilis that were considered to be formidable enough to take out large populations at a time. Infectious diseases like these were the biggest killers of human beings for centuries. Out of desperation, biologists began to search for the next big medical advancement. After Alexander Flemming discovered pencillin, the floodgates were opened and scientists got on the antibiotics bandwagon. They discovered different classes of antibiotics like methicillin, ampicillin, amoxicillin and many others. The 1960s and the 1970s were considered to be the Golden Age of antibiotics, when most of the classes we use today were discovered.

But what happened after the Golden Age? In a word…nothing. Antibiotic synthesis and production was an extremely costly and laborious process and drug companies found that it was not cost effective to discover and mass produce more types of antibiotics when the ones they already had were effective enough against infections. The money started to flow towards research for obesity, diabetes, heart disease and cancer, as they became the new killers of the brand new millennium.

Although the health concerns of humans shifted, it didn’t mean the bacterial infections ceased to exist. They were simply held back by the generous use of antibiotics in the healthcare and agricultural industries. However, this overuse triggered a phenomenon that was inevitable. The bacteria started to evolve.

Bacteria are very simple organisms with a small genome that is contained within one circular chromosome. They are capable of transduction (incorporating DNA via injection by a virus), conjugation (direct transfer of DNA through joined cells), and transformation (incorporating free floating pieces of DNA into their genome). These unique capabilities made for formidable weaponry and meant that while primates took thousands of years to evolve into human beings, some bacteria took only days to evolve into strains that contain brand new genes.

What does this mean for the arms race? It means that we are facing species capable of adapting to any weapon we use against them and that we have been using the same weapons over and over again since the 1970s. This has had devastating consequences, which a 2013 CDC threat report of over a hundred pages details. This report states that in 2013 over 23,000 deaths occurred due to antibiotic resistant infections. This number will continue to increase as long as people overuse the same antibiotics over the next few decades. The CDC also reports a re-emergence of diseases like tuberculosis and syphilis because strains have evolved to be resistant to multiple classes of antibiotics. This means that alternative treatments to antibiotics need to be discovered and soon. If this trend continues not only will people be in an arms race with newly emerging “superbugs” but also with old diseases thought to be defeated decades ago.

References

Blaser, M. (2014). Missing Microbes: How the Overuse of Antibiotics Is Fueling Our Modern Plagues (1st ed., Vol. 1). New York City: Henry Holt and Company.

Threat Report 2013, Antimicrobial Resistance, CDC. (n.d.). Retrieved November 12, 2014, from http://www.cdc.gov/drugresistance/threat-report-2013/index.html