THE WORLD BEFORE THE INVENTION OF ANTIBIOTICS WAS MUCH MORE DANGEROUS. Any infection could be fatal, and complex surgical operations could not even be dreamed of. Scientists are increasingly talking about the coming "post-antibiotic age", when the most common antibiotics stop working. Bacteria evolve and become immune to drugs. We will tell you how it happened and what will happen to humanity next.
Our organisms and the world around us are inhabited by bacteria. Most of them are harmless or beneficial, but some, pathogenic, cause infections. Before the invention of antibiotics, the human body could fight infection only on its own, with the help of the immune system. Because of this, even at the beginning of the 20th century, life was much more difficult: for example, three out of ten people infected with pneumonia died, and five out of a thousand women did not survive after childbirth. Tuberculosis, whooping cough, gonorrhea and other diseases caused by aggressive bacteria were most often fatal. Although this was rare, you could die simply by cutting yourself on the paper.
That all changed with the discovery of penicillins, antimicrobial drugs that can fight certain bacteria. The fungus benzylpenicillin was discovered in 1928 by Alexander Fleming. This happened almost by accident: he left a Petri dish with staphylococcus in the laboratory with an open window overnight and the next morning discovered that a fungus had grown in it. It took more than ten years to make a drug from the substance: Fleming himself experimented on it, as well as scientists Howard W. Flory and Ernst Chain. Flory and Cheyne's penicillin was the first antibiotic.
"Antibiotic" literally means "against life" - in this case, against microorganisms. There are many types of antibiotics: antibacterial, antiviral, antifungal and antiparasitic. Some act against many types of organisms, some only against a few. The most common antibiotics are antibacterial. They either stop the multiplication of bacteria so that the immune system itself can defeat the remaining ones, or they destroy them directly.
It was already known then that bacteria could eventually become resistant to antibiotics. Fleming understood that evolution is inevitable and that bacteria will develop: the more we use penicillin, the faster it will happen. He feared that misuse would speed up the process. The first penicillin-resistant staphylococcus bacteria appeared in 1940, even before the drug was mass-produced. In 1945, Fleming said: “The reckless person playing with penicillin treatment is morally responsible for the death of a person who died from a penicillin-resistant infection. I hope this disaster can be avoided."
How we fought the infection
The sun's rays and ultraviolet lamps were used at the beginning of the 20th century. Ultraviolet radiation kills cells, so doctors left patients in the sun or under an ultraviolet lamp in the hope that the bacteria would also be killed.
Bacteriophages, viruses that attack bacteria, were especially popular in Eastern Europe. Like antibiotics, they are taken by mouth or applied to the skin. After World War II, scientists in the Eastern Bloc actively investigated bacteriophages because they could not import drugs from the United States and Western Europe.
The method of treatment with serum was invented at the end of the 19th century, for which Emil Bering received the Nobel Prize. Serum is made up of antibodies, proteins that find and attack invading cells. To obtain serum, doctors injected humans with antibodies from the blood of horses and other animals infected with bacteria.
Today, the antibiotic resistance of bacteria that Fleming warned about is one of the main problems in medicine and in the world.With the invention of penicillin, humanity entered a race: we are trying to outrun evolution, discovering new antibiotics while bacteria adapt to the old. The antibiotic tetracycline appeared in 1950, the first bacteria with resistance to it - in 1959. Methicillin - in 1960, bacteria resistant to it - in 1962. Vancomycin in 1972 and resistant bacteria in 1988. Daptomycin appeared in 2003, the first signs of resistance to it were already in 2004, and so on. The fact is that bacteria multiply and develop very quickly. A new generation of bacteria appears every 20 minutes, which is why microorganisms evolve so quickly and adapt to external threats. Moreover, the more often we use this or that antibiotic, the more chances we give bacteria to develop resistance to them.
Antibiotic resistance has been talked about for a long time. Serious panic gripped the scientific community ten years ago with the spread of methicillin-resistant staphylococcus. The first such bacteria appeared in the 60s, but then there were only a small proportion of them. Gradually, MRSA (as this bacterium is called, Methicillin-resistant Staphylococcus aureus) began to spread. In 1974, 2% of those infected with staphylococcus in the United States were resistant to methicillin, in 1995 - 22%, in 2007 - already 63%. Now every year in America 19 thousand people die from MRSA.
Now antibiotic resistance is starting to take on truly apocalyptic proportions. We still use them a lot - and we almost stopped discovering new ones. The development of a new antibiotic costs about $ 1 million, and pharmaceutical companies have stopped doing this - it is not profitable. There are no new types of antibiotics, we use old ones, and resistance to them is growing. Moreover, the so-called pan-resistant microorganisms began to appear, resistant to several types of antibiotics, and sometimes to all.
In 2009, a patient at St. Vincent's Hospital in New York contracted an infection with the bacteria Klebsiella pneumoniae after surgery. The bacterium was resistant to all antibiotics. He died 14 days after infection. The British government has launched a project to predict antibiotic resistance: scientists believe that if the situation develops in the same way as today, then by 2050 10 million people a year will die due to resistant bacteria.
The saddest thing is that humanity is to blame for this itself. We have been extremely careless with antibiotics. Most people do not understand how antibiotic resistance works and how they should be used. We are constantly treated with them when it is not necessary at all. There are many countries where antibiotics are still available over the counter without a prescription. Even in Russia, where they are officially sold only by prescription, many of the 30 types of antibiotics available on the market are freely available. In the United States, 50% of antibiotics are prescribed unnecessarily in hospitals. 45% of doctors in the UK prescribe antibiotics even when they know they won't work. Finally, animals: 80% of antibiotics sold in the United States are used on animals rather than humans to accelerate their growth, make them thicker, and protect them from disease. As a result, bacteria resistant to these antibiotics are spread to humans through animal meat.
One of the latest news about antibiotic resistance has to do with drugs used in animals and plants. In China, bacteria were found with resistance to the polymyxin group, and specifically to the antibiotic colistin. In treatment, colistin is used as a "last chance" drug, that is, it is used to treat a patient when no other drugs are working anymore. But resistance in China was found under different circumstances: they used colistin on pigs.
How do we use antibiotics
Any complex surgery is not complete without antibiotics. They are especially needed for organ transplants: lungs, heart, kidneys and liver.To prevent the body from rejecting the transplanted organ, patients take antibiotics, which temporarily suppress the immune system.
Farmers use antibiotics on plants and animals. They make animals thicker and make them grow faster. In Asia, antibiotics are regularly used in fish and shrimp farming to protect them from bacteria that spread in the water.
Antibiotics still play a key role in the treatment of infections, from blood poisoning to sepsis, pneumonia, in dentistry and so on.
What does the future look like without antibiotics? What will we lose? You can add up everything that is in this text above: we will not be able to treat infectious diseases. Childbirth will become dangerous again. We won't be able to transplant organs. We Can't Cure Cancer: Modern cancer treatments like chemotherapy rely heavily on antibiotics to curb a person's immune system. Any injury will become dangerous, potentially fatal - it doesn't matter if you are involved in a car accident or simply fell off a ladder. You will have to live much more carefully and watch your every step. We will lose most of the world's cheap food: meat, fish, fruits will become much more difficult to produce and, as a result, more expensive.
But some scholars believe that we have hope. Antibiotic resistance in bacteria does not go unnoticed. They develop additional genes that cost them an edge over other - nonresistant - bacteria of the same species. If we don't attack them with an antibiotic, bacteria without resistance will multiply faster, and bacteria with resistance will die out. If you alternate between antibiotics, they will work more effectively. Let's say we have been using one type of antibiotics for several years, and then, when bacteria develop resistance to them, we switch to another.
Others, however, are confident that there is no hope. We have already lost the war against resistance - and a future without antibiotics is inevitable. We can only slow down its arrival in order to find alternatives to antibiotics in all areas. This requires slowing the spread of antibiotic resistance. First, to impose restrictions on the use of antibiotics in agriculture. First of all, this applies to the United States: in many countries such restrictions are already in force (for example, in Holland, Denmark and Norway, bans on the use of antibiotics are very strict) in America, they are afraid to tighten control. Secondly, we need to create the conditions under which pharmaceutical companies will again start researching new antibiotics. For example, to make drug patents last longer, or to relax requirements for clinical trials.
One way or another, all this will only delay the inevitable, but humanity is ready to develop. Just a hundred years ago, we lived without penicillin and antibiotics - and we discovered them. Scientists are now looking for the most incredible alternatives to antibiotics, from the use of predatory microbes to microscopic doses of metals that have long been known to work well against microorganisms. Perhaps by 2050 there will be something that will completely eliminate the need for antibiotics.
What alternatives to antibiotics may appear
CRISPR technology can be used against bacteria: scientists turn the bacteria's defense system against
themselves and make them self-destruct.
Predatory bacteria. Some bacteria can help fight off infection because they feed on other bacteria. One such species, Bdellovibrio bacteriovorus, is found in soil. Organisms of this species attach to other bacteria and multiply with their help, destroying the victim.
Antimicrobial peptides. Many organisms - from plants and animals to fungi - produce peptides, molecules that kill bacteria. Peptides from amphibians and reptiles, which are particularly good at protecting against infections, can help create new drugs.
Material was first published on Look At Me
Photos: Winai Tepsuttinun - stock.adobe.com, Sherry Young -stock.adobe.com, artem_goncharov - stock.adobe.com, Olha Rohulya - stock.adobe.com