According to an article in this morning’s Guardian, the age of antibiotics may be “coming to a close.” Researchers have found a gene which is easily transmittable amongst different kinds of bacteria and which provides them with resistance to many of the strongest “last resort” antibiotic drugs we currently have. The gene (called NDM 1) has been found to be widespread in India and is being spread globally via international travel and the increasing numbers of people who travel to India for “medical tourism.” The author of the research paper does not mince words regarding the potential outcome:
“This is potentially the end. There are no antibiotics in the pipeline that have activity against NDM 1-producing enterobacteriaceae. We have a bleak window of maybe 10 years, where we are going to have to use the antibiotics we have very wisely, but also grapple with the reality that we have nothing to treat these infections with.”
A world without effective antibiotics would be a scary and dangerous place. Surgery in general would be much riskier due to post operative infections. Transplant surgery would not be possible, and many maladies that we are able to treat effectively today, like pneumonia, and TB could once again be life threatening.
How did we get to this state? Natural selection plays a role – the bacteria are constantly evolving in an arms race to defeat antibiotics. We humans also share some of the blame – by overprescribing antibiotics, we have gave the bacteria increased opportunities to develop resistance to all of our pharmaceutical weaponry.
It seems to me that if we want to preserve the progress mankind has made in treating infectious diseases, governments and the private sector need to create a new “Manhattan Project” to develop new drugs to meet this evolving threat. This is not a one time project – the little bacterial bastards will keep evolving, requiring additional research and drug development. We also need to stop using antibiotics so indiscriminately – I wish that doctors would stand up to patients who insist on antibiotics even when there is no clinical reason to prescribe them.
In the meantime, wash those hands, folks…
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Interesting post. There is a project going on that could provide an alternative to antibiotics by preventing bacterial communication. Many bacteria have to know they have reached critical mass before launching an attack. This is performed through “Quorum Sensing” which may be disrupted.
Great ted talk on the concept here:
http://www.ted.com/index.php/talks/bonnie_bassler_on_how_bacteria_communicate.html
I explored the idea of a quorum sensing botnet here: http://www.developingsecurity.com/weblog/2009/04/quorum-sensing-botnets.html