Science 9 min read

Antibiotic-Resistant Superbugs: The Past, Present, and Future

simon jhuan | Shutterstock

simon jhuan | Shutterstock

To combat superbugs, researchers are working to develop new classes of antibiotics and find ways around antibiotic resistance.

However, with more superbugs being discovered every day, this may become an issue that humanity struggles to overcome.

What did physicians have in their arsenal to treat infectious diseases before antibiotics? Well, not much.

Used as a medical therapy since ancient times, “bloodletting,” which often involved leeches, was recommended for a wide range of diseases from smallpox to “general malaise.”

If you cringe at the idea of bloodsucking leeches crawling over your skin, know that the FDA approved the use of leeches as “medical devices” in 2004.

With bloodletting, cupping was also widely used by doctors. Actually, the word “doctor” in this context should be taken with a pinch of salt.

With the bloodletting business thriving in the 19th century, many barbers offered their services to sick or ailing customers. That’s why some barbershops still have the white, red, and blue pole as a reference to these “bloody” times.

These and other alternative therapies have been in use for millennia, but whose safety and effectiveness were iffy at best.

Now, we think of ourselves as past these techniques, but the rise of antibiotic-resistant bacteria may put this at risk.

Penicillin and the Age of Antimicrobial Therapy

As far back as the first decades of the 20th century, a minor cut or even a toothache could get you killed due to there being no effective treatment for blood poisoning or most infections.

With the high morbidity and mortality rates of the time, infectious diseases were filling hospitals with patients whose chances of recovery were practically nil.

The world had to wait until the 1940s for antibiotics to be introduced as a miracle solution against infections.

It was almost a century ago, in 1928, when Alexander Fleming ushered in the age of antibiotics with his discovery of penicillin.

In 1940, Ernst Chain and Howard Florey showed the anti-microbial effectiveness of Fleming’s penicillin and shared the 1945 Nobel Prize in Physiology or Medicine with him for their achievements.

The discovery of penicillin was an exceptional breakthrough for modern medicine. It paved the way for antimicrobial therapy that helped save millions of human lives and livestock animals.

After penicillin, with further research and development, some new classes of antibiotics were discovered and put on the market.

Read More: Can We Really Kill Superbugs Without Antibiotics?

Although antibiotics managed to save tens of millions of lives in the past, their effectiveness is now in jeopardy.

Antibiotics that help stop the development of certain bacteria have quickly led to the emergence of antibiotic-resistant bacteria and other superbugs.

We’re Running out of Lifesaving Antibiotics

The very drugs used to cure infectious diseases have led to them acquiring superpowers and becoming resistant to treatment in the long run.

A bacterium’s primary goal, like all living organisms, is to survive. This means they need to adapt to each new threat or, in many cases, antibiotics, in their environment.

To survive these threats, bacteria have developed the ability to mutate to change their genetic makeup spontaneously.

This has given many bacteria the ability to resist and become immune to the most common antibiotics that target them.

After gaining this immunity, bacteria can transmit these resistance genes to the next generation, sparing it from going through the mutation process again.

Mutated bacteria may also transfer this drug-resistant ability to other species of bacteria. They can even transmit resistance to harmless strains that could also become infectious.

This resistance is a natural biological phenomenon that’s been around for as long as there has been life on earth.

But, we just made things worse with the abuse of antibiotics.

The overprescription and misuse of antibiotics have led microbes to develop resistance to these medications rapidly. This is quickly becoming a primary global concern.

Prescribing antibiotics for cases that don’t require such treatment, such as viral infections like the flu, only increase the risk of other bacteria in our environment mutating and developing antibiotic resistance.

According to a study published by the CDC, unnecessary prescriptions for antibiotics in the U.S. account for 47 million prescriptions each year.

To put that into perspective, that’s 30% of all the antibiotic prescriptions provided in the US, all of which are entirely unnecessary.

Antibiotic-resistant bacteria are making infectious diseases deadlier. Even common infections are suddenly becoming life-threatening, especially for the elderly and young children.

Superbugs: the Crisis of Antibiotic Resistance

Superbugs
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Antibiotic-resistant bacteria have earned the infamous nickname “superbugs” as they can resist antimicrobial therapy, sometimes even when targeted with multiple drugs.

Threatening the resurgence of incurable infectious diseases, superbugs pose a worrisome health challenge for the world.

Last year, the World Health Organization released a list of 12 families of drug-resistant bacteria against which new antibiotics need to be developed urgently.

Described by WHO experts as “priority pathogens,” these 12 families of bacteria were deemed to be the most threatening strains to public health.

The “deadly” catalog includes three categories organized by their risk to human health and the urgency of new drugs needed.  The catalog spans from medium, to high, to critical priority.

It’s in the “critical” category where we find the likes of E. coli, which shows resistance even to the most potent antibiotics.

Some strains of E. coli have become almost entirely resistant to most antibiotic treatments, even to drugs of last resort.

“The most critical group of all includes multidrug-resistant bacteria that pose a particular threat in hospitals, nursing homes, and among patients whose care requires devices such as ventilators and blood catheters.” said a representative from WHO. “They include Acinetobacter, Pseudomonas, and various Enterobacteriaceae (including Klebsiella, E. coli, Serratia, and Proteus).”

Now claiming about 700,000 lives worldwide each year, drug-resistant infections could kill more than ten million people by 2050. That’s more than cancer’s, which is around 8 million people worldwide annually.

The more things change, the more they stay the same. Just like during the 1940s, the world seems now to be in desperate need of new drugs.

From 1993 to 2003, the discovery rate for new antibiotic compounds dropped by 56%.

The pharmaceutical industry has been able to develop only a few new classes of antibiotics in recent decades, and money has a large part to play in that.

One of the main reasons is because the ROI for anti-infective agents is considered to be poor by many research labs.

It seems that in the modern pharmaceutical industry, short-term profits from other, more lucrative medicines are given priority over long-term and socially beneficial treatments.

Read More: Are CRISPR-Cas9 & Gene Editing the New Vaccine?

Is the World Doomed by Superbugs?

Superbugs
GiroScience | Shutterstock

The challenge of antibiotic resistance is double-edged: on one side of the spectrum, antibiotics themselves are losing their potency. On the other, with downsized antibiotic R&D, labs can’t deliver new natural or synthesized compounds.

Health organizations and experts regularly sound the alarm on the rise of superbugs and the soaring antibiotic resistance, but it often falls on deaf ears.

However, all is not lost. Researchers are searching for new classes of antibiotics, investigating alternative treatments, and trying to find new ways to circumvent antibiotic resistance.

To give pharmaceutical companies some credit, it’s not just money that gets in the way of finding new classes of antibiotics.

One of the hurdles researchers encounter when dealing with bacteria is that the majority of these microorganisms, up to 99%, can’t be cultured outside their natural milieu.

However, scientists have tried some tricks to cultivate a sample of bacteria that they can work with. Researchers can either culture bacteria in site or use special growth factors in the lab.

The bacteria used represents a new class of antibiotics that reportedly “kills pathogens without detectable resistance.

In an effort to think outside the box, a team of researchers at Oregon State University is trying another approach. They have developed a new molecule that can potentially neutralize the expression of antibiotic resistance genes in bacteria.

Another new technique, proposed by a doctoral student at the University of Melbourne, promises to kill superbugs without antibiotics at all.

This student created a polymer called SNAPP (Structurally Nano-engineered Antimicrobial Peptide Polymers), which could lead bacteria to commit suicide with no antibiotics involved.

This method, if properly implemented, could lead to an enormous boost in our efforts to stem the flow of antibiotic-resistant bacteria.

Taking a similar strategy to SNAPP, scientists at the University of Texas presented a new method that allows researchers to quickly and cheaply screen hundreds of thousands of peptides that could destroy strains of resistant bacteria.

The platform, called SLAY (Surface Localized Antimicrobial Display), was used to test for around 800,000 peptides and identify active antimicrobial sequences. The program was successful and has now led scientists to begin planning for animal testing.

Others are looking for inspiration in the insect kingdom. For example, ants produce natural antimicrobial substances that kill pathogenic bacteria, an effective mechanism for a tight society like ants where disease transmission potential is high.

In all, the danger of superbugs and the demise of antibiotics is genuine. However, although many research and development labs have not seen the funding they would like in recent years, there is significant progress being made in addressing the issue.

This issue will likely become worse before it gets better, but it’s safe to say that there are many hopeful treatments and solutions in the pipeline for the future.

Who knows? Maybe in the near future, we may look at antibiotics like we do at bloodletting today. With new developments in disease prevention and medical advancements occurring every week, it’s safe to have a little faith in the future.

Read More: Bug That Spreads Antibiotic Resistance To Other Microbes Discovered

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Zayan Guedim

Trilingual poet, investigative journalist, and novelist. Zed loves tackling the big existential questions and all-things quantum.

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    John Usrey April 15 at 2:49 pm GMT

    Overusing antibiotics is a major cause of antibiotic resistance. Therefore, new approach to reverse its effect need to develop and discover.

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