How Can I Prevent Antibiotic
By visiting this website, you are taking the first step to reducing your risk of getting antibiotic-resistant infections. It is important to understand that, although they are very useful drugs, antibiotics designed for bacterial infections are not useful for viral infections such as a cold, cough, or the flu. Some useful tips to remember are:
How Does Antibiotic Resistance Happen
Bacteria can become resistant to antibiotics in several ways.
- Some bacteria can change their outer structure so the antibiotic has no way to attach to the bacteria it is intended to kill.
- Some bacteria can ‘neutralise’ an antibiotic by changing it in a way that makes it ineffective.
- Others have mechanisms that pump an antibiotic back outside of the bacteria before it can work.
- Bacteria can also become resistant through mutation of their genetic material. After being exposed to antibiotics, sometimes bacteria can survive by finding a way to resist the antibiotic. If even one bacterium becomes resistant to an antibiotic, it can then multiply and replace all the bacteria that were killed off.
The spread of antibiotic resistance occurs when resistant strains of bacteria are passed from person to person and from non-human sources in the environment, including food.
Historical Timeline Of Antibiotics
- Louis Pasteur unknowingly described the first antibiotic in 1877 when he observed that certain bacteria release substances that kill other bacteria
- In 1909, Paul Ehrlich discovered arsphenamine , an arsenic compound that kills Treponema palladium, the bacterium causing the sexually transmitted disease, syphilis.
- In 1928 Alexander Fleming discovered that a mold inhibited the growth of staphylococcal bacteria and named the substance it produced “penicillin” .
- It was not until 1940 that Howard Florey and Ernst Chain isolated the active ingredient in Fleming’s mold.
- With wide-scale production of penicillin, the use of antibiotics increased, leading to an average eight-year increase in human life span between 1944 and 1972. Unfortunately, many bacterial species continued to survive penicillin treatment due to their resistance mechanisms.
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General Overuse Of Antibiotics
Most antibiotic use is in two areas, that is, in humans in the community and in animals for growth promotion and prophylaxis. It has been found out that 20 50% antibiotics used in human and 40 80% in animals are unnecessary and highly questionable. In Denmark for example, while 24kg of active vancomycin was used for human therapy in 1994, 24000kg of active avoparcin was used as feed additives for animals. In Austria, between 1992 and 1996 an annual average of 582kg of vancomycin was imported for medical purposes and 62,242kg of avoparcin for animal husbandry. As expected vancomycin resistant Enterococcus faecium of animal origin has been detected in humans through consumption of contaminated meat thus making the treatment of these infections, difficult. When avoparcin was banned i6 Denmark , Germany and the whole of European Union countries , the net effect was a dramatic reduction in the incidence of VRE in humans suggesting that antimicrobial resistance can be controlled through prudent use of antibiotics.
How Antibiotic Use Affects Resistance
Antibiotics save lives but their use can contribute to the development of resistant germs. Antibiotic resistance is accelerated when the presence of antibiotics pressure bacteria and fungi to adapt.
Antibiotics and antifungals kill some germs that cause infections, but they also kill helpful germs that protect our body from infection. The antibiotic-resistant germs survive and multiply. These surviving germs have resistance traits in their DNA that can spread to other germs.
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What Is An Antibiotic
Antibiotics, also known as antimicrobial drugs, are drugs that fight infections caused by bacteria. Alexander Fleming discovered the first antibiotic, penicillin, in 1927. After the first use of antibiotics in the 1940s, they transformed medical care and dramatically reduced illness and death from infectious diseases.
The term “antibiotic” originally referred to a natural compound produced by a fungus or another microorganism that kills bacteria which cause disease in humans or animals. Some antibiotics may be synthetic compounds that can also kill or inhibit the growth of microbes. Technically, the term “antimicrobial agent” refers to both natural and synthetic compounds however, many people use the word “antibiotic” to refer to both. Although antibiotics have many beneficial effects, their use has contributed to the problem of antibiotic resistance.
Why Are Bacteria Becoming Increasingly More Resistant To Antibiotics
A University of Granada researcher has a new hypothesis concerning why bacteria seem to becoming increasingly more resistant to antibiotics.
Bacteria are incredibly versatile they have been found in some of the most extreme conditions on the planet, and it may be just evolution in action. In this instance, Mohammed Bakkali, a scientist in the Genetics Department at the Faculty of Science of the UGR,believes that bacteria that are non-resistant to antibiotics acquire resistance accidentally because they take up the DNA of others that are resistant, due to the stress to which they are subjected.
Like anything else, too much of a good thing can be bad and overuse and misuse of antibiotics has exacerbated resistance problems. Whereas we mistakenly banned the use of DDT due to misuse, antibiotics are not going away, so researchers have spent decades examining when, how and why bacteria take up DNA from other antibiotic-resistant bacteria, thus becoming resistant. The answers as to when there is DNA uptake and as to how the bacteria take it up are clear, but, up until now, nobody has pinpointed the reason why bacteria ingest this genetic material Bakkali notes.
In his article, Mohammed Bakkali argues that bacteria do not look for DNA to incorporate and that this uptake is a chance event and the sub-product of a type of bacterial motility that is part of its response to the stress that the bacteria may be subjected to.
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To Stop Antibiotic Resistance Experts Keep A Closer Watch
The World Health Organization and others have called on hospitals and medical centers to adopt antimicrobial stewardship programs that promote appropriate use of the drugs and improve patient outcomes.
At USC, Nanda and a cross-disciplinary team monitor antibiotic use in the Keck Medicine hospital system. Some antibiotics can only be prescribed by Keck Medicines infectious disease specialists, whereas others get special scrutiny once administered. Though Nanda sees progress, changing behaviors doesnt happen overnight.
In the meantime, she wants medical science to explore alternative bacteria fighters, including advanced immunotherapies. Scientists are investigating the powers of bacteriophages, which are viruses that specialize in infecting and destroying bacteria. Chemists and engineers have their eyes on antimicrobial polymers that can kill drug-resistant bacteria in minutes, along with nanoparticles that selectively target certain bacteria.
The public has a role in prevention, too. Practice good hygiene. Demand healthier food practices. Avoid antibiotic overuse and get vaccinated. Everyone can be their own best advocate, Nanda says. Help create a culture of accountability and awareness.
What Can Be Done To Limit This Increasing Resistance To Antibiotics
The first challenge is the significant gaps in surveillance ofantibioticresistance, says the WHO report. In 2001,WHO and the Council of the European Union issued global strategies andguidelines to help countries setting up systems to monitor antibiotic resistanceand to implement efficient actions, including public awareness campaigns.Nowadays, the most immediate and urgent concerns relate to antibiotic resistancein common bacteria. In line with the WHO,the ECDC considers that three strategic areas of interventionshould be prioritized and that each one can play an important role:
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What Is Antibiotic Resistance
Antibiotic resistance happens when bacteria change in a way that prevents the antibiotic from working. Changes in bacteria, known as resistance mechanisms, come in different forms and can be shared between different bacteria, spreading the problem.
Bacteria and fungi naturally use antibiotics as weapons to kill each other to compete for space and food they have been doing this for over a billion years. This means they are used to coming into contact with antibiotics in the environment and developing and sharing antibiotic resistance mechanisms.
Most antibiotics we use today are modelled on the ones naturally created by bacteria and fungi. In the past, if the bacteria didnt encounter the antibiotic they developed resistance for, they could lose the resistance mechanism. But now, because we are overusing antibiotics, the bacteria are encountering them all the time and therefore keeping their resistance mechanisms. Hence the crisis.
Bacteria frequently now encounter antibiotics in the environment as well as in our bodies and those of animals. Antibiotic resistant bacteria mostly survive these encounters and then multiply in the same manner.
This results in an increased chance of people being infected with antibiotic resistant disease-causing bacteria, which can lead to increased complications, prolonged hospital stays and an increased risk of death.
Transmission Of Antibiotic Resistant Bacteria In The Community
Antibiotic resistant bacteria can also be passed from person to person within the community. This is becoming more common. Ways to prevent transmission of organisms, including antibiotic resistant bacteria, are:
- Wash hands before and after food handling, going to the toilet and changing nappies.
- Cover your nose and mouth when coughing and sneezing.
- Use tissues to blow or wipe your nose.
- Dispose of tissues properly, either in the rubbish or toilet.
- Do not spit.
- Stay at home if you are unwell and cannot manage the normal requirements of your day.
- Do not send children to child care, kindergarten or school if they are unwell.
- If you are prescribed antibiotics, take the entire course do not stop because you are feeling better.
- If you continue to feel unwell, go back to the doctor.
- Avoid use of products that advertise they contain antibiotics, or are antibacterial or antimicrobial, unless advised to do so by your health professional.
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Additional Precautions With Antibiotic Resistant Bacteria
Additional precautions are used when caring for people who are known or suspected to be infected or colonised with highly infectious pathogens .Micro-organisms may be classed as high risk if:
- their transmission route makes them more contagious they may be spread through contact or droplets, or may be airborne
- they are caused by antibiotic resistant bacteria
- they are resistant to standard sterilisation procedures.
Additional precautions are tailored to the particular pathogen and route of transmission. Additional precautions may include:
- use of a single room with ensuite facilities or a dedicated toilet
- dedicated care equipment for that person
- restricted movement of the person and their healthcare workers.
Origins And Molecular Epidemiology Of Resistance Genes
Antibiotic resistance should be defined in terms of clinical outcome rather than by laboratory methods and in the medical in vivo setting therefore, a resistant microbe is one which is not killed by an antimicrobial agent after a standard course of treatment. The use of antimicrobials for any infection, real or feared, in any dose over a period of time, forces microbes to adapt or die and it is the surviving microbes which carry drug resistance genes which may be transferred to other strains within their own genus and species and across them even to other unrelated species. Clinical resistance is therefore a complex phenomenon involving interaction between the type of bacterium, its location in the body, the distribution of the antibiotic in the body and its concentration at the site of infection, and the immune status of the patient.
In addition to mutation, bacteria have developed a diverse array of biochemical and genetic systems for ensuring the evolution and dissemination of antibiotic resistance. These include antibiotic modification such that it does not react with the target site such as occurs in b-lactamases which enzymatically cleave four-membered b-lactam ring, rendering the antibiotic inactive.
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How Does Antibiotic Resistance Occur
- Antibiotic resistance occurs due to changes, or mutations, in the DNA of the bacteria, or the acquisition of antibiotic resistance genes from other bacterial species through horizontal gene transfer.
- These changes enable the bacteria to survive the effects of antibiotics designed to kill them.
- This means that when an antibiotic is used, all the bacteria that have not undergone a mutation are killed, while the antibiotic resistant bacteria remain unaffected.
- The antibiotic resistant bacteria are able to continue to divide and grow producing even more bacteria that are not affected by the antibiotic.
- The existence of resistant strains of bacteria means that antibiotics or drugs designed to kill them no longer work, allowing them to spread rapidly, posing a risk to public health.
- When this happens it is necessary for scientists to develop new antibiotics that the bacteria do not have resistance to.
An illustration showing how a population of bacteria can develop resistance to an antibiotic.
Image credit: Genome Research Limited
Antibiotic Resistance A Growing Menace For Human Health
Within the next two decades we may not have any effective antibiotics for simple surgical operations, Dame Sally Davies, Chief Medical Officer for England, reported to Members of Parliament on the House of Commons Science and Technology Committee. Quite simply, she added, there will be no antibiotics left that can deal effectively with routine infections.
Antibiotic resistance has become such a serious threat that it should be added to the governments list of civil emergencies.
Researchers from Tufts University School of Medicine identified an isolate of E. coliwhich is resistant to carbapenems, a class of antibiotics used to treat life-threatening disease-causing bacteria. In a study published in Antimicrobial Agents and Chemotherapy, they reported that the E. coli mutated four times before building up enough resistance to make carbapenems ineffective.
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Global Antibiotic Research And Development Partnership
A joint initiative of WHO and Drugs for Neglected Diseases initiative , GARDP encourages research and development through public-private partnerships. By 2023, the partnership aims to develop and deliver up to four new treatments, through improvement of existing antibiotics and acceleration of the entry of new antibiotic drugs.
Using Jumping Genes To Compare Resistance And Fitness
We analyzed a bacterium called Pseudomonas aeruginosa. Its a major cause of infections in people with cystic fibrosis, as well as very ill patients in intensive care units and people with weakened immune systems.
P. aeruginosa is naturally resistant to several antibiotics and can acquire resistance to numerous others to become multi-drug-resistant or even pan-resistant.
To find out if there was a fitness cost from resistance, we created mutant strains of P. aeruginosa using jumping genes to insert mutations into the bacteria. Because we wanted to see what the cost of resistance was, we made two kinds of mutant strains. Some mutant strains lost their natural-resistance genes, while other mutant strains acquired resistance due to inactivation of genes that made them susceptible to antibiotics.
This meant that we could use DNA sequencing to determine how loss of each mutated gene affected the overall ability of P. aeruginosa to cause an infection in mice and the bacteriums overall fitness.
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How Does Bacteria Become Resistant To Antibiotics
Antibiotic resistance has the potential to affect everyone. Most people would have heard about antibiotic resistance and studies show many are aware the cause of the current crisis is due to their overuse. But few know how and where the resistance occurs.
A recent study revealed 88% of people think antibiotic resistance occurs when the human body becomes resistant to antibiotics. This isnt entirely true.
The resistance can happen inside our body as it is the host environment for the bacteria but the important distinction is that the bodys immune system doesnt change its the bacteria in our bodies that change.
How Resistance Develops And Spreads
Some bacteria are naturally resistant to certain antibiotics. For instance, the antibiotic vancomycin cannot kill Escherichia coli , while metronidazole cant kill the whooping cough-causing Bordetella pertussis. This is why different antibiotics are prescribed for different infections.
But now, bacteria that could previously be killed by certain antibiotics are becoming resistant to them. This change can occur in two ways:
- Genetic mutation
- Horizontal gene transfer.
Genetic mutation is when bacterial DNA, that stores the bacterias information and codes for its traits, randomly changes or mutates. If this change, that could be resistance to antibiotics, helps the mutated bacteria survive and reproduce then it will thrive and outgrow the unchanged bacteria.
Random mutation would happen with or without antibiotic overuse. However, the resistant changes only stay in the bacterial population if the antibiotic is constantly present in the bacterias environment. Our overuse of antibiotics is resulting in the propagation and maintenance of these changes.
Horizontal gene transfer is when one bacterium acquires antibiotic resistance mechanisms carried by a particular gene from other bacteria.
This can occur between the same kinds of bacteria, such as between E. coli that cause urinary tract infections and E. coli that cause food poisoning or between different kinds of bacteria, such as between E. coli and antibiotic-resistant Staphylococcus aureus .
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