“The world is heading towards a post-antibiotic era in which common infections will once again kill. If current trends continue, sophisticated interventions, like organ transplantation, joint replacements, cancer chemotherapy, and care of pre-term infants, will become more difficult or even too dangerous to undertake. This may even bring the end of modern medicine as we know it.”
That’s what the Director-General of the World Health Organization said last April when she appeared before the United Nations. Dr. Margaret Chan wanted to warn of what many deem to be one of the greatest threats to global health today: the increasingly common problem of infections that do not respond to antibiotic treatment.
It sounds alarmist, but it might actually not be alarmist enough.
The efficacy of the world’s antibiotics is quickly decaying – the drugs we’re using to treat infections are working less and less. If we continue at this rate without intervention, we may find that there is not a single antibiotic left to treat any type of bacterial infection.
“This would really change life as we know it,” says Dr. David Weiss, director of the Antibiotic Resistance Center at Emory University. “Consider going to back to an era when a minor accident like a scrape could lead to death.” That’s what a world of total antibiotic resistance could lead to.
But there’s good news: we are not likely to continue at this rate. The world is aware of the problem and there are many organizations, governments, and concerned citizens working hard to avoid a worst-case scenario.
The bad news is that the issue is extremely complex and widespread. And thanks to the very nature of bacteria and how they work – and the damage we have already done – the world will never be entirely free from resistance.
What is resistance?
Say you contract a staph infection. In the past, that was easily treated with penicillin. But today, it is very possible that your staph infection is actually MRSA – a version resistant to antibiotics (only 10% of current staph infections aren’t MRSA). Penicillin is useless against it. In fact, studies show that two in 100 people are carrying around the MRSA bacteria.
Here’s how resistance develops: just like people, bacteria have DNA. And just like in humans, that DNA can mutate or change. Then, when inputs from the outside world interact with those mutations, survival of the fittest means only the strongest variations live on.
So, when humans use antibiotics to kill off bacteria, in some cases, those bacteria spontaneously mutate their genes, which changes their makeup in such a way that the antibiotics cannot kill them. The bacteria that survive those encounters pass these genes on to other bacteria through simple mating (technically known as ‘conjugation’) – and those resistant bacteria can spread from one living thing to another.