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Avoiding a Global Train Wreck: Hope in the Fight Against Antibiotic Resistance

"You can look at antibiotic resistance as a slow moving global train wreck, which will happen over the next 35 years," health law expert Kevin Outterson at Boston University, told Scientific American.

When it comes to antimicrobial resistance, the headlines paint a bleak picture. And perhaps that’s for the right reason. The issue isn’t something we should take lightly, and in most cases, articles on the subject seem to be written in an attempt to motivate change.

Yet there’s only so much fear we can take. That’s why I thought I should deliver some good news on the subject.

New Antiobitics – It’s been nearly thirty years since the last great antibiotic discovery, when scientists found bedaquiline. It’s no surprise, then, that a study reporting a new antibiotic termed teixobactin recently sent shock waves through the global medical community.

It’s produced by the bacterium Eleftheria terrae, and works by inhibiting cell wall synthesis in Gram–positive bacteria. In the lab it’s cured mice of methicillin-resistant Staphylococcus aureus and pneumococcal pneumonia. In cell cultures, it has successfully killed drug-resistant strains of tuberculosis, anthrax and Clostridium difficile in cell culture.

In addition, the study reported that due to the nature of its attack, “this compound suggest[s] a path towards developing antibiotics that are likely to avoid development of resistance.”

The timeline for clinical trials is not set in stone, though some scientists are pegging the start for less than three years down the road.

New Methods – Beyond just discovering an antibiotic, it seems the team behind teixobactin has also heralded a new technology.

“Any report of a new antibiotic is auspicious, but what most excites me about the paper is the tantalising prospect that this discovery is just the tip of the iceberg,” said Mark Woolhouse, professor of infectious disease epidemiology at the University of Edinburgh.

It’s called iChip, and it houses growing bacteria in semi-permeable membranes, enabling them to access nutrients within their environment, but preventing other bacterial contamination of the “houses.” This means researchers can now create suitable environmental conditions for the 99% of microbes – or the “microbial dark matter” – which have thus far been impossible to grow in laboratories. Being able to study bacteria under lab conditions will help find new and better antibiotics.

New Understanding – Bacteria are more complicated than previously thought (or at least taught at the university level). New research indicates a couple of things. One, that some of the most common bacteria in our gut produce cephalosporinases (compounds that protect the bacteria, and their peers, from certain antibiotics). Secondly, bacteria cells differentiate, organize and coordinate through communication processes termed quorum sensing.

Both revelations have huge potential in the world of antibiotics. Perhaps one day, we will see antibiotics unaffected by cephalosporinases or those that target social behaviour (like those that target the collective rounding up of particles) over structure.

“Only by understanding the complicated ecology of bacterial environments can we continue to develop successful treatments against these problematic organisms.” 

My hope isn't that this information will lessen efforts at cooling antibiotic resistance, but instead mobilize those of us disheartened by the negativity of a bleak forecast. The amalgamation of fear (induced by leading experts) and hope (in our capacity to change and some pretty darn cool science) is a far better motivator for change than the thought of impending disaster alone.

Debra Murphy is a field editor for RealAgriculture. You can find her on Twitter and Google+.

Avoiding a Global Train Wreck: Hope in the Fight Against Antibiotic Resistance

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