Antibiotic resistance is a growing threat
Humanity is fast approaching a post-antibiotic era where mortality rates soar due to untreatable microbial infections. In 2012, the then director-general of the World Health Organization (WHO), Margaret Chen, warned that “a post-antibiotic era means, in effect, an end to modern medicine as we know it”. Even today, over 1.2 million deaths are thought to be the direct result of infection with antibiotic-resistant bacteria. If action is not taken, this number has been projected to increase to ten million by 2050.
The development and spread of resistance
Antibiotic resistance arises from random genetic mutations and is propagated through natural selection. Such mutations are particularly worrisome when they occur in genetic elements that can be transferred between individual bacteria and even across different microbial species to spread resistance widely. This problem was recognised soon after antibiotics were first discovered. Indeed, Alexander Fleming warned of the dangers in his 1945 Nobel lecture: “It is not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them.”
Resistance has been stimulated by the careless use of antibiotics, particularly in healthcare and agriculture. The problem of resistance cannot be ignored by individual countries, as resistant strains easily cross borders in today’s interconnected world. Exemplifying this is the bacterium responsible for causing gonorrhoea, Neisseria gonorrhoeae. Since effective treatment became available in the 1930s, N. gonorrhoeae strains resistant to five entire classes of antimicrobials and antibiotics (sulphonamides, penicillins, aminoglycosides, macrolides and fluoroquinolones) have spread throughout the world. Society is now down to its last line of treatment, cephalosporins. However, cephalosporin-resistant strains were first identified in Japan in 2011 and are now observed in additional Southeast Asian countries and in Europe. If no new treatments are found, gonorrhoea will, again, become an untreatable disease.
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