What is antimicrobial resistance?
The simple fact of the matter is that microorganisms, like all living things, acquire resistance and immunity to the circumstances of their environment over time. It’s the nature of existence and the nature of living—to grow, to adapt, and to eventually contribute to the evolution of an entire living population.
When observed in a species like humans, resistance to infection and attack is perceived as a good thing—it’s only when observed in bacteria like Staphylococcus aureus that resistance becomes a problem. Antimicrobial resistance, therefore, is an acquired resistance to antifungals, antivirals, antiprotozoals, and antibacterials that target fungi, viruses, protozoa, and bacteria ,respectively.
How does antimicrobial resistance work?
When attempting to understand how microbes acquire resistance, it’s essential to understand how quickly microbes reproduce and multiply. Humans leave out food and it takes day for noticeable sections of mould to be identified, but the reality is that bacteria and other microorganisms reproduce at exponentially greater rates than macroscopic organisms. Australia’s Queensland government’s food safety department explains that, under the right conditions, bacteria can double their numbers every 10 to 30 minutes.
“If we start with one bacterium that splits every 20 minutes, we would have over two million bacteria in seven hours!,” explains a particularly enthusiastic Queensland Health publication.
There are three main ways that microbes acquire resistance: natural resistance, random mutations, and acquired resistance between species. It’s not just a misuse of antibiotics either; penicillin-resistant bacteria, for example, were shown to exist well before the discovery of penicillin or the introduction of penicillin into medical treatments.
However, the chief concern for microbiologists remains the excessive reliance and ultimate misuse of antimicrobials, like antibiotics.
Why is antimicrobial resistance important?
Once again, it’s important to consider antimicrobial resistance as a process that takes place regardless of human intervention. Contrary to popular belief, humans aren’t apex predators in every single environment on planet Earth, and it is quite difficult for us to systematically destroy the ecosystems of every living thing—especially the living things that we can’t see. Bacteria, protozoa, fungi, and viruses naturally mutate and evolve to survive the harms of their environments. Even without human medicine, microbes would still become more fit over time.
However, understanding how microbes gain resistance is now more important than any other moment in human history simply because of how much the human species has contributed to the acceleration of microbes’ natural resistance-acquiring processes.
One must therefore consider that, in macroscopic eukaryotes like humans—where small, random changes are only observable after hundreds or even thousands of years—random mutations in bacteria are observable in a matter of months and years. Once again, the overall species may remain similar in both human and bacterial examples, but the fact that bacteria can change so rapidly in so little time is precisely what causes concern for health care professionals—and microbiologists—around the world.
Understanding antimicrobial resistance is essential for understanding how to better treat and protect against harmful microbes.
What is the future of antimicrobial resistance?
On Nov. 19, 2015, BBC News published an article suggesting that the human species is on the “cusp of [a] ‘post-antibiotic era.’” The article outlined how researchers had discovered strains of bacteria that were immune to colistin—an antibiotic renowned as “last-resort” medication. Colistin is an antibiotic that is both nephrotoxic and neurotoxic; it is an antibiotic so powerful that even in most cases, doctors often avoid prescribing it because its side effects are almost comically adverse.
There is, however, hope for the apocalypse prophets across the world: The human species is continuously bettering its efforts in discovering new antimicrobials and it is continuously bettering its efforts to curb the overreliance on antibiotics and other antimicrobials.
There are five rights to take into account when prescribing medication: the right patient, the right drug, the right dose, the right route, and the right time. Doctors and patients must work together in determining the appropriate course of action in dealing with infection and illness, and it is only through education that we can slow down the problems we have created for ourselves.
The world may be on the cusp of a post-antibiotic era, but unlike certain other human-caused disasters, at least we have a small chance of not completely causing our own extinction. As always, I’m excited for the truly absurd possibilities.