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Mutant superbugs leave the hospitals and start attacking. They are resistant to all existing drugs. The history of bacterial immunization resembles a sensational film. First, the first antibiotic-resistant bacterium is detected in a specific hospital. Then we only follow its journey and the appearance of victims of this microorganism on other continents.
Bacterial resistance to antibiotics
Antibiotics were a great discovery of the 70th century because they killed pathogenic bacteria. They saved the life and health of many sick people and that is why they were called miracle drugs. Today, after XNUMX years of use, they have lost their power, and this is because the microorganisms they dealt with a few years ago have changed.
Not only that, from the time the first antibiotic-resistant bacteria emerged to the moment when there are so many of them that the problem becomes a global problem, the time passes by, the bacteria also acquire resistance not to one antibiotic, but to many. The pool of such resistant strains continues to grow.
When we are treated with an antibiotic, bacteria that are good for our health are also exposed to it. Their DNA contains information about the antibiotic used. When a hostile microorganism enters the body, it takes up the DNA left by the dead bacteria and acquires knowledge about antibiotics. When it meets other pathogenic bacteria, it transmits the acquired information, thanks to which the bacteria acquire resistance.
Golden staphylococcus resistant to antibiotics
Such abilities were possessed by golden staphylococcus as early as 1961. It was then in England that the first strains of this bacterium resistant to ß-lactam antibiotics (including penicillin and methicillin) were discovered. These mutant bacteria – called MRSA – took over the world in a short time. Today in Poland mutants constitute 20% of golden staphylococci, in England as much as 42%, but in Denmark 1%.
Staphylococcus aureus is a bacterium that frequently colonizes human skin, and also lives in the nasal mucosa. Carrying a staphylococcus may be asymptomatic and harmless. However, if the skin is damaged, has surgery, or weakens the immunity of the carrier, staphylococcus can cause skin infections, impetigo, boils, and pneumonia.
Klebsiella pneumoniae pneumoniae
Klebsiella pneumoniae, resistant to multiple antibiotics, was first detected in 1996 on the US east coast. Five years later, it was found in China, Colombia, Brazil, Israel and France. In Poland, the first strain was found in 2008 in several hospitals and clinics in Warsaw, from where it spread throughout the country. At the moment, we already have 300 cases of infections.
Klebsiella pneumoniae is very common in the respiratory tract and gastrointestinal tract in approximately 20% of hospitalized patients and 1-6% of healthy people. They can cause pneumonia, infections of the digestive tract, bones, joints and urinary tract and sometimes sepsis. In newborns, they cause meningitis.
NDM-1 (New Delhi metallo-ß-lactamase)
Klebsiella pneumoniae turned out to be very intelligent and eventually developed resistance to all available antibiotics. The mutant microorganism was nicknamed NDM-1 after its birthplace in New Delhi, India. He was brought to Europe by a Belgian who injured his leg in an accident in India and tried to heal the non-healing wound after returning from Asia. The bacterium has already caused dozens of illnesses in Great Britain. Infected patients fight for their lives in solitary confinement. It also appeared in France, Greece, Croatia, Serbia, Belgium, the USA, Slovenia, Austria, the Czech Republic and is spreading further around the world. So far, no cases of infection with these bacteria resistant to most antibiotics have been reported in Poland. – However, it is only a matter of time – says prof. Waleria Hryniewicz, head of the Department of Epidemiology and Clinical Microbiology of the National Medicines Institute.
Pneumococcal multidrug resistance
Initially, multi-drug resistance concerned only bacteria living in hospitals. Today, however, it is more and more often a feature of microorganisms responsible for community-acquired infections, especially pneumococci, which cause more than 3,5 million deaths annually worldwide. Children under 2 years of age are most at risk of pneumococcal infection due to their immature immune system. The second group of special risk are people over 65, in whom the body’s immunity dramatically decreases due to their age. Pneumococci are bacteria that inhabit the airways but do not always cause disease. These types of bacteria are dangerous the moment they enter the bloodstream. Together with it, they can reach other organs and cause, inter alia, purulent inflammation of the meninges, ears, lung sinuses, and sepsis.
Overuse of antibiotics
Antibiotics, which are miraculous weapons against bacteria, have stopped working because we have started overusing them. Very often we use them unnecessarily in viral infections causing a runny nose, cough or flu. Meanwhile, it is known that antibiotics against viruses do not work. In Poland, primary care physicians do not use tests to determine whether a sick patient has a bacterial or viral infection. In addition, no bacteriological diagnostics is performed that would allow the selection of an appropriate antibiotic that works on the given bacteria.
Even if the doctor prescribes the correct antibiotic, the patient often stops the treatment prematurely before the pathogenic bacteria are eliminated.
Antibiotics are also used in glaze joints, paints and cleaning agents. Although EU regulations prohibit their use in breeding poultry or other animals, food producers bypass these regulations by using the so-called medicated feed.
New antibiotics
There is no chance of new antibiotics emerging in the near future. – Only two have arrived in the last 20 years. – says prof. Hryniewicz. He explains that most of the available drugs were created in the 50s and 70s, because today it is not profitable for pharmaceutical companies to introduce new antibiotics to the market. The cost of such a venture is about $ 800 million, and bacteria are becoming more and more resistant to these drugs, making them worthless.
Stopping the process of antibiotic resistance is a great challenge for medicine. According to prof. Hryniewicz should use these drugs responsibly. It would be good if doctors had tests to detect bacterial infections. Rapid identification and isolation of those infected with resistant bacteria is also necessary.
Text: Halina Pilonis
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