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BACTERIA, ANTIBIOTICS
AND ANTIBIOTIC RESISTANCE
Photo: Mycobacterium tuberculosis bacteria, NIAID (from flickr).^1 Photo: Staphylococcus epidermidis bacteria, NIAID (from flickr).^2 By ReAct Funding from Marie-Claire Cronstedts Stiftelse
BASIC LECTURE
OUTLINE OF THIS LECTURE
- About bacteria
- About antibiotics
- Antibiotic resistance
- How does it form and spread?
- What are the consequences for global health?
- What can you do?
- A few bacteria can be dangerous to our health by causing infections and even death
- We can get them from outside the body:
- Other humans, animals, food, water
- Sometimes our “own” bacteria can cause disease
- Examples of bacterial infections:
- Pneumonia
- Blood stream infections
- Urinary tract infections
- Wound infections
- The sexually transmitted disease gonorrhea
DISEASE-CAUSING BACTERIA
Photo: Klebsiella pneumoniae , NIAID (from flickr). 4
- Antibiotics are medicines for bacterial infections
- Examples of antibiotics:
- Penicillin and Ciprofloxacin
- Penicillin was discovered by Alexander Fleming in 1928
- Introduced as medicine in the 1940’s
- Antibiotics can have “broad” or “narrow” spectrum
- Broad spectrum: Active against many different types of bacteria
- Narrow spectrum: Active against one or a few types of bacteria
ANTIBIOTICS
Photo: Antibiotics, Michael Mortensen (from flickr). 5
ANTIBIOTICS
- Antibiotics are effective against bacteria
- However, antibiotics have only marginal effect against some bacterial infections such as uncomplicated sinus infections and ear infections (bacterial otitis)
- The body’s immune system can normally take care of these infections without antibiotics
- But for some bacterial infections antibiotics are life-saving medicines! - For example for blood stream infections (sepsis) and pneumonia
- Before antibiotics there was no effective cure for bacterial infections
- Antibiotics were considered “a miracle cure”
- Antibiotics cure infections, prevent infections upon surgery, and make transplantations and cancer treatment safer
ANTIBIOTICS
è Saved countless lives! è Made modern medicine possible!
- Massive use of antibiotics the past 80 years, both appropriate and inappropriate has lead to:
ANTIBIOTIC RESISTANCE
Photo: Drug resistance by Iqbal Osman (from flickr). 6
Increased occurrence and spread of
bacteria that are resistant to antibiotics
ANTIBIOTIC RESISTANCE = The ability of bacteria to protect themselves against the effects of an antibiotic
ANTIBIOTIC RESISTANCE
- Bacteria are experts at surviving in changing environments
- In large bacterial populations there are often a few resistant bacteria
ANTIBIOTIC RESISTANCE
- Antibiotics select for resistant bacteria
ANTIBIOTIC RESISTANCE
Is antibiotic resistance a problem?
- Antibiotic resistance leads to treatment failures
- Antibiotic resistance threatens our ability to perform modern medical procedures
- Antibiotic resistance imposes a major economic burden on society
- Antibiotic resistant bacteria already cause many deaths around the world
… but the consequences of antibiotic resistance are most severe for the poor. For example:
- In South Asia (India, Pakistan, Afghanistan, Nepal, Bangladesh) one newborn child dies every 5 minutes from blood stream infections (sepsis) because the antibiotics given are not effective due to bacterial resistance a
ANTIBIOTIC RESISTANCE
aBhutta Z, Presentation at the Global Need for Effective Antibiotics - Moving towards Concerted Action. http://www.reactgroup.org/uploads/publications/presentations/ opening-session-zulfiqar-bhutta.pdf
- Antibiotic resistance is a global issue!
- Exists on all continents
- Affects both low- and high income countries
- Affects both strong and weak health systems
ANTIBIOTIC RESISTANCE
Photo: The Blue Marble, Eastern Hemisphere March 2014, NASA Goddard Space Flight Center (from flickr). 8
How did we end up here?
USE & INAPPROPRIATE USE OF ANTIBIOTICS
- Use in human and animal medicine
- Use to increase growth of farm animals
- Use for routine prophylaxis in farm animals à Selection and maintenance of resistance
SPREAD OF
RESISTANT BACTERIA
- Poor hygiene and sanitation
- Food and water
- Travel How did we end up here?
USE & INAPPROPRIATE USE OF ANTIBIOTICS
à Selection and maintenance of resistance
