What chemical compounds are causing antibiotic resistance?
Antibiotics have been among the most powerful tools' at doctors' disposal in the fight against infectious diseases. These drugs have been in use since the 1940s, according to the U.S. Centers for Disease Control and Prevention, and have helped countless patients battle bacterial infections. However, their indiscriminate and ineffective use against other types of microbes, such as viruses, has driven a worrisome trend in which very virulent strains of bacteria have become resistant to these drugs and thus raised the incidence of infections with antibiotic-resistant bacteria.
Although poor antibiotic prescription practices are a factor in drug resistance, researchers continue to study other dynamics that contribute to this trend. One team of scientists from Uppsala University in Sweden suggested that both antibiotics and chemical compounds that contain heavy metals enhance the genetic plasmids that are associated with antibiotic-resistance in bacteria, as published in the journal mBio.
How bad is the drug-resistance problem?
Every year, upwards of 2 million individuals in the U.S. are infected with bacteria that are resistant to antibiotics, as estimated by the CDC. Additionally, at least 23,000 of these cases end in death. Illnesses include drug-resistant pneumonia, infections of the skin and soft tissue, and sexually transmitted diseases. When it comes to individual patients who are infected with antibiotic-resistant bacteria, treatments and hospital stays become longer and more expensive compared to what they would have been if the infections were actually responsive to the drugs.
These kinds of problems are not limited to industrialized nations such as the U.S., nor do they only exist inside hospitals where antibiotics are widely used. They can be found in communities in both developing and developed countries. Furthermore, drug resistance is not just caused by widespread antibiotic use in health care. It is also linked to applications in agriculture, as well as biocides used in products such the anti-fouling paint used to keep microbes from growing on boats, according to the authors of the study. Such biocides are often manufactured with heavy metals, including copper, silver and arsenic. The U.S. Environmental Protection Agency noted that anti-fouling paint and other biocides are significantly impacting water quality.
'These results are worrying'
Both researchers and health care experts have known for a while that antibiotics drive drug resistance in bacteria. At Uppsala University, scientists wanted to see if the same were true for heavy metals. In their experiment, they grew two strains of bacteria in cell cultures containing low concentrations of antibiotics, heavy metals or both. Only one of these strains contained a plasmid, or free-floating genetic material, that conferred resistance.
Results showed that the small amounts of antibiotics and heavy metals, either separately or together, enriched the population of drug-resistant bacteria.
"When these chemicals spread in the environment, bacteria with resistant plasmids will be selected," lead researcher Dan Andersson said in a statement. "This indirectly results in antibiotic resistance increasing as well. What's more, in most environments there are complex mixtures of antibiotics, biocides and heavy metals that, together, have intensified combination effects … These results are worrying and suggest that substances other than antibiotics that are present in very small quantities in the environment can drive development of resistance as well. The results underline the importance of reducing the use of antibiotics, but also suggest that our high use of heavy metals and biocides in various contexts should decrease, too."
In the U.S., federal agencies, such as the CDC, have made it a priority to fight antibiotic-resistant bacteria. Their efforts include educational campaigns that encourage more prudent prescription practices for antibiotics. Additionally, the EPA is funding research to develop non-biocide paints for marine vessels.
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