The invisible world
We have World Animal Day, Father’s Day, Mother’s Day, and even Earth Day. But did you know that there is also an Antibiotic Awareness Day? Antibiotics play a big part in our healthcare system and in animal husbandry, but aside from their numerous advantages they have a major disadvantage: resistance.
We mainly associate antibiotics with pills, yet these substances have a natural origin. All around us, as well as on the outside and inside of our own bodies, microbes are waging war on one another. Occasionally, they take up arms, in the form of antibiotics (from the Greek ‘anti’ (against) and ‘bios’ (life)). They use their defensive substances against competing bacteria, disrupting vital processes such as their growth, the construction of their cell walls, and the synthesis of proteins and genetic material. We use these very same substances in our own bodies, in the fight against pathogenic bacteria. Antibiotics are of no use against diseases that are caused by viruses, such as colds or flu.
The Penicillium mold grows from a single spore into a visible colony, and forms antibiotic drops. Time lapse: Wim van Egmond.
The first true antibiotic was discovered by the Scottish physician and microbiologist Alexander Fleming. Fleming studied pathogenic bacteria at St. Mary’s Hospital Medical School in London. It is recorded that, on 28 September 1928, he discovered a brush mould (Penicillium notatum) growing in one of his bacterial cultures. No bacteria were growing in the area around this mould. Fleming isolated a defensive substance from the mould that inhibited bacterial growth. This was how he discovered the first antibiotic: penicillin.
It was only during the Second World War that there was an exposive growth in the production and use of penicillin. From then on, wounds and amputations no longer inevitably led to lethal infections. Thus, it is estimated that penicillin saved about 12% to 15% extra Allied lives during the war. After the war, it emerged that the Netherlands had played a large part in this. Under the code name of ‘Bacinol’, fermentation specialists employed by Royal Netherlands Fermentation Industries (which is now DSM) secretly developed an industrial process for the mass production of penicillin.
Over the past 10 years, antibiotic use has risen by 36%, yet no new antibiotics have been discovered since 1987. This has led to the excessive and imprudent use of antibiotics, resulting in resistance. Bacteria against adapt easily and rapidly become resistant to antibiotics. This is increasingly the case for almost every type of antibiotic in our arsenal. The multi-resistant hospital bacterium, MRSA (methicillin-resistant Staphylococcus aureus), is an example. Antibiotics kill susceptible bacteria, but leave resistant bacteria unharmed. The latter can then multiply freely and spread easily. The misuse of antibiotics speeds up this process even further, resulting in a vicious cycle.
According to some estimates, antibiotic resistance currently accounts for more than 700,000 deaths throughout the world annually. By comparison, the recent Ebola outbreak in West Africa resulted in “only” 11,000 deaths. If nothing changes and we run out of effective antibiotics, there is every chance that we will return to the “pre-antibiotic era”. Common infections and minor injuries will be untreatable. By 2050, the number of deaths will rise to 10 million annually. In short, it is time for a global approach.
Antibiotic resistance: Why do some antibiotics fail? Video: RIVM.
On 18 November, the 2015 European Antibiotic Awareness Day (EAAD), the National Institute for Public Health and the Environment (RIVM) put the problem of resistance firmly on the map by holding a symposium on Antibiotic Resistance and Innovation. Scientists, policymakers and professionals came together to discuss innovation and new knowledge in the field of antibiotic resistance. The problem was tackled in a number of working sessions, each of which took a different approach, for example a lack of knowledge among physicians, little interest on the part of the pharmaceutical industry, and indecision in political circles.
During the interactive brainstorming sessions at EAAD, participants with expertise in different fields gathered to seek solutions in innovative ways. For example a focus on probiotic (rather than antibiotic) treatments. Antibiotic resistance is a multi-faceted issue. Science, healthcare, industry, agriculture and animal husbandry all have a stake in the underlying cause, and in potential solutions. Thus, cooperation is the key to ensuring the effectiveness of our healthcare system well into the future.
