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How to Stave Off a Superbug Pandemic, in Three Easy Steps

A new study may have found the Achilles heel of common superbugs. But we'll need more than one approach to keep bacteria in check.
E. coli bacteria. Image: Mattosaurus/Wikimedia

Researchers based out of the University of East Anglia have discovered a chink in the armor of antibiotic-resistant bacteria. As Michael Byrne reported yesterday, what sets this study apart from similar attempts to defang superbugs is the focus on the defensive membrane of gram-negative bacteria. Drugs that only dismantle this outer membrane aren't exposed to the pathogen, which prevents them from learning the drugs' tricks.

“The really exciting thing about this research is that new drugs will specifically target the protective barrier around the bacteria, rather than the bacteria itself,” said lead author Haohao Dong in a statement. "Because new drugs will not need to enter the bacteria itself, we hope that the bacteria will not be able to develop drug resistance in future."

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Any edge in the fight against drug-resistant bacteria is welcome news, because it is a formidable threat. The World Health Organization emphasized the magnitude of the problem in a massive study released in April 2014. As Jason Koebler reported, the study found that “very high rates of resistance have been observed in bacteria that cause common health-care associated and community-acquired infections in all regions.” Superbugs are clearly gaining traction around the world.

The question of how to combat them is multi-faceted, but there are more or less three main strategies. The first is to find more efficient ways to deliver antibiotics to pathogens. The East Anglia study is a good example of this, but it is far from the only one.

For instance, sequencing the genome of drug-resistant bacteria could give doctors insight into developing individual antibiotic treatment plans. Another study, published in March 2014, found that honey has special superbug-fighting powers. Apparently, its high sugar content produces an osmotic effect that rips water right out of bacterial cells, rendering the pathogens weakened or dead. Those are just a few of the many ongoing research projects looking to outmaneuver superbugs with more precision.

The second approach is more of a public awareness concern. Drug-resistant bacteria are able to gain more of a foothold when people don't follow their prescriptions, or when healthcare providers erroneously prescribe them. The WHO laid out a set of recommendations for individuals and heath workers to follow to reduce the superbug population:

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People can help tackle resistance by: using antibiotics only when prescribed by a doctor; completing the full prescription, even if they feel better; never sharing antibiotics with others or using leftover prescriptions. Health workers and pharmacists can help tackle resistance by: enhancing infection prevention and control; only prescribing and dispensing antibiotics when they are truly needed; prescribing and dispensing the right antibiotic(s) to treat the illness.

It seems straightforward, but the fact that superbugs have been so successful indicates that there are outliers who swallow random antibiotics or, much more likely, don't complete prescriptions. If you're one of them: stop that.

The last main approach is simply finding alternative methods to antibiotics when treating infections. The most promising candidate is phage therapy, a technique that utilizes viruses called bacteriophages in the place of traditional antibiotics.

An electron micrograph of phages attacking a pathogen. Image: Graham Colm.

Phages are precision killers, designed to hunt down very specific bacterial species. This localized approach doesn't disrupt bacterial equilibrium to the extent that antibiotics do, nor does it provide much of an opening for opportunistic superbugs. And while bacteria can become phage-resistant, the process for developing a new phage is theoretically less costly, timely, and damaging than developing a new antibiotic.

Tackling the problems posed by drug-resistant bacteria will require a combination of these approaches, and hopefully even more as research progresses. Until then, be sure to complete your prescription.