Bunea Matei Superbugs-unmasking the threat 4/14/2021

1. Defence and Mechanism(Bacteria-Superbugs)

2. Different approaches for a common goal(Biotechnology)

In the decades since antibiotics were first introduced, strains of bacteria that were once sensitive to
certain drugs developed or acquired mechanisms of resistance—thus rendering some of medicine's best
weapons ineffective against them.1,2 Consider, for instance, Streptococcus pneumoniae. The Centers for
Disease Control and Prevention (CDC) says that over the past five years, S. pneumoniae's rate of
resistance to penicillin has increased by more than 300%, and its rate of resistance to cefotaxime sodium
(Claforan) has increased by more than 1,000%.3 This increase in antibiotic-resistant strains has led to a
corresponding increase in morbidity and mortality from infectious disease.4 Hospitals have had their
share of battles with resistant organisms that are difficult to isolate and treat. Resistant bacteria have
also sprung up in the community, and common infections such as otitis media, community-acquired
pneumonias, urinary tract infections (UTIs), and tuberculosis can all be caused by bacteria that are
resistant to commonly used antibiotics. Several factors have contributed to the spread of resistant
bacteria. They include the overuse and misuse of antibiotics in human and animal medicine and animal
husbandry, global transmission of resistant bacteria as the result of poverty and poor medical and
infection control practices in both developing countries and the United States, increased world travel,
and increasing costs of developing new antibiotics.5,6 To help combat antibiotic resistance and care for
the patients it affects, nurses need first to understand how bacteria develop resistance in the first place.
It's also essential to know which bacteria are problematic for which antibiotics, and the weapons—
current and in development—to which we can turn to address this problem.

 Defence and Mechanism

To understand how resistant bacteria develop, it helps to review how existing antibiotics work.
Antibiotics are classified as either bacteriostatic (meaning they slow the growth of the bacteria
to allow the body's immune system to eliminate the bacteria) or bactericidal (they kill the
target organism). Although bactericidal agents are more efficient, bacteriostatic agents can also
be extremely beneficial, since they permit normal defenses of the host to destroy the bacteria.6
Antibiotics work by inhibiting specific processes that are essential for a bacterium's growth and
replication, including cell wall synthesis, normal cytoplasmic membrane structure and function,
or protein synthesis or ribosome function.6 Each antibiotic may have a unique way of
interrupting one or more of these processes, which makes certain antibiotics effective (or
ineffective) against certain bacteria. A bacterium's resistance to antibiotics is either intrinsic or
acquired. Intrinsic resistance to a specific antibiotic is a result of the drug's inherent mechanism
of action against a particular bacterium. For example, gram-negative bacteria are intrinsically
resistant to cloxacillin sodium (Cloxapen, Cloxilean, others) and vancomycin HCl (Vancocin,
Vancoled) because these bacteria contain a protective outer membrane not found in gram-

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positive bacteria. This prevents the antibiotic from reaching the target site.4 Acquired
resistance results from a change in the bacteria's genetic composition that makes a previously
effective drug ineffective.4 The most important principle of acquired antibiotic
http://www.modernmedicine.com/modern-medicine/content/superbugs-unmasking-threat?...
10/2/2015 resistance is natural selection—"survival of the fittest." Bacteria that develop a
mutation that protects them from the antibiotic are more likely to survive than those without
the mutation.4 In this way, the more susceptible ("weaker") organisms will die, leaving behind
only those organisms "strong" enough to resist the antibiotic.5 These resistant bacteria then
pass on their resistant genes to their offspring by replication. They can also transfer genetic
information that confers resistance to other bacteria by conjugation or transduction.6 In
conjugation, plasmids—pieces of double-stranded DNA that occur outside the chromosomal
DNA—jump from one organism's genetic makeup to another.6 When they jump, they take with
them genetic codes for producing specific enzymes or products that make bacteria resistant. In
transduction, genetic information is transferred among bacteria by a virus that "picks up"
pieces of DNA that encode for resistance. Unlike conjugation, transduction makes it possible for
genetic information to be passed from one species of bacteria to another.

 Different approaches for a common goal

Biotechs like Basilea, AiCuris, RedHill Biopharma and Curetis recognize the seriousness of
antibiotic resistance and aim to tackle the problem. Dr. Laurenz Kellenberger, CSO of Basilea,
and it’s company focuses its research efforts on the improvement of established antibiotics to
treat infections caused by MDR pathogens, as well as exploring novel approaches for targets
not yet exploited by currently marketed antibiotics. Its product, ceftobiprole, gained EMA
approval in 2014 to cover many Gram-positive and -negative pathogens, including MRSA.
Another member of the Alliance is AiCuris, a company founded in 2006 as a spin-off of Bayer
Health Care. The company’s entire research activity is centred around molecules that can beat
bacteria via new mechanisms of action, or derived from novel chemical classes. They focus on
drugs which are clearly differentiated from existing ones in terms of chemical properties,
mechanisms of action and the targeting of various potential vulnerabilities of the organism.By
that approach, these drugs are resistance breaking by design.Focusing mainly on Gram-negative
bacteria, their most advanced antibacterial project, currently in clinical Phase I, has so far
shown to be effective against a very broad collection of resistant bacteria.Also The Israel-
based RedHill Biopharma focuses mainly on development and commercialization of drugs for
the treatment of gastrointestinal and inflammatory diseases. RedHill is currently testing a drug
therapy called RHB-105 for the treatment of Helicobacter pylori infections. RHB-105 is an oral
capsule aiming to become the new first-line treatment. At the same timeUsing cartridges that
can contain tests for up to 130 targets, diseases and infections can be diagnosed within just 4–5

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hours, while microbiologic tests can take up to two days. The cartridges also contain tests for 16
to 22 genetic resistance markers, extremely useful for identifying drug resistant bacteria.
Educating patients on proper antibiotic use is essential to containing resistance. Patient
demand contributes to the unnecessary use of antibiotics, which plays a major role in the
spread of resistance. It's estimated that physicians in the United States and Canada
overprescribe antibiotics by 50%.Because bacteria constantly evolve and can therefore develop
resistance to any antibiotic, we will always face the threat of superbugs. Preventive strategies
and the development of newer antibiotics will certainly help combat resistance. Ultimately,
however, containing the spread of resistant bacteria will depend upon our knowledge of the
"enemy" and appropriate use of antibiotics by prescribers, nurses, and patients alike.

 References
1. https://www.bio.org/gooddaybio-archive/its-time-get-serious-about-superbugs-and-
sustainability
2. https://www.ozy.com/the-new-and-the-next/biotech-firms-fight-panic-over-spread-of-
superbugs/96609/
3. https://www.biospace.com/article/with-growing-threat-of-superbugs-only-a-few-
companies-focus-resources-on-the-problem-report/
4. https://www.fiercebiotech.com/research/fighting-superbugs-supercharged-antibiotics
5. https://www.medicalnewstoday.com/articles/327093#:~:text=Superbugs%20are%20germs
%20that%20have,They%20can%20also%20be%20fungi.
6. https://en.wikipedia.org/wiki/Bacteria