It is not news that antibiotic resistance is a major concern of our modern lives and that WHO has declared it at the top of 10 global public health threats facing humanity. The overuse and misuse of antimicrobials have been the driving forces for the rise of drug-resistant pathogens.
Not long ago, I had the opportunity to talk to a bioscientist with an expertise in antibiotics, which is a topic close to his heart. Michal Zielinsky, born in Poland, has been in the field of academia for quite a few years. He obtained his degree from the University of Dundee, where he specialised in both biological chemistry and drug discovery, as well as molecular microbiology. Following that, he acquired his PhD at McGill University in Montreal, Canada, where for seven years he studied the field of antibiotics and how the old antibiotics are slowly and unfortunately starting to fail us.
In our conversation we discussed the alarming numbers of deaths per annum and what the predictions of casualties are for the near future. And how one of the reasons for the lack of the development of new antibiotics is financial, since such drugs don’t make part of a lucrative field, and the fact that their use should be avoided as much as possible. The amount of antibiotics being used in animal husbandry in a few countries is shocking. And, as he explained, these drugs are not fully deactivated. A sub-inhibitory concentration of antibiotics is created in wastewater.
The other reason for a discovery void at the moment is biological. Soil microbes nowadays are depleted, as they were the easiest ones to be ‘picked’ for the production of antibiotics. Designing a new antibiotic that would be able to stop bacteria growth or kill the bacteria is hard, since these microbes contain a bacterial wall that makes it very difficult for certain substances to get in.
An interesting aspect of our conversation, when I asked him if there is a failure in the system that prescribes antibiotics too often, is that it has been reported that GPs’ clinics are much more likely to prescribe antibiotics towards the end of the day because of fatigue. Medical doctors no longer want to argue with patients that they really don’t need that antibiotic for a sore throat or for a viral infection, as GPs are exhausted.
We also discussed the issue of letting our body balance our microbiome before prescribing antibiotics. Nowadays, we have a lot of antibiotics which are able to act on essentially any and all bacteria – the so-called broad action antibiotics. These completely wipe out our gut microbiome, giving a chance for a common bacteria, Clostridium difficile, to establish itself in our digestive tract. An opportunistic bacteria that is difficult to get rid of.
I’ve learned from Zielinsky’s more recent work that bacteria have enzymes (proteins involved in the speed of reactions inside cells) that act upon two main components used in antibiotics. He explained to me how he has found the resistance caused by these enzymes and how, by knowing the structure of the enzymes and the way that antibiotics bind to them, new antibiotics can potentially be created. His work is of fundamental importance, even if its application may not be known for a while yet. His hope is that his findings will be, as he said, “a little piece of Lego that will be used to build a castle of new antibiotics.”
I’ve asked him if there is any light at the end of the tunnel and what science is able to bring in order to rescue us one more time, and if there is any new therapy in the corner. There are not many promising antibiotic candidates right now, so things look grim. An interest in fulfilling financially this field is paramount. There are alternatives, such as bacteriophage therapy, though.
For those interested, you can listen to more detailed explanations in this very educative conversation with him:
