Resistant bacteria: dangerous, but not scary
Some contemporaries might find the regular reports about the increasing spread of antibiotic-resistant germs creepy. Some doctors are even talking about a "post-antibiotic era". The truth lies between trivialization and "horror story". That is the conclusion of a Bayer press seminar on "Antibacterial resistances - myths, facts, possible solutions" that took place last week in Mayschoß in the Ahr Valley.
Dr. Stefan Wohlfeil, head of the Group's global anti-infective research, first pointed out the increasing importance of infectious diseases in the world: "From 1980 to 1992, the death rate from infections in the USA rose by 50 percent.47 percent of these deaths were related to respiratory diseases."
Of course, resistance problems have existed since the beginning of the development of drug therapies against bacterial infections. dr Georg Peters from the Institute for Microbiology at the University of Münster: "The problem of resistance has arisen almost since the beginning of antibiotics in antibacterial chemotherapy." The insensitivity of germs to such drugs is a biological phenomenon. The selection pressure exerted by the excellent drugs causes such resistances.
Resistant germs develop most frequently in hospitals – in the environment of seriously ill patients, patients with a damaged immune system and the constant use of antibiotics. There is also the possibility that such bacteria "colonize" people without making them ill themselves. – The he althy doctor who carries antibiotic-resistant bacteria in his nasal mucosa easily becomes a dangerous slingshot.
For the most part, this problem can be kept under control by meticulous hygiene and the correct use of antibiotics in sufficient doses. But Ethan Rubinstein from the Sackler School of Medicine in Tel Aviv nevertheless warned: "The race between antibiotics and germs under these circumstances (intensive care units, hospital environment, note) was not won by the drugs. The spread of resistant germs is much faster than discovery new drugs." Prescribing antibiotics as precisely as possible, hygiene, reducing the use of agents as growth promoters in agriculture and strict prescription requirements are appropriate.
On the other hand, there is a whole range of possible targets for new antibiotics that have not yet been attacked by the agents used to date: for example, the cell division apparatus of bacteria, the replication of genetic material and various enzymes. Several already known classes of such substances (kirromycins, niccomycins, sideromycins, lankacids, lantibiotics, etc.) have not really been "exploited".
In the coming year, the Bayer Group will be launching a new antibiotic from the quinolone class, moxifloxacin. It only has to be administered once a day and also "kills" so-called Gram-positive bacteria, which have so far only been weakly attacked by such agents.
Parallel to this - according to Univ.-Prof. dr Reinhard Marre from the Institute for Microbiology and Immunology at the University of Ulm - all conceivable measures to avoid the development of resistance are used. Medicine should continue to stay ahead of bacteria.
Antoine Adremont, Denis Corpet and Patrice Courvalin: Antimicrobial resistance in Spectrum of Science 7/1997, page 50
Antibiotic Resistant Bacteria Leaving Hospitals in Spectrum Ticker, February 26, 1998
