tbx-basic-lecture-abr.pdf
- 1. BACTERIA, ANTIBIOTICS AND ANTIBIOTIC RESISTANCE Photo: Mycobacterium tuberculosis bacteria, NIAID (from flickr).1 Photo: Staphylococcus epidermidis bacteria, NIAID (from flickr).2 By ReAct Funding from Marie-Claire Cronstedts Stiftelse BASIC LECTURE
- 2. OUTLINE OF THIS LECTURE • About bacteria • About antibiotics • Antibiotic resistance – How does it form and spread? – What are the consequences for global health? • What can you do?
- 3. ABOUT BACTERIA • Bacteria are small (microscopic size) organisms that can be found in most environments, for example in soil, water and on and inside the human body • There are around 50 million bacteria in every gram of surface soil • We would not survive without them! – Help degrade the food we eat – Protect against pathogens Photo: Bacteria, Umberto Salvagnin (from flickr).3
- 4. • A few bacteria can be dangerous to our health by causing infections and even death • We can get them from outside the body: – Other humans, animals, food, water • Sometimes our “own” bacteria can cause disease • Examples of bacterial infections: – Pneumonia – Blood stream infections – Urinary tract infections – Wound infections – The sexually transmitted disease gonorrhea DISEASE-CAUSING BACTERIA Photo: Klebsiella pneumoniae, NIAID (from flickr). 4
- 5. • Antibiotics are medicines for bacterial infections • Examples of antibiotics: – Penicillin and Ciprofloxacin • Penicillin was discovered by Alexander Fleming in 1928 – Introduced as medicine in the 1940’s • Antibiotics can have “broad” or “narrow” spectrum – Broad spectrum: Active against many different types of bacteria – Narrow spectrum: Active against one or a few types of bacteria ANTIBIOTICS Photo: Antibiotics, Michael Mortensen (from flickr). 5
- 6. • Antibiotics do not work against viruses! ANTIBIOTICS European Antibiotic Awareness Day key messages, ECDC. • Examples of viral infections: – The common cold – The flu (influenza)
- 7. ANTIBIOTICS • Antibiotics are effective against bacteria – However, antibiotics have only marginal effect against some bacterial infections such as uncomplicated sinus infections and ear infections (bacterial otitis) – The body’s immune system can normally take care of these infections without antibiotics • But for some bacterial infections antibiotics are life-saving medicines! – For example for blood stream infections (sepsis) and pneumonia
- 8. • Before antibiotics there was no effective cure for bacterial infections • Antibiotics were considered “a miracle cure” • Antibiotics cure infections, prevent infections upon surgery, and make transplantations and cancer treatment safer ANTIBIOTICS è Saved countless lives! è Made modern medicine possible!
- 9. • Antibiotics are the cornerstones of modern medicine! ANTIBIOTICS Photo: M. Pränting
- 10. • Massive use of antibiotics the past 80 years, both appropriate and inappropriate has lead to: ANTIBIOTIC RESISTANCE Photo: Drug resistance by Iqbal Osman (from flickr). 6 Increased occurrence and spread of bacteria that are resistant to antibiotics
- 11. ANTIBIOTIC RESISTANCE = The ability of bacteria to protect themselves against the effects of an antibiotic ANTIBIOTIC RESISTANCE • Bacteria are experts at surviving in changing environments • In large bacterial populations there are often a few resistant bacteria
- 12. • Antibiotics select for resistant bacteria ANTIBIOTIC RESISTANCE Population of mainly susceptible bacteria Antibiotics kill or stop growth of susceptible bacteria
- 13. ANTIBIOTIC RESISTANCE • Antibiotics select for resistant bacteria
- 14. ANTIBIOTIC RESISTANCE Is antibiotic resistance a problem? • Antibiotic resistance leads to treatment failures • Antibiotic resistance threatens our ability to perform modern medical procedures • Antibiotic resistance imposes a major economic burden on society • Antibiotic resistant bacteria already cause many deaths around the world
- 15. Antibiotic resistant bacteria each year cause: • More than 38,000 deaths in Thailanda • More than 23,000 deaths in the USAb • 25,000 deaths in the European Unionc ANTIBIOTIC RESISTANCE Photo: Methicillin-Resistant Staphylococcus aureus (MRSA) Bacteria by NIAID (from flickr) 7 aPhumart P, Phodha T et al. Health and Economic Impacts of Antimicrobial Resistant Infections in Thailand: A Preliminary Study. J. Health Syst Res. (2012) 6(3). bUS Centers for Disease Control and Prevention. Antibiotic resistance threats in the United States, 2013. (2013). http://www.cdc.gov/drugresistance/threat-report-2013/ pdf/ar-threats-2013-508.pdf cECDC/EMEA. Technical Report. The bacterial challenge: time to react. (Sept 2009). http://www.ecdc.europa.eu/en/publications/Publications/ 0909_TER_The_Bacterial_Challenge_Time_to_React.pdf
- 16. … but the consequences of antibiotic resistance are most severe for the poor. For example: • In South Asia (India, Pakistan, Afghanistan, Nepal, Bangladesh) one newborn child dies every 5 minutes from blood stream infections (sepsis) because the antibiotics given are not effective due to bacterial resistancea ANTIBIOTIC RESISTANCE aBhutta Z, Presentation at the Global Need for Effective Antibiotics - Moving towards Concerted Action. http://www.reactgroup.org/uploads/publications/presentations/ opening-session-zulfiqar-bhutta.pdf
- 17. • Antibiotic resistance is a global issue! – Exists on all continents – Affects both low- and high income countries – Affects both strong and weak health systems ANTIBIOTIC RESISTANCE Photo: The Blue Marble, Eastern Hemisphere March 2014, NASA Goddard Space Flight Center (from flickr). 8
- 18. How did we end up here?
- 19. How did we end up here? USE & INAPPROPRIATE USE OF ANTIBIOTICS • Use in human and animal medicine • Use to increase growth of farm animals • Use for routine prophylaxis in farm animals à Selection and maintenance of resistance
- 20. SPREAD OF RESISTANT BACTERIA • Poor hygiene and sanitation • Food and water • Travel How did we end up here? USE & INAPPROPRIATE USE OF ANTIBIOTICS à Selection and maintenance of resistance
- 21. How did we end up here? SPREAD OF RESISTANT BACTERIA USE & INAPPROPRIATE USE OF ANTIBIOTICS à Selection and maintenance of resistance LACK OF NEW ANTIBIOTICS • The last new antibiotic class that has been introduced as medicine was discovered in 1987 • Older antibiotics are rapidly becoming ineffective due to antibiotic resistance
- 22. • No new drugs for typhoid fever, gonorrhea, blood stream infections or postoperative infections • Some bacteria already resistant to all available antibiotics LACK OF NEW ANTIBIOTICS Adapted from Silver 2011
- 23. WHAT CAN YOU DO? • Use antibiotics only when you need it – Not for a common cold or the flu • Ask your doctor for advise – Don’t pressure – Don’t self medicate • Wash your hands, especially…. – Before and after handling and preparing food – After visiting the bathroom • Teach others about antibiotic resistance!
- 24. Thank you for your attention! For more information about antibiotic resistance, please visit: www.reactgroup.org www.reactgroup.org/toolbox
- 25. 1 Photo: Mycobacterium tuberculosis Bacteria, the Cause of TB by NIAID (from flickr) https://www.flickr.com/photos/niaid/5149398656/ https://www.flickr.com/photos/niaid/ License: https://creativecommons.org/licenses/by/2.0/ 2 Photo: Staphylococcus epidermidis Bacteria by NIAID (from flickr) https://www.flickr.com/photos/niaid/5613984108 https://www.flickr.com/photos/niaid/ License: https://creativecommons.org/licenses/by/2.0/ 3 Photo: Bacteria by Umberto Salvagnin (from flickr) https://www.flickr.com/photos/kaibara/2234750993/ https://www.flickr.com/photos/kaibara/ License: https://creativecommons.org/licenses/by/2.0/ 4 Photo: Klebsiella pneumoniae by NIAID (from flickr) https://www.flickr.com/photos/niaid/13383560994 https://www.flickr.com/photos/niaid/ License: https://creativecommons.org/licenses/by/2.0/ 5 Photo: Antibiotics by Michael Mortensen (from flickr) https://www.flickr.com/photos/-mic-/754962309/ https://www.flickr.com/photos/-mic-/ License: https://creativecommons.org/licenses/by-sa/2.0/ 6 Photo: Drug resistance by Iqbal Osman (from flickr) https://www.flickr.com/photos/82066314@N06/9502114881/ https://www.flickr.com/photos/82066314@N06/ License: https://creativecommons.org/licenses/by/2.0/legalcode Downloaded 2015-02-05 7 Photo: Methicillin-Resistant Staphylococcus aureus (MRSA) Bacteria by NIAID (from flickr) https://www.flickr.com/photos/niaid/5927204872/ https://www.flickr.com/photos/niaid/ License: https://creativecommons.org/licenses/by/2.0/legalcode Downloaded 2015-02-05 8 Photo: The Blue Marble, Eastern Hemisphere March 2014 by NASA Goddard Space Flight Center (from flickr) https://www.flickr.com/photos/gsfc/14990033062/ https://www.flickr.com/photos/gsfc/ License: https://creativecommons.org/licenses/by/2.0/ All images downloaded 5th of Nov 2014 unless otherwise specified Image references