Evolutionary Forces Behind Antibiotic Resistance

The Columbia University's Mailman School of Public Health article, "How Evolution Explains Antibiotic-Resistant Superbugs," highlights experts' perspectives on how evolution has contributed to the global health crisis.

The article outlines how improper use of antibiotics on an individual basis has exacerbated the problem. "Every time someone prescribed an antibiotic deviates from a prescription, the odds that a new antibiotic-resistant strain will emerge grows," explains Barun Mathema, assistant professor of Epidemiology at the Mailman School. If you look at this on a large scale, the more misuse that occurs, the more antibiotics will lose their effectiveness.

Bacteria are living organisms, so they are susceptible to all evolutionary phenomena. Just as humans evolved to have opposable thumbs that they can grip their food with, bacteria have evolved to avoid the agents designed to kill them. In both scenarios, the living organisms have adapted to survive.

“The thing we all learned in high school, ‘survival of the fittest’ is true. But it’s really survival of the most adaptable. That’s really what resistance is about.”

The article notes, common bugs like E. coli and staph double every 20 minutes, emphasizing the point that the longer someone has an infection, the more likely it is a resistant strain will develop. It truly is a matter of time before antibiotics, which have been life-saving agents for almost 100 years, lose their effectiveness.

What this means on a global scale

For every hour treatment is delayed, the risk of death increases by as much as 8%.

There is a reason antimicrobial resistance (AMR) was named a top global public health threat by the World Health Organization. Its implications are severe. Without proper antimicrobial stewardship programs, commitment from healthcare professionals and patient education, our population will become susceptible to very dangerous superbugs. A simple ear infection that might once have been treated with an antibiotic, could turn into a life-threatening condition.

Further compounding the issue is that there have been very few antibiotics identified in the clinical pipeline. World Health Organization states, "since 2017 only 12 antibiotics have been approved, 10 of which belong to existing classes with established mechanisms of antimicrobial resistance (AMR)." Without new antibiotics to fight off infections and the lack of effectiveness current agents have, there are very few treatment options, leaving clinicians in a challenging position when it comes to patient care.

Learn more about how you can help personally combat superbugs by visiting the CDC's Core Elements of Antibiotic Stewardship or check out how Selux is helping labs combat antibiotic resistance (AMR) through their proprietary rapid antibiotic susceptibility (AST) testing platform.