WHAT happens if bacteria get totally immune to drugs?

Medical experts are alarmed with the discovery of new bacterial strains which render antimicrobial drugs’ ineffective against infectious diseases.

Drug resistance is the condition which enables disease-causing microorganism or microbe to survive even with the presence of antibiotics, said Dr. Evelina Lagamayo, chief of the Microbiology Section of the Faculty of Medicine and Surgery.

“Because of this condition, new bacterial strains, also called ‘superbugs,’ develop resistance to common antibiotics like penicillin, erythromycin, tetracycline, quinolone, and aminoglycoside,” she said.

According to Dr. Joey Matro, a pharmacology professor from the Faculties of Pharmacy and Medicine and Surgery, antibiotics are substances that are directed toward infectious or foreign microorganisms like bacteria.

Generally, the purpose of most antibiotics is to inhibit the bacteria from forming its cell wall. The cell wall keeps the integrity of the cell and the contents of the nucleus intact.

“The moment the cell wall is destroyed, the cell will be very susceptible and the cell will die,” Matro said.

However, bacterial evolution emerges by exposing these microorganisms to antimicrobial agents. Bacterial evolution is a process where mutations and alterations of cellular properties occur in order for a microbe to adapt into its surrounding environment.

“Cellular evolution is a natural occurrence wherein cells would transform into something resistant, which is the general course of all cells,” he said.

There are also several mechanisms of action by which these microbial pathogens develop resistance.

“[Some] microorganisms produce enzymes that destroy the active drug,” Lagamayo said. “Other microorganisms develop an altered enzyme that can still perform its metabolic function without being gravely affected by the drug.”

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By sustaining cellular metabolism, a microbe is able to sustain its life by obtaining the necessary nutrients and energy which it uses to reproduce the same bacterial species with altered traits, including drug-resisting capabilities.

Growing ‘strains’

Some bacterial pathogens have developed strong resistance to some antibiotics.

Methicillin is an antibiotic which was extensively used to treat boils and urinary tract infections caused by Staphylococcus aureus in the 1970s and 1980s, but a new strain of the bacteria quickly developed due to frequent exposure to the antibiotic.

“Methicillin-resistant Staphylococcus aureus (MRSA) rapidly spread from the United States and other Western countries until it reached Asia.” said Francis Abrantes, a microbiology professor from the College of Science. “It now became an indicator on how antibiotic resistance can have a tremendous implication on how to deal with infectious diseases.”

Although MRSA seem to be a serious medical challenge, species of Klebsiella poses a greater medical threat including pneumonia and urinary tract infections.

“The problem with Klebsiella species is that they are resistant to multiple types of antibiotics,” Abrantes said.

Treatments against Klebsiella infections are more expensive as compared to MRSA.

“[Klebsiella infections] are much more difficult to treat because they need a more powerful antibiotic drug,” Abrantes said.

These bacteria produce extracellular appendages and capsules which make it more difficult for antibiotics to penetrate the cell’s interior and destroy it.

‘The doctor is in’

Matro said refraining from self-prescription will lessen the chances of a bacteria evolving into a superbug, adding that it would be best to seek help from medical professionals.

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“Some patients do not consult anymore. They buy their own antibiotics, having no good background on what antibiotic to choose. It matters because certain organisms have their own susceptibility to different types of antibiotics available,” Matro said.

Lagamayo added that aid from medical authorities will avoid delay of proper medical action.

“Since the physician knows what are the best possible drug interactions, side effects, and contraindications, the patients should consult the physician for prescription of these antibiotics.” she said.

Completing the course of antibiotics based on guidelines set by the doctor is very important to ensure that the bacteria were completely removed.

“What happens [if the course is not followed] is that some of the microorganisms are still alive and were exposed to these substances that could potentially kill them,” he said. “They then recognize it and try to protect themselves from it [and] this is where mutation and adaptation comes in.”

Furthermore, the treatment should be directed to the root of the problem in order to effectively combat bacterial cells.

“The strategy should be directed to the offending organism. The pattern of resistance of the bacteria may change when they get exposed to a very strong antibiotic, since cells differ in genetic susceptibility,” Matro said.

Meanwhile, Lagamayo said the strain of superbugs will affect not only the patient’s health, but his finances as well.

“It would be expensive because we will be using the reserved drugs which are more expensive and toxic to the patient. It would require longer hospital stay and may also cause the death of the patient,” Lagamayo said. Altir Christian D. Bonganay and Giuliani Renz G. Paas

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