Antibiotic Resistance

ANTIBIOTIC RESISTANCE -AN INEVITABLE TRUTH

Trillions of the microorganisms live on and in us. Mass of microbes live inside the body and is harmless in normal conditions is collectively called as the normal flora. The flora includes more than 1000 different types of bacteria such as the species of streptococcus, lactobacillus, actinomyces, fusobacterium, treponema & veillonella. They perform important task and hence are essential for human survival. Among these microbes, streptococcus and lactobacillus species are common. There are four natural microbial reservoirs of the human body such as, gastrointestinal tract, urinogenital tract, mouth and skin. Gastrointestinal tract is the largest microbial reservoir of the host which is followed by mouth. The type of flora varies in these reservoirs depend on the hosts age, diet and internal environment such as temperature and acidity.

The member of normal flora helps in vitamin synthesis, improves digestion, increases nutrient absorption, inhibits pathogens and reduces other infections. Intestinal microbe helps in healing many chronic gastrointestinal problems. Devoid of usefulness, many of the bacteria of normal flora can acts as opportunistic pathogens during lowered immunity, overgrowth and toxin synthesis.

In the case of common body ache, headache, sinusitis, people always think of the antibiotics as wonder drugs. The frequent use of these drugs has created severe problems of resistance strain generation. Many of the patients died of bacterial infections that were resistance to antibiotics. Now a day, more and more microbes are developing resistance to various drugs. The majority of bacteria today are resistance to common antibiotics such as tetracyclin, streptomycin, gentamycin and penicillin. Antibiotics itself can not cause the resistance but it creates a condition where the existing microbial variants can only overgrow.

One problem with antibiotic resistance is that patient often stop taking antibiotics too soon because symptoms improve. However, this encourages resistant microbes to proliferate. The infection returns a few weeks later. The selection pressure due to burden of antibiotics develops resistance in microbes.
These variants develop resistance by altering their normal metabolic pathways, confirmation of their own components or due to spontaneous mutations. The MDR-TB is the cause of spontaneous mutation. The resistance can also acquired by bacterial transformation. This includes transfer of genes conferring antibiotic resistance to the other bacteria by means of conjugation and transduction.

Drug resistant microbes may spread in non vegetarian population because the individuals of these population use to take meat of poultry and different animals frequently fed antibiotics for weight gain. E.g. many of the people were developed MDR-Salmonella food poisoning after eating beef from cow fed antibiotics.
In order to slow down the rate of drug resistance, it is necessary to develop new, efficient and safe drugs, “wonder drugs” that can be useful against diversity of pathogens without any harm to hosts essential microbial flora.

Following measures may be useful to control antibiotic resistance.

1.Quick identification and isolation of patients with drug resistance infection.
2.Prescription of narrow spectrum antibiotics, this may restrict the problem of antibiotic resistance.
3.Proper sterilization practices.
4.Cleanliness of hospitals to avoid hospital born infections.
5.Proper disposal of MDR-strains.
6.Use of disposable masks and gloves while working with MDR-strains.
7.Correct medications.

Till, there is the need of collaborative work all over the world to overcome this problem.

RAVI DHANDE AND NILAM SHARMA