{"id":6993,"date":"2017-11-14T15:07:25","date_gmt":"2017-11-14T15:07:25","guid":{"rendered":"https:\/\/blogs.nature.com\/aviewfromthebridge\/?p=6993"},"modified":"2017-11-14T15:08:12","modified_gmt":"2017-11-14T15:08:12","slug":"superbugs","status":"publish","type":"post","link":"https:\/\/blogs.nature.com\/aviewfromthebridge\/2017\/11\/14\/superbugs\/","title":{"rendered":"Superbugs<\/em>: fighting the flood of antimicrobial resistance"},"content":{"rendered":"

Posted on behalf of Andrew Jermy <\/em><\/strong><\/h3>\n
\"Enterobacter<\/a>

Petri dishes with cultured Enterobacter cloacae, Enterococcus faecalis, Staphylococcus epidermidis and Escherichia coli at the London Science Museum’s Superbugs exhibition.{credit}\u00ae The Board of Trustees of the Science Museum{\/credit}<\/p><\/div>\n

Antimicrobial resistance has spread to London this month. The source of the outbreak? The Science Museum: its new exhibition,\u00a0Superbugs<\/a>,\u00a0<\/em>explores this monumental issue and our responses to it.<\/p>\n

As Superbugs<\/em> graphically shows, the inflammatory tone of the many headlines predicting an impending antibiotic apocalypse is not baseless. The evolution and spread of resistance among serious (and increasingly commonplace) bacterial infections continues to blunt much of our antibiotic arsenal, and make routine operations significantly more risky. Such infections now claim almost 700,000 lives annually,\u00a0a figure that could rise to more than 10 million by 2050.<\/p>\n

Superbugs<\/em> isn\u2019t out simply to scare, however. Much\u00a0like\u00a0Nature Microbiology<\/a><\/em>, the journal I edit, the Science Museum aims to join the \u2018resistance against resistance\u2019 by shining a light on the problem\u2019s scale, and the range of potential solutions.<\/p>\n

\"The<\/a>

The monumental ‘wall’ and towers at the exhibition.{credit}{credit}\u00ae The Board of Trustees of the Science Museum{\/credit}{\/credit}<\/p><\/div>\n

The physical design of the installation aptly reflects aspects of the crisis. A vast illuminated wall dominates; set into it is a series of displays. This monolith, emblazoned with the show\u2019s title, speaks of antibiotics\u2019 barrier function \u2014 how they act as a great dam holding back a flood of infections. Standing in front of this cracked levee are 12 small towers into which have been set Petri dishes. Each contains a different type of (inactive) microbe, including MRSA and Neisseria gonorrhoeae<\/em> \u2014 like outposts of resistance that have breached the barricade and now mingle among the crowds. It\u2019s a powerful scene.<\/p>\n

I was drawn irresistibly\u00a0to the inset display cases. Combining text with striking visuals and interactive content, these take the visitor through medical history, from the discovery and introduction of antibiotics in the first half of the twentieth century, to the rise of resistance in the years following the introduction of each new drug, to ongoing efforts to revitalize our dwindling drug cabinet. Peppered through are personal testimonies. We meet doctors explaining why antibiotics are overprescribed; a nurse reminding of the fundamental importance of their work on infection control; designers who create products that enable no-touch use, or incorporate anti-bacterial materials, to reduce the risk of transmission.<\/p>\n

\"Interviews<\/a>

A display on the people at the frontline of ‘resistance against resistance’.{credit}\u00ae The Board of Trustees of the Science Museum{\/credit}<\/p><\/div>\n

We hear a recording of bacteriologist and discoverer of penicillin Alexander Fleming, describing how microbes can become \u2018educated\u2019 to resist a drug. A culture of Penicillium<\/em> mold grown from a stock of his original sample is shown nearby. A video describes the harrowing experience of Geoffrey Pattie, a cancer patient who during surgery contracted a strain of Klebsiella pneumoniae<\/em> resistant to all current antibiotics. He spent five months in an isolation ward, and today lives with the life-altering effects of the infection, such as reduced mobility.<\/p>\n

Nearly half of antibiotic use occurs in agriculture, to treat and prevent infection in livestock, but often also to promote growth. The drugs and bacterial resistance genes that they select for become widespread in terrestrial and marine environments, giving a large potential reservoir from which resistance can leap into clinically relevant pathogens. Inevitably, that is a serious problem for human health. The show reveals some of the technological fixes that are being investigated, including automated systems for monitoring livestock welfare to allow targeted interventions rather than\u00a0treating an entire herd prophylactically. Also presented are possible alternative approaches to tackling infections, such as phages (viruses that kill bacteria) sourcing new antibiotic leads from oceans, soils and host-associated microbiomes in humans<\/a>, komodo dragons and leafcutter ants.<\/p>\n

The promise of such efforts is stirring. But finding a new antibiotic class that will make it to the clinic is \u201clike searching for a needle in a field of haystacks\u201d, cautions one researcher interviewed.<\/p>\n

\"The<\/a>

The bacteria leafcutter ants use to defend their nests against fungi and microbes excrete chemicals that are effectively antibiotics.{credit}\u00ae The Board of Trustees of the Science Museum{\/credit}<\/p><\/div>\n

What isn\u2019t covered in much depth is the parlous state of the antibiotic R&D pipeline. Many large pharmaceutical companies have closed their antibiotic development programmes in recent years. That includes Pfizer, the main sponsor of the exhibit \u2014 although the company did announce in 2016 that it planned to acquire AstraZeneca\u2019s antibiotics division, and reinforced a strategic focus on tackling infectious diseases. The economics of antibiotic discovery and development is complicated: to bring a drug to market takes a massive investment in time and finances. Yet we will need these new drugs to be used ever more sparingly in future. So, under the current system, there is actually a disincentive for industry to put in the necessary investment \u2013 they would never break even, let alone see a return.<\/p>\n

Superbugs<\/em> is doubly timely. This week (13-19 November) is the World Health Organization\u2019s World Antibiotics Awareness Week 2017<\/a>, an opportunity to take stock of progress. Antibiotic resistance, until recent years a concern only of clinicians and microbiologists, is now globally recognised as a crisis through the work of key individuals, such as Britain\u2019s chief medical officer Sally Davies<\/a>,<\/strong> and reports from national and international bodies. In 2016 this culminated in the UN High-Level Meeting on Antimicrobial Resistance (see this Nature<\/em> Microbiology <\/em>editorial<\/a>).The rise in academic research and conferences focused on antimicrobial resistance\u00a0is a positive sign that new approaches can and will be found, despite the issues with the pharma marketplace and the ongoing hunger for antibiotics in agriculture and medicine.<\/p>\n

But we remain a long way from winning what the Science Museum describes succinctly as the \u201cfight for our lives\u201d. Hopefully this polished, fact-packed exhibition will call many more to arms \u2014 from the lay visitor to the family doctor, local farmer and political representative.<\/p>\n

Andrew Jermy is chief editor at Nature Microbiology. <\/em>He tweets at @jermynation.<\/strong><\/p>\n

Superbugs<\/a>: The Fight for Our Lives<\/em>\u00a0is free, and at the Science Museum until spring 2019.<\/strong><\/p>\n

 <\/p>\n

For\u00a0<\/strong>Nature<\/strong><\/em>\u2019s full coverage of science in culture, visit www.nature.com\/news\/booksandarts.<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

Antimicrobial resistance has spread to London this month. The source of the outbreak? The Science Museum: its new exhibition,\u00a0Superbugs,\u00a0explores this monumental issue and our responses to it.  Read more<\/a> Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":3353,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[95,25,19,2088811,545341],"tags":[],"class_list":["post-6993","post","type-post","status-publish","format-standard","hentry","category-agriculture","category-medical-research","category-medical-science","category-microbiology","category-society"],"_links":{"self":[{"href":"https:\/\/blogs.nature.com\/aviewfromthebridge\/wp-json\/wp\/v2\/posts\/6993","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nature.com\/aviewfromthebridge\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nature.com\/aviewfromthebridge\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nature.com\/aviewfromthebridge\/wp-json\/wp\/v2\/users\/3353"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nature.com\/aviewfromthebridge\/wp-json\/wp\/v2\/comments?post=6993"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nature.com\/aviewfromthebridge\/wp-json\/wp\/v2\/posts\/6993\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nature.com\/aviewfromthebridge\/wp-json\/wp\/v2\/media?parent=6993"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nature.com\/aviewfromthebridge\/wp-json\/wp\/v2\/categories?post=6993"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nature.com\/aviewfromthebridge\/wp-json\/wp\/v2\/tags?post=6993"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}