Superbugs on the March: Talk the Talk

Used with permission

A FEW BASICS
First of all, get your anti’s right. ’Antibiotics’ by definition derive from living organisms. There are also anti-bacterial substances which are synthesised in the laboratory, but these are known as ’anti-microbials’.

And because antibiotics are living species, you should refer to similar groups of them as "classes" of antibiotics rather than "types".

It’s true to say that Alexander Fleming discovered penicillin. But it’s not true to say that this was the first antibiotic ever found. Others were already known, but the reason penicillin is the famous one is because it proved SO effective.

Because of the revolutionary impact penicillin had on healthcare, Fleming was hailed as a medical hero by the public. He won all sorts of awards for his work including a Nobel Prize. But the heroes you never hear of were Howard Walter Florey and Boris Chain who managed to isolate penicillin and produce it in a concentrated form. So it’s them who made penicillin the best thing since sliced bread at the time...

Antibiotic resistance - or "AB resistance" as they say in the business - was an inevitability. Alexander Fleming himself warned that people should be sparing with the new drugs because the bacteria would develop resistance over time - and today’s superbugs have proved him right.

...FROM THE HOSPITAL WARD AND LAB...
To fight certain bacteria, a combination of antibiotics has to be used. But as with hosting a dinner party - if the individuals haven’t met before you can never be sure exactly how they will interact over time.

In the case of antibiotics a doctor risks making the situation worse if the wrong combination or dose is chosen. So hospitals need to be able to assess the effect before they give anything to a patient.

In the lab, the drug cocktail is used on cultured bacteria and monitored regularly - producing a graph called a "time kill curve", which to the trained eye, explains how the antibiotics will affect the infection.

When a bacterium develops resistance to one or more antibiotic, other more powerful antibiotics have to be used instead. The problem is that these can cause serious side-effects for the patients. Vancomycin is often known as "the antibiotic of last resort" for just this reason - it’s powerful stuff, but it punishes the body as well as the harmful bacteria.

Not a phrase you’d hope to overhear if you’re in hospital, Red Man Syndrome demonstrates the power of the aforementioned vancomycin - and can happen to men and women alike. It occurs if vancomycin is introduced to the body too quickly - and the symptoms are literally full-body redness of a lurid hue. Fortunately it is easily reversed by changing the rate of the medication.

ABBREVIATIONS
Hospitals live for their abbreviations. And superbugs have added a whole new bunch to their vocabulary. MRSA, VISA, HLGR, MRTB are just a few, denoting antibiotic resistance of various bacteria.

MRSA is undoubtedly the most well-known of these - and stands for "Multiply Resistant Staphylococcus Aureus".

... AND FINALLY: A "THE COUNTRY’S GOING TO THE DOGS" COMMENT ...
Did you know that 1 in 10 hospital patients in the UK picks up an infection in hospital that they didn’t have when they were first admitted? These are known as "nosocomial" infections - and if you’re engaged in a pub debate about NHS spending at any point, you can make the point that "nosocomial infections cost the UK taxpayer £1bn a year".