Can Antibiotic Resistance Be Reversed?

The discovery of antibiotics has changed medicine and transformed our lives in many ways, alleviating much of the misery in the 1930s. However, as wealth started to increase, antibiotics are often over-prescribed and over-used by the public and therefore the resistance of the bacteria to the treatment has been accelerating. The bacteria start adapting to the drugs and are becoming increasingly difficult to kill, posing a significant threat to current and future health. According to Oxford university, antibiotic resistance is one of the biggest rising threats to global health causing 1.5 million deaths per year worldwide. Modern medicines eg. Organ transplants, chemotherapy and surgeries have become more dangerous without effective antibiotics to treat infections. But can this problem of antibiotic resistance be reversed?

Due to the cost of making new antibiotics, many scientists have taken the approach of resensitising bacteria to the drugs so that existing antibiotics hit their target. ‘This is a sustainable and straightforward approach to the problem of antibiotic resistance. New antibiotics take a huge amount of money to develop.’ Said Fedrik Almqvist, professor of organic chemistry at Umea University in Sweden. 

Four defences against antibiotics have been discovered:

1. Bacterial organism changes its physiology so that the antibiotic cannot find its target- it can alter their cell wall structure to make it invisible

2. Bacteria regularly expel antibiotics

3. Proteins within the bacteria can attach themselves to the antibiotic and prevents the antibiotic from successfully binding to its target

4. Bacteria produce enzymes to destroy or modify the antibiotic molecule

Beta lactamases are enzymes produced by bacteria that provide multi-resistance to antibiotics and developing chemicals to slow down this may be the key to reversing antibiotic resistance. The University of Bristol, UK has found the production of beta-lactamase, which destroys the antibiotics, as one of the most important mechanisms associated with beta-lactam antibiotic resistance. According to the Journal of Antimicrobial Chemotherapy, these findings imply that inhibition of beta-lactamase enzymes could be developed and a significant portion of antibiotic resistance could be reversed. Building on these findings, researchers in another study had looked into two types of beta-lactamase enzyme inhibitors. Although this is still under development, the inhibitors were found to have worked extremely well when paired with beta-lactam antibiotics. For example, Stenotrophomonas Maltophilia - a resistant bacteria causing severe infections in immunocompromised patients, usually resistant to all beta-lactam antibiotics, was killed.

Most of professor Almqvist research is focused on tuberculosis, an infection that kills 1.6 million people every year, and its resistance to antibiotics make them particularly difficult to treat. He developed a chemical compound in collaboration with Christina Stalling, a molecular biologist at Washington University, which inhibits the formation of biofilm (a matrix of molecules that surround the bacterial cells) providing protection for the pathogen. Bacteria enclosed in the biofilm are 1000 folds time more resistant. However in the presence of this compound, the TB Bacteria can no longer form biofilm and without it, they can be killed by antibiotics. In his lab, researches of other superbugs such as methicillin-resistant Staphylococcus aureus (MRSA) have also had their antibiotic resistance reversed. 

Another promising research by professor Pinho had used super-resolution microscopy to look into the bacterial cell cycle and look for movement where microbes are most susceptible to actions of antibiotics during its division. DNAC-1 was discovered and has been seen to damage the microbe’s cell membrane allowing the antibiotic to kill the cell. 

Many developments and discoveries have shown that the process of reversing antibiotics is possible. However cost becomes a limiting factor, holding back progress which could lead to curing the problem of antibiotic resistance.