Abstract
This analysis of antimicrobials before antibiotics uses both biological and historical approaches to examine the origins of contemporary antibiotic resistance in the decades prior to the introduction of penicillin. Genetic studies of resistance elements in contemporary bacterial pathogens point toward the importance of early twentieth century chemotherapies as initial selection pressures shaping the landscape of resistance elements even before microbially-produced antibiotics came onto the scene while historical analysis gives insight into the design of these pressures: specific toxicity in arsenicals, sulphonamides, and disinfectant quaternary ammonium compounds, as well as their industrial-scale production and distribution. Turning from production to application, the specific cases of troop mobilization and poultry farming between 1940 and 1950 in the United States are used to illustrate how profound physical and social disruption, outbreaks of epidemic disease, and mass prophylaxis and antisepsis with synthetic antimicrobial agents came together at scale in this period, generating a highly specific landscape of bacterial flourishing and killing, and setting the stage into which the first antibiotics came. Reframing antimicrobial resistance in a longer historical trajectory lends new insight into both the social origins and biological evolution of the phenomenon.
Highlights
Most accounts of antibiotic resistance include an historical schema that explains or assumes the phenomenon dates to the introduction of antibiotics, in particular the development of penicillin during World War II
Taking a note from work in the history of medicine and from cues found in bacterial genomes, the aim of this article is to set the advent of antibiotics— and antibiotic resistance—in the larger and longer frame of modern chemotherapy
The environmental conditions for integron evolution—instability, multiple acute selective pressures, mass-produced chemicals designed for microbial killing that were paradoxically specific and uniform at the same time, intensive microbial population expansion—have been used through this paper as a framework for recounting the story of the period just prior to the entry of penicillin onto the world stage, in order to have a better sense of the biochemical and evolutionary milieu into which the first antibiotics came
Summary
Most accounts of antibiotic resistance include an historical schema that explains or assumes the phenomenon dates to the introduction of antibiotics, in particular the development of penicillin during World War II. Arsenicals and sulphonamides, drugs made by chemical tinkering with synthetic dyes, as well as a number of disinfectants made with metal ions toxic to bacteria, such as mercury or copper, were in use well before the introduction of penicillin. Their industrial origin was as important as their chemical structure, because it meant that the scale of their effects was global. Both from a historical and a biological perspective, it is important to understand the technical, social and cultural logics of the germicidal age, and the changes to the chemical landscape of metabolic challenge and selective pressure that ensued, shaping the conditions into which the first antibiotics arrived
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