Protecting the antibiotic miracle

Abstract

A combination of infection control measures, improved sanitation, and antibiotics have rendered some infections feared by our ancestors manageable. However, the growing number of resistant bacteria threatens the antibiotic miracle. Bacteria can become resistant to antibiotics in numerous ways. Bacteria may employ alternative metabolic pathways to bypass the disruption caused by an antibiotic. They do this by secreting enzymes that destroy antibiotics or altering cell wall composition. In general, bacteria acquire these resistance mechanisms through changes to their genetic code, offering an example of natural selection in action. Spontaneous chromosomal mutations occur once in 100 million microorganisms, but the enormous numbers of bacteria in the human body means that the absolute number of mutations is relatively high, providing ample opportunity for a bacterial strain to acquire antibiotic resistance. This article explains how genetic resistance to antibiotics develops in bacteria, and how nurses can help reduce the emergence of ‘super’ bacterial strains resistant to common antibiotics.