The Problem of Antimicrobial Resistance The success of antimicrobialsagainst disease-causing microbes is among modern medicine’s
great achievements.After more than 50 years of widespread use, however, many antimicrobials arenot as effective particullerely when we use them against viruses, fungi, andparasites. Drug resistance is an especially difficult problem for hospitalsharboring critically ill patients who are less able to fight off infectionswithout the help of
antibiotics. Heavy use of antibiotics in these patientsselects for changes in bacteria that bring about drug resistance. Amutation that helps a microbe survive exposure to an
Antibiotic will quicklybecome dominant throughout the microbial population. Microbes also oftenacquire genes from each other, including genes that confer resistance. The advantage microbes gain from their innate adaptability is augmentedby the widespread and sometimes inappropriate use of antibiotics. A physician,wishing to placate an insistent patient who has a virus or an as-yetundiagnosed condition, sometimes inappropriately prescribes antibiotics. Also,when a patient does not finish taking a prescription for antibiotics, somebacteria may remain. These bacterial survivors are more likely to developresistance and spread. For all these reasons, antibiotic resistance has been aproblem for nearly as long as we’ve been using antibiotics. Natural selectionof penicillin-resistant strains in a bacterium known as Staphylococcus aureus began soon afterpenicillin was introduced in the 1940s.(At The Institute for Genomic Research, NIAID is supporting development of proteomic profiling strategies to analyze surface proteins present in organisms such as S. aureus strains that are resistant to intermediate levels of vancomycin. These surface proteins play a role in virulence and survival in bacterial infections. Further research holds promise for elucidating mechanisms of virulence and antibiotic resistance.) One of the negative impacts of using systemic antibiotics for localizedinfections is that the drug circulates throughout the body killing off bothbeneficial and detrimental microbes. This also unnecessarily subjects thenative microflora to antibiotic selection. NIAID-supported scientists are usinga form of buckminsterfullerene as a photosensitizer and combining that withvisible light to generate reactive oxygen that kills off infecting bacteria atthe site of infections