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Antibiotic Resistance and Its Effects on our World

Walking into the last class of the day, I was excited to see what my Medical Interventions

teacher had in store for us. Medical interventions had been proven to be my favorite class

overall. I had learned so many things related to the medical field thus far that I had never known

about before, such as: how to prevent, diagnose, and treat cancers, how to prevent and fight

against infections, and how to evaluate our DNA amongst many more captivating subjects. As I

set my backpack next to the desk, I looked up at the screen which read “Attack of the

Superbugs”. Curious, I discussed with one of my friends what we could possibly be learning

about today. As the class continued, Mr. Tong, my Medical Interventions teacher, began to

lecture about the rise of “superbugs”. These so-called superbugs were mutants of bacteria that

had been able to fight off antibiotics, known as antibiotic resistance. Antibiotic resistance has

been seen as a first-class World Health threat as of a couple of years ago. Learning this

information shocked me as I had never realized that the smallest actions, such as the misuse and

overuse of antibiotics, could lead to so many problems which could be almost impossible to

resolve if not stopped soon enough.

As I drove home, the idea of antibiotic resistance lingered in my head. Eagerly, I ran up

the stairs and set the computer on my desk. Opening the computer, I began to research more

about this fascinating topic. The room was silent, the only thing audible being the clicking of the

keyboard as I continued to read articles upon articles filled with endless information. It felt like I

had fallen through a rabbit hole, there was so much information I couldn’t even begin to

comprehend, though I tried my best. Hours seemed to have passed unnoticed and before I knew

it, the sun had already set and it seemed to be time to go to bed.

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The next morning at school I walked into Mr. Tong’s class to talk to him about what we

had learned the previous day. We discussed the countless different problems which revolved

around antibiotic resistance and he encouraged me to seek more information. Having that

discussion with Mr.Tong made me realize how many questions still seemed to be unanswered

revolving around antibiotic resistance, and I aimed to help answer one of those questions in order

to bring more awareness to this growing problem. How does the misuse of antibiotics cause a

severe threat to public health?

Antibiotics had been unknowingly used for hundreds of years by people all around the

world in order to treat infections. Researchers believe that Egyptians used molds and plant

extracts during the ancient Egyptian era in order to treat infections based on findings of

antibiotics in human skeletons dating back to around 350 CE. As explained in Dr.Sanchari Sinha

Dutta’s article titled, The History of Antibiotics, “Before the commencement of the modern

antibiotic era (more than 2000 years ago), microbes that produce antibiotics were used as

interventions to treat infectious diseases in Serbia, China, Greece, and Egypt.” (Sanchari).

Humans were unknowingly using natural antibiotics for thousands of years, and in 1928 the first

ever antibiotic was officially presented to the world when doctor Alexander Fleming accidentally

discovered penicillin. He had found mold growing on a petri dish of staphylococcus bacteria and

noticed that the mold had been preventing the bacteria around it from growing. When further

analyzing the petri dish he realize that the mold produced a chemical that could kill bacteria.

This chemical would later be called penicillin. “When I woke up just after dawn on September

28, 1928, I certainly didn’t plan to revolutionize all medicine by discovering the world’s first

antibiotic, or bacteria killer. But I suppose that was exactly what I did.” (Tan and Tatsumura).

The formal discovery of penicillin proved to have a great impact on the world of Medicine,

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enabling the control of many diseases that had previously had a great impact on society and

population. A textbook created by the American Chemical Society further supports this by

stating, “Before its introduction, there was no effective treatment for infections such as

pneumonia, gonorrhea or rheumatic fever. Hospitals were full of people with blood poisoning

contracted from a cut or a scratch, and doctors could do little for them but wait and hope.”

(American Chemical Society). The discovery of penicillin also allowed researchers to discover

many other antibiotics using the same techniques used during the discovery of penicillin. Some

of these discovered antibiotics included: streptomycin and chloramphenicol along with many

others. These new findings allowed for diseases to now be curable and on top of that, allowed

medical procedures such as organ transplants and possible cancer treatments to develop in the

future.

The discovery of these new antibiotics seemed to have a short-lived celebration as an

alarming rate of antibiotic resistance soon seemed to be growing. By the mid-to-late 1940s, only

about 20 years after its first discovery, penicillin along with other antibiotics had become

accessible to the general public making it easy for just about anyone to get their hands on this

new drug. At the time there was still very little known about these antibiotics, meaning that

people did not know how to properly use them. When speaking with Lucky Tran, a pediatrician

at the Kaiser center in Antioch, California, she explained, “It’s hard to talk to parents when it

comes to treatment for their children. They immediately turn to antibiotics as a quick fix when

that isn’t the case every time. I believe that that the disregard to learning about antibiotic

resistance is one of the biggest problems in medicine and is one of the main things that has

gotten us to this point with antibiotic resistance,” (Tran). In 1940, the first report of antibiotic

resistance was made by Edward Abraham and Ernst Chain, who claimed that an E.coli strain was

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able to create resistance against penicillin by producing penicillinase, an enzyme which can

inactivate penicillin. The spread of penicillin resistance rapidly grew soon after its first

discovery, being seen in hospitals and communities. Though there seemed to be a halt to the

spread of this resistance due to the mutations of different antibiotics, it was a matter of time

before the bacteria mutated again and became resistant once more. Like any other organism,

bacteria are easily able to obtain many new attributes through mutations. These mutations allow

for changes in DNA sequences as a result of acts such as deletion, insertion, exposure to certain

chemicals, etc. One of the ways that scientists are controlling the mutation of bacteria is by

tracking it. In a BBC article published by Erin Biba titled ‘How We Can Stop Antibiotic

Resistance’, she explains, “Surveillance for antibiotic-resistant bacteria is a big part of our

mission. We do this to measure the burden of infection and also characterize the types of

resistance we see. This helps us strategize how best to prevent resistance.” (Biba). In today’s

world very few antibiotics are able to fight against the new strains of bacteria, and at times the

strongest of antibiotics are barely ever able to fully fight against mutants.

Since the first case of antibiotic resistance was discovered in the 1940s, it has had a lot of

effects on our world and society, one of the biggest effects being an increase in mortality rates.

As stated in ‘Antibiotic resistance – The faceless threat’, “Mortality as a result of infectious

diseases represents one-fifth of global deaths.” (Nordberg). Though our population has increased

significantly around the world, it is the number of deaths caused by drug-resistant bacteria that

has increased, having scientists and doctors concerned with the future of antibiotics. “A 2016

review on antimicrobial resistance estimates that, by 2050, as many as ten million people could

die each year as a result of AMR.”(Thompson) claims one article made by Tosin Thompson for

the Nature news. This is an alarming statistic since in 2022, only 50,000 people died from AMR.

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Developing countries are significantly impacted since they don’t have the available resources in

order to fight against this problem. ‘Antibiotic resistance – The faceless threat’ further supports

this by stating, “Although the effects of antibiotic resistance are more documented in

industrialized countries, there is a greater potential for harm in the developing world, where

many of the second and third line therapies for drug-resistant infections are unavailable and

unaffordable.” (Nordberg). Scientists acknowledge the spike in death rates and continue to

monitor and research it in order to find ways to lower these worrisome numbers. Some scientists

even believe that the death rates caused by antibiotic resistance might even be higher than the

death rates caused by cancer. In a BBC article written by Fergus Walsh titled ‘Superbugs to kill

'more than cancer' by 2050’ he reveals that “Drug resistant infections will kill an extra 10 million

people a year worldwide - more than currently die from cancer - by 2050 unless action is taken.”

(Walsh). Seeing these statistics has encouraged scientists and doctors to push toward finding

strong and effective treatments for antibiotic resistance.

Rising death rates haven’t been the only thing proven to be an outcome associated with

antibiotic resistance. Antibiotic resistance has also been proven to cause problems with our food

and environment. Antibiotics are sometimes given to animals used for food as a way to treat and

prevent certain diseases. Fecal matter from these animals can contain drug residues and potential

drug-resistant germs as a result of consuming these antibiotics. This is important since this fecal

matter is at times used as fertilizer for crops in order to keep them healthy. If the fecal matter

used as fertilizer is contaminated with antibiotic residue and is used on crops, it can potentially

contaminate not only the produce, but the soil and water sources nearby as well. In an article

published by Nicholas Skandalis ‘Environmental Spread of Antibiotic Resistance’ among others,

they state, “...soil bacteria act as a reservoir of ARGs. Multiple studies have shown a substantial

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increase in AR nonpathogenic, environmental bacteria. More than 97% of the 123 strains tested

were resistant to ciprofloxacin and almost 50% were resistant to erythromycin.” (Skandalis).

This type of misuse of antibiotics leading to contaminated food can have a significant effect on

human health. Many people around the world suffer from food poisoning as a result of this, and

in some cases can result in fatality. Germs such as salmonella can cause up to 700,000

antimicrobial-resistant infections every year, and it is hard to treat these infections with

antibiotics with the amount of mutant drug-resistant bacteria there is. Around 400 people die

from salmonella every year and young children seem to be the demographic most impacted by

these deaths. Individuals are able to prevent the contamination of salmonella by keeping raw

meats separate from other produce as well as properly cleaning surfaces and utensils when

handling uncooked meats.

Alongside our food supply, antibiotic resistance seems to have spread to different water

supplies around the world, specifically in developing countries. As stated before, developing

countries have a higher rate of antibiotic resistance due to having fewer resources and living in

more unsanitary circumstances. Hospital wastewaters and pipelines are the main targets when it

comes to antibiotic resistance since it is the main source of bacteria. In an research article made

by La Thi Quynh Lien among others named ‘Antibiotic Resistance and Antibiotic Resistance

Genes in Escherichia coli Isolates from Hospital Wastewater in Vietnam’, they explain the

circumstances that hospitals in Vietnam are in due to there not being effective treatment plans in

order to get rid of the antibiotic-resistant bacteria. Lien states, “Hospital wastewater treatment

plants containing antibiotic residues can favor the development of antibiotic resistance due to the

selective pressure placed on bacteria. “ (Lien). This is quite unnerving since antibiotic resistant

bacteria can easily spread to patients in hospital facilities which can cause there to be more

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hands-on care for these patients. This can be a challenge for some hospitals, especially in

developing countries which might not have sufficient staff to take care of all of the patients with

the same amount of attention. There are many methods and treatments that are being used in

order to prevent the spread of contaminated wastewater. One of these methods included a

procedure in which water samples were collected every 24 hours to check for any bacteria. This

is a very tedious process since it requires a lot of attention and precision in order to get accurate

results.

Antibiotic resistance has even been able to affect those with health risk factors such as

diabetes. Individuals with diabetes tend to have high levels of blood sugar as well as problems

with soft tissue, making it easier for bacterial infections to form in the body and grow quickly.

Individuals with diabetes also tend to have a weaker immune system, another factor which can

make it easier for their body to obtain bacterial infections. One of the main infections that

individuals with diabetes suffer from are urinary tract infections. In a study done by Demiss

Nigussie and Anteneh Amsalu titled, ‘Prevalence of uropathogen and their antibiotic resistance

pattern among diabetic patients’, They state, “Urinary tract infections are generally

asymptomatic in diabetic patients before development of symptomatic UTI. In addition, the

prevalence of asymptomatic bacteria is higher among women with type II diabetes which leads

to serious complications especially if glycemic control is poor.” (Nigussie and Amsalu). Having

a higher chance of developing UTI’s also means of having a higher chance of developing

antibiotic-resistant bacteria. Patients with diabetes need to be more careful and persistent when

taking antibiotics since their bodies are at a higher chance of becoming compromised if mutant

bacteria enters the body. When talking with Dr.Tran, she explained “People with underlying

conditions and diseases such as diabetes need to take into consideration how well they need to be

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taking care of their bodies, especially when it comes to things like bacteria and antibiotics; it can

be a real life threat if not,” (Tran). Dr.Tran along with many other doctors all over the world aid

in helping those with risk factors understand the importance of knowing about antibiotic

resistance and how to protect themselves.

Whether it has been recognized or not, antibiotic resistance is a developing problem that

has severely impacted the medical field both positively as well as negatively. The discovery of

antibiotics and antibiotic resistance has allowed for new innovations such as cancer treatments

and technological innovations to be pushed forward in hopes of accelerating antibiotic resistance

research. Prior to the discovery of penicillin, people unknowingly used antibiotics in order to

treat certain infections with no problem. This leads people to question if the discovery of

penicillin sparked the creation of antibiotic resistance. Would we have been better off without it?

This among other questions is what sparked interest in this informational topic. Deaths caused by

antibiotic resistance seem to be rising every year based on studies showed. However, the

continuous deaths and mutations of bacteria causing them to become resistant have allowed

scientists and researchers to take advantage of the bacteria and use this opportunity to gather

more information about how and why bacteria become resistant and how we can potentially stop

them from fighting back in the future. Though some bacteria are healthy as well as necessary for

humans to survive, such as probiotics like lactobacilli, there needs to be a fine line between what

needs to be treated and what can be left alone. The step towards decreasing antibiotic-resistant

cases are by actively becoming aware of the subject of antibiotic resistance and informing others

on how to properly handle situations where bacteria might become resistant. Doing simple things

such as properly taking antibiotic medication can be the first step to fighting back against these

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mutating bacteria. Though we can’t prevent these things from happening ever again, we can help

slow down the process until we’re able to find a permanent solution.

Work Cited

“Alexander Fleming Discovery and Development of Penicillin - Landmark - American Chemical

Society.” American Chemical Society,

www.acs.org/education/whatischemistry/landmarks/flemingpenicillin.html Accessed 21

Feb. 2023.

Biba, Erin. “How We Can Stop Antibiotic Resistance.” BBC Future, 24 Feb. 2022,

www.bbc.com/future/article/20170607-how-we-can-stop-antibiotic-resistance Accessed

7 Mar. 2023.

“Environmental Spread of Antibiotic Resistance.” Antibiotics, vol. 10, no. 6, MDPI, May 2021,

p. 640. https://doi.org/10.3390/antibiotics10060640 Accessed 7 Mar. 2023.

“Interview.” Lucky Tran, interview by Stefany Vaca Martinez, Accessed 7 Mar. 2023.

News-Medical.net. “The History of Antibiotics.” News-Medical.net, 21 June 2022,

www.news-medical.net/health/The-History-of-Antibiotics.aspx Accessed 20 Feb. 2023

Nigussie, Demiss, and Anteneh Amsalu. “Prevalence of Uropathogen and Their Antibiotic

Resistance Pattern among Diabetic Patients.” Türk Üroloji Dergisi/Turkish Journal of

Urology, vol. 43, no. 1, Feb. 2017, pp. 85–92, https://doi.org/10.5152/tud.2016.86155

Accessed 27 Feb. 2023.

ReAct. “The Threat &Ndash; Antibiotic Resistance &Ndash; ReAct.” ReAct, 9 Sept. 2022,

www.reactgroup.org/antibiotic-resistance/the-threat Accessed 11 Mar. 2023.

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Skandalis, Nicholas, et al. “Environmental Spread of Antibiotic Resistance.” Antibiotics, vol. 10,

no. 6, MDPI, May 2021, p. 640. https://doi.org/10.3390/antibiotics10060640 Accessed

16 Mar. 2023.

“Superbugs to Kill ‘more Than Cancer’ by 2050.” BBC News, 11 Dec. 2014,

www.bbc.com/news/health-30416844 Accessed 17 Mar. 2023.

Tan, Siang Yong, and Yvonne Tatsumura. “Alexander Fleming (1881–1955): Discoverer of

Penicillin.” Singapore Medical Journal, vol. 56, no. 07, Medknow, July 2015, pp.

366–67. https://doi.org/10.11622/smedj.2015105 Accessed 22 Feb. 2023.

Thompson, Tosin. “The Staggering Death Toll of Drug-resistant Bacteria.” Nature, Nature

Portfolio, Jan. 2022, https://doi.org/10.1038/d41586-022-00228-x Accessed 16 Mar.

2023.

Timsit, Jean-François, et al. “Will 10 Million People Die a Year Due to Antimicrobial Resistance

by 2050?” PLOS Medicine, vol. 13, no. 11, Public Library of Science, Nov. 2016, p.

e1002184. https://doi.org/10.1371/journal.pmed.1002184 Accessed 21 Feb. 2023.

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