This week marks World Antibiotic Awareness Week (16th-22nd November 2015), the third since its inception in 2013. It had its genesis in the European Antibiotic Awareness Day, which originated on 18th November 2008, as well as the U.S. “Get Smart about Antibiotics” week (originally in October 2008). It serves as a way to increase public awareness of antibiotics and its uses (and misuses).
There are more activities related to the Antibiotic Awareness Week in Singapore this year compared to the past. It is a good start, and I hope that in the coming years, these activities can merge to become a Singapore-wide campaign.
The Lancet has also posted a series on antimicrobials and antimicrobial resistance in conjunction with the World Antibiotic Awareness Week. For a change, the articles are free, although registration is required.
Finally, in a sombre reminder of how far we are behind in terms of the “arms race” with bacteria, here is a report (behind a paywall) on the discovery of a polymyxin resistance gene on a plasmid found in an Escherichia coli isolate which came from a pig in China. There was a rise in colistin (polymyxin) resistance from food animals in China, leading to the investigation. Polymyxins are a toxic and somewhat ineffective class of antibiotics, ditched in the 1970s when cephalosporins and anti-pseudomonal penicillins were created. They have made a “comeback” in the past decade because of rising carbapenem and multidrug-resistance among many hospital Gram-negative bacteria, especially Acinetobacter baumannii, and represent the last-line of antibiotics against such bacteria. Resistance to polymyxins have been reported (and is in fact inherent in certain Gram-negative bacteria), but these resistance mechanisms have to date been non-transferrable between bacteria, and almost always incur significant fitness costs on the bacteria as well. The presence of a polymyxin resistance gene mcr-1 on a mobile genetic element (plasmid) represents a huge evolutionary step forward for bacteria, and raises again the spectre of untreatable bacterial infections becoming more commonplace.