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Friday, August 19, 2016

Crisis Averted

Written by  Debbie Anne

For years now, those of us who work in public health have been keenly aware of a looming crisis – the ever increasing resistance of bacteria to current antibiotics – from Methicillin-Resistant Staphylococcus Aureus (MRSA) to Vancomycin-Resistant Enterococci (VRE) to Multi-Drug Resistant Tuberculosis, to Multi-Drug Resistant Gonorrhea. From a public-health perspective, the prospects have looked pretty frightening and people would surely die for lack of an antibiotic treatment. And then came the most welcome medical breakthrough since the discovery of penicillin – the first new antibiotic in 30 years – teixobactin.

In the past few decades pharmaceutical companies have stopped developing new antibiotics because there wasn’t as much money to be made in them as in the newest designer drugs for auto-immune diseases as well as drugs for cancer, diabetes, HIV, and hepatitis C. So teixobactin was not developed by a pharmaceutical company but through a collaborative effort between the University of Bonn in Germany and Northeastern University in Boston. An article in Readers Digest reports that the new drug “has the potential to work against a broad range of fatal infections … and is highly unlikely to lead to drug resistance,” as has been seen in other antibiotics.

An article in Medical News Today describes the details of the breakthrough, “Most antibiotics used today come from soil microbes … there is a major problem with researching soil microbes – they are very difficult to culture in the lab.” It’s estimated that about 99% of soil microbes have not been researched because of this problem. Microbiologist and professor at Northeastern, Kim Lewis, and her colleagues have changed the game by developing a way to culture the bacteria in a setting that replicates its natural environment. They have successfully cultured 10,000 colonies, and these led to 25 potential new antibiotics including teixobactin which is believed to be the superhero of them all.

Teixobactin works differently that many other antibiotics because it breaks down the cell walls of other microbes destroying their line of first defense. This means that unlike other antibiotics that trigger resistance in the other microbes because the microbes are able to build alternate defenses, teixobactin will always be able to achieve destruction of the other microbes because it shuts down the first line of defense and doesn’t allow the development of mutations.

Don’t go to your doctor today and ask for teixobactin though. It’s probably going to be about five years before there is FDA approval of the new drug. Expect that for the next few years your doctor will still refuse to prescribe antibiotics for your cold or flu. And even if she suspects that you may be developing a secondary bacterial infection, she will want you to give it about ten days to see if you will recover without antibiotic intervention. She will tell you to let your immune system do its work. If she does prescribe an antibiotic she will tell you how very important it is to finish your course of antibiotics completely. All of these measures work to slow the development of resistant bacteria, and we need to be mindful of that until we have the newly developed drugs in hand.

In the meantime, we can rest knowing that with the development of teixobactin and the new technology to study many more soil microbes, a medical disaster has been averted. Thanks to the folks at Northeastern University and University of Bonn!


Debbie Anne is a Public Health Nurse with Frederick County Health Department in Frederick, Maryland. In 2014 was awarded a Governor’s Citation for her work with Marylanders living with HIV/AIDS.

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