Where did antimicrobial resistance start? If AMR were a comic book villain, what would its origin story be? Well, the origin story dates back millions of years. Evolution of life. Early days on the planet, bacteria were emerging, fungi we're emerging and here when you think fungi I want you to think the kind of fungi you see on a log. You're walking in the forest you come across a log, it's got some fungi growing on it, very pretty fungi. What are those fungi doing? Well, they're eating the log.
Next to them, though you can't, it would take a microscope to see them, they're also bacteria out there and the bacteria would like to eat that log too!
And the origin of AMR is here in the battle of who gets to eat the log and the fungi figured out some millions of years ago that they actually could make things that killed the bacteria and we would these days call us an antibiotic. That's actually where penicillin came from this, the fungus that Sir Alexander Fleming found on his petri dish, made something that diffused that, and saw the bacteria dying and that's the story of Sir Alexander Fleming.
And same thing's going on out there in the log, the fungi are making these things that kill bacteria and, I don't know if there's a case of bacteria making something that kills fungi to be honest with you, but you get the idea here that these various forms of life are battling with each other to eat the log and this also tells you something about the inevitability of antimicrobial resistance.
All living beings mutate steadily over time. Bacteria and fungi are constantly reinventing themselves, bacteria are doing it every couple hours, many times a day, and every one of those cycles is an opportunity to experiment.
And what we know is that resistance develops to everything over time. No matter what the fungi made, some bacteria would figure out how to escape from it. No matter what clever new antibiotic we create, ultimately the bacteria will figure out how to escape from it. You can even argue that just from one perspective antimicrobial resistance is necessary.
If it were possible for an antibiotic to be so good that it killed off all the bacteria that would probably be bad for us. We need our bacteria. There are a lot of bacteria that live in and around us, the bacteria in your gut and your colon that are making vitamins and doing other interesting things for you. You would not want to kill them off, they are helpful parasites but the nature of antimicrobial resistance, when they get out of that place and the bacteria is in the wrong spot then you do want to have an antibiotic and that's the whole story about why we need to continue to invent new antibiotics. Antimicrobial resistance will constantly emerge, any new drug we invent, the bacteria will develop over time, they will, they will figure out how to escape and it's a story that dates back millions of years to when the bacteria and the fungi were duking it out to figure out who got to eat the log.
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John H. Rex, MD | Chief Medical Officer, F2G Ltd. | Operating Partner, Advent Life Sciences. All opinions are my own.
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