Revenge of the Microbes: How Bacterial Resistance is Undermining the Antibiotic Miracle

Cover
Title Page
Copyright Page
Contents
Foreword by Stanley Maloy
Preface
About the Authors
CHAPTER 1 Antibiotics: What Are They?
WHY IS THERE STILL SOME CONFUSION?
WE LIVE IN A MICROBIAL WORLD
HOW DO ANTIBIOTICS DIFFER FROM ANTISEPTICS AND DISINFECTANTS?
HOW DO ANTIBIOTICS DIFFER FROM VACCINES?
WHY DON’T MOST ANTIBIOTICS WORK AGAINST FUNGI AND PARASITES?
WHY DON’T ANTIBIOTICS WORK AGAINST VIRUSES?
POINTS TO PONDER
CHAPTER 2 The “Miracle” in “Miracle Drugs”
SYPHILIS
TUBERCULOSIS
BACTERIAL PNEUMONIA AND MENINGITIS
SURGERY MADE SAFE
CANCER CHEMOTHERAPY AND ORGAN TRANSPLANTS MADE POSSIBLE
IMPROVING QUALITY OF LIFE: ACNE AND ULCERS
POINTS TO PONDER
CHAPTER 3 Bacterial Resistance Threatens the Mighty Reign of Antibiotics
ANTIBIOTIC RESISTANCE BECOMES A GROWING PROBLEM
IMPACT OF MULTIDRUG RESISTANCE (MDR)—WHYDOES IT MATTER?
MDR BACTERIA—ENTERTHE SUPER-SCARY SUPERBUGS!
ANTIBIOTIC RESISTANCE ISSUES CROP UP IN UNEXPECTED PLACES—LIKECROPS
HOW’RE YOU GOING TO KEEP BACTERIA DOWN ON THE FARM, AFTER THEY’VE SEEN ANTIBIOTICS?
ANTIBIOTICS AS A BROADER ENVIRONMENTAL ISSUE—THEY’RE EVERYWHERE!
POINTS TO PONDER
CHAPTER 4 A Brief Look at the History of Antibiotics
PURIFYING SOIL AND UNCOUTH EARWAX
THE SULFA DRUGS
PENICILLIN IS DISCOVERED (ALMOST BY ACCIDENT)
THE RISE OF ANTIBIOTIC DISCOVERY—HOWANTIBIOTICS BECAME SO IMPORTANT IN OUR BATTLE AGAINST INFECTION
POINTS TO PONDER
CHAPTER 5 Bacterial Targets of Antibiotics: How Antibiotics Work
KEY COMPONENTS OF BACTERIAL CELLS THAT ANTIBIOTICS TARGET
ANTIBIOTICS THAT INHIBIT BACTERIAL CELL WALL SYNTHESIS
Other antibiotics targeting the cell wall and how they work
ANTIBIOTICS THAT INHIBIT THE SYNTHESIS OF BACTERIAL PROTEINS
How antibiotics interfere with the bacterial process of protein synthesis
Streptomycin and other aminoglycosides
Tetracyclines
Erythromycin and other macrolides
Clindamycin: an antibiotic class effective against anaerobic bacteria
Mupirocin: an antibiotic that targets amino acid-tRNA synthesis
ANTIBIOTICS THAT TARGET BACTERIAL DNA AND RNA
Metronidazole—bacterial-specific DNA damage
Ciprofloxacin and other fluoroquinolones—targeting DNA replication
Rifampin—targeting RNA synthesis
Sulfonamides and trimethoprim—targeting folic acid (vitamin B9) biosynthesis
MEMBRANE-TARGETING ANTIBIOTICS—POLYMYXINB AND E (COLISTIN)
Polymyxins—polymyxin B and E (colistin)
THE SPECIAL CASE OF TUBERCULOSIS: ANTI-TBDRUGS
Streptomycin
The TB-specific antibiotics
POINTS TO PONDER
CHAPTER 6 Bacteria Reveal Their Adaptability and Gain Resistance
HOW DO BACTERIA BECOME RESISTANT TO ANTIBIOTICS?
EXAMPLES OF HOW BACTERIA RESIST ANTIBIOTICS
Preventing access to the target
Inactivating the antibiotic before it can act
Bypassing the antibiotic’s action
THE RISE OF RESISTANCE TO CURRENT ANTI-TBDRUGS: CONNECTING THE DOTS
IS IT ALWAYS THE BACTERIUM’S FAULT? OTHER REASONS FOR TREATMENT FAILURE
THE ORIGINS OF BACTERIAL RESISTANCE GENES: A PUZZLING BUT RELEVANT MYSTERY
POINTS TO PONDER
CHAPTER 7 The Spread of Antibiotic Resistance
HOW BACTERIA RAPIDLY ACQUIRE AND SPREAD ANTIBIOTIC RESISTANCE
Gene sharing—resistance acquisition via horizontal gene transfer
ANTHROPOGENIC FACTORS THAT CONTRIBUTE TO THE SPREAD OF ANTIBIOTIC RESISTANCE
Use of antibiotics in human medicine and resistance gene transfer
Hospital-acquired MDR infections and the ESKAPE pathogens
Agricultural use of antibiotics and environmental sources of resistance
Antibiotics as environmental pollutants
Fluoroquinolones: a widely (too widely?) used family of antibiotics
Food safety—contribution of GM foods and globalization to resistance
Regulatory decisions that impact the spread of antibiotic resistance
POINTS TO PONDER
CHAPTER 8 The Escalating Crisis in Antibiotic Availability Amidst Renewed Efforts
ESCALATING BACTERIAL RESISTANCE TO ANTIBIOTICS SPAWNS NEW GENERATIONS OF ANTIBIOTICS
Scientists strike back: combatting beta-lactamases
Bacteria develop another resistance strategy that trumps the beta-lactamase inhibitors
REDISCOVERING/REPURPOSING OLD OR ABANDONED ANTIBIOTICS
Another type of cell wall synthesis inhibitor: vancomycin
Synercid: the first of the human-use streptogramins
DAPTOMYCIN—REFORMULATION YIELDS A NEW DRUG OF LAST RESORT
NEW CLASSES OF ANTIBIOTICS—A FEW SUCCESS STORIES TRICKLE THROUGH
Large-scale, high-throughput screening efforts for natural product leads
MODERN COMBINATORIAL CHEMISTRY AND COMPUTER-AIDED RATIONAL DESIGN APPROACHES JOIN THE HUNT FOR NEW DRUGS
THE PROFITABILITY CALCULATION: AN INESCAPABLE FEATURE OF MODERN MARKETS
DO WE REALLY NEED NEW ANTIBIOTICS?
WHAT IS TO BE DONE?
POINTS TO PONDER
CHAPTER 9 The Battle Continues To Combat Antibiotic Resistance: Alternative Approaches
NEW APPROACHES TO DRUG DISCOVERY
Genome sequencing and mining microbial genomes for drug discovery
Lifestyles of the small and vicious—how understanding microbial physiology helps to identify new targets
NEW ALTERNATIVE STRATEGIES ON THE HORIZON
Probiotics and fecal microbiota transplantation
Antiadhesion therapy
Bacteriophage therapy
Bacterial parasites . . . of bacteria
CHANGING HABITS—THEIMPORTANCE OF HYGIENE AND AVOIDANCE
THE ROLE OF ANTISEPTICS AND DISINFECTANTS
New uses of antiseptics and disinfectants—triclosan
Resistance to antiseptics and disinfectants
THE GROWING IMPORTANCE OF VACCINES AND PASSIVE IMMUNIZATION
POINTS TO PONDER
CHAPTER 10 Building a Viable Framework for Tackling the Escalating Antibiotic Resistance Crisis
THE STAKEHOLDERS IN COMBATTING THE ANTIBIOTIC RESISTANCE CRISIS
Who should be responsible for drug discovery and development? Who should foot the bill?
Providing incentives—topush or to pull?
Other stakeholders weigh in
ENVISIONING A PATH FORWARD
Removing key regulatory barriers
Beyond the hospital—social responsibility and the fight against antibiotic resistance
SCIENCE EDUCATION AND DISSEMINATION OF ACCURATE INFORMATION
Science literacy and dissuading science skepticism
Thinking outside the box
Index
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