There has been much talk recently of the new NDM-1 gene moving quickly around the world, and how it makes bacterial pathogens resistant to every antibiotic that we have available.  The lead author of the study is quoted as saying that there is “a bleak window of maybe 10 years” before all the major pathogens have acquired NDM-1 and we have nothing to treat them with.  Is this really true?  Is this the end of antibiotics as we know them?

Yes and no.  The age of antibiotics discovered the traditional way is over or will be soon.  But biology has advanced at such a ferocious rate recently that a new form of science is emerging.  Take for example the sequencing of the swine flu that caused the global pandemic recently.  This virus was sequenced, annotated, and published in less than a month.  This kind of speed was unthinkable even 5 years ago, and gave clinicians and scientists a jump-start on how to diagnose and treat swine flu, lessening the impact of the pandemic.  As proof of the power of this approach, the vaccination rate for swine flu was as low as 35% in parts of Canada, and yet the pandemic ended so quickly that many thought it was alarmist to declare it a pandemic at all.  Granted, had this been Ebola, we would have seen a different outcome, but my point stands:  faster science and faster communication allows more people to make more progress faster.

The same speed is being applied to NDM-1.  The initial discovery, sequencing, and studies of this gene are already complete, allowing detailed study of the mechanism by which it provides antibiotic resistance, and thereby allowing the discovery of new classes of antibiotics that will treat it.  Further, the technology of high-throughput biology and in-vitro selection of molecules has advanced, allowing the selection of new antibiotics from large libraries of potential candidates quickly.  My research group is but one working on developing and refining such methods, and I am therefore confident that we have tools in our toolbox that will allow us to find new molecules that will treat bacterial infections in the future.

Bacterial pathogens and humans have been in a molecular arms race for millennia, and the bugs were winning until about 1940.  Now, the bugs have acquired a new missile, and so we need to develop a new anti-missile gun.  The struggle between phyla continues.