"Antibiotics may become null agaist bacteria"

Jordi Vila: "Antibiotics may become null against bacteria
Jordi Vila is responsible for bacteriology at the Hospital Clinic of Barcelona
          7 votes25 reviewsDecrease font fuenteAumentarWill print-mailRaquel Quelart | 18/08/2010 | Updated at 01:30 pm | Citizens
Just last year the threat of influenza virus did jump all alarms health authorities. Recently, a study published in the journal The Lancet warned that a gene found in bacteria that cause urinary tract infections or pneumonia, had become highly resistant to most antibiotics. Since India and Pakistan has spread to the United Kingdom by persons who traveled to these countries in recent months. But bacteria can convert the New Delhi (NDM-1) in a new public health problem?MORE INFORMATION

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Jordi Vila, director of the bacteriology section of the Microbiology Service of Hospital Clinic of Barcelona, is coordinating a research study on bacterial resistance. In addition, Vila is a professor of microbiology at the Faculty of Medicine, UB. His team has focused on studying the molecular basis of bacterial resistance to antibiotics and to develop new drugs to combat this natural phenomenon.
- How much concern is the resistance of bacteria to antibiotics?- No need for alarm today, but you have to be proactive. For two decades it is known that bacteria have been increasingly developing resistance to antibiotics, while, on the other hand, the pharmacological weapons to combat these infections caused by multiresistant bacteria may become void. Eventually the resistance level is very high, and indeed, since there are strains resistant to all antibiotics.
- Why do bacteria become resistant?- There are two mechanisms. The first relates to the changes. Every 15 or 20 minutes, the bacteria multiply. During this process there are mutations in certain genes in the genome of the bacterium that can confer resistance to antibiotics. The second mechanism is the acquisition of genetic material between bacteria and, specifically, the transfer of a small molecule of DNA - plasmid ", within which there may be genes that also develop resistance to antibiotics.
- What role does the overuse of antibiotics in this process?- The selection of resistant mutants. It is possible that a bacterial population to the antibiotic sensitive bacteria thousand of them find it becomes tough. What happens if we use a lot of antibiotics? Annihilate the 999 sensitive bacteria, while it has mutated begin to multiply. The antibiotic-resistant mutants selected by eliminating the sensitive.
- How do resistant bacteria spread?- It is a multifactorial situation: the lack of hygiene in some hospitals that receive the highest concentrations of microbes, by eating animals that have taken antibiotics wastewater have ended up where human excrement containing resistant bacteria, the underdeveloped countries where medication with antibiotics is rampant flights, or taking antibiotics without prescription.
- In parallel, little research on the development of new drugs.- Yes, and whose reason is economic. It is estimated that investing in a new antibiotic costs about $ 800 million (621 million euros). To recover such amount, pharmaceutical companies would not sell much, but today it is not possible. Antibiotics are drugs with a prescription of short duration and with an expiration date because the bacteria develop resistance to antibiotics constantly.
- How to prevent the spread of resistant bacteria?- First, hospitals should exercise extreme vigilance about the emergence of multi-resistant bacteria and take measures to prevent spreading. Measures such as strict hygiene - which has already been in hospitals in Spain -, isolate the patient who has been infected, and take a good antibiotic policy.
- As not dispense antibiotics without prescription.- Self-medication is to be annulled, in the pharmacy does not have to sell antibiotics without medical prescription as required by law. Today pharmacies and follow this approach unlike 20 years ago. And apart from this, it is important to adopt strict legislation regarding the use of antibiotics in veterinary medicine.
- What characterizes the bacteria New Delhi?- The fact that it has acquired a mechanism of resistance - beta lactam-enzyme, similar to some that were already described, which is able to degrade a very broad class of antibiotics - beta-lactam antibiotics. Furthermore, this strain is multidrug resistant, and is only sensitive to tigecycline as an antibiotic and toxic old, colistin. We are very limited because it could also become resistant to these antibiotics.
- What if someone is infected by this bacterium?- If a healthy person, there would be no problem as they respond to treatment with tigecycline. The problem is that an individual is immunocompromised infected with a serious disease base. In this case, the infection could become fatal.
- How do you get the bacteria?- Although bacteria can be transmitted by air - through breathing the bacteria circulating New Delhi seems more contact. For this reason the conditions of hygiene in hospitals, especially in underdeveloped countries, should be extreme.
- What is your level of infection?- If your health is optimal, would be low.
- What are the chances you can get to Spain?- All this type of multi-resistant bacteria have a geographic transfer. We have the experience of another enzyme (KPC), which began in the U.S. and has spread through a patient to Israel. From there he went to Greece, Italy and probably in future meet in Spain.
- What time could happen?- It is difficult to predict.
- Can you become a global public health problem?- I think you are exaggerating because the global problem is the resistance to antibiotics in general.