In the early 1970s, it was believed that all infections would soon be under control using antibiotics. Instead, in recent years there have been increasing reports of “killer germs” threatening people in nursing homes or hospitals. Bacteria against which our conventional antibiotics are no longer effective. Are we back on track to times as people knew them before the discovery of penicillin?
Discovery of penicillin
Penicillin, the first antibiotic, was discovered by Fleming in 1928. However, scientists did not find out how it worked until the 1950s. Since then, hundreds of different antibiotics have been found and developed that can attack bacteria in different ways. Like penicillin, they prevent the cell wall from being built up or destroy the cell membrane; they slow down protein production, hinder bacterial metabolism or activity; they attack the bacteria‘s genetic material or make it more difficult for them to develop defense strategies.
All antibiotics have one thing in common: they do not help against viruses. This is because they are structured differently and act differently from bacteria. They board human cells and therefore can hardly be destroyed without also harming the host.
Multi-resistant germs – a growing danger?
Despite all the advances in research, bacteria have found ways to protect themselves. Resistance is the name of their weapon, that is, insensitivity to an antibiotic. Through mutation, they manage, for example, to alter enzymes of the drugs in such a way that their effectiveness is reduced or to adapt their cell wall in such a way that the antibiotic can no longer penetrate.
But that’s just the beginning of the problem: bacteria multiply and change at breakneck speed. In the process, they can transfer the modified genetic information and thus also the resistance to other bacteria.
In this way, new strains of bacteria can perfect their defenses within a short period of time so that the effectiveness of the antibiotic completely fizzles out. Or bacterial species exchange different gene information and thus become resistant to several antibiotics: Multiresistance as a superweapon.
Hospital and nursing home – germ cells for pathogens
Multiresistant bacteria arise particularly frequently in hospitals, and infections acquired there (“nosocomial infections”) are therefore especially difficult to treat. There are many reasons for the development of resistance in hospitals, but two issues in particular play a major role.
First, many advances have been made in recent years in the treatment of certain diseases (for example, organ transplants), but these are bought with drugs that suppress the immune system. This lowers the body’s defenses, and germs have an easier time and more time to multiply.
Especially in intensive care units, where these patients often lie, measures are also necessary that increase the risk of germs entering the body. Artificial respiration, feeding tubes, heart or bladder catheters, infusions via a venous access: all of these open up countless opportunities for bacteria to get to places where they can wreak havoc, even with strict hygiene.
Particular risk of infection in hospitals
Secondly, a hospital is of course not germ-free: there are many people in a confined space, many of whom also have diseases that are difficult to treat, not to mention staff and visitors.
This means that the risk of transmission and infection is high and many different pathogens come together, which can exchange their resistances at their leisure. They cling to hands, gowns and stethoscopes, cling to hair, food trays and examination tubes, hide on door handles and X-ray machines, hide in water and filter systems.
Nursing homes and homes for the elderly are also affected. And when patients develop an infection, it naturally needs to be treated. This, in turn, can lead to germ selection and the development of resistance. In addition, broad-spectrum antibiotics, for example, destroy the natural intestinal flora, which means that pathogenic germs can then settle and spread even more easily. A vicious circle that is very difficult to counteract.
