PATHOGENIC DYSTOPIA

The NHS is facing the greatest crisis of its lifetime. Not from practitioners leaving the UK. Not from those pushing for a privatised system. And not even from bureaucracy denying the cutting of red tape to boost funds. The threat is imminent, prevalent, and can only be seen under the lens of a microscope. Yes, the danger to our healthcare system is in the form of super-resistant pathogens, especially specific strains of bacteria.

In today’s day and age of advanced medicinal treatments, one can expect a course of antibiotics if infected by a strain of bacteria. Some will consume the entire course, some won’t, and some will use antibiotics even when they are not infected. The last two instances result in the user allowing bacteria that survive to mutate, and to become resistant to the particular type of antibiotic being used. As this process goes on, more and more bacteria become resistant to a greater range of antibiotics- making it more difficult to treat bacterial infections due to a diminished roster of treatments to choose from.  Since 1987, when Lipopeptide antibiotics were discovered and successfully synthesised, there have been near to no new antibiotics discovered. The latter is a worrying predicament, as it means that the currently still effective antibiotic numbers are not being topped up at the same rate of those losing their usefulness (due to bacterial resistance against them)- which would eventually result in the number of antibiotics being completely depleted.

But what does that mean? It means that treatment for common bacterial illnesses such as strep throat, tonsillitis, some STDs and TB will no longer exist, and death rates for these diseases will rapidly increase to those seen in the industrial revolution. The effects of a lack of antibiotics are also present in the NHS’s vast hospital facilities across the country; the sterile conditions are a perfect breeding ground for resistant strains, such as MRSA (methicillin resistant staphylococcus). Due to their resistance, they are extremely difficult to treat, and the dangers of the effects of MRSA are exemplified by the nature of hospitals: open wounds, a variety of travelling people and weakened immune systems- these conditions are consequently making medical facilities a hotspot for MRSA cases. Pathogens as such are so prevalent in hospitals, that they can even remain in wards after deep sterilisation and cleaning- and this is only for one example; should antibiotic resistance become an issue for a greater diversity of pathogens- the quality of healthcare in public faculties will be drowned out by the unnecessarily lofty death rates. This may result in the closure of many large health trusts, jeopardising the efficacy and efficiency of the NHS as a national health system; and maybe even to the point that it collapses.

But what can be done currently to prevent this pathological dystopia? Research into new antibiotics is promising, but drug companies need to be urged to further their rate of progress- government allowances could be used here to incentivise them.  A mitigation strategy (particularly for use within medical facilities) is the increase in personal hygiene- meaning that all people entering hospitals and certain wards have to wash their hands using an antibacterial solution and all instruments and equipment must be thoroughly sterilised before reuse. Another strategy to increase the life span of antibiotics is to use specific antibiotics wherever possible (tailored specifically for a single bacteria) rather than broad spectrum “carpet bomber” antibiotics that target a whole host of bacteria (these can be used as a last line resort if the specific range ones do not work well- such as Carbapenems for example).

We know that antibiotic resistance is a pressing contemporary issue. It is up to us through our actions as to whether we minimise the impacts and continue to reap the antibacterial benefits they bring or let the antibiotic age come to an end.

Hamzah Rahman

Photo Credits due to: WedMD, ABC