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Antibiotic resistance: what can we do about it?

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Nitish
Nitish Oct 26, 2020

[1]Allen, H., Donato, J., Wang, H. et al. Call of the wild: antibiotic resistance genes in natural environments. Nat Rev Microbiol 8, 251–259 (2010). https://doi.org/10.1038/nrmicro2312

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Creative contributions

Find new ways to destroy pathogenic bacteria - namely CRISPR.

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Jamila
Jamila Oct 26, 2020

[1]Chokshi, Aastha, et al. "Global contributors to antibiotic resistance." Journal of global infectious diseases 11.1 (2019): 36.

[2]Terns, Michael P., and Rebecca M. Terns. "CRISPR-based adaptive immune systems." Current opinion in microbiology 14.3 (2011): 321-327.

[3]Langdon, Amy, Nathan Crook, and Gautam Dantas. "The effects of antibiotics on the microbiome throughout development and alternative approaches for therapeutic modulation." Genome medicine 8.1 (2016): 39.

[4]Khan, Rabia, Fernanda Cristina Petersen, and Sudhanshu Shekhar. "Commensal bacteria: an emerging player in defense against respiratory pathogens." Frontiers in Immunology 10 (2019): 1203.

[5]Askarova, Sholpan, et al. "The Links Between the Gut Microbiome, Aging, Modern Lifestyle and Alzheimer's Disease." Frontiers in Cellular and Infection Microbiology 10 (2020): 104.

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Nitish
Nitish4 months ago
I think the idea to find novel antibiotics against the resistant pathogen is very much abstract and does not seem to be that much reliable. Because once a pathogen develops resistance against a particular drug it certainly develops for others in a quicker way For eg. we have multi drug-resistant Staph aureus etc. CRISPR-Cas system is a promising tool but it has its own disadwantages and public prespectives and perceptions. We exactly dont know when we will be able to use this tool in public health. Therefore, for now, we dont have any method and technique on the ground to fighjt this virtual pandemic.
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Manel Lladó Santaeularia
Manel Lladó Santaeulariaa month ago
Nitish Absolutely agree with you. Also, using CRISPR is not necessarily the panacea. First, you would need to target CRISPR to specific sequences, probably of the bacteria's DNA, and random mutations would be selected for, conferring bacteria resistance against that CRISPR treatment.

Also, the main problem as always is delivery: how do we make our gRNAs reach the specific bacteria we want to eliminate? SNIPR BIOME proposes using strain-specific CRISPR-Guided Vectors but I would need to find more information on how they work. Still, while this could work for the gut microbiota, it could be way more complicated to deliver for other infections like respiratory or urinary infections.

Take antibiotics only when absolutely necessary

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Shubhankar Kulkarni
Shubhankar Kulkarni Oct 26, 2020

Hospitals should strictly comply with the cleaning and safety procedures

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Shubhankar Kulkarni
Shubhankar Kulkarni Oct 26, 2020
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Povilas S
Povilas S4 months ago
I've heard about a study which showed that only 1/3 of the doctors (as far as I remember) wash their hands before and after entering the hospital room (I think it was the operating room or maybe a room where they inspect patients, etc.). And it didn't change even after they installed cameras and put signs about this:D

More responsible doctor's prescriptions

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Martina Pesce
Martina Pesce Oct 26, 2020

[1]T. P. Lam and K. F. Lam, “What are the non-biomedical reasons which make family doctors over-prescribe antibiotics for upper respiratory tract infection in a mixed private/public Asian setting?,” J. Clin. Pharm. Ther., 2003.

[2]“Race against time to develop new antibiotics,” Bull. World Health Organ., 2011.

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Nitish
Nitish4 months ago
A philosophical solution though. The practicality of which is certainly not accountable.
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Shubhankar Kulkarni
Shubhankar Kulkarni4 months ago
Martina Pesce I agree that doctors should prescribe antibiotics responsibly. There exist standard protocols (might differ from country to country) for the administration of antibiotics. [1,2] However, the decision of prescription of the antibiotics lies with the physicians. I don't think there exists enforcement of these rules, at least for those pertaining to prescribing antibiotics. Complex procedures and surgeries might have rules enforced strictly. From the physician's point of view, the symptoms vary largely from patient to patient. A "one rule fits all" strategy does not work. I don't know how we can come up with a solution that respects both views.

References:
1. https://www.nice.org.uk/about/what-we-do/our-programmes/nice-guidance/antimicrobial-prescribing-guidelines
2. http://iamrsn.icmr.org.in/images/pdf/STG270217.pdf

Implementing "natural antibiotics" in our diet

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J
Juran Oct 28, 2020

[1]https://www.medicalnewstoday.com/articles/321108#seven-best-natural-antibiotics

[2]https://www.medlife.com/blog/12-best-natural-antibiotics-infection/#4-red-pepper

Do not miss your antibiotic doses

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Shubhankar Kulkarni
Shubhankar Kulkarni Oct 26, 2020
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Darko Savic
Darko Savic4 months ago
And finish the entire course as prescribed. Often that means continuing to take the antibiotics past the time where you feel well again. Any microbes that manage to survive are the ones most likely to evolve antibiotic resistance. So finish them off properly while you have the upper hand.

Try to prevent infections in the first place

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Jamila
Jamila Oct 26, 2020

Antibiotics resistance is not necessarily being spread by taking these drugs directly

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Nitish
Nitish Oct 28, 2020

Strictly avoid using expired antibiotics

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Shubhankar Kulkarni
Shubhankar Kulkarni Oct 26, 2020

Proper disposal of expired antibiotics

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Shubhankar Kulkarni
Shubhankar Kulkarni Oct 26, 2020

Blocking the bacterial "evolvability factors"

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Shubhankar Kulkarni
Shubhankar Kulkarni Nov 02, 2020

[1]https://www.sciencedaily.com/releases/2018/11/181116164514.htm

Antimicrobial peptides as potent weaponry against pathogens

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Nitish
Nitish Feb 02, 2021

[1]Mahlapuu, M., Håkansson, J., Ringstad, L. and Björn, C., 2016. Antimicrobial peptides: an emerging category of therapeutic agents. Frontiers in cellular and infection microbiology, 6, p.194.

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Shubhankar Kulkarni
Shubhankar Kulkarnia month ago
Hi Nitish! Are you suggesting using these antimicrobial peptides as drugs to kill pathogens? If yes, how will that overcome the problem of drug resistance? Also, what if the pathogens develop resistance against the antimicrobial peptides?

I like the idea of modulating the host's immune system instead of targetting the pathogens. Correct me if I am wrong but won't they act like vaccines?
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Nitish
Nitisha month ago
Shubhankar Kulkarni Yes sir, I am suggesting the use of antimicrobial peptides as potential drugs against resistant microbes. Actually, there are already so many peptides reported from various sources including human milk which shows tremendous antimicrobial activities. However, they have never been employed against resistant microbes. Which will be a good alternative, I guess. If we could kill such bugs with peptides, we will need not to search for new drugs and dissemination of resistance among microbes can be handled. Yes, I completely agree with you on peptide resistance, microbes can develop different strategies to fight with these peptides, and one of such is proteases. However, there are so many antimicrobial peptides in counterbalance having proteases stability, mechanisms of which can be explored in antimicrobial peptides against resistant microbes.
All the peptides don't act as vaccines, and it certainly depends upon the source of these peptides. For example, the peptides from human sources or some prokaryotes simply act as the first defence line. They work as first-hand weaponry against invading microbes. However, peptides from microbial sources can generate an immune response in humans as vaccines, which need to be explored further. Till date, only synthetic peptides are being used as vaccines, which mimic the structural components of natural microbes.
Anti-microbial peptides are the promising alternatives to traditional antibiotic drugs; however, there are some limitations such as stability, short half-life, toxic side effects of these biomolecules needs to be explored further in details.

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