The Threat of Superbugs

• Humanity inadvertently creating collaborative effort to engineer perfect super bug
• Could potentially kill hundreds of millions of people
• Process currently happening through misuse of antibiotics

Bacteria Fundamentals

• Among oldest living things on planet
• Smallest entities still considered life
• Masters of survival, found everywhere
• Most harmless to humans
• Human body hosts trillions of beneficial bacteria
• Some can invade, spread quickly, kill

Historical Impact of Antibiotics

• Millions died from bacterial infections before antibiotics
• Antibiotics + vaccinations revolutionized medicine, saved millions of lives
• Kill vast majority of susceptible bacteria quickly
• Leave small group of survivors for immune system to handle

How Antibiotics Work

• Target bacteria as complex machines with thousands of processes
• Disrupt complex machinery through multiple mechanisms:
  • Interfere with metabolism, slow growth significantly
  • Attack DNA, prevent replication, stop multiplication
  • Rip outer layer to shreds, cause contents to spill out
• Don't bother human body cells

Evolution and Resistance Development

• Pure random chance creates small minority with evolved protection
• Protection mechanisms:
  • Intercept antibiotics, change molecules to become harmless
  • Invest energy in pumps that eject antibiotics before damage
• Few immune bacteria manageable by immune system
• Problem occurs when they escape and spread immunity

Bacterial DNA Exchange Mechanisms

• Two kinds of DNA: chromosome and free-floating plasmids
• Exchange plasmids by "hugging" to share useful abilities
• Immunity spreads quickly through populations
• Transformation process: bacteria absorb DNA from dead bacteria
• Works between different bacterial species
• Creates superbugs immune to multiple antibiotics

Current Superbug Landscape

• Variety of superbugs already exist globally
• Hospitals are perfect breeding grounds
• Humans have short memories about pre-antibiotic era horrors
• Treat antibiotics as commodity instead of game-changing scientific achievement

Global Access Disparity

• Hundreds of millions lack access to antibiotics in developing countries
• Other regions overprescribe and misuse antibiotics
• Should be last resort drug, not for minor ailments like colds

Livestock Industry Problems

• Humanity holds 20-30 billion animals as livestock at any time
• Animals kept in horrible, tight, unhygienic conditions
• Perfect breeding ground for disease
• Many animals given antibiotics to kill bacteria, prevent sickness
• System driven by need for cheap meat (cheeseburger costs $1)
• Created more antibiotic-resistant bacteria

Last Resort Antibiotics

• Use different antibiotics to counteract resistance
• Specific antibiotics reserved to wipe out resistant bacteria
• Strict rules exist to avoid creating super bacterium

The Colistin Crisis (Late 2015)

• Scary news from China: resistance against colistin discovered
• Colistin = last-ditch antibiotic
• Old drug, rarely used due to liver damage potential
• Little resistance made it great last resort antibiotic
• Used for complex hospital infections against multi-drug resistant bacteria
• Resistance potentially destroys last line of defense

How Colistin Resistance Developed

• Millions of animals in Chinese pig farms given colistin over few years
• Resistant bacteria developed, spread animal to animal
• Then spread to humans unnoticed
• Average day: over 100,000 flights connect every human globally
• Modern infrastructure built for dangerous pandemic spread

Current Outlook

• Don't need to panic yet
• Bacteria evolve, humans research new antibiotics
• Technology advancing daily
• Problem real and serious but fight far from over
• If humanity plays cards right, superbugs might not be very "super"