As woolly mammoths and scimitar-toothed cats roamed what is now Canada 30,000 years ago, something with a surprising ability lurked beneath their feet. Frozen in the soil were bacteria that – defrosted millennia later – could fight off vancomycin, one of today’s antibiotics of last resort. Antibiotic resistance is often portrayed as a modern crisis driven by antibiotic misuse.
Yet its origins are much older. Many antibiotics weren’t dreamed up in the lab, but evolved in nature long ago to help microbes battle one another in the struggle for survival. Some resistance genes are equally as old, meaning the environment – even in places untouched by recent human activity – is both a sink and source for such genes.
Worryingly, that source is becoming more potent. A study published in April concluded that global warming is driving the spread of antibiotic resistance among bacteria in grassland soils. Factor in the possibility that our best drugs might not work against some of the resistance genes held by microbes now emerging from melting permafrost, and the future looks bleak.
But there is a silver lining. With modern gene-sequencing tools, we can analyse environmental samples in unprecedented detail, then use the information to identify reawakened resistance genes long before they can establish themselves in the bacteria responsible for some human diseases. The approach could even herald a new era of medicine – one in which we future-proof antibiotics so they can overcome resistance that human pathogens have yet to evolve.
Novel antibiotics failing to reach patients: what needs to change Antibiotic resistance is one of medicine’s greatest challenges. In 2019 alone, drug-resistant bacterial infections were directly responsible for an estimated 1.27 million deaths worldwide, and this figure has been forecast to rise to around 1.9 million deaths annually by 2050. It is no mystery how resistance arises.
Every time we use an antibiotic, we impose a powerful selective pressure on microbial communities. Although most bacteria die from exposure to the drug, a few may survive because they have a natural genetic resistance. The survivors will multiply and the resistance genes they carry will become more common.
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