Antibiotic resistance: here are the new weapons against superbugs

Antibiotic resistance: here are the new weapons against superbugs


Becoming resistant to drugs. This is the super power of bacteria which, treatment after treatment, have learned to develop new strategies to resist the effects of antibiotics, transforming themselves. An unequal fight, precisely because we cannot keep up with them: we have few weapons at our disposal, and we are not even good at using them. Due to bacterial evolution, non-adherence to therapies and the incorrect use we make of them, all antibiotics currently on the market will tend to become ineffective. So much so that, by 2050, multi-resistant microorganisms could become the leading cause of death worldwide.

In Italy alone, antibiotic resistance already causes 11 thousand deaths a year. This is why every new molecule isolated is always good news. In recent months it has been welcomed with enthusiasm the discovery of solanimycin, which can be extracted from potatoes and is effective against a wide range of fungi both at an agricultural and human level, starting from Candida albicans. Clovibactin, capable of fighting multiresistant Gram-positive bacteria, was extracted for the first time from bacteria that were considered uncultivable, and a phase III study demonstrated the efficacy of zoliflodacinin which hopes are placed to stem the spread of the so-called “super-gonorrhea”.

Thanks to artificial intelligence, important progress is being made in the pharmacological field. A few days ago was the discovery of one new structural class of antibiotics against the feared Staphylococcus aureus, which occurred thanks to “deep learning” approaches that helped in the virtual exploration of new chemical targets. In practice, researchers at the Massachusetts Institute of Technology and Harvard University were able to test millions of chemical compounds in a few weeks to identify a molecule that seemed promising, a feat only possible for a super computer. Today’s news is instead a new clinical candidate belonging to another new class of antibiotics againstAcinetobacter baumannii resistant to carbapenems, a critical pathogen with priority 1 by the World Health Organization among intra-hospital infections.

This microorganism is the practical example of how bacteria are evolving to resist antibiotics. It has built an armor based on lipopolysaccharide that does not allow the penetration of various drugs, which allows it to continue infecting the human host undisturbed. The antibiotic just discoveredidentified by Claudia Zampaloni, Patrizio Mattei, Konrad Bleicher and colleagues from the pharmaceutical company Roche and Harvard University, is a macrocyclic peptide called zosurabalpine that is based on an unusual mechanism of inhibition of lipid transport, extending this class of antibiotics to other Gram-negative pathogens.

“The creation of new molecules and every advance in scientific research is fundamental. But it is only one side of the coin”, explains a Health doctor Giovanni Maga, director of the Department of Biomedical Sciences of the National Research Council Cnr-Dsb. “Every antibiotic tends to create resistance and trigger bacterial evolution, which is why it is equally essential to find new strategies to control the growth of microbes and learn to best manage the treatments we have. Technological innovations are certainly speeding up research, but there it will take some time before the new molecules discovered, however promising, reach the patients’ bedsides. But the problem of antibiotic resistance is already current and dramatic and this should open our eyes and understand the absolute importance of correct management of the drugs that we have available today”.

In Italy there is a National plan to combat antibiotic resistance and thanks to Pnrr funds the Inf-Act Foundation“an alliance of 25 public and private research institutions distributed throughout the national territory, of which we at the Cnr are also part, against emerging infectious diseases, which starts from the identification of the main current threats and those that could emerge in the future. And a section was dedicated to drug resistance – continues the virologist -. Training is a pillar, both for researchers and healthcare workers but also for patients. Only with a generation of more aware scientists will it be possible to achieve to new effective discoveries, but to solve the problem we need the commitment of every person who comes into contact with an antibiotic, not just research laboratories, industries, farmers and healthcare personnel”.

An aspect that is too often underestimated is “the management of antibiotics by us end users – concludes Maga -. Taking them preventively is no longer a sustainable approach. If we want the antibiotics at our disposal to work until new ones are authorized molecules, it is absolutely necessary to take them upon medical indication and in the right doses. And when we finish the treatment, the remainder must be disposed of correctly: the drugs must be taken to the appropriate containers present in pharmacies, clinics and hospitals. They must never be thrown into the unsorted rubbish , just as liquids should not be emptied into the kitchen sink or bathroom and then separated into glass. This is because, even if expired, there is always an active ingredient which, spreading in the environment, leads to the selection of new drug-resistant bacteria who in turn may infect us but will resist treatment.” A vicious circle that began when Fleming discovered penicillin in 1928 and which today represents one of the most impactful health challenges of the coming years.



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