By Marc Maury – Scientific Director, Unither Pharmaceuticals _ Full article published in Pharmanetwork: PDF file The Origins of Multi-Resistant Bacteria When multi-resistant bacteria emerge, detailed investigations are carried out to trace their origins and limit their spread. Advances in genome analysis — including MALDI-TOF, PCR, and high-throughput sequencing — have expanded our capacity to understand these mechanisms. Paleomicrobiology: Looking into the Past With progress in bioinformatics, researchers can now study ancient bacterial genomes extracted from fossils or sediments. Surprisingly, antibiotic resistance genes have been found in organisms several thousand years old — long before the first use of antibiotics by humans. Availability: A Hidden Crisis Despite the occasional launch of new antibiotics, the number of available products in pharmacies continues to decline. Often, antibiotics are withdrawn not due to inefficacy or toxicity but due to low profitability. Regulatory changes, low prices, and limited market sizes all contribute to this erosion. A Global Public Health Challenge While many headlines stress the lack of new antibiotics, this narrative misses a key point: old antibiotics still exist. The problem lies not only in innovation but also in access, stewardship, and intelligent use. The rising resistance crisis demands a deeper understanding of its true causes. Nature’s Role in Resistance Termites, Gorillas, and Antibiotics Gorillas, without medical treatment, often carry resistant Klebsiella pneumoniae. Traced back, the resistance comes from termites in their diet. These termites cultivate fungi and secrete natural antibiotics like penicillin — creating an environment where resistance naturally evolves. In some African villages, termite mound extracts are even used as traditional medicine. Deforestation and Ebola Outbreaks of Ebola often follow deforestation, which disrupts ecosystems and pushes reservoir species like bats closer to human populations — increasing the risk of spillover. These same ecological dynamics can influence bacterial resistance too. Agriculture and Resistance Intensive Farming Practices Farming uses massive quantities of antibiotics — not just to treat disease but to promote growth. For example, vancomycin resistance in humans emerged after turkeys were treated with avoparcin (a similar compound), selecting resistant Enterococcus strains that later infected humans. Pesticides as Antibiotics Many pesticides and herbicides (e.g., glyphosate) have antibiotic properties. Used in massive quantities, they apply selective pressure on soil bacteria — creating yet another source of resistant genes. Understanding Resistance Dynamics Resistance genes are not created by antibiotics — they are selected by them. In environments where antibiotics eliminate susceptible bacteria, resistant strains thrive. Over time, this leads to the emergence of so-called “superbugs”. However, when resistance offers no advantage, bacteria may lose these genes through mutations — potentially becoming sensitive again. This could help explain the cyclical nature of epidemics. Better Use of Existing Antibiotics Antibiotic treatments are often standardized, with limited personalization. Yet each infection is unique. With better diagnostics and microbiology tools, we could adapt dosages and regimens for each patient — lifting resistance and improving outcomes. Actionable Solutions We must act on the root causes, not just search for new drugs. Reduce antibiotic use in livestock and agriculture. Minimize exposure to antibiotic-like pesticides. Re-optimize the use of old antibiotics through dosage improvements and combinations. Leverage phages and microbiota as natural allies against resistant bacteria. Conclusion: Rethinking the Antibiotic Arms Race Relying solely on new discoveries is risky. Nature has given us a wealth of defense and resistance mechanisms — and understanding them could unlock sustainable strategies against resistance. We need to be smarter. By reducing pressure on ecosystems and rethinking how we use antibiotics, we can avoid a health crisis. At the same time, we must continue searching for new therapeutic “swords” — before existing bacterial “shields” overpower them all.
