For millennia, humankind has used antibiotics to treat infections empirically, even before knowing those infections were caused by bacteria—or that bacteria existed.
In the 19th century, antibacterial chemicals began to be used to systematically treat certain infections. At the beginning of the 20th century, Selman Waksman coined the term “antibiotic” to refer to substances that destroy or inhibit the growth of microorganisms (more specifically, bacteria).
As with many instances throughout history, a mistake led to a revolutionary discovery in 1928 when Alexander Fleming accidentally left a Staphylococcus culture plate uncovered for a few days. When he got back, he discovered that the plate had been contaminated by a fungus that inhibited bacterial growth. Fleming experimented with the fungus, and Penicillin, the first antibiotic to be industrialized and commercialized, was born. The finding led to a true scientific revolution. Treatment of certain diseases and conditions, which were considered lethal a few years before, became routine. The future looked bright for a new era of medicine.
However, a few decades later, a new problem arose. The mechanisms for adaptation and evolution, which take centuries in humans, can develop in populations of microorganisms in just a few days because they multiply so rapidly. And because there are so many microorganisms in a relatively small colony, the chances that some of them would generate offspring that is resistant to certain environmental conditions (such as the action of antibiotics) is relatively high. Cases of microorganisms that were resistant to antibacterials (and colloquially referred to as “super-bacteria”) were documented, including some outbreaks of antimicrobial resistant (AMR) bacteria in hospitals.
In 2014, the importance of AMR in the political agenda increased when UK Prime Minister David Cameron commissioned the independent Review on AMR, chaired by macroeconomist Lord James O’Neill. Lord O’Neill led a team of experts who produced a comprehensive report (PDF) recommending a number of actions that should be taken to reduce the impact of AMR. The report, however, was most known for two shocking figures that were provided or estimated by the experts—it predicted that, by 2050, 10 million people will die annually due to AMR, and that inaction would result in a cost associated to global production losses of approximately $100 trillion. Some disagreed, arguing that those numbers were based on speculation and limited data, resulting in an over-reaction that has negatively impacted the development of a number of industries worldwide. The debate was and is vibrant, and has resulted in a number of changes in policy in many countries, starting most notably in Northern Europe and expanding globally.
There is a need to generate scientific information to understand the dimension of the problem and offer alternative solutions and options to protect animal, public, and environmental health, as well as the safety of food animal products. In addition to the research on antimicrobial use and AMR led by a number of University of Minnesota College of Veterinary Medicine (CVM) faculty over the last years, the CVM has responded to the pressing problems that AMR presents to our work by recently investing in expanded research and education capabilities. In this issue of the CAHFS One-to-One newsletter, we highlight some of those new resources and ideas, including:
- The profile of Noelle Noyes, DVM, PhD, who was recently hired as a tenure-track faculty member in the Department of Population Medicine, to focus on AMR research
- Recent research results of Ehud Elnekave, DVM, PhD, a postdoctoral fellow in CAHFS on Salmonellosis AMR in Minnesota,
- Collaborative research between CAHFS, the Minnesota Department of Health, and the University of Minnesota Veterinary Diagnostic Laboratory studying AMR in human and animal health, and
- An initiative for capacity building on food safety and AMR at the national level promoted by CAHFS in collaboration with the Pan American Health Organization (PAHO).
There is no doubt that AMR policy and management is a changing landscape at both national and international levels, and that future years will see a new revolution in our knowledge on the dynamics and impact of antimicrobial use in humans and animals. CAHFS and the University of Minnesota are looking forward to stand at the forefront of that new revolution, conducting the research, and educating the workforce required to protect the health of our animals, people, and environment.
- Andres Perez
Director, Center for Animal Health and Food Safety