WHERE DO BACTERIA COME FROM?
When we begin to consider how to treat someone with a bacterial infection, we may do well to remember where bacteria have come from and how their evolution has progressed to present day. Bacteria were one of the very first species to appear on earth. They are single-celled organisms, mostly surrounded by a cell wall, named prokaryotes, meaning before (pro) nucleus (karyote).
Eukaryotes, in contrast, are much larger cells found in plants and animals. They are more complex cells comprised of DNA enclosed in a nucleus, organelles including energy-producing mitochondria. Current evidence suggests cooperation between bacterial and eukaryotic cells was highly important for human origins and existence. As a result of this union, primitive eukaryote cells were formed and have evolved into the complex ecosystems that we have today. The relationship between bacteria and humans may be observed in our microbiome. The “good” bacteria or “probiotics” often prescribed by doctors are key factors in maintaining important physiological functions including the assimilation of nutrients, regulation of the immune system and the restriction of potentially-pathogenic bacteria.
Bacteria can be found in almost every environment. If bacteria have lived and helped us evolve for millennia, how did we fall so far to consider bacteria an “enemy”, forgetting that our ecosystem functions in an intricate balance where cooperation and an interweaving of support allows us to thrive.
Louis Pasteur, known for his work in chemistry, microbiology, and the germ theory, is reported to have renounced much his life’s work, on his death bed claiming that the microbe is nothing, the terrain is everything. The terrain theory, introduced by Claude Bernard, a contemporary of Louis Pasteur and furthered by Antoine Béchamp (among others) proposed that it is the terrain or the internal environment that determines an individual’s state of health. A healthy terrain would not host an overgrowth of pathogenic bacteria, however, if the internal milieu was out of balance inharmonious bacteria would take their opportunity to flourish.
Antibiotic Resistance
We must question if the entire concept of an ‘antibiotic’ is in itself problematic. The term antibiotic stems from “antibiosis”, meaning “against” (anti) “life” (biosis). When antibiotics first came into practice, there was much optimism surrounding them, and for good reason — they worked. They saved lives. Alexander Fleming’s discovery of penicillin in 1928 was lauded as a miracle drug. It was thought of as a way to kill all of the germs that caused disease. More antibiotic types and classes were developed to destroy a greater variety of bacteria. Antibiotics revolutionized medicine, saved lives and destroyed the bacteria they were designed to attack. However, what has emerged in the hundred years since their introduction is a growth in antibiotic resistance.
Drug-resistant strains were first identified in hospitals in the 1930’s-40’s where the majority of the antibiotics were being used. Resistance begins when a minority of organisms survive the onslaught of an antibiotic. With repeated exposure to an antibiotic, the few resistant, surviving bacteria begin to multiply. In our enthusiasm over the success of antibiotics, the innate intelligence of life and the microorganism’s purpose to survive was underestimated. Though simple prokaryotes, bacteria have faced innumerable threats to their survival by antimicrobial compounds and survived, with eons to practice adaption and mutation. Our present dilemma of antibiotic resistance has numerous biochemical and physiological mechanisms as contributors.
Antibiotics target essential bacterial physiology and biochemistry, causing microbial cell death or the cessation of growth.The five major targets include: the bacterial cell wall (e.g., beta-lactams, Vancomycin), the cell membrane (e.g., Daptomycin), protein synthesis (e.g., Linezolid, Tetracyclines, Macrolides, Aminoglycosides), DNA and RNA synthesis (e.g., Fluoroquinolones, Rifamycins) and folic acid metabolism (e.g., Trimethoprim, Sulfonamides).
How Resistance Occurs
Bacterial resistance to antibiotics can occur in a number of ways:
1. Altered uptake of antibiotics: many antibiotics use special “holes” to enter into the bacteria cell in order to destroy them. To resist this cell entry, bacteria have closed these “holes” or permanently eliminate them.
2.Target modification: bacteria physically change their structure to prevent the antibiotic targets effect.
3.Enzymes: bacteria produce antibiotic-degrading enzymes to degrade the antibiotics and render them useless.
4.Efflux pumps: bacteria pump out antibiotics before they have a chance to work.
The development of tolerance and resistance to antibiotic treatment has become commonplace. Antimicrobial resistance is now occurring in every reporting country in the world. Globally, bacteria such as Staphylococcus aureus, Escherichia coli, and Klebsiella pneumoniae, are demonstrating a reported range of resistance of between 5% and 80% of tested strains. Antibiotics have become ubiquitous in our modern day environment and bacteria are consequently adapting and developing resistance to drugs designed to eliminate them. The farming industry has introduced small, continuous amounts of antibiotics for non-therapeutic purposes contributing to antibiotic resistance. As certain bacteria gain resistance, they are able to transfer information about antibiotic resistance to other forms of bacteria in which they come in contact. They promiscuously cooperate in sharing survival information, rather than compete for resources. This information exchange among bacteria and the continuous exposure supports exponential growth of antibiotic resistance.
Antibiotic resistant bacterial infections add considerable costs to our overburdened health care system. In addition, antibiotic resistant infections often require a longer hospital stays . At the beginning of the 20th century with improvements in hygiene in the hospitals, sanitation of water, proper disposal of sewage, the judicious use of antimicrobials and technological advances in detecting and monitoring infectious disease, the incidents of death due to infectious disease began to decline. This decreasing trend in mortality due to infectious disease began changing, however, at the end of the 20th century with the re-emergence of Tuberculosis, the appearance of AIDS and an increase of mortality due to infectious disease. Now in the 21st century, with the emergence of new infectious diseases, the re-emergence of old disease, large foodborne outbreaks and acts of bioterrorism we are facing a reversal of the previous decreasing trend in mortality due to infections disease. There is also evidence surfacing that bacteria that survive treatment with antibiotics are more likely to have inflammatory properties as the drug may alter the mechanism by which our immune system responds to the microbe, and therefore also contribute to non-communicable diseases.
We have tools at disposal not only to address and interfere with the microbes that are resistant to antibiotics, but we also have the skills and tools to address and improve the terrain of the body, reducing the development of severe disease from infections. Reversing resistance requires restoration of the former beneficial flora in people and animals and in the environment. One of the brightest tools we have in addressing antibiotic resistant microbes and supporting the immune system is botanical medicine. The remainder of this article will discuss herbal medicine and specific herbs that may be compounded together in order to support the body’s resistance to harmful bacteria and to improve the terrain.
Herbal Medicine
Plants have been adapting and evolving along with bacteria for billions of years. Whereas bacteria have quickly adapted to a single antibiotic, they have been less successful in resisting the complex patterns found in living herbs. Herbal medicines contain many active constituents and it is not always possible to identify a single active compound or method of action responsible for the clinical effect. It is more likely that several compounds using multiple strategies combined provide a synergistic effect. For example, Hydrastis canadensis contains berberine, an antimicrobial substance as well as a potent synergist that acts as an efflux pump inhibitor. Though berberine can be quite effective against many microorganisms on its own, it is markedly more effective by the potentization of another constituent called 5’-methoxyhydrocarpin, a multidrug efflux pump inhibitor.
As far as my research is concerned(co-author of this column), being PhD , and working in field as veterinary Assistant Surgeon, I got to know much about the antibiotic- resistance and effect of herbal medicines in curbing that. Certain herbals especially used in clinical condition “Mastitis” work good in the field. In my Masters research paper “artemisia meritima” was used as an anti-helmintic alternative and it showed good effects in actual practice. More to say, my PhD research paper included 5 anti-microbial herbals of Kashmir , which I used in ‘subclinical mastitis’ after proper AST and Cytotoxic studies and surely they produced promising results. Apart from this, if we talk of Kashmir in general, the application of herbal remedies in hospital care settings has been very wide and promising since many decades.
Some herbal antimicrobials act primarily on the bacteria’s cell membrane functions, disrupting normal metabolic processes in the cells causing cell death whereas others target the microbial virulence factors. For complete and effective treatment of bacteria using botanical medicines, antimicrobials are used alongside other herbs that have a system tropism or support particular body systems improving the tissue state, assisting in the rejuvenation of the body post-infection and enhancing the immune system. Informed and responsible care must be taken when using herbs to treat infection. Improvement should be observed within a day or two, signs of improvement should continue, and the infection should be resolved in seven to ten days.
Promise Of Plant Medicines
Plants have long been, and still are, humanity’s primary medicines. They possess certain attributes that pharmaceuticals never can. The chemistry of plant medicines is highly complex — too complex for resistance to occur. Instead of a silver bullet in the form of a single chemical, plants often contain hundreds to thousands of compounds, and have developed sophisticated responses to bacterial invasion over millions of years.
Plants are free or nearly so; whether you buy them or grow them yourself, they are remarkably inexpensive. Anyone can use them for healing — you don’t need years of schooling to learn how to use plants for your health. They are quite safe — in spite of the unending hysteria in much of the media, properly used herbal medicines cause minimal side effects of any sort, especially when compared with the millions of people who are harmed every year by pharmaceuticals
Conclusion
In this article, we have discussed what antibiotic resistant bacteria are and how they came into existence. We have also attempted to provide a solution in dealing with the microbes through the careful combination of herbal medicines. The use of herbal medicines allows not only the elimination of infection from the body but the ability to strengthen the immune system and heal the tissues affected. With the increase of antibiotic resistant bacteria, we must come to an understanding whereby we recognize the significance of healing the environment both on an individual and a global scale. In doing so we may be able to also heal our relationship with the ever evolving bacteria.
(The authors Dr.Tasaduk Hussain Itoo a Resident doctor at Acharya Shri Chander College of Medical Sciences and Hospital Jammu and Dr. Imtiyaz Ahmad Reshi a Veterinary Assistant Surgeon write on pressing issues concerning public health care. Their views are personal )
