4

Are antibiotic-resistant bacteria more dangerous besides their resistance?

I am aware of the way things were before the first antibiotics: people died from infections often and diseases like syphilis were protracted death sentences.

My question is motivated by the following ideas:

  1. Is it possible that antibiotic resistance also means that some bacteria will be harder for the immune system (without effective antibiotics) to combat? That in a general sense, antibiotic-resistant bacteria are "stronger" or more aggressive?

  2. If there is a genetic component to fighting off bacterial infections, do the generations since antibiotics have a higher percentage of members who are not going to be as good as people were on average 90 or so years ago at dealing with infections?

Bryan Krause
  • 14,047
  • 4
  • 34
  • 54
releseabe
  • 221
  • 1
  • 6
  • Here's one interpretation of that possible frightening near-future: http://surgeonx.co.uk/ – Chris May 03 '19 at 08:34
  • That sounds like fiction. Also like the Japanese comic Blackjack. Is there any reason to believe this is fact-based? – releseabe May 03 '19 at 10:34
  • Apologies, it is definitely fiction. I am planning to answer your question later when I get home if I can, but I was simply sharing a pop culture reference to the “antibiotic apocalypse” that I had found intriguing myself :) – Chris May 03 '19 at 11:02
  • 1
    This question is entirely hypothetical, so not answerable with a convincing evidence. You may want to search about what is already known about antibiotic resistant bacteria, such as MRSA. – Jan May 04 '19 at 09:05
  • @Chris If you plan to answer this question please do so because otherwise I agree with Jan that this question is hypothetical and unanswerable. – Carey Gregory May 04 '19 at 15:34
  • @CareyGregory I agree. I can’t find sources to answer the question as it stands. – Chris May 04 '19 at 15:44
  • The last para isn't the [edit] that's needed to get this RO. For an RO you need to show us a bit of your prior research, and refocus, away from social hypotheticals towards perhaps an epidemiological angle? (Parts of this Q I do think are answerable, fact-based, looking at past evidence and expert opinions and evidence. Emphasize these points and get it going again? With "parts" I also want to convey that this is bordering "too broad", so don't expand its scope!) – LаngLаngС May 04 '19 at 20:12
  • @LangLangC I agree that parts are answerable, but the ultimate question is this: "So are we facing a truly frightening near-future, compounded of course by increased population density and international air travel?" and that is not answerable with anything other than opinion and speculation. – Carey Gregory May 04 '19 at 23:21
  • @CareyGregory This will need editing, agreed, but the opinion part can perhaps be 'reasoned away', after all. 'Subjective' comes in two flavours https://stackoverflow.blog/2010/09/29/good-subjective-bad-subjective/ and OP might find a way to get this into better shape. The 'some parts' might also lead to excision of the 'core' you identified and still yield a Q&A that's overarchingly or even just correlationally useful to OP. I hope this Q comes around somehow. – LаngLаngС May 04 '19 at 23:45
  • 1
    @LangLangC I hope so too. – Carey Gregory May 05 '19 at 04:04
  • May I suggest to cut out all the "obvious" things, concentrate on the (to you) non-obvious from the bold part at the top now (and subQ/idea "1"), and that you add some preliminary prior research? Just the dangers from resistant bacteria… [I think the A to that will by implication serve you well for the rest of your thoughts] – LаngLаngС May 05 '19 at 10:42
  • It's true for the acquired immune system. In case of antibiotics there won't be much of an evolutionary arms race, as our methods to fight back against microbes defending themselves against what we throw at them, amounts to almost nothing. So, it's game over almost immediately compared to the long evolutionary arms race between pathogens and our immune system. This is not going to cause new diseases to develop that our immune systems can't handle, but it will cause problems for hospital treatment where antibiotics are essential. – Count Iblis May 13 '19 at 00:08
  • @CountIblis Are you prepared to post an answer that isn't just opinion? – Carey Gregory May 13 '19 at 04:05
  • @CareyGregory Points 1 and 2 made by the OP are wrong, it's known that antibiotic resistance comes at a big price for microbes. Also, one can discuss the real threats, such as operations becoming more riskier when no effective antibiotics are available. Even simple treatments like having your wisdom teeth removed without antibiotics to prevent infection could become too risky. These things have been discussed in the literature, but I think that the medical experts here can write about this much better than I can. – Count Iblis May 13 '19 at 04:18
  • 1
    I tried to pare this down to a more answerable question that can focus on what is known today rather than speculation about the future. – Bryan Krause May 17 '19 at 21:16

1 Answers1

4

Is it possible that antibiotic-resistant bacteria become stronger, that is harder for the immune system to combat?

Short answer: It depends on the species of bacteria, immune status of an individual, etc.

The authors of this article: The Complex Relationship between Virulence and Antibiotic Resistance (PubMed, 2017) make a vague conclusion that:

Increased virulence [the potential of certain bacteria to cause disease] may naturally evolve in response to or concurrently with increased antibiotic resistance...

In one study in mice, antibiotic-resistant bacteria were less virulent than the antibiotic-sensitive ones. Comparison of the virulence of methicillin-resistant [MRSA] and methicillin-sensitive Staphylococcus aureus [MSSA] (PubMed, 1994)

These results indicate that MRSA is less virulent than MSSA in normal hosts, but that they are equally virulent in immunocompromised hosts.

It's not possible to make a general conclusion from a single animal study, though.

Another aspect is that bacteria resistant to one antibiotic are prone to become resistant to other antibiotics. Staphylococcus aureus can become resistant to methicillin (methicillin-resistant S. aureus or MRSA), vancomycin (VRSA) and several other antibiotics (PubMed, 2009). Furthermore, plasmids (the DNA particles in the bacteria that induce antibiotic-resistance) can spread to other species of bacteria, for example, from staphylococci to enterococci.

If there is a genetic component to fighting off bacterial infections, do the generations since antibiotics have a higher percentage of members who are not going to be as good as people were on average 90 or so years ago at dealing with infections?

Antibiotics helped to survive many "bacteria-sensitive" people, and their offsprings may be more sensitive too, so it is possible that today there are more individuals sensitive to bacteria than 90 years ago. However, according to one 2015 study in twins, variation in the human immune system is largely driven by non-heritable influences (Cell.com).

Jan
  • 15,851
  • 24
  • 70