What To Expect When Expecting A Super Antibiotic

It is an unfortunate fact of life that bacteria are getting stronger and stronger as they develop resistance to many of the antibiotics that we use. They are becoming super-bacteria and our options of dealing with them are shrinking. One such super-bacteria is vancomycin-resistant enterococci (VRE). VRE is primarily found in hospitals, the breeding ground of other super-bacteria like MRSA, and generally, results in dangerous wounds and bloodstream infections [1]. This makes it a dangerous mix for hospitals and is considered one of the biggest threats to human welfare and health by the World Health Organization (WHO) [2]. While there are still antibiotics capable of treating VRE, the chances that they will become useless due to resistance in bacteria is prevalent and problematic. Vancomycin, a 60-year-old antibiotic, met that fate and lost its effectiveness against VRE.

For every supervillain, there is a superhero to clean up the mess and save the city. Ideally, for every super-bacteria, there needs to be a super-antibiotic to protect the people and save the day. That is the goal of a team of scientists at the Scripps Research Institute in California. They want to create a super-antibiotic from vancomycin to combat the superbug VRE [1]. Vancomycin works by preventing some bacteria from forming cell walls, which results in their deaths as it disrupts the cell wall synthesis process. VRE is resistant to vancomycin because it has modified its cell wall synthesis process to avoid the damage that vancomycin does [3]. Instead of this singular mechanism of action in vancomycin, the Scripps researchers changed vancomycin to now have three mechanisms of action [1].

By modifying the molecular structure of vancomycin, the researchers were able to strengthen its ability to destroy cell walls (to bypass the current resistance), increase the durability of the antibiotic (so you need less for the same effectiveness), and add a new way of inhibiting the cell walls of the bacteria [4]. This new super vancomycin is now over 1,000 fold more active and stronger than the old version, making it an ideal candidate for VRE [4]. This makes it much harder for VRE to avoid the effects of vancomycin because developing resistance is a very intensive process for a single mechanism and having to develop resistance to three mechanisms is extremely difficult.

The researchers have not tested this super-vancomycin on people or animals yet, but they hope to have the drug be available for use in five years or so after they have completed the necessary testing [1]. The WHO has noted that many pharmaceutical companies are focusing on easy and profitable treatments to bolster their pockets rather than focus on clinical need [2]. Hopefully, other researchers and pharmaceutical companies can take inspiration from the Scripps researchers and look at ways to modify other antibiotics to combat the growing number of antibiotic-resistant bacteria. This, at least, should be an easy start for them as it is using existing antibiotics to modify rather than trying to find new ones, which remains a difficult process.

As global warming continues to expand the homes of bacteria, viruses, and parasites, it is becoming increasingly important to improve our chances of survival against these threats. With the addition of globalization and the large movement of people around the globe, this threat increases more. Hopefully, the research into super-antibiotics can become the heroes to shield us from these terrors or at the very least buy us more time to research more ways to combat the super-bacteria.

Photo of Enterococci bacteria cluster. Acquired from Scienctific Computing

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