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Molecular Mechanisms of Antibacterial Multidrug Resistance Cell 128(6):1037-1050 Michael N. Alekshun and Stuart B. Levy Treatment of infections is compromised worldwide by the emergence of bacteria that are resistant to multiple antibiotics. Although classically attributed to chromosomal mutations, resistance is most commonly associated with extrachromosomal elements acquired from other bacteria in the environment. These include different types of mobile DNA segments, such as plasmids, transposons, and integrons. However, intrinsic mechanisms not commonly specified by mobile elements—such as efflux pumps that expel multiple kinds of antibiotics—are now recognized as major contributors to multidrug resistance in bacteria. Once established, multidrug-resistant organisms persist and spread worldwide, causing clinical failures in the treatment of infections and public health crises.... The means that microbes use to evade antibiotics certainly predate and outnumber the therapeutic interventions themselves. In a recent collection of soil-dwelling Streptomyces (the producers of many clinical therapeutic agents), every organism was multidrug resistant. Most were resistant to at least seven different antibiotics, and the phenotype of some included resistance to 15–21 different drugs...
Integrons are found in the genome of hundreds of environmental bacteria but are mainly known for their role in the capture and spread of antibiotic resistance determinants among Gram-negative pathogens. We report a direct link between this system and the ubiquitous SOS response. We found that LexA controlled expression of most integron integrases and consequently regulated cassette recombination. This regulatory coupling enhanced the potential for cassette swapping and capture in cells under stress, while minimizing cassette rearrangements or loss in constant environments. This finding exposes integrons as integrated adaptive systems and has implications for antibiotic treatment policies.
I'm pleased to be the first to welcome you back, mattison. You've been sorely missed; we get a different class of creationist in here nowadays.
If there are organisms that synthesize and secrete antibiotics in nature, as indeed there are, why is it surprising that bacteria should have evolved defences against them?
Originally posted by rogerstigers
reply to post by mattison0922
Yeah, this all makes sense. I discussed this earlierr today with NRA4ever333 here. Specfically I pointed out an interesting article about epigenetics which says in a nutshell that DNA is not the only thing that controls what traits are expressed. This plus the role of "junk" DNA, which I believe to be merely compressed (zipped) instruction sets, raises a lot of questions about the function of DNA in adaptive mutations.
I don't hold anything against Darwin. He did the best that he could with what he had, just as Newton and Corpurnicus(sp?) did. I believe evolution is real, but it is a mechanism for adapting, not necessarilly the driving force behind it.
Originally posted by liveandlearn
All we here about and a concern for me is that resistant organisms are mostly acquired in the hospital. Not true, as there is what is commonly known as a community acquired MRSA (methicillin resistant staph aureus) as well as many gram negative organisms not as widely known.
I am here to place the fault elsewhere, at least in part based on my on observations and what I can understand of your post, and that is squarely on doctors who very often and in most circumstances give multiple antibiotics to patients. I mean 3 or 4 different classes of antibiotics. Not only do they give multiple antibiotics they give them at the most common dosage instead of giving them on a weight based dose. It is a 'one size fits all' from the 200 lb 5 ft tall woman to the 200 lb 6'2" tall man. Children are given doses based on weight and while there are weight based recommendations for adults they are not adhered to by most physicians.
In my facility we do bariactric surgeries. This is a bypass surgery for obese patients. We were having a lot of infections so I had to do some research. I found that a study done on these subjects during surgeries at different times with the appropriate weight based antibiotic in the end showed 35 % approximately never reached a minimum initiatory concentration of antibiotic in their tissue for gram negative or gram positive bacteria.
If sufficient antibiotic isn't given the patient then the remaining organisms are free to mutate and develop resistance.
If surgeons and hospital physicians who are required and even inundated with this information do not keep up, how much more likely is the family practitioner to keep up.
Can you tell me, based on what you have posted, the validity, or not, of what I have suggested.
Hospitals are the most common sources of antibiotic resistant bacteria; this is simply a function of the fact that hospitals are generally the places where the largest concentrations of antibiotics are used per capita.
In theory, yes. In general what happens is that a person who doesn't have a sufficient dose does breed resistant strains, however resistant strains have historically been outcompeted by sensitive strains. In other words, it used to be that you could defeat antibiotic resistant bacteria by ceasing antibiotic usage. Normal flora historically outcompete resistant flora.
However we are starting to see more and more community acquired cases of antibiotic resistant, which indicates that trend is coming to an end.
What you've written appears to be valid, but is really only part of the problem. If we could every physician in the world to comply, we've got antibacterial toys, antibacterial wipes, antibiotics are used prophylactically in the agriculture industries; their use is wide spread, and each little bit contributes to the overall problem of resistance.
This is true but the implication is that it is the nurse, not the doctor, who is mostly at fault. While nurses can carry it on their unwashed hands, I think it is mostly due to the prescribing habits of physicians.
Well, in hospitals across the nation we now consider once MRSA always MRSA. This is mostly true in patients with multiple comorbidities but with essentially healthy patients of normal weight many do overcome with normal bacteria.
And this relates to my posit that family practitioners
are giving inappropriate antibiotics as well as patients not completing their medication.
As for Streptomyces, I had to google it because I was only familiar with streptococcus.
I don't believe I implied this; I certainly didn't intend to imply this.
Completely different. Streptomyces are soil microbes. Streptomyces spp. are notable because they possess complex secondary metabolisms; this secondary metabolism produces a variety of chemicals, from which about 2/3 of our natural antibiotics are derived.
Streptomyces produce antibiotics, and thus, are necessarily resistant to the antibiotics they produce.
Originally posted by soficrow
YEAH mattison. Well done. S&F
Good to see you posting again.
And thanks. I have been floundering trying to figure out how to argue against 'survival of the fittest.'
The classic Darwinian story describes this as a random chance with respect to which organisms survive. Organisms are blessed with genes that allow them survive go on to reproduce, those that die... well they don't. However, this new data suggests that individuals do have an adaptive response, one that may or may not result in antibiotic resistance.... that's the big change, the fact that antibiotic resistance is a response, not a pre-existing condition.
Does that make sense?
I pointed out an interesting article about epigenetics which says in a nutshell that DNA is not the only thing that controls what traits are expressed... raises a lot of questions about the function of DNA in adaptive mutations.
I don't hold anything against Darwin. He did the best that he could with what he had...
I believe evolution is real, but it is a mechanism for adapting, not necessarilly the driving force behind it.
Originally posted by Astyanax
I follow your reasoning. But bacteria evolve too. Can you see any insuperable obstacle to their evolving a mechanism for extracting from other, related bacteria, chemicals useful in their own defence? I freely admit to being a non-biologist; perhaps I do not have the subject knowledge to see why this could be impossible? Given the weirdness and variety of life, I should think it quite likely.
Thank you for the clarification. I really don't see that the studies you cite in the OP imply what you say they do.
Integrons are found in the genome of hundreds of environmental bacteria but are mainly known for their role in the capture and spread of antibiotic resistance determinants among Gram-negative pathogens.
We report a direct link between this system and the ubiquitous SOS response.
We found that LexA controlled expression of most integron integrases and consequently regulated cassette recombination.
This regulatory coupling enhanced the potential for cassette swapping and capture in cells under stress, while minimizing cassette rearrangements or loss in constant environments.
This finding exposes integrons as integrated adaptive systems and has implications for antibiotic treatment policies.
How does it differ from other adaptive traits of a phenotype, such as - say - a squid's camouflage response to its surroundings?
These little beggars aren't evolving antibiotic resistance; they're acquiring it from theirr fellows.
Originally posted by mattison0922
reply to post by Astyanax
These little beggars aren't evolving antibiotic resistance; they're acquiring it from theirr fellows.
Exactly, in stark contrast to the classic Darwinian story.
Originally posted by mattison0922
Mobile genetic elements capable of capturing and transferring genes are found in lots of bacteria, and are largely responsible for acquisition of antibiotic resistance.
This statement in and of itself stands in opposition to the story of Darwinian evolution of antibiotic resistance.
The SOS repair system is somehow involved with generating the mutations that induce antibiotic resistance. In other words, mutation, in this instance is mediated – in a deliberate manner – by the SOS system.
In other words, the mutation is directed.
The release of a squid’s ink is a pre-programmed response; it exists in the squid from the time of birth to the time of death (presumably). There are no changes at the DNA sequence level that induce release of ink. With these bacteria, were talking about the acquisition of new genetic information; the difference is like night and day.
A deleterious mutation coupled with an advantageous one can be undone in organisms with sexual reproduction. Horizontal gene transfer in bacteria allows a similar situation. Source
* * *
Originally posted by soficrow
So it's not 'survival of the fittest' - it's survival of the most cooperative and approachable.
Originally posted by Astyanax
Yes. Why could such elements not have evolved through natural selection?
I don't see that it does; it merely adds a new chapter to the story.
Which is an evolved system.
And the SOS response is triggered by environmental factors just like any mutation in a gamete. It's all chemicals at this level, isn't it?
By an evolved mechanism.
I think not; it is merely the difference between a prokaryote and a eukaryote. As you know, eukaryotes swap DNA with each other in order to acquire disease resistance; it's called sexual reproduction.
But eukaryotes have specialized cells with which to do it, so they don't have to monkey with their own DNA.
Prokaryotes, having only one cell, must evolve some other mechanism to swap genes in order to beat Müller's ratchet. This is it. Another step forward for evolutionary biology and certainly no threat to Darwin.
Originally posted by Astyanax
Originally posted by soficrow
So it's not 'survival of the fittest' - it's survival of the most cooperative and approachable.
This betrays a misunderstanding of the phrase.
Originally posted by mattison0922
The story of the evolution of antibiotic resistance according to Darwin.
It... stands in opposition to the Darwinian story...
The... mutation that drives antibiotic resistance is directed - it's an active response to the enviroment, which - whether you like it or not is not part of the classic evolutionary story.
the notion of directed mutation is practically scientific heresy.
Astyanax: And the SOS response is triggered by environmental factors just like any mutation in a gamete. It's all chemicals at this level, isn't it?
No. The SOS response isn't present in organisms that produce gametes. It's a prokaryotic system exclusively. The SOS system is described as DNA repair; it's not necessarily triggered by environmental factors, it's triggered by DNA damage, and cellular stress, which are not necessarily environmental in origin.
Sexual reproduction is not about disease resistance.
(From above source: in species where asexual reproduction is possible (as in many plants and invertebrates), coevolutionary interactions with parasites may select for sexual reproduction in hosts as a way to reduce the risk of infection in offspring.
Astyanax: But eukaryotes have specialized cells with which to do it, so they don't have to monkey with their own DNA.
Sure they do. There are all kinds of site specific recombinases, there are transposons, pseudogenes, all of which have a role in creating new genetic diversity in an already existing organism.
This is not about swapping genes, it's about generating mutations in a directed manner in response to environmental stress.