Today, doctors treat infections and diseases almost exclusively with antibiotics. However, bacteria have two big ways of fighting back: they can pass around genes for antibiotic resistance, and they can coat themselves under biofilms to keep antibiotics at bay. In this ongoing chess game, the move is now ours. What strategies should we take as we continue the fight for health among communicating superbugs?

One method that needs to be put to good use is simply to stop using antibiotics so often. Doctors often prescribe antibiotics to patients complaining of a sore throat – something that can easily be caused by viruses. But antibiotics only fight bacteria, and viruses are not bacteria. They are not even cells! A virus is simply a bunch of proteins encapsulated within some vestige of genetic material. They are not alive, so they will not respond to antibiotics at all. And when doctors prescribe antibiotics where they are not even needed, all they are doing is encouraging the bacteria already inside you to select for that gene of antibiotic resistance.

The extremes of this can be seen in modern India, which has a very high rate of antibiotic consumption. Hospitals can also be breeding grounds for superbugs. Many different types of antibiotic resistant bacteria can be found in such locations, including MRSA. MRSA (usually pronounced “MER-sah”) is the common name for “methicillin resistant Staphylococcus aureus.” S. aureus is a bacteria that can infect people, and methicillin is one of the strongest antibiotics we have. MRSA is so devious it is resistant to even our most potent treatments, which is what makes it so incredibly dangerous. If the bacteria don’t respond to treatment, doctors may be forced to remove the infected region.

Another place where antibiotic overuse is causing problems is within cattle ranches and other farms that produce meat and animal products. Oftentimes, ranchers will prescribe antibiotics to their livestock not in response to an infection, but as a preventative for disease. This is a recipe for disaster. Antibiotic usage in the United States is higher among livestock handlers than among medical practitioners. If the caretakers on the farm are then exposed to the antibiotic resistant bacteria, or if one of those bacteria stays on the meat that’s sold in grocery stores, those genes can spread out to the general population. Remember, through transformation, even dead bacteria can share their genes with living bacteria around them.

Thus, the spread of resistance genes can be slowed by a more careful administration of antibiotics. First, they should only be used when there is an actual infection or sickness involved – never as a preventative. Second, doctors should test for other possible sources of the sickness, in case a virus or other pathogen is to blame. Only when bacteria can be identified as the guilty culprit should antibiotics be used. After all, those resistant bacteria have genes that make them less fit in a natural environment. If bacteria aren’t exposed to antibiotics, there is pressure to get rid of those genes. So it is completely reasonable to hope for a future where superbugs are rare.

That's only going to help us slow superbugs, however. What about actually engaging with them? A potential new method of fighting bacterial infections starts with bacterial communications. What if scientists could find a way to interrupt bacterial conversations? If they can stop bacteria in a biofilm from communicating with each other, those bacteria will think that they’re alone and break up, making it easier to defeat them with antibiotics.

Furthermore, bacteria only work pathogenically when they sense a certain number of likeminded bacteria around them. This means that interrupting their conversations can save patients infected with antibiotic resistant bacteria – even MRSA. If all the MRSA’s can’t speak to each other, they won’t act pathogenically in the person at all, and antibiotics won’t even be needed. It’s as if you stopped the bioluminescent octopus’ bacteria from talking to each other. Without communicating, they would never know when they reach their threshold number. So, they’d never turn on the light. In the same way, antibiotic resistant bacteria would continue living, completely harmless, inside you! This makes research into the language of bacteria an extremely exciting field. For the first time since Alexander Fleming, we may have a revolutionary new way to defeat bacterial infections.

Sources (for all three essays):

“Bugging Your Bugs” by Hayley Birch. Published by New Scientist in March 2010.

“Low-Tech Bacteria Battle: To Fight Antibiotic Resistance, Doctors Need to Change the Way They Prescribe” by Nathan Seppa. Published by Science News in October 2014.

“Quorum Sensing: Bacteria Talk Sense” by Costi D. Sifri. Published by Clinical Infectious Diseases in October 2008.

“Silent Treatment” by Cassandra Willyard. Interview of Bonnie Bassler. Published by Discover in June 2014.

“The Enemy Within” by Maryn McKenna. Published by Scientific American in April 2011.

Prescott’s Microbiology by Willey, Sherwood & Woolverton.

Rise of the Superbugs. Journeyman Pictures 2012.