The coronavirus pandemic has accelerated the emergence of drug-resistant bacteria and fungi. Scientists and physicians note cases when previously harmless to humans microorganisms become pathogens for humans, and in relation to some bacteria antibiotics lose effectiveness, and most often such strains appear in hospital conditions. Vera Sadykova, Doctor of Biological Sciences, Deputy Director and Head of the Department of Microbiology at the G.F. Gauze Research Institute for Research on New Antibiotics, told about it in an interview with RT. According to the expert, scientists are now developing alternatives to traditional drugs. For example, bacteriophages – special viruses that are not dangerous to humans – are proposed to be used against resistant strains.

• Recently in the USA the results of the research have been published. The research has revealed increased levels of bacteria resistant to antibiotics in people hospitalized during the pandemic of coronavirus infection, both those who underwent COVID-19 and those whose tests were negative. The researchers concluded that the pandemic had affected the bacteria’s development of resistance to antibiotics. Is there a similar trend in Russia and other countries?
• Indeed, the intensive use of antibiotics to treat COVID-19 complications provoked a burst of antibiotic resistance in bacteria and fungi. For example, there is now a rapid increase in the incidence of deep mycoses, which are extremely severe and cause high mortality. Note that if we talk about pathogen resistance, we are not only talking about bacteria – fungi have recently begun to come out on top in terms of resistance to drugs.

Although the pandemic has played a negative role, in general the problem has a long history and is related to the massive use of antibiotics, which is only increasing every year. For example, use of these drugs increased by 65% from 2000 to 2015. Much of the increase is due to increased access to drugs in developing countries.

Antibiotics are indispensable in the treatment of infectious diseases, as well as for prevention of immune impairment, but the irrational and excessive use of such drugs has created a global problem of drug resistance of pathogens, which have adapted to survive in the presence of antibiotics.

Treating infections caused by resistant strains is much more difficult and expensive, and for panresistant microorganisms (those resistant to all known drugs. – RT) may have no effect at all.

Every day doctors are faced with infections that do not respond to available antimicrobials.

• The World Health Organization (WHO) has named the problem of antimicrobial resistance as one of the ten global threats to human health. How common are such infections and how often do doctors encounter them in their practice? What diseases are most often caused by them?
• There is a whole group of such pathogens. These bacteria cause nosocomial infections, which are difficult to treat and especially dangerous for weakened patients. It is in hospitals that the most suitable conditions for the emergence of such resistant microorganisms arise. Dangerous fungal diseases are also on the rise.

For example, some fungi previously known as typical saprotrophs (microorganisms that feed on dead remains – RT) are becoming pathogenic to humans. Especially with the COVID-19 pandemic, the number of fungi resistant to all antifungal drugs in use is growing.

At the same time, the development of new drugs requires very large resources: the development of a new effective antibiotic requires 10-12 years and requires $800 million to $2 billion.

Large foreign pharmaceutical companies and leading universities are engaged in such developments. However, on the whole, the pharmaceutical industry has not paid enough attention to this area in the last decade.

• How big is the “contribution” of medical organizations to the problem? For example, antibiotics are often prescribed to patients without microbiological studies, by blind selection. Can this also be a negative factor?
• Yes, the erroneous prescription of antibiotics without prior testing for pathogen sensitivity can contribute to the development of antibiotic resistance.
• Researchers at Australia’s Monash University recently found that a significant percentage of beef and salmon sold in supermarkets are populated by bacteria that are resistant to a variety of commonly used antibiotics. Another study has emerged that suggests antibiotic-resistant bacteria can be transmitted to humans from pigs – the animals’ microflora is gaining resistance due to the use of antibiotics on farms. Is the use of antibiotics in livestock farming one of the causes of resistant strains?
• Yes, this factor also contributes to the emergence of resistant strains. But this is due to human consumption of products containing antibiotic residues, not to the possible transmission of animal pathogens to humans.
• According to the WHO, none of the antibiotics currently in clinical development will be able to solve the problem of bacterial resistance, since almost all of the drugs belong to the old class of active ingredients. Does this mean that traditional antibiotics will soon cease to perform their functions?
• Antibiotics will continue to be used in medicine, but we just need to create drugs with a different principle of action. I would like to point out that the technology for developing traditional antimicrobials is also evolving. So now it is very important to modify classic antibiotics with semi-synthetic or synthetic antibiotics of the next generations.

Antibiotics are produced with the help of natural producers – special microorganisms – as well as by biosynthesis. Natural antibiotics have a number of advantages. They are structurally diverse, highly active against pathogens, and have a broad spectrum of action. However, their production is difficult to scale up.

In the last decade, biosynthesis has been increasingly used to produce antibiotics. In addition, work is underway to modify already known natural antibiotics using chemical or genetic methods.

The new substance must meet a number of requirements. For example, its molecules must be bioavailable – to penetrate the bacterial membrane and bind to specific targets in the pathogen. Also, such drugs should have no side effects, not be toxic, and be inexpensive to produce. Selecting a substance that meets all the necessary requirements is very difficult, so new antibiotics appear relatively rarely.

Of course, since the discovery of antibiotics in the first half of the 20th century, the search for new drugs has evolved considerably. In recent years, scientists have had access to microbial genome sequencing technology, which has opened up entirely new strategies for finding drugs.