Antimicrobial Resistance: A Tale of Nasty Enemies and Powerful Weapons

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Authors : Fabiola Vacca , Dario Cardamone , Marco Troisi , Claudia Sala , Rino Rappuoli

Artwork: Figures 1-3 by Susan Nasif.


Have you ever had a sore throat, cough, or fever? All of us have felt badly at least once in our lives! A doctor may have helped you by prescribing antibiotics to kill the microbes responsible for the infection, thus eliminating pain, cough, and fever. Thanks to medicines like antibiotics, we can recover quickly from diseases. Unfortunately, the extraordinary power of antibiotics is threatened by a phenomenon called antimicrobial resistance. What is antimicrobial resistance and is there anything we can do to stop it? In this article, we describe antimicrobial resistance, how it may arise, and how we can help to prevent it by vaccination.

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  • Figure 1 – How antimicrobial resistant (AMR) bacteria arise and spread.
  • (A) Bacteria that cause an infection in the body, for instance in the gut, are mostly antibiotic-sensitive (blue). One of them may develop AMR (red) because of a mutation in its DNA. (B) Antibiotics, here shown as pills, cure the infection and kill almost all of the blue bacteria, but the red ones survive and multiply, until they reach a very high number (see panel C). This is dangerous because antibiotic-resistant bacteria are difficult to kill and can cause a severe infection to the body. (D) The red bacterium can then transfer a piece of DNA to a sensitive bacterium (the blue one), transforming it into a resistant bacterium also.
  • Figure 2 – Vaccines and the immune system.
  • (A) The vaccine (syringe) teaches cells of the immune system what a certain type of bacteria is made of. (B) Immunological memory keeps a record of the bacterium, so that the body is ready to fight again if the same type of bacterium comes back. (C) When the body later encounters the actual bacterium, the trained immune cells can quickly produce antibodies (Y-shaped arrows) to fight the bacterial invaders, which try to defend themselves from the attack.
  • Figure 3 – The importance of vaccination for herd immunity.
  • In the top panel, there are very few vaccinated people (those with a bandage on their arms). There are not enough vaccinated people to protect the ones with the green and yellow shirts, who have not been vaccinated, from catching the virus from someone who is infected (the guy surrounded by red circles). In the bottom panel, there are enough vaccinated people to basically create a shield against the infection for people who, for medical reasons, cannot be vaccinated. This is herd immunity: after enough people are vaccinated, an infection cannot easily spread in the population, so all people, including those who are unvaccinated, are protected. Herd immunity helps with AMR because, if fewer people are infected, less antibiotics will need to be used.

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