Human society entered a new era in its relationship with contagious disease when Alexander Fleming discovered antibiotics in 1928. Infections that had once been fatal could now be treated with relatively simple cures. The innovation profoundly changed warfare, demographics and food systems. But the very ubiquity — and overuse — of antibiotics has given rise to drug-resistant diseases that threaten to roll back some of the gains of the past nine decades. And despite its gravity, the problem has not received the same amount of attention or resources that acute outbreaks of diseases such as Ebola and Zika have gotten. On Feb. 24, however, researchers at Technion-Israel Institute of Technology in Haifa published a groundbreaking discovery in the journal Science that could eventually help treat one of the most prevalent antibiotic-resistant diseases, methicillin-resistant Staphylococcus aureus, or MRSA.
MRSA is a public health problem of growing concern, especially for hospitals. The antibiotics currently in use to treat MRSA infections rely mostly on the same mechanism to kill the bacteria they are designed to target. But bacteria adapt easily, and the ones that the drugs do not eliminate can evolve to resist treatment. Using a variety of cutting-edge microscopy and crystallography tools, the researchers in Haifa determined how the shape of amyloids — proteins that stick together to form thin fibers — control the toxicity of bacteria. The new information could provide a novel mechanism of action that bacteria have not had the opportunity to adapt to, perhaps eventually leading to a new family of antibiotics.
Still, the breakthrough is only the first step in a long process — one that may never be completed without a paradigm shift. Research into new antibiotics has lagged since the 1980s, despite the increasingly glaring need for new drugs. The problem is mostly economic: In the pharmaceutical industry, researchers often have little financial incentive to pursue new antibiotic targets. Consequently, scientists have made only a few promising discoveries in the field in recent years. The crisis of drug-resistant disease, meanwhile, has only worsened. Antibiotic resistance poses a growing threat to many economies. More than half of new tuberculosis cases in multiple former Soviet countries, for example, are resistant to medication. Even so, the improper use and overuse of antibiotics continue largely unabated in agriculture and in human populations. Until competing factors — such as increased demand for meat and poultry in emerging markets — subside, it will be difficult to achieve the international cooperation necessary to truly combat the problem.