
The Equal Power of Antibiotics And Antimicrobial Resistance

“Antibiotic” is a term that has traditionally been used to describe drugs that target diseases caused by bacterial pathogens. Antibiotics are also referred to as “magic bullets” and” miracle drugs,” since they can diffuse throughout the body and help inhibit the growth of or kill a bacterial pathogen without significantly affecting the metabolism of the infected patient.
The introduction of antibiotics, antivirals, antiparasitics, antiseptics, and disinfectants, as well as an understanding of how to apply these powerful drugs and biocides, has changed the course of humanity. It is almost impossible to count the number of lives that have been extended by these drugs or to fully understand the impact these drugs have had on modern medicine, food and agriculture production, and the environment. However, as indicated by the late Professor Stuart B Levy’s book title, “How miracle drugs are destroying the miracle”, a reckoning is now upon us. Because of the continued process of evolution and natural selection, microbes are gaining the edge on human ingenuity and our collective ability to produce new antimicrobials and, more appropriately, to utilize the antimicrobials within our access. Besides becoming resistant to antibiotics given systemically to patients to cure serious bacterial infections, bacterial pathogens can also demonstrate reduced susceptibility or tolerance to antiseptics or disinfectants. During the “new normal” and continued onslaught of the COVID pandemic, will the broader and more frequent use of antiseptics and disinfectants select for bacterial pathogen populations that demonstrate reduced susceptibility to these biocides?
At this point in history, some have suggested that we have exhausted our ability to use existing microbes to produce new classes of antibiotics, while some have developed culturomics methods to disprove this idea. Synthetic biologists have also harnessed and manipulated antibiotic biosynthetic pathways in a push to develop novel drugs. Chemists continue to modify existing antibiotics and develop new types of synthetic antimicrobials with antibacterial activities and are pining to demonstrate low toxicity followed by clinical trials. Researchers are also investigating excipient non-antibiotic drugs for antimicrobial activity and are developing compounds that act in synergy with existing antibiotics. There is also great interest in re-exploring phage-based therapies for bacterial infections, re-examining the application of metal ions in infection prevention protocols, and exploring traditional medicine approaches to identify novel antimicrobials.
While mechanisms of antibiotic resistance vary in their mechanics and genetic underpinnings, all mechanisms of resistance essentially disallow the antimicrobial from reaching their specific target or targets. Surprisingly to some, the genes that encode antibiotic resistance were present in nature before antibiotics were even introduced to clinical practice, some arising within the antibiotic-producing organisms themselves. The ability of antibiotics to select for bacterial mutants has revealed the degree to which mutations in bacterial genomes can alter essential functions and still lead to resistance expression. Over the past 80 years, scientists from around the world have identified almost every mutation and gene that contributes to antibiotic resistance in bacteria. Today, antimicrobial-resistant pathogens and antimicrobial resistance genes can be identified not only in hospitals and the community, but also in waste treatment plants, rivers and streams, soils, agricultural areas, and throughout human and animal populations. The recent identification of a multiple antibiotic-resistant strain of bacteria from the International Space Station accentuates the picture of how far antimicrobial resistance has spread. Today, around the world, infections caused by multiply antibiotic-resistant pathogens such as the ESKAPE pathogens, known for their propensity to acquire antimicrobial resistance mechanisms, have become the new normal. Astonishingly, researchers have adopted terms such as “extremely drug-resistant” to describe Mycobacterium tuberculosis strains resistant to all first- and second-line antimycobacterial drugs. The spread and evolution of genes encoding for extended- spectrum b-lactamases and carbapenemases represents a good illustration of how single genes can disseminate and create new pathogen threats. The evolution of antimicrobial resistance continues, and our full understanding of the changing epidemiology of infections caused by antimicrobial-resistant pathogens remains critical. We also need to continue to develop pathogen-specific infection control protocols to reduce the spread of these antimicrobial-resistant organisms and utilize methods that improve the stewardship of these incredible miracle drugs.
Researchers continue to identify “new targets” for antimicrobial development and small molecules that inhibit the activity of these targets. Some of these targets in bacteria encode intrinsic gene products that play a “scaffolding” role that allows antibiotic resistance genes to function (e.g., stress response genes, multidrug efflux pumps); others represent novel metabolic pathways (e.g., outer membrane biosynthesis) found only in bacteria and not present in their eukaryotic hosts. Not long ago, microbiologists realized that bacteria are not simple single-celled organisms, but instead are capable of thriving in multicellular-surface-dwelling communities referred to as “biofilms,” and biofilm-enmeshed bacteria are now known for their ability to resist antimicrobials. Research on biofilms is entwined with the elucidation of the intricate process of bacterial communication through two-component regulatory systems, areas rich with antibiotic targets. Researchers have also begun to analyze gene products involved in creating intricate biofilm architecture as novel targets for the development of antibiotics. Today, the literature on molecules that can reduce the ability of bacterial pathogens to produce virulence factors is growing. It is likely that the exciting and controversial research on bacterial persistence and the toxin–antitoxin systems that support this phenomenon will provide us with a myriad of new undeveloped targets. Why can’t new antibiotics be developed that resist the ability of bacteria to become resistant to the selecting antibiotic? Basic research on antibiotic resistance is ongoing, and scientists around the world have produced new libraries of small molecules with the hope of being able to challenge each new antibiotic-resistant bacterial pathogen threat as it emerges. A large number of research groups around the world continue investigations on novel approaches to develop vaccines against M. turberculosis and other antibiotic-resistant pathogens; however, some suggest that success in these research avenues might require another major breakthrough in the biological sciences. The historical success of vaccines in preventing infectious disease continues to lay the foundation for and support these research efforts.
Many scientists, industry leaders, and government officials are in open discussion about a “post-antibiotic era”, at a time when all participants need to remain enthusiastic about new discoveries and maintain funding for research required to fight the forever plague of antibiotic resistance. There are few branches of science similar to antibiotic and antibiotic resistance research, since these efforts require drawing from the strengths of a myriad of scientific disciplines to overcome one of the greatest threats facing humanity.
This premier virtual event sponsored and supported by MPDI and the journal “Antibiotics” hopes to inform and engage participants on a wide variety of subjects associated with antimicrobials, such as:
This free virtual “new normal” event encourages all researchers working on antimicrobial research to register for the meeting and submit an abstract. In light of the COVID-19 pandemic, we are interested in having a number of presentations from researchers working on antiviral agents and vaccines. We are also particularly interested in encouraging young investigators and researchers, postdocs and graduate students, and underrepresented minorities to register and submit an abstract for a presentation during this virtual event. Following this event, all presenters will be able to prepare and submit a full research article to Antibiotics for publication at a greatly reduced price.
On behalf of the entire virtual event Committee, the Antibiotics Chief Editor, the Antibiotics Journal Editorial Board, the Publisher, and Staff, we all look forward to your participation in this event!
Best wishes from Stillwater Oklahoma
Prof. Dr. John E. Gustafson
Professor and Department Head
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Conference Secretariat
Ms. Monica He
Ms. Hellen Wang
MDPI Branch Office, Beijing
E-mail: eca2021@mdpi.com

Edited by Prof. Dr. John E. Gustafson (Oklahoma State University, USA)
Deadline for manuscript submissions: 30 September 2021.
Special Issue Information
Dear Colleagues,
The 1st International Electronic Conference on Antibiotics (ECA 2021) will be held from 8 to 17 May 2021, as a result of the great interest from the community in this Conference Series. The e-conference will be hosted on sciforum.net, an online platform developed by MDPI for scholarly exchange and collaboration.
Many scientists, industry leaders, and government officials are in open discussion about a “postantibiotic era”, at a time when all participants need to remain enthusiastic about new discoveries and maintain funding for the research required to tackle antibiotic resistance. There are few branches of science similar to antibiotic and antibiotic-resistance research, since these efforts require drawing from the strengths of a myriad of scientific disciplines to overcome one of the greatest threats facing humanity.
This premier virtual event, sponsored and supported by MPDI and the journal Antibiotics, hopes to inform and engage participants on a wide variety of subjects associated with antimicrobials, such as:
This Special Issue welcomes selected papers from the ECA 2021 that promote and advance the exciting and rapidly changing field.
Submitted contributions will be subjected to peer review and, upon acceptance, will be published with the aim of rapidly and widely disseminating research results, developments, and applications.
It should be noted that submitted manuscripts should have at least 50% additional, new, and unpublished material as compared to the ECA 2021 published paper.
We look forward to receiving your contributions.
Prof. Dr. John E. Gustafson
Guest Editor