The spread of superbugs—bacteria that have changed in ways that render antibiotics ineffective against them—is a serious and growing threat around the world, according to the World Health Organization’s first global report on antibiotic resistance.

Once common treatments for everyday intestinal and urinary tract infections, pneumonia, infections in newborns, and diseases like gonorrhea, are no longer working in many people.

The new report on the global threat adds to a Centers for Disease Control and Prevention report showing that two million people in the United States are infected annually with antibiotic-resistant bacteria, and 23,000 of them die each year as a result.

To understand the dangers posed by superbugs, National Geographic spoke with Stuart Levy, chair of the board of the Alliance for the Prudent Use of Antibiotics at Tufts University School of Medicine in Boston.

What exactly are superbugs?

Superbugs are bacteria resistant to one or more antibiotics, and they make it difficult to treat or cure infections that once were easily treated. The antibiotic has lost its ability to control or kill bacterial growth. The bacteria can grow even in a sea of antibiotics because the antibiotic doesn’t touch them. Superbugs can be a big problem for healthcare providers as fewer antibiotics can kill the bacteria and stop them from multiplying.

How are the bacteria able to circumvent the power of antibiotics?

At a molecular level, these tiny organisms are finding ways to outsmart the drugs designed to kill them. In the case of ‘superbugs’ they don’t just survive - they thrive. The bacteria have acquired the ability to destroy the antibiotic in order to protect themselves. They’ve developed a gene for resistance to, say, penicillin, and that gene protects them. A genetic mutation might enable a bacteria to produce enzymes that inactivate antibiotics. A bacteria may have developed resistance to five or six antibiotics, so in treatment, you don’t know which one to choose, and the bacteria accumulate resistance by developing new genes. Genetics is working against us, almost like a science-fiction story.

Why are these superbugs spreading and the threat growing?

We’re continuing to use antibiotics in a bad way. They’re supposed to be used to combat bacteria, not viruses. The common cold is a virus. Any time you use an antibiotic when it’s not needed, you’re pushing antibiotic resistance ahead. People are misusing them in their homes. They may have a stockpile they’ve saved, and think taking an antibiotic will help them with a cold. They’re not helping their cold, and they’re propagating resistance.

What about other uses, such as using antibiotics in animal feed by the meat industry?

This is a big issue. About 80 percent of antibiotics manufactured are given to beef cattle, chickens, and hogs to help them grow better and put on more weight. They excrete them, and the antibiotics largely are not broken down. They enter the environment—the ground and the water—and retain their ability to affect bacteria and promote antibiotic resistance. 

How can we combat the further growth and spread of superbugs?

By using antibiotics only when we need them, and by eliminating their use in animals. There’s a paucity of new antibiotics to take care of these multi-resistant superbugs, so we’re at the mercy of the bacteria.

Are there new antibiotics in development?

Antibiotics are important medicines that have been used to treat bacterial infections for 70 years. They work by either disrupting processes bacteria need to survive or preventing them from reproducing.

But these drugs are becoming less and less effective against bacterial infections and could one day run out. Right now there aren’t any alternatives that could take their place.

It’s conceivable that in 20 years, treatments such as chemotherapy and simple surgery will become impossible because these rely on antibiotics. We are facing a future where a cough or cut could kill once again.

The best way to fight back?

Instead of relying on external responses (antibiotics) to protect us from bacterial and viral infections, we would greatly benefit from keeping our immune system as strong as possible. The immune system, very much like bacteria and viruses, can evolve and adapt. The stagnant and unadaptable response of an antibiotic against a superbug is counter-productive, and it would be ideal to give our bodies a strong immune system to prevent and cure diseases, instead of solely relying on outdated antibiotics.

The World Health Organization recommends that people should use antibiotics only when prescribed by a doctor, that they should complete the full prescription, and never share antibiotics with others or use leftover prescriptions.

Sources: bbc.co.uk, nationalgeographic.com, cbsnews.com