Resistance Efficient antibiotic therapy developed against resistant pathogens

Resistant germs in the dead end - New treatment approach discovered
Antibiotic-resistant pathogens are a growing problem in medicine. For years, the World Health Organization (WHO) has warned of an impending "antibiotic crisis" and there are growing fears "that a post-antibiotic era is imminent," according to the announcement of the Christian-Albrechts-Universität Kiel (CAU). Researchers at Kiel University have now developed new sustainable forms of treatment in antibiotic therapy based on the so-called evolutionary principle.

Due to the increasing resistance of pathogens, bacterial infections, which used to be well-controlled, may not be treatable in the future. According to the WHO, antibiotic-resistant pathogens could become the most frequent causes of non-natural deaths within a few years, the CAU scientists warn. They have now developed a new treatment approach for successful antibiotic therapy in resistant pathogens. The researchers published their results in the journal "Molecular Biology and Evolution".

A new treatment approach can circumvent the antibiotic resistance of pathogens and provide better treatment options. (Image: jarun011 / fotolia.com)

New treatment approaches are urgently sought
The rapid evolution of antibiotic resistance, according to the researchers, represents a dramatic threat to public health. The spectrum of effective antibacterial drugs is shrinking and "life science research is facing the challenge of responding to this risk as quickly as possible with new treatment approaches," she says the CAU. In addition to the development of new antibiotic agents, improved research on the effectiveness of existing antibiotics through new therapeutic approaches is also a focus of research.

Evolutionary adaptation of the germs exploited
The working group on evolutionary ecology and genetics at the CAU has now developed a more efficient treatment approach for antibiotic therapy on the basis of findings from evolutionary medicine. The international research team led by Professor Hinrich Schulenburg investigated how different forms of antibiotic administration affect the evolutionary adaptation of pathogens. In their recent study they were able to prove that the bacterium "Pseudomonas aeruginosa" simultaneously leads to an increased sensitivity to certain other antibiotics, "according to the CAU. This concept of so-called "collateral sensitivity" opens up new perspectives in the fight against multidrug-resistant pathogens.

Alternating sensitivities are an advantage in therapy?
The scientists investigated which antibiotics can lead to mutual sensitivities after resistance formation. For this purpose, an evolution experiment with the pathogen Pseudomonas aeruginosa was carried out in the laboratory. "This bacterium is often multiresistant and particularly threatening to immunocompromised patients," explain the experts. In the experiment, the pathogens were exposed at 12-hour intervals to ever higher doses of eight different antibiotics. As a consequence, the bacterium have each developed a resistance to the various active ingredients.

Combination of antibiotics with promising effects
In a further test step, the researchers tested how the resistant pathogens behaved towards other active ingredients with which they had not previously come into contact. In this way "they were able to determine which resistance formations simultaneously brought sensitivity to another active substance", reports the CAU. The combination of antibiotics, which have different mechanisms of action, has proven to be particularly effective. In particular, a combination of the classes of aminoglycosides and penicillins showed here, according to the researchers, a convincing effect.

Driven pathogens into the evolutionary dead end
According to the researchers, the study of the genetic basis of these resistance forms has shown that "three specific genes of the bacterium ensure that it becomes resistant and susceptible at the same time." This effect can also be used to improve antibiotic therapy. "The combined or alternating use of antibiotics with mutual sensitivities can potentially drive the germs into an evolutionary impasse," explains Prof. Schulenburg.

Hope for a respite during the development of resistance
Once the pathogens become resistant to one agent, they are sensitive to the other and vice versa, Prof. Schulenburg explains the effect. The new results from the laboratory give hope that a targeted combination of the still effective antibiotics can provide at least for a respite in the fight against the very problematic resistance formations, so the conclusion of the scientists. (Fp)