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Just in time for Halloween: A Spooky Story time!
How One Antibiotic Once Considered Weak and Puny Is Helping Superbugs Resist Another.
Rifaximin, once considered a low-risk in causing superbugs, is a medication we use in treating liver disease. It works by attaching to a part of bacteria called RNA polymerase. This attachment stops the bacteria from making the RNA which is essential for their growth and survival. Without proper RNA to produce proteins, bacteria struggle to function and reproduce.
In this case the rifaximin causes the bacteria to mutate or change their RNA polymerase which in turn changes their cell surface (membrane). This can make the membranes less flexible, making it harder for daptomycin—an antibiotic that sticks to the cell membrane—to be able to do its job effectively.
This is important because daptomycin is one of the few antibiotics to treat vancomycin-resistant enterococcus (VRE). This contagious infection causes severe reactions in people who are sick in hospital.
In relation to health it is considered to be a category 5 infection - like how we rate storms or hurricanes we consider the severity, the impact, the rarity and the response.
You can think of this situation as a lock (representing RNA polymerase) that is becoming worn out over time. As the lock deteriorates, keys (representing antibiotics) that are supposed to fit into it may no longer work properly.
When one antibiotic can’t do its job because the target has changed, it can also make it harder for other antibiotics to work. This example shows how complicated the relationships between different treatments are and another way bacteria can develop resistance.
Of course, there are things that even you can do to help slow down this spread—cleaning and drying your hands properly after playing, going to the bathroom, before eating, or touching and cooking food. Plain soap and warm water are always the best options when washing your hands.
If at all possible, avoid the use of antibacterial handwashes! They only worsen things and should only be used in special situations after your hands are clean!
Make sure you get your vaccinations. Only use antibiotics for bacterial infections, not for a cold and flu. Ensure you have all your antibiotics; do not stop because you feel better.
So, how do we know our hands are clean? Perhaps you could get your school to do a fun experiment with glowing powder and lotion like in the video below!
https://www.youtube.com/watch?v=Q87vy1d2F04
Make sure you and your family and friends get your vaccinations and boosters. They will reduce your risk of getting sick, or if you do get sick — it will not be as severe, and you will recover faster — it also protects everyone around you!
Confirm that you and your family only use antibiotics for bacterial infections, not for a cold and flu. If your doctor or GP does tell you you need them, ensure you take all your antibiotics; do not stop just because you feel better.
Feel free to question your doctor, GP, or veterinarian if they have done a swab and culture if they suspect a bacterial infection and how they dispose of all those old antibiotics.
We certainly don’t want all those antibiotics in the ocean or available to bacteria to learn how to gain superpowers in resistance!
You can also help by telling your friends and family how to be safe and make good choices when it comes to their health, their family and friends, their animals, and our planet!
Turner, A.M., Li, L., Monk, I.R. et al. Rifaximin prophylaxis causes resistance to the last-resort antibiotic daptomycin. Nature (2024). https://doi.org/10.1038/s41586-024-08095-4
