Impact on human health

F-Xavier Lescure,
Bichat Hospital, Paris, France
 The discovery of antibiotics, 1928

Penicillium Glaucum

"The thoughtless person playing with penicillin

treatment will be morally responsible for the death
of the man who succumbs to infection with the
penicillin-resistant organism.“
Alexander Flemming

2 F-Xavier Lescure – Impact on human health

 The miracle of antibiotics, first uses

miracle drug image in our

collective unconscious
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 Direct impact during bacterial infection
Effect of penicillin on pourcent survival in
pneumococcal bacteriemia

Austrian R and Gold J, Ann of Intern Med 1964

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 The antibiotics and the modern medicine
Bacteria Surgery

ATB

Oncology Transplantation
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 The adaptation of bacteria for antibiotics

Hearth: -4.5 billion years

Bacteria: -3,8 billion years
Hominides: -7 million years

Antibiotics: -90 years!

Illustration: hominidés.com

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 Bacterial developing antimicrobial resistance

A headlong rush in our own ecosystem

1928 Penicillin à 1940 Staphylococcus peni-R
1950 Tetracycline à 1959 Shigella tetra-R
1960 Methicillin à 1962 Staphylococcus meti-R
1967 gentamicin à 1979 Enterococcus genta-R
1972 Vancomycin à 1988 Enterococcus vanco-R
…
Today
Enterobacteriaceae R to Fluoroquinolones
3GC
Carbapenems
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 The adaptation of bacteria for the human being

1 Human being =
3,8x1013 bacteria

Source: gutmicrobiotaforhealth.com

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 Consequences of microbiota depletion
ATB wipe out both
bad and good
bacteria
1
2

Healthy microbiote 1. Resistance

protects from emergence or acquisition
infections 2. Systemic damage
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 Consequences of bacterial resistance
on morbidity and mortality
UE
385.000 infected patients
25.000 attributable deaths
European Center for Disease Control, 2007

USA
2 millions infected deaths
?
23.000 attributable deaths
Center for Disease Control, 2009-2011
Report WHO, 2014

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 Potential consequences for the future (2015-2050)

Source: The review on AMR, Jim O’Neill 2014

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 Take home messages
1. ATB is considered as a « miracle » drug
Revolution of bacterial infections prognosis
Involvement in overall modern medicine

2. Bacterial adaptative capacity

Bacteria and humans in the same ecosystem
Ecological global vision is essential

3. Potential post-antibiotics era

Negative impact on infectious diseases field
Negative impact on other fields of medicine
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