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For more than 70 years, | 0:00:04 | 0:00:06 | |
we've waged war against bacterial infections | 0:00:06 | 0:00:08 | |
using antibiotics. | 0:00:08 | 0:00:10 | |
But it's a war we're now losing. | 0:00:12 | 0:00:14 | |
Drug-resistant superbugs... | 0:00:17 | 0:00:19 | |
..are spreading. | 0:00:21 | 0:00:22 | |
To find out what we're up against, | 0:00:24 | 0:00:26 | |
I'm donating my body to an extraordinary experiment. | 0:00:26 | 0:00:29 | |
We are going to unleash bacterial hell on a clone of my body. | 0:00:32 | 0:00:37 | |
Woohoo! | 0:00:37 | 0:00:38 | |
We're hoping this experiment - which is novel and rather spooky - | 0:00:38 | 0:00:42 | |
will give us a whole new insight into the way that bacteria | 0:00:42 | 0:00:45 | |
fight back against antibiotics. | 0:00:45 | 0:00:47 | |
-That is absolutely revolting. -It's fabulous! | 0:00:50 | 0:00:54 | |
I'll search high and low for radical solutions... | 0:00:57 | 0:01:01 | |
Die, bacteria, die! | 0:01:01 | 0:01:03 | |
..to stop the spread of the superbugs. | 0:01:03 | 0:01:06 | |
When I remove the bandage, we should see quite a difference. | 0:01:07 | 0:01:11 | |
Oh, yeah! | 0:01:11 | 0:01:13 | |
Is it too late to prevent antibiotic Armageddon? | 0:01:13 | 0:01:16 | |
Me and my body are about to find out. | 0:01:18 | 0:01:21 | |
Hello. | 0:01:30 | 0:01:31 | |
-Good to see you upright. -Well, it's nice to be upright. | 0:01:31 | 0:01:33 | |
-Come and have a seat. -Thank you. | 0:01:33 | 0:01:35 | |
Hi there. | 0:01:35 | 0:01:36 | |
A month ago, 57-year-old John Shelton was fighting | 0:01:36 | 0:01:40 | |
for his life against a sudden bacterial infection. | 0:01:40 | 0:01:43 | |
HE EXHALES LOUDLY | 0:01:43 | 0:01:45 | |
-Good. -When I arrived here, they opened me up, there was a big mass. | 0:01:45 | 0:01:48 | |
It was very, very infected, | 0:01:48 | 0:01:50 | |
and the bacteria were already working their merry havoc, | 0:01:50 | 0:01:53 | |
trashing my body, shutting down my lungs, | 0:01:53 | 0:01:55 | |
shutting down my kidneys, shutting down everything, pretty much. | 0:01:55 | 0:01:58 | |
-You don't remember anything? -Not a thing. | 0:01:58 | 0:02:01 | |
His lung had almost completely filled up with bacteria, | 0:02:01 | 0:02:04 | |
or infection, and he wasn't able to oxygenate his blood. | 0:02:04 | 0:02:08 | |
Bacteria called staph aureus caused the infection. | 0:02:10 | 0:02:14 | |
They were eventually stopped by a concoction of antibiotics, | 0:02:14 | 0:02:18 | |
but for a while it was touch and go. | 0:02:18 | 0:02:20 | |
-HE INHALES AND EXHALES -Brilliant. | 0:02:20 | 0:02:22 | |
-EMOTIONAL: -When they thought he'd had a brain haemorrhage - | 0:02:22 | 0:02:25 | |
sorry - | 0:02:25 | 0:02:27 | |
that was not a great moment. | 0:02:27 | 0:02:29 | |
You know, just one day at a time, really, and you do place your faith | 0:02:29 | 0:02:32 | |
in the fact there's going to be another antibiotic to come up. | 0:02:32 | 0:02:35 | |
It's interesting that, you know, there is a lot of technology here, | 0:02:35 | 0:02:38 | |
there is obviously a fantastic staff | 0:02:38 | 0:02:40 | |
but, in the end, it's kind of antibiotics versus bacteria. | 0:02:40 | 0:02:44 | |
That's it. Simple as that. | 0:02:44 | 0:02:46 | |
There is no doubt in my mind that, without antibiotics, | 0:02:46 | 0:02:48 | |
I would not be here. | 0:02:48 | 0:02:49 | |
Before the 1940s, up to a third of deaths were caused | 0:02:54 | 0:02:57 | |
by bacterial infection. | 0:02:57 | 0:02:59 | |
A simple cut could kill you. | 0:03:01 | 0:03:03 | |
Then came antibiotics - drugs able to kill bacteria. | 0:03:06 | 0:03:09 | |
The first was penicillin, | 0:03:11 | 0:03:12 | |
discovered by Alexander Fleming in 1928. | 0:03:12 | 0:03:15 | |
More followed. | 0:03:18 | 0:03:20 | |
But then, the pipeline dried up. | 0:03:20 | 0:03:22 | |
No totally new antibiotics | 0:03:24 | 0:03:26 | |
have been found for more than 30 years. | 0:03:26 | 0:03:28 | |
And more and more bacteria are becoming resistant | 0:03:29 | 0:03:32 | |
to our dwindling stock... | 0:03:32 | 0:03:33 | |
..including superbugs, | 0:03:36 | 0:03:38 | |
which threaten to send modern medicine back to the Dark Ages. | 0:03:38 | 0:03:41 | |
Around 700,000 people die every year because of drug-resistant | 0:03:44 | 0:03:48 | |
strains of infections like E. coli | 0:03:48 | 0:03:50 | |
and TB, but that figure could soar to around 10 million a year | 0:03:50 | 0:03:54 | |
by the middle of this century if urgent action isn't taken. | 0:03:54 | 0:03:57 | |
Increasing numbers of people are finding that antibiotics are | 0:03:59 | 0:04:02 | |
no longer working. | 0:04:02 | 0:04:03 | |
People like Slawa. | 0:04:05 | 0:04:06 | |
Slawa's foot is so infected with E. coli. | 0:04:28 | 0:04:31 | |
It could lead to her whole leg being amputated. | 0:04:31 | 0:04:33 | |
Be warned, this glimpse into a post-antibiotic world | 0:04:36 | 0:04:39 | |
is gruesome. | 0:04:39 | 0:04:40 | |
So, if you are squeamish, look away now. | 0:04:40 | 0:04:42 | |
'If we do nothing, | 0:04:56 | 0:04:58 | |
'modern medicine in all its finery will become much more hazardous.' | 0:04:58 | 0:05:03 | |
Cancer therapy, immunotherapy... | 0:05:04 | 0:05:08 | |
I mean, just simple infections like meningitis. | 0:05:08 | 0:05:11 | |
All of these things become more hazardous. | 0:05:11 | 0:05:14 | |
So anti-microbial resistance is the biggest single issue | 0:05:15 | 0:05:19 | |
which is affecting modern medicine at the moment. | 0:05:19 | 0:05:23 | |
In 2015, 34 million prescriptions | 0:05:26 | 0:05:29 | |
were issued for antibiotics in the UK alone. | 0:05:29 | 0:05:32 | |
Have we created superbugs by popping too many of these pills? | 0:05:35 | 0:05:39 | |
I want to find out exactly what antibiotics do and why | 0:05:46 | 0:05:49 | |
bacteria are resisting them. | 0:05:49 | 0:05:51 | |
Time for an unusual experiment. | 0:05:54 | 0:05:56 | |
So I have done a lot of strange things in my time, | 0:05:58 | 0:06:03 | |
and a lot of self experiments, but nothing quite like this. | 0:06:03 | 0:06:07 | |
Now, I'm in pretty good health and I only take antibiotics | 0:06:11 | 0:06:14 | |
when I absolutely have to, but I am going to explore what | 0:06:14 | 0:06:18 | |
a powerful antibiotic does to my body | 0:06:18 | 0:06:21 | |
by making my bacteria visible. | 0:06:21 | 0:06:25 | |
If you'd like to know, I have not washed for two days. | 0:06:25 | 0:06:27 | |
-Great. -All right! Yeah, that's... | 0:06:27 | 0:06:28 | |
When I start doing these things, I always think, | 0:06:28 | 0:06:30 | |
"Oh, it sounds like a good idea," | 0:06:30 | 0:06:32 | |
and when I actually get there, I start to wonder if it really is. | 0:06:32 | 0:06:34 | |
THEY LAUGH | 0:06:34 | 0:06:36 | |
Artist Mellissa Fisher specialises in creating | 0:06:36 | 0:06:39 | |
living biological sculptures. | 0:06:39 | 0:06:42 | |
HE LAUGHS | 0:06:42 | 0:06:44 | |
-Oooh! -Right in between your toes. | 0:06:44 | 0:06:46 | |
With Professor Mark Clements of Lincoln University, | 0:06:46 | 0:06:48 | |
she is leading a team to make | 0:06:48 | 0:06:50 | |
a living bacterial sculpture out of me. | 0:06:50 | 0:06:53 | |
So, that's the...the right here. | 0:06:55 | 0:06:58 | |
Step one - collect material from all over my body | 0:06:58 | 0:07:01 | |
using cotton-wool swabs. | 0:07:01 | 0:07:03 | |
On the skin, you've got over 1,000 different types of bacteria. | 0:07:07 | 0:07:11 | |
And each person is unique. | 0:07:11 | 0:07:13 | |
All different parts of the body will have slightly different | 0:07:13 | 0:07:16 | |
micro flora, depending on whether it's a moist area, | 0:07:16 | 0:07:20 | |
whether it's a dry area, oily area... | 0:07:20 | 0:07:23 | |
By moist, I'm thinking armpits, probably. | 0:07:23 | 0:07:25 | |
Yeah, the very moist areas... | 0:07:25 | 0:07:27 | |
The armpit and the groin are particularly good. | 0:07:27 | 0:07:29 | |
-OK. I might do my own groin. -Yes. Yeah, yeah, yeah. | 0:07:29 | 0:07:32 | |
Next, I'm wrapped in plaster to create a mould of me... | 0:07:37 | 0:07:39 | |
Woo! | 0:07:42 | 0:07:44 | |
..and given a full body wax in the process. | 0:07:44 | 0:07:47 | |
YELLS: Ow! | 0:07:47 | 0:07:49 | |
Do you want your hair back? | 0:07:49 | 0:07:51 | |
THEY LAUGH | 0:07:51 | 0:07:53 | |
Our home for this experiment is Imperial College in London. | 0:08:00 | 0:08:04 | |
It's right on that edge, there. | 0:08:04 | 0:08:06 | |
Here, our team of scientists and sculptors turn my body mould | 0:08:06 | 0:08:10 | |
into possibly the world's largest Petri dish by filling it | 0:08:10 | 0:08:14 | |
with a nutrient-rich jelly called agar. | 0:08:14 | 0:08:17 | |
Good morning, gang. Good morning. | 0:08:20 | 0:08:21 | |
After 12 hours, the agar jelly has set. | 0:08:21 | 0:08:25 | |
It is like Tutankhamen's tomb, isn't it? | 0:08:25 | 0:08:28 | |
All right, so nice and gently, up and out. | 0:08:28 | 0:08:31 | |
There's two parts to this experiment, | 0:08:31 | 0:08:34 | |
which is why my rather spooky clone is split in half. | 0:08:34 | 0:08:37 | |
-The foot's out. -Woohoo! | 0:08:37 | 0:08:40 | |
That is wonderfully weird. | 0:08:40 | 0:08:42 | |
On one side, we want to grow bacteria from all over my skin | 0:08:42 | 0:08:45 | |
to see what's living on me. | 0:08:45 | 0:08:47 | |
It kind of looks like me, I must admit that. | 0:08:47 | 0:08:51 | |
A slightly bald version of me, but... | 0:08:51 | 0:08:52 | |
THEY CHUCKLE Wow. | 0:08:52 | 0:08:55 | |
On the other side, we've added a broad-spectrum antibiotic used | 0:08:56 | 0:09:00 | |
in hospitals against a wide range of infections. | 0:09:00 | 0:09:03 | |
But before we even get the chance to add my bacteria, | 0:09:04 | 0:09:08 | |
something else has snuck in. | 0:09:08 | 0:09:10 | |
What's the green stuff? | 0:09:10 | 0:09:12 | |
-Does this suggest the presence of bacteria already, then? -It does. | 0:09:12 | 0:09:16 | |
On this side, where we don't have any antibiotics, | 0:09:16 | 0:09:19 | |
-then there has been some growth of bacteria. -Right. | 0:09:19 | 0:09:22 | |
So even given the tiniest opportunity, | 0:09:22 | 0:09:24 | |
the bacteria have got stuck in. | 0:09:24 | 0:09:26 | |
They do, they do. Yes, yep, yep. They're everywhere. | 0:09:26 | 0:09:28 | |
We don't know where these green bacteria have come from. | 0:09:31 | 0:09:34 | |
But you can see that the antibiotic embedded on the left-hand side | 0:09:35 | 0:09:39 | |
have so far stopped the invader from growing. | 0:09:39 | 0:09:42 | |
Time to add bacteria collected from my body. | 0:09:45 | 0:09:48 | |
These are all the swabs we've taken of your body. | 0:09:49 | 0:09:52 | |
We're going to start with the bottom of the feet, so number 20. | 0:09:52 | 0:09:55 | |
We want to make visible the invisible microbes - | 0:09:57 | 0:10:00 | |
mainly bacteria - that live on a healthy human. | 0:10:00 | 0:10:02 | |
So we're adding each of my samples to the corresponding | 0:10:03 | 0:10:06 | |
part of my clone. | 0:10:06 | 0:10:09 | |
Let's see what they make of their new home. | 0:10:09 | 0:10:12 | |
OK, we can do this. | 0:10:14 | 0:10:16 | |
Our giant Petri dish is sealed into an airtight case. | 0:10:16 | 0:10:20 | |
It really does feel like they're taking my body and embalming it. | 0:10:20 | 0:10:24 | |
Whoa! | 0:10:24 | 0:10:26 | |
-Oop, the foot's gone. -Oh, no! | 0:10:26 | 0:10:29 | |
Despite a couple of rather nasty foot injuries... | 0:10:31 | 0:10:34 | |
..Microbial Michael is now ready for our experiment to start. | 0:10:36 | 0:10:40 | |
Which microbes will thrive and where? | 0:10:40 | 0:10:42 | |
I would expect, within the next few days, | 0:10:45 | 0:10:47 | |
we'll start seeing them emerge on that side. | 0:10:47 | 0:10:51 | |
The question is, will they be able to overcome the antibiotics | 0:10:51 | 0:10:55 | |
and start growing on this side? | 0:10:55 | 0:10:57 | |
The truth is, we have absolutely | 0:11:00 | 0:11:02 | |
no idea what is going to happen next, because this sort of thing | 0:11:02 | 0:11:06 | |
has never been done on this sort of scale before. | 0:11:06 | 0:11:10 | |
We simply have to wait to find out. | 0:11:10 | 0:11:12 | |
Time for a road trip. | 0:11:21 | 0:11:23 | |
I want to dig deeper into the roots of the crisis. | 0:11:25 | 0:11:28 | |
So why are more and more bacteria becoming resistant? | 0:11:32 | 0:11:36 | |
Is it simply that we're overdoing the antibiotics, | 0:11:36 | 0:11:40 | |
or is it more complicated than that? | 0:11:40 | 0:11:42 | |
I recently read about a fascinating discovery made here, | 0:11:44 | 0:11:47 | |
in New Mexico, which changed the way I think about antibiotic resistance. | 0:11:47 | 0:11:52 | |
Now, this is the spot. Gorgeous, isn't it? | 0:11:53 | 0:11:57 | |
Unfortunately, what I am looking for is not here, on the surface. | 0:11:57 | 0:12:00 | |
It is deep underground. | 0:12:00 | 0:12:02 | |
And I say unfortunately because I am pretty claustrophobic. | 0:12:02 | 0:12:05 | |
My guide is Dr Hazel Barton. | 0:12:08 | 0:12:10 | |
-Hey-ho. Hello. -Hi, Michael, how are you doing? -Glad to see you. | 0:12:10 | 0:12:14 | |
Hazel's a microbiologist who searches for new species | 0:12:14 | 0:12:17 | |
of bacteria living deep under Carlsbad National Park, | 0:12:17 | 0:12:21 | |
in a vast network of caves. | 0:12:21 | 0:12:23 | |
-Thank you. What's the longest you've been down here for? -Eight days. | 0:12:23 | 0:12:28 | |
-Eight days? Cool. Journey to the centre of the earth. -Yeah. | 0:12:28 | 0:12:33 | |
So we're getting off the tourist trail here. | 0:12:33 | 0:12:36 | |
Blimey. It gets narrower, doesn't it? | 0:12:36 | 0:12:39 | |
-It's quite big in here. -Yeah. It's cool. | 0:12:40 | 0:12:44 | |
It was in 2012 in a cave much deeper than I'm able to go that | 0:12:44 | 0:12:49 | |
Hazel's team made their breakthrough discovery. | 0:12:49 | 0:12:53 | |
So the kind of areas that we sample look quite a bit like this. | 0:12:53 | 0:12:58 | |
Hazel took a bunch of bacterial samples from the cave and | 0:13:00 | 0:13:03 | |
sent them off to a lab for analysis. | 0:13:03 | 0:13:05 | |
The results shocked everyone. | 0:13:07 | 0:13:09 | |
So I sent him just 100, right? | 0:13:09 | 0:13:11 | |
He started testing them, and he's like, | 0:13:11 | 0:13:12 | |
"You're not going to believe this, | 0:13:12 | 0:13:14 | |
"but they are resistant to everything." | 0:13:14 | 0:13:16 | |
-Blimey. -Everything that's used... | 0:13:16 | 0:13:17 | |
So these were bacteria you found on a wall in a cave. | 0:13:17 | 0:13:20 | |
Much more remote than this, | 0:13:20 | 0:13:22 | |
-much further away. -That had not seen humans for... | 0:13:22 | 0:13:25 | |
We know humans had never been in there because we know... | 0:13:25 | 0:13:27 | |
we had the exploration records, | 0:13:27 | 0:13:29 | |
so there was no impact on it. | 0:13:29 | 0:13:31 | |
And they were resistant to practically every antibiotic | 0:13:31 | 0:13:34 | |
-that's used in the clinic. -Wow. | 0:13:34 | 0:13:36 | |
That is both incredibly exciting and incredibly scary. | 0:13:36 | 0:13:39 | |
Nobody had ever thought that you would find resistant bacteria | 0:13:39 | 0:13:43 | |
down in the bottom of a bloody cave. | 0:13:43 | 0:13:45 | |
They'd had no interaction with humans, | 0:13:47 | 0:13:50 | |
but the bacteria Hazel found in the cave were resistant to | 0:13:50 | 0:13:53 | |
a huge array of antibiotics we use in modern medicine. | 0:13:53 | 0:13:57 | |
This resistance had clearly evolved over millions of years | 0:14:00 | 0:14:04 | |
without us having anything to do with it. | 0:14:04 | 0:14:06 | |
Why? | 0:14:08 | 0:14:10 | |
Well, it makes sense when you think of antibiotics | 0:14:13 | 0:14:15 | |
not as man-made but the by-product of war between microbes. | 0:14:15 | 0:14:19 | |
They make chemical weapons to destroy their enemies and | 0:14:23 | 0:14:26 | |
steal their resources... | 0:14:26 | 0:14:27 | |
..weapons we have learnt to exploit as antibiotics. | 0:14:31 | 0:14:34 | |
The bacteria living deep in the cave have had millions of years to | 0:14:37 | 0:14:41 | |
evolve weapons that can target and destroy even their toughest rivals. | 0:14:41 | 0:14:46 | |
The battle for scarce resources like nutrients and energy is | 0:14:49 | 0:14:54 | |
particularly brutal down here, in the caves. | 0:14:54 | 0:14:57 | |
It's really starved down here. There's no resources. | 0:14:59 | 0:15:03 | |
It's probably one of the most starved environments on Earth | 0:15:03 | 0:15:06 | |
because, if you think about it, any energy needs to come in through | 0:15:06 | 0:15:10 | |
the rock, and so there's a big competition for nutrients. | 0:15:10 | 0:15:15 | |
The fewer the resources, the more intensely the microbes battle, | 0:15:15 | 0:15:19 | |
and that creates resistance because the bacteria under | 0:15:19 | 0:15:23 | |
attack don't just lie back and die. | 0:15:23 | 0:15:25 | |
When billions of bacterial cells are bombarded, | 0:15:28 | 0:15:31 | |
all it takes is for one cell to mutate its DNA... | 0:15:31 | 0:15:35 | |
..in such a way that the antibiotic can no longer kill it. | 0:15:37 | 0:15:41 | |
This ability to resist then spreads...fast. | 0:15:44 | 0:15:48 | |
So developing resistance to antibiotics is an entirely | 0:15:50 | 0:15:53 | |
natural process, which the bacteria | 0:15:53 | 0:15:56 | |
of Carlsbad have taken to the extreme. | 0:15:56 | 0:15:59 | |
-So, a fierce competition going around us all the time. -Uh-huh. | 0:16:02 | 0:16:05 | |
Microbes producing antibiotics, | 0:16:05 | 0:16:07 | |
but this is all happening millions of years before Fleming and | 0:16:07 | 0:16:11 | |
his friends at Oxford actually developed penicillin. | 0:16:11 | 0:16:13 | |
Right. And that's what we discovered down here that kind of blew | 0:16:13 | 0:16:16 | |
everybody's mind, is the thought that resistance and that antibiotic | 0:16:16 | 0:16:20 | |
battle is because we've been using antibiotics, | 0:16:20 | 0:16:23 | |
but it can't be down here cos these guys have never seen | 0:16:23 | 0:16:26 | |
the antibiotics that Fleming, everyone has made since. | 0:16:26 | 0:16:30 | |
But if resistance to antibiotics arises naturally, | 0:16:33 | 0:16:36 | |
what does that mean for us? | 0:16:36 | 0:16:38 | |
Let's see if Microbial Michael has any answers. | 0:16:47 | 0:16:50 | |
Bloody hell. That is grotesque. | 0:17:02 | 0:17:04 | |
We've left him alone for a few days, | 0:17:09 | 0:17:11 | |
and the bacteria swabbed from my body have run riot. | 0:17:11 | 0:17:15 | |
I'm hoping immunologist Dr Sheena Cruickshank | 0:17:19 | 0:17:21 | |
from Manchester University | 0:17:21 | 0:17:23 | |
can help me make sense of what's happening. | 0:17:23 | 0:17:26 | |
Michael, meet Michael. | 0:17:30 | 0:17:32 | |
That is so weird. | 0:17:32 | 0:17:33 | |
-I just think it's so exciting to be able to see... -It is both exciting | 0:17:35 | 0:17:38 | |
and really, really disgusting, I have to say. | 0:17:38 | 0:17:41 | |
There's something, as well, about seeing me down there, effectively | 0:17:41 | 0:17:44 | |
covered with this stuff. | 0:17:44 | 0:17:45 | |
I think you should be looking at this as showing you the | 0:17:45 | 0:17:49 | |
amazing life that is living on you. | 0:17:49 | 0:17:52 | |
We're starting on the right-hand side, | 0:17:52 | 0:17:55 | |
where there's no added antibiotic. | 0:17:55 | 0:17:57 | |
That means these different-coloured bacteria should be part of my | 0:17:58 | 0:18:01 | |
normal skin flora. | 0:18:01 | 0:18:03 | |
Look at this amazing white, blue... | 0:18:03 | 0:18:05 | |
OK, I thought white, blue meant there was nothing growing there, | 0:18:05 | 0:18:08 | |
but there is something? | 0:18:08 | 0:18:09 | |
No, that's actually growing over the blue, | 0:18:09 | 0:18:11 | |
and that's really exciting | 0:18:11 | 0:18:13 | |
-because it suggests that perhaps it is battling with the blue. -OK. | 0:18:13 | 0:18:17 | |
It's competing with it. | 0:18:17 | 0:18:19 | |
And I think that's Staphylococcus epidermidis, | 0:18:19 | 0:18:22 | |
and that's a really common skin bacteria. | 0:18:22 | 0:18:24 | |
And we actually know that some bacteria make anti-bacterials, | 0:18:24 | 0:18:27 | |
so they compete with each other and they kill other bacteria. | 0:18:27 | 0:18:30 | |
So, perhaps that's what's happening here. | 0:18:30 | 0:18:32 | |
So we're kind of seeing warfare in action between the bacteria. | 0:18:32 | 0:18:35 | |
Absolutely. | 0:18:35 | 0:18:36 | |
What this side of this experiment is showing us very colourfully is | 0:18:37 | 0:18:41 | |
how bacteria in a healthy body keep each other in check as they | 0:18:41 | 0:18:45 | |
battle for space and nutrients. | 0:18:45 | 0:18:47 | |
Because most bacteria living on us are harmless or beneficial, | 0:18:49 | 0:18:52 | |
in a balanced ecosystem, they leave limited room | 0:18:52 | 0:18:55 | |
for the bad bugs - the pathogens. | 0:18:55 | 0:18:58 | |
Behind the scenes, our team is identifying exactly what's grown | 0:19:00 | 0:19:04 | |
using DNA analysis. | 0:19:04 | 0:19:07 | |
And they found something potentially nasty up my nose. | 0:19:07 | 0:19:11 | |
This is really interesting. | 0:19:13 | 0:19:14 | |
If you look around your nose there, around your nostril, | 0:19:14 | 0:19:17 | |
there is Staphylococcus aureus growing there. | 0:19:17 | 0:19:20 | |
That is the sort of orangey... | 0:19:20 | 0:19:22 | |
-They call it the golden staph, don't they? -Yeah. | 0:19:22 | 0:19:24 | |
A lot of people - about a third of people - | 0:19:24 | 0:19:26 | |
have Staphylococcus aureus in their nostrils. | 0:19:26 | 0:19:28 | |
It's quite, quite normal. | 0:19:28 | 0:19:30 | |
But a lot of people associate it with being a pathogen. | 0:19:30 | 0:19:34 | |
In the right circumstances, it's fine. | 0:19:34 | 0:19:36 | |
In the wrong, it can be deadly. | 0:19:36 | 0:19:38 | |
If our immune system takes a hit, some species amongst our bacteria | 0:19:41 | 0:19:45 | |
can get out of control and do serious harm. | 0:19:45 | 0:19:48 | |
That's what then relatives of the golden staph aureus in my nose did | 0:19:51 | 0:19:55 | |
to patient John Shelton, | 0:19:55 | 0:19:57 | |
overrunning his body's defences and very nearly killing him. | 0:19:57 | 0:20:01 | |
On this side of the experiment, | 0:20:05 | 0:20:07 | |
my bacteria are keeping each other in check, just as I'd expect. | 0:20:07 | 0:20:11 | |
But on the other side, it's a different story. | 0:20:19 | 0:20:23 | |
So we are coming across to the side which was actually enriched | 0:20:23 | 0:20:27 | |
-with antibiotics, wasn't it? -Mm-hm. | 0:20:27 | 0:20:29 | |
Peer past the fog of condensation caused by | 0:20:30 | 0:20:34 | |
so much microbial activity, | 0:20:34 | 0:20:36 | |
and our time-lapse cameras reveal that even on the side which | 0:20:36 | 0:20:40 | |
is heavily impregnated with broad-spectrum antibiotics, | 0:20:40 | 0:20:44 | |
there are still bacteria growing. | 0:20:44 | 0:20:46 | |
Though, admittedly, there are a lot less of them. | 0:20:49 | 0:20:52 | |
Here, just here, at the top of the head, you can see, | 0:20:58 | 0:21:02 | |
there's actually quite a few clear zones. | 0:21:02 | 0:21:05 | |
So that suggests that certainly the antibiotic is doing its job | 0:21:05 | 0:21:08 | |
in areas, and it's certainly been controlling in this area | 0:21:08 | 0:21:12 | |
the blue, which was kind of taking over everything. | 0:21:12 | 0:21:16 | |
One of the things that is very striking to me | 0:21:17 | 0:21:19 | |
-is that on the other side, there's competition going on... -Mm-hm. | 0:21:19 | 0:21:22 | |
..which suggests that wiping out all your bacteria is | 0:21:22 | 0:21:26 | |
a bad idea because actually you do want sort of good bacteria, | 0:21:26 | 0:21:30 | |
if you like, to kind of compete with the pathogens and stop them | 0:21:30 | 0:21:33 | |
-encroaching. -Absolutely. | 0:21:33 | 0:21:35 | |
What this demonstrates very clearly is you shouldn't take | 0:21:38 | 0:21:41 | |
a broad-spectrum antibiotic unless you really need to. | 0:21:41 | 0:21:45 | |
As the caves of New Mexico showed us, | 0:21:51 | 0:21:54 | |
the more bacteria are attacked, the more they will resist. | 0:21:54 | 0:21:58 | |
But there is also an unfortunate fact - that broad-spectrum | 0:22:04 | 0:22:07 | |
antibiotics carpet bomb friend and foe indiscriminately. | 0:22:07 | 0:22:11 | |
There is a lot of collateral damage amongst the benign | 0:22:13 | 0:22:16 | |
and beneficial species. | 0:22:16 | 0:22:18 | |
This accelerates resistance because surviving pathogens now have | 0:22:24 | 0:22:28 | |
less competition for resources, | 0:22:28 | 0:22:30 | |
and they can colonise the whole battlefield. | 0:22:30 | 0:22:34 | |
If one of these survivors is resistant to multiple drugs | 0:22:37 | 0:22:41 | |
and potentially harmful, it's a superbug. | 0:22:41 | 0:22:43 | |
The bad news for me is the team have found two growing on my clone. | 0:22:46 | 0:22:51 | |
One that is particularly interesting is an organism called | 0:22:51 | 0:22:54 | |
Enterococcus faecium. | 0:22:54 | 0:22:56 | |
And this is an entirely normal part of our gut flora. | 0:22:56 | 0:23:00 | |
But if it gets into the wrong parts of the body, | 0:23:00 | 0:23:02 | |
or if the person has a compromised immune system, | 0:23:02 | 0:23:06 | |
it can cause really serious invasive infections. | 0:23:06 | 0:23:09 | |
And because it's inherently resistant to antibiotics, | 0:23:09 | 0:23:12 | |
it's very, very hard to treat. | 0:23:12 | 0:23:13 | |
The team has also found Pseudomonas growing through the antibiotic. | 0:23:16 | 0:23:20 | |
It's not part of my skin flora, but a travelling pathogen | 0:23:23 | 0:23:26 | |
that can cause infection and pneumonia | 0:23:26 | 0:23:28 | |
if it gets inside our bodies... | 0:23:28 | 0:23:30 | |
..say, through an open wound. | 0:23:32 | 0:23:34 | |
Microbial Michael has shown me superbugs on my skin. | 0:23:37 | 0:23:41 | |
But what about inside me, where some really important stuff happens? | 0:23:45 | 0:23:50 | |
I've sent off a very personal sample to be analysed. | 0:23:52 | 0:23:57 | |
So, we've received our poo sample from Michael. | 0:23:59 | 0:24:03 | |
And we want to have a look to determine if he's got any | 0:24:03 | 0:24:06 | |
resistant bacteria. | 0:24:06 | 0:24:07 | |
When you think about antibiotics, | 0:24:09 | 0:24:10 | |
most of these us will take these | 0:24:10 | 0:24:12 | |
orally, and also we'll take it | 0:24:12 | 0:24:14 | |
with a drink of water, | 0:24:14 | 0:24:15 | |
so therefore, the antibiotics will hit the gut first. | 0:24:15 | 0:24:18 | |
Our guts and intestines are home to at least 1,000 different | 0:24:21 | 0:24:24 | |
species of bacteria. | 0:24:24 | 0:24:25 | |
But now there's new research about what can happen to them when | 0:24:28 | 0:24:32 | |
we take antibiotics. | 0:24:32 | 0:24:33 | |
The striking thing about | 0:24:35 | 0:24:38 | |
a healthy person who takes an antibiotic | 0:24:38 | 0:24:40 | |
is that, in all likelihood, | 0:24:40 | 0:24:43 | |
they will get resistant bacteria | 0:24:43 | 0:24:46 | |
in their tummies - in their colon, actually - | 0:24:46 | 0:24:49 | |
after about seven days. | 0:24:49 | 0:24:52 | |
And with some antibiotics, | 0:24:52 | 0:24:53 | |
these resistant bugs last in their tummies for up to a year. | 0:24:53 | 0:24:59 | |
That sounds like another compelling reason not to take antibiotics | 0:25:01 | 0:25:05 | |
unless you really have to. | 0:25:05 | 0:25:07 | |
I'm hoping my gut doesn't contain resistant bacteria. | 0:25:08 | 0:25:12 | |
Right, so you had my poo samples. What did you find? | 0:25:12 | 0:25:15 | |
-So... -'Lindsay has tried growing my gut bacteria | 0:25:15 | 0:25:19 | |
'on plates containing four clinically important antibiotics.' | 0:25:19 | 0:25:23 | |
-Presumably, these plates should be clear of bacteria. -Yeah. | 0:25:23 | 0:25:27 | |
If you had susceptible bacteria, then they should be clear, | 0:25:27 | 0:25:29 | |
but as you can see, there's multiple colonies on each of | 0:25:29 | 0:25:32 | |
the plates, which would suggest they are resistant to that antibiotic. | 0:25:32 | 0:25:35 | |
That does surprise me. | 0:25:35 | 0:25:36 | |
I haven't had that many antibiotics in my life. | 0:25:36 | 0:25:38 | |
Well, I was going to ask, | 0:25:38 | 0:25:39 | |
when was the last time you had a course of antibiotics? | 0:25:39 | 0:25:41 | |
Probably about four years ago. | 0:25:41 | 0:25:43 | |
Yeah, OK, so that's quite a long time ago, | 0:25:43 | 0:25:45 | |
but maybe does correlate with some of the data that we've shown. | 0:25:45 | 0:25:49 | |
That's a nasty surprise. I've got bacteria growing inside me | 0:25:49 | 0:25:52 | |
which are resistant to all four antibiotics - | 0:25:52 | 0:25:55 | |
one of which I've never even taken. | 0:25:55 | 0:25:58 | |
I know the name, but I think I would know if I'd had it. | 0:25:58 | 0:26:01 | |
Yeah, you would probably know if you had vancomycin. | 0:26:01 | 0:26:04 | |
It's a last-resort antibiotic, | 0:26:04 | 0:26:05 | |
-so this is what you get if you're really ill. -OK. | 0:26:05 | 0:26:08 | |
That is really quite worrying, I must admit. | 0:26:08 | 0:26:11 | |
And what is really quite striking is the fact that the main | 0:26:11 | 0:26:15 | |
culprit in terms of having antibiotic resistant genes | 0:26:15 | 0:26:18 | |
is E. coli. | 0:26:18 | 0:26:19 | |
Blimey. I have E. coli in my gut which is resistant to everything. | 0:26:19 | 0:26:23 | |
-Yes. -Blimey. That's bad news! | 0:26:23 | 0:26:25 | |
OK. That's not what I was hoping to hear. | 0:26:25 | 0:26:28 | |
There are lots of different strains of E. coli. A few are very nasty. | 0:26:32 | 0:26:36 | |
We don't know what strain I've got, | 0:26:38 | 0:26:41 | |
but we do know it is very resistant. | 0:26:41 | 0:26:44 | |
Now, that was an unpleasant surprise. | 0:26:45 | 0:26:47 | |
It's one thing to talk about antibiotic resistance, | 0:26:47 | 0:26:50 | |
but to discover that I've got these E. coli, | 0:26:50 | 0:26:53 | |
and they are resistant to all sorts of antibiotics is, | 0:26:53 | 0:26:56 | |
I must admit, worrying. | 0:26:56 | 0:26:57 | |
I'm not really worried by the fact it's E. coli. | 0:26:59 | 0:27:03 | |
It's the resistance bit. | 0:27:03 | 0:27:05 | |
Why? | 0:27:05 | 0:27:06 | |
Well, once resistance emerges in one species of bacteria, | 0:27:06 | 0:27:10 | |
it can spread to other species. | 0:27:10 | 0:27:12 | |
It's all to do with the way they exchange genes, | 0:27:12 | 0:27:15 | |
as Sheena can explain. | 0:27:15 | 0:27:18 | |
We get all our DNA from our parents, - so you get half from your mum, | 0:27:18 | 0:27:21 | |
half from your dad. That's your lot. You don't get any more. | 0:27:21 | 0:27:25 | |
You might see that chap down the corridor who never catches | 0:27:25 | 0:27:28 | |
a cold and think, "Oh, I'd love to be able to steal that ability." | 0:27:28 | 0:27:31 | |
But we can't. | 0:27:31 | 0:27:33 | |
But imagine you could. | 0:27:33 | 0:27:34 | |
Imagine you could steal DNA and swap DNA just as easily as you swap your | 0:27:34 | 0:27:39 | |
e-mail or your telephone number. And basically, bacteria can do that. | 0:27:39 | 0:27:44 | |
It's called horizontal gene transfer, | 0:27:44 | 0:27:46 | |
and this is the way antibiotic resistance can spread. | 0:27:46 | 0:27:50 | |
Using this trick, | 0:27:55 | 0:27:56 | |
different species of bacteria share genetic information... | 0:27:56 | 0:27:59 | |
..including the ability to resist a specific antibiotic. | 0:28:02 | 0:28:05 | |
The bacteria don't even have to be touching because they can also | 0:28:09 | 0:28:13 | |
pick up bits of genetic information left in the environment around them. | 0:28:13 | 0:28:17 | |
That means the E. coli inside me could, theoretically, | 0:28:22 | 0:28:25 | |
share its genes with other species... | 0:28:25 | 0:28:27 | |
..and turn my gut into a factory of resistant bacteria. | 0:28:28 | 0:28:32 | |
And we have plenty of evidence that really does happen. | 0:28:36 | 0:28:40 | |
Resistance is spreading from microbe to microbe. | 0:28:40 | 0:28:43 | |
Wherever antibiotics are used intensively, such as hospitals, | 0:28:45 | 0:28:49 | |
more resistant bacteria emerge. | 0:28:49 | 0:28:52 | |
They share their genes. They multiply. | 0:28:52 | 0:28:54 | |
This explains how superbugs like MRSA and E. coli can resist | 0:28:56 | 0:29:01 | |
so many different drugs. | 0:29:01 | 0:29:02 | |
And they don't stay confined inside our hospitals... | 0:29:04 | 0:29:07 | |
..because, like us, bacteria can travel. | 0:29:08 | 0:29:11 | |
And people aren't the only source of resistant bacteria. | 0:29:13 | 0:29:17 | |
Globally, half of all antibiotics are given to animals. | 0:29:17 | 0:29:21 | |
COW LOWS | 0:29:21 | 0:29:23 | |
In countries like America and China, | 0:29:23 | 0:29:25 | |
they are even widely used as growth promoters. | 0:29:25 | 0:29:28 | |
COW LOWS | 0:29:28 | 0:29:30 | |
Animals and humans alike pump out more and more resistant bacteria. | 0:29:32 | 0:29:37 | |
But how far is the wave of resistance spreading? | 0:29:39 | 0:29:42 | |
In Cornwall, | 0:29:49 | 0:29:50 | |
a pioneering new study has found evidence that resistant bacteria are | 0:29:50 | 0:29:55 | |
travelling through our waterways, out to sea, and then back again, | 0:29:55 | 0:30:00 | |
into humans. | 0:30:00 | 0:30:01 | |
Hi. I'm going to talk to you about the Beach Bums survey. | 0:30:02 | 0:30:07 | |
We recruited 300 people to our survey - | 0:30:07 | 0:30:11 | |
surfers and people who don't surf, as well - | 0:30:11 | 0:30:16 | |
and asked them to collect swabs of their faecal material. | 0:30:16 | 0:30:20 | |
You take the swab, send it back to us in the post, | 0:30:20 | 0:30:23 | |
and then we test it for the presence of resistant bacteria. | 0:30:23 | 0:30:26 | |
What we found is that a greater proportion of surfers have | 0:30:27 | 0:30:31 | |
resistant bacteria in their guts compared to people who don't surf. | 0:30:31 | 0:30:35 | |
We think that, if you swallow a lot of seawater, | 0:30:39 | 0:30:42 | |
that some of the bacteria that are present in the seawater | 0:30:42 | 0:30:45 | |
survive and go on to live inside...inside your gut. | 0:30:45 | 0:30:48 | |
If resistant bacteria can make it out to sea and then into surfers, | 0:30:52 | 0:30:56 | |
I could have picked up the resistant E. coli in my gut from, well, | 0:30:56 | 0:31:00 | |
just about anywhere. | 0:31:00 | 0:31:01 | |
The good news is that in the UK and some other countries, | 0:31:08 | 0:31:11 | |
antibiotic use in farming has started to come down. | 0:31:11 | 0:31:15 | |
But there's no putting the genie back in the bottle. | 0:31:20 | 0:31:23 | |
Resistant bugs are in our bodies and all around us. | 0:31:25 | 0:31:28 | |
There isn't any doubt that we have been complacent | 0:31:31 | 0:31:35 | |
and we have walked into this huge problem. | 0:31:35 | 0:31:39 | |
But humans have been between a rock and a hard place here. | 0:31:40 | 0:31:44 | |
They want to use antibiotics, but as soon as they use them, | 0:31:44 | 0:31:47 | |
resistance arises. | 0:31:47 | 0:31:49 | |
Because they are life-saving, if you stop using antibiotics, people die. | 0:31:49 | 0:31:55 | |
MONITOR SIGNALS FLATLINE | 0:31:57 | 0:31:59 | |
At the end of the day, | 0:31:59 | 0:32:01 | |
we need new antibiotics. | 0:32:01 | 0:32:03 | |
Trouble is, modern medicine hasn't found | 0:32:07 | 0:32:10 | |
a totally new type of antibiotic in more than 30 years. | 0:32:10 | 0:32:13 | |
Each new drug involves a long and complex process of chemical | 0:32:16 | 0:32:19 | |
engineering and testing. | 0:32:19 | 0:32:21 | |
They are certainly difficult to make from scratch. | 0:32:24 | 0:32:28 | |
Instead, scientists have relied on finding new microbes, | 0:32:28 | 0:32:31 | |
growing them and then trying to identify and extract any | 0:32:31 | 0:32:34 | |
chemicals with potential antibiotic properties. | 0:32:34 | 0:32:37 | |
One problem is that many microbes simply won't grow using | 0:32:43 | 0:32:46 | |
traditional lab techniques. | 0:32:46 | 0:32:48 | |
And without being able to grow them, | 0:32:48 | 0:32:50 | |
we will struggle to develop new antibiotics. | 0:32:50 | 0:32:53 | |
Time to search out some novel solutions. | 0:33:00 | 0:33:03 | |
Here in Boston, I've come to meet a maverick microbiologist who, | 0:33:05 | 0:33:09 | |
I'm told, has developed a whole new way of growing bacteria | 0:33:09 | 0:33:13 | |
and, in the process, discovered possibly the first new class | 0:33:13 | 0:33:16 | |
of antibiotics in decades. | 0:33:16 | 0:33:18 | |
Dr Slava Epstein has promised to show me his secret. | 0:33:20 | 0:33:24 | |
Do you see a suitable spot somewhere around here? | 0:33:26 | 0:33:28 | |
We can find a suitable spot just about anywhere on the planet. | 0:33:28 | 0:33:34 | |
So, the first thing that happens, we collect soil. | 0:33:34 | 0:33:37 | |
We collect soil. | 0:33:37 | 0:33:39 | |
We don't have to have too much of it | 0:33:39 | 0:33:41 | |
because every gram of soil is | 0:33:41 | 0:33:44 | |
easily a billion or 10 billion cells. | 0:33:44 | 0:33:46 | |
But what we're going to do with the cells in the lab is going to | 0:33:46 | 0:33:50 | |
be very different. | 0:33:50 | 0:33:51 | |
Two thirds of our most important antibiotics were originally found | 0:33:52 | 0:33:56 | |
in microbes living in soil, a well which looked like it had run dry. | 0:33:56 | 0:34:02 | |
But now, Slava has thrown out the 130-year-old Petri dish and | 0:34:02 | 0:34:07 | |
replaced it with a device that, to my eyes, looks equally low-tech - | 0:34:07 | 0:34:11 | |
a plastic tray into which his assistant adds a diluted | 0:34:11 | 0:34:15 | |
solution of the soil sample. | 0:34:15 | 0:34:18 | |
In this vial, there is about 100 cells. | 0:34:18 | 0:34:20 | |
-100 cells down from a few billion? -Yes. -And these are all bacteria? | 0:34:20 | 0:34:23 | |
These are all bacteria. | 0:34:23 | 0:34:24 | |
It is starting from this point that things are going to be different | 0:34:24 | 0:34:27 | |
because we are not going to put them into a Petri dish. | 0:34:27 | 0:34:29 | |
Instead, we are preparing this device. | 0:34:29 | 0:34:33 | |
-It is just a collection of wells with a porous bottom. -OK. | 0:34:33 | 0:34:37 | |
So, I have to say, this doesn't look that radical. | 0:34:39 | 0:34:42 | |
Not being a microbiologist, | 0:34:42 | 0:34:44 | |
I probably don't understand why it is so different. | 0:34:44 | 0:34:47 | |
It is radical because | 0:34:47 | 0:34:49 | |
-have I ever mentioned any word nutrient? -No. | 0:34:49 | 0:34:53 | |
-Because there is none. -OK. -We don't need them. | 0:34:53 | 0:34:56 | |
Unlike the Petri dish, we do not. | 0:34:56 | 0:34:58 | |
We do not want to create artificial conditions. | 0:34:58 | 0:35:01 | |
-Now that will go into the soil... -OK. | 0:35:03 | 0:35:06 | |
-..from which these cells came from. -Ah! | 0:35:06 | 0:35:10 | |
-That is clever. -So inside... Thank you. | 0:35:10 | 0:35:14 | |
-Inside... -I get it at last. -..chemically... -OK, yeah. | 0:35:14 | 0:35:18 | |
..it will not be different from the outside. | 0:35:18 | 0:35:20 | |
So if the cells can grow in nature... | 0:35:21 | 0:35:23 | |
-You are returning them to their normal environment... -Yes. | 0:35:23 | 0:35:25 | |
..rather than sticking them in agar. | 0:35:25 | 0:35:27 | |
-They should be able to grow inside. -Ah! | 0:35:27 | 0:35:29 | |
By putting the bacteria back into the soil they came from, | 0:35:31 | 0:35:35 | |
Slava is encouraging them to grow just like they would in the wild. | 0:35:35 | 0:35:39 | |
Compared to using agar jelly, | 0:35:39 | 0:35:42 | |
the results are astounding. | 0:35:42 | 0:35:44 | |
The difference in colony count between the two methods | 0:35:44 | 0:35:46 | |
-is 30,000%. -Wow. | 0:35:46 | 0:35:49 | |
You can grow 30,000% more cells if you do it this way than if | 0:35:49 | 0:35:54 | |
you do it the conventional way. | 0:35:54 | 0:35:56 | |
That's correct. | 0:35:56 | 0:35:57 | |
This technique means they can grow bacteria that would normally | 0:35:58 | 0:36:01 | |
be missed, and they have created versions of the device to | 0:36:01 | 0:36:05 | |
look for novel bacteria in all sorts of environments, | 0:36:05 | 0:36:08 | |
including the human mouth. | 0:36:08 | 0:36:11 | |
-Very neat. -It's also very simple. | 0:36:11 | 0:36:14 | |
You can really build this device in your garage. | 0:36:14 | 0:36:19 | |
What excites me about Slava's discovery is it means | 0:36:20 | 0:36:23 | |
there's clearly a whole world of microbes out there, | 0:36:23 | 0:36:27 | |
just waiting to be found. | 0:36:27 | 0:36:29 | |
Imagine you are an ancient Greek looking up at the sky. | 0:36:32 | 0:36:34 | |
You'd only see a tiny handful of the stars and planets that are | 0:36:34 | 0:36:38 | |
actually out there. | 0:36:38 | 0:36:39 | |
In some ways, we are a bit like that ancient Greek when it comes to | 0:36:39 | 0:36:43 | |
the microbial world. | 0:36:43 | 0:36:44 | |
There is a vast galaxy of tiny creatures, | 0:36:44 | 0:36:48 | |
and we are currently only aware of a very small proportion of them. | 0:36:48 | 0:36:52 | |
We need to start looking for new antibiotics much further | 0:37:00 | 0:37:03 | |
afield than the soil under our feet. | 0:37:03 | 0:37:05 | |
Some scientists think seabeds could be rich in antibacterial potential. | 0:37:08 | 0:37:13 | |
Easier pickings are washing up on our shores with evidence | 0:37:16 | 0:37:20 | |
clips of seaweed contain microbial agents effective against MRSA. | 0:37:20 | 0:37:24 | |
And deep in the caves under New Mexico, Hazel Barton's team | 0:37:27 | 0:37:31 | |
has discovered that millions of years of intense bacterial | 0:37:31 | 0:37:34 | |
warfare has produced chemicals we may be able to use. | 0:37:34 | 0:37:39 | |
One of the organisms that we found | 0:37:40 | 0:37:43 | |
made 38 novel antimicrobial compounds, | 0:37:43 | 0:37:46 | |
-of which three were new antibiotics. -Hm. | 0:37:46 | 0:37:49 | |
So the potential is that people turn their attention to these | 0:37:49 | 0:37:52 | |
extreme environments - like caves, like the deep ocean, like, | 0:37:52 | 0:37:55 | |
you know, the Arctic - we are going to have this explosion | 0:37:55 | 0:37:58 | |
in new compounds over the next ten, 15 years. | 0:37:58 | 0:38:02 | |
The hunt for antibiotics is not just in extreme environments | 0:38:07 | 0:38:11 | |
but anywhere that's home to novel microbes. | 0:38:11 | 0:38:14 | |
Professor Matt Hutchings has found what could be | 0:38:15 | 0:38:18 | |
a novel antibiotic in... | 0:38:18 | 0:38:21 | |
an ant farm. | 0:38:21 | 0:38:22 | |
It's an amazing system. | 0:38:25 | 0:38:26 | |
They've been using antibiotics for 50 to 60 million years. | 0:38:26 | 0:38:29 | |
The secret Matt's team has unlocked is in the relationship | 0:38:32 | 0:38:36 | |
between these leaf-cutter ants and their food source. | 0:38:36 | 0:38:39 | |
The fungus is the only food for this whole ant colony. | 0:38:40 | 0:38:43 | |
And if they smell any foreign fungi that might cause disease in there, | 0:38:43 | 0:38:47 | |
they cut it out, they carry it over to this part, | 0:38:47 | 0:38:50 | |
which is the waste dump, which is usually outside the nest. | 0:38:50 | 0:38:53 | |
They rub their bodies against it and then they dig it back into | 0:38:53 | 0:38:56 | |
the ground. | 0:38:56 | 0:38:57 | |
The really interesting thing for us is the reason they rub their bodies | 0:38:57 | 0:39:00 | |
against it is because their bodies are covered in | 0:39:00 | 0:39:02 | |
antibiotic-producing bacteria that the ants can use to defend | 0:39:02 | 0:39:05 | |
their fungus against disease. | 0:39:05 | 0:39:07 | |
Matt's lab has extracted a couple of experimental new antibiotics | 0:39:11 | 0:39:15 | |
from the bacteria on the ants. | 0:39:15 | 0:39:17 | |
They haven't yet been tested on humans. | 0:39:21 | 0:39:24 | |
So, time for part two of our experiment, using my body - | 0:39:28 | 0:39:32 | |
well, bits of my body - to test out some of these novel drugs. | 0:39:32 | 0:39:36 | |
We are creating a biohazard and infecting different parts of | 0:39:40 | 0:39:43 | |
me with three of the most common multi-drug-resistant superbugs - | 0:39:43 | 0:39:48 | |
MRSA, salmonella and Pseudomonas. | 0:39:48 | 0:39:53 | |
Where should I put it, then? | 0:39:53 | 0:39:54 | |
-On the fingers. -On the fingers, in there? OK. | 0:39:54 | 0:39:56 | |
Then, we'll try to cure them. | 0:39:56 | 0:39:58 | |
First, I want to see if ant antibiotic can tackle | 0:40:01 | 0:40:05 | |
an infection of MRSA... | 0:40:05 | 0:40:06 | |
..on my face. | 0:40:10 | 0:40:11 | |
MRSA can cause skin infections. | 0:40:15 | 0:40:17 | |
If it gets inside us and attacks our lungs, | 0:40:18 | 0:40:21 | |
it can be particularly dangerous. | 0:40:21 | 0:40:23 | |
We've given my face a few days for the bacteria to take hold. | 0:40:25 | 0:40:28 | |
So, this is the ant antibiotic, and it is genuinely new and | 0:40:32 | 0:40:37 | |
really rather exciting because, as you can see, it is really working, | 0:40:37 | 0:40:41 | |
because that white disc on my forehead there, | 0:40:41 | 0:40:43 | |
there's a zone of death around it which suggests | 0:40:43 | 0:40:46 | |
that it really is killing | 0:40:46 | 0:40:47 | |
all those bacteria. | 0:40:47 | 0:40:49 | |
So the good news is, it's new and it's working. | 0:40:49 | 0:40:52 | |
The bad news is it's probably ten, 15, 20 years away. | 0:40:52 | 0:40:57 | |
Why so long? | 0:40:59 | 0:41:00 | |
Well, finding an antibiotic in nature is just the first stage in | 0:41:00 | 0:41:04 | |
an expensive and very complicated process. | 0:41:04 | 0:41:08 | |
To discover a new antibiotic, I mean, | 0:41:09 | 0:41:11 | |
you have to go from the early stage of discovery - | 0:41:11 | 0:41:13 | |
so isolate bacteria from a place like a leaf-cutter ant nest - | 0:41:13 | 0:41:16 | |
get those bacteria growing on a plate, | 0:41:16 | 0:41:18 | |
solve the chemical structure of that antibiotic - which is not trivial - | 0:41:18 | 0:41:22 | |
and then, of course, you have to get a drug company interested | 0:41:22 | 0:41:25 | |
because they're the only people with enough money | 0:41:25 | 0:41:27 | |
to get things through clinical trials. | 0:41:27 | 0:41:29 | |
The reality is, less than 1% are actually suitable candidates | 0:41:29 | 0:41:33 | |
and make it through to actually get them to the stage where they're | 0:41:33 | 0:41:37 | |
approved as safe to use in humans. | 0:41:37 | 0:41:38 | |
So it can take 15, 20 years and cost, well, | 0:41:40 | 0:41:43 | |
between half and 1 billion. | 0:41:43 | 0:41:45 | |
A time lag of 15 to 20 years is massive given that around 700,000 | 0:41:51 | 0:41:57 | |
people already die annually because of antibiotic-resistant bacteria. | 0:41:57 | 0:42:02 | |
So what are we going to do until new drugs emerge? | 0:42:06 | 0:42:09 | |
For starters, surely we could use our existing stock more carefully. | 0:42:12 | 0:42:16 | |
Half of all hospital prescriptions are for broad-spectrum antibiotics. | 0:42:18 | 0:42:22 | |
And given everything I've learnt, that can't be a good idea. | 0:42:25 | 0:42:28 | |
Why do doctors continue to use broad-spectrum antibiotics? | 0:42:29 | 0:42:32 | |
It strikes me as like carpet bombing everything and you'd be better off | 0:42:32 | 0:42:36 | |
if you were a bit more targeted. | 0:42:36 | 0:42:37 | |
Well, as a doctor, you're confronted with a dilemma. | 0:42:37 | 0:42:39 | |
When you see a new patient, | 0:42:39 | 0:42:41 | |
you don't necessarily have the diagnosis in front of you. | 0:42:41 | 0:42:43 | |
-So you want to save the patient... -Mm-hm. | 0:42:43 | 0:42:45 | |
..and you want to cover all the eventualities. | 0:42:45 | 0:42:48 | |
And hence, you use a broad-spectrum antibiotic. | 0:42:48 | 0:42:50 | |
-Right, because you don't know what it is you're trying to hit. -Exactly. | 0:42:50 | 0:42:53 | |
To use targeted narrow-spectrum antibiotics, doctors need to | 0:42:57 | 0:43:01 | |
be able to quickly diagnose the specific infection in a patient. | 0:43:01 | 0:43:05 | |
For some bugs, like the ones that cause tuberculosis, | 0:43:07 | 0:43:10 | |
that means taking samples, growing the bacteria | 0:43:10 | 0:43:14 | |
and sequencing its DNA - | 0:43:14 | 0:43:16 | |
a process that can take up to ten weeks. | 0:43:16 | 0:43:19 | |
But Tim's part of a team working on | 0:43:22 | 0:43:24 | |
a prototype gadget that could massively speed up DNA sequencing. | 0:43:24 | 0:43:28 | |
So, you see the patient and they spit into your pot. | 0:43:30 | 0:43:33 | |
Yep. And the DNA from your phlegm goes on there. | 0:43:33 | 0:43:37 | |
-OK. -You close it. | 0:43:37 | 0:43:40 | |
-And then it... This sequences it? -That sequences it. -Bloody hell. | 0:43:40 | 0:43:44 | |
-Now... -That is really, really impressive, I have to say. | 0:43:44 | 0:43:47 | |
That is impressive. | 0:43:47 | 0:43:48 | |
So, how quickly would you then be able to make a diagnosis? | 0:43:48 | 0:43:52 | |
-The sequencing of the genome will take less than an hour. -Yeah. | 0:43:52 | 0:43:56 | |
The analysis takes about two minutes. | 0:43:56 | 0:43:58 | |
MICHAEL LAUGHS OK, right. | 0:43:58 | 0:44:00 | |
-OK. Two minutes as opposed to ten weeks? -Yes. | 0:44:00 | 0:44:04 | |
Right, that is really crunching it, isn't it? | 0:44:04 | 0:44:06 | |
And this, presumably, isn't just for TB. | 0:44:06 | 0:44:10 | |
No. It's of great use for TB, but it can be used for any bacterium. | 0:44:10 | 0:44:14 | |
If you're able to get a diagnosis within minutes of seeing your | 0:44:15 | 0:44:19 | |
patient, it enables you to give the correct narrow-spectrum | 0:44:19 | 0:44:21 | |
antibiotic that targets just those bacteria that are causing the | 0:44:21 | 0:44:24 | |
illness and nothing else, | 0:44:24 | 0:44:26 | |
so it's precision bombing rather than carpet bombing. | 0:44:26 | 0:44:29 | |
If trials in clinics over the next couple of years are successful, | 0:44:30 | 0:44:33 | |
this device could extend the life of antibiotics by slowing | 0:44:33 | 0:44:37 | |
the pace of resistance. | 0:44:37 | 0:44:39 | |
But what if we could also stop some bugs from resisting altogether? | 0:44:43 | 0:44:47 | |
Some commonly prescribed antibiotics work by getting into | 0:44:51 | 0:44:54 | |
bacterial cells, and when they hit a lethal dose, | 0:44:54 | 0:44:57 | |
this causes the bacteria to rupture - | 0:44:57 | 0:45:01 | |
something they have evolved ways to resist. | 0:45:01 | 0:45:03 | |
Dr Jess Blair is part of a team from Birmingham University | 0:45:12 | 0:45:16 | |
with a plan to stop the bacteria fighting back. | 0:45:16 | 0:45:20 | |
She is going to try and explain the principle behind her approach | 0:45:20 | 0:45:23 | |
using a bucket as a bacterial cell. | 0:45:23 | 0:45:27 | |
OK, so you've got a watering can here full of antibiotic. | 0:45:27 | 0:45:30 | |
If you start pouring that into our bacterial cell, what we hope, | 0:45:30 | 0:45:33 | |
then, is that this will kill off the bacterial cell. | 0:45:33 | 0:45:36 | |
So, for argument's sake, let's say our level at which the | 0:45:36 | 0:45:38 | |
antibiotic becomes toxic is here. | 0:45:38 | 0:45:41 | |
So you need to keep pouring. | 0:45:41 | 0:45:43 | |
However, bacteria have a nifty trick. | 0:45:44 | 0:45:47 | |
In their membranes, they have pumps called efflux pumps. | 0:45:48 | 0:45:52 | |
So I'm pouring in antibiotics, | 0:45:52 | 0:45:53 | |
and the bacteria are just pumping them out. | 0:45:53 | 0:45:56 | |
Pumping them straight back out again. | 0:45:56 | 0:45:57 | |
So now it's not looking quite so good. | 0:45:57 | 0:46:00 | |
-Sorry, I'm getting your feet wet. -Yep. | 0:46:00 | 0:46:02 | |
It's going to become a bit more difficult for you to get | 0:46:02 | 0:46:05 | |
the antibiotic towards our line at which it's going to become toxic. | 0:46:05 | 0:46:08 | |
Right. | 0:46:08 | 0:46:09 | |
And what happens when they become really antibiotic resistant | 0:46:09 | 0:46:12 | |
is they make more and more of these pumps. | 0:46:12 | 0:46:14 | |
OK, that's a very neat trick. So, what can you do about it? | 0:46:14 | 0:46:17 | |
Well, in my pocket, | 0:46:17 | 0:46:19 | |
I've got a cable tie to sort of demonstrate this. | 0:46:19 | 0:46:22 | |
So, we have inhibited the efflux pump. | 0:46:24 | 0:46:26 | |
-So you're able to keep pouring the antibiotic in... -There we go! | 0:46:26 | 0:46:28 | |
..and we're about to reach the level | 0:46:28 | 0:46:30 | |
which is going to kill our bacterial cell. | 0:46:30 | 0:46:32 | |
Die, bacteria, die! | 0:46:32 | 0:46:33 | |
There we go. OK. So that's the theory. | 0:46:33 | 0:46:36 | |
I mean, how close are we to it in practice? | 0:46:36 | 0:46:39 | |
When I say we, I mean you, of course. | 0:46:39 | 0:46:41 | |
Well, people have been able to find molecules that do this. | 0:46:41 | 0:46:44 | |
The problem is there's no molecules at the moment which are able | 0:46:44 | 0:46:47 | |
to both inhibit efflux pumps but also are OK to be given to a person. | 0:46:47 | 0:46:51 | |
Most of the ones that we currently have are toxic to people. | 0:46:51 | 0:46:54 | |
Because she can't test her inhibitor chemical on a living human being, | 0:47:02 | 0:47:07 | |
Jess is going to test it instead on a salmonella infection in my hand. | 0:47:07 | 0:47:12 | |
While she does that, | 0:47:16 | 0:47:17 | |
Dr Andy Edwards and I are trying out another experimental chemical | 0:47:17 | 0:47:22 | |
on my other hand, which we have infected with MRSA. | 0:47:22 | 0:47:25 | |
Andy wants to show me what he calls an antibiotic amplifier. | 0:47:27 | 0:47:31 | |
It's designed to stop this superbug from resisting | 0:47:31 | 0:47:34 | |
an existing antibiotic called ciprofloxacin. | 0:47:34 | 0:47:37 | |
So, what ciprofloxacin does is to break up bacterial DNA. | 0:47:39 | 0:47:43 | |
It smashes it into lots of small pieces. | 0:47:43 | 0:47:45 | |
And MRSA is really good at then sticking that back together | 0:47:45 | 0:47:48 | |
and surviving. | 0:47:48 | 0:47:49 | |
So what we want to do with our antibiotic amplifier is | 0:47:49 | 0:47:51 | |
prevent the bacterium from sticking the DNA back together again. | 0:47:51 | 0:47:55 | |
MRSA has a very bad reputation, doesn't it? | 0:47:55 | 0:47:57 | |
It has a bad reputation for a good reason. | 0:47:57 | 0:47:59 | |
So, MRSA causes lots of lots of surgical-site infections and | 0:47:59 | 0:48:03 | |
other skin infections, particularly in hospitals. | 0:48:03 | 0:48:05 | |
And once it gets into the blood, it is very, very serious. | 0:48:05 | 0:48:08 | |
It can attach to your heart, bones and joints. | 0:48:08 | 0:48:10 | |
So you're going to try and make this non-resistant again, | 0:48:12 | 0:48:15 | |
reverse it if you like. | 0:48:15 | 0:48:16 | |
That's right, that's right. We're trying to outsmart the bug. | 0:48:16 | 0:48:20 | |
Andy's antibiotic amplifier and Jess's pump inhibitor are | 0:48:23 | 0:48:27 | |
amongst a number of so-called resistance breakers currently | 0:48:27 | 0:48:30 | |
in development. | 0:48:30 | 0:48:31 | |
The results from our test certainly suggest they could have | 0:48:33 | 0:48:36 | |
a promising future. | 0:48:36 | 0:48:38 | |
Though, the first one is easier to make out on | 0:48:38 | 0:48:40 | |
a Petri dish than on my agar hand. | 0:48:40 | 0:48:43 | |
This is the pump inhibitor, | 0:48:45 | 0:48:47 | |
the one that stops the bacteria pumping out the antibiotics. | 0:48:47 | 0:48:51 | |
And this one is working rather well. | 0:48:51 | 0:48:53 | |
You've got the salmonella infection here, | 0:48:53 | 0:48:57 | |
and it is resistant to the antibiotic | 0:48:57 | 0:48:59 | |
which is in the rest of the plate. | 0:48:59 | 0:49:01 | |
But here, in the middle, | 0:49:01 | 0:49:03 | |
that bit there is working because the area around it is clear. | 0:49:03 | 0:49:07 | |
So that's promising. That's good. | 0:49:07 | 0:49:09 | |
Next, the hand that was infected with MRSA. | 0:49:13 | 0:49:16 | |
What's encouraging is the area that I painted | 0:49:18 | 0:49:21 | |
on the back of the hand, here, | 0:49:21 | 0:49:23 | |
which was a mixture of the amplifier | 0:49:23 | 0:49:26 | |
and the antibiotic, that is clean. | 0:49:26 | 0:49:29 | |
So that would suggest the amplifier is doing what it should do, | 0:49:29 | 0:49:32 | |
which is preventing bacteria from reforming their DNA, | 0:49:32 | 0:49:38 | |
and therefore, the bacteria are being killed. | 0:49:38 | 0:49:40 | |
That one I give high marks to. That one worked. | 0:49:40 | 0:49:44 | |
That's encouraging results from one experimental antibiotic | 0:49:47 | 0:49:51 | |
and two resistance-breakers. | 0:49:51 | 0:49:52 | |
But none of these cures will be ready to use on you or me | 0:49:55 | 0:49:58 | |
any time soon. | 0:49:58 | 0:50:00 | |
BELL CHIMES | 0:50:01 | 0:50:03 | |
The final thing I want to look at is something which will kill | 0:50:03 | 0:50:07 | |
bacteria but which isn't actually an antibiotic. | 0:50:07 | 0:50:10 | |
This is where I normally come. | 0:50:12 | 0:50:14 | |
At Oxford University, microbiologist | 0:50:14 | 0:50:17 | |
Dr Alex Betts is investigating | 0:50:17 | 0:50:19 | |
viruses which naturally attack bacteria. | 0:50:19 | 0:50:22 | |
Mind your feet, cos we are looking for...something, actually, | 0:50:22 | 0:50:26 | |
a lot like that. Perfect. | 0:50:26 | 0:50:28 | |
Alex is one of a handful of scientists in the UK working | 0:50:31 | 0:50:35 | |
with bacterial phages. | 0:50:35 | 0:50:37 | |
All right, here we go. Oh, look at that. Isn't that disgusting? | 0:50:39 | 0:50:43 | |
This is a fresh goose poo, and from these, | 0:50:43 | 0:50:46 | |
I can isolate the bacteria and the viruses that are inside | 0:50:46 | 0:50:50 | |
the digestive tract of geese. | 0:50:50 | 0:50:52 | |
And that I can take back to the lab, and it should be a treasure | 0:50:52 | 0:50:55 | |
trove of things that could potentially treat disease in humans. | 0:50:55 | 0:50:59 | |
Lovely. | 0:51:01 | 0:51:02 | |
I want to see if Alex's viruses can cure me. | 0:51:03 | 0:51:06 | |
-Here we go. -Oh, wow. -I have a gift for you, my lovely face. | 0:51:08 | 0:51:11 | |
For the scientist who has everything. | 0:51:11 | 0:51:12 | |
-It's quite weird, isn't it? -Look at that nose! | 0:51:12 | 0:51:14 | |
LAUGHING: Thank you(!) | 0:51:14 | 0:51:16 | |
What we're going to do now is test a type of virus Alex | 0:51:19 | 0:51:23 | |
has acquired from a sewage farm against a superbug - Pseudomonas. | 0:51:23 | 0:51:28 | |
This bug causes septicaemia and pneumonia. | 0:51:29 | 0:51:32 | |
In short, it's very nasty. | 0:51:32 | 0:51:35 | |
It's a powerhouse of antibiotic resistance. It's a real problem. | 0:51:35 | 0:51:38 | |
And it's been isolated from food, | 0:51:38 | 0:51:42 | |
soil, drinking water, | 0:51:42 | 0:51:43 | |
even really extreme environments like aviation fuel. | 0:51:43 | 0:51:46 | |
This thing can grow on pretty much anything. So it's... | 0:51:46 | 0:51:48 | |
-It's a good test, basically. -Very much so. | 0:51:48 | 0:51:51 | |
If we can beat this, then we are in a good position. | 0:51:51 | 0:51:53 | |
-So these are billions of viruses, is that right? -Yes, indeed. | 0:51:55 | 0:51:58 | |
These are viruses that infect and kill bacteria, | 0:51:58 | 0:52:01 | |
just as part of their natural life cycles. | 0:52:01 | 0:52:04 | |
It's not something we've engineered in the lab. | 0:52:04 | 0:52:07 | |
These images were taken with a hugely powerful microscope. | 0:52:08 | 0:52:13 | |
You can see the tiny viruses known as phages clamped on to | 0:52:13 | 0:52:17 | |
a single bacterial cell. | 0:52:17 | 0:52:20 | |
Phages are parasites for bacteria. | 0:52:20 | 0:52:23 | |
They inject their genetic material into a cell, | 0:52:25 | 0:52:27 | |
forcing it to produce a huge number of new phages. | 0:52:27 | 0:52:30 | |
These then burst out of the cell, destroying it. | 0:52:32 | 0:52:35 | |
Research into phages is just getting started in the UK. | 0:52:40 | 0:52:43 | |
BELLS CHIME | 0:52:45 | 0:52:47 | |
But in Eastern Europe, they've been experimenting with | 0:52:47 | 0:52:50 | |
viruses therapeutically for almost a century. | 0:52:50 | 0:52:53 | |
And in the Polish city of Wroclaw, | 0:52:55 | 0:52:57 | |
there's a specialist clinic that's achieving really impressive results | 0:52:57 | 0:53:01 | |
in treating people with antibiotic-resistant infections. | 0:53:01 | 0:53:04 | |
THEY SPEAK POLISH | 0:53:07 | 0:53:08 | |
Remember the gruesome wound in Slawa's foot? | 0:53:10 | 0:53:14 | |
Her E. coli infection is so bad and so untreatable, | 0:53:14 | 0:53:18 | |
there's a serious risk she will have to have it amputated. | 0:53:18 | 0:53:21 | |
Now she's hoping phages can save it. | 0:53:21 | 0:53:24 | |
Through our experimental phage therapy, | 0:53:24 | 0:53:27 | |
we want to protect her against amputation. | 0:53:27 | 0:53:29 | |
I'm going to apply | 0:53:31 | 0:53:33 | |
phage preparation into the wound. | 0:53:33 | 0:53:35 | |
And I show you how I do it. | 0:53:35 | 0:53:37 | |
This is a phage preparation against E. coli. | 0:53:37 | 0:53:40 | |
The doctors hope to get Slawa's infection under control | 0:53:42 | 0:53:46 | |
and then perform an operation to save the foot. | 0:53:46 | 0:53:49 | |
Look away for a minute if you're squeamish. | 0:53:49 | 0:53:52 | |
The patient will have surgery, which aim is to cut | 0:53:56 | 0:54:01 | |
this dead tissue, | 0:54:01 | 0:54:03 | |
but we apply phages before to decrease a lot of bacteria. | 0:54:03 | 0:54:08 | |
After surgery, Slawa will receive combination therapy using | 0:54:32 | 0:54:36 | |
phages and targeted antibiotics. | 0:54:36 | 0:54:38 | |
SHE LAUGHS | 0:54:52 | 0:54:54 | |
It will be months before Slawa knows if the therapy is working. | 0:54:54 | 0:54:57 | |
Fingers crossed. | 0:54:57 | 0:54:58 | |
In the meantime, let's see how my virus treatment is getting on. | 0:55:01 | 0:55:04 | |
-Here we go. -OK. | 0:55:05 | 0:55:07 | |
Now, it doesn't look obviously different. | 0:55:07 | 0:55:09 | |
So, under white lights, the bacteria aren't particularly visible, | 0:55:09 | 0:55:12 | |
cos they have kind of a similar colour to the agar, | 0:55:12 | 0:55:14 | |
but there is this neat trick. | 0:55:14 | 0:55:16 | |
They produce a molecule that fluoresces very intensely | 0:55:16 | 0:55:18 | |
under UV light. | 0:55:18 | 0:55:19 | |
-Look at that. -Yeah! | 0:55:21 | 0:55:23 | |
-And hopefully, when I remove the bandage... -Yeah. | 0:55:23 | 0:55:26 | |
-..we should see quite a difference. -Oh, yeah! | 0:55:26 | 0:55:29 | |
That is very, very striking, isn't it? | 0:55:30 | 0:55:32 | |
-And that is because the bacteria were unable to grow in there. -Right. | 0:55:32 | 0:55:35 | |
-It's really done the business, hasn't it? -It has done, yeah. | 0:55:35 | 0:55:38 | |
The viruses are natural parasites. | 0:55:38 | 0:55:39 | |
They haven't evolved to completely obliterate their hosts, | 0:55:39 | 0:55:44 | |
but what you will get is, hopefully, | 0:55:44 | 0:55:45 | |
in the context of therapy where you're treating | 0:55:45 | 0:55:48 | |
a patient with an immune system, | 0:55:48 | 0:55:49 | |
that you'll push the bacteria far enough | 0:55:49 | 0:55:52 | |
the patient's immune system can take care of whatever's left. | 0:55:52 | 0:55:54 | |
There have been no clinical trials in the UK yet. | 0:55:56 | 0:55:59 | |
But I'm hoping that one day phages will make | 0:56:01 | 0:56:04 | |
a significant contribution to frontline medicine. | 0:56:04 | 0:56:08 | |
They're not going to replace antibiotics, | 0:56:08 | 0:56:09 | |
but there are certain roles that they can fulfil that would | 0:56:09 | 0:56:12 | |
ease the pressure on our existing therapeutics, | 0:56:12 | 0:56:14 | |
buy us some time to develop new antimicrobials, | 0:56:14 | 0:56:16 | |
and it can certainly be used alongside antibiotics. | 0:56:16 | 0:56:19 | |
Phages are going to have to step up and take a role. | 0:56:19 | 0:56:22 | |
So what have I learnt about antibiotic resistance? | 0:56:30 | 0:56:33 | |
Well, the biggest lesson is that bacteria will never stop | 0:56:36 | 0:56:40 | |
evolving ways to fight back... | 0:56:40 | 0:56:41 | |
..which means we need a multi-pronged response, | 0:56:43 | 0:56:47 | |
including, of course, new, better-targeted antibiotics. | 0:56:47 | 0:56:52 | |
It's going to take serious resources to turn things around and prevent | 0:56:52 | 0:56:57 | |
the projected death toll. | 0:56:57 | 0:57:00 | |
If ten million people a year are going to die by 2050, | 0:57:00 | 0:57:02 | |
that's not that far away | 0:57:02 | 0:57:04 | |
if you consider that it takes 20 or 25 years | 0:57:04 | 0:57:06 | |
to get a new drug to market. | 0:57:06 | 0:57:07 | |
And you don't just need one new antibiotic - | 0:57:07 | 0:57:09 | |
you need a whole generation of new antibiotics, | 0:57:09 | 0:57:11 | |
so it's going to cost tens of billions of dollars, basically. | 0:57:11 | 0:57:13 | |
And the reality is that, | 0:57:13 | 0:57:14 | |
if you spend 1 billion getting an antibiotic to the clinic, | 0:57:14 | 0:57:17 | |
you probably won't make your money back. | 0:57:17 | 0:57:19 | |
So it's not great business. | 0:57:19 | 0:57:20 | |
That money has got to come from somewhere and, presumably, | 0:57:21 | 0:57:25 | |
it's going to be at a government level. | 0:57:25 | 0:57:27 | |
Last year, the United Nations passed a resolution, | 0:57:29 | 0:57:32 | |
unanimously signed by 193 countries, | 0:57:32 | 0:57:36 | |
saying that all countries | 0:57:36 | 0:57:38 | |
should get together and take action, | 0:57:38 | 0:57:41 | |
so I do detect movement forwards, | 0:57:41 | 0:57:44 | |
but these things are slow. | 0:57:44 | 0:57:47 | |
If we fail to act, we risk plunging medicine back into the Dark Ages. | 0:57:50 | 0:57:54 | |
But I'm encouraged by the fact there's a vast world of | 0:57:56 | 0:57:59 | |
microbes out there, packed with potential allies as well as | 0:57:59 | 0:58:03 | |
enemies - a world which we are only just beginning to explore. | 0:58:03 | 0:58:08 | |
I'm actually feeling more confident than I was at the beginning of | 0:58:11 | 0:58:15 | |
this film that we will find ways to combat the threat of | 0:58:15 | 0:58:17 | |
antibiotic resistance. | 0:58:17 | 0:58:19 | |
I can only hope that when we develop new weapons, we will treat them | 0:58:19 | 0:58:23 | |
with greater care and respect than we have in the past. | 0:58:23 | 0:58:27 |