Episode 2

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0:00:01 > 0:00:08Welcome to Bang Goes The Theory, we are here with the science behind

0:00:08 > 0:00:13the headlines. Tonight we are looking at something inescapably,

0:00:13 > 0:00:18infectious disease. From flu to SARS, our bodies are under threat

0:00:18 > 0:00:23of infection from one source or another. If that wasn't bad enough,

0:00:23 > 0:00:27recent news stories are full of the biggest weapon against disease has

0:00:27 > 0:00:31been blunted. Antibiotics may have become useless against new breeds

0:00:31 > 0:00:35of becomes. Today Britain's Chief Medical Officer presented a report

0:00:35 > 0:00:40on this subject to the Government. We were granted a preview and it is

0:00:40 > 0:00:44a wake-up call, I it kel you. I will speak to her about it later in

0:00:44 > 0:00:51the programme. First, Maggie asks if public

0:00:51 > 0:00:56transport puts us more at risk from spreading germs. She reveals one

0:00:56 > 0:00:59solution to a problem doctors face every day, deciding when to

0:00:59 > 0:01:03prescribe antibiotics. Doctors always want to do the best they can

0:01:03 > 0:01:07for the patient in front of them. One of the dangers is we overtreat

0:01:07 > 0:01:13and give antibiotics where they are not necessary. I find out where not

0:01:13 > 0:01:18fin pirbing a course of antibiotics can lead -- finishing a others of

0:01:18 > 0:01:25antibiotics can lead to resistance. You have a strain of a superbug

0:01:25 > 0:01:29happy able to grow. Gem reveals why different weapons are needed to

0:01:29 > 0:01:39combat viruses and bacteria. That should do it. That's tonight

0:01:39 > 0:01:40

0:01:40 > 0:01:44on Bang Goes The Theory. One of the places many of us worry

0:01:44 > 0:01:49about picking up coughs and colds on public transport. Planes, trains

0:01:49 > 0:01:56and buses. I have been on a mission to see if they really deserve their

0:01:56 > 0:01:59reputation as hot beds of infection. . There are lots of people who

0:01:59 > 0:02:03unfortunately are quite filthy and don't put their hands over their

0:02:03 > 0:02:08mouth. It is almost impossible to avoid. You have to hold your breath

0:02:08 > 0:02:12and hope for the best. It is warmer. Dirtier. That is why I don't use

0:02:12 > 0:02:16public transport. You don't have fresh air, if I have flown, I

0:02:16 > 0:02:26generally get a cold or sore throat after it. It is all about having to

0:02:26 > 0:02:28

0:02:28 > 0:02:32share your air. And on planes that problem can feel especially bad. We

0:02:32 > 0:02:36have all had that sinking feeling when you get on plane and hear

0:02:36 > 0:02:41someone coughing a few rows back. You instinctively feel if you were

0:02:41 > 0:02:44in an enclosed space like on a bus, train or plane, you are far more

0:02:44 > 0:02:54likely to catch anything that is going around. Just how infectious

0:02:54 > 0:02:57is the air that circulates in a plane?

0:02:57 > 0:03:07I have come to this state-of-the- art testing facility in Germany, to

0:03:07 > 0:03:11investigate if the air on board a plane really is a soup of other

0:03:11 > 0:03:19people's breath. It takes serious technology to work out how the flow

0:03:19 > 0:03:29of air in an aircraft cabin can affect the movement of germs, you

0:03:29 > 0:03:29

0:03:29 > 0:03:33need a massive air tight chamber to copy the conditions. And an air

0:03:33 > 0:03:38controlled system. To make it as accurate as possible, all the

0:03:38 > 0:03:43dummies are heated t feels strange, but helps recreate natural body

0:03:43 > 0:03:48heat, and the small thermals of air created bypass injuries on a plane.

0:03:48 > 0:03:54Just to show you, take a look at the thermal-images camera, as I

0:03:54 > 0:03:59walk along. That face belongs to Victor, he will demonstrate what

0:03:59 > 0:04:05happens when you cough as soon as we have taken off.

0:04:05 > 0:04:14Are we set to go? Yes, we are set to go. Shall I do the honours.

0:04:14 > 0:04:18A little smoke helps to highlight the gentle air movement. We usually

0:04:18 > 0:04:24try to develop in the aircraft cabin to have a cross sectional

0:04:24 > 0:04:29movement of the air flow. So when you look at the sketch, for example,

0:04:29 > 0:04:33we supply the air on the very top and it hits the overhead bin here,

0:04:33 > 0:04:37circulates down there and is extracted here.

0:04:37 > 0:04:42We can see this circular movement in the test cabin. The steady

0:04:42 > 0:04:47currents drag air down from above, and across the cabin to exit

0:04:47 > 0:04:53vefrpbts near the floor. Almost -- vents near the floor. None travels

0:04:53 > 0:04:58along the floor of the cabin. What happens when someone cows into the

0:04:58 > 0:05:01air? Can you do the cough experiment? It is quite home spun

0:05:01 > 0:05:06but effective. It is interesting, you can see him doing it now, with

0:05:06 > 0:05:13what you start to see is that actually when you cough, the

0:05:13 > 0:05:16particles are not going that far. The downward movement of air

0:05:16 > 0:05:21carries most coughs and sneezes down towards the floor, where they

0:05:21 > 0:05:25get extracted from the cabin. you are travelling by plane, and

0:05:25 > 0:05:35you hear someone coughing six rows ahead, you are not worried? No, I'm

0:05:35 > 0:05:36

0:05:36 > 0:05:40not worried by those things. But if the air is sucked, germs and

0:05:40 > 0:05:45all, through the floor, where does it go then? Back into another

0:05:45 > 0:05:51section of the cabin? Well, no, actually around half of the cabin

0:05:51 > 0:05:55air is expelled through vents like this. The other half is routed but

0:05:55 > 0:06:00HGPA filters, the same filters found in hospitals in operating

0:06:00 > 0:06:05theatres, to keep the air clean and bug-free. That clean, filtered air,

0:06:05 > 0:06:10is mixed with the same quantity of fresh air from outside the plane.

0:06:10 > 0:06:14That is what comes out of the vents above your seat. The air on the

0:06:14 > 0:06:19plane is refreshed roughly every two-to-three minutes. If you

0:06:19 > 0:06:27compare it to an office, it is every five-to-ten minutes. If you

0:06:27 > 0:06:36are in a cinema, you could be sitting in the same germ-laden hair

0:06:36 > 0:06:41for up to 20 minutes. So airbourne germs are not the problem on planes.

0:06:41 > 0:06:46Touching condominated surfaces is a far greater risk than breathing the

0:06:46 > 0:06:50same air. Germs spread like this wherever you are, on a plane, on a

0:06:50 > 0:06:55train, in a school, in the office or going around the shops.

0:06:55 > 0:07:02All this suggests that in theory at least, public transport is no more

0:07:02 > 0:07:04infectious than any other public space. But do the statistics agree?

0:07:04 > 0:07:10For several years researchers across Europe have been monitoring

0:07:10 > 0:07:14the health and travel habits of over 30,000 volunteers. What has

0:07:14 > 0:07:21that taught you about the risk of catching colds and flu on public

0:07:21 > 0:07:24transport? However we look at the data, there is no increased risk of

0:07:24 > 0:07:27getting flu-like illness from getting flu-like illness from

0:07:27 > 0:07:30taking public transport. We have seen looked at people who

0:07:30 > 0:07:34take public transport for over an hour-and-a-half every day. When

0:07:34 > 0:07:40they are compared to people who take no public transport, there is

0:07:40 > 0:07:45no increased risk. Why is that? It seems so counterintuitive, you are

0:07:45 > 0:07:49packed in with all those people you hear coughing and wheezing? That is

0:07:49 > 0:07:52a good question, but the short a good question, but the short

0:07:52 > 0:07:55answer is we don't really know. A slightly better answer is, the fact

0:07:55 > 0:07:58is, when you are on public transport, you really aren't in

0:07:58 > 0:08:03people's faces, it is quite an uncomfortable situation. If someone

0:08:03 > 0:08:06is facing you with their face right in front of you, you are likely to

0:08:06 > 0:08:10look away. The likelihood of someone sneezing or coughing on you

0:08:10 > 0:08:13is quite small. Most people would find that really surprising?

0:08:13 > 0:08:16found it very comforting, considering I have to take public

0:08:16 > 0:08:20transport in every day. Did you identify any areas where you might

0:08:20 > 0:08:24be more at risk? Yes, having children under the age of 18.

0:08:24 > 0:08:28Children tend to be a bit more tactile, be a bit more in your face

0:08:28 > 0:08:32maybe not wash their hands as much as they should. And consistently we

0:08:32 > 0:08:39have found that this is a big risk factor for getting the flu.

0:08:39 > 0:08:46can't do much about that? So what about when you do get an

0:08:46 > 0:08:51infection? There is one thing many of us hope will sort us out every

0:08:51 > 0:08:58time, a course of antibiotics. But how much do you really know about

0:08:58 > 0:09:03them? In UK hospitals more money is spent on antibiotics than any other

0:09:03 > 0:09:12type of drug. Britons take almost 50 million courses of antibiotics a

0:09:12 > 0:09:16year. To tackle a range of infections from earache to MRSA.

0:09:16 > 0:09:21Antibiotics seem to fight so many infections and are so effective, it

0:09:21 > 0:09:25is little wonder they have gained a reputation as cure-all medicine.

0:09:25 > 0:09:30Why is it doctors are often reluctant to hand them out when we

0:09:30 > 0:09:37turn up at their surgeries feeling ever so poorly? Well, we first need

0:09:37 > 0:09:41to look at the actual germs that cause most common infections. Many

0:09:41 > 0:09:47of us already know that infectious illnesses are often caused by

0:09:47 > 0:09:50viruses or back tearia. But how many of us know actually what --

0:09:50 > 0:09:55and bacteria. But how many of us know actually what difference that

0:09:56 > 0:09:59make. You normally need a microscope to explore the

0:09:59 > 0:10:03differences between viruses and bacteria. But studying things in

0:10:03 > 0:10:07lab is not my scene. I find it easier to explain things when I get

0:10:07 > 0:10:12my hands dirty and see things properly. That is why I have come

0:10:12 > 0:10:17here. The most obvious difference between viruses and bacteria is

0:10:17 > 0:10:23size. To us, a single bacteria might be pretty small, a thousandth

0:10:23 > 0:10:29of a millimeter. To a virus, they are looking very large. If we scale

0:10:29 > 0:10:34things up, and took a typical virus to be the size of a suitcase, in

0:10:34 > 0:10:39which case, a bacterium would be the size of a van. The comparison

0:10:39 > 0:10:43doesn't end there. Just like this van is a fully functioning machine,

0:10:43 > 0:10:47with different working parts for specific jobs, wheels, engine, fuel

0:10:47 > 0:10:51pump, windscreen, et cetera. So too is a bacterium. It is a self-

0:10:51 > 0:10:59contained unit, with a wall around it, and all the biological

0:10:59 > 0:11:02machinery of a living cell. Where as a virus just has a thin

0:11:02 > 0:11:09protein coat. Inside it is practically empty, no machinery of

0:11:09 > 0:11:15its own. Just a string of genetic material, like DNA, like, in fact,

0:11:15 > 0:11:21an instruction manual. Alone it can do nothing, it has to hijack a

0:11:21 > 0:11:28living cell and turn it to its own purposes. It is only by using

0:11:28 > 0:11:30something else's biological material that a virus can

0:11:30 > 0:11:35repeatedly clone itself, before bursting out and infecting

0:11:35 > 0:11:39countless more cells, in a destructive chain reaction. These

0:11:40 > 0:11:44essential differences mean that we have to use very different weapons

0:11:44 > 0:11:50for fighting viruses and bacteria. Of course, one big weapon in a

0:11:50 > 0:11:54doctor's tool kit, or medicine bag, is antibiotics. There are several

0:11:54 > 0:12:04different types of antibiotics, and because they work in subtley

0:12:04 > 0:12:05

0:12:05 > 0:12:10different ways, it means they are a tremenduously versatile drug.

0:12:10 > 0:12:20Some antibiotics like the famous penicillin work by rupturing the

0:12:20 > 0:12:24bacteria. Cells have to divide to multiply, and pencil lin stops that.

0:12:24 > 0:12:29They keep swelling and burst like a balloon because they can't divide.

0:12:29 > 0:12:32What most all antibiotics have in common is the ability to cripple a

0:12:32 > 0:12:42particular function of the bacterial cell. There are many ways

0:12:42 > 0:12:44

0:12:44 > 0:12:52of doing this. With so many parts to attack, antibiotics can disable

0:12:52 > 0:12:58bacteria in many different ways. With a virus, there is nothing to

0:12:58 > 0:13:05disable. This is just the wrong tool for the job. Which is why

0:13:05 > 0:13:09antibiotics are useless for viruses. So, unless you have a bacterial

0:13:09 > 0:13:14infection there is no point in your doctor prescribing antibiotics.

0:13:14 > 0:13:18Nine times out of ten with coughs and colds it is a virus that is

0:13:18 > 0:13:24caution the problem. Drugs to combat viruses work in a totally

0:13:24 > 0:13:28different way. Most anti-viral drugs need to physically block the

0:13:28 > 0:13:36virus from getting into or out of the cell it needs in order to

0:13:36 > 0:13:41replicate. That should do it. It seems hard to believe that only

0:13:41 > 0:13:46a generation ago many bacterial infections were fatal. A scratch on

0:13:46 > 0:13:50the knee could kill. We rightly celebrate new medical breakthroughs,

0:13:50 > 0:13:55cancer treatments, for example, that extend lives by months or even,

0:13:55 > 0:13:59but antibiotics we seem to take for granted. Even though they save

0:13:59 > 0:14:09lives. Not just extending them, every single day. They are truly

0:14:09 > 0:14:09

0:14:09 > 0:14:14impressive. Still to come tonight: Maggie

0:14:14 > 0:14:21reveals surprising medical research into new antibiotics.

0:14:21 > 0:14:25And I find out why bacterial resistance is such big news. Anti-

0:14:25 > 0:14:29bacterial hand washes, gels and cleaning products might not be all

0:14:29 > 0:14:34that great, because they too can encourage bacterial resistance.

0:14:34 > 0:14:38When did you last get prescribed antibiotics, did you finish the

0:14:38 > 0:14:43whole course? On hostly? We hear the same course -- honestly? We

0:14:43 > 0:14:46hear the same mess arpblgs you need to finish the course even if you

0:14:46 > 0:14:51start feeling better half way through. Once you feel better it is

0:14:51 > 0:14:54easy to forget about them, leave them in the cuboard or fridge and

0:14:54 > 0:15:01not take them again. What is so good about finishing? It is useful

0:15:01 > 0:15:05to think about curing an infection in two cries, one, microbial cure,

0:15:05 > 0:15:09where all the back tear is completely eradicated. And then the

0:15:09 > 0:15:12symptomatic cure, you feel better and no more symptoms. Even then

0:15:12 > 0:15:17there may still be a few bacteria hanging around. That is where the

0:15:17 > 0:15:23risk is. They then stand a chance of becoming resistant to the

0:15:23 > 0:15:33antibiotics. Liz has been to find out more.

0:15:33 > 0:15:34

0:15:34 > 0:15:38So how do bacteria become resistant. What we have got here is footage

0:15:38 > 0:15:43from Harvard University of a bacterial colony growing across an

0:15:43 > 0:15:45agar plate, along which are sections with increasing

0:15:45 > 0:15:48concentrations of antibiotics. Watch what happens, this is a

0:15:48 > 0:15:55bacteria growing on a section with no antibiotics, growing and

0:15:55 > 0:16:02dividing, so far so good. It meets the junction to the first

0:16:02 > 0:16:06section where there is a low concentration of antibiotic. The

0:16:06 > 0:16:11antibiotic initially prevents the bacteria from spreading any further.

0:16:11 > 0:16:20But as it is only a low dose, it doesn't kill off all the bacteria

0:16:20 > 0:16:25and some invade. Bacteria grow and divide at extremely fast rate. A

0:16:25 > 0:16:31new generation is produced every 30-minutes or so. As they divide,

0:16:31 > 0:16:34random mutations take place. And sometimes that mutation can lead to

0:16:34 > 0:16:38a resistance to a particular antibiotic. That is exactly what's

0:16:38 > 0:16:41happening here. You have got a mutated strain now that is

0:16:41 > 0:16:48resistant to this antibiotic, and is able to grow quite happily

0:16:49 > 0:16:54across the agar. Then the spreading bacteria reaches

0:16:54 > 0:16:59a section with 30-times the antibiotic dose. It stops them in

0:16:59 > 0:17:05their tracks. But not for long. A lot of it is killed off, but some

0:17:05 > 0:17:10of it continues to grow and divide. Most importantly the mutated strain

0:17:10 > 0:17:13of bacteria, the one that is resistant to the antibiotic, is

0:17:13 > 0:17:19happily growing and dividing across this section of antibiotics.

0:17:19 > 0:17:23Initially only killing some of the bacteria allows a stronger strain

0:17:23 > 0:17:27to survive. That's how bacteria can evolve to become resistant. It will

0:17:27 > 0:17:31happen naturally, to a certain extent, but it can be greatly

0:17:31 > 0:17:34speeded up when people take repeated courses or take

0:17:34 > 0:17:39antibiotics for the wrong reason, or they don't finish the course.

0:17:39 > 0:17:44This effect is not just limited to antibiotics. Anything that kills

0:17:44 > 0:17:49bacteria can put pressure on the bugs to evolve resistance. Anti-

0:17:49 > 0:17:53bacterial hand washes, gels and cleaning products might not be all

0:17:54 > 0:17:59that great. They too can encourage bacterial resistance.

0:17:59 > 0:18:07And it is not only in humans that bacteria are becoming resistant to

0:18:07 > 0:18:11antibiotics. Talk me through a scenario where it is not an organic

0:18:11 > 0:18:15farm like this, animals are in close contact with each other. Do a

0:18:15 > 0:18:18lot of farmers give antibiotics on a regular basis? They seem to need

0:18:18 > 0:18:24to. If you are trying to produce your meat really cheaply, if you

0:18:24 > 0:18:28have a lot of animals Onazi concrete, in housing inside, the

0:18:28 > 0:18:33opportunities for disease spread are much greater. In situations

0:18:33 > 0:18:39like that antibiotics might be given to a whole herd to stop Anne

0:18:39 > 0:18:45fex spreading. Just as we overuse antibiotics in medicine, there is a

0:18:45 > 0:18:53danger of overuse in large scaling as well. As farmers try to meet the

0:18:53 > 0:18:57demand for low-cost food. I have made a new friend! Oh yes.

0:18:57 > 0:19:03So healthy pigs. Is there ever a situation where you have to use

0:19:03 > 0:19:08antibiotics with these? We produce 4,000 young pig as year. On that

0:19:08 > 0:19:13lot five or six individual pigs fight get a antibiotic treatment a

0:19:13 > 0:19:17year. There are times in animal and human medicine where we do need

0:19:17 > 0:19:20antibiotics, they are very precious and we need to look after them.

0:19:20 > 0:19:24Meanwhile resistant bugs continue to build up in the environment

0:19:24 > 0:19:28through use of antibiotics in animals and humans. And that's why

0:19:28 > 0:19:32today the UK's Chief Medical Officer released her report

0:19:32 > 0:19:37detailing the extent of the problem. What scale are we talking about,

0:19:37 > 0:19:41how serious is this, really? I have described an apocalyptic scenario,

0:19:41 > 0:19:46where you could go in, for the little operation I had earlier this

0:19:46 > 0:19:52week, to release a nerve in my hand, get an infection, but that

0:19:52 > 0:19:56antibiotics don't work and I die of it. Or a hip replacement. Let alone

0:19:56 > 0:20:00cancer patients who won't be treatable and will die early in

0:20:00 > 0:20:06their treatments and organ transplants, kidney, for instance,

0:20:06 > 0:20:10where we might not be able to do them. It is a very serious issue

0:20:10 > 0:20:14for mankind. How on earth have we let it get to this stage?

0:20:14 > 0:20:18haven't put enough focus on it. In this country we have taken quite a

0:20:18 > 0:20:23lot of effort in the human field and increasingly in the animal

0:20:24 > 0:20:28field, but it is across the world problems. Partly because of travel,

0:20:28 > 0:20:32but also because of the transport of food and animals. What

0:20:32 > 0:20:35recommendations has your report put forward to tackle this massive

0:20:35 > 0:20:41problem? Clearly there are two areas, one is how do we preserve

0:20:41 > 0:20:44the antibiotics we have got, that is about using the right anti-

0:20:44 > 0:20:50biotic at the right time, in the right dose for the right period.

0:20:50 > 0:20:54Then, how do we promote new drug development. That is looking at the

0:20:54 > 0:21:00ways you can stimulate big pharmaceutical companies so they

0:21:00 > 0:21:03start to invest in again in this area. Do you think antibiotics

0:21:03 > 0:21:07still have a place in modern medicine, or are we looking to

0:21:07 > 0:21:11something else to sort the problem out? We can't have modern medicine

0:21:11 > 0:21:14without antibiotics, we have nothing else to replace them at the

0:21:14 > 0:21:20moment. We have to take this very seriously. Now we cannot afford to

0:21:20 > 0:21:25lose a focus on this. So, what does the future hold for

0:21:25 > 0:21:30the battle since infectious diseases. A couple of series ago I

0:21:30 > 0:21:34looked at the cutting-edge research tackling the problem head on, that

0:21:34 > 0:21:38research is still going on. Maggie is finding out about the medical

0:21:38 > 0:21:42advances being used right now. The immediate challenge is to find

0:21:42 > 0:21:46ways to use antibiotics more carefully. But in some areas of

0:21:46 > 0:21:49medicine, that's not always straight forward.

0:21:49 > 0:21:53In fairness, it is sometimes quite difficult to tell whether an

0:21:54 > 0:21:58infection is bacterial or not. The only way is by a blood test, and

0:21:58 > 0:22:04typically you can wait two-to-three days for the result.

0:22:04 > 0:22:08But wait ing for days -- waiting for days is no good on a hospital

0:22:08 > 0:22:12critical care ward, where some bacterial infections can kill

0:22:12 > 0:22:16vulnerable patients in a matter of hours. Doctors often prescribe

0:22:16 > 0:22:22antibiotics just to be sea. When you take into account farm use, GPs

0:22:22 > 0:22:27and hospitals, it is estimated that two third ofs antibiotic use is

0:22:27 > 0:22:30either highly questionable or totally unnecessary. And that's a

0:22:30 > 0:22:37tragic waste. So the most recent developments are in methods to cut

0:22:37 > 0:22:40down that waste. And that could ultimately save many lives. One of

0:22:40 > 0:22:48those methods is being introduced here at the Royal Hampshire

0:22:48 > 0:22:52Hospital. We popped by today to see how you are. Can you tell us what

0:22:52 > 0:22:55brought you into hospital? I have difficulty breathing, I get very,

0:22:55 > 0:22:59very breathless. One of the reasons we have come along as the infection

0:22:59 > 0:23:04team is to try to decide if you need any antibiotics. We have a

0:23:04 > 0:23:07special blood test, which is a relatively new development which

0:23:07 > 0:23:12can distinguish between bacterial and viral infection or no infection

0:23:12 > 0:23:22at all. I think we will do that on your samples, which will help us

0:23:22 > 0:23:24

0:23:24 > 0:23:29make a decision as to whether or not you need antibiotics. Right, OK.

0:23:30 > 0:23:38Maggie this is the biology and immune nolg lab. This is where we

0:23:38 > 0:23:43would bring her test to. Her blood is being cultured, they will take

0:23:43 > 0:23:47five days to grow bacteria, they may come up in 24 hours if they are

0:23:47 > 0:23:51there if we are lucky. This test can be done in two hours which

0:23:51 > 0:23:56helps decide whether or not she has a bacterial infection and whether

0:23:56 > 0:24:03we have to give antibiotics. test is looking for levels of a

0:24:03 > 0:24:10blood protein, which rises during a bacterial infection, but not in a

0:24:10 > 0:24:15viral infection. This reason does pro--calcitonin tests, and this is

0:24:15 > 0:24:19the read out, it gives us an accurate representation of the

0:24:19 > 0:24:25presence in the blood. It is less than 0.05. That indicates for this

0:24:25 > 0:24:29particular patient there is no necessity to give antibiotics now.

0:24:29 > 0:24:33The doctor closely monitors patients to make sure not giving

0:24:33 > 0:24:41them antibiotics is the right decision. And since introducing the

0:24:41 > 0:24:45system, this unit has cut down antibiotic use by half. To have a

0:24:45 > 0:24:49test like this, which enables us with our clinical diagnosis to be

0:24:49 > 0:24:52sure if a patient has or has not got a bacterial infection, is

0:24:52 > 0:24:57really useful. It is only being used in handful of places so far.

0:24:57 > 0:25:04But the ultimate goal is to make this test economical enough to use

0:25:05 > 0:25:10in GPs' surgeries, where 80% of antibiotics are prescribed.

0:25:10 > 0:25:13So there is hope in sight. But meanwhile, the hunt is on for the

0:25:13 > 0:25:19next generation of antibiotics. Although it has been 25 years since

0:25:19 > 0:25:27the last ones were found. This mould, which often grows on bread

0:25:27 > 0:25:31is a good source of pencil lin. And most of the penicillin, and most of

0:25:31 > 0:25:35it comes from nature, in the soil. The problem is coming to find new

0:25:35 > 0:25:41ones is we have looked in most of the obvious places.

0:25:41 > 0:25:44So we are now having to look in ever more obscure places, which can

0:25:44 > 0:25:50be surprising, even to medical professionals.

0:25:50 > 0:25:58Now I have got some rather unusual things on this trolley. So we have

0:25:58 > 0:26:06some soil from the Attacama desert. We have some disgusting-looking

0:26:06 > 0:26:16sludge from an estuary. And some plants, this is crocodile blood. Do

0:26:16 > 0:26:17

0:26:17 > 0:26:21pass them round. One last thing, we have a few friend! Ahhh. Uhhh.

0:26:21 > 0:26:26they cockroaches? They are. Yes. But they can't climb the plastic

0:26:26 > 0:26:31walls, we are all right. As unpleasant as these seem to us,

0:26:31 > 0:26:35they are all home to microbes, which rely on their own germ-

0:26:35 > 0:26:42killing chemicals to survive. There is something that links all of

0:26:42 > 0:26:49these things, therapy tension sources of antibiotics. Ohhhh.

0:26:49 > 0:26:53these? Yeah, yeah. The brains, crushed, apparently. How did

0:26:53 > 0:26:58somebody think of that! In research labs all over the world we are

0:26:58 > 0:27:03trying to harness those antibiotics for our use. But the process is a

0:27:03 > 0:27:06long, labourious, time-consuming and very expensive one. Every new

0:27:06 > 0:27:12antibiotic is expected to cost millions of pounds before it ever

0:27:12 > 0:27:16reaches a patient. In the meantime it is critical we all do what we

0:27:16 > 0:27:20can to reduce the spread of disease. In fact, simple soap and water

0:27:20 > 0:27:26remain the best way to prevent many bacterial, viral and fungal

0:27:26 > 0:27:33infections. That's it from this programme, a lot to think about.

0:27:33 > 0:27:38There is more on antibiotics in the new health report, and on the myths

0:27:38 > 0:27:41of sneezing too on the BBC website. And follow the links to the Open

0:27:41 > 0:27:48University, for a bacterial challenge and much more about

0:27:48 > 0:27:52microbes. Next week, we put sugar on trial.

0:27:52 > 0:27:56Liz finds out why we have such a sweet tooth.

0:27:56 > 0:28:00Without sugar, our cells couldn't do their jobs, our muscles wouldn't

0:28:00 > 0:28:05work, and most importantly our brains simply wouldn't function. We

0:28:05 > 0:28:09meet the doctor, horrified to find his diet has given him fatty liver

0:28:09 > 0:28:13disease. It was this wake-up call of needing

0:28:13 > 0:28:17to change my lifestyle, this will only get worse if I don't go

0:28:17 > 0:28:20something dramatic. Maggie discovers that sugar is a

0:28:20 > 0:28:24secret weapon in the fight against infection.