Antibiotic Resistance — Reading

Passage

A Alexander Fleming used his 1945 Nobel lecture to warn that the drug he had discovered would stop working. Penicillin was easy to obtain, he pointed out, and a man who underdosed himself could cultivate resistant organisms and pass them to others. The warning was issued before the antibiotic era had properly begun, and it was accurate in every particular. What Fleming did not anticipate was the scale, or that the largest consumer of antibiotics would turn out to be agriculture rather than medicine. B Resistance is not a side effect of antibiotic use; it is the predictable result of it. Bacteria reproduce in minutes and acquire mutations constantly, so any population exposed to a drug that kills most of its members leaves behind those that happen to survive. What makes bacterial evolution unusually fast is horizontal gene transfer: resistance genes travel between organisms on plasmids, small loops of DNA that can cross between unrelated species. A resistance gene arising in a harmless gut bacterium can therefore appear later in a dangerous one, without either descending from the other. C Agricultural use dominates by volume. In many countries the majority of antibiotics are given to livestock, historically at low doses to promote growth rather than to treat illness — a practice that is close to ideal for selecting resistant strains, since it exposes vast populations to concentrations that kill some bacteria but not all. The European Union banned growth-promotion use in 2006 and the United States restricted it in 2017, but global consumption in animals continues to rise as meat production expands. D The pipeline that once supplied replacements has largely emptied. Most antibiotic classes in use were discovered between the 1940s and 1960s, and very few new ones have reached patients since. The reason is economic rather than scientific. A successful antibiotic is taken for a week or two, is priced low, and — if it works against resistant infections — will be deliberately reserved for emergencies, which means it barely sells. A drug for a chronic condition is taken for decades. Several companies that did bring new antibiotics to market went bankrupt afterwards. E Proposals to fix that incentive treat antibiotics as infrastructure rather than products. Subscription models pay a fixed sum for access regardless of volume, decoupling revenue from prescriptions; the United Kingdom piloted this from 2020. Prize funds and extended exclusivity have also been proposed. All share a recognition that a market rewarding sales cannot supply a drug whose correct use is to sell as little as possible. F Meanwhile the least glamorous measures do most of the work. Hand hygiene, catheter protocols and isolation reduce transmission whether or not an organism is resistant. Rapid diagnostics matter because much prescribing is precautionary — a physician who cannot distinguish bacterial from viral infection within the consultation will often prescribe anyway. Vaccination reduces antibiotic use twice over, by preventing bacterial disease directly and by preventing the viral illnesses that generate unnecessary prescriptions. G The framing of a coming post-antibiotic apocalypse is both a useful warning and a misleading one. Resistance is not a future event but a present and uneven condition, severe already in some countries and some organisms while much of medicine continues largely unaffected. It also has no end state at which the problem is solved, because bacteria will continue evolving in response to whatever replaces the current drugs. It is a permanent maintenance obligation, and describing it as a crisis to be defeated encourages exactly the intermittent attention that created it. H Agriculture consumes a larger share of the world's antibiotics than human medicine does, and for much of the twentieth century a substantial portion of that use had nothing to do with treating sick animals. Low, continuous doses added to animal feed were found in the 1940s to promote faster growth in livestock, a use that became routine across large parts of industrial farming for decades before regulators began restricting it, and one that exposes enormous numbers of bacteria to selective pressure with no therapeutic justification at all. The European Union banned the practice for growth promotion in 2006; the United States moved more slowly, restricting rather than banning it in 2017, and enforcement in many other major agricultural producers remains inconsistent or largely voluntary. Resistant bacteria that emerge on farms do not stay there: they can spread to humans through direct contact with livestock, through undercooked meat, through agricultural run-off into water supplies, and through the general movement of people and animals. Public health researchers increasingly describe antibiotic resistance as a single interconnected problem spanning human medicine, veterinary medicine and agriculture — sometimes termed a 'One Health' framing — precisely because interventions that address only the human-medicine side, while agricultural use continues largely unchecked, address only part of a shared reservoir of resistance.

বাংলা অনুবাদ জমা দেওয়ার পর দেখা যাবে — আগে ইংরেজিতে বোঝার চেষ্টা করুন।