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 ourselves up the creek when it comes to bacterial infections. These resistant bugs often makes us helpless. Patient shows some sign of recovery and all of a sudden some resistant members turn the reality into nightmare. We can do nothing. Perhaps we could know what they are harbouring.’ And the possible answer of this question was my research area. I decided to study the resistance mechanism of multidrug-resistant bacteria.
However, the path was not easy. I started learning again. The information I collected was really fear-provoking. Humans and bacteria share a strange relationship. We are associated in such a way that we are benefited as well as harmed at the same time from bacteria. Bacterial pathogens are responsible for many infections in humans, and they are the main cause of death worldwide. The only way out to treat them is antibiotics. There are many species and genera of clinically important pathogenic bacteria. They all
are not untreatable. Scientists
and physicians have identified
six different families of such
resistant bacteria and named
them ‘ESKAPE’. Each letter in
this word represents one family
of bacteria. These ESKAPE
pathogens have created havoc
and are responsible for the loss
of millions of lives worldwide
every year. Researchers,
scientists, government
agencies and pharmaceutical
companies are trying their
hard to combat these smart
creatures.
Broadly, bacteria are classified as Gram negative and Gram positive. Out of the six families, four are Gram negative. Therefore, one can imagine the importance of this type. In the golden era of antibiotics, many different classes of this wonder drug were invented. They
Mr. Amol Kulkarni || 429
are still in use, but the resistant bacteria makes them useless with their outstanding ability of resistance. It is important to know that we can still use most of the members of antibiotics if we exactly know the resistance mechanism of infecting pathogen. By using this information, a doctor can design the treatment using a mixture of appropriate antibiotics. However, bacteria harbours more than one mechanism, which makes many antibiotics difficult to use, and therefore doctors are unwillingly pushed to use empirical therapy. In simple words, depending upon their experiences, doctors start the therapy in many cases. Moreover, doctors generally rely on the class of antibiotics that they are using most often and that has a proven record of killing bacteria. In my story, this class is ‘Fluoroquinolones’.
When it comes to severe Gram-negative infections, the first name that comes to doctor’s mindisfluoroquinolonesorsimplyquinolones.
Doctors have been using the members of this class to treat the bacterial infections since 1970. Other classes such as beta-lactams are also there, but quinolones are among what they call as the first line of therapy. Like any other battle, the first strong attack can lead you to the victory. This is true for the battle between humans and bacteria as well. Quinolones have rapid bactericidal activity, or simply they have tremendous ability to kill the bacteria rapidly. Under laboratory conditions, it was observed that a sensitive
bacterial population in the range of 108 could be killed in merely 2 h. Yes, you heard it right, in just 2 h! This is the main reason why this class is so favourite. Another reason is that it reaches to different body sites rapidly and starts acting immediately. But over the period
   A team of doctors struggled a lot but all efforts were useless. It was shocking for all of
us but true as well. Being a microbiologist, I was unable to understand what had happened. She had shown improvement for sure, and we kept our fingers crossed.
  








































































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