At some point in your life you’ve probably heard of the phrase ‘come back stronger’ used to encourage someone to try harder and thought, “Wow, that’s cheesy”, but there are individuals out there who are beginning to take that phrase literally. Tiny individuals, to be precise. Enter, the bacteria who creep in every crevice of the world. They’re called ‘superbugs’, and no they are not a satirical superhero or even an actual bug at all, rather, a superbug is any kind of pathogen who’s developed an immunity to most, if not all of our modern medicinal remedies. Laugh at their silly name and inferior size now, but superbugs are anticipated to kill more humans on average than cancer by 2050, already having a kill streak of over 35,000 annually in the United States alone. If antibiotics are one of the last lines of defense humanity holds up to disease, what does it mean for us now that such life-saving substances we are dependent on, are increasingly null? As we watch bacteria effortlessly circumvent our only weapon, are we also watching the fate of humanity be sealed before our eyes?

Prior to 1928, people could only use the crudest of methods to deal with infections. Whether it was letting your precious blood run dry, applying hazardous material to an infection, or using simple yet questionable herbal cures, all of these supposed treatments were thrown out with the discovery of penicillin, mankind’s first antibiotic, by Alexander Fleming. Though discovered completely by accident, penicillin’s capability to fight off bacteria revolutionized the field of medicine, and would be mass-produced for use on the frontlines of the Second World War. Fleming is praised for his landmark breakthrough, but many overlook the warnings he left us regarding the use of penicillin - a warning that can be applied to every single one of today’s antibiotics. Fleming believed that not applying sufficient penicillin can kill off the more vulnerable bacteria, but leave the tougher, more well equipped strains alive and healthy.

How did we get here? Well, for most of our lives, we’ve used antibiotics whenever we felt the slightest unwell, and as counterintuitive as it may sound, that’s why superbugs are a thing. Let me get one thing clear: the development of antimicrobial resistance by pathogens was inevitable. But when people begin to utilize antibiotics excessively or when antibiotics are just not needed, antibiotics could do more harm than good. The average human response to the flu serves as a great example of this: The first mistake the average human makes is using antibiotics to begin with–the flu is a virus, not bacteria, meaning antibiotics serve little to no purpose here but to destroy a bunch of other bacteria, even the ones that are meant to keep you healthy. The harmful bacteria tough enough to survive the wave of antimicrobials are left standing, and so they duplicate as all bacteria do. When more antibiotics enter the body, the cycle perpetuates and the most impervious bacteria keep reproducing and evolving with continued exposure. One can infer that if our body’s beneficial bacteria are constantly killed off and the harmful ones are left intact, a simple flu could easily spiral into something much worse. When you think of germs, you likely just think of something like a cold or a snotty nose, maybe even the whole thermometer-in-your-mouth idea, but superbugs can be way worse than that. way worse.

Necrotizing fasciitis is one of the world's most formidable bacteria, notorious for shredding human

flesh and skin, granting it the name of the ‘flesh-eating bacteria’. While it is quite rare to contract and requires specific conditions to be met, the flesh-eating bacteria acts quickly and can kill individuals within two days, but it doesn’t work alone - catching Necrotizing fasciitis is accelerated with the presence of another bacteria known for nasty infections named Vibrio vulnificus. Vibrio vulnificus infects wounds and may require amputation to get rid of it, often leading to Necrotizing fasciitis as it lays waste to your skin. Concerningly enough, researchers are reporting more and more cases of Vibrio vulnificus that have developed some form of antimicrobial resistance. In essence, a nasty disease that causes an even nastier disease is becoming increasingly durable against our antibiotic resolutions, which could have very serious implications on the long run if this antibacterial resistance continues to strengthen and spread.

Human Immunodeficiency Virus, or simply HIV, is one of humanity’s most feared opponents. When HIV enters your system, the virus seeks out white-blood cells to infiltrate and replicate itself inside of before it kills the cell and continues forward to the next. When the body cannot produce enough white blood cells, the immune system is weakened and HIV progresses into Acquired Immunodeficiency Syndrome, or AIDS. Once HIV enters the body, the virus stays there for life. Your immune system becomes permanently afflicted and less effective at intercepting any illness that enters your system, meaning any sickness that normally would not hurt you now poses a serious threat. And while treatment exists to keep HIV under control, that too is coming under threat from a rise in antibiotic resistance. When HIV reproduces in the presence of antiretroviral drugs, the virus has a chance to mutate and develop immunity against the drugs, allowing for the virus to keep mutating and replicating itself with greater fluency. Not only can these drug-resistant HIV strains spread from one person to the other, but they can also render HIV treatment entirely useless. The debilitating virus that once stigmatized thousands into the life of a pariah could be making a comeback with the rise of antibacterial resistance, and yet, even if this threat has been observed for decades since the 1940s, only a handful of our population genuinely see the horrors lying in wait for us as superbugs become increasingly prevalent.

To list every bacteria who’s developed some kind of antimicrobial resistance is to do the impossible, but just know there are so many more deadly diseases that are gradually counteracting our once highly coveted solutions. Whether it be the abhorrent gonorrhea, the once rampant tuberculosis, or the aptly named “nightmare” bacteria strains resistant to all of humanity’s last ditch efforts against antimicrobial resistance, the list of potentially fatal illnesses capable of bypassing our antibiotics sees only growth.

But is disease and illness truly all that awaits us in the years to come? Perhaps not, actually! Like superbugs, our war on bacteria is constantly evolving. As such, health researchers are constantly searching for ways to push back the advancements made by our microscopic adversaries. Superbugs aren’t all that tough - as pharmaceutical companies develop fresh batches of new antibiotic weaponry, ridding of superbugs is as simple as finding the right antibiotic for the job when the previous one starts to fail. Yet again, as previously mentioned, some bacteria have armored themselves to withstand even the most powerful antibiotic thrown at them. How do we deal with those? The answer to that is that we technically don’t. Instead, we leave that job to our globe’s most vicious predator: the bacteriophage. Bacteriophages are a virus that seek out a specific type of bacteria to latch onto and inject their DNA into. The phage then creates copies of itself inside the bacteria until the bacteria bursts open, leaving up to over 1000 new phages to repeat the cycle. Phage therapy is an experimental operation where a plethora of these handy critters are injected into our bodies to effectively deal with a superbug infection. Not only does phage therapy protect the helpful bacteria in our body, but it has already seen substantial success before. Tom Patterson was deathly ill after he contracted Acinetobacter baumannii during his time in Egypt, a bacteria known for its constant evasion of antibiotics, but after three days in phage therapy, Patterson woke up from his coma and would leave life support after 1-2 weeks of continued phage therapy. 

As the cold season rolls in, superbugs serve as the perfect reminder for us to closely monitor our health. Remember to follow the usual cleanliness procedures and wash those hands regularly! The amount of you who don’t is revolting. If you are sick, read instructions before using prescribed antibiotics and try to maintain some distance with others so as to isolate infection. Wiping down surfaces is also recommended, as superbugs are NOT a rare occurrence and can be on just about every surface around you. 

Superbugs have waged a brutal war that takes the lives of millions annually, though we will not back down to such intimidation. Our fight against antimicrobial resistance is far from over, but while researchers uncover the latest armament for the cause, we must push forward collectively as well to facilitate better sanitation and ensure that antimicrobial resistance has no foothold on us.