when I was young
well younger I got your infections a lot
the course of the infection would often
go something like this I would go to the
doctor and about an hour later we would
leave with a one-week supply of some
antibiotic whose name I couldn’t
pronounce antibiotics are drugs that
kill or inhibit bacteria antibiotics are
also one of modern medicines greatest
triumphs since they were discovered
nearly 80 years ago they have greatly
reduced morbidity and mortality and
saved millions of lives across the globe
in my case I would follow the doctor’s
instructions and take the gross tasting
medicine every day and has continued for
a few days
but after a few days I would start to
feel better my ears didn’t hurt my fever
was down my symptoms were gone I must be
better I could stop taking the
antibiotics even though the doctor
prescribed them for a full week right
but then a few days later I would get
another ear infection and I didn’t
understand why until now it makes
perfect sense now it’s because of this
phenomenon called antibiotic resistance
the doctors gave me the antibiotics in
hopes that they would kill the bacteria
causing my infection in various ways
like prevent them from making a cell
wall and in these first few days the
antibiotics did just that they killed
all of the easy to kill bacteria which
we call the susceptible bacteria but in
this large a population of bacteria some
individuals are bound to have random
mutations and some of these random
mutations are bound to make the
individuals less sensitive to the
antibiotic so after all of the easily
susceptible bacteria are gone what’s
left well these random mutants that will
quickly spread and soon after I would
have another ear infection but this time
the same antibiotic would no longer work
because the bacteria were already
resistant to it here’s a video showing
just how quickly antibiotic resistance
can occur
[Music]
so we entered a building was basically a
petri dish except that it’s 2 feet by 4
feet and the way we set it up is that
there are nine bands and at the base of
each of these bands we put a normal
petri dish thick agar with different
amounts of antibiotic on the outside
there’s no antibiotic just in from that
there’s barely more than this Nicole I
can survive inside of that there’s ten
times as much 100 times and then finally
the middle band has a thousand times as
much antibiotic and then across the top
of it pour some thin agar that bacteria
can move around in the background is
black because there’s ink in it and the
bacteria appear as white first you see
they spread in the area where there’s no
antibiotic up until the point they can
no longer survive then a mutant appears
on the right it’s resistant to the
antibiotic it spreads until it starts to
compete with other mutants around it
when these mutants hit the next boundary
they to have to pause and develop new
mutations to make it into ten times as
much antibiotic
[Music]
then you see the different mutants
repeat this at 100 and after about 11
days they finally make it into 1000
times as much antibiotic as the
wild-type that survived and so we can
see by this process of accumulating
successive mutations that bacteria which
are normally sensitive to an antibiotic
can evolve resistance to extremely high
concentrations in a short period of time
we’re essentially playing leapfrog with
antibiotics we discover one and
resistance comes a few years later
penicillin was discovered in 1928
resistance came in 1940 tetracycline was
discovered in 1948 and resistance came
just five years later as a society we’re
losing our antibiotic firepower very
very fast running out of options for
cheap and not so cheap antibiotics the
era when pneumonia or tuberculosis was a
death sentence could face us once again
so in this post antibiotic era what will
life be like and will every disease have
a version 2.0 like my ear infections did
well without antibiotics surgeries and
transplants will become extremely
difficult and procedures like neonatal
care and chemotherapy will become tricky
going to hospitals it’ll be more likely
to get sick than to get better and as
much as it sounds like a zombie or a
sci-fi movie this could be our reality
to be able to do anything about it we
first need to understand the causes the
first one being ignorant kids like me
not wanting to take the full course of
the gross tasting medicine but here’s
another cause most doctors understand
the problem of antibiotic resistance but
somehow they’re one of the major
contributors to it doctors may know
which antibiotic to prescribe but often
they don’t know how much of it to use
too much too little the patient doesn’t
get better so frequently they prescribe
much too much and this is fine and all
but when does it actually become too
much well in 2014 doctors in the United
States alone wrote over 266 million
prescriptions for antibiotics
that’s 835 prescriptions per thousand
people okay that’s a lot but maybe there
was just a really bad disease that
spread to a bunch of people well it
would be nice to know were that simple
but the CDC estimates that over 30
percent of antibiotics prescribed are
unnecessary most of them are for
infections not even caused by bacteria
so antibiotics would be useless my
research is an improving antibiotic
therapy by giving doctors an estimate
for the least amount of antibiotic that
they need to prescribe especially in
developing countries the hope is that
this could slow the spread of the
resistant bacteria by prescribing less
antibiotics I did this by finding a
correlation between a low-tech
measurement that they have in developing
countries and relating it to an
expensive one that we have in countries
like the United States I then
incorporated this correlation into a
smartphone app where doctors in
developing countries can enter a
measurement from their test and my app
will output the least concentration of
the antibiotic that they need to
prescribe so this could greatly reduce
could greatly for long lives in
developing countries but right now it
might be worth it to take the full
course of the gross tasting medicine
[Applause]
well younger I got your infections a lot
the course of the infection would often
go something like this I would go to the
doctor and about an hour later we would
leave with a one-week supply of some
antibiotic whose name I couldn’t
pronounce antibiotics are drugs that
kill or inhibit bacteria antibiotics are
also one of modern medicines greatest
triumphs since they were discovered
nearly 80 years ago they have greatly
reduced morbidity and mortality and
saved millions of lives across the globe
in my case I would follow the doctor’s
instructions and take the gross tasting
medicine every day and has continued for
a few days
but after a few days I would start to
feel better my ears didn’t hurt my fever
was down my symptoms were gone I must be
better I could stop taking the
antibiotics even though the doctor
prescribed them for a full week right
but then a few days later I would get
another ear infection and I didn’t
understand why until now it makes
perfect sense now it’s because of this
phenomenon called antibiotic resistance
the doctors gave me the antibiotics in
hopes that they would kill the bacteria
causing my infection in various ways
like prevent them from making a cell
wall and in these first few days the
antibiotics did just that they killed
all of the easy to kill bacteria which
we call the susceptible bacteria but in
this large a population of bacteria some
individuals are bound to have random
mutations and some of these random
mutations are bound to make the
individuals less sensitive to the
antibiotic so after all of the easily
susceptible bacteria are gone what’s
left well these random mutants that will
quickly spread and soon after I would
have another ear infection but this time
the same antibiotic would no longer work
because the bacteria were already
resistant to it here’s a video showing
just how quickly antibiotic resistance
can occur
[Music]
so we entered a building was basically a
petri dish except that it’s 2 feet by 4
feet and the way we set it up is that
there are nine bands and at the base of
each of these bands we put a normal
petri dish thick agar with different
amounts of antibiotic on the outside
there’s no antibiotic just in from that
there’s barely more than this Nicole I
can survive inside of that there’s ten
times as much 100 times and then finally
the middle band has a thousand times as
much antibiotic and then across the top
of it pour some thin agar that bacteria
can move around in the background is
black because there’s ink in it and the
bacteria appear as white first you see
they spread in the area where there’s no
antibiotic up until the point they can
no longer survive then a mutant appears
on the right it’s resistant to the
antibiotic it spreads until it starts to
compete with other mutants around it
when these mutants hit the next boundary
they to have to pause and develop new
mutations to make it into ten times as
much antibiotic
[Music]
then you see the different mutants
repeat this at 100 and after about 11
days they finally make it into 1000
times as much antibiotic as the
wild-type that survived and so we can
see by this process of accumulating
successive mutations that bacteria which
are normally sensitive to an antibiotic
can evolve resistance to extremely high
concentrations in a short period of time
we’re essentially playing leapfrog with
antibiotics we discover one and
resistance comes a few years later
penicillin was discovered in 1928
resistance came in 1940 tetracycline was
discovered in 1948 and resistance came
just five years later as a society we’re
losing our antibiotic firepower very
very fast running out of options for
cheap and not so cheap antibiotics the
era when pneumonia or tuberculosis was a
death sentence could face us once again
so in this post antibiotic era what will
life be like and will every disease have
a version 2.0 like my ear infections did
well without antibiotics surgeries and
transplants will become extremely
difficult and procedures like neonatal
care and chemotherapy will become tricky
going to hospitals it’ll be more likely
to get sick than to get better and as
much as it sounds like a zombie or a
sci-fi movie this could be our reality
to be able to do anything about it we
first need to understand the causes the
first one being ignorant kids like me
not wanting to take the full course of
the gross tasting medicine but here’s
another cause most doctors understand
the problem of antibiotic resistance but
somehow they’re one of the major
contributors to it doctors may know
which antibiotic to prescribe but often
they don’t know how much of it to use
too much too little the patient doesn’t
get better so frequently they prescribe
much too much and this is fine and all
but when does it actually become too
much well in 2014 doctors in the United
States alone wrote over 266 million
prescriptions for antibiotics
that’s 835 prescriptions per thousand
people okay that’s a lot but maybe there
was just a really bad disease that
spread to a bunch of people well it
would be nice to know were that simple
but the CDC estimates that over 30
percent of antibiotics prescribed are
unnecessary most of them are for
infections not even caused by bacteria
so antibiotics would be useless my
research is an improving antibiotic
therapy by giving doctors an estimate
for the least amount of antibiotic that
they need to prescribe especially in
developing countries the hope is that
this could slow the spread of the
resistant bacteria by prescribing less
antibiotics I did this by finding a
correlation between a low-tech
measurement that they have in developing
countries and relating it to an
expensive one that we have in countries
like the United States I then
incorporated this correlation into a
smartphone app where doctors in
developing countries can enter a
measurement from their test and my app
will output the least concentration of
the antibiotic that they need to
prescribe so this could greatly reduce
could greatly for long lives in
developing countries but right now it
might be worth it to take the full
course of the gross tasting medicine
[Applause]
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