(Text 11) The miracle that failed

Staphylococus aureus is one of the deadliest bacteria on earth, and one of the most common. It lurks
in the human body, in pet animals, and even in the soil in fields and gardens. Usually kept at bay by the
body's innate immune system, it can, given the opportunity, cause blood poisoning (septicaemia), septic
arthritis, infections within the bone (osteomyelitis) and, in its most virulent form, toxic shock syndrome -
all of which can kill.

It was 'staph' bacteria that, in the 1920s, the Scottish bacteriologist Alexander Fleming saw being
destroyed by a mold on one of his petri dishes - a chance even that led 20 years later to the development
of wonder-working antibiotic drugs and a revolution in medicine.

At the beginning of the 1950s, when that revolution was well under way, penicillin - the original
antibiotic drug - was able to stop a staph infection in its tracks in virtually 100 per cent of cases. Just 30
years later, penicillin was effective in fewer than one in 10 critical cases. The bacterium had mutated into
a 'superbug', resisting all but a few new and expensive antibiotics. Nor was it alone in turning from an
apparently feeble organism that the original antibiotics destroyed at a stroke into a tough, resilient, all-
too-efficient killer. Penicillin was also used to deal with another common bacterium, Streptococcus,
which caused scarlet fever, impetigo, rheumatic fever and a host of other diseases. Some, like scarlet
fever, were both common and frequently lethal. In the 1940s a four-day course of 10,000 units of
penicillin a day would deal with most strep-related infections, and by the early 1950s scarlet fever had
become virtually unheard-of in Europe and the USA. But in 1992, it took a daily dose of 24 million units
of penicillin to combat a strep infection, and there was still no guarantee that it might not kill.

Dozens of antibiotics that had once cured an extraordinary range of infections were failing to work
after only a few decades. The so-called 'Age of Antibiotics' was beginning to look like no more than a
brief breathing space in the war between man and microbe. Experts warned that a new age of incurable
and untreatable diseases might be dawning. Only one or two human generations would have had the
benefits of antibiotic drugs. Worse, many of the deadly superbugs that were treating life-saving
antibiotics as if they did not exist were thriving in uncounted billions in the very places people went to be
cured. Superbugs especially flourish in hospitals.

What went wrong? Where did the superbugs come from? Have we any defense against them?

To answer those questions, we need to see how antibiotics work, and how bacteria react to them. And
we also need to see how people have used antibiotics. It was not only doctors who were both over-
enthusiastic and insufficiently cautious about employing these 'miracle' drugs.

Bacteria are minuscule creatures that consist of a single biological cell. They are named for their
shapes: 'cocci' are round, 'bacilli' are rod-shaped, 'vibrios' look like commas and those that